Fertility Services FAQs

By Maya B. Bledsoe, M.D.

I’m sure you have many questions. My patients come to me to help with the treatment of their infertility. Some patients know why they’re visiting me and want to go on to the next step. Some patients are just starting in the evaluation and treatment of infertility. The first visit involves history-taking and a physical exam. Subsequent visits involve lab work, sonograms, more exams, and treatments. Sometimes you may seem overwhelmed by the amount of information or instructions given to you; hopefully, this will help you if questions arise.

 

• Am I really infertile?

  Infertility is defined as being unable to achieve pregnancy after one year of unprotected intercourse in an otherwise healthy couple or if you are a female over 35 after trying for six months. It may also be defined as being unable to carry a pregnancy.

• What is the cause of my infertility, and is it treatable?

  The cause of infertility is not always obvious. Blood tests and exams at particular times of a cycle are necessary to find what problem to treat. There may be one or several factors contributing to this condition. When no explanation can be found, it is called “unexplained infertility.” I will explain what I find and what I can do about it at each step. Please do not hesitate to ask questions. The phone nurses answer questions all day; if they don't know an answer, they will find out for you.

• Are you board certified to treat infertility?

  I am board certified in the practice of endocrinology, which encompasses reproductive medicine. The other part of my practice includes treating diseases of the pituitary, thyroid, and adrenal glands, among other things. Treating infertility is my first love. I treat both men and women for fertility.

• Are all my visits covered by my insurance?

  Maybe, since every insurance policy is different, some things may or may not be covered. The business office staff can help you contact your insurance company to find out your benefits. However, you are ultimately responsible for all fees not covered. I do not stay very well informed on insurance issues because rules keep changing. Please address your questions to your insurance company or my front desk. Austin Regional Clinic has a policy that previous cycles are paid in full before starting a new cycle.

• My partner’s sperm count has never been checked. Is this a problem?

  One of the first steps in the evaluation of a couple is to check a sperm count if it has not already been done. A specimen can be brought to any ARC lab (preferably Seton Northwest, Round Rock, or South locations) within 30 minutes of collection between the hours of 8 and 10 AM. The labs request specimens be brought in at that time to start processing right away.

• Do you do artificial insemination?

  Treatment of your problem may include intrauterine insemination (IUI), which is done here in the office. IUI is used to treat couples with poor sperm counts and/or poor mucus quality in the woman. I do not perform in vitro fertilization, which is a surgical procedure where eggs are surgically removed and then fertilized. This is not a procedure many women need, as most women have at least one fallopian tube that is open.

• What are the chances of success of IUI?

  Each IUI cycle has approximately a one in six chance of success if there is adequate sperm. For a couple without infertility, the chances for a pregnancy in any one month are about one in five. For those that IUI will work for, 75% of couples become pregnant in the first three cycles and 95% in the first six cycles.

• Will it hurt if I want to take a break from treatment?

  No, unless you have a rising FSH level, which we would have already discussed. Just call when you are ready to return.

• What if I have a question after I leave, or I really need to talk to you on a weekend?

  If you have a question, call 8-12:30 or 1:30 to 4:30 Monday through Friday and ask for a phone nurse. The nurse may be able to answer your question right away, or they may need to get your chart and have me look at it. If you are trying to reach my nurse directly and cannot get her, please leave a message with your questions with the phone nurse to avoid having to try again and again. Our goal is to return your call ASAP, especially on the same day. If you must reach me on a weekend or a holiday, call the After Hours Clinic at 346-6611 and ask that I be paged. If I am out of town, a partner will be covering for me. We are only closed for major holidays.

• My partner has a low sperm count. Can we collect several samples and freeze them to get a higher count for IUI?

  No. Sperm that is already low in count or motility will not survive the freeze and thaw procedure well. You need a high count to freeze in order to get an adequate countback after the thaw. Increasing the number of eggs is a treatment choice.

• Why do I need so many sonograms?

  There are specific findings that only a sonogram can tell me. Not every cycle is exactly the same, so the ovaries and uterus must be continually reviewed. A sonogram is necessary to use Clomid or shots.

• How will I know what to do next?

  At each visit, my nurse or I will tell you what to do next, as far as labs, sonograms, visits, etc. I also write instructions onto your basal body chart, as well as on a "follow-up instructions sheet." There is a window of time to call for appointments and lab work. If you are waiting for your period to come in for lab work and your period starts on a weekend, just call Monday morning. We will work you in.

• What if I need an IUI or sonogram on a weekend?

  Inseminations and sonograms are performed on a weekend on an as-needed basis. If I am not available to do an insemination (this is rare), my partners or my nurse will take care of you. For sonograms, there are several sonographers at ARC who rotate call to see my patients on weekends, if necessary. I try to limit your weekend visits, if possible, since there is an additional charge.

• Do I really need to check my temperature every day?

  Yes, your basal body temperature chart is an important tool in your treatment. Please bring your temperature charts to every appointment.