Frequently Asked Questions
Some patients are surprised that initial treatments, like intrauterine insemination, are not very expensive (under $1,000). If your best chance for pregnancy includes any form of ART (Assisted Reproductive Technologies), the treatment cycles can range anywhere from $4,000 – $25,000.
It is generally believed that insemination is a reasonable initial treatment that can be utilized for a maximum of about 3-4 months in women who are ovulating (releasing eggs) on their own. However, for women with certain conditions, it is reasonable to try IUI for longer than this amount of time. Each patient and situation is different, and you should speak with a doctor at Pacific NW Fertility regarding your specific situation.
Pacific NW Fertility is contracted with several medical insurance companies, some of which cover an initial consultation and diagnostic testing, while others cover fertility treatments. Not all insurance companies cover fertility. We encourage you to consult with your insurance provider.
There is no age limit for patients who wish to discuss the probability of becoming pregnant and the likelihood of delivering a healthy baby. However, age has a significant impact on fertility—it is not reversible and not all fertility treatments are successful in older women. Our egg donor program requires that women complete treatment by their 51st birthday.
Egg quality refers to how prepared your eggs are to develop into embryos once they are fertilized, however it’s difficult to determine the quality of an egg simply by looking at it. Using in vitro fertilization, doctors can see whether the egg will grow or not. However, there are also fertility tests which can be done to determine if you may be suffering from poor egg quality. Typical tests that evaluate your egg quality include:
Day 3 FSH Test: This test measures your levels of FSH or Follicle Stimulating Hormone. Elevated levels may indicate poor egg quality. Antimullerian hormone (AMH): This is a substance made by the follicles within the ovary. Each follicle within the ovary has an egg, therefore the higher the AMH, the higher the egg supply. AMH as a reflection of egg supply and fertility potential is a relatively new test, but the exact level considered 'normal' by age is still being studied. In general, an AMH <0.1 ng/mL is considered menopausal and an AMH >2.0 ng/mL reflects a good egg supply. Unlike FSH, the AMH level can be checked at any time in the menstrual cycle and even while someone is on hormonal birth control (like birth control pills). The doctors at Pacific NW Fertility conduct these and other in-house tests to measure egg quality.
Some of the common tests include checking hormone levels in blood, hysterosalpingogram (fallopian tube x-ray), semen analysis and ultrasound.
We recommend women younger than 35 try for one year before seeking help, but six months for women 35 and older. Any woman with a complicated gynecological history should be seen sooner than one year.
Intrauterine insemination is also called artificial insemination, and has been used with the male partner's sperm for infertility since the 1940's. IUI can be an effective treatment for some causes of infertility in women under about age 41, and is most commonly used for unexplained infertility, as well as for couples affected by mild endometriosis, problems with ovulation, mild male factor infertility, and cervical factor infertility. IUI is not effective for couples with tubal blockage or severe tubal damage, ovarian failure (menopause), severe male factor infertility, or advanced stages of endometriosis.
FSH/E2 stand for “Follicle Stimulating Hormone” and “Estradiol” and this is a hormone test that is usually performed on the 2nd or 3rd day of the menstrual cycle (first day of FLOW is cycle day 1). Generally speaking, an FSH level around 10 IU/ml or higher indicates diminished ovarian reserve (diminished egg quality). The Estradiol should be less than 70 pg/ml. If the Estradiol is higher, this can also predict for diminished ovarian reserve.
Polycystic ovary syndrome (PCOS) is a health problem which often affects a woman's menstrual cycle, hormones, heart, blood vessels, appearance, and ability to have children. While some women with polycystic ovarian syndrome will not be able to get pregnant, the majority can have healthy babies, though usually require fertility specialist assistance. Patients with PCOS need a full hormonal evaluation to determine which medication(s) may be most appropriate for treatment. It should be noted that there does appear to be higher rates of miscarriage, gestational diabetes, pregnancy-induced high blood pressure (pre-eclampsia), and premature delivery in women with PCOS.
Unfortunately, having your period does not necessarily mean that ovulation has taken place. Some women experience what is known as ananovulatory cycle, (meaning no ovulation) and can experience some bleeding. Though often mistaken for a period, it is actually not a true period, but is bleeding caused by either a buildup in the uterine lining that can no longer sustain itself or from a drop in your estrogen level. Tracking your body temperature is the main way to decipher if ovulation is in fact taking place.
Your physician may recommend a semen analysis for the male partner. If so, simply phone the andrology lab at 206.515.0002 to schedule. If you have been referred to our laboratory by an outside provider/physician, we need a written order from your physician before you can make an appointment in the lab.
The HSG is an x-ray examination to determine whether the fallopian tubes are open and to evaluate the uterine cavity. At least one tube must be open to allow the sperm to contact the egg and for the fertilized egg to travel back to the uterus. The uterus must also be normal to allow the fertilized egg (embryo) to properly implant and develop.
