Luis Noble

He is a very knowledgeable doctor who seemed to offer options that other clinics did not. He took into account the personal wants and concerns we had. I had a Bilateral Tubal Blockage with Hydrosalpinx. He informed us tubal repair was an option, which hadn’t been the case with other REs. He successfully performed a tubal repair on one of my Fallopian tubes. This was a far better scenario than we had expected. During my stimmed cycles afterwards he adjusted my medication accordingly and really listened to how I was feeling. He is always very personable and never made me feel like I didn’t have time to communicate with him.

Be completely open with him about all of your concerns. He will listen.

I had my laparoscopic tubal repair in November 2019. From August 2019 until surgery we had performed genetic testing, ovarian reserve tests, semen analysis as well as full panels of bloodwork. After surgery I waited one month before I began my medicated intercourse cycle. My protocol was two Gonal F injections, three Menopur injections, five days of Letrozole 2.5mg and ten days of Dexamethasone .05mg. On my trigger day I took a 10k unit injection of Pregnayl. During my two IUIs that followed I was on the same protocol accept I added one Gonal F injection and one Menopur injection. None resulted in a positive pregnancy test.

Visits were $200 Ultrasounds ranged from $150-$180 IUIs were $1300 including medication. Surgery was a little over $3,000. (Not including hospital fees) Bloodwork/Testing was roughly $2500

Dr. Noble is very bright and passionate about his field. He conducts lots of research and bases his treatment decisions on evidence. During a low volume day at the clinic, you will get more undivided attention from him. When it is a busy day, you almost feel forgotten while you wait for him to see you and then rushed during your face-to-face time with him. Dr. Noble does not really consider your personal family planning goals, but instead pushes protocols even if they don't align with your personal family building choices at the time. For example, my husband and I were in agreement to try IUI but did not want to do IVF to build our family. Dr. Noble never asked if we were open to IVF but continued mentioning it as a treatment option. When reminded that we did not want to do IVF, he seemed dismissive and continued mentioning IVF during upcoming appointments. This was very unsettling because my husband and I were left feeling unsure if the doctor forgot what we had said (did he even remember us as patients?) or if he just didn't care. I once cried during an appointment after my 1st failed IUI and the doctor's response was "I know you women get so emotional when you are taking hormonal medications and injections." I did not find this compassionate at all. I wanted to tell him that sure, the hormones made things worse, but I had been crying about the possibility of never having children long before I set foot in his office.

I would say to let Dr. Noble bring his professional knowledge to the table and meet him halfway with your personal knowledge of what works for you and your partner (if you have one). Do not be afraid to pause the conversation, ask questions, or to share your personal family building preferences. Do not expect Dr. Noble to be gentle in his delivery of information or to ask you how you are feeling along this difficult journey. Think of him like a scientist working on the world's most precious science experiment, which is preparing your body for a pregnancy. Trust in him and the research, but do not expect much else. I suggest that all patients of Dr. Noble work with a fertility coach, as I have, to get the emotional support that you will not receive working with him at his practice.

My husband and I did all the initial/new patient testing (including an HSG) that was required of us and were told that we had "unexplained infertility." Dr. Noble highly suspected that I had endometriosis and recommended a laparoscopy to confirm/rule-out diagnosis. I was found to have Stage 2 endometriosis. After 3 months of not getting pregnant naturally after the surgery, Dr. Noble recommended we try doing IUI; we ended up doing 3 cycles. During each cycle, I took Letrozole and Dexamethosone orally with Gonal-F and Menopur injections. I also had routine transvaginal sonograms and would use the pregnyl HSG trigger shot before each IUI. Dr. Noble made small changes to injection schedule and Letrozole dosage across each IUI cycle. After 3 failed IUIs, Dr. Noble requested to meet with my husband and me for a consult before proceeding further with treatment. I called to book this consult appointment in October and there was no availability until December.

The initial consult was about 200. I was referred to do an HSG which cost approx. 200 (with insurance). I paid for initial lab work, but do not recall the exact cost. My husband and paid about 400 for genetic testing for both of us. I paid a little over 6,000 dollars for endometriosis laparoscopy. I did 3 rounds of IUI. The initial sonogram was about 200 and then each sonogram after was about 120. The IUIs themselves were about 350. All 3 rounds of IUI cost us lots of money in expenses for the hormonal injections; I cannot recall how much altogether but i estimate between 1-1.5 k. I had met my deductible for the year and did not have to pay additional fees for the letrozole or dexamethasone.

