Rachel Ashby

Dr. Ashby is one of the very best in her field and I trusted her recommendations and process completely. She carefully reviewed our case, gave us an extremely tailored treatment plan, and clearly communicated the reasoning behind her recommended approach. Dr. Ashby and the Brigham team went above and beyond to give us the best shot at a healthy pregnancy; we had a complex case, and I believe she even asked Embryology to devote additional time to match the best eggs and sperm to give us viable embryos. I also felt she very carefully calibrated my IVF medication to ensure high quality eggs (as opposed to high quantity). I appreciated that she was direct - when you're undergoing IVF, it can be tough to hear IVF treatment may not guarantee success - but I respect that her intent was to manage our expectations and mentally prepare us for possible outcomes.

Several good girlfriends of mine recommended Dr. Ashby to me, and I think my expectation was she was very warm and cuddly. Dr. Ashby IS an extremely empathetic doctor, which I value immensely. She can be direct and it did take me off-guard once or twice - I am only sharing this to say that Dr. Ashby is truly prioritizing your best interest and wants you to have success. She was honest and managed my expectations (I walked in thinking this was an easy case, and it was more complex - that can be hard to hear but I appreciate her honesty). The IVF doctor at our prior clinic we had left sugarcoated everything, and I was devastated when the cycle failed - meanwhile, Dr. Ashby was upfront, but she managed our egg retrieval and transfer perfectly. Dr. Ashby is looking out for her patients, she is compassionate, and she truly wants her patients to have success.

We used Antagonist protocol (Gonal F, Menopur, and Cetrotide), with a Lupron trigger. We did not do PGTA testing we were working with fewer fertilized embryos. We did ICSI, as well as 3-day and 5-day transfers. I took a prenatal and CoQ10.

Lab and ultrasound monitoring appointments varied. - The 850 Boylston location was probably the fastest (in and out within about 30 minutes) since they have set hours set aside for IVF patients; having said that, your ultrasound will be with a lab tech and they usually can't disclose much. This is the best location for basic labs and monitoring. - There is Newton Wellesley and that can vary, having said that, it can take 45 min-2 hours (erring on the longer end if you go in the day before a long weekend). - Monitoring at Brigham in downtown Boston can vary (it can run over an hour if they are short-staffed) - I believe the pro with ultrasounds at Brigham is that there is often a doctor who stops in. If you do get pregnant and are at your 7/8/9 week scan, this may give you the most peace of mind because an ultrasound doctor stops by and can confirm heartbeat and such. None of these felt like cattle calls, but 850 Boylston is the fastest, whereas downtown Brigham may be best for more critical appointments like 6-8 week pregnancy scans.

I believe a round of IVF and transfer may have ran about $22K (but I could be wrong) - the majority covered by insurance. This may seem more costly than similar IVF clinics in the Boston area, but Brigham's approach is to get it right the first time, whereas other clinics (BostonIVF) are happy to charge less but encourage 3-8 egg retrievals plus transfers and not changing protocol between procedures. I'd rather pay more and get things done right with 1 egg retrieval and 1-2 transfers, since IVF is expensive and takes a toll on a person's mental and physical health.

We transferred multiple embryos, which made sense for our diagnosis and my age (>35).

Dr. Ashby is all about woman empowerment. She had a good approach in discussing my fertility options and advocating for myself as a woman, a caregiver to do what was best in my health for me. She was straight with the facts, but empathic about the journey i.e. hormones, appointments, and possibility of not getting a pregnancy test.

Be prepared with any questions as both of your times are valuable.

I started with Oral Birth Control on Day 1 for about 12 days - 5 days later when menses began had a baseline ultrasound. I took 300 IU of menopur in the AM followed by 300 IU gonal-f in the evenings. After 5 days, I started cetrotide in the AM along with the menopur. I stimulated for ~13 days then trigged by HCG intramuscular shot (evening) followed by retrieval two days after trigger shot

I have a high deductible insurance plan for my husband and I. I require to pay $3000 toward my deductible which I did with IUI/testing at a previous clinic. My prescriptions were covered with no coinsurance and all medical appointments were covered. Prescription (including additional needed for my cycle) would have been ~$30k for initial order and $13k for additional. Medical appointments were ~15k, but again did not have to pay anything out of pocket. I did do the genetic testing through Myriad. My insurance didn't approve it, but I'll likely pay $350 out of pocket.

