Rachana Garde

Shady Grove, and Dr Garde, may not be for everyone but they were great for me. They run a big operation, and some people may not like the feel. For me, there was always someone there to respond or see me on a moment's notice, bloodwork is run quickly, etc. Dr Garde clearly has many patients and is booked fully and isn't always the one to reply to emails or even do all the procedures (her nurse team and other doctors assist). This doesn't bother me - They were always well-coordinated and she was there for the at the times that mattered.

Use Dr Garde if you want someone matter of fact and willing to explain things fully. I don't require a ton of empathy or bedside manner, someone who needs a high level of warmth may not get it from her simply because she's busy and direct.

We did 3 egg retrievals, all with the same drugs (gonal-f, cetrotide) but varied amounts. I produced a high number of eggs for my age but after my first retrieval it became clear that quality could be my issue. I did genetic testing in my first two cycles and decided not to in my 3rd cycle (then eventually came back and did genetic testing on 2 frozen embryos from that 3rd cycle - now my daughter!).

I don't recall exactly, but my insurance covered the vast majority (I was very lucky for this) but not genetic testing, which I recall being about $5000 per attempt.

SGF policy is pretty strictly adhered to. If embryos are genetically tested and normal, then only one can be transferred. They won't transfer abnormal embryos. And in the case where we didn't do genetic testing, I was allowed to do multiple and I chose to transfer 2 embryos at once in consultation with Dr Garde (I did this twice - once was fresh and I failed to get pregnant; once was frozen and I miscarried).

Doctor Garde is wonderful I can't believe how understanding and patience she is with me. I'm a strong person and even Dr.Garde has a was of bring the best out of a tuff day. She is always very good at coming up with a plan and always making sure me and my husband are comfortable. She is very good at listening concerns and always will to try and coming up with a solution. There are no words to describe her she is one of the best doctors I have ever had. Doctor Garde is truly my blessings and I can't wait to continue our journey. I truly believe that if any Doctor can help me with having a little angel it would be Doc.Garde.

Be honest, trust her judgment and everything will just fine. Trust that she always has your best interest at heart.

I'm a self pay so paying was not a problem. I was always told how much my next appointment payment would be. Most of the time it's a estimate price.

Dr. Garde was very sweet and caring I wish she would have performed my procedures and that I actually saw her and not just communicate over the phone. I didn’t feel the personalized experience that I had expected. I would go in to the office twice a week sometimes three and I never got a warm and fuzzy from the staff. I had to contact a supervisor on one of the nurses because she was being very insensitive. I also had a hard time dealing with the fact that they allowed children to attend appointments.

Demand to have one doctor do all of your procedures instead of a different doctor each time.

Dr Garde put me on very high dosages of medication due to quote, my age. I took 450 iu Gonal F, 150 iu Menopur, Cetrotide, and 10000 HCG. I hyper stimulated my first retrieval and was in extreme pain for a month. The next cycle she change my trigger to Lipton and my ovulation was delayed so she switched me back to HCH for my third cycle.

12,500 plus HCG and monitoring cost $700

I do not

Dr. Garde is very personable and relatable, and is the only woman that practices at the clinic I was at. In hindsight she was a little too optimistic and her hopes for a pregnancy with my own eggs ended up costing me a lot more than I thought I would expend to get pregnant, finally only having a viable pregnancy through donor egg (and two separate donors at that). I only saw her in person twice, once for my initial consult and once during an early ultrasound with my first pregnancy. The rest of the time all comms came through the nurse. I did have several phone calls with Dr. Garde to discuss the outcome of my miscarriages and the way ahead. She was always very supportive, but I feel like almost too gentle without providing solid recommendations for the next step, ie when to move on to donor egg.

Ask her the hard questions, because she will not tell you unless you ask. If you ask, she's very forthcoming.

I did 3 cycles using an "antagonist" protocol, each with increasing doses of menopur and gonal F. My first cycle rendered the most eggs and embryos, but none of the cycles ever ended up producing a PGS-testable "blastocyst" and so embryos were implanted without testing, resulting in miscarriage or BNF. First cycle implanted 3 embryos resulting in week 11 miscarriage. Second cycle implanted 2 embryos resulting in week 7 twin miscarriage. Third cycle implanted 2 embryos resulting in BNF. Dr. Garde never explained the rationale behind the protocol or the increase in dosage or why she didn't want to use a different protocol. After the third cycle I moved on to donor egg.

I was a self-paying patient (no insurance coverage) and was provided a 25% discount for being active duty military. First 2 cycles were purchased as a group for ~$17000 (with discount) and 3rd cycle was purchased separately for ~$12000.

We discussed very early on my desire for a singleton, but was convinced that due to advanced age that more embryos needed to be implanted, and my decision was helped because the embryos were not of freezable quality, so it was either implant or destroy, so I did the multiple embryo transfers.

