Mitch Rosen

We ended up going to several different fertility clinics in the Bay Area (we met with six different REs across five centers) as it was difficult to find a good match and our case turned out to be much more challenging than we expected. Without a doubt we can say that Dr. Rosen has been the best for us to work with and is a brilliant physician. While there are many exceptional centers & physicians offering IVF in the Bay Area, it is evident that Dr. Rosen is not only one of the most academically accomplished reproductive endocrinologists nationally but he is also an outstanding clinician. He was able to comprehensively assess our case & then fine tune our IVF protocol to produce results that we were not able to achieve until then. We went from feeling like we may very well not be able to conceive at all to having many healthy embryos now “in the bank” and will be attempting implantation for pregnancy soon. Dr. Rosen was very conscientious about answering all of our questions and also incorporated our own preferences and input. We are immensely grateful to Dr. Rosen and so very lucky to have been able to work with him. September 2020 UPDATE: Our fertility journey was very long and challenging, but Dr. Rosen guided us through and now we are pregnant!!! He and his clinical nurse manager Liz Gomes were extraordinary. They have been so smart, caring, patient, professional and supportive. We could not have been in better hands.

Be aware that while in-cycle, on weekends you might work with RE Fellows rather than directly with an Attending.

All out of pocket

Dr. Rosen is very direct and will tell provide you with pros/cons and options. He first tries to understand what your objectives are to provide better answers for you. If you are looking for someone warm and fuzzy, this may not be the right doctor for you, but if you are looking to achieve an outcome and care a little less about the bedside manner (not that it is bad at all), this is the doctor for you. He would keep us in our place when we tried to ask about a backup plan and would have us focus on Plan A only. Dr. Rosen is the best, if not one of the best at UCSF, and am so grateful to have had the opportunity to be his patient. I couldn't recommend him more and hope when we plan for a second child, he will still be there to guide us again through our journey.

Be prepared with questions and do some of your own research. Advocate for yourself if something is important to you.

I did my first egg retrieval cycle with estrace priming and then gonal f/menopur. I was reacting quite well to the medication so my dosage changed quite a bit. Although I yielded a good number of eggs (I think around 26), only 2 made it through PGS testing. Had two single embryo transfers, using medicated cycle (given my periods are irregular). Both failed. Did an hysteroscopy and everything was fine. Did an ERA test and also came back normal. This was followed by a second egg retrieval cycle, primed with birth control so that the eggs would grow closer in size compared to the first cycle. Gonal f lower does and menopur. Went for 14 days vs 10 in first cycle. Worked well. Had 33 eggs of which 8 embryos were PGS normal. We did a third cycle insurance was helping to cover the 2nd and 3rd cycle and did the exact same protocol as second egg retrieval but had completely different results. 21 eggs of which only 2 PGS embryos resulted. I honestly think the difference in results was due to lifestyle (much more stressed during this cycle). So have 10 embryos banked. Given two failed FETs, transferred two embryos (one day 5 and one day 6 embryo) and success (at least for now)!

Monitoring appointments are a well oiled machine. I was usually in and out within 15 minutes (bloodwork and ultrasound). I could always get in a time convenient for me.

I paid out of pocket my first cycle. A full fresh cycle is around $16k, excluding medications. A frozen cycle is around $4k, excluding medications. My second and third retrievals were covered by insurance.

Doctor's and UCSF preference is eSET but given I had two failed ones, on my third transfer, doctor was ok putting in two.

I'm sure he's well educated and knows things in his field. But he seems way to busy for patient care. He is head of the lab at UCSF, and he's helping with some other new clinic out of the country, so patient care is not his priority. If you have a pretty straightforward case, you'll do well on a standard protocol. But I wouldn't expect him to turn over every stone to help you get pregnant

IUIs with clomid; full IVF with menopur and Gona, ganirelixl and trigger shot; mini-IVFs with gonal only, ganirelix and trigger shot

Self-pay cost, no insurance coverage: - 2K for IUI - 6K for mini-stim IVF with cryo preservation/ no transfer - 15K for a full IVF with cryo/ no transfer - 4K for frozen transfer

They seem to be very strongly preferring singleton pregnancies. Every time I mention that twins are ok, he cringes.

After my first cycle it was clear adjustments needed to be made, but I was told the next cycle would proceed exactly as before. It wasn't until after 2 cycles that a nurse called to get detailed feedback for her rounds with Dr Rosen and my treatment was adjusted for cycle 3.

