Miriam Krause

Dr. Krause was very helpful in the beginning. As we furthered along in the treatment, I felt like I was always rushed along. I lived 2 hours away from the clinic. I would drive to the clinic to wait around 45 minutes and for Dr. Krause to come in and out within 10 minutes of the appointment. It was difficult to ask questions without feeling like I should already understand the concept of the treatment. Although she seemed very knowledgeable, it was hard to talk to her as a human sometimes.

Explore your options. Although you are so eager to become a mommy, make sure you get second opinions and go with your gut feeling. If you feel the doctor isn’t a match with you and your spouse, don’t be afraid to take the time to look into different clinics.

I was taking Menopur through injections. In the beginning of the treatment we started at half a vile a night. We did this for a few days. Meanwhile I was visiting the clinic which was 2 hours away around twice a week. The Menopur was not growing my eggs as Dr. Krause would have liked. She slowly raised my dosage even though it wasn’t making much progress with my eggs. After one month of slowly raising the dosage I was told to stop treatment and start over. Due to this I was forced to pay again for the treatment at the clinic. I felt all along I should have been advised to raise the dose a little higher than I was told. I had to pay for the treatment twice before the correct dosage to mature my eggs was discovered. It was very frustrating and money consuming when I was under the impression this treatment would only last around 2-3 weeks. After trying the treatment once more, it did result in a negative pregnancy test.

For the super ovulation treatment as timed intercourse it was $1,200.00 which only included 4 ultrasounds and bloodwork visits. I paid this amount twice due to my medicine dosage not being increased frequent. The Menopur and HSG shot was around $4,000.00.

This did not apply to my treatment, however once I had a few eggs matured, Dr. Krause implied that I had too many eggs matured which would result in multiple births. She implied she was against this.

Dr. Krause has been so very patient with me, and my body. Things haven't always gone smoothly, but Dr. Krause was honest about what was going on with my body, and adjusted her course of treatment. She took every step/ precaution to ensure a favorable outcome with every attempt at pregnancy.

Trust her.

I attempted two rounds of IUI, with no success. So, I moved onto IVF. After reviewing my history, Dr. Krause prescribed my injections throughout stimulation for favorable outcomes. She really knew how to utilize the different injections/ patches/ oral medications for my specific issues. Specifically, I was having issues with my uterine lining being too thin for FET, so I was prescribed estrodial & estrogen patches to address the issue. My first (fresh) transfer resulted in a blighted ovum. Also, after my 2nd FET didn't result in a pregnancy, Dr. Krause recommended an Endometrial Receptivity Analysis, which provided valuable information in regards to how many days of progesterone my body needed before the FET.

FEA accepts insurance, so it depends on you fertility benefits. Though, the clinic, Louisville Reproductive Center does not. That is all out of pocket. One round of IVF, plus 2 FETs has cost $14K, plus medications.

While Dr. Krause seemed prepared to advise me on the risks of carrying multiples, I already knew that I'm considered to be of 'advanced maternal age', and I knew that going into the situation. With that being said, I know a pregnancy with multiples can be risky, and had already decided to transfer one embryo at a time. Dr. Krause agreed.

She is straightforward with the treatment plan, which I very much appreciate. Dr Krause is also kind and understanding that infertility can be emotional. She has comforted me while crying and laughed with me on other occasions. She is very passionate about what she does and her dedication to her patients shows.

Make sure to do your research ahead of time so you are prepared with questions to ask. She will happily take the time to answer anything you ask.

I had already done 6 rounds of letrozole under the care of my OB/GYN. After my consultation with Dr Krause, she suggested 3 cycles of letrozole + HCG trigger shot. After two of these cycles my eggs were not developing as she would have liked, so she increased the dose of letrozole for the remainder of my treatments. After 3 unsuccessful cycles, she indicated that we could try IUI.

Unsure

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Dr. Krause is a great doctor to have in your side during this difficult time. She is open and caring and understand the emotional needs of her patients. She does an amazing job of explaining the procedures before and during the process so there are no surprises.

