The Fertility Center is devoted to assisting couples with fertility problems in becoming pregnant. Our practice also specializes in the evaluation and treatment of endometriosis, recurrent pregnancy loss, and menopause issues. We conduct a variety of diagnostic tests and treatment procedures including the following: Operative Laparascopy and Hysteroscopy Laser and Microsurgery Tubal Reversal Male Factor Evaluation and Treatment Intrauterine Insemination Cryopreservation Donor Egg Program Assisted Hatching (AH) In Vitro Fertilization Zygote Intrafallopian Transfer (ZIFT) ICSI (Direct Sperm Injection) Embryo Adoption.

As a team of specialists devoted to helping patients with infertility, we work closely with your primary care physician and obstetrician. With your permission, we will send a complete report to your physician detailing the types of tests and procedures we performed. When patients become pregnant, we refer them back to their obstetrician or family practice physician for ongoing prenatal care. Our practice does not provide obstetrical care.

To make an appointment, please call 616.988.2229 or toll-free at 877-904-4483 for the Grand Rapids, Mason, or Traverse City offices. For the Kalamazoo office, please call 269.324.5100. We are available to see patients Monday through Friday and we also reserve weekend and select evening appointments for specific treatments and time sensitive tests.

During your first visit, we generally conduct a comprehensive consultation and answer any questions you may have. First visits last approximately 60 minutes. We do ask that you arrive 30 minutes early for your first appointment so that we may complete the necessary forms for your records. We make every effort to remain on schedule and to not keep you waiting. In order to do so, we kindly ask the same consideration from you.

Payment is expected at the time of service. If you have questions regarding our insurance participation, please contact our office.

During office hours, if you have a question please call the office. You may need to leave a message for the nurse. Please keep in mind that the nurses are with patients during the day, and your call will be returned as soon as possible. If you have a question after hours, there is an emergency answering service that can page the nurse or doctor on call. If your question is not an emergency, please call the next morning when the phones are turned on at 8:00 AM.

Intrauterine Insemination (IUI) involves the washing of partner’s (or the use of frozen donor) sperm, which is prepared in the laboratory and placed in a small catheter. The catheter is then inserted through the cervix and deposited into the uterus. The sperm are closer to the fallopian tubes with this procedure, where fertilization occurs. This is an office procedure, takes only several minutes, and minimal discomfort is involved. In vitro fertilization (IVF) is where the woman takes injectable fertility medications to stimulate the ovaries until multiple follicles are mature. At that time, the woman undergoes a minor surgical procedure, called an egg retrieval, where the follicles are aspirated vaginally under ultrasound guidance, while the woman is under intravenous sedation. The eggs are then fertilized with sperm, and the resulting embryos are watched for development, and transferred back into the uterus at the appropriate time.

During the “monitoring” phase of your treatment cycle, you will need to be available for multiple appointments to assess the growth of your follicles. Your nurse, prior to your cycle, can assist you in planning for these appointments.

IVF and other assisted reproductive technologies provide many couples with the opportunity to get pregnant that otherwise wouldn’t be able to have children on their own. During your consultation with the doctors, they will be able to discuss your own set of unique circumstances and give you a realistic expectation as to your individual chance for success.

We recommend only low impact exercise (walking or bicycling). The ovaries may become enlarged from the fertility medications you may be taking, and high impact (bouncy) exercise may put you at risk for ovarian torsion, where the ovary can twist on itself. This is a very rare, but serious side effect.

Day 1 of your cycle is considered the first day of heavy flow, not just spotting.

After embryo transfer, we ask that you refrain from intercourse until your follow-up appointment or your OB ultrasound.

Air travel should be fine following the embryo transfer. We recommend NO heavy lifting. Ask for a form for the airline from the nurse if you will be traveling with needles and medications.

Intravenous sedation is given during the egg retrieval procedure and the procedure lasts approximately 20 minutes. Most patients experience very minimal discomfort. Some patients have mild cramping after the procedure. Tylenol may be taken as needed. Contact our office if you are experiencing increased pain.

Pregnancy success percentages vary from patient to patient- your physician can best predict outcome for your individual situation after reviewing your history, evaluation, and prior response to fertility medications. We are pleased that our success rates are in the top 5% nationally. IVF programs are required to report their statistics to the Centers for Disease Control (www.cdc.org/art) and/or the Society for Assisted Reproductive Technology (www.sart.org). These statistics are available for public review. You can view our success rates on our website also.

The cost for fertility treatment varies depending on a variety of factors (what treatment is recommended for you, how much medication you will need, whether insurance covers a portion of treatment, etc.) While our billing coordinators make every effort to gather your individual insurance coverage, it is your responsibility as the patient to contact your insurance company for your benefit information prior to your first consultation. If you have any other questions, you can contact the Billing Department at our Grand Rapids office at 616-988-2229 ext. 102.

