Kaiser Permanente
Sacramento, CA

Key Points
- Kaiser overlooked my endometriosis for years — it was found incidentally during a routine ultrasound, not through proactive investigation
- My partner's HbA1c was never tested or flagged — in my opinion this significantly impacted our first retrieval outcome, though I cannot prove causation
- Birth control pretreatment was standard protocol before every cycle — retrieval and transfer alike
- When I flagged concerns about birth control affecting my ovarian response, my doctor dismissed them — in retrospect I strongly believe my instinct was correct
- I had to find ReceptivaDx BCL-6 testing myself after two failed transfers — Kaiser never suggested it
- Three personal transfers at Kaiser. All failed.
- Everything was paid out of pocket — no insurance covered any fertility treatment
My Experience
I liked my doctor at Kaiser as a person. I genuinely did. I don't believe he was trying to do harm or cut corners intentionally. But things were missed — and in my opinion they were missed because Kaiser was taking on more patients than they could deeply individualize care for. When you're seeing that volume of patients things fall through the cracks. It's not malicious. It's the reality of a system stretched too thin.
What was missed in my case: my endometriosis was not proactively investigated — it was found incidentally during a routine ultrasound. My partner's HbA1c was never tested or flagged as relevant to our fertility outcomes. I raised a concern about birth control affecting my ovarian response and was dismissed. I found ReceptivaDx BCL-6 testing myself after researching recurrent implantation failure — Kaiser never suggested it after two failed transfers. My BCL-6 came back significantly positive at 2.4 against a threshold of 1.4.
I can't prove any single one of these things caused our transfers to fail. What I can say is that in my opinion — based on my experience and the experiences of others I've spoken to who have gone through Kaiser — the pattern of missed things isn't random. It reflects a system managing more than it can handle.
My Experience with Birth Control at Kaiser
The month before my first egg retrieval I went in for a baseline scan around cycle day three or four. My ovaries were already developing multiple follicles — a strong, promising baseline.
I was then put on birth control for approximately ten to fourteen days before starting stimulation. When I got off birth control and my next period started I went in again on cycle day two or three for another baseline scan. My follicles were not developing the way they had been the month before. The difference was noticeable. The doctor couldn't explain it.
I told him I thought it was the birth control. He dismissed it.
I started stimulation medication anyway. After a few days of poor response — significantly fewer follicles than my baseline scan the prior month had suggested — we made the decision to cancel that cycle rather than proceed.
The next cycle I did not use birth control pretreatment. My follicles came back.
Three cycles. The key difference between the one where I didn't produce and the ones where I did was birth control. I cannot prove that was the cause — but I strongly believe it played a significant role and the timeline is hard to ignore. The doctor dismissed my concern. I'm sharing it here because maybe it will help someone else ask the question before their doctor dismisses theirs.
What I'd Tell Someone Going Into Kaiser
- Push hard for a comprehensive workup for both partners before you start — don't assume that because they ran labs they ran the right labs
- Ask specifically about HbA1c for your partner
- Ask about birth control pretreatment and whether there is a clinical reason specific to your situation
- If you have endometriosis history or suspected endo be proactive — it may not be investigated unless you push
- If a transfer fails ask specifically about ReceptivaDx BCL-6 testing — don't wait for them to suggest it
- Kaiser is a system. Work with it but be your own advocate within it.
Approximate cost breakdown
- IVF retrieval procedure
- $22,365
- Medications (Mandell's Pharmacy — not shopped around)
- ~$4,520
- PGT testing
- $1,470
- Three transfers
- $13,170
- ERA test
- $795
- ReceptivaDx
- $1,085
- Approximate total
- $43,000+