Rafael Cabrera

Lack of bedside manner. I went in for my HSG procedure, and the second it was done, while I was still lying there, I was told my tubes were blocked, and my only option was IVF. The delivery of the news was that short and simple. It was one quick casual sentence as if the Doctor was giving me a simple update about the weather that day. He could see how confused I was and finally realized he had to slow down and explain from the top. On my way out, he gave me a paper on my diagnosis and said I would get a call to schedule a Laparoscopy. I never heard back from him or his staff. Zero empathy.

Ask him to slow down and explain all your options. Also, ask him for a method of communication other than the corporate number.

We just did the workup to find the diagnosis for my infertility. He performed my HSG procedure and quickly told me I needed to get my tubes removed and do IVF. No explanation or mention of other options.

I don't remember.

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I found this doctor to be pessimistic, and did not show much compassion as he delivered what was the hardest medical diagnosis I have ever received to date. He did not give me any hope and told me that my only chance was with donor eggs. (My second opinion dr disagreed completely, especially since Age is on my side still). I would have appreciated more compassion and a better bed side manner.

I would recommend going somewhere else and see someone who is willing to fight for your case and for you to have a child. There are many doctors who specialize in DOR, and who are hopeful and don’t put you in a box. Find that dr!

We didn’t get that far into treatment but once he reviewed my amh and fsh he immediately said donor eggs was my best option and that IvF would be unsuccessful. I ended up leaving this clinic to get a second opinion.

I had to pay out of pocket for my consultation, blood work, genetic testing (approx $200), and HSG. I’d say in all I spent around $500-700.

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We met with Dr. Cabrera for our consult and appointment for results on labs, He is very nice and takes his time to explain information. It is too early to thoroughly review him as we have not started treatment.

You have to be ready with questions. He does take his time and explain but I noticed we had to ask about vitamins and procedures and what are the next steps.

We have major male factor infertility and I have a low AMH. Dr. Cabrera recommended IVF with ICSI.

The Siemen analysis was $195 Consultation was $100-$150 Bloodwork and Genetic testing seemed to be covered under my insurance

During our first consultation, Dr. Cabrera said that we would transfer 1 embryo because of my age (34) but once my results came that showed a very low AMH he said we would only retrieve 5-6 eggs and that he would suggest 2

It took a few visits for Dr. Cabrera to "warm up", but through the stim process I realized how invested he was in our success. He is a man of few words, unless you engage and ask questions. If you speak up he is more than willing to spend the time explaining.

Engage him and he will respond!

My protocol first called for 225 units of Gonal-F and 20 units of hCG daily. Through the course of stims we lowered the Gonal-F to 175 units and ultimately raised it again to 250 units. Dr. Cabrera closely monitored my US's and bloodwork and made adjustments as necessary. Ovidrel was used as my trigger shot. I was on 12 days of stims, triggered on day 13 and retrieval took place on day 15.

We paid $8995 for our first IVF cycle, that did not include the trial transfer ($300), anesthesia ($300) for the egg retrieval or the first round of medications ($4500). In total we paid $14,095. Since we weren't able to do a fresh transfer we have to pay $1000 for the FET conversion and $500 for additional medications. In total we will have spent $15,595. This includes one year of storage fees for our frozen embryos. We did not do PGS/PGD testing.

Brown Fertility highly recommends single embryo transfer, especially for a fresh transfer and anyone 30 or younger. They do allow two embryo transfers during a FET or patients over 35.

Dr. Cabrera is very good and professional I wished all clinic would change my meds according to how I respond each cycle instead of keep using same meds. He does all the Ultrasound and all visit except egg retrieval or transfer. Depend on who’s on call that time. I wished he would do all my retrieval and transfer since he know me when I visit for blood works and ultrasound

I wished he would explained what he saw on ultrasound and how big my follicles or how many I have

My protocol is Gonal F and Hcg with centrotide for all cycles Not sure what’s the rationale but HCg help my egg to mature

I get all my time I request. Scheduling is good

Retrieval cost about $11000 and medicines is about $4000-8000

Dr. Cabrera was kind and warm, but the consummate professional. He was straightforward, didn't sugarcoat anything, but always positive and encouraging. He is incredibly knowledgeable, and always knew how to convey the knowledge in a way that we understood what was going on.