If you are looking for someone with a gentle personality to guide you through this process, Dr. Krause is a great choice!

Per our request and Dr. Krause's advice we started with the least invasive and least expensive options. As those options were unsuccessful, Dr. Krause was open with us about when to move to the next step and ultimately left the decision up to us. We felt very informed of our options throughout the entire process.

Since I don't have insurance coverage, we took advantage of the packages offered. I researched costs of these procedures at other clinics and found the package prices to be very reasonable for infertility treatments.

We started seeing Dr. Krause in January. After having bloodwork and different tests done, we decided to try Letrozole for 3 rounds. She left every decision up to us and offered an IUI should we want to proceed down that road. We are currently at the end of our 2nd cycle with Letrozole. Results are TBD. We are really happy with how she has given us options and hasn’t tried to push us down one road or another and if letting us take baby steps.

Do your research in different types of treatments before hand so you will be able to have a more informed discussion with Dr. Krause, that way you can come up with a good plan together.

My husbands sperm was assessed and was great. My labs all came back normal except for my vitamin D was low. My husband and I have a history of a miscarriage and 2 chemical pregnancies so we decided that progesterone suppositories were a good idea just in case that was the cause of my miscarriage. I began taking vitamin D and started on Letrozole 5 mg for days 3-7 to see if it would increase egg quantity and increase our chances of a successful pregnancy. We are on round 2 now. Cycle 1 failed, waiting to test for cycle 2.

Insurance covered some of the costs. Our Saline ultrasound was $110 with insurance. Blood work was around $50 uncovered.

Dr. Krause is lovely. There’s not anything negative I can say. She strives to achieve the best outcome. She’s patient and I never feel rushed. Her education in fertility is superb. Excellent bedside manners. Overall just a great doctor.

See her! You will feel that she has your best interest at heart and that you’re not just another infertility case.

I’ve struggled with infertility for 5 years. During that time I’ve seen 4 fertility clinics. 2 of them made me feel like a number. Another outside of Dr. Krause was good but out of town. With Dr. Krause she carefully looked over my medical history and thought it would be best for 3 more IUIs which we did but they were positive outcomes. The rationale for this is that I should do a total of 6 before moving on to IVF, which I had already done 3 with another doctor.

About $500-700 for IUIs and approx $15k-$20k for IVF. My insurance paid for some on the IUIs so I can be exact.

It’s impossible to talk to her if I’m not physically in the office, but she’s very easy to talk to and takes time to answer all my questions when I am there. She is always positive and upbeat and doesn’t seem rushed / annoyed when I keep throwing questions at her. I’ve felt comfortable with her from the beginning. When I finally got pregnant, she seems genuinely happy and wanted to be updated. She just seems like she truly cares about her patients and it’s not about the paycheck or the job for her.

Come to your appointments with any questions you may have.

We started with just letrozole + trigger shot+ TI for a couple cycles (after TTC for about 20 months). She felt confident this would get me pregnant since I ovulate on my own already and don’t have any other issues that have been indicated by testing. After a few cycles, we added in the IUI. She increased my dose of letrozole and I ended up growing more follicles than expected. She explained the different strategies we could follow and explained the risks very well so that we could make an informed decision on how to proceed.

Letrozole was about $5-15 with my insurance, trigger shot about $80, ultrasound and IUI about $250 (before insurance), sperm wash $160 (separate)

I have not gone through this

Dr. Krause is a fantastic doctor. She has always been so sweet and caring and supportive. She explains everything in terms you can understand and will cover all questions before you even ask. She makes us feel like we aren’t alone in this horrible struggle to conceive.

Always feel free to ask what ever questions you have. She will never make you feel like it’s a stupid question.

We started out with IUI with clomid. Started the clomid on day 3 and continued to day 5. We had three attempted IUI’s. The second cycle we missed ovulation by less then 12 hours so she did not do the insemination. My husband was also seeing a male fertility doctor and was on clomid and vitamins. After the three failed attempts and no improvement in sperm quality we moved on to IVF with ICSI. We had 11 eggs retrieved 6 fertilized and 5 survived. We transferred 1 day 5 embryo fresh and then froze the remaining. After that transfer failed we transferred two embryos. That transfer was also unsuccessful. With only two remaining embryos we decided to transfer one which resulted in a chemical pregnancy. We still have one embryo frozen.

