Nancy Klein

I appreciated Dr. Klein's clinical expertise and warm interpersonal skills. I ask a lot of questions, and Dr. Klein took the time to answer them all. I left feeling like she was able to tell us more than I was able to learn on my own, which was refreshing. I also left feeling like we had a plan for the next steps. For example, after our initial consultation, Dr. Klein referred my husband to a urologist to get more information about our male factor questions/concerns, and suggested I schedule imaging to get more information about me in the meantime. She was responsive and warm in her written communication via the patient portal in between appointments. Dr. Klein also gracefully acknowledged the financial strain and pressure we are under as people who need IVF but don't have insurance coverage. That is a very sensitive and uncomfortable situation, and I felt that she handled it well. I never felt pressured or shamed to undergo any procedures; in fact, she advised me to wait for certain diagnostic procedures so I wouldn't "waste" the money. All in all, I have had a very positive experience with Dr. Klein.

Come prepared to ask the questions you want to ask during your appointments! She will take the time to answer them.

So far, we have only done diagnostic procedures (HSG, AFC ultrasound, bloodwork).

So far we have only done initial appointments and diagnostic procedures. Our insurance covers very little beyond that. I requested an out-of-pocket treatment estimate from the financial team, and they sent me one. It estimated a cost of $15,000 for 1 IVF cycle with a fresh transfer (not including medications or embryo genetic testing). Frozen transfers are $4500 each, so 1 cycle with frozen transfer ranged from $15,000-30,000. They do offer a multi-cycle price of $30,000 for 2 retrievals and unlimited frozen transfers. That also does not include the cost of medications or embryo genetic testing.

Dr.Klein helped me through the process detailing through from my AMH level, my tubal blockage concerns, my egg quality, window of implantation issues,embryo quality,nutrition and accupunture guidance. It made us be more prepared during every cycle.

Have patience , its not magic and really takes time. Try asking all doubts and questions if cycles are unsuccessful. I had an ERA test done even though my doc said not must but nice to do. Go with your instincts and try every option available.It turned out I was pre receptive and the test gave answers why I had failures.

I had totally done 2 egg retrievals. My AMH level was very low in my 1st round and I got 13 eggs and 21 in second round. After PGS only 4 viable embryo. I followed my nutrionist to increase my AMH and that made wonders with my AMH going from 0.89 to 2.41. I had 4 embryo transfers. 2 failed and I did a ERA to check my implantation window which gave answer I was Pre-receptive hence the transfer failed. 3rd one they added an extra 12 hour injection for my pre-receptive situation which failed due to embryo quality. Finally the 4th one was a success and we had a baby girl in 2022. I took Accupunture in all my rounds.

My 1st 2 egg retreival cycle and transfer was covered by insurance. My last 2 transfers cost me about 5k each. I also had to pay for my ERA about $1200.

I wished patients had a choice on it they wanted multiples or singles. SRM is particular about single transfer. It worked well for me as I had a tough pregnancy and single transfer was best for my age and health situation.

Dr. Klein was very knowledgeable, compassionate, and responsive. She took the time to call back and talk through complicated or difficult topics. She also showed true empathy for our situation but still told us the truth to get us to our family.

You will probably only see Nancy at your consultation and major appointments where big decisions need to be made. But she was very available via email throughout the whole process.

We tried two different kinds of pills on their own and in conjunction with 5 IUI attempts and 4 IVF cycles. None of them were successful in achieving a live birth. 3 of the 4 IVF cycles were canceled due to low/poor follicle response. The one IVF cycle that went to retrieval did not end in a viable embryo to transfer. We finally purchased donor eggs and the first transfer ended in a live birth!

I don’t recall specific prices. We used fertility insurance for the IVF cycles. We paid out of pocket for IUI’s - I think they were in the $300-500 range?? Maybe less.

