Preparing For Your Initial Consult

By: Kyra Lumpkin

So you have taken the plunge. You have called and scheduled your initial consultation! You are hoping that this visit will change your trajectory for having a baby. Now what? Every clinic is a little different, but the general forms that we describe below review the types of information that you should expect to provide at any new patient visit.

How to Prepare For Your Initial Visit

As the old adage goes, “you can’t tell where you are going unless you know where you’ve been”. Prior to coming to the office for your new patient consultation, we strongly urge you to prepare. Ensure that you have completed all of the forms in the New Patient Packet provided to you. This packet typically will include a Health and Physical History form for you to summarize your past medical history. Additionally, you will receive consents explaining our office policies, practice statement, and notice of practice privacy. Last, we have included a form to retrieve any pertinent medical records. These items are very important for us to receive prior to your appointment. After all, our goal is to optimize your fertility experience, and our physicians and clinical team need this information in advance to prepare for your visit.

Preparing For Cost

A benefit check is done before you come in for your initial consultation to better prepare you for any monies that you may have to pay. After scheduling your appointment, take a moment to snap a picture of your insurance card, front and back, and then forward it to your clinic. After your picture is received, the billing department will run a benefits check against the insurance information you provided to assess what will or will not be covered. The results are then emailed to you with an explanation of the findings. You will then be equipped with everything you will need to know about the costs of your appointment. If your clinic doesn’t do this routinely, be proactive and ask for this information or call your insurance company yourself. Most fertility patients are healthy individuals who have had little reason to use their insurance for more than a $20.00 office visit co-pay or a $10.00 prescription. This experience will be different for most patients.

What to bring

When you arrive at your initial consultation, please have a valid form of identification, any fees you will have to pay, and your insurance card ready.

What to Expect At Your First Appointment

The New Patient exam lasts approximately 60-90 minutes, and your partner is encouraged to come with you. During this appointment, the physician will perform an antral follicle count (AFC) using a transvaginal ultrasound. Afterwards, you, your partner and your physician will discuss your medical history in detail. This is the perfect time to ask any questions or present any concerns you may have. This visit is for you, so the physician is listening intently to understand what your fertility and family goals are.

A few examples of good questions to ask are:

  • What are your success rates?
  • I am still young, why do I need fertility treatment or Pre-Implantation Genetic screening (PGS)?
  • What are my chances of success if I don’t do PGS?
  • On average, how long does a full cycle take, from initial consult to transferring my embryos?

Taking control of your fertility challenge is a huge step. It takes bravery and patience. To aide in your own success, do not be afraid to ask as many questions as you feel you need.

Experience Excellence

At Lane Fertility Institute we are a team. A team dedicated to giving our very best at all times. A team that will do all that we can to assist you in achieving success on your journey to parenthood. We pride ourselves on providing the optimal experience from your very first phone call. Whatever clinic you decide to work with should have a similar attitude. If you don’t feel that the fertility team is in line with your needs, never be afraid to make a change. Fertility is already taxing on your emotions and resources, you should have an expectation of excellence every step of the way!

Good luck on your fertility journey!!

ABOUT THE AUTHOR

Kyra Lumpkin. Kyra Lumpkin is the Administrative Coordinator for Lane Fertility Institute. Kyra has been in the Administrative field for over 7 years. She commits herself to patient satisfaction and outstanding patient service. She has a strong belief that one’s business is only as good as the treatment provided to its patrons. Being a parent herself, Ms. Lumpkin is passionate about her ability to aide and prepare patients for their journey to parenthood. Her email is kmlumpkin@lanefertility.com

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.

Best

Signature

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.

Choosing a pediatrician

By: Diana Montgomery, M.D.

Choosing a pediatrician is an exciting – and sometimes daunting – milestone. It’s one thing to find a doctor for yourself. But deciding on a doctor for your baby brings one of those moments when you realize that you will soon be someone’s parent, wholly responsible for a completely new person. Now what? Here are some suggestions to guide you towards finding a great fit with your pediatrician.

Consider your sources. Family, friends, co-workers, your obstetrician – ask around and see who they take their kids to. Are they happy with their choice? What do they like about their pediatrician and their pediatrician’s office? What do they wish could be better? This may help you generate a list of practices to investigate further and maybe some to skip. Online forums and websites can be great – but don’t believe everything you read. Recommendations from people that you know and trust are likely to be much more reliable.

Logistics are important. Is the office convenient? Assuming all goes well, you can expect to take your baby for a visit with the pediatrician eight times in the first year – and that’s just for regularly scheduled well checks. Is it important to you to see a doctor with an office in your neighborhood or are you willing to drive across town for the right person? There’s no right or wrong answer here – it’s just good to know what your tolerance is for a commute. Is moving to Marin a likely possibility for you? It might make sense to choose a practice with multiple office locations so that you won’t have to change doctors when you change counties.

