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

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 (http://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy)

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

 

ABOUT THE AUTHOR

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.

Who’s Taking Care of YOU … Self-Care During Conception and Pregnancy

By: Valerie Mendels, L.Ac, Dipl.Ac, M.Ac.

As an acupuncturist specializing in fertility and pregnancy, one of the most important areas that I coach my patients in is caring for themselves. Whether you are trying to conceive, or you are already pregnant, in order to be optimally healthy during this special time you must raise your self-care to the highest level.

The word “self-care” might conjure up the nice things that one ideally would do for oneself: getting weekly acupuncture, taking a relaxing bath, meditating daily. These are all wonderful things (and of course, I am a big advocate of acupuncture for fertility and pregnancy support, as well as for self-care) but let’s discuss the absolute basics of self-care, the most fundamental things that you need to do: eating, drinking, and sleeping. Strange as it may seem, in our busy modern lives most of us have forgotten how to tend to these basics.

Lane_Mag_2015_Self_Care_ChartMaybe your life is made up of long days at the office or you are in a helping profession where you are busy caring for patients; perhaps you are at home taking care of a small child or you may have a high pressure job that includes lots of travel. Whatever your day to day life involves, it is easy when you are busy to ignore your body and push aside your own basic physical needs. Ask yourself how many of the self-care questions apply to you.

Most of us would answer yes to some or all of these questions, and realistically speaking it is quite “normal”, although not ideal, to neglect one’s needs in these ways when busy with a job, taking care of a child, or both.

But when you are trying to conceive or get pregnant, ignoring your body’s basic needs in this way can be quite harmful. Now is the time to do something new and actually start listening to your body! This means that when you are thirsty, don’t wait – DRINK. When you are hungry – EAT. When you are tired –REST or SLEEP. Sometimes, however, you may not hear your body’s signals (especially if you have been ignoring them for many years), so you also need to use your mind and your intention to remember to take care of yourself.

Remembering to eat

Your pre-pregnancy and pregnancy diet should be balanced, made up of whole foods (free of processed foods), nutrient dense, and organic. A healthy diet is a critical part of your self-care. To learn more, I recommend “Real Food for Mother and Baby” by Nina Planck.

An important goal should be to keep your blood sugar stable by avoiding refined sugar, and eating frequent small meals, or low-glycemic snacks between meals. Never skip breakfast, include some protein with every meal, and try not to go more than 4 hours (during your waking hours) without eating something, to prevent low blood sugar. Once you are pregnant, be sure to carry healthy snacks with you everywhere, so that when you suddenly get hungry, you always have something on hand. This does not mean that you will be eating more food than usual; you will be eating more frequently but having smaller meals.

By keeping your blood sugar stable, you can not only help to reduce your risk of gestational diabetes, but you will also keep your cortisol (stress hormone) levels more stable, and help prevent adrenal fatigue.

Remembering to drink

As a general guideline the National Institutes of Health recommends, pregnant women need 8-10 glasses of water per day. In addition, 1 glass of water should be consumed for every hour of exercise. The NIH further confirms that most municipal water contains fluoride which can be helpful in the development of teeth and bones in the growing fetus. Be sure to get a water filter to purify your tap water, and also consider getting your water tested to determine whether there is any risk of heavy metal contamination. Studies have shown that water tainted with lead can result in spontaneous abortion, decreased stature and neurodevelopmental deficits in the growing fetus. Plastic bottles that leach harmful chemicals such as Bisphenol A (BPA) should also be avoided.

According to the principles of Chinese medicine, it is best to drink room temperature or warm water, and to avoid drinking cold water and ice water.

Remembering to sleep

When you are trying to conceive or are pregnant, sleep needs to become a high priority. If you have little ones at home who wake up during the night this may be a challenge, but do your best.

Here are a few suggestions to help you think about your sleep.

  • Go to bed early. The sleep before midnight is much more restorative than the sleep after midnight. The more sleep that you get before midnight the better.
  • Sleep as much as you can. Fertility treatment can be as exhausting as your first trimester of pregnancy. Once pregnant, some women need as much as12 hours of sleep per night. Don’t feel lazy or guilty about it; think of sleep as medicine for you while you are pregnant or trying to conceive.
  • Take naps. If you can’t fall asleep during the day, at least lie down. Getting horizontal and closing your eyes for a while will give your body and mind a chance to rest.
  • For deeper sleep, avoid all caffeine and turn off electronic devices at least 1 hour before bed.
  • If you have insomnia, try acupuncture. Be sure to see an acupuncturist who is specialized in fertility and pregnancy.

By following this advice for basic self-care you will be well-nourished, well-hydrated and well-rested, and your levels of stress hormones will be reduced . . . a great foundation for a healthy pregnancy and a happy baby and mom.

ABOUT THE AUTHOR

ValerieValerie Mendels, L.Ac., Acupuncturist (specialized in fertility). Valerie’s practice is based in Petaluma, California. She has been treating patients with acupuncture since 1999, and holds a Master’s degree from the traditional acupuncture Institute, School of Philosophy and Healing in Action (TAI Sophia) in Maryland. In addition to acupuncture, Valerie uses Chinese herbal medicine, nutritional and dietary therapy, and lifestyle counseling to help her patients gain optimal health and fertility. Valerie is passionate about helping her patients experience greater peace, joy and well-being while working with them to achieve their fertility goals. Her website is www.valeriemendels.com