Be aware that UCSF is a big hospital and doctors do not review results as frequently as they should.

IUI cycle 1: Clomid 50 mg for days 2-7, ultrasound on day 10, trigger shot on day 11, insemination planned for day 13 but moved up to day 12 because I observed LH surge on OPK test on day 11. IUI cycle 2: same as cycle 1. Cancelled ultrasound & insemination because of timing conflict with husband's work travel, still took Clomid + timed intercourse. IUI cycle 3 (in progress): Adjusted treatment based on result from cycle 1. Switched to letrazole because Clomid caused thin uterine lining on cycle 1. Moving ultrasound up to day 9.

$2000 per cycle of IUI billed to my insurance. Breakdown not provided

Overall I had a good experience. Except for what I mentioned previously in that I allowed myself to be put in the “infertility box” and didn’t trust my gut instincts, and I know my body very well. I should have been more sure of myself and only transferred one embryo as I knew my body couldn’t handle a twin pregnancy. However, I did appreciate his vast knowledge about infertility and he put a great plan in motion for me and far as my protocol. I was nervous when I found out he wasn’t able to perform my egg retrieval or transfer. But the staff was top notch and I was very comfortable with everyone who helped me.

He’s one of the best, If not the best doctors at the clinic so be patient if you want to get on his schedule. He rarely has openings.

We opted for a mini cycle and I was very pleased with the outcome. I responded well and after taking clomid for 5 days, a couple shots of ganarelix and I think one or 2 shots of gonal I was ready to trigger. It happened very quickly.

All in we paid about $8,500. This included meds, anesthesia, appts, ultrasounds, etc.

I shouldn’t comment bc I don’t have fertility issues, my tubes are tied and I’m super fertile.

Dr. Rosen is not necessarily the "warm and fuzzy" type. But neither are we, so he is the prefect match for us. He also took the time to connect with my husband to make him feel more comfortable about the process. After coming from a previous RE where I did not feel as comfortable, every single time I see or talk to Dr. Rosen I walk out of the clinic feeling more positive and hopeful than before. Even with setbacks out of any of our control. We really love Dr. Rosen.

Some people need a warmer demeanor. And I think setting up those expectations from the beginning would be helpful. For us, he is perfect. But he may not be a match for everyone. So laying out his personality/"bedside manner" type during introductions before going into treatment plan would be helpful for people to decide if he is the right doctor for the long haul.

First cycle: estrogen priming, gonal F, menapur, started ganorelix around day 6, stimmed for 9 days, egg retrieval on day 11. Had done IUIs with that combination and it worked well, so he decided to try that. Second cycle: about to start. Doing a random start time with no priming (due to there being a cyst that is delaying ovulation). Not sure yet what medications we will use to stim this cycle, but believe it will be around the same.

One retrieval round for us, with insurance, was around $9100. We anticipating one more retrieval. And then we will also have to pay for transfer (around $4000). Other expenses were sent to my other provider.

Dr. Rosen is very clear that if you do PGS testing, he will only transfer one back. He said that at the beginning and even when we (Husband and I) were toying with the idea of 2 after all of the delays. But he did not waiver and said only 1 an option. Which we actually were good with, and he had stayed consistent with that position, which I appreciated.

Dr Rosen is a funny, kind, and positive individual. That being said, he is also very honest to the extent that it may be interpreted as lack of compassion. Sometimes he may have seemed bored by some of our questions, but having gotten to know his personality and style, I can say that this is nothing more than his knowledge and experience coming through. (He doesn’t give false hopes and he knows what he knows.)

Do not assume that he is cold, lacking in warm bedside manner, or disinterested in helping you achieve your dream. If anything, know that he wants to simply cut through worthless talk so that he can help you achieve your goal sooner and with the most potential for a successful outcome.

Antagonist protocol, PGS all blast, freeze normals. 150mg menopur, 300mg cetrotide and Gonal-f unknown amount (can’t remember) for first part of cycle. Sorry can’t remember details regarding exact calendar.

First cycle cOvered by insurance and only Minimal copays for required rX.

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Dr. Rosen was straightforward but showed compassion. He is incredibly busy but made sure that he responded to me. Sometimes a nurse wouldn't get back to me and I would message him. He was always responsive and ensured I was heard. Also, when I suffered OHSS (Ovarian Hyperstimulation Syndrome) unexpectedly, he helped me make the appointment to drain the fluids free of charge. Working with Dr. Rosen made me feel cared for.

