How to choose RE (have BCBS Carefirst)

[Anonymous]

I am looking for any advice on choosing an RE. I live in NW so my preference would be for someone with DC offices. It seems as if every RE I search for has people who both love & hate him/her, so I guess I am curious if anyone else who has Carefirst has any suggestions? All of the main REs seem to be covered, but I wasn't sure if there was a difference in what you end up paying, if some have shorter waits than others for initial appointments, etc? I am just anxious to get this process moving & really don't want to take time off from work meeting different drs to select one when i likely will be taking off tons of time in the near future for appointments for treatment. I am 33, have been ttc for over a year and my regular dr (at Reiter & Hill) thinks I have PCOS. Thanks

[Anonymous]

Hey there, I was also 33, trying for over a year and have BCBC/Carefirst. I went to Dr. Sacks at Columbia Fertility, and he was great. Never ever had to wait long - probably the longest was 15 minutes. He really takes the time with you (as did the male fertility specialist there my husband saw - Dr. Sherins). He did a good job figuring things out and was in good communication with Sherins (husband turned out to be more of the problem). Only complaint was his recommendation on my first try to implant more than one (he didn't push too much though, but it was his recommendation - in reviewing the literature and knowing my circumstance, I didn't think it was warranted). Anyway we didn't, and I am pregnant first try. Good luck! Oh, and BCBS didn't pay for any fertility treatments at all. They paid for my and husband's visits to the practice, but when actual treatment came, it was about 13k out of pocket with 2kish in meds. That's not there issue though, it was our plan. Otherwise, copays were like 5 or 10 dollars.

[Anonymous]

I just started seeing Dr. Rifka also at Columbia. I have Carefirst BCBS (feds) and they cover all the diagnostic tests for me as well as my husband. The also cover, from what I understand, a lot of the treatments. They don't cover IUI or IVF. I have a friend who is 50 and pregnant and went through lots of fertility treatments, along with miscarriages along the way. She told me what was covered. Someone else chime in if I am mistaken.

I have no idea how they treat PCOS. I can recommend Columbia. They have been incredibly responsive with test results and keeping me up to date. The office, to me, feels pretty calm, not at all rushed and harried. I've had to wait a bit longer for Dr. Rifka than the PP, but it's not been awful. I go to the office downtown.

[Anonymous]

I went to Dr. Rifka (whom I love!) for surgeries and ivf. I had coverage under both the federal BCBS plan and a Carefirst PPO (my husband's insurance). Each type of BCBS plan covers things a little differently. For example, though we paid out of pocket for IVF (since neither BCBS plan would cover it), my very expensive ivf medications were generously covered under my BCBS federal plan (I think we might have paid a little over $100 in co-pays for the drugs).

For non-ivf office visits and my three surgeries, the BCBS coverage was excellent. This included what I used to call "clothes on" appointments -a couple of consulations I requested with Dr. Rifka to go through my treatment plan at various stages. As PPs have said, the diagnostic testing was all covered (besides those pesky co-pays).

In terms of wait times, Sacks always seems to be on time, and is at the office earlier. Rifka was almost always on time (out of about 20 appointments, I can only think of 2 that had a noticeable wait, and then everyone was very apologetic), but he often starts seeing patients a little later in the morning 9-9:30ish. (He often has surgeries scheduled at CASI or Sibley in the wee hours). Rereading what OP said, I think one of her questions might be how long did it take to get that first appointment: For me, a few weeks, and that was simply because of Christmas and New Years. When I needed followups after that, I never had a problem getting an appointment. In terms of personality, Sacks seems to be a soft-spoken, sweet guy. Rifka is a straight shooter who doesn't sugar coat, but when a patient is hopped up on fertilty drugs, he handles tearful, emotional women very well.

I had a terrific experience at Columbia's downtown office, and I recommend them to anyone I know who is having fertility issues. Best of luck to you on your journey!


P.S. Thanks to my care at Columbia, I am pregnant after surgeries to repair some issues and one round of IVF (this, after my OB told me I was unlikely to ever have children)!

[Anonymous]

I have PCOS, saw Dr. Sacks, and am now home on maternity leave with my daughter. : )

I LOVED Dr. Sacks. He is kind, patient and excellent at what he does. There was never a lengthy wait. I went to both the DC and Virginia offices. About 15 months ago, the VA office staff was not all that competent, so I switched to the DC office, where they are excellent. I think the VA office was going through a staff transition at the time, though, so I would expect that things have improved.

We have Federal Carefirst BCBS. Most of the diagnosis stuff was covered. IUIs were not. Meds were covered, as long as you ordered through the BCBS mail-away pharmacy. We did not have to do IVF, so I can't speak to that. Good luck!

[Anonymous]

I also have PCOS and saw Dr. Sacks. My due date is in 2 weeks . He did more thorough testing and suggested alternatives that Shady Grove was not going to bother with. I ended up being able to get pregnant on metformin alone, which was not something ever suggested by the doc I saw at Shady Grove.

[Anonymous]

I have Federal Employee Carefirst, which covered diagnostic testing but no infertility treatments (IUI or IVF). Thankfully we added my husband's insurance which does cover the treatments. We see Dr. Frankfurter, who is fantastic (and who was highly recommended by my ob-gyn), at GW IVF, right by the Foggy Bottom metro stop. We did not have to wait too long to get an initial appointment with him and although he is very busy, he has been very attentive and makes every effort to fit us in as soon as he can. We haven't had success yet but are going to keep trying.

