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Learn about Fertility
Familiarize yourself with common fertility terms and treatments. Browse our most commonly asked questions and read first-hand testimonials by people like you.
- Intrauterine insemination (IUI)
- A type of artificial insemination in which washed semen is injected into the uterus using a catheter.
What is infertility?
Infertility is commonly defined as “not being able to get pregnant after one year of trying.” Experts often recommend that women who are older than 35 years and have not conceived during a six month period of unprotected sex should make an appointment with an infertility specialist. Women who do not have a regular monthly period should also consider seeing a reproductive endocrinologist because ovulation problems are the most common infertility factor in women.
- Intrauterine insemination (IUI)
- A type of artificial insemination in which washed semen is injected into the uterus using a catheter.
What is infertility?
Infertility is commonly defined as “not being able to get pregnant after one year of trying.” Experts often recommend that women who are older than 35 years and have not conceived during a six month period of unprotected sex should make an appointment with an infertility specialist. Women who do not have a regular monthly period should also consider seeing a reproductive endocrinologist because ovulation problems are the most common infertility factor in women.
- Consultation and fertility testing
- Patients interested in fertility preservation start with a consultation to discuss their medical history and fertility goals in detail with our provider. Based on the patient’s individual situation, we will make a plan to assess ovarian reserve and other relevant medical factors. Once these baseline parameters have been established, we will work together to individualize a plan for serial ovarian reserve monitoring or fertility preservation based on the patient’s preferences for moving forward.
- Egg freezing
- An egg freezing cycles takes about two weeks to complete. Medications are taken to stimulate multiple eggs to develop, and the process is monitored using serial bloodwork and ultrasound assessments. Once ready, mature eggs are removed through a minor procedure done in our office under anesthesia. The eggs are cryopreserved via vitrification and remain in long-term storage until a patient is ready to use them to start or grow her family. Some patients may choose to pursue additional cycles for banking if desired or needed.
- Embryo banking
- Embryo banking is analogous to egg freezing from a patient’s perspective—the only difference is that mature eggs are fertilized with partner or donor sperm following the retrieval, and embryos are cryopreserved via vitrification at the blastocyst stage 5-7 days after retrieval. The embryos and remain in long-term storage until a patient is ready to use them to start or grow her family. Some patients may choose to pursue additional cycles for banking if desired or needed.
- Embryo banking + PGT
- Patients choosing to bank embryos for future use may also consider using preimplantation genetic testing to assess the genetic health of the embryos they are storing. This can be particularly valuable for patients considering multiple cycles of embryo banking. PGT can be used for aneuploidy, monogenetic disorders, or structural rearrangements (PGT-A, PGT-M, PGT-SR, respectively), as indicated by the patient’s clinical situation and preferences.
- Oncofertility
- Many types of chemotherapy and radiation are now available for the fight against cancer. Unfortunately, some cancer therapies can severely diminish a patient’s ovarian reserve and lead to future infertility. For young women and girls at risk of ovarian damage, options for fertility preservation are available. Due to the timesensitivity of these situations, expedited consultations and treatment timelines are available, and we have financial support resources in place to reduce associated costs. For patients who decide to move forward, treatment can be completed in as little as 2-3 weeks, and egg or embryo freezing can be considered based on a patient’s individual situation and preferences. Cryopreserved tissues can remain in long term storage until the patient has completed her oncology care has been cleared to pursue pregnancy.
- Racing Louisville FC partnership
- KFI was proud to partner with Racing Louisville FC during their inaugural season in 2021, making them the first athletes in the National Women’s Soccer League to have complimentary access to fertility preservation and cryostorage services. Our partnership allows elite professional athletes to pursue their careers without concern that the time they invest could come at the expense of their ability to have a family upon retirement. In addition to directly benefitting our local players, we are honored that our program has inspired a number of other teams in the NWSL to implement similar benefit programs for their players.
- Reciprocal IVF
- Reciprocal IVF (RIVF) is a variation of IVF treatment that is commonly used by same-sex female couples and females with a transgender male partner. With RIVF, eggs are retrieved from one partner, fertilized with donor sperm outside of the body, and a resulting embryo is transferred to the other partner for pregnancy. This unique process allows both partners to biologically contribute to a pregnancy.
- IUI with donor sperm
- Intrauterine insemination (IUI) can be used by patients without a male partner by placing donated sperm into the uterus at the time of ovulation. Sperm donation is tightly regulated by the FDA, and all donors must undergo rigorous screening before being allowed to donate. Multiple options for medications and monitoring can also be considered in conjunction with IUI treatment based on a patient’s history and preferences.