Medications are not included in the cost of a cycle, as the amount of medication needed will vary from patient to patient.

You may take some medications during your treatment cycle. Tylenol, Extra Strength Tylenol, Sudafed, Robitussin are allowed. Please ask your nurse if you need need to take other medications.

Herbal supplements are not recommended and may cause unknown effects. If you are on such supplements, please inform your nurse.

Colace, Metamucil, Citracal and increased water intake may relieve the symptoms of constipation.

Side effects from fertility medications vary from patient to patient and what specific medication you are taking, but typical side effects may include abdominal bloating, headaches, and nausea. Please check with your nurse regarding specific symptoms you may be having.

The Fertility Center does not provide fertility medications for your cycle, but a prescription will be given to you or can be faxed to the pharmacy of your choice. We have a list of specialty pharmacies that carry these medications. Some insurance companies require you to go to a specific pharmacy. Discuss this with your nurse as needed.

Fertility medications cause more follicles to develop, so there is an increased risk of a multiple pregnancy. During your cycle, we will discuss the risk of a multiple pregnancy based on your response. If you are pursuing IVF, a discussion in regards to how many embryos to transfer will occur, thus decreasing the risk of multiples.

Yes, monitoring appointments need to be scheduled in the morning. The lab work needs to be processed and evaluated by your physician to decide if there will be a change in the medication plan for that day.

It is recommended that your partner attend the new patient appointment with you, as well as subsequent consults. They do not need to attend the monitoring appointments. You can ask the nurses if they should attend any procedures you may be having.

Spotting (pink, dark red or brown) can be quite normal early in pregnancy. However, if you experience bright red bleeding, please get off your feet immediately and call our office. Mild cramping may also be normal. If cramping is moderate to severe, you should notify our office.

Pregnancy tests should be accurate 16 days from detected ovulation, or from the administration of the HCG injection. With IVF, pregnancy testing is scheduled 12 days after the embryo transfer. Any earlier testing (especially when using a home pregnancy test) could result in a false positive pregnancy test.

You will have blood tests and ultrasounds to determine appropriate growth of the pregnancy before you are released. Typically you will not be discharged to your OB/GYN until 8-10 weeks of pregnancy.

It is OK that you get the seasonal Flu vaccine as well as the H1N1 vaccine. Please see the CDC’s information below… Q: Why does CDC recommend that pregnant women receive the 2009 H1N1 influenza vaccine? A. It is important for a pregnant woman to receive the 2009 H1N1 influenza vaccine as well as a seasonal influenza vaccine. A pregnant woman who gets any type of flu is at risk for serious complications and hospitalization. Pregnant women who are otherwise healthy have been severely impacted by the 2009 H1N1 influenza virus (formerly called “novel H1N1 flu” or “swine flu”). In comparison to the general population, a greater proportion of pregnant women infected with the 2009 H1N1 influenza virus have been hospitalized. In addition, severe illness and death has occurred in pregnant women. Q: Is there a particular kind of flu vaccine that pregnant women should get? Are there flu vaccines that pregnant women should not get? A. There are two type of flu vaccine. Pregnant women should get the “flu shot”— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm. The flu shot is approved for use in pregnant women. The other type of flu vaccine — nasal-spray flu vaccine (sometimes called LAIV for “live attenuated influenza vaccine)—is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant. Q. Will the seasonal flu vaccine also protect against the 2009 H1N1 flu? A. The seasonal flu vaccine is not expected to protect against the 2009 H1N1 flu. Similarly, the 2009 H1N1 influenza vaccine will not protect against seasonal influenza. Q. Can the seasonal influenza vaccine and the 2009 H1N1 influenza vaccine be given at the same time? A. It is anticipated that seasonal flu and 2009 H1N1 vaccines may be administered on the same day but given at different sites (e.g. one shot in the left arm and the other shot in the right arm). However, we expect the seasonal vaccine to be available earlier than the 2009 H1N1 influenza vaccine. The usual seasonal influenza viruses are still expected to cause illness this fall and winter. Pregnant women and others at increased risk of complications of influenza are encouraged to get their seasonal flu vaccine as soon as it is available.

Key points from “The Fertility Diet” by Walter Willet, MD and Jorge Chavarro, MD… Increase fresh vegetables and fruits. Have at least two servings of both each day. Avoid processed foods and in particular transfats. Minimize carbohydrates other than whole grain breads. Increase chicken and fish. Minimize red meat. Avoid caffeine and sweetener substitutes. For more information, consult the book or ask one of our doctors!