How was your experience with Harry Lieman at Montefiore Medical Center?
Dr. Lieman clearly cares about what he does and is very knowledgeable. He picked up the pieces after my care at my first clinic and immediately knew things we could try. He always gives us options and explanations, which helps us feel involved in our care. His knowledge of the medical literature is completely up to snuff. He is up to date on the latest information and critically evaluates the literature as well. He doesn't simply take all studies as fact and analyzes whether it is reliable based on the details in the paper and how it fits with other papers. He also keeps in mind what he observes at his clinic and combines these two sources to make better decisions. Whenever I bring up a concern, he discusses it with me right away. I never feel like I am being forgotten or like I am not being heard. He did say in the beginning that his specialty is not as much the thyroid, so he recommended that I go to a separate regular endocrinologist specifically for that (which I did and having that other specialist has gotten things under control quickly). I appreciate that he knows where his limits are and refers out to make sure I am receiving optimal care. I also appreciated that when he first started with us, he did not simply go along with what we were planning on doing (another embryo transfer) but that he said he could do that, but gave us another option that he thought made sense given our history. He then recommended we take a little time to decide (which we did-- that extra time was huge). He is clearly not in it for the money at all (that transfer makes more monetary sense for him). We fully trust him with our care. I keep trying to come up with a weakness, but I am seriously struggling to do so. I feel my care under Dr. Lieman has been phenomenal. I would recommend him to anyone in a heartbeat, and have in the past.
What's one piece of advice would you give a prospective patient of Harry Lieman at Montefiore Medical Center?
Honestly, my best advice is to trust him because he knows his stuff. Trust and relax because you are under good care. Also be sure to bring up any questions or concerns you have to him.
During treatment, were you treated like a number or a human with Harry Lieman at Montefiore Medical Center?
I went into my first appointment with Dr. Lieman after having poor treatment from my last RE and two prior pregnancy losses and was somewhat traumatized from the prior experiences. Dr. Lieman was very understanding of our history from the start and cared. This was in stark contrast to my old doctor. He always explains options with reasoning and gives his thoughts on the medical literature whenever I ask. I came in from my old clinic with multiple embryos and was ready to do a transfer, but he recommended we try something else that was less invasive and a lower cost, first, given my medical history, but said it was up to us. Even though the first two cycles of the lower cost intervention did not end in a pregnancy, they got me to ovulate (a real feat with my history) and I feel so much better going into our next transfer (after a failed transfer at the old place) having tried these things first. He never seems rushed, even though I am sure he is. It is readily apparent how much he cares. Not a comment on the doctor, but on the place as a whole: everyone who works there treats me similarly and they have even said they were sorry after a failed cycle, something that really meant a lot to me and that I never heard at my old clinic. I always feel treated like a human here and it makes a huge difference.
Describe the protocols Harry Lieman used in your cycles at Montefiore Medical Center and their degree of success.
Dr. Lieman started me on letrozole at 5 mg. He started at 5 mg of letrozole because I had quite spectacular failures to stimulate with clomid at my old clinic, had way overstimmulated on FSH injections at my old place (leading to IVF rescue and moderate OHSS), and had no stimulation with lower dose FSH injections at my old clinic. I had not tried letrozole before and had only had one ovulatory cycle at my old clinic before moving on to IVF and having the failed transfer. Because PCOS and thyroid are my only known issues, trying the letrozole made sense. 5 mg did get me to ovulate, even though it was slow. We then tried 7.5 mg letrozole which has gotten me to ovulate at a pretty normal speed with 2-3 mature sized follicles, increasing our chances. Unfortunately all three letrozole cycles ended in BFN. This was no fault of the protocol. After the third cycle failed, he gave us the recommendation to either try IUI or transfer one of our waiting embryos. He did not think it would be a good idea for us to combine FSH injections with letrozole given the risk of me overstimulating and my history of overstimulating with the injections. I agree with every recommendation he has given. We did a frozen embryo transfer of a single PGS normal 5 day embryo using letrozole to induce follicle stimulation, trigger shot, and vaginal progesterone supplementation. We did this protocol at my request due to previous reactions to progesterone in oil injections. The FET worked and gave us a healthy singleton live birth.
Describe your experience with the nursing staff.
The nursing staff are always compassionate and explain everything. They are efficient and organized. I never feel rushed and am always confident they will address any issues. The blood draws are quick and relatively painless (and I am notorious at other places for horrible veins). I always receive calls with results or answers to my questions the same day. I never feel forgotten. They clearly care and have expressed they were sorry after failed cycles, which meant a lot to me and made me feel less alone and more cared for. Again, I am trying to think of something even a tiny bit negative so I can give a fair and balanced review, but I really can not think of anything.
Describe your experience with Montefiore Medical Center.
I love how everyone at this clinic cares. Sometimes I call the place multiple times in one day and have never heard any annoyance on their part or frustration. They simply want to make sure everything is seen to. It did take a little bit of time before my first consult, but it really wasn't that bad (a few weeks, and part of it was because I could not make the only time they had available before then). One thing to know is they will not start treatment until after a financial consult. As frustrating as it can be to wait and have a bit of a delay, I think this is a wise decision so that way you know exactly how much you have to pay out of pocket going into a cycle (my previous place did not do this and I ended up with several unanticipated costs at the last second; I think this method is way better). Another thing to know is that at the start of each cycle, the require up-front payment for that cycle (but if your insurance ends up covering more than anticipated after the fact, they will reimburse you). As fertility treatments do have a high cost, I think this is reasonable, but it is important to know going in. You usually only see Dr. Lieman for monitoring ~1/3-1/2 of the time. The rest of the time you will see other doctors and will often have other doctors in training. Every single time I have gone into monitoring with the other doctors, even those in training, I have never failed to be impressed by their level of compassion, detail, and knowledge. I always feel I am in good hands. I always get same-day results and my questions and concerns are always addressed in a timely manner. Overall, I am extremely satisfied by my care at this clinic.
Describe the costs associated with your care under Harry Lieman at Montefiore Medical Center.
The first cycles we had done were minimal intervention and thus had minimal costs. Bloodwork and ultrasounds ended up being covered by my insurance and my copay was $0 so my only costs for those cycles were for the letrozole and the trigger shot. My insurance does not cover IVF though, and my FET cycle was ~3-4k, if I am remembering correctly. According to my financial consult, the total out-of-pocket cost for a retrieval would have been half of that from my old clinic (don't remember exact costs from the consult and it was very specific to my treatment plan and depends on whether my insurance would cover bloodwork and ultrasounds for the next transfer and retrieval, if needed, but I do remember calculating that the cost was half that of my old place).