Intracytoplasmic sperm injection (ICSI) is a technique where sperm is injected directly into the center of an egg. The fertilized egg or embryo is then allowed to grow in a laboratory for one to five days, and is then placed in the woman's uterus. ICSI is often used to help overcome a man's fertility problems if he produces too few sperm, has sperm of irregular shape or movement, if the sperm have trouble attaching to the egg, or if the man has a blockage in his reproductive tract. ICSI can also be used when the use of traditional IVF has not produced fertilization, regardless of the condition of the sperm.
If you have been diagnosed through an HSG (Hysterosalpingogram) with having both of your fallopian tubes blocked, it is possible for you to become pregnant through IVF (In Vitro Fertilization). IVF involves the process of a woman taking injectable hormones between 9-12 days to help her ovaries produce many eggs. The eggs are then retrieved from the ovaries via a noninvasive surgical procedure and combined with a sperm source. The embryos, or fertilized egg(s), are then transferred into the woman’s uterus. Therefore, in this process it is not necessary that the egg travel down the fallopian tube and a successful pregnancy can still be achieved.
Premature Ovarian Failure (POF) is technically described as the loss of ovarian function in a woman under the age of 40. In these women, periods stop, estrogen levels are low, and the follicle-stimulating hormone (FSH) level is elevated. Unlike menopause or “premature menopause” which is the permanent loss of ovarian activity, POF may not be permanent. Many women with POF intermittently produce estrogen and ovulate, and may be reversible.
PGD, also called “embryo screening,” refers to procedures that are performed on embryos prior to implantation. PGD tests for the presence of genetic “indicators” linked to a variety of conditions and characteristics such as Down syndrome, cystic fibrosis, muscular dystrophy, sickle cell anemia, Tay-Sachs, Gaucher’s disease, and mental retardation. A cell is extracted from an embryo and genetically analyzed. PGD was developed to allow couples at risk of passing on a serious genetic disease to have children not affected by it. PGD also allows for better understanding the problem of recurrent, early miscarriage and the genetic errors that arise in pregnancies of older mothers.
First, you need to schedule a new patient visit with one of our providers. Next, there are required screening lab tests that need to have been done recently or can be done in our clinic. You may begin treatment when your testing is completed and reviewed by a clinician.
Every year, Pacific NW Fertility's in-house donor program helps over 100 women become pregnant. Our program provides women and their partners the ability to use eggs from a chosen, qualified donor for in vitro fertilization, which has proven to be an extremely valuable resource for women who do not have their own viable eggs to achieve pregnancy.
Endocrinology is the study of the glands and hormones of the body and their related disorders. A Reproductive Endocrinologist is a medical doctor who is certified in the OB/GYN specialty, and has completed a fellowship and an additional 3-4 years of training in Reproductive Endocrinology.
Infertility primarily refers to the biological inability of a person to contribute to conception, and in women it often refers to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, many of which may be helped with medical intervention. Our reproductive endocrinologists consider a couple to be infertile if:
- the couple has not conceived after one year/12 months of contraceptive-free intercourse if the woman is under the age of 34
- the couple has not conceived after six months of contraceptive-free intercourse if the woman is over the age of 35
- the woman is incapable of carrying a pregnancy to term
If you have had tubal ligation, there are currently two options available. One would be to have a tubal ligation reversal; the other option is In Vitro Fertilization (IVF).
Pacific Northwest Fertility does not offer tubal ligation reversals. There are however clinics in Oregon, California, and throughout the United States who do offer this service. The cost of a tubal ligation reversal ranges from approximately $7,000-$17,000 dollars. It should be noted that insurance companies do not typically cover this procedure. A tubal reversal is a major surgery where general anesthesia is performed. The procedure must be done in an outpatient surgical facility and will last between one and three hours. Because many factors influence success following a tubal reversal, success rates are individualized to each patient’s unique condition. Severely damaged tubes, severe male factor, diminished ovarian reserve, or being a poor surgical candidate may be contraindications to having a tubal reversal. If you have any of these factors, proceeding with IVF can be a beneficial and highly effective treatment for achieving a pregnancy.
In the IVF process, a woman is given injectable hormones between 9-12 days to cause her ovaries to produce many eggs. The eggs are then retrieved from the ovaries via a noninvasive surgical procedure and combined with a sperm source. The embryos, or fertilized egg(s), are then transferred into the woman’s uterus. IVF can be more successful than a tubal ligation reversal depending on many factors as described above. It also leaves your contraceptive method intact. If you have further questions please contact Pacific Northwest Fertility today. One of our providers would be happy to speak with you further on whether tubal reversal surgery or IVF is best suited to your situation.
At Pacific NW Fertility, we are committed to offering fertility preservation options for cancer patients. Pacific NW Fertility was the first clinic in Washington to offer egg and/or embryo freezing to cancer patients. Please visit our Center for Fertility Preservation page for more information.
I was absolutely amazed at the kindness and professionalism of everyone we worked with. Regardless of how things turn out for us, we feel we’ve been given the best chance of success. Special thanks to everyone for your extra time and attention. We really appreciate it.