Kyle Tobler

I came from a clinic where the provider had told me I should focus on a surrogate without trying IUI or IVF first. I have endometriosis and my bowels are attached to my uterus. My fallopian tubes has been badly twisted and linked due to veins adhered to my fallopian tubes, but they are open. My previous doctor had said my left ovary was no good. Dr. Tobler made it sound like it was a non-issue. He explained it wasn’t ideal and would be tricky to retrieve eggs if needed, but that it was not hopeless. All I needed was hope when I saw Dr. Tobler. I was so physically exhausted from what had happened to my body with the endo. The pain, the vomiting, the flares, the ER visits, the excision surgery, the excision surgery not yielding very successful results. Mentally I was exhausted from almost 3 years of trying to conceive - from telling my husband month after month it was a no and then going from mentally hoping for a pregnancy to then mentally prepping for an endo cycle and the extreme 96 hours of pain that was going to onset. Kyle finally made me feel hope again.

Go see him. Don’t wait. I’d been referred to multiple clinics and had so many people tell me ICRM was the way to go. The first clinic I went to had a shorter wait time, so I went with them. I regret it.

Kyle explained that letrozole was better for endo patients. Clomid can exacerbate endo. I came in for an ultrasound on CD3. Started the letrozole. I returned for an ultrasound on CD10? I had a vigorous response to the letrozole and had 3 mature follicles with 2 more very close behind and almost 4 more not much further off. They had me trigger that day. We did IUI on CD11. I am on day 11 of my two week wait. I believe I am pregnant. I had a very faint line this morning. I am at high risk for ectopic pregnancy, though, because of the condition of my fallopian tubes, so I am cautiously optimistic. We’ll see what happens. Kyle was very clear that ectopic pregnancy was a risk. He also was very clear that we shouldn’t waste time with more than 2-3 cycles of IUI before moving to IVF if we didn’t have success.

I haven’t received a bill yet. I have fertility coverage up to $15000 so I likely won’t receive a bill for this first round of IUI.

Dr. Tobler is open to multiple embryo transfer. He discourages it for a woman my age, but he said he would do it if it comes down to that and it’s what I want.

Dr. Tobler is calm, kind, compassionate, and intelligent. I trusted him to give me the best care and attention when I needed it and he did. He was able to answer my questions and I had a couple consultations even after our second round of IVF didn't work. When he told me that he was "thinking about us often," I believed him and it helped to heal my heart.

Ask all the questions, he'll answer them.

We used Clomid and Ovidrel for the trigger shot for the IUI cycles, but were unsuccessful. We used all the typical IVF drugs- Menopur, gonalF, Omnitrope etc. My first round of IVF was very unsuccessful, I did not respond to the stims as I should have. My second round was much better, yielding 11 eggs. Seven of my eggs arrested within three days and the two that made it to blastocyst came back abnormal as did the two eggs from my first round of IVF. Unfortunately, we ultimately decided that my egg quality is not good even with having higher than average AMH levels. My official diagnosis remains unexplained.

About 25,000 for both IVF rounds. Around 600 for the IUI's.

Our experience was excellent. Due to primary male infertility we were unable to pursue IUI, and Dr. Tobler was honest regarding our chances with IVF. Our outcome closely aligned with his predictions. He was present for retrieval, transfer, saline sonograms, etc. any major appointments. He was easily accessible and I felt comfortable emailing with questions at any time. He would call or email back quickly. I am someone who really likes to explore every possible avenue before moving ahead, and after my first transfer failed Dr. Tobler was willing to try adjustments to my protocol and to perform additional testing. He thoroughly explained why he thought something was helpful or not helpful, great communication. I felt like part of a team in my own treatment which was very important to me, and I never once felt shut down. He is also very professional and compassionate.

If you’re curious about something, anything, don’t hesitate to ask. Dr. Tobler will not make you feel badly for asking, and he’ll provide you with an honest and thorough answer.

Retrieval: My basic fertility testing revealed no issues, and I was on the antagonist protocol. My injections were a lower dose, and I produced 11 eggs (10 mature). Dr. Tobler mentioned possibly increasing doses if I were to undergo another retrieval but the goal is no more than around 15 eggs. I was happy with this number. My husband does not produce much sperm, and numbers have varied between 10 to around 3 milllion total, 20ish% motility. For fertilization, we froze 2 vials of sperm just in case, but he did produce a sample with enough sperm on the day of retrieval and we used ZyMot for sperm separation. Dr. Tobler had not used ZyMot before but was willing to try it out. Studies are limited, so we don’t know for sure if this helped, but we had good results: 11 eggs>10 mature>8 fertilized normally>5 embryos>3 PGT-A normal. Transfer: Our first transfer was a standard fully medicated frozen embryo transfer protocol with progesterone in oil injections, estradiol injections and progesterone suppositories and assuming we fell into the standard need of 120 hours of progesterone prior to transfer. First transfer was a failure so we opted for additional testing: ERA, ReceptivaDX, EMMA/ALICE and some additional blood work to check for thyroid and blood clotting issues. We ultimately did 2 months of Lupron depot, added 10 days of vaginal probiotic, and added Lovenox. 2nd transfer has been successful.

