Margaret Graf Garrisi

Back in 2018 my husband and I could not conceive naturally. I heard about Dr. Garissi from a friend and immediately saw her. She was very knowledgeable, understanding, caring and determined to help us through our issues. She can be blunt which is a good thing in my mind because we didn't want anything sugar coated - just the facts and what our plan was. This is exactly what Dr. Garissi did. She told us how it is and kept us at bay as there is no guarantee. Now I don't want people to get the wrong idea. SHE HAS BEEN AMAZING! I ended up getting 4 eggs and 1 took and now I have a beautiful 3 year old girl, Samantha! Fast forward to 2020 and we wanted to try again, and did. This time not only do I have issues with Diminished Ovarian Reserve but my husband also is having fertility complications. Throughout this time we needed him to see a urologist and eventually have a surgery. Dr. Garissi was also amazing through this process explaining that I needed a retreival at the same time as my husbands surgery so they may create the embryo immediately. She explained how it was all going to work and what to do to coordinate with the urologist. Sadly at that time we only ended up with 3 eggs and nothing fertilized. We are still going strong and Dr. Garissi is still working with us to date. I did another retrieval with 1 egg to freeze and we are currently in process to do a few more retrievals to give us our best chances with multiple eggs. I don't physically see Dr. Garissi often, but we do have video chats a lot which I actually like better - saves time traveling. I would HIGHLY recommend Dr. Garissi to anyone - she is a great doctor!

Just don't be afraid to ask questions. She can get a bit sciency so if you aren't understanding just ask and she will be happy to explain.

Back in 2018 I Used the Microdose Lupron Flare Protocol and that resulted in 4 eggs - be mindful I have been diagnosed with Diminished Ovarian Reserve so that can explain the low eggs retrieved. I didn't have any issues that I can remember with any medications. In 2020 I used this protocol again and did 2 retrievals which in total yielded 3 eggs. In 2022 I was changed to the Femara Antagonist Protocol given my increased age and low AMH. This yielded 1 egg only. In May of this year we are trying Estrogen Primed Microdose Lupron Flare Protocol to see if we can get more eggs.

In 2018 our IVF costs were $10,000 for IVF then medications came to another $10,000. Site fees were $2000 ($1000 each) for the retrieval and surgery. We do not have insurance that covers anything. In 2020 we had some insurance so out of pocket for 2 retrievals we paid about $8000 total (Meds, site fees, IVF that wasn't covered with Insurance) In 2022 we have already done one retrieval which cost $14000 plus $8000 in medications and $1000 site fee for the retrieval. We do not have insurance this year either. We have paid an additional $12000 for 2 more retrievals and will also need to pay another $16000 in medication then each time we do a retrieval another $1000 for site fees. Oh also we know Anesthesia is not covered so we will probably pay another $1000 or so each retrieval for that. In 2020

I dont have any comments. I didnt get that many eggs so we are just hoping to get a good one to transfer this year

She was not always the doctor that saw me, or did procedures. I only consulted with her if something went wrong. She was a sweet doctor but sometimes i felt there was a lot of miscommunications and at times i felt like maybe she didn’t know what she was doing knowing my issues. She would give me wrong dosages, at wrong times and would have to cancel cycles. It was a lot of frustrations.

Be patient and always ask for her to get back to you, to check you or monitor you, not a technician or a nurse. Communicate well with her and ask her to explain things instead of just rambling on.