I would say to communicate very directly and just follow up if you don't hear a response right away as he is a very busy person. He is more on the straightforward side than the "nurturing" side.

I think my situation was quite standard, or at least standard for a cancer patient. He spelled out exactly what the timeline would be. The nurse, Liz Gomes, was the one who walked me and my husband through the injections and how to ensure best success. I went into UCSF every morning for those two weeks to get my blood tested. I underwent an ultrasound every other day. One thing that did get lost a bit in translation was during the last couple of days. I was unclear when exactly retrieval would be. Overall, the situation was a success!

Not quite sure, maybe $15,000-$20,000?

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Dr. Rosen knows what he is doing and I trust him. Our fertility process is still ongoing and has been extremely difficult, but Dr. Rosen has been very helpful along the way. He's not pushy at all and tries to start with the least invasive approach to help you. I recently had a miscarriage (from natural conception) and it's taken a huge emotional toll on me. Instead of rushing me to IVF, Dr. Rosen recommended that I take a break, get back on my feet, and then call him to proceed with IVF. Part of me wants to rush into things, but part of me is secretly thanking him for telling me to pause and recover first.

Dr. Rosen can be a little quirky. He's also director of the lab and can geek out over scientific methods, evidence, etc.. If that's not your cup of tea, then you might want to look for another provider. Also, keep in mind that as a teaching hospital, UCSF only practices evidence-based medicine. So some patients may perceive them as being too conservative or not risky enough (for example, they're not too enthusiastic about combining fertility treatments with eastern medicine). It depends on the type of provider you want.

We started with 3 rounds of IUI (first two with clomid, last with injectables). Dr. Rosen wanted us to start with the least invasive procedure first and see how it goes. I didn't react well to the clomid, so we upped the treatment to injectables during the 3rd round (which led to a much higher number of mature follicles). Sadly, the IUIs didn't work out. For our future treatment plan, we will increase the amount of injectables (basically do IVF). If <3 follicles mature, then we will do IUI. If >3 follicles mature, we will do IVF. Please wish us luck.

No

Up front, if you want a doctor who will literally hold your hand throughout the process, this isn't going to happen. If you want a candid and honest approach about your fertility chances and the process, then Dr. Rosen will do this. While I personally understood conversations and meetings, I know my spouse would sometimes be confused or have questions later on. Admittedly, it is probably very different being the one who actually goes through all the procedures versus just having to hear it as the spouse. However, Dr. Rosen took the time to go back and walk through everything and the future steps to make sure we were all on the same page. One frustrating thing, is that Dr. Rosen will not go into a whole of details if something doesn't succeed, as in, will you have to deal with X or Y. He will tell you that oftentimes, or at least in my case, there's too many variables to predict what course of action will be most effective or recommended. There have been a few bumps in the road here and there, but we've managed to work through them. Dr. Rosen does understand that ultimately, as the one going through both the physical and mental anxiety of the process, ultimately, you should do what feels best for you.

Don't expect a touchy-feely type doctor. Be ready for a matter of fact approach and demeanor. I think he does get uncomfortable if you cry, so be prepared. But I do think he does feel for his patients and does try his hardest to get you pregnant.

Since I have DOR, we were put onto the estrogen protocol. The first cycle I produced 7 follicles, which was good given my situation. Five eggs were mature and two fertilized but did not make it to blast. The second cycle was a bit random because it came on the heels of a hysteroscopy. I actually produced 11 follicles, but only 2 fertilized among the ones retrieved. He changed the protocol to a clomid flare, which produced the most follicles to date and most eggs retrieved. 15 eggs retrieved, 11 mature, and again, only 2 fertilized. It was very devastating. The last four were frozen at day 3. If we do another retrieval, there will be a change to the protocol to try and address the low fertilization rates.

You get a discount if you self-pay your IVF cycles. Medicines are separate. If your insurance does not cover certain procedures you must pay OOP.

No comment since we're not there yet.