IUI cycles were around $300 to $500. Our IVF cycle we bought a package through a financing company. It was close to $15000

She suggested to transfer one embryo for the first transfer stating that frozen embryos have giving better results.

Great communicator. Very kind person. She has gone through infertility herself and thus knows how hard and emotional it can be. Her staff can be a little difficult to communicate with sometimes. Some staff members are wonderful, others don't seem to listen to you which leads to some minor and annoying misunderstandings (like not relaying the correct question to the doctor).

Make sure to ask lots of questions. Make sure you have a full understanding of the process and what treatments she thinks is best.

For 4 months we were prescribed Letrozole. I took it days 4-7 of my cycle. Then on day 10 or 11 of my cycle I went into the office for an ovulation check. During this last cycle, I was also given a HCG trigger shot on the same day of the ovulation check to cause ovulation to occur within 24 hours. We were instructed to do timed intercourse, which mean having intercourse once every 24 hours for the next 72 hours.

I don't know her approach.

She is not pushy, she lets me make an informed decision. She calls to check on me, and was very caring during my miscarriage. I feel like she is really rooting for me, and is understanding of my losses and infertility.

Chose her. She is caring and compassionate.

I was referred to Dr. Krause after my 2nd missed miscarriage in a row. She ran additional repeat loss labs that me OB didn’t. She performed a saline US. She had me take birth control pills prior to my hysteroscopy to help thin my lining. She performed my hysterectomy, I wore a foley catch in my uterus for 5 days, and took estrogen for weeks after my surgery. I took probers to get my cycle back. I had another Saline US and we were cleared to TTC. I had an annovulatory cycle followed by a very long cycle, so we did 50mg clomid, Trigger shot and timed intercourse, that cycle didn’t work so I tried 100mg clomid, Trigger shot of pregnyl and timed intercouse, that cycle was negative do I had an hsg then I took a 4 month break from the RE, after the break she called to check on me, and we decided my husband needed a Sperm analysis. It was fine. We did 100mg of clomid, Trigger shot and timed intercourse and got a BFP. She check 2 betas, and an US at 6w4d, baby did not have a heartbeat. She rechecked US 1 week later baby still did not have a heartbeat. I stopped my progesterone, and she gave me a prescription for cytotec and pain meds to induce the mc if I desired. I miscarried at home naturally and she wrote orders to have to baby genetically tested. Baby had an extra chromosome. We took 5 months off from medicated cycles continued to try on our own. I did 2 more clomid cycles with trigger and timed intercourse, and I am now on my first Femara cycle with a trigger and timed intercourse. Dr. Krause has given us the option of ivf with pgs, donor eggs, or donor embryos, but we have no infertility coverage so she is willing to let us go as little or as much as we want.

Clomid $30, Trigger shot $90, insurance covered US and visits bc of how the coded them. I had to pay my deductabile and 10% after for my hysteroscopy. My HSG was covered bc I had met my deductible. The sperm Analysis was $150.

From the very first appointment that I had with Dr. Krause she made eye contact, sat beside me not in front me, and made an entire written care plan that went from best case scenario to worst case scenario. We immediately started with blood work and she started working on my diagnosis and just like that the care plan was implemented. I have always felt very comfortable telling her the good, bad, and ugly of my emotions, side effects, and both me and my husband's feelings about where we were in the care plan. During the almost two years I've been with Dr. Krause, we have had ups and downs including delays, accidentally dropped very expensive medication, surgery, extremely uncomfortable procedures but all in all I feel most comfortable with her.

This is a funny question because unfortunately I know many women who have difficulties conceiving and I highly recommend Dr. Krauss every time. I explained that I've been to other doctors, and she is the only one that makes me feel relaxed, comfortable and has fought so hard for a diagnosis for me. She's really the whole package! My advice is always for them to find somebody that you're comfortable with, at least have a consultation and you'll know then.

