How was your experience with John Rapisarda at Fertility Centers of Illinois?
Dr. Rapisarda seems very knowledgeable in the field. From day 1 he was very open to answering all of my questions and providing information. I never felt like I was being pushed into any specific treatments or tests. He maintains a professional manner without being too personal (which I personally don't like in doctors) and without also seeming cold.
What's one piece of advice would you give a prospective patient of John Rapisarda at Fertility Centers of Illinois?
Don't be afraid to ask hard questions.
During treatment, were you treated like a number or a human with John Rapisarda at Fertility Centers of Illinois?
The clinic does seem like it churns women through it. But all of my experiences have been good. The nurses are excellent.
Describe the protocols John Rapisarda used in your cycles at Fertility Centers of Illinois and their degree of success.
We started the process with testing my husband's semen for analysis and getting bloodwork done on both of us. Since we had been trying to get pregnant for a couple years of trying, and with normal cycles and ovulation, the first couple months we monitored my cycles and bloodwork and ovulation. I also had ultrasounds done to look at any physical issues and saline ultrasound to verify that my tubes were clear. Genetic testing was also done on me to see if I was a carrier of any of the most common bad genes. Everything came back good.
Once everything came back clear, the doctor recommended starting with IUI and Clomid. The cycle used OTC ovulation kit to predict ovulation, a trigger shot and a scheduled IUI. Monitoring using bloodwork was done to rest estrogen levels and progesterone levels. I was given Prometrium due to low progesterone levels post IUI. Two weeks later I had the pregnancy test bloodwork done and it came back positive but with low HCG levels. Follow up tests over the course of a couple weeks weren't looking good. It turned out to be an ectopic pregnancy. Since I was being monitored so closely, we caught it early. I was prescribed Methatrexate to end the pregnancy and was told that I wouldn't be able to try to get pregnant for 3 months due to possible birth defects from the medication. I was given that information in advance of taking the medication. My options were to take Methatrexate or remove my fallopian tube where the pregnancy was.
We ended up waiting about 5 months before the next IUI. In the meantime I had bloodwork monitoring until the HCG levels came back down to 0 and another saline ultrasound to make sure my tubes were cleared following the ectopic pregnancy.
Round #2 of IUI, the doctor switched it up to try Femara. It works similar to Clomid but in a different way. Starting this cycle, I was monitored more closely with more ultrasounds to track the size of the follicles. Also did a triggers shot with Ovidrel, IUI and Prometrium on the latter part of the cycle. Pregnancy test came back negative.
Round #3 of IUI, we went with Letrozole. Ultrasound monitoring of follicle sizes, Ovidrel triggershot, IUI and progesterone again on the latter half. Once again, negative pregnancy test.
After two rounds of no results with IUI, the doctor recommended going with FSH injectibles. I was injecting 75IU of Follistim daily for 3 days, had a checkup and was told to go 2 more days at 75IU. After the next appointment, I was instructed on 1 day of 75IU and 1 day 66IU. Following those days, I was told to trigger shot with Ovidrel that night and IUI the following 1.5 day. A few days following the IUI, I was put on Progesterone in Oil shots daily. Pregnancy test came back positive. The first appointment to measure heartbeat (6wk), I was told the heartbeat wasn't as strong as they wanted to to continue monitoring. At the 7wk appointment, there wasn't too much growth from 6wks and the heartbeat was still lower than they wanted. They also said the gestational sac was irregular in shape. A few days later I had some light spotting. I was able to get in the next day and still there was low heartbeat and not any measured growth. The doctor indicated that it didn't look like a healthy fetus. I as told I could continue progesterone shots and see what happens. I was still spotting this whole time. A few days later I decided to stop the progesterone shots. When I went in for an ultrasound a few days after that, there was no more heartbeat. I was given several options following this. 1) I could wait and let my body miscarry the fetus on it's own which could take several weeks. 2) I could have a D&C to remove the tissue but there would be risk of scarring that could cause problems getting pregnant down the road. Or 3) Take Misoprostal to induce 'labor' essentially. It causes the uterus to contract and release the fetal tissues. The doctor explained the side effects of the medication and what the process would be like. He also explained that there is a chance that my body wouldn't expel all of the tissue and I might still require a D&C. I decided to take the Misoprostal that following weekend. It took about 5-10 hours for major cramping to kick in. About 12 hours later I had bad cramping and felt a rush of liquid and tissue pass. I collected the tissue in a specimen cup since we were going to send it off for genetic testing. Cramping continued for another day or so but got a lot lighter. 1.5 days later, I passed some more tissue, saved it and dropped it off with the other sample at the doctor's office. Bleeding continued, similar to period bleeding, for another couple weeks. It was very light. I went in weekly for HCG level monitoring until it dropped to zero. The tissue specimens were sent for genetic testing. All of the tests they ran came back normal. Since miscarriages happen typically due to a genetic abnormality, the doctor wanted to run a few tests to check for possible other issues. I had bloodwork done for immune system sensitivity that could have caused the body to reject the fetus. I also had a uterine biopsy done to check for bacterial issues that could have caused it. And lastly a bacterial swab of the vaginal cavity to check for bacterial issues. All tests came back normal. Essentially the miscarriage is unexplainable. The doctor said it still could have been genetic but something rare that isn't tested for typically. They only test the most common issues.
After my cycle came back, we waited 2 months of normal cycles before trying two more rounds of IUI with Follistim injections and Progesterone in Oil. Both resulted in no pregnancy. We are currently in a self-imposed wait before jumping into IVF. This was a decision we have made as a couple. The doctor didn't even mention anything to us about switching to IVF. We just feel it's time to move on from IUI. In the next month or so we'll go in for our IVF consultation and see where that all goes.
Describe your experience with the nursing staff.
There are different nurses. The ultrasound techs only perform the ultrasounds for monitoring. They've been very helpful, pointing out anything that was relevant. The nurses that take blood are always caring. I have bad veins and have had issues being poked, but they've done a much better job than other places I've been to. The doctor's nurse is the one who calls to follow up on blood results and ultrasounds. She was also the one to perform the IUI and met with me to go over how to administer my shots at the beginning of this all.
Describe your experience with Fertility Centers of Illinois.
I like that they open very early in the morning. I'm able to schedule majority of my ultrasound appointments and blood collection before I go to work. It works great with my work schedule. Only the doctor consultation and IUI are done during working hours. All of the staff are efficient and I'm able to get in and out of the office in great time.
Describe the costs associated with your care under John Rapisarda at Fertility Centers of Illinois.
I had some insurance coverage, mostly for ultrasounds and bloodwork. But the IUI and medication was not. For a Clomid IUI cycle, I paid $1,600 after insurance. For Femara IUI cycle, I paid $1,450 after insurance. The Follistim monitored IUI cycles were about $2,500-3,500 based on how much monitoring was required. An office visit consultation with the doctor was about $300.
Describe John Rapisarda's approach to eSET (elective single embryo transfer) vs. multiple embryo transfer at Fertility Centers of Illinois.
We haven't had this conversation yet.
What specific things went wrong at Fertility Centers of Illinois?
- Failed to call with results