[Anonymous]

OP here. Thanks for all of the encouraging replies. Ironically, the 2 REs that were recommended to me are the 2 that have been mentioned here, and they both seem to have glowing reviews. Thanks for the reassurance, as it sounds like I will be in good hands with either one of them. My Carefirst will cover diagnostic testing, including unlimited ultrasounds, diagnostic procedures, etc., but IUI or IVF and the medications will be out of pocket. arrggghhh.

[Anonymous]

One of the PP posters here with Carefirst. No, the medications will be covered too. I looked it up the other day. You still have a copay amount so it is way cheaper to go through the mail order pharmacy. Injectables are way pricy. I was told by my doctor that IUI is around 500, he said it is definitely less than 1000. He may not actually know for sure, but 500 doesn't seem too bad to me. 1000 is getting expensive. IVF is the big bucks.

[Anonymous]

Oh thank you! May I ask which Dr. said IUI is less than 1000? That sounds great to me.

[Anonymous]

I see Dr. Rifka at Columbia. He is the one that said that IUI is definitely less than 1000.

[Anonymous]

Just to give you an idea of cost at Columbia (with my BCBS plan):

Clomid IUI (done last spring) was $1000 + meds (which were covered like any regular Rx).
IUI Injectables (last summer) was $2500 + meds (which were covered like any regular Rx).
IVF $11,900 + meds (which are covered like any regular Rx). The $11,900 included cryopreservation and storage (if you end up with nothing to store, they refund this portion of the fee to you).

Though the procedures, themselves, were not covered, I was so relieved at the excellent Rx coverage I had.

[Anonymous]

18:28 here - Well, I had BCBS/Carefirst, and my meds were NOT covered at all. Probably depends on the exact plan. I had prometrium, bravelle and menopure - about 2k total out of pocket.

[Anonymous]

Ok, I have to post my comment AGAINST Dr. Sacks. While I liked him as a person, let's just say that with his treatment, I could have been octo-mom. I have PCOS, and I was producing VERY LARGE numbers of eggs, and he still went ahead and did an IUI. Unfortunately, I didn't realize that producing oh 8-12 eggs (of equivalent size) on clomid was not a desired result. I was EXTREMELY lucky that I never got pregnant. I decided to get a second opinion when it was time to move onto IVF. The Dr. I then saw (at Shady Grove) told me that allowing me to proceed with the IUIs with the eggs I had was extremely risky -- and I don't want to disparage a Dr. here, but I think you get my point. Anyway, the dr at SG cut my clomid down to 1/4 the dose I was taking, and I produced two eggs.

In the end, I did IVF, and I have a healthy, beautiful daughter.

If you go to IVF, I think there are compelling reasons not to go to Columbia Fertility. I could be wrong, but when I was there years ago, the clinic did not have the capacity to deal with blastocyst embryos, and the lab simply was not as sophisticated as others in the area. So look around. And, if you go with Dr. Sacks -- careful with the number of eggs you produce. I have friends who went there and were thrilled with the care; it just was not the right place for me.

[Anonymous]

Anonymous wrote:Ok, I have to post my comment AGAINST Dr. Sacks. While I liked him as a person, let's just say that with his treatment, I could have been octo-mom. I have PCOS, and I was producing VERY LARGE numbers of eggs, and he still went ahead and did an IUI. Unfortunately, I didn't realize that producing oh 8-12 eggs (of equivalent size) on clomid was not a desired result. I was EXTREMELY lucky that I never got pregnant. I decided to get a second opinion when it was time to move onto IVF. The Dr. I then saw (at Shady Grove) told me that allowing me to proceed with the IUIs with the eggs I had was extremely risky -- and I don't want to disparage a Dr. here, but I think you get my point. Anyway, the dr at SG cut my clomid down to 1/4 the dose I was taking, and I produced two eggs.

In the end, I did IVF, and I have a healthy, beautiful daughter.

If you go to IVF, I think there are compelling reasons not to go to Columbia Fertility. I could be wrong, but when I was there years ago, the clinic did not have the capacity to deal with blastocyst embryos, and the lab simply was not as sophisticated as others in the area. So look around. And, if you go with Dr. Sacks -- careful with the number of eggs you produce. I have friends who went there and were thrilled with the care; it just was not the right place for me.

I just went through a successful IVF at Columbia this past winter. While I can't speak of lab conditions a couple of years ago, when I was there they were able to handle blastocysts. Percentage wise, they may not produce as many blasts as SG, but one reason for that is that they tend to have more poor responders in their population (i.e. fewer eggs at retrieval -and with a low number of eggs retrieved, you often have a day 3 rather than day 5/blast transfer). When I went, we were really hoping for day 5/blasts, but I only had three embryos surviving on day 3. They recommended putting in the two best ones, and we tried to take the lesser quality one to blast (which was a long shot, but we wanted to give it a try), but it unfortunately didn't survive. The head nurse had mentioned that success rates were going up in recent months, so perhaps something different is going on in the lab.

My own personal take is that it seems each of the big clinics has some cases where it steers people wrong -and I would agree with PP who was alarmed with an IUI and copious egg production. That being said, I can only speak to my own experience, and they have given me a baby in one round of IVF. I think if at any time you have qualms about the treatment you are receiving, you shouldn't hesitate to seek a second opinion, as PP did.