Ask a lot of questions and take your time when you're in the office. There are no silly questions.

May 2017 - initial consultation with Dr. Cabrera to discuss health history, and what Brown Fertility does. They briefly reviewed the IVF process. June 2017 - Blood test done to ascertain AMH and other various levels. HSG done to investigate the condition of my tubes and uterus (blockages and such). My husband also underwent blood testing as well as a semen sample. My right tube was found to be almost completely blocked (I did not have a left tube at that point, as a result of a left salpingectomy), and my right ovary was scarred to my uterus. My endometriosis was determined to be a level 4 throughout. The inside of my uterus looked clean and clear, however. My husband was the epitome of child-bearing health. Due to the severity of my endometriosis, I was determined not to be a candidate for IUI, but the perfect candidate for IVF. My AMH was incredibly high, so that couple with my husband's stellar sperm, Dr. Cabrera anticipated a successful oocyst retrieval and hopefully a number of healthy embryos as a result. July 2017 - we took the month off to relax and let my body rest before starting the IVF process. August 2017 - Took birth control and baby aspirin for two weeks in order to regulate my cycle and shut down my reproductive system. A trial transfer was performed to ensure there would be no surprises during the actual transfer. Everything went smoothly. September 2017 - I started initial injections on September 2, and continued through September 9. Meds varied, but typical day looked like this: Gonal-F (150 units) // Lo Dose hCG (20 units) // Cetrotide // Aspirin 81 mg. I did one trigger shot of Ovidrel on September 10, in preparation for our September 12 retrieval. I was directed to take doxycycline from September 11-16, for prevention against risk of bacterial infections. Cabergoline was prescribed for September 12-19, to reduce incidence of OHSS. Oocyte retrieval went smoothly, with a total of 23 eggs retrieved. With that many eggs, however, I was diagnosed with OHSS, so we ended up doing a freeze all cycle. Our eggs were fertilized using ICSI, and we ended up with 13, day 5 blastocysts. October 2017 - Once my body recovered from OHSS, I resumed birth control and baby aspirin, in order to continue regulating and normalizing my menstrual cycle. Once I completed two weeks of birth control, and my reproductive system was quiet and under control, we began preparations for our November frozen embryo transfer. I took a pregnancy test on October 14, as a precaution prior to beginning next phase of meds. Upon negative result, we added Leuprolide (Lupron) 10 units daily. Birth control discontinued on October 20, Lupron continued at 10 units. Baseline ultrasound conducted to ensure no reproductive activity was occurring. When that was confirmed, Estradiol was added to daily regimen - twice daily, increasing over time until November 9. November 9, Lupron was discontinued, and progesterone added. November 16, we transferred two little embryos. Estradiol continued until mid-December. A two-week blood pregnancy test was done on November 27, and came back POSITIVE! A second round of bloodwork was done to confirm increasing HCG, and was positive. Progesterone continued until 10 weeks. July 23, 2018 - At 38 weeks and 2 days, we gave birth via c-section to fraternal boy/girl twins. Both were healthy, and required no NICU stay. They are 21 months old as of today!

Our IVF cycle included all visits required to prepare, HSG, all necessary baseline ultrasounds, oocyte retrieval and frozen embryo transfer, and cost approximately $10,370 (not including medications).

Our doctor initially recommended transferring one embryo, because of my age and the intention of doing a fresh cycle. Upon deciding to do frozen transfer, they suggested two embryos to increase our chances. We were adequately educated on the chances, risks, and possible outcomes of transferring one or two.

