When first considering or starting fertility treatment, many questions abound. What type of treatment is best, will it work, how will I afford it, how can I fit treatment info my life? Our Getting Started video captures some of the common patient questions and concerns and helps to set minds at ease.
Other common questions patients ask as they consider starting fertility treatment:
Do I need a referral to be seen at Shady Grove Fertility or begin infertility treatment?
While Shady Grove Fertility does not require a referral from your OB/GYN or primary physician to be seen in our office, your insurance provider may. If you are not sure if you will need a referral, a general rule of thumb is the following: HMO plans from any provider, along with United Healthcare’s MDIPA and Optimum Choice and Kaiser, will likely require a referral in order for the consultation to be covered. If you are not sure or want to verify what your plan requires prior to scheduling an appointment, call your insurance company directly or call 1.877.971.7755 to speak with a New Patient Center team member who can help determine if you need a referral. Shady Grove Fertility participates with over 30 insurance providers and each office has a financial counselor dedicated to helping patients navigate their insurance coverage and financial options.
What is included in the diagnostic testing?
After an initial consultation with a physician, you will be instructed to call your nurse on the first day of your cycle—defined as the first day of full menstrual flow—to schedule an appointment for day 3 hormone testing. During the appointment, your medical team will test several hormones including anti-Müllerian hormone (AMH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH). Together, these hormones, along with the results from an antral follicle count obtained from an transvaginal ultrasound of the ovaries, tell your physician the quantity of eggs remaining in your ovarian reserve.
A hysterosalpingogram (HSG) will also be performed, which is an x-ray dye test of the Fallopian tubes that will verify that your uterus and tubes are clear of obstructions.
In addition to these tests, if there is a male partner, he will need to have a semen analysis. Based on the results of the initial diagnostic testing, your physician will be able to recommend which treatment plan will be most successful for you.
What is morning monitoring? What happens during monitoring visits?
Think of your morning monitoring visits as a check-up to take note of your treatment’s progress. You have about 4 to 6 monitoring visits from day 3 to day 14 of your treatment cycle. Monitoring visits are in the early morning, usually between 7:00 a.m. and 9:30 a.m. depending on the office. The visits last about 20 to 30 minutes, during which a medical assistant will draw your blood and a provider will complete a transvaginal ultrasound to see how your follicles are developing. Results for the blood tests will be sent to your medical team that afternoon and you will likely receive a call from your nurse with an update including any changes, if any, to your medication protocol.
Can male partners be tested in a Shady Grove Fertility office?
Yes, all Shady Grove Fertility offices have semen analysis services. In 40 percent of couples that are having trouble conceiving, male factor infertility is the contributing issue. Therefore, testing the male partner is a critical piece in determining a patient’s treatment path. The male patient can collect a sample at home and bring it to the office or the collection can be obtained in one of our offices (select offices only).
Do patients typically start with in vitro fertilization (IVF)?
No. After a patient has had their initial baseline testing and bloodwork, a treatment plan is created and, if medically indicated, we would start with intrauterine insemination (IUI) treatment, which is considered a basic, or low-tech, treatment option. Studies have shown that after three or four IUIs, it becomes less likely for this approach to be successful. In the event severe male factor infertility or a blockage in the Fallopian tubes is found, it would likely suggest moving straight to IVF.
Another factor to consider is insurance coverage. Some plans will require a certain number of IUIs before moving on to IVF. Others will cover a certain number of IUIs, in which case many patients may exhaust that option before starting an alternate treatment. Your financial team will verify your benefits and determine what your unique plan requires. Then you, your medical team, and financial team will work together to determine the best course of action.
What is the time frame between diagnostic testing and starting fertility treatment?
Patients will come in for the initial consultation to meet their physician and review medical history. From that point, it typically takes about 4 to 8 weeks until treatment will begin. This time frame is dependent on several factors, including where you are currently in your cycle and what testing has previously been completed.
If a patient is overweight and has a high body mass index (BMI), would you have them lose weight before starting fertility treatment?
Maybe; it depends on the individual patient’s BMI and infertility treatment plan. While we want both our male and female patients to be in a healthy weight range, the ability to move forward with treatment is mainly dependent on the female partner’s BMI. For patient safety, we require a BMI of 44 or less when starting an IUI cycle and 40 or less for IVF. Studies have found that weight can drastically impact the ability to conceive, and even a modest 5 to 10 percent weight loss can help to increase the chances of conceiving. If you need help losing weight, your physician can recommend a nutritionist to help determine a weight loss program.