At this was my first IVF cycle and I'm classified as Obese (Cat III) she elected eSET. I don't think I'd be a candidate for MET due to my weight.

Dr Ashby is wonderful. She focuses on getting the best outcome for the patient and takes into account their specific circumstances. She is highly skilled with complicated cases. She is direct and explains the medical protocols and procedures in a very approachable way (often drawing pictures). She takes the time to answer questions and thinks about the patiently holistically - including your emotional and mental health.

Lupron Flare protocol with Dr Ashby (after 2 other protocols recommended for DOR / poor responders at another clinic); we timed the start of the cycle to coincide with natural cycle (as opposed to using birth control) - since I do not have a uterus, this requires more blood work with the nurses at the beginning. My egg retrieval was expected to be done transabdominally (even though I have a healthy BMI) but ultimately both ovaries were not able to be accessed abdominally and the procedure was completely vaginally. We retrieval 9 eggs, 5 fertilized (in my prior cycles at another clinic we retrieved 1 eggs, 1 fertilized and 2 eggs, 2 fertilized).

I have fertility coverage with my insurance: out of pocket costs were $800 for embryo freeze storage and $140 for scripts

I froze 2PN embryos and will be using a gestational carrier; Dr Ashby was supportive of using two embryos given 2PN embroys have a lower chance of pregnancy

Dr. Ashby is as knowledgeable as they come and it shows in her delivery. She is kind and patient, has good bedside manner and is caring but she is also direct and to the point and doesn't sugarcoat things but she is flexible and listens to the concerns of the patient.

Come ready with questions, be open and honest.

2 round of IUI on clomid, meds for retrieval were minimal with desired results, mock transfer to measure placement. Retrieval and fertilization without ICSI for first round. We did PGS so froze embroys after Day 6.

Insurance covered 90% for us. IUI was $300 range and IVF retrieval and testing was $875. Meds were $2,500 before deductible for retrieval

Dr. Ashby is a big proponent of single ET vs multiple. I would not suggest Dr. Ashby if you're looking to implant multiples

Dr Ashby is extremely intelligent and a great communicator. She will explain everything in detail without having anything be misleading or related without clarification. She has shown that she has been doing this for quite some time so she doesn’t give way to sympathy however her tone and manner shows she cares. She treats you like you are the only patient. When there was an issue with my insurance she called them the day it happened to resolve the problem. We absolutely adore her and love that she doesn’t sugar coat anything and gives false hope and emotions.

She will tell you everything in detail and assertively. She is extremely talented and intelligent. She has the same goals as her patients and strives to get you to achieve that goal.

In process now

5,000

She has a strong preference towards SET. She explained the risks which we were not comfortable with. I don’t know that she will do a DET as we have the same feelings.

Dr. Ashby really knows what she’s doing. She was candid with me and set realistic expectations, which is very important. She advised on the best treatment for me personally and helped my husband and I think through decisions.

Ask questions if she talks too quickly.

Birth control for 12-15 days, break, injections including Menupur & Gonal F, trigger shot. Then for 10 weeks Endometrin suppositories twice a day.

My IVF was covered by insurance so I’ve had to pay copays for ultrasound and prescriptions. That ended up being pricey but that’s because of my insurance plan. They were very helpful with helping with costs and contacting the insurance provider.

We ended up transferring 2 embryos based on their recommendation. Dr Ashby’s advice was based on my age and number/quality of embryos. One of the embryos took so I’m glad we transferred two.

