Reproductive Endocrinologists at Kaiser
Parent Q&A
I did IUIs at Kaiser Oakland and one round of IVF with Kaiser in Fremont. They were mediocre for IUIs but basically got the job done. They were TERRIBLE for IVF and literally quadrupled the stress I was under just by being incompetent/having a terrible system for care (examples include the Dr. flat out ignoring an email I sent about my concerns, hour long waits for a 2 minute ultrasound, being on hold for 20 minutes every time you call with a routine question (you can't email their nurses) and taking 3 months of weekly phone calls to get my refund after my cycle was cancelled.
Round two of IVF we went with Reproductive Science Center out of Orinda with Dr. Willman. The experience was like night and day- they were really great and very patient centered (our case manager, Jenny Miller, was wonderful as well). I highly recommend RSC even if they hadn't managed to get me pregnant (which they did ) the care there made you feel like a person not cattle. I was pregnant through RSC BEFORE I would have even been scheduled to have my embryo transfer with Kaiser (had my first cycle not been cancelled). I still feel very lucky that we switched. Infertility is SO stressful, find a place that is going to support you!
Archived Q&A and Reviews
Related page: Fertility Treatment
June 2011
Re: Reproductive Endocrinologist in East Bay
Hello, In response to wanting a recommendation for a reproductive endocrinologist. My husband was diagnosed with cancer and following that chemotherapy, so our whole getting pregnant experience was at the doctor (as we had to use frozen sperm). Kaiser San Francisco has a great reproductive endocrinology department. Dr. Huang was wonderful and his nurses were very helpful. We eventually did IVF through the Alta Bates program, also a wonderful experience - Dr. Chetkowski is extremely knowledgeable. I know we were in a different situation, but I believe all of these doctor's work not only with getting you pregnant, but keeping you pregnant too! CG
Kaiser won't cover fertility--where to transfer?
Nov 2009
I've got Kaiser insurance but it doesn't cover fertility treatments (no individual plans at Kaiser cover it). The fertility nurses AT KAISER suggested I might find more reasonable fees elsewhere, and gave me a list of clinics to try. (For example, a follicle ultrasound if covered 50% is $110, but if not covered, they rake you for $580!) Right now I'm trying Letrazole with an HCG trigger shot.
Has anyone successfully transferred their labs from Kaiser to a non-Kaiser fertility clinic without too much delay? Any recommendations for clinics or how to do this to minimize repeat testing etc.? Many thanks for any info you have! Still trying
I had the same problem at Kaiser it was ridiculous! I only did 3 iui's and cost me over $1000 with no meds! We had to hold off. Luckily we have new insurance now...but I do recommend the Reproductive Science Center in Orinda,they are amazing. The Dr's actually call you on the phone to check in, what a concept?! http://www.rscbayarea.com With Kaisers records you can get most of that online and print out your lab results. I did have Kaiser copy all my IUI procedures for me too and that took a few weeks to get to me. I recommend getting your own copies that way you can have it on hand if you want to switch clinics. I also tried UCSF prior to RSCB, but I am glad I found RSCB they are wonderful. A.
After three (unsuccessful) rounds of injectibles/IUI at Kaiser, we switched to RSC (reproductive science) in Orinda and San Ramon, where we ultiamtely did IVF. (We left Kaiser at that time due to job change, so couldn't have stayed in any event). I found the experience at RSC to be far, far superior. At Kaiser Oakland, for example, I had to come in every morning for blood work by 7:15 am, then had to have ultrasounds after 8:30-- except every single ultrasound patient was scheduled for 8:30, so it was a total crapshoot as to when you'd get your actual appointment and the whole experience was horrible demoralizing. At RSC, you'd come in for your specific time, quickly give blood, get your u/s, and then go. I didn't have problems transferring my records-- although what I did do (at the Kaiser nurses' advice) was to come in and they photocopied my fertility treatment record, and I took it, as I understand that going through the official channels (which I also did) takes much longer. RSC accepted most of the tests I'd already had done, though I did have to repeat Day 3 tests, etc. (which would be standard, as these can change over time). Oh, and I'm now the proud mother of twins glad to be done with fertility treatments
Experience with Kaiser Fertility Clinic?