Dr Klein described all the available options to our during our first appointment. After I was diagnosed with endometriosis, she said that IUI could potentially take more time and required a surgery. Since my insurance covered IVF we agreed that IVF is the best and fastest option for us

Do some research and ask questions. She is very knowledgeable and ready to answer them

On the second day of my cycle I started to take birth control pills and continue taking them for 22 days. They adjusted my protocol during this time, since my estradiol level was not low enough. I had to take birth control for an extra week. My protocol included one dose of Medication between 7-9pm: Gonal-F 300 IU & Menopur 75IU. In 6 days antagonist Centrotide started in the morning. I had an egg retrieval in 12 days: 22 eggs got retrieved. Dr Klein mentioned that half of them didn’t survived ICSI due their fragility. But we still end up with average number of healthy embryos after PGS testing

I had an insurance coverage through Microsoft progyny. After my out of pocket got exceeded, I didn’t pay anything for procedure. Overall cost was about 2000$, maybe a little less.

Dr Klein recommended only one embryo to transfer. I didn’t want multiples

Dr. Klein is compassionate and caring. She listened to our concerns. Dr. Klein took the time to respond to messages and check-in, which we didn’t expect. However, she didn’t adjust our treatment (By increasing our dosage) even after 4 cycles even when it didn’t work.

I would make sure you ask as many questions as possible. Be your own advocate. Don’t be afraid to ask, “why are we doing that?” I wish I would have asked about upping my dosage of medicine in the very beginning.

My husband and I are diagnosed with unexplained infertility and he has a mild male factor. Dr.Klein had us do all tests including an HSG. Dr. Klein wanted to try medicated cycles (with Letrozole) first to see if our timing or my ovulation had been off. We tried that for one month and then because of the male factor, we decided to move to IUIs. We did 4 rounds of IUI on letrozole (but no trigger shot). I was only getting 1-2 follicles and was on a low dose but we didn’t change the dosage. After 4 failed cycles we were set to begin IVF protocols in April but were unable to begin due to COVID-19. Also, we began looking for other clinics in March.

Our IUI procedures were about $650. When we looked at IVF cost, we were going to do two cycles for 27,000 but we have to pay upfront and you don’t know if you will need 2 or more.

Nancy was Very knowledgeable and that made my husband and I super comfortable that we would have success with her plan of action. Nancy predicted it would take us four rounds of letrozole with potential trigger shots and timed intercourse, it took us 3. She was spot on with her recommendations and was very strong in her belief we would be successful which was super important when there is so much uncertainty in this process. I will go back to see Nancy for any future fertility related goals.

Trust Nancy, she is a good patient advocate and has been doing this for YEARS. She is very understanding and knowledgeable so don’t be afraid to ask a million questions. As one of the founders of SRM you are in amazing hands!

I was diagnosed with very moderate PCOS, really just needed to sync my ovulation on regular timing. Nancy was very convinced I would have no issue getting pregnant, looking back I wish I would have listened more instead of letting anxiety take over. She started me on metformin with increasing dosage from 500mg to 2000mg as it has been shown to help women with PCOS, even though it wasn’t medically necessary. She explained to me that it may help, and I was willing to do anything to boost my chances. Since my periods were normal she tried a low dosage of letrozole (5mg) on days 3-7 for the first round. That didn’t seem to get the response from my ovaries so we stepped it up to 7.5mg. One more unsuccessful round in November with a trigger shot (started in October), December cycle we were pregnant with the help of a trigger shot. The process of pregnancy diagnosis and handoff before I went to my OBGYN was amazing. Ultra sound machines are high quality and the nurses were so kind and were happy to answer my questions until my handoff at 8 weeks to my OB. They also ran a blood panel test on my thyroid (standard practice when you get positive pregnancy) and they found it was slightly stimulated, so they started me on a micro dose of thyroid medication which worked immediately. This ultimately helped reduce miscarriage risk in the first trimester which shows they not only give amazing care pre pregnancy but during pregnancy as well.

We probably spent ~$1,500. Our situation was tricky because my insurance through progyny covers fertility care and costs in a weird way, for example you get 2 pies to allot to care coverage and IVF takes away 3/4 of one pie. Since we used drugs and timed intercourse - which was about $50 a round for three sounds, we wanted to have backup coverage for IVF if it was needed since that is $10k. The biggest expense was the $175 ultrasounds I needed 2x per round sometimes 3.

This was not something that applied to me.