Since I had already started fertility medications with another physician that did not turned out to be successful, Dr. Krause immediately explained her rationale for a different medication and planof attack. I was convinced so we started on femara. She explained that it was not FDA-approved for the route that we were going to be taking, but in her experience had seen a lot of success. She explained that she understood if we were uncomfortable moving forward since it was not FDA-approved. I truly believe she would have altered the plan of care she was not trying to persuade me out of my comfort zone at all. She also ensured she would check for ovulation with ultrasound technique versus blood work which was what I had previously been doing. When after several months of treatments, positive follicle growth, and positive ovulation, she decided to become more invasive with finding out the reason as to why I had not been conceiving. This is when she order the hsg test to check for blocked tubes. In discovering that my right tube was completely blocked we scheduled surgery. The surgery was successful and that my tube is now open, we (myself, her, and my husband) decided that we would try timed intercourse 2 months on our own before we would move to IUI. After two failed rounds of IUI my husband and I decided to take a break. Dr. Krause explained that she thinks that we are good candidates for IVF and during this break we are saving money so we can hopefully afford IVF one day.

All of the costs for specimen cleaning and IUI were relatively appropriate. I was never sucker punched into expensive cost. I remember sitting down with the Financial Coordinator for IVF and walking away kind of surprised that there were so many Financial options and that it was a little cheaper than I thought it was going to be.

Dr. Krause said that she is not comfortable doing more than a 2 Embryo transfer for IVF due to complications that might arise. At first I was a little disappointed because of my age (32) and I have been wanting a baby for many years so I wanted as many babies as I possibly could, as fast as I could. But I understand her success rate is higher with these numbers which means my success rate would be higher if I take her advice and only transfer one or two embryos at a time. When talking with her about all of the options she is very knowledgeable about the latest methods and her comfort level which is refreshing.

After trying to conceive for a year under the guidance of my OB-GYN and knowing there were some irregularities and obstacles, my husband and I took the leap and scheduled an appointment with Fertility and Endocrine Associates. I had a friend that had seen Dr. Homm and had success with their three boys! I remember calling and asking for an appointment with Dr. Homm and I was told his schedule was super packed and it would be quite a while until there was an opening. It turned out that there was a newer doctor who had recently joined the office and her schedule was not quite as full (yet!) and could see us much sooner. I decided, we wanted to get started as soon as possible and Dr. Krause turned out to be unbelievably amazing!!!!! Dr Krause walked us through each procedure and made sure we understood even if we weren’t asking questions. After our loss, she was honestly more emotional than me which allowed me to feel my heartache instead of being tough for the sake of procedures.

Listen. Listen to her ideas and weigh the options. She will always let you decide but she has so much information and insight to share.

We chose to use ovulation medication before we considered IVF. I used letrazol/femera for 6 rounds (months) before IVF was our solution. The ovulation medication was the financially safe way to try controlling some variables.

Louisville Repeodictive was $10,000 Medication was around $3000 And Fertility&Endocrine was $7,000

Dr Krause gave us lots of information on single vs multiple embryo transfers. The embryo I used had a 50 percent chance of working and using another would raise our percent of success to 55 but could also lead to twins. My husband was not a fan of the idea of twins and Dr Krause was sure to be honest about the risks.

The first time we met Dr. Krause I felt that she Was very patient with us. We did not feel rushed and she answered all of our questions. Although we have only completed 3 IUI due to my husbands inability to provide a sample each time due to a spinal cord injury we have waned to try severe more times. Dr. Krause and her office staff was always so understanding when we would call can cancel 30 minuets before our appointment because of this issue and never made us feel like it was our fault even though it was. She would always call and let me know that she was there if we needed anything and that we could change our course of action at any time. Dr. Krause is awesome and I would recommend any of my friends or family to her.

You will love her. She is very personable and she does not act like she knows more than you. You would not know she is a doctor because she talks to you like a friend would and is very passionate about her profession and patients.