Sept 2009
I'm 36, and my husband and I have still been unable to get pregnant. We are now in the position of actually moving ahead with Kaiser. We are looking at various Fertility Clinics through Kaiser, and I'm wondering if anyone has experience you could share. I am hopeful someone can share thoughts on Fremont's clinic, and Drs. Akagbosu and Shen, which is where I think we will go. If someone has had a fantastic experience at another clinic, can you share that? What can you expect from your first consultation with a Kaiser fertility doctor? Are they eager to just start Clomid? I'm also really scared and anxious, and hopeful they offer other help. Do they have support groups? Any thoughts -- I would really appreciate them. 36 and counting...
I had a great experience at the Oakland Kaiser Fertility treatment. Luckily I ended up only needing low level treatment. I really liked working w/ Dr. Hirata and the Staff. I had been on a ''Trying to Conceive'' Yahoo group so I was very prepared & knew what to expect going in. Kaiser makes you take a class but if you've been following an on-line support group and/or reading Taking Charge of Your Fertility it was way too basic. It does help to know exactly where you are in your cycle when you begin so you can jump right into all the diagnostics and not have to wait an extra cycle. I also recommend the Mothering.com fertility boards if you haven't checked those out. - No. 2 Finally Arrived
I had a very good experience with Kaiser Oakland's fertility clinic. If the Fremont clinic is similar to the Oakland one, than you are jumping the gun a bit with your questions. First and foremost you need to get a referral from your OB to the clinic. Then they have you go to a one time ''class'' that is offered several times a month. There a nurse will go over the process, what Kaiser offers, and give you a folder with instructions and all sorts of lab slips for tests you have to do. Most of the tests are blood work that is done at different times of your cycle to test various hormone levels, your uterus will get looked at to make sure fibroids aren't an issue and your partner's sperm needs to be tested (the frequency of male infertility/sperm issues being the cause of the problem is about equal to that of female infertility). We were assigned a fertility doctor.
All of this takes months so get on it now. Once they have all the test readings they can determine what your issue is and what steps to follow. It's different for everyone. Some folks skip Clomid and go to the next more aggressive level. Some folks do several rounds of Clomid. I did one round, then because of my hormone readings went to the next level which is injectable hormones and got pregnant with one round of that. Others I know did none of the above and had to go directly to an egg donor. I'm just telling you all this so you don't get worry about what's going to happen till you get the tests done and a diagnosis. Like I said, my experience was with Kaiser Oakland. I really, really liked how organized everything was, and how friendly/helpful the fertility nurses were (during the hormones you are closely monitored and talk to them almost every day). Good luck anon
my heart goes out to you. i know how difficult this time can be. while i dont have experience at the fremont office i do have a little info on the richmond clinic. the doctor is dr thompson and i really didnt care for her at all. she really was seeming eager to get me one meds as your concern, however mine wasnt clomid. the thing is though that you kind of have to go through all their hoops to even get all the lab tests and hormone stuff done to narrow down what it is you will need, and a doctor has to be overseeing it. i would see her and she'd order some tests and then email me the results and i did all my own research as to what it all meant. i think i actually only saw her twice because once i found out exactly what my issue was ( low progesterone) i went to accupuncture and was pregnant in 3 months. she thought it was due to the meds which i never took- ha! also the billing was a major issue with them; according to my policy it stated ''services to determine infertility are covered at the regular co pay rate'' which means that all the initial tests to find out just what the issue is and until they label you ''infertile'' ( which is just heartbreaking, i know) are covered. be sure to look into this and ask many people many times if necessary, otherwise you will be paying an arm and a leg for each test. and know that it will happen for you! just remember that your baby will come to you when ready. its so hard but so worth it
We had a very positive experience at the San Francisco campus. The staff, RNs, NPs, and Drs. Nachtigall and Feigenbaum were very supportive, thorough and patient with us. I was 35 yo when I first went to them. They did all the testings to see what the problem was. When nothing was obvious, they suggested we move to do clomid, which we tried for a couple of trials. Nothing changed, so they suggested intra uterine insemination- IUI. We weren't ready at the time, took 6 months off to try an alternative means. It didn't work, so we called up Dr. Nachtigall and requested to start IUI. 11 months later, we had our healthy little boy. We're planning to go back to them next year if we can't get pregnant on our own. I didn't think there was a support group that met regularly, though there was a class we had to attend prior to meeting with the clinic. anon