Dr. Tobler is down to earth, easy to talk to, incredibly smart, upbeat, and motivated to make fertility dreams come true. He doesn't give up, and he spends time researching, understanding, and figuring out answers/resolutions. After telling Dr. Tobler my history (a natural intrauterine miscarriage, 2 ruptured ectopic pregnancies, and 3 failed FETs from an IVF cycle at Seattle Reproductive Medicine) I thought he was going to go straight to the IVF statistics (which is what a lot of Doctors do). Instead, Dr. Tobler listened and discussed what he would do differently after taking time to understand what they did and didn't do.

DON'T GIVE UP ON YOUR FERTILITY DREAMS - SEE DOCTOR TOBLER INSTEAD!

IVF with PGTA protocol 5 Day Frozen embryo transfer - 81 MG Aspirin, 2 mL PIO every morning, 0.15mL Estradiol injection every Tuesday/Friday, 40 MG Lovenox once daily, 8 MG Methylprednisolone one daily during the 5 days leading up to the transfer.

Dr. Tobler's preference was to transfer one embryo; however, I asked politely if I could please transfer two, and he did.

Even though I didn’t/don’t get to see him much. He always puts in orders, meds and is on top of it for us. He’s right down to the point but in the most caring way. He’s laid out several options for us, since my husbands deployed half the year every year he understands the difficulties with both 1. Infertility on top of constant 2. Deployments. My husband was Injured in an IED accident in 2009, which just adds more fuel to the fire but Dr Tobler always comes in to help put the fire out.

You won’t be disappointed. He wants to genuinely get you pregnant. He listens, he’s kind, he gives options but mostly he treats you as a human and not “just another patient. “

We’ve tried Clomid, thyroid meds, I’ve had 3 saline sonograms, 3 Dye sonograms, I was on gonal-f and menopur , my husband started HCG in January’s since 4 semen analysis were 0! The HCG worked!!! And now we have a 5 vials of sperm frozen when the other Drs told us no to HCG over a year ago. We already had our donor sperm picked out and ready to go.

$450 total for sperm freezing $9,800 for ICSI IVF (cancelled because of corona virus)

He told us to only transfer one embryo. He said multiple births is a medical mistake/not good.

Dr. Tobler was a nice guy. As a doctor, I think he's over-worked and he has too many patients to try to keep track of. I appreciated his knowledge but some of the things he would say I wasn't too sure about. We had our first consultation and then ended up getting pregnant but resulted in an early miscarriage. When we saw him next to chat about the miscarriage, he said "Looks like all you needed was a consultation!". That clearly wasn't the right thing to say considering I had miscarried and was back in his office to try an IUI.

Just spend the extra money and go somewhere else.

I am a young, healthy woman so when I was diagnosed with diminished ovarian reserve, everyone was a little surprised. I was told by Dr. Tobler we would do a high dosage for medications, he said "we're not messing around with this" so I fully trusted him to make that call on dosage. The staff at the clinic also said things about how I'm young and age trumps any lab result so I should respond well to the medications. We got 4 mature eggs from retrieval and by Day 5 transfer, I had one low grade embryo and none left to freeze. That transfer failed. We also did 5 IUI's prior to our IVF and I felt as though the medications could've been managed differently too.

Each IUI was $240 for the sperm wash. I never received a bill for any of that. Medications were through the pharmacy and were free. Once in a while, you'd order from Freedom Fertility and would have a co-pay of no more than $30.00. IVF was $8,600. We did a fresh transfer and had no embryos to freeze. We did not do genetic testing.

We didn't have to discuss this because we only had 1 embryo by the day of transfer.

Everything was very much like herding cattle because they were seeing a good sized group all at once. So no real personal contact. Very rushed. Until I got ohss then I was treated as I would hope to be and had already been. And once we lost Charlie-Jo at 36 weeks he was compassionate and willing to work us in for future cycles.

That he is a good doctor, but you will not have much personal one on one time, as we all felt like cattle being herded. It’s very rushed. Hard to understand what’s happening and the whole process since everything is done in a large group all at once. You must give your own trigger shot. But If a serious health issue arises he will give you personal attention.

I honestly don’t remember most of the shots. Menopure & gonal and something else, I had 3 different ones and one of them I had an allergic reaction to and had to take Benadryl to help curb the side affects. Then there was the trigger shot. I took 2 different suppositories before transfer and and continued one of them 3 times a day. I also wore a hormone patch 3 days and then replace. I have a calendar somewhere with the protocol I can find and send later. Oh! And baby aspirin. And a Valium the morning of transfer.

