Frequently asked Questions and Answers

Answers to your questions about Invitro Fertilization

We've compiled answers to some of the most commonly asked questions about our policies, procedures, and treatments. Please remember that this does not replace your conversation with Dr. Putman or his staff. If you have questions about your treatment, please contact our office for assistance.

• Do I have to be referred by another doctor before Dr. Putman will see me?
• No. While many of Dr. Putman's referral patients are from the patient's own physician, anyone who thinks they have a fertility problem can call the office to schedule an appointment.
• Should I bring my medical records with me, or wait until after my first visit with Dr. Putman?
• It would be very beneficial to send your medical records to our office before your first appointment so the doctors have time to review them, but bringing them with you will still be very helpful. Even if you don't have them, a great deal can be accomplished in your first visit.
• I was referred by my OB/GYN and she has done some testing. Will Dr. Putman take up where she left off?
• All previous studies are important to your situation. Most of the time it will not be necessary to repeat tests. Sometimes, some tests will need to be repeated because they where inconclusive or a similar but more specific test is needed.
• How do I know if I need treatment for fertility problems?
• If a couple has been trying unsuccessfully to achieve a pregnancy for 12 months and they are under 30 yrs. of age, they should consult their ob/gyn or a fertility specialist. If older than 30, don't delay past 6 months. If you know that you have a specific problem such as not ovulating or your tubes are blocked or your husband has a sperm problem, seek help as soon as you are ready to start a family.
• What caused my fertility problem?
• Many things can decrease your chances of becoming pregnant, 40% of the time it is male-related, 40% of the time it is female-related, 15% of the time it is a combination of male and female problems, and 5% of the time it may be unexplained. However, we have been studying a new area of immune-related causes that may explain what is happening to you. Ask us for more details.
• My husband does not want to do the semen analysis; he thinks it's a female issue.
• The fertility disorder preventing pregnancy is a male factor 40% of the time! A comprehensive semen analysis is one of the most important tests to do and should be one of the first tests performed. 25% of the time there exists both a male and female problem contributing to not conceiving.
• My husband has a child from a previous marriage. Is semen analysis still necessary?
• Absolutely! A lot can happen even in a short period of time. It is very important to be sure his semen is still normal.
• When is the best time to take a prenatal vitamin supplement? Is over-the-counter OK?
• Start your prenatal vitamins when you start trying to conceive. Prescription vitamins have a higher amount of folic acid and are formulated for pregnancy. Ask your OB/GYN for a prescription that she prefers. We will put you on prenatal vitamins if you aren't already taking them.
• Will I still have a period if I don't ovulate?
• Most patients who don't ovulate will not have regular, predicable monthly periods, but may have menstrual flow at unpredictable times. An ultrasound study can be done to determine if you are ovulating.
• Don't all women ovulate on day 14 of the menstrual cycle? Why should I test with my ovulation kit as early as day 9?
• The ideal ovulation cycle has 28 days with ovulation being day 14. However, not all women's cycles are 28 days. Some women may ovulate earlier or later than day 14; it is critical to know precisely when ovulation occurs. Testing early may detect an early sign of ovulation.
• When I am using an ovulation predictor kit, when is the most fertile time for intercourse?
• The brain detects the presence of a mature or ripe egg by the ovary's production of estrogen. This occurs approximately 36 hrs. prior to ovulation. Once the brain has received the ovary's message; it sends back a message to the ovary telling it to complete the maturing process and release the egg. Thirty six hours after the brain's message (LH surge); ovulation takes place. The ovulation predictor kit detects the LH message 24 hours before ovulation. The most fertile times for intercourse are the day of LH surge and the day after (day of ovulation). While the sperm can live for several days; the egg lives for only 24 hours.
• I've heard that intercourse every other day is the best way to become pregnant. Is this true?
• No. The egg lives only 24 hours and you only ovulate once a cycle. The best way is to know when you ovulate in your cycle so that you have intercourse during your fertile time.
• Why is it necessary to come in for more than one ultrasound in an evaluation period?
• To determine how well the egg is developing during a cycle, several ultrasounds need to be performed. We may find that you ovulate earlier or later than you thought or we may detect abnormal ovulation patterns or even that you aren't ovulating.
• Can being overweight or underweight affect conception?
• Absolutely! The closer you are to your ideal body weight, the more likely you are to ovulate on your own without having to take fertility drugs. However, there are always exceptions where both overweight and underweight patients may have no problem with ovulation.
• My friend started taking thyroid medication and got pregnant in one month. Should I try this?
