At your initial telemed appointment, you will meet your provider to review your medical and fertility history, any testing you have completed, make recommendations for diagnostic testing, and review treatment options. We want to partner with you, making sure that we address your concerns and customize a fertility plan that works towards your family building objectives. There will be time to go over any questions you may have. After your new patient appointment, your assigned nurse and financial counselor will follow-up with a phone call or portal message. Your financial counselor will review your insurance coverage, the costs of testing/treatment recommended by your provider and answer any questions you may have, and your nurse will review your next steps.
I don’t live near one of your clinic locations, do you see patients from outside the area or state?
It is our goal to make treatment as convenient as possible no matter where you live. We work with a network of providers comprised of obstetricians, gynecologists, and Advanced Registered Nurse Practitioners in Alaska, Idaho, Montana, and Washington who are skilled and trained in the diagnosis and treatment of infertility. Should you need IVF, network doctors and nurses work closely with SRM providers to develop a treatment plan and coordinate care. If your local provider is unable to perform certain procedures, our patient care team can coordinate necessary appointments with local laboratories and imaging services, if available. This keeps travel limited to when you have your retrieval and/or transfers at an SRM clinic location in either Seattle or Spokane Valley.
At SRM, we believe that a team approach beyond clinical care is important to include in our services, so we have incorporated on-site mental health counseling and integrative health services like genetic and fertility counseling, acupuncture, and nutritional support. Our PCOS and Wellness and Fertility Programs offer a multi-disciplinary approach to our patient’s fertility care which are vital resources throughout one’s fertility journey.
How can I know more about my fertility now, so I can plan for when I want to start a family later?
Two main features of reproductive aging are the decline in the number of eggs and a decline in egg quality. Those in their 30’s may benefit from a fertility assessment in order to have an understanding of their reproductive potential.
A semen analysis is the mainstay of our assessment of sperm function. First, it tells us if sperm are present and, if so, in what concentration. Can they swim adequately, are they normally formed, and is there any sign of infection? An abnormality in any of these parameters may indicate poor sperm function.
Our virtual Open House webinars are a great opportunity to get to know SRM better and ask questions before becoming a patient. Meet one of our Reproductive Endocrinologists, Nurses, and Financial Counselors online. During our events, you’ll learn more about treatment options and what to expect during a telemedicine initial consultation. There is plenty of time to ask questions throughout the webinar. We have webinars for general fertility, egg freezing, LGBTQI+ family building, PCOS and more.
You will need to download and fill out this Release of Medical Information form.
a. If you have been trying to conceive and are looking for additional guidance or treatment
b. Are experiencing repeated miscarriages
c. Interested in preserving your fertility or to discuss future fertility
d. Have a previous history of tubal ligation or vasectomy
e. Interested in using donor sperm, egg, or a gestational surrogate
f. You have been told that you have PCOS or abnormalities of the uterus, fallopian tubes, and/or ovaries
g. You have been diagnosed with cancer or have a history of cancer
h. If you have a personal or family history of genetic diseases or at risk of having a child with a genetic disease
i. Currently or have a history of taking testosterone
Egg Freezing Questions
Egg Freezing FAQ
All patients will be under anesthesia for about 20 minutes, resulting in a nearly pain-free experience. Upon waking up, patients may feel a little sore, achy, and slight cramping. Most patients take a couple days to recover, while others can take up to a week.
Birth control is considered an optional tool to help create a schedule that works for you. You will be able to continue your current birth control, or keep your IUD inserted, if you so choose.
Every woman’s hormone sensitivity is unique. For most women, estrogen results in good feelings and minimal mood fluctuation. After egg retrieval, you may experience a decrease in estrogen, which could result in a more drastic hormonal shift.
No, egg freezing will not lower your body’s natural egg count. Every month there is a small group of follicles, only one of which will grow and release the egg at the time of ovulation. The remaining follicles from this small group will degenerate as part of the normal process. For egg freezing, the medications stimulate all those potential eggs for that cycle so that they can be frozen and avoid degeneration.
- Eat a healthy well-balanced diet. Caffeine and alcohol are okay during a cycle but in moderation.
- Take a multivitamin daily.
- Continue to exercise which may include low impact activities such as walking, light running, biking, or swimming.
- Inform your provider before starting any new prescribed medication or supplements.
Most women go back to work one to two days after the procedure. You may experience some soreness in the vaginal area, some abdominal cramping, or some spotting, which could last a few days. Most women feel back to normal within a week. You can expect your next menstrual period to start within 1-2 weeks after your procedure.