Dr Klein is experienced. Knowing what it is like in healthcare, and especially ART, she has a tough job. She has to come along side the couple and believe in the impossible with them but remain objective, analytical, and realistic. Her presence was comforting and she was understanding with each tear, but sensible too. I was disappointed when she wasn’t going to be doing our harvest but the rationale made a lot of sense. I would have liked to hear from her after the harvest but I have a good connection with her nurse so that worked. Also, Dr Klein was very responsive to my portal questions, even during off hours. Those little things were noticed and appreciated.

Try to put yourself in her shoes when you are tempted to feel slighted. Emotions run high for her patients and she has to walk a careful tightrope to make us happy. Dr klein’s Experience shine through her work. She (and her team) has done everything with in power, knowledge, and skill to set us up for success as far as I can tell. I know we are in good hands.

Fairly standard IVF for a 41 y/o female using own eggs to create embryo(s) for transfer to a GC.

Can’t remember

Nancy has always been gently and compassionate, but thorough in her explanations and delivery. I am a big question asker and she is always ready to answer and deliver news in a way that works for me. I’ve never felt like her approach is one size fits all, and I’ve always felt good leaving her office.

Tell her what you need from her from the beginning, and that is what you will get.z

We started with Letrozole IUI and when 2 didn’t work, moved to menopur for 2 or 3 more. I over responded for one of those, was advised of the risk of multiples and we decided to proceed. We tried one more round this way and we’re not Successful. Nancy understood my financial contrraints and helped us qualify for a clinical trial at no cost. This was the RITA double blind trial. I did end up responding to the study, and used the antagonist ganirelix, but we only ended up with one out of 5 viable embryos. It arrested by day 5. We met with Nancy immediately after the failure and she explained what she had learned about how I responded and what she would like to do differently next time. She assures us that this trial would not be indicative of our next cycle and even said she wanted to consult with her colleagues to make sure they found a protocol better suited. We took a few months off, used Letrozole and timed intercourse and just had our 6th and final failed IUI. We weren’t ready to jump back into IVF.

The costs of the IUI were close to 800 per cycle. Nancy was mindful of our budget and prescribed meds accordingly. The clinical trial was free, and they will discount our next IVF due to the fact that we were not successful. (That was not a part of the study)

It would be nice to have a check in from the doctor besides hearing from our fertility coordinator (nurse) when we are initiating a new cycle. It was nice to see her doing one appointment for a procedure and she walked me through the entire process.

Ask whatever questions or concerns you have and she’ll provide resources

I felt that they were listening to my concerns since I’ve had a child from a previous relationship and was concerned about hormone meds. They allowed us to do a natural iui as we requested and provided all the information and answers for the follow up medicated iui if needed. Dr Klein and her team were quick to answer emailed questions for confirmation.

Communication with the clinic directly regarding estimated costs were not reliable. However, our insurance was able to cover most of our fertility treatments.

N/A

Nancy Klein was very personable upon first meeting her. I liked her and thought that her recommendation for mini IVF was great. The problem was that I didn’t see her after that, not talk to her about the treatment. She wasn’t available during the monitoring stages and was away on a trip when I was informed that the IVF would need to be switched to an IUI. This was incredibly upsetting, stressful and left me feeling very abandoned (first time ever doing god type of treatment). I liked her but the way SRM operates was not for me.

You won’t be working directly with her so make sure you like SRM as a whole.

I was on a “mini IVF” treatment plan. They have a certain number of follicles that they require to be growing in order to move forward. This wasn’t explained in detail to me and my cycle was cancelled. I had 3 various injectables, all low dose, and a trigger. Progesterone tablets to follow converted IUI.

Mini IVF was about $10,500 and meds were around $800+

Dr. Klein was very caring and compassionate about our situation, in addition to being very knowledgeable and experienced. She answered all our questions patiently and provided explanations in language we could understand. When parts of my cycle weren't going according to plan, she reached out personally by phone to check in and reassure me. It's obvious that she's a very busy doctor, but she never made us feel rushed or like we were a bother. I felt like she really took the time to understand me and my medical history before each step of the process.

Appointments are short, so come prepared with questions, and don't be shy about asking them.

I don't remember exactly, but she thoroughly explained why she had chosen the protocol that she did.

Consistent with the national average. We compared costs with the other major clinic in the city, and they were almost identical.