Dr. Ashby is pretty straight forward, she definitely gives you a dose of reality, but in a compassionate way. Prior to seeking her help I had one cycle converted to IUI, and one cycle where I ovulated prematurely when I went in for retrieval of two follicles (both at Boston IVF). My numbers were not good when we met - my FSH was basically 12, and she did not think my chances of getting eggs were great. We discussed considering donor eggs, and tried to help me see that a child that wasn't genetically mine would still be a child worth loving. She also said that she felt IVF cycles might be robbing me of getting pregnant naturally, because I was spending a lot of time to get one egg, which I was already getting each month on my own. I left her office a MESS. My previous doctor had mentioned donor eggs, but had seemed more optimistic about my chances of conceiving with my own eggs. It was definitely a hard conversation to have, but I appreciated her candor. Despite her concerns, Dr. Ashby said she would try her most aggressive approach (Lupron flare) to see if she could wake up my ovaries. It felt like it was going to be a last ditch effort, and if it didn't work, I was likely to stop trying. Well it did work. I stimmed for 18 long days, but they retrieved 4 eggs, all which fertilized and were frozen (my progesterone had spiked so I had to freeze all and wait to transfer in the next cycle). Dr. Ashby was SO happy for me. She said she had hoped for 2, and was amazed I got 4, and they all fertilized. She was newly optimistic for me - and said she would definitely do it again if this time didn't take, based on those results. Ultimately 3 were transferred (4, 7, 10) but none stuck - so we are back at it again next month. But Dr. Ashby is confident now - and said the two larger embryos were really nice - so my chances aren't bad.

Dr. Ashby wants you to succeed in getting pregnant, that is her goal, she is on your side.

We did a lupon flare protocol. BCP for 10 days before cycle, then 300 iu Menupur and diluted Lupron in AM, and 300 iu of Follistim and diluted Lupron in PM. The downreg of Lupron really slowed me down so they could kick as much FSH into me as possible. My follicles grew really slow, then in a day grew 5mm all of sudden. Ultimately I stimmed for 18 days before an Ovidrel trigger and retrieval.

the appointment was $645 to meet with the doctor, my meds were about $30k (but that was billed to insurance so I don't know the real cost) my surgery for retrieval was $12k and the transfer was $4,500. I am so fortunate to have had insurance coverage.

We transferred 3 - Dr. Ashby said she would transfer 2 if they looked good or 3 if they looked not great. The embryologist said the algorithm they use said to put back 3 - but the smallest was only 4 cells so I kind of felt like that one was a low chance shot of 'why not?' since the 4th was only 3 cells - it didn't make it to refreezing.

Dr. Ashby is fantastic - just because I have not yet gotten pregnant, I do not blame her. She is very knowledgeable and will even call you on the phone if the wait to see her is too long. She works with a team which has its plusses and minuses. They brainstorm together which helps to come up with a good plan and they can compare experiences against a lot of other patients. It does sometimes feel weird, though, when you go in and have a different doctor do your transfer or retrieval. But I honestly don't mind, because I believe their team to be one of the best around.

I wish she could be more available to each patient, but I also know that she has a ton of patients.

My first two retrievals we started medicine mid-cycle (so I waited until I ovulated and then we started a few days after that.) I apologize as I don't remember the names for all of these treatment strategies. The first cycle didn't produce as many eggs as the second, but neither was successful. I did not get a positive pregnancy test from either. For the third cycle, Dr. Ashby said she wanted to be more aggressive so we started medicine right after my period began. On that cycle, I produced 16 eggs which is great for someone my egg and we fertilized 13. Of those, there were 4 5-day blast embryos. I transferred two in a fresh cycle and then two in a frozen cycle. Again, I did not get positive pregnancy tests from either of those cycles, but I felt like we were headed in the right direction.

I have insurance coverage for the IVF cycles but I still had to make a copay of about $2,000. And the first cycle my pharmacy costs were around $900, but after that they were free.

Because of my age, I was allowed to transfer multiple embryos. The risks were made clear to me, but also the fact that it was unlikely they would all work, so I was happy to give that a try.

We haven't gotten our baby yet but I am confident that in the course of my treatment, no stone will be left unturned. She is known for having conceived and delivered her twins through IVF. That edge is what sealed the deal for me but the case was already pretty strong. When we were looking to switch practices, we asked around and she was recommended to us by friends who have a 1 year old son. They also experienced a previous loss and an early miscarriage with Dr. Ashby and described feeling very well cared for and supported.