- IVF with donor sperm
- In vitro fertilization (IVF) is a process that involves fertilization outside the body. A patient’s ovaries are stimulated with medications to allow multiple eggs to develop, and mature eggs are removed from the ovaries through a minor office procedure done under anesthesia. For patients without a male partner, mature eggs can be fertilized with donor sperm to form embryos. Sperm donation is tightly regulated by the FDA, and all donors must undergo rigorous screening before being allowed to donate. The resulting embryos can either be cryopreserved for future use or transferred to the uterus for pregnancy.
- Donor egg
- Donor egg treatment is a variation of in vitro fertilization (IVF) in which embryos are made using eggs that are not from an intended parent of the pregnancy. The donormay either be non-identified or known, and the pregnancy can either be carried by an intended parent or gestational carrier. Donor egg treatment is commonly used by patients with decreased ovarian function, advanced age, premature ovarian insufficiency, or genetic abnormalities. It can also be used by same-sex male couples or single men.
- Gestational surrogacy
- A gestational carrier is an individual who carries a pregnancy that another individual or couple intends to parent. The gestational carrier is not directly related to the embryo that she carries and cannot donate her own eggs as a part of the process. Gestational carriers are used when an individual or couple cannot carry a pregnancy due to biological, medical, or psychological factors.
- Transgender fertility options
- We encourage transgender men and women who are interested in having children in the future to consider egg or sperm cryopreservation prior to undergoing gender affirming treatments that can compromise fertility. We are happy to meet with patients during any stage of transition to discuss options that may be relevant for both their near-term and future reproductive care.
- Financial options
- We know that for many of our patients, fertility treatments can represent a significant financial investment. At KFI, we believe finances should never get in the way of building your family, which is why we provide options to help make your dream possible. We accept most commercial insurance plans, as well as fertility-specific benefit providers such as Progyny and Stork Club. You may also pay for treatment through an HSA or FSA. We are here to help you navigate your options and find the right solution for you. At KFI, you will have a dedicated financial counselor who will verify your coverage before your initial visit and answer any questions you have along the way. Additionally, once you and your physician have agreed upon a treatment plan, our financial counselor will prepare a full cost summary that will outline the cost of treatment based on your coverage. For services that are not covered by insurance, we’ve created bundled pricing packages to make paying for the cost of fertility treatments as transparent and seamless as possible. We are proud to partner with Future Family, The Lending Club, and CapexMD to provide options for financing for patients undergoing fertility treatments. The application process is simple, and plans are flexible. Loan programs are designed to help alleviate financial stresses so you can focus on treatment.
- Success rates
- KFI is a proud member of the Society for Assisted Reproductive Technology (SART). Our program’s success depends on individualized treatment plans and a patient centered approach to care. The experience and expertise of our dedicated medical team, combined with our state-of-the-art facility and laboratory, have distinguished us as a leader in IVF treatment and a regional referral center for advanced reproductive care. View our current success rates [here]
- Referring providers:
- Refer online (see https://springfertility.com/refer-a-patient/) → to [email protected] • Download a Referral form (see https://www.seattlefertility.com/wpcontent/uploads/2023/06/SRM-Referral-Sheet-06-2023-3.pdf ) • For oncologists According to the American Society for Clinical Oncology, healthcare providers should offer fertility preservation to patients prior to cancer treatment when appropriate. Cancer survivors may be at higher risk of future infertility and may benefit from a consultation with our team to discuss fertility preservation and family planning goals. As a participating center with the LiveStrong Fertility Program, we are able to offer expedited, compassionate care at a significantly discounted rate for sperm, egg, or embryo freezing prior to cancer treatment. For more information, please visit [https://www.livestrong.org/what-wedo/program/fertility]. For urgent appointments, please call 502-996-4480.
- Anti-Müllerian Hormone (AMH)
- AMH is a hormone made by ovarian follicles that helps to assess a patient’s ovarian reserve, which is a measure of how many eggs are present in the ovaries. Whether a patient’s AMH is high, low, or normal for her age can have important implications on her fertility care and is used to create individualized medication protocols for patients undergoing treatment.
- Hormone testing
- Hormones control every step in achieving pregnancy, from the stimulation and development of the egg to ovulation and implantation of a fertilized egg into the uterus. Each hormone involved must be produced in a specific amount at a precise time for normal function to occur. Hormonal testing can identify many common causes of infertility and help to determine a patient’s most effective treatment options.
- Pelvic ultrasound
- Ultrasound uses high-frequency sound waves to create images of pelvic organs on a monitor, and is a common test used to diagnose conditions of the ovaries, uterus, and fallopian tubes ovaries that are associated with infertility. Ultrasound is also an important tool for monitoring the development of ovarian follicles and uterine lining in response to fertility treatment.