I am an out-of-state patient with Dr. Klein. She went out of her way to perform my transfer when she could have had her regularly scheduled colleague complete it. She had a conflicting appointment that day but I was very happy to meet her for the first time at my first visit (also my transfer day) at Seattle Reproductive Medicine-Seattle.

I would simply advise that she is warm and informative as I expect an RE to be. She was recommended to me by the people at Embryo Adoptions of Cedar Park.

I've had two frozen embryo transfers with hormone replacement therapy with Dr. Klein. Baseline US, then 2mg of Estrace TID. Bloodwork for estradiol and progesterone and US to evaluate endometrial lining before starting vaginal progesterone BID and daily IM Progesterone. Embryo transfer 5 days later. All my US and bloodwork resulted within desired limits.

$2660 for out of state patient FET. Monitoring was done remotely in CA. A one time $500 Embryo adoption coordination fee.

She initially recommended eSET for these first 2 transfers because the embryo quality was great and the eggs came from a 28 year old egg donor. However, DR Klein said she will probably recommend an ERA and/or start transferring 2 embryos with the next (3rd) transfer.

Dr. Klein was compassionate and kind. She didn't force donor eggs on me right away even with my less than stellar test results and gave me hope while also being realistic every step of the way. We felt that she was genuine and that as patients we mattered.

go with your gut and make sure you are comfortable with any doctor you see. Just like test driving a car, anyone can make a recommendation but you'll know when the right doctor comes along. Do your research, read reviews. And get consultations.

We tried multiple iris with different meds... clomid and femara. She felt with a POF diagnosis iui may be my best attempt to save money since my chance of producing eggs was low. We then tried multiple iui with injections like menopur and gonal f. we tried starting anywhere from cycle day 1-5. Many attempts were made at my request before we agreed deivf was our best option.

An average iui cost was around 400-600... depending on meds type it could be more.

She was excellent and was very patient and explained everything thoroughly. She was knowledgeable and had a plan for whatever course we were/are ready to pursue. She never pushed me to do any treatments we weren't ready for and was supportive of the research i'd done and allowed me to direct my next step(s) with her guiding me along. I highly recommend her

Don't be scared to tell her how and what you'd like done. She's very receptive to the research you've done and the course of treatment you see fit for your body. She's a strong advocate for listening to and knowing your own body

Weight loss (not required but recommended), levothyroxine (hypothyroidism), Femara, trigger shot, monthly ultrasounds and bloodwork. I ovulated successfully every month, got pregnant once but miscarried by angel at 6 weeks

They billed most everything under my PCOS, so most bloodwork, ultrasounds, and medications were covered. Unfortunately, IUI and IVF will not be

When we pursue IVF, she will only allow 1 embryo to be transferred at a time. That is my biggest complaint and fear. I strongly feel and want to transfer 2.

I am so incredibly thankful for Dr Klein. Her compassion, honesty, caring, patience, and experience is second to none. My diagnosis is due to some very complex medical history and she took the time to understand my history. She was very honest about our options and how we could proceed. She was patient and understanding when we wanted to take some time between diagnosis and treatment to adjust our supplements, diet, and emotionally deal with our diagnosis. I was incredibly thankful she did my egg retrieval as she was able to discover some info on my anatomy that was helpful for my transfer. She didn’t do my transfer, but Dr Thyer was amazing and I felt very comfortable at transfer. Graduating from our clinic was bittersweet - I cried as we will truly miss Dr Klein!!!

Have a list of questions with you to ask and discuss! She takes the time to make sure you understand and all questions are answered. You can also send questions via the portal, she is very responsive!

As we did a freeze all cycle (we thought I’d need another surgery before transfer), she was a bit more aggressive with my dosing - 300 iu of gonal-f, 75 iu menopur, plus cetrotide. Dosed for 9 days. Ended up with 12 eggs, 10 were mature, 7 fertilized (with ICSI as my husband was 37 at the time), 2 embryos frozen and biopsied on day 5 and 1 embryo frozen and biopsied on day 6. 2 of the 3 embryos were normal (one from day 5, plus the day 6). Dr Klein said this was very normal/typical and we had adjusted my protocol if we needed to do a second round. We did not as our frozen transfer (3 months after retrieval) was successful and I’m pregnant (15 weeks, Singleton, single embryo transfer, all genetic tests are normal)! We still have one frozen embryo. My FET was medicated - with endometrin, PIO, and estradiol.