Dr. Noble has been a patient provider. He presents the facts and clearly lays out our options, without judgment or pressure regarding our preferences, or concerns/hesitations. He has been encouraging and positive, while also being realistic. I prefer knowing all the details and research behind any recommendations/options, and find that he will provide that, if I probe further.

Ask lots of questions, take notes and be patient. Don’t hesitate to advocate for yourself or speak up if something is unclear or doesn’t seem like the right fit.

First IUI: Ultrasound baseline and Letrozole on Day 5 of cycle (took for 5 days). Gonal F injections on Days 5 & 7. Menopur on Days 10 & 12. Ultrasound on Day 11. Husband began Mucinex Days 12-14. Inject 10,000 units Pregnyl trigger at 5 pm Day 13. IUI 8am Day 14 Results: No pregnancy. pelvic and lower abdominal discomfort/feeling of fullness. Although I am normally regular (cycle every 28 days), my second cycle following failed IUI came at 19 days. Second IUI: Ultrasound baseline Day 2 of cycle. Letrozole on Day 3 of cycle (took for 5 days). Gonal F injection on Day 3. Menopur on Day 7. Ultrasound on Day 9. Husband began Mucinex Days 10-12. Inject 10,000 units Pregnyl trigger at 11pm Day 10. IUI 8am Day 12. Results: No pregnancy. Although I am normally regular parentheses cycle every 28 days), my second cycle following failed IUI came at 19 days.

I have a $6k lifetime fertility benefit via insurance. After two IUIs, this has not yet been exhausted. I have had to pay at least $300 out of pocket for injections which I was told were not covered during the second round of IUI. These costs were not from the clinic, but rather with an online specialty pharmacy.

We have not had to do this, as we have not tried IVF. However, he has stated they only do single embryo transfers.

Dr. Noble seems like a good person and is a great doctor. He explained everything well and remained hopeful for us. I do wish he would try some less costly approaches, but I think he is just trying to get us to our goal the best/fastest way.

Save your money if your insurance doesn’t cover infertility and learn how to bill your secondary insurance yourself.

I first had a consultation. I then had certain bloodwork completed on certain days of my cycle, had a ultrasound completed to check follicles. Later I had an HSG completely. I received the results which were that yes I ovulate and HSG was clear. But b/c of my two csections and horrible infection, which caused me to PPROM and lose my daughter, he thought a laparoscopy would be ideal. Laparoscopy was completed and yes scar tissue and maybe a little endometriosis were discovered and removed. I had a post op appointment, plan was to try naturally for two months then try 3 medicated IUIs and finally IVF. IVF was always on the table, but super expensive. My age and AMH aren’t the best, but doctor and use seemed hopeful. We haven’t tried IUI yet b/c insurance doesn’t pay and we need to wait until we have the money and time for appointments.

Expensive!!! And they don’t bill secondary insurance so I had to learn how and am still waiting to find out if they picked up the rest of the bill. Plus they only take Care Credit if the card has a visa/MasterCard logo. Mine does not. They only see you if you have paid your bill, which is understandable BUT waiting for secondary insurance since they don’t bill secondary.

I don’t know since we aren’t there yet.

He seems very knowledgeable and has been willing to spend time explaining everything to us. He is always friendly and calls you by name. He presented us with multiple treatment options and explained each in detail.

Have questions ready because he is willing to answer them when he is in the room with you but getting answers after that can be difficult.

We are currently doing a hybrid IUI cycle with a low dose of clomid and injectables with plans to do the iui next week. I will have had 2 ultrasounds prior to iui to Check for follicle development. The reason for this treatment is that my husband has semi low motility with some coagulation and there seems to be no issues with me. We chose a conservative route for the first round.

Consultations and diagnostic ultrasounds were roughly $500, the iui process with medications for one cycle totals $1100

Dr. Noble is kind and compassionate. He had wonderful bedside manner and went above and beyond our expectations. We feel very blessed to have him here in El Paso, TX. He was very attentive to our needs and sensitive to our journey.

He's wonderful! Even if our treatments didn't work, he is sensitive and attentive to your needs.

first cycle- letrozol and trigger shot (gonal F) with donor sperm iui before ovulation, negative pregnancy test Second cycle- letrozol, injections and trigger shot (Gonal F) with donor sperm iui during ovulation, negative pregnancy test Third cycle- letrozol, injections every other day once menstrual cycle was done (7 days or so) and trigger shot (gonal F) with donor sperm iui after ovulation, positive pregnancy test

I can't recall a breakdown of everything but over all we paid $12,000 out of pocket, as insurance in Texas doesn't cover fertility treatments. The 12,000 included all the testing that needed to be done before starting treatments and the procedures and the donor sperm.

we would order our sperm from California CyroBank and our clinic would prepare and spin the sperm for us. Dr. Noble would then inseminate me and would elevate my lower half for 20 minutes after the insemination.

