Cost and Financial Questions
Insurance benefits range from 0% to 100% coverage and depend largely on the state you live in as well as your individual policy (not just the provider). Prior to your consultation, you will be able to speak with our excellent financial team with experience in insurance who will explore every avenue to get you the most coverage possible.
After the retrieval procedure, you will be told how many oocytes in total were retrieved. Only mature eggs can be fertilized and therefore only mature eggs are injected with sperm. The next morning they are observed under a microscope, and the presence or absence of fertilization is determined. That morning you will receive a phone call regarding how many eggs were mature for ICSI and how many fertilized. This is when the day of your transfer will be decided. Fertilized embryos remain in culture media in the incubator until they are transferred into the patient’s uterus and/or cryopreserved. Embryos are only checked on Day 1, Day 3, Day 5 and Day 6. At the end of your cycle, you can find a Patient Summary report in the Patient Portal.
Day 5 embryos are given one number and two letters, i.e. 4AA. The first number indicates the stage of development for the embryo: 6=Hatched Blast, 5=Hatching Blast, 4=Fully Expanded Blast, 3=Expanded Blast, 2=Early Blast, 1=Early Blast. The cells making up the blastocyst are represented by the letter: A=Good, B=Fair, C=Poor. The first letter following the number describes the inner cellular mass, the portion of the blast that will develop into the fetus. The second letter following the number represents the quality of the trophectoderm, the portion of the blast that will develop into the placenta.
We use this system to try to determine which blastocysts will continue development and ultimately lead to a successful pregnancy and healthy child. With that said, just because we grade an embryo as “good” doesn’t mean it will lead to a successful pregnancy, and just because we grade an embryo as “poor” doesn’t mean that it won’t develop into a beautiful baby. The grading is very subjective and we urge clients to not focus all attention on embryo grades.
Day 3 cleaving embryos are given two numbers, i.e. 3/8. The first number indicates the grade of the cleaving embryo which is based on several factors including the blastomere size, symmetry, and amount of fragmentation. 3 & 4=Good, 2=Fair, 1=Poor. The number of cells in the cleaving embryo is represented by the second number. Generally 6-8 blastomeres are common for Day 3.
We use this system to try to determine which embryos will continue development and ultimately lead to a successful pregnancy and healthy child. With that said, just because we grade an embryo as “good” doesn’t mean it will lead to a successful pregnancy, and just because we grade an embryo as “poor” doesn’t mean that it won’t develop into a beautiful baby. The grading is very subjective and we urge clients to not focus all attention on embryo grades.
Assisted Hatching (AH) is performed as part of the embryology lab’s protocol during an IVF cycle to assist embryos in hatching from their shell (zona pellucida). The zona pellucida initially helps to protect the egg and resulting embryo, but it is essential that the embryo hatch from the zona pellucida for it to implant on the uterine wall and create a pregnancy. Assisted Hatching may help patients with increased FSH levels, who are of advanced maternal age, or whose embryos have thick zonas. Patients who have embryos cryopreserved and are preparing for a Frozen Embryo Transfer (FET) can also benefit from AH. AH is used only when necessary before a transfer if the zona pellucida is not already thinning. Because we consider AH a necessary part of IVF for many people, it is included in our price of IVF. There are no known long term effects of AH.
Yes, we do ICSI and traditional IVF fertilization in the embryology lab of both of our offices that do IVF (Syracuse and Albany). Because ICSI is complementary in that it is included in our IVF price of $3,900 over 90% of our clients choose to do ICSI due to it’s higher rate of success.
Fertility Treatment/Procedure Questions
Some bloating and tenderness is common but if it is excessively painful you should discuss this with a nurse or one of our providers.
Generally, the process takes 2-3 weeks but is very patient dependent. Most women average around 11-12 days of stimulation (taking medications) in preparation for an IVF cycle.
Yes, you need an appointment for any procedure. This helps us to be sure all of your paperwork is in order and will expedite your appointment.
An optimal sample can be collected after abstaining for 3 days but not more than 5 days. The sample cup must be a sterile, previously sealed cup. You can pick one up at our office or at a pharmacy. Other containers that have been washed are NOT suitable and may contaminate the sample. Label the top and bottom of the container with the following:
- Both partners first and last names
- The date
- The time of collection
You may collect at the office in our collection room, or at home if you live within an hour of our office. If you are planning to collect at home be sure you have the collection cup prior to needing to collect. Keep the sample at body temperature and upright during its transport to our facility
Yes, Endometrin and Crinone will give a white discharge that can cause minor vaginal irritation. If irritation or burning is severe and persists, please
We encourage increasing your water intake. You may also take an over the counter stool softener.
We encourage any Tylenol Products, Robitussin plain, no letters after, Mucinex plain, no letters after (ie: Avoid Robitussin DM, CF., Avoid Mucinex DM) Please avoid the use of Ibuprofen.
YES, please give all medications prior to your appointment except your vaginal medication if you are doing a morning transfer. If your embryo transfer is scheduled to happen first thing in the morning you may hold off on your morning vaginal medications until after your transfer. If your embryo transfer is scheduled to happen in the afternoon, you may take your morning vaginal medications.
The day of transfer and number of embryos transferred will depend on several factors. Patient age, infertility factor(s), embryo quality, previous failed cycles and other factors are taken into account. Before an embryo transfer, there will be an opportunity to discuss this with your physician.