I was able to get pregnant with twin boys while going to the Kaiser's Fremont clinic. After given a fertility plan, I was then passed over the nurse prac. and had a bad experience of us not staying on track. After I voiced my opionion and pitched a hormonal fit, then I only had to work with a doctor and got pregnant with my boys the next cycle. Though I had one bad experience with the whole process, it was well worth it. I found the staff very responsive, helpful and supportive. I do not recall any of the staff's name, I totally recommend this clinic to anyone who's trying to get pregnant. Ask lots of questions about your process and what would be the next steps if the current program isn't working. Good Luck! Kellee
I am only seeing the heading of this post. After several rounds of unsuccessful meds and unnecessary, painful tests at the Kaiser (In)Fertility Clinic, I was told that I would never have a child. So, after acupuncture treatment, when I was pushing my baby in a stroller and ran into the very respected clinician who had told me that, this ''doctor'' told me that they have no idea what makes someone fertile, and that the very best pregnancy success rate comes from acupuncture treatment. The ''doctor'' didn't say anything about the ethics of having wasted my time and broken my heart. Now when I see the women heading to the fertility office, I feel slightly sick. It's hard not to think they'd get pregnant faster if they spent more quality time with their partner and less in those smelly doctors' offices. Good luck to everyone trying. I know that our bodies know how to help us better than strangers who make their living roping us in with their ''methods.'' Surely my experience is not everyone's--but I am here to say THERE ARE A LOT OF US. Sending Good Luck to You
I went through Kaiser's fertility process. They were fantastic. When testing revealed sub-par hormone levels I was prescribed Clomid and became pregnant in the 2nd month of taking it. Simple as that! The class that they require is very informative. The hardest part was getting my husband to give his sample.. Gen
June 2006
Re: Seeking great fertility doctor
Dr. Erica Breneman at Kaiser Oakland is a great physician....highly recommended. Also, UCSF Center for Reproductive Health is very well regarded....great team of docs that operate in a cohesive practice anon
April 2002
Does anyone have any recent experience with the Infertility Clinic at Kaiser Oakland? I've just been referred to them from my Kaiser Ob/Gyn and am wondering what to expect. Do they do all of the same procedures as private clinics? Are they supportive? Any feedback you can give is great! Thanks, Heather
My experience at Kaiser Oakland was 3 yrs ago. Kaiser's limits in infertility treatments do not extend to ivf, though they do include treatments by a reproductive endocrinologist. They offered artificial insemination, clomid, etc and assisted ovulation, I think it's called (where you take drugs to increase ovulation, and the size & # of eggs are followed until ovulation is triggered by an hcg shot). We were not impressed with our Dr. at the time (Dr. Lee, who I think has moved on) nor was it a supportive environment, to say the least. We also had a difficult time getting all of the testing done in a timely matter, though maybe that was the doctor. In all fairness, though, Kaiser really can't afford to offer the one-on-one care that expensive clinics offer. janet
We conceived Fall 2001 after navigating Kaiser Oakland. They do not do ivf. They do provide fertility drugs and iui. They also now offer a monthly support group. We saw Janie Hirada. I charted my temperature on chlomid and she responded by halving my dose. She was willing to try this when standard is to double it. My familiarity w/ my cycle and luteal phase was key. W/ Kaiser it is essential to do your research (Resolve is a good resource) and be your own advocate. The worst thing about it from my perspective which isn't necessarily different from a practice is having to go to a sperm lab by alta bates and drive across town w/ your precious cargo; and then sometimes wait a long time for your appointment at Kaiser. Also you get the iui appointment w/ whichever practioner is available when you ovulate so I found it alienating and even a bit traumatic to see a different person for successive inseminations. The last and successful time we prepared for it mentally (the drive across town will take longer than we think; there will be no parking; we will wait in the waiting room a long time. We brought a book we love and my husband read to me while we waited before and after the procedure) and it was even a 'nice' experience. Once you are pregnant they take incredible care w/ you, monitoring your hsg closely until it reaches a certain number; providing early ultrasound to rule out ectopic pregnancy. anonymous
I was referred to Dr. Hirata at Kaiser in the summer of 2000, after trying to conceive for about 6 months. She started with blood tests (and semen check for my partner) which were helpful,as my thyroid level was low (besides helping to regulate the other hormones, thyroid is important to have at the correct level during pregnancy). I had done some reading and was losing weight towards what I felt was more balanced, which she approved (one study showed even 6 pounds gained or lost towards a balanced weight has a huge fertility impact). I had been charting my temperature carefully but she did not look at it.