Dr. Mitchell Rosen is an exceptional fertility expert, in every way: - Dr. Rosen has the rare combination of being scientific, straight-forward, direct and realistic about the fertility treatment process, options, and trade-offs while also being extremely caring and kind. His explanations are thorough and make complexity easy to understand. I experienced this from our very first appointment with Dr. Rosen, when we learned our fertility challenges were due not only to male factor, but also female factor. Dr. Rosen explained the options, trade-offs, odds, and gave us the space we needed to decide how to move forward. - He is on top of and driving the latest fertility research; it is clear he applies his wealth of knowledge when carefully considering how to customize the protocol and what is being learned from each cycle. We did 4 cycles for embryo freezing and fresh embryo transfer: Dr. Rosen customized each cycle considering how my body responded to previous cycles and what was the latest research. Despite my low follicle count (4 at baseline scan as opposed to 20+), his relentless analytical mindset led to a 4th cycle which yielded 15+ day 3 embryos and 6 blastocysts at day 5 (previous cycles had yielded 3, 5, and 3 embryos at day 3). - Fertility treatment can be long and draining. In my experience Dr. Rosen acted not only as a doctor, but also as a partner fully invested in a successful outcome. In every interaction with him my husband and I had no doubt that he was as committed as we were to a positive outcome and shared in our stumbles and successes along the way. This was clear after changes to the protocol in the 3rd cycle didn't yield the response we were looking for - Dr. Rosen was as upset (or more) than I was. He also geeked out with my husband over probability theory to help us decide how many embryos to freeze and was fully empathetic in my first cycle, hugging and telling me it was ok to be "greedy" and want all my few follicles to mature despite the low count and size distribution during the cycle.

1st cycle: "standard" protocol for patient with diminished ovarian reserve - estrogen during first month followed by injections of Folistim (300), Menopour (150), Ganorelix. Goal: learn how my ovaries would react to the treatment, with expectation of 0-1 day 3 frozen embryo. Results: 3 day 3 frozen embryos. 2nd cycle: If I remember correctly, same protocol was followed, with adjustment on timing of egg retrieval. 5 day 3 frozen embryos. 3rd cycle: addition of growth hormone. Results: 3 day 3 frozen embryos. 4th (final) cycle: removal of growth hormone, double dose of estrogen, egg retrieval 38 hours after trigger shot (as opposed to 36). Result: double number of eggs, most mature, 14 day 3 embryos, 6 day 5 embryos, 2 embryos transferred, 1 healthy baby.

I'm not exaggerating when I say there is literally no doctor better or more qualified than Dr. Rosen. From my initial consult with him until the very last pregnancy ultrasound, he has been positive, kind, caring, and confident that I would get pregnant. It has been quite a long road for me and my husband, with PCOS, low sperm count, multiple IUIs, and a couple IVF cycles - but Dr. Rosen never lost hope and was always so encouraging that we would find the perfect protocol for me. He was so thorough at every appointment, explaining everything in detail, explaining what he was changing and why that would effect the outcome of the cycle. Not only is he an extremely intelligent and highly skilled doctor - he's also a genuinely kind and down to earth person, always bringing humor, kindness, and compassion to every appointment. I know that Dr. Rosen has hundreds of patients, but he has a way of making you feel like you are his only patient - the most important one. He remembers my history without looking at a chart, and is all around just a great person and amazing doctor. I literally could not have gotten through the last couple of years without the help of my amazing doctor, Dr. Rosen... He wasn't only concerned about success rates (like other clinics who turned me away), he was worried about me, my well being, and helping make my dreams come true... and he did as I am now almost in my second trimester with my first baby. I can't wait to go back for him for baby #2.

I was 100% out of pocket, so each IVF was just under $20k... that includes medications, ICSI, embryo freezing, etc.

DR. ROSEN and his TEAM at UCSF REPRODUCTIVE CENTER 499 Illinois st San Francisco ca Dr Rosen and his Team are bar none the best fertility team you can ever work with. They are very professional. They are with you each and every step of the way Dr Rosen and his staff are very accommodating and they are prompt when returning your phone call as well as they will make you feel comfortable and Dr Rosen and his staff are straight forward they don't waste time and they make sure before you leave they you understand everything step by step. They are great and they take pride of everything they do and make time for each and every patient and the care and will never leave you confused. Dr Rosen and his staff are top notch you will not regret it if you chose Dr Rosen I have recommended my friends and family who are doing ivf and looking for a fertility specialist and I recommended Dr Rosen and his Staff and they are pretty excited and happy. And I wouldn't go to anyone else for fertility or recommend anyone but Dr Rosen and his Team. Dr Rosen did my embryo transfer the first time and I'm pregnant....

