Describe your experience with Fertility Institute of Virginia.
Strengths: You're a person, not a number. Dr. Steingold is a partial owner of the andrology clinic where samples are run and IVF procedures are done, which makes for effective continuity of care. Samples were never lost or delayed. There's plenty of parking at both facilities and they're easy to find. Everyone feels like a stakeholder in the process, and no question is too ridiculous. (Ex: The embryoscope was the latest and greatest thing when we were doing IVF, and I had questions about it -- Dr. Steingold put me in touch with their lead embryologist, who called me and had a really candid conversation with me about the process of embryo selection, and why he (at that point) didn't believe the research was compelling enough to justify purchasing an embryoscope, and that the second the literature showed otherwise, Dr. Steingold would be writing a check for one. He point-blank explained that even with all of the technology they have, they still don't know why some embryos take and others don't. I can't say enough how much we appreciated this kind of honesty and candor -- they're not selling a product or a guarantee of achieving parenthood, but they sure as hell are going to put everything they can into place to give you the best shot at it. IUIs and transfers can be done on weekends or on a holiday -- this was not the case when we were patients at VCU, where procedures weren't done on Sundays. They have actual price lists for everything. Patty, their billing lady, will work with your insurance company to try and get as much covered for you as possible. If your insurance takes LabCorp, there is a LabCorp facility in the building, so there's at least one fewer stop if you need blood work done.
Weaknesses: They don't have a separate waiting room for patients with children, but I never saw kids in the office. (I think the patients who are parents are savvy enough to not bring their kids. We brought our daughter to meet Dr. Steingold and the staff, but it was after hours and they brought us in through the back entrance just to make sure we didn't run into a patient.) They still do paper charting, and there is no way to email your nurse or the doctor. (To be fair, I never encountered any inefficiencies as a result of this, but it did surprise me to not see anyone carrying around a laptop.) If you are a hard stick, go downstairs to LabCorp to have your blood drawn -- my veins are awful, and the nurse wasn't able to get a sample from me after multiple attempts.
During treatment, did you feel like you were treated like a number or a human?
Dr. Steingold was our second opinion after a bad experience at VCU. Treatment under him felt much more personalized. We met in his office, not the examining room. The plan of attack every month was discussed step-by-step, and he wrote everything out for us each cycle so we had something to refer back to if we had questions later. He seemed just as crushed as we were when our last attempt at IUI failed, and we were faced with the reality of proceeding to IVF. I've heard from other folks that they feel Dr. Steingold doesn't take an aggressive enough approach to treatment -- for us, that gradual approach worked. We wanted to exhaust all options before going down the road of IVF, and he was willing to back our play. Appointments were never rushed, the nurses were wonderful, the staff is warm and friendly, and they have one dedicated person who does billing. Having one point of contact makes a HUGE difference when you are trying to negotiate the murky waters of health insurance and what procedures/medications are and are not covered.
Describe your experience with the nursing staff.
As my husband just said, "They're incredible." The nurses are AMAZING, especially Beth and Lisa. They are warm, friendly, compassionate, patient, funny, and everything you need when you are in a vulnerable, emotional and awful place. I don't know if anyone was ever specifically assigned to us -- I think they share patient responsibilities, which meant everyone got to know us over just a few visits. We never had any problem not getting test results back because "our" nurse was out of the office, etc. They were always very prompt returning calls, and at no point did I ever feel like I had to stalk them in order to get test results back.
How was your experience with Kenneth Steingold?
Dr. Steingold strikes me as a deceptively quiet guy who is a huge hit at parties. He does this thing where he sits back at his desk and gives you a piercing look as he's getting his thoughts together, and you're not sure whether to stare right back at him, start making stilted conversation, or just play with the random fidget objects he has on his desk. I think some might find his bedside manner to be a little awkward, but my husband and I are awkward people, too, so we all got along really well.
He didn't bat an eye at our first appointment when I handed him a history of our previous treatment, which included the statement "Sh*ttiest Christmas Present Ever" regarding the results of a failed December IUI. (I spelled the whole word out on the paper I gave him.) When we arrived at his clinic, we had already done a year of unsuccessful infertility treatments at VCU and were reasonably well-informed patients. I was afraid he would make us start all over to see whether his approach to treatment had better results, and was incredibly relieved when he didn't make us repeat any needless tests (HSG, etc). We picked back up from where we left off with VCU. We did four IUIs, all of which failed, and then one cycle of IVF, which worked. As cheesy as it sounds, he grieved with us in the failures, and rejoiced in the successes. He provided clear explanations throughout each of the treatment cycles, and made me feel like an involved, integral member of a team instead of someone who was just along for what amounts to a really, really crummy ride.
Also, he keeps a bobblehead figurine of Stewie from Family Guy in his office. This earned him a ton of bonus points from me.
What one piece of advice would you give a prospective patient of Kenneth Steingold?
He may not immediately come off as being warm and fuzzy, but he is. A friend referred me to him, and one of the things she spoke so highly of was his compassion as she and her husband went through the process of infertility. We absolutely saw that compassion during our treatment.
Describe the protocols Kenneth Steingold used in your cycles and their degree of success.
We never had a clear diagnosis. The closest we got was unexplained infertility, along with possible PCOS, and a defective luteal phase. My husband's sperm had major motility issues (<5%), however, his counts were off the charts, which was why we were never officially diagnosed with MFI.
We did increasing dosages of Gonal-F for all of our IUIs, along with the trigger shot, and ultrasound monitoring. Our last two cycles also included Crinone from the time of the IUI until the BFP/BFN (they were all BFN). Our last IUI was a back-to-back one, at our suggestion, in hopes that it might boost our chances (it didn't).
I can't remember the specific drugs for our IVF cycle, but based on what others have described, it was fairly standard protocol (birth control followed by hormones, hormones, and more hormones -- also baby aspirin [this was my idea based on stuff I read online; Dr. Steingold said it couldn't hurt], Valium for the day of the transfer, short term dose of prednisone, and an antibiotic). They retrieved 20 eggs, 13 of which fertilized using ICSI, and 7 of which made to 5-6 day embryos. (The recommendation for ICSI surprised us, as we hadn't been diagnosed with MFI. When I asked why, Dr. Steingold shared that they recommend ICSI for all of their patients simply out of an abundance of caution, but that ultimately it was our decision. It meant more money, but we decided to go ahead with it because we didn't want to hurt our chances of success.)
We opted to transfer two embryos; when we discussed it with Dr. Steingold, he said that statistically transferring two versus one gave us "a little bit of an edge." We were desperate and thought twins sounded like a great idea. One of those embryos stuck, and our daughter was born 9 months later.
We went back two months ago to do a frozen transfer. Dr. Steingold's approach was to duplicate everything we could from the fresh transfer, although I admittedly forgot to do the baby Aspirin. The protocol for it was Endometrin and Estrace, and repeating the Valium, prednisone, and antibiotic that we did for the fresh transfer. The only difference was that we chose to transfer one versus two embryos. Dr. Steingold agreed with this decision. We were in a different spot than we had been two years before, and didn't need that "little bit of an edge" -- we could more easily come to terms with a failed cycle, and had four remaining embryos. I'm currently 8 weeks pregnant with one baby. I'm going to stay on the Estrace and Endometrin through the end of week 13, assuming we get there.
Describe the costs associated with your care under Kenneth Steingold.
This is complicated question to answer. We had some infertility coverage through the majority of our treatment, but it still resulted in significant out-of-pocket expenses. They were in line with, or below national averages for IUI and IVF.