After a few months I went back and was offered an HSG (checks the fallopian tubes by shooting a dye through and watching its progress) and clomid. I declined both. I had blood draws to check hormone levels, and an ultrasound of the ovaries. I went to a midwife practice for a fertility consult at this point and got a lot more info and reassurance. The midwife recommended I read about the use of clomid---it can have severe side effects, one of which is drying up fertile mucus which has to be there to provide a ladder for sperm. At Kaiser there had been no mention of side effects.
I agreed to the HSG after another month or so. The HSG was ok, not painful, just strange. I felt quite strongly pressured to go with the clomid. One nurse during a call told me I wasn't ovulating, (I knew I was from my charts), and that I would never get pregnant without clomid, leaving me in tears after I hung up. I stuck to my resolve to avoid invasive measures at that point.
I conceived during the cycle after the HSG (this is somewhat common, according to Dr. Hirata) and my daughter was born in July 2001. I was glad for the help in finding the thyroid deficiency and the HSG procedure, but I was quite upset and stressed by the pressure (especially from the fertility nurses) to take clomid. The month by month hopefulness and disappointment is soooo hard, and the midwife consult helped in a way that the Kaiser clinic did not.
I would recommend keeping yourself well informed and visiting a midwife practice too. A book I found that is long but very informative and compassionately politicized about fertility issues is Beyond Second Opinions: Making Choices About Fertility Treatment by Judith Steinberg Turiel. I wish you the best of luck! anonymous
I know you were curious about the services at Kaiser Oakland, but can I offer an alternate recommendation if you find you do not get a good response or do not like the services there? I saw Dr. Feigenbaum at Kaiser SF and found him to be very direct and candid about my issues with infertility. He did not pull any punches, but I like that in a doctor. Kaiser SF also has some state of the art equipment for infertility diagnosis and treatment. If you ask your OB, he/she should be able to send you there.
You may already know about this, but you can also post on the INCIID website for recommendations about Kaiser Oakland or others' experience. It is also nice to get some support for yourself. I was lucky in that 3 of my close friends were going through the same thing (we all have babies now) and my experience has been that infertility is too traumatic to try and handle on your own. Best to find people who understand what you are going through and won't just tell you to 'relax' or 'stop trying and you'll get pregnant.' I wish you lots of luck, and all of us with infertility issues are thinking of you! Please feel free to contact me with any questions. kmmills
I worked with Dr. Janie Hirata at Oakland. I was disapointed in her communication style but, in the end, felt she was very responsive to what I wanted to do. I did not feel good about the guidance I got from her so I took some extra time to get as much information as I could on my own - I talked to people who had used fertility treatments and most importantly I joined a group called Resolve. (www.resolve.com) They had (and maybe still do) a monthly evening group where a fertility MD came to answer questions. I went three times and from there decided how I wanted to proceed. I presented a plan to Hirata and she agreed to the whole thing. I did get very lucky and got pregnant the first time so I did not have a lengthy experience with her and her coordinating nurse. Another fertility MD who has much less availability is Brenamen. From what I have heard, she is excellent. There is also an MD, Dr. Fiegenbaum I believe, at SF Kaiser who is also excellent.