No practice or physician is perfect - the important thing is finding a clinician whose style matches your needs. She is very in demand but if you need extra time and attention, she will accommodate you. Dr. Ashby is positive and forward moving but not one to sugar coat things. For me, that is a positive but everyone is different.

My 1st retrieval with another practice was antagonist. I got 5 blasts but it was absolute torture and was switched to freeze all because I was at risk for OHSS. My 1st cycle (2nd overall retrieval) with Dr. Ashby was also antagonist. It was also torture - though not as bad. The results were abyssmal - 1 full day 5 blast and two morulas were transferred. My 2nd cycle with Dr. Ashby (3rd overall retrieval) was an agonist micro flare protocol. It produced 5 day 5 embryos and 1 day 6 embryo. We did PGS and had 1 PGS normal, 1 mosaic and 4 abnormals. We are starting stims for the next cycle later this week with the same micro flare protocol starting with slightly higher doses of gonal and menopur. Results TBD.

Other than PGS, my care has been covered by insurance.

We only had one PGS normal to work with so we went with that. We opted not to transfer the mosaic with a normal. If we had had two normals, with the prognosis for my age we probably would have been advised and opted to transfer more than one so that we could move to the next retrieval since time is of the essence. Before my last retrieval Dr. Ashby made sure to explore my feelings about multiples and explain the risks involved.

As a patient, I've had a good experience with Dr. Ashby, despite not being pregnant yet. She doesn't just spit out what we need to do, but talks to us and asks how we are doing during this whole process.

Ask lots of questions - don't be afraid.

Round 1 (birth control pills at beginning, started on follistim injections, then cetrotide injections and follistim injections. Post retrieval/transfer used crinone gel, medrol, estradiol) Round 2 (started on patch, then cetrotidge injections, then once I got my period again, I started on follistim and menipur injections, then added cetrotide injections. Post retrieval/transfer used crinone gel, medrol, estradiol) Round 3 Frozen (birth control pills at beginning, then estradiol, progesterone injections. Post transfer continued on progesterone injections and estradiol) Round 4 (lupron injections, then added follistim injections and then menipur injections. No fertilized eggs)

My insurance covered 90% so we paid $1,000 up front for each round that we started. And then a few additional costs I think.

Dr. Ashby always treated me like a friend. She was open, compassionate and really took her time to explain my diagnosis and how we were going to move forward with a plan. I had 3 egg retrievals and 0 embryos from all 3 combined. I have Diminished Ovarian Reserve and outlook was looking bleak. She had the difficult conversation with me and my husband about exploring other options like donor eggs or adoption. This was very upseting to us but she gave us examples of couples she had treated in the past who were successful with donor eggs. She never made me feel bad about my diagnosis and was always very positive and said that we will have a baby one day and she was going to help us get there one way or another. She had a gentle bedside manner but at the same time was always very candid with the reality of our situation. She never forced us to move forward with donor eggs. She explained she would continue to treat us and try another protocol but after 3 failed cycles, it wasn't looking good. She also recommended a 2nd opinion just so we could feel good about our decision moving forward.

Trust her advice and opinions. She isn't super clinical but still explains the clinical side of fertility treatments. Ask lots of questions.

I don't remember the exact treatment plan but considering I have diminished ovarian reserve (at 35), I went through 3 very aggressive treatments.

They were pretty efficient for the most part.

My insurance covered the majority of the meds and procedure costs. I was lucky.

She has a strong preference for one embryo transfer. Her end goal is healthy mom and healthy baby.

I saw Dr. Ashby at the recommendation of a family member who had a successful pregnancy with Dr. Ashby's help. At the first appointment, me and my husband knew we were in great hands. She is direct and knowledgeable, and gives her patients confidence that she is an absolute expert. She thought we would see great results with IVF but our insurance required us to try 3 IUIs with injectables before we could move on to IVF. I was disappointed since I really hoped to start IVF right away, but to everyone's surprise the first IUI worked! We had a complication very early on - when my first ultrasound was performed at 6w3d, it was discovered that my pregnancy was heterotopic, meaning that I had a viable pregnancy in my uterus and a second one in a fallopian tube. The radiologists sent me to Dr. A's office and she saw us immediately. She laid it on the line - I had a perfect embryo in the uterus but the ectopic needed to be removed immediately before it could rupture and put my life in danger. It was something seen more commonly with IVF but not unheard of for IUI patients. She felt that this procedure would not harm my viable pregnancy. Needless to say we were shocked and upset, but she and her staff were great. The moved us to a private room while they made surgery arrangements so we could process what was happening. One of her associates removed the fallopian tube that afternoon. A week later we had another ultrasound which showed a healthy heart still beating. The rest of pregnancy was uneventful and I had my healthy, perfect daughter.