Frozen cycle: 11,950. FET: 3,500.

Dr Klein strongly recommended single embryo transfer as I have a ton of abdominal scars and scar tissue, and a twin pregnancy would be super high risk. I agreed and my OB was in 100% agreement - she was also against a multiple embryo transfer.

Strengths: kind, compassionate, smart, took my case seriously, utilized her peers to consult for advice on treatment, optimistic, very available and quick to respond to emails. Challenges: didn't every really change my treatment protocol, which after three failed retrievals I would of thought she would, which is why I eventually left her. She wasn't as aggressive as I would of liked. She never recommended any sort of supplements or anything. She was a little indifferent about my recurrent failure.

She is good but if you have one or two failures with her I would seek advice from another clinic and doctor, one with a very good reputation for aggressive treatment.

The first two treatments were focused on stmulating the most possible eggs, which worked well, I indeed had many eggs. however, the issue was the egg quality as the embryos often began deteriorating on day 4-6 of development. The third cycle she took a different approach which was a less aggressive stimulation but longer, to see if that would improve the egg quality, but it did not have different results. I still had a high number of eggs retrieved and no good embryos as of day 5-6.

We spent about $45,000 out of pocket in 2017 for three rounds of IVF.

She had a very strong prefernce to only transfer one embryo at a time. She also never recommended PGS/D, so this was always something I disagreed with her about. She had the attitutde that PGS/D made no difference in the end, but in my mind it made a huge difference, as undergoing failed transfers because the embryo s bad is earth shattering. I think she doesn't quite realize the impact a failed transfer has on the psych.

Dr. Klein was great, she set us on a good course of treatment for our infertility and got the ball rolling very quickly. Though we only saw her for our initial consultation and for another check in, the course of treatment was designed by her and worked well in our case, despite us having an early miscarriage.

Ask a lot of questions!

We have male factor infertility so we were basically heading into this with the knowledge that we would be using icsi. I also have PCOS and was prescribed metformin. We did a very typical ivf round with standard stims and injections for 11 days, retrieved 29 eggs but only 10 were mature as a result of PCOS. Unfortunately we only had one egg that made it to day 5, so it was our only option for implanting. We decided to not do any testing so we could have a fresh cycle and we implanted and had strong initial HCg levels, but miscarried due to a sub chorionic hematoma at 6 weeks.

The price was 10k not including medications (this was the insurance contracted amount, they can’t charge insurance companies the same amount the charge people, the actual IVF cost for people without insurance is 15k) we paid 3k for meds, 5500 out of pocket initially and another 4K when our insurance didn’t actually cover anything (reduced from 6k by negatotiating with the bill collectors). So out of pocket total we paid 13k.

The doctor explained that I was you g and healthy enough that multiple eggs were not needed for transfer.

Dr Klein was so warm and inviting and didn’t make me feel like my infertility was my fault. She presented many options, was patient and kind and had the highest standards for the care she provided. Though an extremely scientific process, Dr Klein never made my treatment feel too clinical or sterile.

Be upfront with your goals and timelines if they are important to you. Listen to her advice and try not to get too far in the weeds of “what if’s”. She advised IVF early on but because I knew more about IUI, I opted to try that several times first. Turns out, they were a waste of time and money and IVF was inevitable. I wish I would have listened to HER rather than friends/family/societal norms.

Out of pocket, I think the cost for my cycle ended up being about $4k, but I had great insurance that had a $20k infertility lifetime coverage.

Dr Klein did recommend a single embryo transfer, which I was surprised by since you hear about so many IVF pregnancies with multiples.

We have 1 viable embryo left from a 2017 cycle. And are completely out of pocket so this is our last cycle. Knowing how much rides on this last FET, I recently brought her a list of additions to get her opinion. We went through each one and she helped me weigh the options and decide together on a course of treatment for FET that we feel comfortable with.