Logistics are really important. What if you have a question for the doctor outside of a regularly scheduled visit – or your baby needs to be seen after hours? Find out how this works. If you call the doctor’s office for advice, who calls you back – and how quickly – during business hours and beyond? Some practices have a nurse available by phone but require that you make an appointment in order to speak with your doctor. Other practices will have your doctor respond to non-urgent medical questions during the day, but have an after-hours advice line staffed by nurses who relay messages to an on-call doctor as needed. Some doctors take their own calls after hours. If your child needs to be seen for an illness, are you likely to see your regular doctor or whoever is available in the practice? You may be comfortable with a large practice and lots of different faces – or you may prefer more consistency. If your child needs to be seen in the evening or over the weekend, know whether your office has extended hours or has an after-hours clinic that they refer to. If you are willing and able to pay a fee that is over and above what your insurance reimburses, concierge practices and private doctors provide greater access to your physician – and even house calls. So think about your needs, and make sure that your pediatrician’s office is set up to provide care in a way that works for you. No parent should feel left alone to worry about their baby without support from their baby’s doctor.

What’s your style? This may be the hardest piece to suss out. Answers to the questions above can be found on the web and from other parents. But really knowing whether your baby’s soon-to-be doctor will work for you requires a conversation with the pediatrician, either by phone or in person. Here again, there is no right or wrong answer. Some parents prefer a dialogue with their doctor about various treatment options – others prefer to have a doctor who calls the shots. I suggest asking a question and seeing how the doctor answers. Ask about their advice on sleep training an infant or how they support breastfeeding or what their take is on circumcision. What they answer is probably less important than how they answer. Is this a doctor you trust to guide you through babyhood and beyond?

Good luck – and welcome to parenthood!

 

 

Let’s Get Started

By: Danielle E. Lane, M.D.

Remembering your relationship as a part of your fertility journey is very important. After all, having a baby is supposed to be an exciting part of your life as a couple, but with fertility challenges, this can be a trying time.

In a recent study conducted by HealthyWomen, nearly 25% of women reported that infertility had a negative impact on their relationships.   The survey also found that, one-third of women felt that their infertility challenges left their relationship stronger. Most women stated that their partners were very supportive during their fertility treatment and the majority of women were still with their partner after completing treatment. In cases where a couple separated after fertility treatment, most women indicated that the reason for separation was unrelated to the fertility treatment.

There are many ways to protect your relationship if you are facing fertility challenges. First, it is critical to avoid blame. Reassure your partner that you are a team in this process. Remember why you love your partner and why you want to have a child together. Discuss your frustration and anger. By approaching your journey as a team, you are able to celebrate and cope together.

Remember to keep your relationship healthy. Focus on yourselves sometimes and not soley the thought of having a baby. Enjoy dates that do not allow conversation about fertility. Separate having sex from getting pregnant. Insemination cycles may be a relief to couples who have struggled to maintain a challenging schedule of intercourse in the name of “optimizing pregnancy”.   This also means having a conversation about how far you will go in the fertility process. It is easy to exhaust your resources – financially and emotionally. Setting/Establishing a limit that feels comfortable for both partners is important in protecting what you have. Turning to friends or fertility groups who can discuss their experience may be helpful in providing some guidelines.

Stay open to seeking outside help. Patients are often times uncomfortable sharing their fertility experience with anyone.   Many patients are offended at the idea of talking with a therapist or fertility group. They work hard to keep information from their friends, families and work colleagues. Certainly this is one approach, but in reality, it is very difficult to maintain this charade. Missed work, family gatherings and social events can become difficult to explain. Privacy is indeed important and it is good to understand your needs as a couple, however, it is often a tremendous advantage to benefit from the experience of others.

In the end, no matter what choices you make, it is important not to lose the wonderful partner that you entered this journey with!
ABOUT THE AUTHOR

Danielle E Lane, MD, Reproductive Endocrinology and Infertility specialist. Dr. Lane attended McGill University before completing her medical training at the University of Pittsburgh school of medicine, her residency at Yale-New Haven Hospital and her fellowship at the University of California, San Francisco. She opened the Center for Reproductive Health at Kaiser Permanente in Napa-Sola-no in 2005. In 2009 she founded Lane Fertility Institute. The Institute has grown to a four physician, multi location practice with a state of the art embryology laboratory. She is committed to providing education for women about preservation of their fertility and developing lower cost models to improve access to care.