I think Dr. Cabrera is compassionate but I do feel that the entire office is not open to exploring immune protocols or really anything other than what is considered very basic and standard. Dr. Cabrera is very friendly and kind, he has a great bedside manner but at the end of the day I still am not pregnant and don’t know why.

Advocate for yourself and ask upfront before beginning treatment, if there is a protocol you are interested in trying, ask if they are willing to implement such things if things aren’t working otherwise. After failure I asked about adding some things that are geared toward possible immune problems and though they were aware of such things they wouldn’t even discuss implementing them.

They use a cookie cutter protocol for everyone it seems.

IVF 8,995 ICSI 4-500 Assisted Hatching 4-500 Anesthesia 450 Endo Scratch 250 Hcg test 125 Genetic prescribing maternal 2-500 (can’t remember exactly) IVF meds 5500 Prescreening bloodwork female 1200 Male bloodwork 400

We ended up doing a double embryo transfer but only because I pushed in our fresh cycle. When I did my FET I only had 2 embryos left and didn’t want to waste them so I suggested only doing 1 but at that point Dr. Cabrera recommended both and since they were both thawed that’s what we ended up doing.

Doctor Cabrera performed a polypectomy on me and I am currently undergoing treatment with a medicated cycle. We are still early in our treatment but Doctor Cabrera is thoughtful and kind and will explain everything until it is understood fully. He is helpful and compassionate, while also being knowledgeable and empathetic.

My only advice would be to make an appointment that is after work or during a day you can take off from work. The clinic tends to run late appointment times.

He is a very straight forward doctor but he is very knowledgeable, I asked to try on my own without intervention after my laparascopy before moving to IVF and he was open to it. I appreciated that is also a surgeon and was able to perform my laparascopy and unblock my tubes.

Be open to honesty. He will not take on cases he thinks are not likely to be successful.

I did most of my initial testing with my gynecologist who misdiagnosed me with PCOS. They did not perform an HSG. Dr Cabrera caught this and redid my testing where he found a blocked tube. After he scheduled and completed laparoscopy on me in which he unblocked my tube. I became pregnant a few months later. It did turn out to be a chemical pregnancy but it gives me hope that I am more fertile now.

I'm very lucky to have insurance to cover most costs. My first cycle will be about 4000$ mostly due to my deductible. They do have financial assistance available.

He will not recommend multiple transfers to women under 35. You can sign a waiver to allow him to so multiple transfers.

As a patient I felt like my dream was possible, dr.cabrera told me I had everything for me except one thing, but he still had strong faith of me becoming a mother. He would talk to me try to explain everything I had concerns or questions about. We're not sure why the transfers have not worked yet, but we are not giving up. Dr Cabrera says it will happen.

Ask every question u have don't be afraid.

My first cycle I used very little stims gonal-f, estradiol,crinone,lupron,baby aspirin, and my trigger shot. Everything worked great. Just did not end in a positive prergnancy test

My first step of ivf cost about 10,000 my additional FETs were 3500 each

My dr would only do 1 embryo the first transfer because of my age and my chances of becoming pregnant they were afraid of multiple pregnancies.

Dr. Cabrera was very honest and patient when explaining the IVF and ICSI process and why it would be the best option in our case. He spent a good deal of time with us and reassured us that our chances of success are high. Although this entire process is daunting, I'm glad that we will be under the care of a knowledgable and compassionate doctor.

Ask as any and all the questions that you can. Dr. Cabrera did a great job of answering all of our concerns. This is such an important, emotional, hopeful, and life-altering journey. Make sure you are as well informed as possible.

We have only paid for the initial consultation, semen analysis, and blood work so far.

Dr. Cabrera is absolutely amazing! He is very thorough and explained everything so that my husband and I would fully understand where we stood. Through treatments and procedure we knew what to expect because Dr. Cabrera took the time to explain to us the process.

Dr. Cabrera truly has your best interest so trust him and his course of action.