It was a cattle call with patients staggered and constantly full waiting room and hectic.

Being as I was seeing a doctor at a military treatment facility, that portion was covered, the lab used is civilian owned and contracted with the government/army etc. Our cost was $9,800 and $2,500 for thawing 2 embryos/morulas at a time. We pay a sperm storage fee of 30$ a month I believe, and 50$ a month for our 2 morulas. Of course airfare, and hotel stay until the Fischer house had an opening and I was able to stay there and be close within walking distance of hospital.

I was on board widh transferring 2 embryos as reccomendes. It resulted in one 36 week stillborn beautiful daughter. We would agree to transfer 2 embryos again.

Great, great doctor. Very respectful. He knows who we are. He understands the delicacy of his profession and he is more than willing to take the time to answer questions, concerns, etc. Our first FET transfer in 2021 was successful and he walked us through every step of the way. In 2023, we transferred again, and unfortunately, that transfer failed. With the steps taken after the failed transfer, Dr. Tobler's staff have been very responsive and easy to work with.

Go in with a list of questions! Ask away. He's more than willing to answer and help walk you through the process!

Dr. Tobler strongly suggests single embryo transfers (unless there is an obvious reason why multiple should be done). Him and his staff like to say "healthy baby, healthy mom" and that is much more guaranteed with a single embryo transfer.

I think he could have been more compassionate regarding pain I had after a saline sonogram but other than that things went well. He followed up and let us know about our options and was very reassuring about freezing my eggs.

I would suggest that they ask for his contact information early on so that they can email him directly. That is very helpful.

We're dealing with severe male factor infertility and IVF was considered our best option. Unfortunately, after retrieving my eggs, my husband's urologist (at a different clinic) wasn't able to retrieve any sperm. We froze my eggs and will eventually need to use a sperm donor. We're taking time to think it through and grieve the fact that my husband will never have biological children but we eventually will choose a donor and create our embryos.

He let me be involved in my care. I was allowed to suggest options I had heard from other in my experience. He never made me felt less than, he would give me medical data and say it was my choice if it didn’t work we could re-evaluate.

No one is perfect I’m sure he has his days. Some days perfect some things are missed. Overall he is worth it. Minor set back are expected in the long game.

I was first on pills only then went to pills and injections. Dr Tobler supported my desire to use progesterone.

Expensive but affordable

Dr. Tobler has been awesome from the start and has helped me conceive in just the short 6 months we’ve been with him. He helped break down every procedure and walk me through the steps that he was wanting to take to help me conceive. If I had any questions he was quick to answer all of them and even returned my phone calls in a very timely manner. He was real and honest with me from the start and made me aware of what he believed my cause of infertility was. No other doctor was able to diagnose me and without him and his staff,I wouldn’t be pregnant with my rainbow baby.

take notes, prepare questions for him.

I believe this was my 5th cycle of femara with the trigger shot. I had a miscarriage in August however got pregnant right away again in October. I am now currently taking progesterone and baby aspirin.

Being that this was a military facility and we did not have to undergo IVF or IUI, it has been free so far.

He seemed distract and not concerned with my situation. He was super short and didn’t fully answer questions. He was nice overall. He does do well with interacting with patients. My main concern is their ability to treat IUI patients with the same care and concern as their IVF patients.

Make sure that you advocate for your own healthcare and stay on top of them.

I was on 75 of gonalF and then the pregnyl trigger shot. I started gonalF on day 3 of my cycle and did IUI day 8.

Due to this clinic being military and only serving military families and IUI will cost $260.

NA

Great communicator but struggles making personal plans for patients. He attempts to make the personal connection but when challenges are encountered no change outside of "normal protocol" is sought after for resolution

Be your own advocate. Speak up and continue to push to get answers to your questions. Never take the normal protocol as the path you must follow. You have the ability to ask questions and make suggestions

4 cycles of timed intercourse with femara (start with 2.5 mg and move up to 5 mg and 7.5 if needed) then move to 4 iuis with femara 5mg and injectable. Last attempt would be ivf

Very minimal. Thankful for this.

Na

I am honestly impressed with the infertility clinic at womack. I am more than a number. They have diagnosed me with things that other doctors have told me were just inexplicable. Dr. Tobler took his time to explain my diagnosis and the bet course of action to take.

Ask any questions you want.

My last cycle was 5 mg of femara and 75 iu of gonal-f. I still do not know the results of the IUI, but I am hopeful, we will be doing 2 more IUI's before moving into IVF.

$220 per IUI. all medication was free and/or covered.

He is very nice and down to earth. My overall experience went very well without any hitches which I was very worried about. I always wanted to know how each step went and was always very well informed and given time to ask all of my questions.