Rachana was very informative and was able to answer any questions we had. She was friendly, listened to put concerns and was supportive in our decisions whilst also advising on what she would recommend for our course of treatment and what testing was needed to track hormones abd other factors affecting our situation.

Come prepared. She will ask what you know about your situation when you meet with her. Also don't be afraid to speak up for yourself and tell her what you want to happen.

We decided on an IUI cycle because previous unmonitored clomid and letrozole cycles resulted in no pregnancy. The protocol started with letrozole 5mg for 5 days, followed by ultrasounds every 3 days. This disagree had no effect on follicle growth so she added Gonal-F 75IU injected once a day for 4 days followed by another ultrasound. There was still no follicle growth so the dose was increased to 150IU and continued for another 3 days. The next ultrasound also showed no change so Dr Garde then informed us that in order to increase the dose any more would need to switch to an IVF cycle in case of OHS and maturing too many follicles. We could not afford to switch to IVF so we cancelled the cycle without completing the IUI.

The cost for the IUI procedure was approx $3,500. We got a portion of that refunded because the cycle was cancelled. The medications totalled approx $1,500.

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She’s in the office often performing ultrasounds, and just by the ultrasound area so it’s nice to be able to have a quick convo without scheduling something formal. I’ve gone through several cycles at SGF with her, and she calls with results sometimes as well. I appreciate her want to work with me on what I’m comfortable with and not rush me into anything.

Dr Garde is my primary RE. She may not perform every IUI or Egg retrieval, but she gets the information and makes the decisions and either she or her immediate staff contact me. She works for a clinic with multiple offices and RE's. She is very thorough and takes the time to explain the options and processes involved.

Be open about your situation and ask questions. Oh and take notes.

First 2 IUI's were with clomid. No pregnancies. Next 4 IUI's were with FSH and trigger shots. 1 pregnancy ended in miscarriage due to genetic problem. ER-rationale- age factor, need to move on from IUI. 2 egg retrievals. Both using FSH. 1st-2 embryos that were PGS tested as abnormal. 2nd-3 embryos have been sent for PGS testing. Awaiting results.

IUI's were covered by previous insurance. Insurance no longer covers infertility. Multi-cycle IVF pkg with ICSI and Assisted Hatching = $21,500. Does not include meds or PGS testing.

No comment

Dr. Garde was easy to talk to and she really attempted to get a feel for what was important to US.

Travel as far as you need to to see Dr. Garde!

We traveled from another state because having a singleton was very important to us. Dr. Garde understood that. We did two cycles with her and she always adjusted the protocols as needed along the way.

Another reason we chose this clinic is because they had one of the most generous shared help plans in the country. We did misunderstand the plan (our fault) and did not use it the first cycle (although we had an income-based discount). If we had had a full understanding of the program, we would have ended up saving ourselves the cost of that one cycle.

She is a wonderful doctor, we dont see her much but when we do she gives all the information and answers any and all questions. Shes very polite and kind. She draws pictures to help us understand and stops along the way to make sure we dont have any questions

Ask questions

We used Clomid for 5 days, had 3 fertilized, this was expected. Then did ovidrell to trigger, then performed an IUI. Everything was perfect in terms of lining and eggs just unsuccessful

For our first iui we spent 1800 not including medications which were a little over 200.

Understanding, patiently explained all treatment options, warm personality!

She splits time between the Annandale and Woodbridge offices and isn't frequently available in Annandale. If it is important to you to actually SEE your doctor frequently, I'd recommend the other office location or selecting a different doctor.

Each cycle we added another element: Clomid only, Clomid + IUI, Clomid + Injectables + IUI

The fact that she would leave me a voicemail with devastating news about the status of our embryos tested with PGT with no way to get in touch to learn more about why or details was HORRIBLE. She showed little compassion or care to leave news like that without talking to a patient directly. My sister's doctor (also at Shady Grove) called her day of her retrival to see how she was feeling but I got no such call from Dr. Garde.

Be prepared to have your expectation set and wait to see her. Also check and see if your insurance is covering what costs are for out of pocket meds and then filing a claim later. Insurance rates for medication were not "discounted" and my $15,000 lifetime benefit didnt cover all drugs for the first round, which was subsequently cancelled.

. We started with a protocol that included 450 iUs of GonalF daily, 150 IUs of Menopur, and then Cetrotide. That cycle resulted in a cancelled retrieval due to development of a dominant follicle. The 2nd cycle started with 10 days of birth control followed by 2 days of Lupron Injections (2x daily), 450 IUs daily of Gonal F and 150 IUs daily of Menopur. This resulted in 3 follicles with 2 eggs retrieved, 2 healthy high quality embryos, but one had genetic condition and other chromosomal issue.

eSET is doctor and insurance preference