- Saline-infusion sonohysterogram (SIS)
- A saline-infusion sonohysterogram (SIS) is a medical procedure in which a doctor uses ultrasound to evaluate the inside of the uterus. The uterus is filled with sterile saline during the procedure, which helps achieve a clearer picture of the internal contours of the endometrial cavity. This test is commonly used to evaluate infertility, abnormal or painful periods, and congenital uterine anomalies. It can also be an important tool for planning fertility treatments and surgical procedures.
- Hysterosalpingogram (HSG)
- A hysterosalpingogram (HSG) is an office procedure that checks for abnormalities of the fallopian tubes, uterus, and surrounding pelvis. During the procedure, sterile contrast dye is gently instilled into the reproductive tract, and realtime X-rays are used to visualize patterns of dispersion that may identify causes of infertility and help guide subsequent treatment planning.
- Hysteroscopy and Laparoscopy
- Hysteroscopy and laparoscopy are minimally-invasive surgical procedures that allow diagnosis and real-time treatment of common conditions that can affect the pelvic organs and contribute to infertility. These are outpatient procedures and typically involve minimal recovery.
- Genetic testing
- Genetic testing such as karyotyping and carrier screening can be used to identify individuals or couples who may be at increased risk of infertility, miscarriage, or having a child affected with a genetic condition. Many individuals with genetic risk factors may not show clinical symptoms, and when risks are identified, fertility treatments can often be used to reduce the risk of having an affected child.
- Semen analysis
- A semen analysis is the most important test for evaluating male fertility. The test uses a semen sample collected by masturbation to evaluate multiple factors, including assessments of sperm concentration, motility, and morphology (shape). If the results are abnormal, a repeat analysis may be performed. In some cases, additional testing or evaluation by a urologist may also be helpful.
- DNA fragmentation analysis
- Damaged DNA molecules inside sperm cells have been associated with infertility and pregnancy loss. Sperm DNA health can be affected by environmental factors, such as exposure to pollutants or pesticides, as well as age, overall health, and lifestyle factors. Increased DNA fragmentation may impair natural fertility and reduce success rates of some fertility treatments.
- Genetic testing
- Genetic testing such as karyotyping and carrier screening can be used to identify individuals or couples who may be at increased risk of infertility, miscarriage, or having a child affected with a genetic condition. Many individuals with genetic risk factors may not show clinical symptoms, and when risks are identified, fertility treatments can often be used to reduce the risk of having an affected child.
- In Vitro Fertilization (IVF)
- In vitro fertilization (IVF) is a process that involves fertilization outside the body. A patient’s ovaries are stimulated with medications to allow multiple eggs to develop, and mature eggs are removed from the ovaries through a minor office procedure done under anesthesia. The mature eggs can be fertilized with partner or donor sperm, and resulting embryos can either be cryopreserved for future use or transferred to the uterus for pregnancy.
- Intracytoplasmic sperm injection (ICSI)
- Intracytoplasmic sperm injection (ICSI) is a lab procedure in which an embryologist injects a single healthy sperm into an egg. This assisted fertilization technique is commonly used when sperm count or quality is impaired, or when other concerns over fertilization are present.
- Frozen embryo transfer (FET)
- A frozen embryo transfer (FET) is an office procedure in which a previously cryopreserved embryo is thawed and replaced into the uterus for pregnancy. A number of different medication protocols are available to prepare the uterine lining and help improve the likelihood of successful implantation.
- Preimplantation genetic testing (PGT)
- Preimplantation genetic testing (PGT) involves taking a small biopsy of a day blastocyst (day 5-7 embryo) for genetic analysis. Testing for aneuploidy (cells with abnormal chromosome numbers) can identify embryos that may fail to implant or result in miscarriage or birth of a child affected with a genetic syndrome. Testing for monogenetic disorders can reduce the risk of having a child affected with a singlegene disorder when a known heritable risk factor is present. Testing for structural rearrangements is useful when a patient carries a chromosomal translocation that increases their risk of infertility or pregnancy loss. These tests are commonly referred to as PGT-A, PGT-M, and PGT-SR, respectively.
- Intrauterine insemination (IUI)
- Intrauterine insemination (IUI) is a simple office procedure that involves placing sperm from a partner or donor into the uterus at the time of ovulation. Multiple options for medications and monitoring can also be considered in conjunction with IUI treatment based on a patient’s history. IUI is a common treatment for patients diagnosed with unexplained infertility, mild male factor, prior cervical procedures, sexual dysfunction, or patients using donor sperm.