I will display my full journey. I was diagnosed with PCOS, an ovulatory dysfunction and a blocked dysfunctional tube. met with dr. Garrisi on 10/18/2017 after being referred to her by my gyno. had an ultrasound done. Prescribed Provera and started taking it on 10/19 for the next 7 days. ** Nurse said once I start bleeding on the first day to call them to schedule an appt. for an HSG test. Started first pill of Provera, same day. Few days later, 6th day of pill, a few clots of blood, Spotting. On November 6th had a Saline Sono done. Days later i followed up wit Dr Garrisi, discuss the surgery for removing the polyps. Blood work and ultrasound. Discussed My husband’s blood work and mine. He is a carrier of genetic disorder and I’m negative. (Nothing to worry about) On the 16th- started taking birth control as prescribed to stop my cycle, waiting for surgery schedule date. Surgery scheduled for 12/11 at 10am. Went well. Surgery done on 12/11 - went well. follow up after surgery. found out my polyps were benign but have a chronic endometriosis infection on my uterus lining. Prescribed antibiotics for 14 days to cure the infection. RWas told on the 2nd week to make an appt for the 3rd or 4th week to have follow up biopsy done again. Cervix is back to normal. 12/23 - started taking the antibiotics. Metronidazole 3x a day Doxycycline 2x a day 14 days. *2018* 1/5 - ended the two week antibiotics. Follow up appt done for the 4th week, on 1/17 3 pm No bleeding since. 1/17- follow up appt with dr. Garrisi, has a biopsy done to check if the infection is gone. 1/25 - results in... infection gone. Dr wants to do a saline sono once my period comes to double check if everything is okay to proceed. Need to get on the pill for my period to come. 1/29 - blood work and ultra sound to put me on medroxyprogesterone. 1/30 - started taking the pill for 7 days (call dr. office at cycle day ) 2/13 - Cycle day 1. Called to make the Saline sono for Wednesday 2/21. (Cycle day 9) 2/21 - Saline sono - everything is good and prescribed meds to start the ivf cycle Started birth control at 8:51 pm to stop my cycle For the next 5 days. Cycle day 9. IVF cycle treatment starts March 3rd 2018. 3/3 - started IVF cycle. appt in Livingston, blood work and ultrasound. First injection of gonal F pen 225 units and menapur 75 units. 7:30 pm Saturday, Sunday and Monday only. Tuesday 3/6 appt at 7 am Hoboken. 3/4 - cycle 3 - bleeding less not as heavy. Injections day 2. 3/6 - blood work and an ultrasound in Hoboken. 7 am. Continue injections. Menapur, gonal F and cetotide 3/8 - cycle day 24 - blood work and ultrasound 7 am Hoboken - tech said i had a lot of follicles and that’s good! Take three injections as usual. 6th day of stimming. 3/9 - cycle day 25. Blood work and ultrasound 7 am Hoboken. 3rd time this week. One shot of HCG at 11:30 pm, no other shots. Found out the retrieval is Sunday!!!! 3/10 - cycle day 26. Cramping a lot, a lot of pain. No shots. 3/11 - cycle day 27. Retrieval surgery done at 11:30 am by dr. Thompson Took out 15 follicles/eggs. Went well but In a lot of pain. Starting new medication. Shot of progesterone and two sets of pills. So much pain! 3/12- pain!!!!! Cycle day 28. Found out only 4 eggs fertilized. 3/13 - pain decreased but still there. Cycle day 29. 3/14 - not the greatest of news! Estrogen Levels are really highly 5860 and i have OHSS. Couldn’t do the transfer on day 3. Pain still there. 3/16 - we decided to cancel the day 5 transfer. Ovaries are still enlarged even though my levels went down to 3000 but doctor said it was wise to cancel and wait till next month to do the transfer. I’m okay with this decision, my health comes first. I could’ve gotten very sick. Less pain but still feel it. Super bloated from the fluids in my uterus and back. 3/18- learned the 3rd embryo didn’t make it and i could’ve miscarried. Did not get frozen and i only have two day 3 embies. 3/21 - blood work and ultrasound- estrogen levels are back to normal, ovaries still a little large but everything is healing good. Have a few ovarian cysts due to the retrieval, which according to dr garassi, will go away. 3/27 - appt for blood work and ultrasound. I’m okay. Starting birth control pills to control the cycle, evening. 3/28 - period gone. Cycle day 4 - 2nd day on bc pill. 3/29 - cycle day 5, follow up with dr. Garrisi, everything went well. Will start the meds next week and transfer will be scheduled for 4/24 or 4/25 or 4/26 4/2 - last day of birth control pill. Cycle day 9. 4/3 - follow up for monitoring. Asked to stop the bc pill and will hopefully start Saturday the hormone pills. 4/5 - cycle day 12. Everything normal so far. 4/7 - appt in Livingston- found a lot of cysts in the ovaries and must continue birth control till Thursday. Was not able to start hormones. 4/12 - last day of birth control pill. Monitoring check up Tuesday. 4/17 - no bleeding, doctors appt. I’m okay to start the estrace tonight. 2 pills 2x a day. 4 mg (HERE WE GO! Starting the cycle again!) 4/21 - monitoring, hormone levels went up from 48 on Tuesday 4/17 to 208 and was Told to start taking 2 pills 3x a time. 6 mg. 4/23 - blood work; everything came out okay to continue pills. Levels 296. 4/30 - Doctor appt for monitoring, everything came out okay. Received the email that I’m ready to start preparing for the embryo transfer and it’s scheduled for 5/7. MONDAY IS THE BIG DAY!! start all the rest of the meds and injections on Wednesday. 5/7- was not the big day!!! A huge mistake with the medications happened and the injections were given to me two days too soon and the transfer should’ve been on 5/5 not 5/7. My heart broke! Second time this process has been cancelled. Have to start all over again due to the staffs mistake. Have to wait for my period to come. Stopped meds. 5/14 - first day of period, spoke to nurse Kim, refilled my hormone medications and hopefully after monitoring tomorrow, i can start Tuesday May 15th. 5/15 - appt for usual. Everything came out okay to start hormones today. Second time starting meds for the thaw cycle., third time starting hormones for the IVF cycle. Started estradiol two tablets twice a day, to Friday. Saturday, appt in Livingston 5/23 - day 9 on hormones. doctors appt for monitoring. One week completed. 6/4 - transfer day!!! Two baby embies went in! Finally. 6/15 - positive result. I’m pregnant! My HCG BETA levels are low (22) but have to go in Monday to test again and see if they rising up. Staying positive!! nurse says it’s too soon. 6/18 - results stated i lost the embryos and had an early miscarriage. In July went for a follow up and found out my insurance will no longer cover another treatment and must pay out of pocket. I was not told this during my first and only cycle that it would be my only shot. It was a nightmare of journey which ended up in a big disappointment.