• No- not unless you are someone that has a deficiency of thyroid hormone. Blood tests to measure your thyroid function are part of our evaluation. If you are hypothyroid- then taking thyroid will help in both getting and keeping your pregnancy. It is also very important for your baby's development.
• Does fertility treatment increase or decrease the risk of birth defects?
• Any pregnancy has a 3-5% risk of birth defects. Fertility treatment neither decreases nor increases the risk.
• I've been told my tubes are blocked; does Dr. Putman treat this?
• Yes. Treatment can be corrective surgery ( usually a day surgery procedure) to open your blocked tubes or in vitro fertilization can be done when the tubes are not repairable.
• I have endometriosis. What are my chances of becoming pregnant?
• The severity of the endometriosis is the critical factor in becoming pregnant. The more severe the endometriosis, the less likely you can conceive on your own. Surgical treatment by removing or destroying all visible endometriosis increases the pregnancy chances. If there is too much scarring around the tubes and ovaries, then in vitro fertilization can often be successful.
• Will Clomid increase my chance of getting pregnant? I want to try it first.
• Clomid is very effective for patients who don't ovulate. It has recently been shown in studies to actually decrease pregnancy chances in patients that ovulate normally. It is best to evaluate you and see what treatment is needed based on your individual situation
• Dr. Putman recommended super-ovulation (injectable hormones). Why do I have to give the injections at home?
• During a super-ovulation stimulation cycle, we must carefully monitor the response of your ovaries to the medication. Ultrasound studies are done to detect the number of developing eggs and their maturity. Estrogen (hormone produced by the ovaries) is measured in your blood to further determine the egg maturity. The results are made available to Dr. Putman in the afternoon; they can then best determine the dosage needed that evening to give you the best chance for success.
• My husband and I have one child, but I have not been able to conceive again. Why?
• Secondary fertility problems can be caused by a variety of conditions. It is best to evaluate them just as with someone who has never conceived. Fortunately, most patients who have had a prior successful pregnancy will have a very good chance of being successful again.
• Does Dr. Putman see patients who have immune problems?
• Yes- more is being learned every day about the role that the immune system plays in pregnancy. New tests have been developed to identify immune disorders, and new treatment methods appear to increase the chances for a successful outcome.
• Is it best just to do In Vitro Fertilization and skip all of the evaluation process, or other treatments?
• Many times the problem can be found and corrected without having to go to In Vitro Fertilization. Remember IVF is an expensive and time-consuming process that may not be suitable for everyone. If success can be achieved by a simpler, less expensive and less invasive method- then that's what we need to do!
• Will any of my fertility evaluation and treatment be covered by my insurance?
• Possibly. It depends on what your individual insurance plan states about fertility disorders. Some insurance will provide coverage for evaluating why you are not conceiving (diagnosis coverage only); while others may include some or all treatments. It is very important to know exactly what your policy will cover. If you have a copy of your policy, look under infertility coverage to see what is included or excluded. We will try to obtain your coverage information prior to or at your first appointment. Some times that information will not be available to us unless you bring in your policy or contact your human resources person at work or directly contact your insurance company. Remember to get any information from your insurance company in writing by fax or letter! You have insurance to assist you in paying for medical care- you are still responsible for your costs. We will glad to provide you with estimated costs for your evaluation and treatment before you start the process. Please don't hesitate to ask the front office staff or our office manager, if you need assistance.
• If I have insurance that states it pays for my fertility evaluation and treatment, why do I have to pay for special tests and treatments?
• Read your policy carefully. Many times evaluation and treatments have limitations. For example, it may not cover intrauterine insemination but does pay for ovulation drugs. There may be a lifetime dollar amount that applies to fertility . Most insurance companies contract with a laboratory (ie. Quest, Labcore) to provide lab testing. If your tests are available from these labs, then you will not have to pay for those tests. There are special tests (immune studies such as embryo toxicity assay and natural killer-cell phenotype and comprehensive semen analysis with ultraspecific morphology) that are not available from these labs. You are expected to pay for these tests. You can file for these tests with your insurance company; however they may not reimburse you at all or at a lesser amount. There are times during your treatment when blood tests results must be available to us on the same day they were drawn- ie. estrogen levels during ovulation stimulation to determine your medication dose- the contracted laboratories with your insurance cannot provide this stat (available that day) service during both week days and weekends. You will be responsible for part or all of those charges depending on your policy coverage.