Trust her!

For my IUI we used Gonal-F with ultrasound monitoring throughout, then an HCG trigger when follicles were ready. This produced 2 mature follicles and several smaller ones.

It was covered by insurance so we paid very few out of pocket costs

n/a

She is an excellent practitioner with great bedside manners: She has skillfull hands and is part of a great team. She came to me recommend from several friends (all healthcare professionals). I will recommend her to all my friends who need fertility treatment. Also, as a plus...When I had a miscarriage, the whole office treated me with compassion and kindness.

Ask her to clarify any terms/vocabulary that don't understand. People new to fertility treatment may find that the amount of information shared initially is very dense and overwhelming

I did a low dose AB agonist protocol during the first cycle. While I got 18 eggs retrieved, we had lower fertization rates than expected. Also, the embryo transfer was very difficult because I have a tight cervical opening (which my Doctor hypothesized lead to my uterus to contract post transfer, and pushed my embryo into my Fallopian tube, and causing my ectopic pregnancy). After my failed cycle Dr. Ashby and her whole team met for a "cycle review" and suggested I do the same protocol, with the addition of Menapur, ICSI, and placement of a malencot catheter (to make the transfer easier). This resulted in 21 retrieved eggs, 6 five day blastocysts (they transfered one, and froze 5). The transfer was much more smooth, and I am happy to say we are now pregnant!

Ultrasound and blood work monitoring was very streamlined and organized

My insurance covers 6 rounds of IVF, so I am unsure about actual costs. I paid $75 for all my meds and a $50 copay each cycle

I really appreciated Dr. Ashby's approach. I was working with another doctor before who was very knowledgeable but I felt was almost too timid in her strategy. Dr. Ashby was willing to be a little more aggressive and understand that I wanted results immediately. For each appointment she was up-to-date on where I was in the process and ready to explain the next steps and why. She was very efficient, yet I felt that I had time to ask any questions I needed.

She moves fast and is down to business. If you need someone to go slowly and be a bit more nurturing, I am not sure if this would be the best fit. That said, I would never say Dr. Ashby doesn't care and/or is cold.

I was on Letrozole to help me ovulate and then tried timed intercourse. The first round did not work. The second round we decided to do IUI and that worked! Another round of letrozole and follicle monitoring. There was question about whether or not I had too many mature follicles, but Dr. Ashby felt it was fine to proceed with IUI and I'm so thankful I did.

Insurance covered my treatments so I do not know exactly the costs.

n/a

I adore her. She is the best and you could not ask for better medical and emotional care. I cannot say enough accolades about her! She answered every medical question thoroughly and appreciated that I had done my own research. I felt confident that I wasn't just a number and she cared and was willing to take risks on my drug cocktail to get better results. She even coordinated care for me while I was living abroad so I could come back to Boston for a FET.

She is very busy so use your time thoughtfully. Trust her. She will be candid with you and doesn't care about the stats for her patients. She wants the best result for everyone.

No lupron - antagonist cycle instead since I had had poor egg quality with lupron suppression. We also used some sort of "sweetener" to enhance egg quality. Used gonal f and ganirelix

All paid by insurance except for a CET cycle I had to pay for myself since located outside of USA

Dr. Ashby is very clear and knowledgeable, and definitely listened to my goals when planning my fertility journey. She was highly supportive of me becoming a single mother by choice. She did some of my procedures including one IVF retrieval. The other IVF was done by the doctor on call that day, who was also great.

Don't hesitate if you think you want to have kids. It may take many tries.

