Our family has been patients w/ PennMed since 2020,& our experience at other network locations has…read moregenerally been positive.This review covers our personal experience at Penn Fertility Care specifically, navigating family planning w/ a known genetic risk (FMR1/Fragile X syndrome),through IVF & PGT-M.Before starting,we asked whether the clinic had hands-on experience managing Fragile X cases.We were told yes, & our care was handled by Dr. Anuja Dokras.All 5 consultations were virtual, w/ occasional tech delays one stretching to ~40 min. Gaps of 1-3 mos between appts left us feeling short on time to unpack complex genetic questions & fully grasp next steps amid the uncertainty. We asked twice to switch physicians (at intake & again early on, requesting someone specific), but were turned down both times (see att.).After genetic counseling & 2 stimulated cycles,we had pressing questions about realistic odds of getting a healthy,transferable embryo using our own eggs.Cycle 1:16 eggs retrieved,2 embryos formed,neither cleared PGT-A.Cycle 2:14 eggs retrieved,1 embryo formed carrying the full mutation.Only after repeated follow-up,once a 3rd cycle was already on the table, did we finally get an individualized estimate:roughly 10% odds per cycle.Layer in a ~50% embryo transfer success rate,standard freeze/thaw risks,plus a 94%+ chance that a 133-repeat maternal premutation expands to a full mutation (ruling out transferring a female carrier embryo something never clarified upfront), & the cumulative odds were startlingly low.Chasing a single healthy embryo at any cost, on an open-ended timeline, felt like a losing strategy absent full counseling from the start.We respect clinical judgment & understand IVF guarantees nothing.Still,we never got an early,plainly explained picture of how age, the FMR1 premutation,& PGT-A/PGT-M results combined to shape our actual prognosis.A candid,timely talk about alternatives donor eggs included before 2 costly,grueling cycles could've spared us significant financial & emotional strain.In a meeting w/clinic leadership,we pressed on strategy & communication gaps.We were shown general IVF stats from genetics,but felt these broad figures didn't capture our complex case.We were offered a $2,500 partial reimbursement for administrative issues appreciated,but it didn't touch our core concern: poor communication & lack of personalized planning.At our grievance meeting w/ the Division Chief of Reproductive Endocrinology & Infertility, the clinic manager opened by asking about our jobs.Through the mtg, we felt our case was being framed as bad luck, sidestepping accountability for the level of attn given to a case like ours a ~40yo patient w/ Fragile X.It closed w/ a genetics-lab branded mousepad citing general IVF stats.Overall,we felt unheard,w/our core points seemingly dismissed.To be clear, this isn't a claim of formal medical error just a candid account. Penn Fertility Care,Dr. Dokras,& the HUP Patient Experience dept have real room to improve:explaining individualized prognoses sooner,surfacing options earlier,& building a more empathetic communication culture for complex genetic cases.We remain open to dialogue & sent full documentation to Penn Med's CEO & VPs,requesting an independent grievance review & a fair resolution given incomplete informed consent.Other issues worth flagging:Embryo storage, materials stayed in cryo by default even when unusable,& we only learned about active fees after getting an invoice.For cycle 2,we had to proactively file paperwork ourselves to stop storage of the affected embryo (see att.).Procedure concern during a follow-up visit, a fellow attempted catheter insertion twice unsuccessfully,causing real discomfort, until an attending MD stepped in & completed it; this was documented & raised w/ leadership. Finance dept,non-routine requests took 2-4 wks w/ repeated follow-ups; a simple itemized bill needed for an employer grant faced major delays;we were referred to ARC Fertility (13-18% APR) despite much cheaper personal credit options;recurring billing errors required insurance-side audits;& before prepayment, we were sent the wrong contract package,raising further coordination concerns (see att.).All of this eroded our trust.We're giving 2 stars specifically to recognize the dedicated nurses,clinical staff,& individual physicians who showed real empathy & care throughout.Fresh perspectives & strong leadership could genuinely move this clinic forward.Sincere thanks to Kathleen O'Neill,Marissa Weiss,Alexandra Taylor,Laura Swartz, the procedure room nurses,& the front desk team