Talia came to Extend Fertility in 2020 after quite a rollercoaster: in just over three years, she’d seen four doctors, had three surgeries, and experienced several chemical pregnancies and an early pregnancy loss. Happily, she was able to get and stay pregnant after working with Dr. Klein to address her primary fertility concerns—uterine scarring and a thin lining—before a frozen embryo transfer.
We talked to Talia about her experience with Extend Fertility, how it differed from the care she received at other practices, and her insightful advice to others on this same journey.
Where did your fertility journey take you prior to Extend Fertility?
After being on the pill for a decade, my period was regular, but it was very thin, and that was concerning. So as soon as I started thinking about having a baby, I went to a fertility doctor without doing very much research. I ended up at a large fertility network in NYC. After my first two monitored cycles failed, the doctor quickly suggested IVF, which was still scary at that point, and I felt I should do a bit more research before diving in.
I ended up at another large clinic next. While I felt it was a high quality of care, I didn’t feel like the doctor was able to customize a solution for me once I started to face some road blocks. Although I did get pregnant after a few IUIs, it unfortunately ended with a lost heartbeat at seven weeks, followed by a dilation and curettage (D&C).
The D&C led to scarring in my uterus, or “Asherman’s syndrome,” which prevented my period. I believe Asherman’s is underrepresented in the fertility conversation, and can be fairly common with patients who have had a D&C or other uterine surgery. Thankfully, I was able to go to a specialist in Boston who was able to remove the scarring.
Did you feel ready, at that point, to move on to IVF?
Yes. When I came back to my fertility center, I was thinking, “Let’s get this show on the road.” We started IVF.
I had a good result with the egg retrieval and several embryos that were genetically normal, which was great—but my uterine lining was still very thin (around 6mm). Even though the scarring had been removed, my lining was slightly thinner than a year prior. After my first two frozen embryo transfers (one failed, one chemical), my doctor suggested a surrogate. Since this was only a year after I started “trying,” I felt there were other roads to go down first—I just didn’t think this doctor had the bandwidth to address a patient that didn’t fit in the standard toolbox.
I ended up next at a small practice in NYC. It was like a breath of fresh air, in that I didn’t need to get in line first thing in the morning for 30–60 mins with two dozen other women for blood work, and I was always given the option of seeing my doctor for monitoring. The doctor had a list of tests that she thought may reveal the root of my problems, and suggested running through each of them. These were often invasive, time-consuming, and expensive, and none came back with anything notable. Eventually I felt it was a dead end and waste of time.
How did you decide to move on to Extend Fertility?
Dr. Klein had a great reputation, but I hadn’t seen him before because he didn’t take my insurance. In January 2020, he started to, and I made an appointment.
In our first meeting, he said, “Your problem has always been thin lining and scarring. Let’s focus on that, because you’ve gotten pregnant before.” He really wanted to address the issues at hand, instead of running through popular tests that may find other issues. His approach made sense. I suggested a few options forward and suggested doing his own research to see what made most sense. I really appreciated that he wasn’t just reading out of a textbook, but examined my situation holistically to figure out the best path forward.
Ultimately, he suggested looking to see that the scarring was in fact completely removed and had not come back (which shockingly no other doctor had done). He went in and saw that there was still scarring, and was able to remove it. He thought that there was enough scarring removed that the next transfer could have a positive outcome, even though my lining was still thin. He also suggested slight tweaks to my medication to keep the pregnancy “sticking.” We did a frozen embryo transfer (number five!), on a 5.8mm lining and it worked!
How would you describe your experience at Extend Fertility?
I love the small practice. I knew that I could always see Dr. Klein if I wanted to and he was always very reachable if I had a question. At previous practices, calls to nurses often went straight to voicemail and email was limited or non-existent. [EF] was just so much more organized, so much more transparent, and so much more personalized than prior clinics.
There was one specific time where I had an issue filling a prescription while at the pharmacy. I had to start the medication that night. I was able to get in touch with EF almost immediately and they were able to address and fix the problem (which was not even their fault, just something that had to be cleared with insurance). That would have never happened at my previous facility. It would have taken days to get it cleared up.
When I had my transfer, the office was under COVID-19 operating procedures, so admittedly, I was one of the only people in the office. But I felt like a celebrity because of the attention and care I got. I thought, “This is what Beyoncé must have felt like when she was doing IVF!”
One of the sonographers, Ana, was a consistent positive force throughout my cycle. She was authentically excited for me when my pregnancy blood work was positive. I’ve had positive tests at prior practices, and have been in many times for blood work, and I never felt connected to a nurse or staff member on that level.
Dr. Klein is super bright, and super thoughtful, but also has the humanity side, which is so important. I felt that all the doctors and nurses I met at Extend had that combination of kindness, humility, and intelligence.
Is there any advice that you would give to someone who is just starting out on their fertility journey?
I have two pieces of advice. One, you really do have to be your own advocate. Some doctors are just reading out of a textbook; you know your body, and you should work together with your doctor to figure out what makes most sense. I would have saved so much time if I had said, “No, I don’t need a test for endometriosis. I have no signs of endometriosis!”
The other piece of advice is that I strongly recommend a smaller clinic. The larger clinics often have good reputations, and may have great doctors. But why wouldn’t you go to a place where the doctors are equally bright, but manage a smaller number of patients, where you can rely on communication about your treatment, insurance, and your medication? This whole experience is tough enough. Go to a place where you are treated like a human being, and not a number.