On our first visit she discussed our treatment options. She suggested we start with IUI because my lab results was great and nothing indicated differently at this time. The issue we have is my husband has a spinal cord injury and has a low sperm count. We tried IUI without medications and then IUI with medication and still no success at this time.

The cost for iui is expensive and I was able to pay on a month to month basis

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She is intelligent, gifted at her profession, compassionate, and patient. Dr. Krause never talked down to me, was never rushed, and provided wonderful care. I looked forward to my visits because she was always able to calm me while providing me with correct information and realistic expectations. I knew she was great, but after talking to other infertile couples, I learned that not all REs were nearly as wonderful.

Be yourself and ask any question. But really don't they need my advice, she will take care of them.

It is hard to remember all of this. I used Letrozole with an HCG IM trigger shot each of my IUIs and progesterone suppositories to follow. My follicle growth was on track with each. I did a single IVF retrieval and while there was a time I could tell you ever med, it is all a fog now. I did not transfer fresh due to a blood test that sugggested my uterus was not in time with the embryos. I later transferred a single embryo after BC pill suppression, Estrodial, Estrogel, progesterone suppositories and IM. I had a successful pregnancy. Most recent FET was a noncarriage (negative pregnancy test). Will increase estrogen on next cycle to address uterine lining being slightly thinner than preferred.

I think within average. They billed insurance as much as possible. Even though my insurance won't cover infertility they did cover a few services.

Due to my medical condition eSET is the only option. Dr. Krause would not allow anything else as it would put me and children at very high risk.

One thing that I greatly enjoyed about the care given to me by Dr.Krause was her explanation of what I was seeing during the ultrasound. Sure, a patient just sees a grainy image but she pointed out every little thing and if I had a question she was quick to answer and explained it in a way that I could easily understand. It is often that patients get textbook responses to questions and they walk away confused with more questions than they possibly had going in to see their physician. I left the office with little to no questions and I knew exactly what the next steps would be and I also had a good idea of what those steps would entail financially.

Don't be afraid to ask any questions. She thoroughly explains everything if you ask and she will explain it in a way that is easy for you to understand. It is better to be more informed. Something you might feel is a stupid question or something about your medical history that you might consider irrelevant can actually be mind opening!

Initially I saw Dr. Kit Devine and towards the end I was seen by Dr. Miriam Krause. Dr. Kit Devine initially did some bloodwork and ultrasounds and a thorough medical review. I had all of my records sent to them from my OBGYN, Dr. Jacqueline Riely of OBGYN and Associates and from my endocrinologist, Dr. Lohano at Joslin Diabetes Center. We reviewed my condition together, prolactinoma which included blood work, MRIs and more. She developed a plan to start me on Chlomid along with my current dosage of Bromocryptine (this medication prescribed by my endocrinologist works to lower my prolactin level. Normal range is in the teens and my level initially was 385). We tried a couple rounds of this medication along with some other medications which I believe were called Letrozol and femara. I can't recall dosages and instructions for the medications. After attempting two cycles of medication with no signs of ovulation on the pelvic ultrasound they decided to increase the dosage of medication. After my third pelvic ultrasound the findings were the same and there was still no signs of ovulation. It was concluded by Dr. Miriam Krause that the medication was not strong enough to induce ovulation and that I would have the most success moving on to injectables with IUI or IVF.

The pelvic ultrasounds were around $200 and I believe I had 3. My office visits were $22 and I believe I might have been seen around 4 or more times. The only other costs I incurred would have possibly been my consultation fee and my medication although my medication cost would have been from a local pharmacy and not their practice.

After a third unsuccessful attempt with medications I was information for IUI and IVF. I thoroughly reviewed the information given to me and I clearly understood the process. For the medications I was also given a list of a variety of pharmacies so that I could compare costs. I liked that in the explanation of embryo transfer they mentioned that sometimes they have to make the tough call to cancel a cycle if it doesn't appear to be working. They said unfortunately sometimes fertilization and implementation does not occur and they will cancel a cycle and hold a thorough review of that cycle. They review the cycles success and how it progressed so that modifications can be made to the next cycle if need be. It was even mentioned that IVF technology does change and that could even result in changes to a patients treatment.