If you are working with Dr. Hirata and her RN, ask lots of questions. This all is so routine for them it seems like they forget that it is new for the patients and sometimes don't explain things as thoroughly as they could. Feel free to contact me if you would like to discuss my experience. Good luch to you. Elizabeth
I have experience from 7 yrs ago. I went to an outside clinic w/my own $ for a 2nd opinion. Glad I did that, the unintended but definitely fortuitous result was that Kaiser did the diagnostic testing, and treatments (unsuccessful) for a number of cycles. When Kaiser said I was not a good candidate I went straight to the outside doctor and was pregnant the next cycle. Anon
Sept. 2000
In response to the fertility specialist question posted below. I can recommend Dr. L. Darlene Lanka of Kaiser Walnut Creek. She is not only a fantastic OB-GYN/surgeon & remarkable person (voted Best of the East Bay by Diablo Magazine), she co-authored a book titled Perimenopause, She is one of Kaiser's fertility specialists and has a special interest in diabetes (her daughter had childhood onset diabetes). She is a UC Berkeley undergrad and a UCSF Medical School grad. She may not be taking new patients, but if you pester Kaiser enough you may get in to see her. She's definitely worth a try. Nancy
Congratulations on your upcoming move to the Bay Area! We have gone through several IVF procedures with Kaiser. Our insurance policy did not cover IVF but it did cover all the other procedures that were part of our overall fertility treatments. We used an egg donor and paid Kaiser $15,000 which covered all the medical costs for both the donor and myself. Kaiser doesn't provide egg donors; we went to an outside agency and paid them directly for the donation.
When we tried again later using the frozen embryos that we already had, the cost was only $4500 for my needs. I don't know the specific costs for the medications since we paid a lump sum. I would advise that when you get insurance through Kaiser, that you specifically what the difference in the annual cost is with and without IVF coverage - it could be that you are better off paying out of pocket for the implantation rather than paying super high annual premiums.
I can't speak to the insurance portion of your question, except to say that many policies do not cover fertility treatment. My understanding with Kaiser is that if one's policy does not cover fertility treatment, the only benefit is that most of your lab work may be covered, which is minimal in the scheme of fertility treatment costs.
I would recommend choosing a clinic based on reviews of REs and proximity to work/home. I've had a positive experience of Reproductive Science Center, which is in San Ramon but has several satellite clinics for scans and routine blood work.
I can't speak to the cost precisely, but the egg retrieval (including meds) is the most expensive part of treatment, so if you already have the eggs you'll be in good shape financially. I think transfers cost approximately $300 per cycle and meds for transfer cost less than $100 per month, but those are both ballpark figures. I paid for a package, so have no idea how much scans cost.
Good luck!
We took 13 months to conceive our son so around month 11 I started digging in. I had a really good Kaiser plan at the time and they only covered 6 rounds of IUI and 50% coinsurance on the meds/labs. Your Kaiser plan may be better, but after looking around... I think that was one of the better infertility treatments offered by many insurers (Anthem, Blue Shield, UHC, Cigna, etc) at the time.
I don't have all your answers, but I can point you to another place to get answers: Resolve, the National Fertility Association, has a forum where there are lots of people who can share their experiences and there are often questions about these things and many people in the bay area who can give specific recommendations and experiences.
I have Kaiser and went there for testing, but have not gone on for IVF. My husband has good insurance that pays for 50% co-insurance for testing and treatment, excluding IVF. The doctor told us that no Kaiser plan covers IVF, but it is possible for companies to buy a specific IVF policy in addition to a regular plan. It won't be included in your regular plan, and you'll have to talk to your HR department and ask if they have IVF. I'm not sure if meds and monitoring would be covered with our fertility coverage, but I think it's likely since IUI is covered, I think it's just the IVF itself that is not covered. So I'd ask what their fertility coverage is (it's rare to have any coverage for it at all- both the financial office and the RE's office we're suprised we had coverage). Alternately, the fertility centers in the area probably offer monitoring and meds. I knows I've seen this question asked and answered recently on the Resolve forums with someone doing out of state IVF, see definitely check out that forum. Good luck and best wishes for success!
In terms of pricing (I feel money sick all over again looking at my IVF spreadsheets;)- my clinic charged about $300 for an initial consultation and then $490 per monitoring visit- that included the ultrasound, and blood work for estrogen and progesterone levels. The embryo transfer ran about $5,300 but it would have been closer to $3,700 had it been a frozen transfer which yours likely will with donor eggs (unless you're leaving the country for that part). Then there were two blood draws to test for hcg levels (pregnancy hormones) at $65 a pop and a mandatory 7 week sonogram to confirm the pregnancy that ran about $270. If you already have the egg retrieval taken care of your medication costs will probably be quite low in comparison to the $3-6k for a full retrieval cycle (but I'm just guessing here) you may only be on the hook for lupron ($200-300 for a 14 day course) and progesterone which is about $120 for a 10 day supply of injectables (this is from memory, may be wrong) plus about $100 a week for progesterone suppositories if your doctor likes to double up. I was on the progesterone until I was 11 weeks pregnant so that cost adds up but I've heard people have good luck ordering from Europe (ivfmeds.com or the like) where the cost is about 75% less.