Eggs are frozen (cryopreserved) by vitrification, a fast-freeze method that puts your eggs into a glass-like frozen state. Vitrification reduces the likelihood of ice crystal formation which could damage the egg. There is no known limit on how long your eggs can be frozen ad there is no evidence that the health or viability of frozen eggs decreases over time.
Your eggs will remain in storage at SRM until you are ready to use them. All eggs are kept super chilled in liquid nitrogen (-320 F). We have multiple systems in place systems that are designed to maximize the safety of your eggs.
The process for using your eggs is the same as in an in vitro fertilization (IVF) cycle. First, your eggs are thawed in a highly controlled lab environment. One sperm is injected into each surviving egg and incubated overnight. Some of the embryos will continue to grow and divide, creating blastocysts, (embryos that are ready for transfer into your uterus). The embryo transfer is a quick and easy office procedure. The estimated livebirth rate per thawed egg is 5-12% in women under 35 years of age.
One cycle of egg freezing costs $8250 plus medications. Medication costs range from $2500 – $5500.
Our financial counselors will help you investigate whether you have insurance coverage for egg freezing.
At SRM, you will be assigned a dedicated financial counselor who will work with you throughout your fertility journey. Our financial counselors have years of experience helping patients make the most of their insurance coverage. They can also recommend loan programs that may provide assistance with treatment costs. Our financial counselors strive to make the financial portion of your treatment journey as stress-free as possible.
Your financial counselor will reach out to you after your new patient consult with the physician to review your insurance benefits and expected out of pocket costs. Once your treatment plan is in place, your financial counselor will explain the corresponding cost information. They will provide you with the information and support you need to help you achieve your dream of growing your family, in the way that makes the most financial sense for you.
SRM offers two fixed fee multi-cycle programs to patients without insurance coverage to help make treatment more affordable; one for IVF and one for Frozen Donor Egg. Our multi-cycle programs make paying for treatment easy to understand and affordable. Enrolling in the multi-cycle program provides financial peace of mind allowing you to focus on what matters most, a positive outcome.
How do I find out if I have insurance coverage for fertility treatments and tests? What insurance companies do you contract with?
Benefit coverage for infertility treatment varies considerably. Be sure to review the benefits and requirements of your medical plan, specifically any infertility related coverage. We make every attempt to verify coverage for new patients, but you can avoid potential issues by understanding the details of your insurance plan, benefits, and requirements.
Several employers in our area have partnered with Progyny to provide a comprehensive fertility benefit. Progyny is a third-party insurance company that manages an inclusive fertility benefit plan known as a “Smart Cycle.” Our Financial Counselors can assist you with making the best decisions to best utilize your Progyny benefits.
We understand that cost is an important consideration when making decisions regarding your treatment. The costs of fertility treatments and tests vary depending on your customized treatment plan. You will receive your specific treatment pricing from your dedicated financial counselor once you and your provider have established a final treatment plan.
LGBTQIA+ Family Building Questions
LGBTQI+ Family Building FAQs
In general, there a two main options for sperm donors. One is an anonymous sperm donor through an agency, or sperm bank. The second is a “known” or “directed” donor in which a person known to you donates sperm. There are pros and cons for both anonymous and known sperm donors. Your provider can help you to decide which is best for you.
We only utilize sperm banks that conform to ASRM, AATB, and FDA guidelines and regulations. They must also be certified by CLIA and registered with the FDA. Before you choose a donor/bank make sure you notify your provider and/or care coordinator to make sure it is an approved bank and to help facilitate transfer of your purchased sperm to SRM.
Things to consider when choosing a sperm bank may include cost, donor selection and availability, cost and logistics of shipping to SRM, and quality guarantees.
A few of the things to consider when choosing your donor include characteristics/traits that are important to you and/or your partner, has the donor caused any pregnancies, and is the donor positive for any genetic diseases.
We partner with the following sperm banks:
- Seattle Sperm Bank
- NW Cryobank
- California Cryobank
- Cryos International
- Fairfax Cryobank
Reciprocal IVF is also called Shared Maternity, Shared Parenthood, or Co-Maternity. It is an option for couples in which both partners have eggs/uteruses. One partner undergoes an IVF cycle in order to retrieve eggs. The eggs are then fertilized using donor sperm to create embryos. An embryo is then transferred into the other partner’s uterus. It is a wonderful way for each parent to share a role in the creation of their child.
There are two options for findings an egg donor. You can choose an anonymous or agency donor from an egg bank. Or you may choose to use a “known” or “directed” donor. For example, some patients may ask the sibling of their partner to be their egg donor. Whether you choose an egg bank or a known donor your donor coordinator will guide you through the process.