Just talk to him and he will listen and he will alway be up front with u about everything

Progesterone, estradiol, leuprolide

$13000

Appointment were timely, although the front desk is a bit scattered. But once you got in to see dr Rosen, at least the first time I met with him, I had a good feeling about him. He had a six sense but I also felt that he was 10 steps ahead of me. For instance, I got an hsg test done and the results sent over. It took some time to even get a call with dr Rosen and for about 5 min to discuss it. He instantly dismissed the fact that it said I may have one blocked tube. I asked if he saw the scans and he said he doesn't look at them anymore and can tell by reading the results. He didn't think I had a blocked tube and I guess he was right because I'm expecting.

Be proactive with your questions and on the procedures. Follow up constantly and when taking to dr Rosen, take notes. You might want to also be sure what choices and options you want to go down before you see him, if possible.

Dr. Rosen is very experienced and made sure I am ok. I had a lot of follicles and my estrogen levels were raising rapidly due to IVF injections. Dr. Rosen tailored the treatment to ensure I get maximum mature eggs and I do not have adverse post retrieval symptoms such as PCOS. I was monitored almost on a daily basis for follicle growth and estrogen levels to ensure I am safe and healthy at the end of the treatment. I had 2 egg retrievals and did not have any side effects post retrievals

Make sure you let Dr. Rosen know about your health history

Dr Rosen was much more thorough and thoughtful in reviewing my history before our first meeting. I felt like he actually had a sense of my various cycles and created a plan based on that history (whereas with Dr Cedars, she seemed to just come up with stuff on the fly). I was pretty happy with him as a doctor. My main complaint was the way his care team is organized at the UCSF practice. Again, no one person took the lead on managing my case and that led to a critical error in the end--an error which should never happen to anyone.

You as the patient still really need to take responsibility for managing your case. The UCSF team is there to support you but they are not likely to be as dilligent as you would be. So you need to stay on top of your own course of treatment, schedule, timing of tests, prescriptions, etc etc. It's a pain but will likely lead to be a better outcome and fewer mistakes. Trust your gut!

Dr. Rosen is very honest and straightforward, explained the numbers without sugar coating. He spent a while working with my husband about a decreased sperm count and he was very up on the literature about all aspects of our care

I think Dr. Rosen is a very good doctor and I would highly recommend him.

We used frozen donor eggs, and we did a single 5 day embryo transfer. I used vivelle patch and IM Progesterone in oil injections every other day, which was painful, but I think it helped keep the levels more even.

$23,000 for frozen embryo cycle and meds

Dr. Rosen made us feel comfortable and confident in our decision to go to UCSF. I felt like we had enough access to him to ask questions and enough time with him to get answers that we could understand.

Trust that the process will unfold and that you are in capable hands of a Dr. that cares about the outcome and the patient's well being.

We only saw him once, we were working with the duty doctors, but he was nice, confident, and calm.

You may not see him very often, depending on if he's on duty when you go in for ultrasounds and what not, but everyone at the clinic is awesome.

Birth control to make sure we knew which day to start the cycle, nightly injections for 2 weeks, a few medications, egg retrieval, ICSI, and then putting the embryo back.

Roughly 11K for the procedure and 2k for the medication.

Mitch is an excellent doctor, caring and clinical...honest and ethical about the situation. He did not try to sell us procedures that were unlikely to be effective.

Be honest with yourself, and give everything you can to succeed.

I don't recall the detail of the protocols. We had high egg counts on stimulated cycles, and concerns about multiples, but no actual pregnancies resulted. Mitch recommended that he look inside my uterus. He found a "false wall" of tissue that could have been a cause, because if the embryo tried to attach, it wouldn't get enough blood. That was a good hunch, and was important for going further to IVF and Ovum Donation IVF.

Most doctor's fees were covered by insurance. The one shock was the hormone injection system (pen) the clinic used was twice as expensive with insurance as expensive as mixable one without insurance

He was honest, nice enough, very open, optimistic, great nursing staff.

He doesn't have the best bedside manner in the world, but it's certainly good enough and does a fantastic job of explaining the process, the risks, and expectation setting.

Spent 1+ hours with us at the initial appointment understanding everything. Very clearly explained all my hormone levels. Prescribed Clomid and when we asked about the possibility of multiples he said "I'm not worried about multiples"

Great doctor. Doesn't seem to care about multiples, however!

I thought the clinic especially the nurses were incredible. The only downside is after initial plan was set I never saw Dr. Rosen again and it would have been helpful to speak to him directly. Everything was done in a matter of weeks and the doctor who performed the retrieval was also very nice.

Go in with questions and prepared to freeze.

I don't recall much . except that it took place over three weeks or so.

$12000 - 10k for procedure plus meds and labs

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