I did two cycles of clocks and timed intercourses as my ovules were growing and seemed to be releasing. After two cycles not working, we did iui so that we could assist the sperm along into the uterus. Due to financial reasons we could not continue after the first negative with iui

Amazing cannot complain even if I wanted. He explained everything in details. He went through my family and medical history and based my visit off of this. He explained my husband process and procedures. He explained what to expect.

Take a notebook and list all your concerns and questions. He is more than happy to look it over and answer each question to details.

He did not individualize my care, therefore my chances for success were decreased. Specifically, during my first IVF cycle the gonal f was at max dose and he never adjusted it despite each visit saying my follicles were growing very fast. As a result, my follicles grew too big, too fast and although we still retrieved 6, I could have had over 12 retrieved and would not have needed to do another IVF cycle for more follicles if the medication was adjusted during my visits prior to retrieval. He told me after the chemical pregnancy that it must be my embryos. When I said the grading from the embryologist showed good embryos he said "that grading does not mean anything" He also said what is important is what is inside the embryo and said "there is no way to tell what happening inside" I now know that PGT-A testing would have allowed me to know which embryos to transfer but they don't offer that test and as a result you can see the stats that show very, very poor success with women over 37 treated at Brown fertility. He did not communicate with Dr Bruce Rose who did my transfer. The first transfer he only transferred 2 embryos even though we agreed to do 3. The second IVF cycle Dr Rose said 2 minutes before the transfer that he did not agree with transferring 3 and he strongly recommended against it. He also said "I can get any woman pregnant" The cycle resulted in a negative pregnancy test. Dr Cabrera lost his temper with me when talking to me the day the nurse called to tell me the results were negative. He was extremely arrogant and never once said I'm sorry. Instead he said " I did not do anything wrong and I did not guarantee you anything" I was shocked. At that point I knew I would never return and no matter how much they charge me to transfer my embryos I would do that rather than work with Brown fertility doctors again.

For the reasons I detailed above, I would say do not go here. Even if you have to wait for a few months for an appointment somewhere else. There is a reason for that. He says what you want to hear and once that payment is received there are no refunds. After the cycle ends you will never hear from them again.

He used the same protocol he uses for all IVF patients at this clinic. I had concerns about implantation success and was always wondering if my progesterone levels were ok but I got no answers on that. Also, I think the most important thing I learned after doing my own research after the 2nd failed fresh IVF cycle is that a frozen cycle would have allowed him to make sure my lining was optimal for implantation. I also found out that the other clinics in my area rarely do fresh cycles anymore especially after a failed fresh cycle. That type of change in protocol is a critical change that based on everything I have read including this fertility site would have increased my chance for success dramatically.

I spent about 35,000 dollars here over 4 months. This included 2 IVF cycles and the over priced medications from SMP pharmacy in Miami for each of those cycles. It also includes the anesthesia costs and hotel costs because the procedures are done in Jacksonville not Orlando.

Dr Cabrera said I could have 3 transferred but he did not communicate that to his partner doing the transfer so only 2 were transferred. During my second IVF cycle it was made clear we would do 3 and again 2 were transferred. No apology and no explanation was given.

He treated us as we were wasting our time discouraged us to even try as to no hope ivf would work for us had no problem crushing my dreams and made me unhopeful that no one else would help us .. put me in depression for a long time until people in ivf groups suggested i look into CNY

Dont see him

I had genectics testing all blood work a Hsg done and more blood work.

Co pays of 35 dollars rest billed to cigna

My experience with Dr. Cabrera is a bit different since I was originally under the care of a nurse practitioner that is no longer with the clinic. This made me anxious about staying with the clinic when she left but I am extremely happy that I chose to stay. Dr. Cabrera has assured me that I am in good hands and has taken the time to understand my history.

Don't be afraid to ask him to speak slower.

My insurance has paid for diagnostic care so we only paid a $45.00 co pay when having regular visits. We pay out of pocket for IUI but we haven't finished that so we don't have a full number.

Dr. Cabrera told us that the goal is 1 healthy baby at at time. That is what we want to be looking for, not multiples.