Team Member Feature

Ms. Tulay Gaines, RN, MSN, FNP-C, In May 2015, Lane Fertility Institute (LFI) welcomes Ms. Tulay Gaines. Tulay completed her undergraduate degree in Biological Sciences at UC Davis. She went on to complete both her Bachelor’s of Science in Nursing and Masters of Science in Nursing at Columbia University. In addition, she is a nationally certified Family Nurse Practitioner. She has worked at Reproductive Medical Associates, one of the top fertility practices in New York City, both as an IVF Nurse and later as a Nurse Practitioner in the Ovum Donation Department.

Prior to joining LFI, Tulay worked at JumpstartMD, a Bay Area medical weight loss clinic. Her focus was helping overweight & obese patients reach their wellness goals. Finally, Tulay holds national certifications as a facilitator for Open Airways for Schools, Freedom From Smoking, Not-On-Tobacco, and the Better Breathers  Club. Tulay will be monitoring and caring for our  fertility patients in the San Francisco location.

On The Cutting Edge

Father’s Day is just around the corner, and although you may still be on your fertility journey, it is an opportunity to celebrate the father-to-be in your life. Remember why you partnered with him to build a life together. Find the activity or relaxation technique that gives him the most joy, and create a time to do that with him.

Our next issue will feature a segment by a fertility psychologist on keeping your relationship healthy during your fertility treatment. We will also highlight additional insurance updates. We will have an article on the predictors of fertility success. Our patient story will feature a couple who has struggled with weight on their fertility journey. We will also feature the latest information on the benefits of vitamin D and DHEA as supplements to your fertility treatment.

As always, we are eager for your feedback. Please use our Facebook page or email contact to make suggestions and let us know how we are doing.



FAQ’s for our New Moms

By: Sandra Cisneros, RN

Sometimes getting pregnant is just as scary as the journey itself. After all the work to get to pregnancy, couples are petrified of anything that could jeopardize the pregnancy. The good news is that most pregnancies that have had two normal ultrasounds with a good fetal heartbeat each time and good interval growth between the first and second ultrasound have a terrific chance of reaching live birth. Here are some of the most common questions that we get from patients.

What foods should I avoid?

The American College of Obstetricians and Gynecologists (ACOG) has developed a document to assist patients with understanding the safety recommendations around food during pregnancy. If provides the most current evidence based research on this topic. It can be found at this link (

Can I have intercourse?

In general, the answer is yes. By the time that you leave your fertility physician, you are likely between 6-10 weeks pregnant. The pregnancy is well implanted by this time. In most cases, intercourse is fine. However, if you have had vaginal bleeding during the first weeks of pregnancy or have had bleeding after intercourse, your physician may recommend that you abstain from intercourse.

When should I see my obstetrician?

You should plan to see your obstetrician between 8-10 weeks. Each office will have specific guidelines. This allows your physician to order certain blood tests and ultrasounds to further confirm the health of the pregnancy.

Am I now considered a “high-risk” pregnancy?

In general, the use of fertility treatment to conceive does not make your pregnancy high-risk. There are specific reasons that you may, however, fall into that category. Some examples include high-order multiples (more than twins), diabetes, maternal age, or high blood pressure to name a few. Typically, your obstetrician will refer you to the high-risk service if they deem it necessary.

When should I tell people that I am pregnant?

This is a very individual question and there is no right answer. Usually couples wait because they are trying to ensure that the pregnancy is “ok” – meaning that the risk for miscarriage or genetic abnormality is low. In general, pregnancies in which there have been two normal ultrasounds, which show good interval growth and positive heartbeat, are likely to reach live birth. Many couples already know that their pregnancy is genetically normal from embryo biopsy. If you are using non-invasive prenatal testing, chorionic villus sampling or amniocentesis, you may want to wait for those results. If the only parameter is time, typically most miscarriages happens within the first trimester (by then end of 12 weeks of pregnancy).

Can I exercise?

The American College of Obstetricians and Gynecologists (ACOG) recommends that women become active and exercise at least 30 minutes on most, if not all, days of the week. This will decrease symptoms of pregnancy including backaches, constipation, bloating and swelling. It may help prevent or treat gestational diabetes. It will improve your mood and energy.

Safe forms of exercise include walking, swimming, cycling, and aerobics. Women who were runners prior to pregnancy can likely continue during their pregnancy. Activities to avoid are generally those with a high risk of falling. Examples include gymnastics, water skiing and horseback riding. In addition, downhill skiing, contact sports and scuba diving are not recommended.