Dr. Krause is very kind, but doesn't sugarcoat results or treatment plans. She has also never tried to push procedures on us, or put us through unnecessary treatments. This fits our personalities perfectly. We want someone who cares, but is upfront about our chances. She makes sure we leave with the knowledge we need to make decisions correctly for us.

She is compassionate and kind, but presents the facts based on the on the medical information. If you are looking for someone who will always tell you what you want to hear, she is not the doctor for you. She will do what is best for you and recommend treatment options based on your medical history, not pricey procedures.

I had already been under the care of endocrinologists before I saw her, so she had a lot of my medical history before she even saw me. She did some initial bloodwork, and made some changes to my medications based on the results. Because of my medical history, she really wanted to get a look inside to see what was going on. After laproscopic surgery, she gave us treatment options based on what she saw. We could go with IVF, which would give us the highest chance of pregnancy but is costly. Or we could do a few rounds of iui first, which is less expensive and gives us less of a chance of pregnancy. Again, she presented these options on a neutral basis, which left us to make a decision best for us. We chose to do 3 iui cycles, and then re-evaluate. In addition to iui, she also put me on letrozole and hcg trigger shot. The first iui went fine, but I started my period too soon for an unknown reason. The second iui went well, but Dr. Krause added progesterone to prevent premature bleeding. This worked, and we currently have an active pregnancy. It is still early, but she says everything looks great. We are hopeful.

Each iui procedure cost 500, with an additional 125 for semen analysis and prep. My insurance covered office visits and surgical procedures.

I felt comfortable at every appointment. I felt like I had my doctors complete attention and she had my best interest at heart. I can genuinely tell that she cares. She is thorough and clear about all treatment and is available to answer any questions and/or ease any concerns.

Ask questions and utilize the staff and doctor for support. They are very responsive and very willing to address all of your needs/concerns.

I don’t know my protocol compared with the protocol of others undergoing IVF but, I would imagine I was under a pretty standard protocol being that it was my first time doing IVF and I had no other medical/fertility issues that were causing infertility. My infertility was completely unexplained.

The cost in total was about 11000.

My doctor explained the risks and statistics for single vs. multiple embryo transfer and was supportive of my decision.

Dr. Krause was professional and compassionate. She listened to my fears and offered realistic hope. Her optimism was welcome since I was so guarded with my expectations. I can honestly say there were no cons in working with Dr. Krause.

Don’t be afraid to ask questions and be honest about your fears.

Dr. Krause did not want to correct my blocked tube, instead focusing on the other side. She put me on a medicated cycle with time intercourse, and on the second cycle she suggested IUI.

With our insurance, a medicated cycle with time intercourse cost around $275.

Dr. Krause really took the time to educate us on all the positives and negatives that can happen with IVF including with genetic testing. She has great bed side manner. She was very compassionate when none of our embryos made it.

Be sure to ask questions...she will give you very honest questions.

We did IVF with embryo genetic testing. We used Gonal-F, Menopur and Ceteotide before the egg retrieval. We decided to go with the genetic testing as I have had recurring pregnancy losses.

$15,000 including genetic testing

She highly recommended single for my age, but we didnt make it to that stage.

Dr. Krause was always at the appointment and throughly explained everything. We could call her anytime day or night if there was a question.

Prepare yourself it is not a quick process. We started this process in March we are now in October and still going through it. It takes time and patience

Dr Krause was able to take the time to sit down with me for additional an additional consultation after my initial plan and need had changed. She discussed why she was not able to perform the surgery at that time that I needed and advised me of other options and where we would pick back up with my treatment.

Come prepared with questions you would like to discuss and give yourself grace as a single person debating on fertility treatment options and/or your rationale to delay or postpone treatments

I did not have the need for much or a work up with Dr Krause because I had recent labs from a PCP and a RE in Florida

All out of pocket

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