Dr. Noble has always been very honest with my husband and I. He has allowed us to try several different options without leading us on too long. He also has explained my husbands condition as we are dealing with male factor infertility. That is what we respect the most from him. I'm always given exact instructions and information so I'm never left with many questions.

Be prepared financially and also have the time to be going to several visits.

My husband was first put on pregnyl for 6 months after 6 months his semen analysis still showed 0 sperm because of his pituitary macroadenoma. My husband and I then chose to go with donor sperm so now we are doing iui with donor sperm. I already did one full medicated round of iui with no pregnancy as a result. I will be trying again in May. I took clomid, menopur, gonal-f, and triggered with novarel.

In total including purchase of donor sperm we paid $2500 for medicated iui cycle.

He is amazing describes everything and is positive entertaining about him. He has completed my endo surgery and explained everything in none medical person terms. He has a great spirit about him and truly cares about us patients and their well being! He is absolutely wonderful!

Be an open book tell him everything going on with your body he will listen!!!!!!

After my first visit he ordered thorough test and once those came back he stated what the protocol was going to be. After the my first IUI I wound up pregnant he monitored me very closely because I have a history of ectopic pregnancy. He had me do blood work every other day. Sadly the pregnancy ended. We did 2 more IUIs which sadly failed. I had surgery one week ago he was very thorough during the surgery got rid of all the endo he could find. He is allowing us to try naturally for 2 months he was very optimistic!

At least a thousand for an injection IUI cycle.

N/a

Dr. Noble ordered tests to ensure that nothing would jeopardize embryo transfer. He was always patient and calming and kept appointments positive. He respected my plan and didn't try to convince me to try treatments that had already been unsuccessful.

Be upfront about your goals and he will do his best to support your journey.

I sought out Dr. Noble after many failed IUIs and IVF treatment. I had a plan to pursue embryo donation/adoption. He was reluctant at first because I was working with Embro Connections. and he had never accepted donor embryos. He was happy to explore the options and support my transfer.

$8400 for an embryo transfers cycle (much less without hatching/ICSI fee)

Not applicable yet.

He knew his science, knew the timing of everything and was very upfront. He answered all the questions that I had. Went over all the test results with me. I would definitely go back to his office again.

I had to see a psychologist first before he would proceed which I found to be unnerving, but she was really nice. But I think an overall waste of money in that we just ended up chit chatting about area schools.

I don't remember them. Once all my blood work was cleared I was given a calender to follow of when to take which pills and injections

Truthfully I don't remember the costs. It was all out of pocket. The most expense was the sperm and the medications

Dr. Noble has a reputation of being an intelligant fertility doctor so my expectations were high. However during my first and second visit he didn't explain to me what my diagnosis are, what he was looking for with each test he ordered and what the results of the test could possibly mean. I was looking for more communication as I wanted to know why I couldn't get pregnant. I felt my history was unique as I have an autoimmune disease (immune thrombocytopenia) as well as multiple episodes of pelvic pain and ovarian cysts so given that I thought he would have more of an ideal as to why I was having fertility issues. However, he only stated that he would start off with lab work, diagnostic exams and meet again with the results. That was it. Then I was handed the typical work up of radiology imaging and lab work. During my second visit I completed the blood work and some of the radiology studies but was pending the hysterosalpingography, Dr. Noble looked through my results and just mumbled "low ovarian reserve" and stated "We'll get you pregnant." He didn't explain the results of each test and diagnostic test I had done. He didn't formally tell me a diagnoses. I was instructed to follow up after the last diagnostic test was completed for next steps however because I was so disappointed that I didn't have any answers or an informative conversation with him after completing so many tests I decided not return. I wish he would have explained low ovarian reserve to me further because now that I know women with this have poor outcomes I would have made my infertility issue a priority and continue seeking treatment.

I would recommend make a list of questions before you see him and ask him each question. Do not leave the room until he answers all your questions.

I did not proceed with treatment with Dr. Noble.

At the time I saw Dr. Noble my health insurane did not cover fertility services so I paid all services out of pocket. The office did not offer me a discount or refer me to resources that could help cover the cost. The initial consultation was around $325. Lab work and diagnostic testing was all together around $600. The follow up vist for results was around $200.

N/A