For further information refer to the ACOG document



Sandra Cisneros, RN, Ms. Cisneros is an IVF Nurse at Lane Fertility Institute. She has been in the field for almost 20 years. After receiving her nursing degree from the College of San Mateo in 1993, she began her career in the field of fertility. She has worked at Pacific Fertility Center and UCSF Center for Reproductive Health prior to her current position. Ms. Cisneros’ goals are to help patients achieve their dreams of being parents. She strives to lessen their stress along the way. She is currently very interested in empowering women to take control of their future fertility with egg freezing and embryo banking.

Dinner For Two

By : Jabir Ponce

with Chicken & Cauliflower Hash


2 Boneless, skinless organic Chicken Breasts
3 C Low sodium organic Chicken Broth
16oz Diced Frozen Mangos

  • Add to one large sauce pan, 2 cups diced mango and the three cups chicken broth; bring to a simmer for 10 minutes.
  • Remove pan from stove and pour mango and broth into a Vitamix or a Cuisinart, (a soup wand may be used in pot on stove) puree until it is a smooth consistency.
  • Return the puree to sauce pan and place the two chicken breasts in pan. Bring sauce to a light simmer and place lid on top. Cook for 15 minutes; stir sauce every few minutes to make sure it does not burn.
  • Remove chicken breasts from poaching liquid and let rest for 3 minutes before slicing.
  • Reduce sauce to desired thickness and spoon over sliced chicken breast.


Shopping List

2 C Medium diced cauliflower
1 C small diced sweet potato
1 C medium diced carrots
1 C medium diced yellow pepper
1 C medium diced red onion
1 C medium diced Celery
1 Tbls chopped ginger
½ C rough chopped Basil
2 cloves chopped garlic
1 Tbls Cold pressed organic Olive Oil
Salt and pepper

  • In a large sauté pan add olive oil and turn heat to high. Once oil is hot add; cauliflower, sweet potato, carrots, yellow pepper, onion, celery, ginger and garlic. Sauté and stir the pan until the onion starts to become translucent. Turn off heat and mix in basil. Salt and pepper to taste. and broth into a Vitamix or a Cuisinart, (a soup wand may be used in pot on stove) puree until it is a smooth consistency.



Jabir Ponce, Private Chef. Jabir Ponce’s first passion is food and its preparation. While working in the pastry line and bake shop at the Ritz Carlton Manalapan, Mr. Ponce received his culinary degree in 1993 from the Florida Culinary Institute. After returning to San Francisco Mr. Ponce helped to open several small restaurants while running his own catering company. He served as the Lead Concierge for the Archbishop’s Mansion until its closing. Since July 2009, he has worked in San Francisco as a private chef. His email is

A Fertility Story – A Patient’s Experience With Her Insurance Benefits

By: SUZANNE – A patient at Lane Fertility
(Names in the article have been changed to protect patient identity)

This is my second time getting help from a fertility treatment facility. The first time I paid out of pocket. While this was expensive, in a way it made everything easy, because I did not have to deal with the insurance company and I could focus on just staying calm and getting ready for the journey. We underwent a cycle of In Vitro Fertilization (IVF) and had a successful pregnancy the first time. When my daughter was almost 2, we decided to try again.

The second time we had insurance coverage. We thought that this would be great from a financial perspective. However, in order to access the benefits, I had to go through a very painful and emotional process in order to obtain insurance approval. This felt like the last thing that I needed as I started my fertility treatment!

After visiting the clinic and developing a treatment plan, the fertility treatment clinic submitted a request to have my treatment authorized. This took a long time and left me very nervous. I was constantly thinking “What if they don’t approve me?” “Who are they to decide whether I can have more children or not.” After weeks of waiting, a representative called from the insurance company to ask questions, and ordered me to get some lab work done. The fertility treatment clinic had anticipated this and had asked me to take care of the bloodwork several weeks before. I explained to the nurse that my physician had already sent the results along with a letter explaining why I needed the specific treatment. But the representative was unaware of this and asked me to do it again. She also said that a nurse would be calling me in 24 hours to go through a questionnaire.

Lane_Mag_2015_Questions_AskedI waited and waited, and finally three days later I received the phone call from the nurse. Conveniently, I was right in the middle of taking a walk with my daughter and my dog. The nurse then began to ask questions that were very emotional and somehow painful. It felt awkward to answer these questions in the street, but all she wanted to hear were straight answers. There was little sensitivity to the private nature of the questions she was asking.

After answering the questions, the insurance company completed its process and the treatment was approved. However, after the initial cycle was unsuccessful, Suzanne’s insurance refused to authorize her to do a second round of IVF. Suzanne’s fertility treatment center has appealed this denial on her behalf.

I have found that the insurance process involves great deal of frustration and personal intrusion. It is important to understand this if you are going to use your insurance benefits to obtain fertility treatment services.