2014 cycle - Follistim 300, Menopur 75, Galenrlix. trigger on Day 9. 13 retrieved, 11 mature, 8 fertalized via ICSI, 4 made it to Day 5 to PGS test, 2 normal. First FET resulted in 7/2015 birth. Second FET in 2016 resulted in chemical. 2016 cycle - Gonal F 450, Menopur 75, Cetrotide. trigger on Day 9. 11 retrieved, 8 mature, 5 fertalized with ICSI, 3 made it to Day 5 to PGS test. No normals. 2017 cycle - after being on supplements, some of which were recommended by Dr Klein. Follistim 450, Menopur 75, Ganerlix, trigger Day 9, 7 retrieved, 6 mature, 5 fertalized, 2 made it to Day 5, 1 normal. Because of my age (40), she felt the max dose was warranted. I was concerned that high meds impacted egg quality but she explained it's a numbers game - trying for as many eggs as possible because the number of normals declines rapidly as we age.

$13K per retrieval and ICSI, $2500 for PGS testing, $4K for meds.

We were adamant we only transfer one at a time and did PGS to help improve our chances. She never tried to talk us out of our preferred approach.

She was very happy to talk to us, we never felt rushed, even when the husband started talking about articles he'd read and wanted to know the nitty gritty biology stuff. She was friendly and kind during procedures.

Ask lots of questions. If you want her to be involved in any treatments make sure you say that. Or at least find out the odds of whether or not she'd be the ones doing things like the IUI. I don't think she did any of the IUIs for us, which was fine, but it was a bit odd to see three different people each time.

We did about 3 cycles of clomid with Nancy, standard dose. When those didn't work we moved on to IUI with clomid for three cycles. I only needed the HCG shot for one of them I believe. We were going to move on to IVF but the cost and some marital difficulties put that on hold. We haven't been back since.

Nothing was covered by health insurance after a diagnosis of infertility. I think it was probably about $1000/visit on average. Costs for IVF, which we didn't go through, seemed on par with the market, probably too expensive for us. So appointment visit, iui, sperm analysis, HCG shot were the typical charges.

She seems busy but is kind and caring during telehealth visits. we have only seen her via telehealth visits which makes it a bit harder to judge her character. She has been compassionate towards us as a queer couple, acknowledging what other queer couples have done and what we may consider. She is kind during her visits. Most of the time she is a bit late to the telehealth visits.

Just know you may never meet her in person.

We’ve used letrozole to stimulate ovulation earlier for my IUI procedure. I was given ovidrel as the injection but I did not take it.

Not bad

Dr. Klein listened to our questions and addressed our concerns. She provided us with information in many different forms (consults, literature, statistics), and was patient with us while we processed.

Carefully ask about next steps so you can limit unnecessary visits or consults (I.e., save money)

We used ICSI because we had unexplained infertility.

$16,000

She recommended a single transfer. After consideration, we intend to request a multiple transfer and are willing to accept the health risk associated with a multiples pregnancy.

Dr. Klein cares about her patients. She listens to me, anticipates, my concerns, and adjusts my treatment when something isn't working. She's up to date on the latest research and is constantly suggesting different options when something doesn't work. There are a lot of things are still unknown about fertility, and she is candid about that, but tries her best to give informed answers whenever possible.

Don't be afraid to ask questions and be your own advocate. Dr. Klein encourages this and often can offer different options and solutions if you are not satisfied with the course of treatment.

Medicated FET, natural FET

Nancy is a very caring person and a professional. She is a mother of 4 and really listened to what I wanted. She took the information I gave her and quickly put in place a plan to achieve our goals. I had complete confidence in her and her team. Her partners made me feel very comfortable, but I am glad she is my primary physician.

Tell her exactly what you want. How many kids ideally. She will be truthful about your odds etc.

I lived in another state and had my appointments at a local clinic

Dr. Klein is a wonderful doctor. She is very personable and listens to everything you say. It's great to have a Doctor that takes the time with you. It is great to have a doctor like her, especially going through a stressful IVF procedure. I trust her and I want to thank her for everything she has done for the family.

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Start antagonist before STIM cycle starts, and use the regular medications throughout the cycle.

Don't remember as they bill insurance directly. My out of pocket expenses are limited.

No comment as I only have one viable embryo that is healthy.