Ask questions if you have them.

With Tricare Prime, all my medications and visits were completely covered. I only payed for the IVF procedure which was around $8500 (this was done at a different facility that was not Womack Army Medical Center).

I really liked him. He was aggressive in his treatment which was what I wanted. He was very compassionate and we never felt rushed. We would highly reccomend him. I felt like I was in good hands and trusted his judgement.

Always ask any question you have!

Iui only cost was sperm wash which was $240. IVF would be around $9000 with ICSI

Doctor was very detailed and didn't make me feel rushed. Fully explained options to me and took into account what was important to me. I look forward to continuing treatment with him. He spoke kindly and made me feel confident in his knowledge.

Wonderful caring Dr. He picked the right profession. He is knowledgeable and approachable. I had many questions and he never made me feel dumb- and being in the medical field myself (a nurse) he worded things how I would understand them:

Go see him for fertility help

I used standard egg retrieval drugs (can’t remember names anymore) and for ivf used progesterone and estrogen

$28,000

He is an amazing doctor, very precise and great with explaining of what is going on. I would recommend him to anyone who is struggling to ttc for a long time. He always takes time and never gives up and try to find the reasons for everything.

I am not able to specify as we are a military family and it was different.

He is very informative let me know what to expect and how to get there I barely started seeing him as of this month of June 2022 so at this point I have not much experience as a patient with him I do expect that he will be a great fit with my journey.

His strength is he had a warm bedside manner. Very friendly, looked you in the eyes. Weakness compassion he was very energetic so it may have come across wrong. I had surgery and he wasn't very clear to details or statistics. I felt like it was the first time he was doing one.

Ask questions

8,700

Dr. Tobler is very professional. With something as expensive and medically invasive as IVF, the most reassuring doctor would be someone who is experienced and knowledgeable about their field. Dr. Tobler was precise in his care, made adjustments as needed, and comforted me through obstacles with his medical knowledge and experience. Having a Day 7 blastocyst transferred was nerve racking. But, Dr. Tobler had experience with these blastocysts and shared with me his success rates. This brought my anxiety way down and allowed me to have a little faith. I am glad I did, because I am currently beginning my second trimester!

Don't be afraid to ask questions. I am sometimes intimidated by doctors and don't wish to take up their time, but Dr. Tobler is a great communicator and makes you feel validated for your questions and concerns.

Unfortunately, my egg retrieval cycle was a long time ago, so I don't remember my medications and dosages. For my embryo transfer, we approached it with the standard injectable medications of progesterone in oil and estradiol. I started on 1 mL of progesterone and 0.15 mL of estradiol. As they were monitoring my progesterone levels, it became apparent that I needed to increase my dosage (despite the fact that I have a low BMI). For most of my cycle, I was on 2 mL of progesterone. In addition, I had progesterone suppositories that I began using after the transfer.

Approximately $25,000 all-in cost.

I didn't have an option - I only had one viable embryo!

Great communicator and always very responsive. He gave me hope that we would conceive and he also adjusted my treatment when he saw an opportunity. I was very pleased with how thorough and efficient him and his office staff were.

Go in with an open mind and listen to the advice of the doctor.

We initially started with the thought of doing three rounds of IUI treatment. After our second IUI Treatment failed, we were preparing for our last one. He adjusted my medication slightly which in turn I ended up responding so well as I had many follicles. We decided to convert to an IVF cycle at a reduced cost. I ended up pregnant from that cycle with my twins.

Because we covered my IUI cycle to IVF due to me responding so well to the drug change, I was able to do the IVF at half the cost of a regular cycle. I believe everything including ultrasound, retrieval, and IVF cycle cost approximately $4800 which was wonderful and affordable due to the discount.

He went through the risks of multiple embryo transfers and due to my age we decided to transfer the two embryos.

Dr. Tobler helped us get pregnant with Gonal-F and IUI on the FIRST try. We now have a beautiful little boy, who's now 2 years old. We wanted to make him a sibling, we flew across the country from west Texas to North Carolina for IVF with him. Again, we got pregnant on the FIRST try!! :D You won't find a more professional, passionate, and knowledgeable infertility doctor!

You are getting the best!

He recommended ICSI. If we didn't do ICSI, we likely would not have had any embyos.

Tricare covered everthing except the Embryology portion, which cost $8000+

Given that my wife is 39 years old, he said he felt transferring 2 embryo's was safe and would increase our chance of pregnancy and live birth.

Dr. Tobler always gave us every option and let us decide on what our course of action was. If he didn’t agree he’d respectfully explain why he didn’t agree and if we still wanted to go the course we chose he gave us the option to continue.

Keep in mind that things change and he’s going to give you the best options and chances even if it doesn’t go with what you had in mind

We did repeat hsg, saline sonograms, and then exploratory surgery to see if my tube could be repaired.