I would have liked for my doctor to monitor me but it was always a technician who never said a word to me but good morning and have a good day. Never worried about hurting me.

My insurance had a limit of $10000 for infertility treatments once in a lifetime

We have not yet started our cycle so we've only had a few appointments with the doctor. However, she has been candid and compassionate along the way and this has made my husband and I feel more comfortable with the process. She has explained everything in a way that is easy to digest, even if it's not been the information we were hoping for at the time.

Take notes! She is thorough and she provides answers to all of your questions but be certain to take notes so you can reflect on it all after you've left the appointment.

Again, since we haven't started our cycle (but are hoping to later this spring), this is difficult to answer. I have my list of medications planned but this will all be finalized as we get closer to the start date.

The minimum cost for one cycle will be $12,000. If we opt to do two cycles then we will be faced with a cost of approximately $21,000.

Dr. Garissi is straight and to the point. She talks in scientific terms but she does know what she’s doing. She is not warm and fuzzy, but I do trust her and eventually she got us to our desired outcome, which she was determined to do.

Advocate for yourself. You know your body best- even better than a doctor does.

Chloymid natural cycle, chloymid iui, two glonal f IUIs. Medicated egg retrieval with frozen transfer. First transfer was cancelled due to an infection. Second transfer over 1 year after beginning treatment was a success.

Lines could be very long as could the waits. The earlier you got there before monitoring the better. With the amount of women there on any given day, I do think they managed time well.

Insurance covered most of our costs other than copays and yearly rate to freeze our embryos ($15 each visit, and $1300 for the year).

I appreciated Dr. Garissi not transferring an embryo until she was sure the environment was 100 percent right, although the cancelled cycles made for a difficult road at the time.

We really respect Dr. Garrisi for her experience and knowledge. In addition, her husband, who also comes highly recommended, works in the lab. I spoke to 5 of her patients on the phone (I found them on Facebook) and spoke to each one of them for an hour asking about their experience and if they would recommend her. Out of those 5, 4 said they would highly recommend her. She has caught very difficult to catch conditions and is extremely knowledgeable.

I would recommend that they also reach out to other patients/former patients of Dr. Garrisi's. It's important to feel good/confident about choosing the right fertility doctor. You are spending a ridiculous amount of money and you want to make sure you feel you have made the right choice. The doctor must not only have a great deal of fertility knowledge to understand your condition, but they also must be able to help you focus on solutions to get you your wanted end result, a baby!

Drugs for Egg Retrieval: Follistim (900 iu), Menapur (25 vials), Ganirelix (250 mg), ACG (One 10 unit Vile) Progesterone Olive Oil (Two 10mg vials), Methylprednisolone (Four 16 mg tablets) and Doxycline (Eight 100 mg capsules). Drugs for Transfer: I was on BC for about 10 days (I believe that's how many days), Estrace and Progesterone. I think I also took Doxycline. Throughout this whole process, I was also taking Metformin (not prescribed by Dr. Garrisi, but used to regulate my period) and Vitafol Prenatal.

The Hoboken clinic was run like a well-oiled machine. I get very stressed at ultrasounds because the technician cannot discuss your scans and it causes a tremendous amount of anxiety. I wish this part was done by a doctor.

IRMS is located in Hoboken (City) and located right next to NYC... It's a very expensive town, so the bills have coincided with the location, fairly expensive.

I have heard that single embryo transfer has much healthier results. I'm 39 years old and don't want to risk multiple pregnancies, risking the health of the babies.

I like Dr. Garrisi, she was not my first choice however, i saw her and the experience was good. I nothing to complain about. I saw her a few times during my treatment but i dealt with the nurse and other covering docs more.

She is a very nice person overall, her bedside manner is good. One piece of advice ask questions lots of them even if they might seem stupid to you.

The treatment strategies and protocols were as expected as she did explain to me during my initial visit.

My treatment consists of co-payments, deductible and insurance costs.

There were no specific preference for me.

She was good but never gave us any hope and she also bluntly told that this is the last chance if I dont get pregnant it will never happen.she also told it would be a good idea to use donor eggs rather than my own even though i am fairly young also she never gave us any hope if this will work

Go with an open mind

My protocol was not adjusted and i was kept on the same stuff i did IVf two times

Dr. Garrisi is a great doctor. I have been under her care since June 2017. I think she and her team are really great and helpful. I have undergone 2 IUI cycles which I was told the outcome before hand. She is very wise and knowledgeable.

I would say ask a lot of questions, it's the only way to know the answers.

I have used clomid, trigger shots, estrogen pills to increase my uterus lining 2mg three times per day, vivelle dot patch 1mg - change every other day. Progesterone pills in my first IUI cycle after insemination.

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