In terms of your insurance- very few insurance plans in the US cover IVF. If you're lucky enough to work for a major tech company you might get hooked up but most others will be out of luck. Ours covered 50% of infertility (dignostics, IUIs, any procedures necessary to help your fertility like HSG or laproscopy) but nothing for IVF (or egg donation). If your insurance covers any of the IVF costs, I'd stick with them though I had an awful experience at the Kaiser IVF center in Fremont and later switched to Reproductive Science Center Orinda which was wonderful- had my insurance paid for anything I would have sucked it up and stayed at Kaiser.
In terms of where your monitoring can be done- any place that offers full IVF will be set up for it. Kaiser used to do IVF satellite monitoring out of a number of offices, including Oakland but stopped allowing patients to go to Oakland while I was there in June so you had to drive all the way to Fremont and wait an hour (first come first served) for a two minute ultrasound and then drive to a separate lab wait and wait in a huge line to get blood drawn every two days. RSC was a very quick, one stop shop where you got blood and ultrasound done at the same time and with very little wait.
All the figures above are pulled from a cycle where I used my own eggs though so please know that it's just what it cost in my case- I'm not an expert in treatments with egg donations.
Good luck to you- it's a stressful and insanely expensive ride but totally worth it if it all works out (the kid just better get a scholarship to college because we're fresh out of money;P)
I'm sorry to hear you have to go through IVF -- we are in the process ourselves and it is very stressful for us! The good news is that there is very good fertility care in the bay area. The bad news is that it can be quite expensive and both treatments and medication are frequently not covered by insurance. Our fertility doctor told us about 20% of his patients have some kind of fertility insurance. A lot of people actually go abroad for a cycle to get lower cost treatment! Even with missed work it can be a more affordable option.
In terms of the insurance question, it really depends on what is offered by you or your wife's employer. Fertility treatments are so expensive it really is worth making your health insurance decision around which plan, if any, covers fertility. Check carefully through the plans, and talk with the HR people at you or your wife's work, and call the plans themselves. I think if you are getting coverage through a big tech company like google you are more likely to find fertility coverage. If you are going through Covered California (ObamaCare/ the semi public health plan), you probably will not be able to get any kind of coverage (at least when I had it there were no plans). I once had an employer sponsored plan that covered fertility evaluation, but not treatment. My friend has a Kaiser plan that covers 50% of the costs, although she hasn't been particularly happy with her care (but I'm sure there are a variety of doctors there). Also worth knowing that Kaiser's main fertility centers are in Fremont and Sacramento, although there are some smaller offices. https://www.kpivf.com/
The costs to you will really depend on what kind of coverage you have. I am looking at my paperwork, and if you have to pay the full costs yourself at my clinic (like I do), the ultrasounds are $280 per visit. I'm not sure which hormones they will be looking at for donor egg transfer (we are doing egg retrieval), but labs for progesterone, estradiol, and HCG are $120 each (although insurance should cover HCG and progesterone tests if you are already pregnant). The stim meds for egg retrieval are really expensive $5000 per cycle), but it sounds like you won't be doing that if you already have a donor egg lined up. I don't know what meds are involved for a donor egg transfer cycle, but meds for our frozen embryo transfer were around $300. Most clinics offer a bundle package for all the treatment and testing needed for one cycle. I don't know about donor eggs, but a traditional IVF cycle runs from $15000 to $20,000 per cycle.
Best of luck! It so tough to be struggling not only with fertility, but figuring out how to navigate the medical system side of things as well.
In terms of where you can get your testing done, we love our doctor, Dr. Herndon, at AltaBates IVF in Berkeley, although the doctors do their surgical procedures in another clinic. You can also check out Pacific Fertility Center or Spring Fertility Center in SF. In Marin there is Marin Fertility Center.