- Donor egg
- Donor egg treatment is a variation of in vitro fertilization (IVF) in which embryos are made using eggs that are not from an intended parent of the pregnancy. The donor may either be non-identified or known, and the pregnancy can either be carried by an intended parent or gestational carrier. Donor egg treatment is commonly used by patients with decreased ovarian function, advanced age, premature ovarian insufficiency, or genetic abnormalities. It can also be used by same-sex male couples or single men.
- Ovulation induction (OI) and Ovarian Stimulation (OS)
- Ovulation induction (OI) is a common first-line treatment for patients who do not ovulate regularly. Ovarian stimulation (OS) involves the controlled use of medication to induce the development of more than one egg at a time. Drugs like letrozole, clomiphene citrate, and gonadotropins are commonly used, and protocols for medication and monitoring will always be individualized for a patient’s specific situation.
- Donor sperm
- Donor sperm involves the use of sperm from a donor who is not an intended parent of the pregnancy. Donor sperm can either be used for IUI or IVF treatment, and donors can either be non-identified or known to the patient. Donor sperm is commonly used by same-sex female couples, single women, and heterosexual couples affected by severe male-factor infertility.
- Gestational surrogacy
- A gestational carrier is an individual who carries a pregnancy that another individual or couple intends to parent. The gestational carrier is not directly related to the embryo that she carries and cannot donate her own eggs as a part of the process. Gestational carriers are used when an individual or couple cannot carry a pregnancy due to biological, medical, or psychological factors.
- Reproductive surgery
- Many gynecologic conditions associated with infertility can be successfully managed with surgery. Dr. Hunter is one of the few reproductive endocrinologists in the country who has earned an ABOG Practice Focus Designation in Minimally-Invasive Gynecologic Surgery (MIGS), and our practice is proud to serve as a regional referral center for patients in need of fertility-enhancing or fertility-sparing gynecologic surgical care.
How do I connect on the day of my telehealth appointment?
The web link for all telehealth visits is https://doxy.me/drhunterkfi. You can connect to our telehealth platform using either a smartphone or laptop, and your partner can use the same link to connect from a separate location if they are not able to physically be with you at the time of the appointment. Please make sure that you have access to a stable internet or wi-fi connection. We recommend logging in at least 10 minutes before your appointment time to make sure your connection is working appropriately. Please contact our front desk if you need any assistance.
What things should I have with me the day ofthe consult?
It can be helpful to have a list of your questions, as well as copies of any testing or treatment records that you have previously had. Please make sure to request that all outside records be forwarded to us at least 4 weeks before your appointment date using this form to give us adequate time to receive and review them.
Who should be with me the day of the consult?
If you have a partner, we recommend that they also be present for the conversation, but it is not required. They can log on to our telehealth platform using a separate connection if they are not able to physically be with you at the time of the appointment.
Should I be concerned with my privacy while using with telemedicine?
We utilize a HIPAA compliant telemedicine program called doxy.me for all telehealth visits. They are well-established as a leader in telemedicine and utilize state-of-the-art security and encryption protocols to ensure that data integrity and privacy are maintained. Their platform is fully compliant with HIPAA, GDPR, PHIPA/PIPEDA, and HITECH requirements.
How long will my consult last?
No two cases are the same! Depending on a patient’s situation, a new patient consultation can be as short as 5-10 minutes, or in some cases, could last over an hour! Please allow appropriate time for your initial consultation accordingly. Follow-up visits commonly last between 15-30 minutes.
Is it okay if I have a lot of questions?
Of course! Our consultation doesn’t end until all of your questions for the day have been answered.
If our telemedicine connection is poor and we can’t hear or see, how do we troubleshoot the problem?
If you and your provider cannot see/hear one another, try disconnecting from our telehealth platform and logging back in—that will often fix the issue. If problems persist, our provider will call you on the phone number listed on your account.
It’s been 15 minutes past my scheduled appointment time, and my provider has not admitted me into the consult, what should I do?
Some appointments and procedures run longer than expected, and it is possible that your provider may be running behind at the time of your appointment. If it has been more than 15 minutes, you can send a “chat” message to your provider using doxy.me to request an update. You can also contact our front desk if you need to reschedule. We respect your time and appreciate your understanding.
Is my telemedicine appointment covered by my insurance?
Sometimes. We can’t guarantee insurance coverage, but we are able to you’re your insurance for telemedicine appointments as long as we are in-network with your plan.
Can I use telemedicine if I don’t speak English?
We generally recommend in-person visits for patients requesting interpreter services to maximize the quality and efficiency of your appointment.