We did 4 IUIs in order to get insurance to cover IVF. First IVF was a high dose gonal f and menopur protocol with 5 day transfer. Second successful IVF was menopur only and 3 day transfer.

Insurance covered most everything except ICSI and donor sperm.

For over 40 the clinic has an algorithm to estimate how many embryos to transfer. I had 3 transferred both times. If I had had more available we would have transferred more for the 3 day fresh transfer. The clinic is good for "advanced maternal age" treatment decisions.

Rachel Ashby was wonderful. Appointments with her were like talking to a good friend. I felt that she truly cared and was totally honest with us about expectations and outcomes. I cannot recommend her highly enough. When there was a setback in my latest cycle, she phoned me out of hours to reassure me and answer any questions.

She is so popular that it can take months to get an appointment. She is worth waiting for. I made the mistake, in my haste to get in with a fertility doctor, to initially go to someone else. In the long run, that cost me a lot more time. Wait a few extra months to see Dr Ashby, she's totally worth the wait.

We did two rounds of IUI to conceive our son with Dr. Ashby and are now about to start IVF after two miscarriages to hopefully complete our family. My last miscarriage was a natural pregnancy at 13 weeks. Dr. Ashby called before my D&E and helped us through an extremely difficult time. She has met with us several times to present us all the options and risks of each. She has been compassionate and positive and we feel very lucky she is supporting our decision.

Trust her!

2 rounds of IUI and about to start IVF

IUI was covered by insurance.... about to start IVF

I have found Dr Ashby extremely straightforward and pragmatic. She listens to what I want, and balances it with her medical opinion. I am a Single Mother by Choice and she has been fully supportive and encouraging of that route to parenthood.

She's very straightforward - if you like that, you'll like her!

I felt immediately at ease and comforted with Dr. Ashby- she talked to us like a friend and not a doctor. I never felt as if I were rushed and she even gave me her email address when I wasn't able to get in touch with the nursing staff.

She will try to find a solution that is minimal - from impact to you but also risks associated with the options. She was great to not jump to IVF off the bat yet started with less invasive steps.

Dr. Ashby communicates with patients in an empathetic yet realistic manner. She cares about her patients specific concerns and needs during treatment. For example, we were concerned about creating extra embryos and she was willing to work with us on a less aggressive protocol to limit the number of eggs and, thus, embryos produced.

2 long lupron protocols, one with gonal-f, one with gonal-f and menopur. Second cycle added menopur and less gonal-f with hopes of producing better quality eggs

Very difficult to get an appointment. But once you have one, she is great. The whole office is not very open to new "alternative" treatments such as reproductive immunology. She is matter of fact instead of coddling, which I prefer.

Ask questions. Not sure how you get an appointment - it's a challenge for new patients.

Very early in the morning. A challenge with Boston traffic.

A lot

Goal is one live birth, so they put as few in as possible. Because of my age and reproductive history, they transferred as many as 3.

There really were no weaknesses to her treatment or bedside manner- she was exactly what I was hoping to find in a fertility doctor. Because of her (and her staff) I was SO much calmer, happier and confident than with my previous cycle with another doctor. She advocated for what she believed was best for me while also listening to me and taking my opinion and feelings into consideration.

CALL HER NOW! And see her at the Newton- Wellesley location- SO much better than the Brigham. Appointments on time, better nurses and no more super early morning ultrasounds/ bloodwork.

Dr. Ashby had faith that she could help us have a family when perhaps another doctor would not. I was referred to her by a family friend who is in her practice and doesn't do IVF--hers was a name I had heard from other women and when I was also referred to her by a colleague and a family friend, I knew she was the right doctor for me. When my first IVF round was cancelled because I didn't respond to the meds, she told me not to worry, she had only begun to fight. One full cycle later I was pregnant with my daughter and with only one embryo remaining from that one cycle, we are now looking forward to completing our family with the arrival of a little boy in early summer.

Dr. Ashby is a great professional and takes her time explaining everthing. She made sure we understood each step and did not rush us. We were successful on our first treatment and hoping to do another in the near future.

I did IUI with gonal F with successful pregnancy.

Covered by insurance