No after an embryo transfer, you may resume your normal daily activities. Comprehensive studies have confirmed that bed rest may actually be harmful to the developing embryo since inactivity combined with high levels of estrogen can promote blood clot formation as well as a rise in insulin resistance. Of course, we recommend restraining from any and all intense exercise like cross fit, sports, running, and jumping. However, nice brisk walks should be continued and a nice way to connect and spend time with your partner or enjoy some nice quiet you time!
Yes, we do. Mini IVF is really the same procedure as (normal) IVF, only with a reduced medication protocol. Therefore the cost of Mini IVF is still $3,900, but you would see a substantial reduction in the cost of your medications which can make a cycle much more affordable. Of course, a Mini IVF isn’t just a financial decision, it can also be medically useful for those who are “poor responders,” to medication and therefore don’t benefit from high doses of medications often used in a traditional IVF. Additionally, many would normally make many embryos from a traditional IVF cycle would prefer to create fewer embryos with the hope that they do not have to make the difficult decision of what to do with remaining embryos after a successful IVF cycle.
Blastocyst embryos (usually day 5, but also 6 and 7) are more developed and thus stronger, more resilient, and generally have a better chance of a successful implantation. This does not mean whatsoever that day 3 (cleavage) embryos cannot and do not make the most beautiful babies. Generally, if you have plenty of embryos that are developing well we let them continue to day 5 before transferring or freezing. If the number and quality of developing embryos is lower, then we highly recommend doing day 3 transfers as no home (regardless of how great our embryology lab is) is better than your uterus for that developing embryo and future child of yours.
Think of this time as the preparatory period for a pregnancy. Light exercise like walking/yoga, high fat low carb diet, vitamins and rest are recommended. It is best to abstain from alcohol, quit smoking not take any harmful substances.
No you do not need a referral although many of our clients come through referrals.
Infertility is defined as the inability to conceive for 1 year when having unprotected intercourse. For women over 35, infertility is defined as the inability to conceive for 6 months or more.
This may be the first question that goes through your head after you have been trying to conceive for any amount of time, or if you have begun your treatment for infertility. Infertility is a tricky condition. There are a variety of emotions associated with it, the stigma in our culture is that pregnancy should be “easy” and “natural” and these phrases can cause couples to feel inadequate and frustrated with their situation. The truth is that 10% of all couples are infertile and infertility is a disease and should be given the same emotional support as other diseases are given, and be free of that stigma.
There is nothing that you have done wrong which has caused your infertility. Dealing with the emotions that infertility brings about can often lead couples to the blame game. They can blame themselves, (oh if I just hadn’t waited so long) or their partners (well if he/she just had done this..) when the truth of the situation is that the blame game will only hurt your relationship at a time when you need to support one another the most. Take your infertility factor, whether it be male factor, female factor or both, as your united diagnosis. Don’t make it a “mine” or “your” issue, become a united front! You will likely feel sadness and pain, find comfort in your partner and offer your comfort to your partner.
The journey of infertility can be long, with highs and lows. Knowing that it’s you and your partner against the world will help you during all these times.
We recommend women take Ovavite, TherOmega, Ovasitol, and DHEA (75 mg per day unless you have PCOS). For our male clients, we recommend Conception XR Motility Support, Theromega, Ovasitol, Vitamin D (if blood levels are below 30), and NeoQ10. Of course, we also recommend that you eat a high fat low carbohydrate diet, also known as the BEBB (bacon, eggs, butter, beef) Diet, appropriately pronounced baby!
Please contact our office AT LEAST 2 weeks prior to the start of your menses. It can take a minimum of 2 weeks for you to receive your medications and to be certain all necessary prior authorizations are in place. Of course, if you have not yet had your new patient consultation, we often book those out months in advance and therefore recommend setting your consult up as soon as you know you are ready to get started. Our initial consultations are free if you don’t have insurance or if your insurance does not cover the consultation. After your initial consultation you can begin treatment with the start of your next cycle (if there is enough time to receive all your meds) but are also free to wait a few months to get started. If your cycles are irregular, then once you have your meds, you can come in for a baseline and begin your treatment.
Currently, our Syracuse and Albany offices have embryology labs and perform egg retrievals and embryo transfers. However, monitoring for an IVF cycle can be done at any of our offices or any OB/GYN, Hospital, radiologist, or clinic that capable of doing blood work and ultrasound monitoring.
Yes! In fact, due to the incredible medical and personal care we give to each and every one of our clients coupled with the affordability of our treatments (which is less than 1/3 the national average) over 1/3 of our clients come from outside the state of New York and over half of our clients come from over a 2-hour drive from any of our facilities. How is all of this possible? Well all of our out of town clients have one of two options, travel to us and stay with us for the entirety of your treatment (usually a few weeks) or have a majority of your treatment (all of your monitoring) managed by us, but done through your local OB/GYN, hospital, radiologist, or fertility clinic. If you, like a vast majority of our travel clients choose option two, we have a dedicated travel team that will provide you with orders for local monitoring and will communicate all of your instructions throughout your cycle. You then only have to travel to us for your actual fertility procedures. For IUI, that is your insemination and for IVF that is your egg retrieval and embryo transfer. For each of these, we recommend you arrive the day before your procedure. If you are driving, you may leave later the day of your procedure (only if someone else is driving). If you are flying, we recommend you wait until the day after your procedure to return home.