Traditional surrogacy is when the egg donor also carries the pregnancy. We do not offer traditional surrogacy at SRM.
Yes – we have many resources on reproductive law and refer you to a professional who can help you to navigate your situation.
Possibly. We still don’t know to what extent gender-affirming hormones such as estrogen and testosterone impact sperm and eggs.
If you are on estrogen and/or spironolactone: You will likely need to complete a semen analysis to see if you are currently producing sperm while on your hormones. Depending on these results you may need to come off your hormones prior to freezing sperm. In this case, your provider will recommend how long your time off hormones should be.
If you are taking testosterone: We don’t yet have the research to know if and for how long a person should be off testosterone prior to freezing their eggs. There are many proposed recommendations but no consensus at this time. 4-8 weeks is the most common recommendation, but your provider can help you decide what amount of time is best for you.
This is a very common concern for transgender, gender non-binary, and gender queer individuals. We understand that reproductive and fertility care can be anxiety-provoking for some. We are committed to providing you with the most sensitive and compassionate care. Talk with your provider about your concerns. In many cases we can have options or alternatives to prevent or mitigate triggers leading to dysphoria.
Male Fertility Questions
Male Infertility FAQs
About 1 in 7 couples have difficulty getting pregnant (ie, trying for 12 months without success). Of these couples, 50-60% will have a cause that is related to the male partner. Male factors include abnormalities in semen analysis, little or no sperm, issues with erections or ejaculation, hormonal issues, varicoceles, and blockage of the vas deferens from a prior vasectomy.
The standard test to check for male fertility is the semen analysis. A variety of parameters are assessed including concentration (number of sperm), motility, and morphology (shape). Preferably this would be done at a fertility center such as SRM to ensure reliable, standardized results and a better patient experience. At SRM, you will have a quick follow-up phone consultation to go over your test results a few days after your appointment.
Yes. There are many things we can do to improve sperm counts including: lifestyle changes, medications for erections or ejaculation, hormonal medications, and sometimes surgery.
A few examples of lifestyle changes are to exercise regularly, at least 30 minutes 5 days per week if possible; decrease stress, eat a healthy and balanced diet, lose weight (if needed), avoid substances and activities known to have a negative impact on male fertility, like tobacco and marijuana use, certain medications, regular use of hot tubs; avoid medications or supplements that contain testosterone or its precursors (DHEA).
A few reasons would be if you need a semen analysis, if you had an abnormal semen analysis, if you have a varicocele, if you have a history of or are currently using testosterone, or if you are concerned about your fertility.
- irregular menstrual cycles
- Increased hair growth on the face, chin, or parts of the body called “hirsutism”
- Acne on the face, chest, and upper back
- Thinning hair or hair loss on the scalp; male-pattern baldness
- Weight gain or difficulty losing weight
- Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
- Increased risk for diabetes
- Increased risk for obesity
- High cholesterol
- Sleep disturbances
- Endometrial cancer
- Difficulty conceiving
- Poor pregnancy outcomes, increased risk of miscarriage, high blood pressure, preterm delivery
- Anxiety and depression
- Disordered eating
- Sexual problems
The best and first line treatment is optimizing your lifestyle. Positive changes will result from a healthier lifestyle whether or not weight loss occurs. Regular exercise and a good diet will stabilize and improve metabolism and mood. These lifestyle changes are very powerful and some women with PCOS will ovulate without additional treatment or medication.
It is particularly important to maintain a well-balanced, low-fat diet that is both rich in whole-foods and fiber AND low in processed food and saturated fats. The challenge for those with PCOS is that weight loss is more difficult because elevated androgens increase appetite with intense food cravings and insulin, which is a growth hormone, promotes weight gain, especially in the abdomen.
While there is no single best diet for PCOS, some diets such as the Mediterranean diet are rich in vegetables, fruits, nuts, and whole grains, which are well balanced. Intermittent fasting may be considered if you are not trying to get pregnant. Even a weight loss of only 5-10% may reduce androgens and help restore normal ovulation.
Fun fitness and movement have been shown to be particularly beneficial for people with PCOS. Exercise can help decrease insulin resistance, prevent weight gain or stabilize weight, regulate ovulation, and improve mood.
The best part – many of the benefits associated with exercise can be achieved regardless of whether or not you lose weight.
Although it takes time and effort, those with PCOS can successfully achieve a pregnancy with a strong lifestyle foundation and sometimes combined with ovulation induction medication. Commitment to a strong lifestyle program can double your chance of pregnancy without IVF and will have a beneficial impact not only on pregnancy but also on your long-term health.