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Infertility FAQ

Normally, one egg matures each month, but when we stimulate the ovaries for IVF or ICSI, we attempt to mature multiple eggs for fertilization. In vitro fertilization (IVF) involves removing eggs from the ovaries and fertilizing them outside of the body (“in vitro”). With conventional IVF, many sperm are placed in a dish with a healthy egg, whereas with Intracytoplasmic sperm injection (ICSI), a single sperm is carefully injected directly into each egg.

Ovarian stimulation usually requires 10-14 days of hormonal stimulation and monitoring before the eggs are retrieved. Once the eggs are in our care, we need to consider several key steps:

  • Fertilization: Conventional IVF or ICSI? 
  • When to plan your transfer: How long should we care for your embryos before transferring or freezing them? 2-3 or 5-6 days?
  • Embryo Transfer: Fresh or frozen? If frozen, do we transfer them in the future using a controlled or natural cycle?
  • Genetic testing: Do we test your embryos before transferring them?

Based on your history, assessment, and goals, we’ll help you navigate several steps and decision points depending on your particular situation and requirements.

“I was 34 when I decided to be a single mom by choice. Who knew I could create my own love of my life.” -- Regina

Want to build a family on your own? Congratulations on making this choice. It may take a village to raise a child, but not to make one. We’re here to help.

Here’s what it takes:

  • A healthy egg from you or an egg donor
  • Healthy sperm from someone you know or an anonymous donor
  • A way for the sperm and egg to meet: either IUI or IVF

Whatever your needs, we can help. We’ll work with you to assess any obstacles, plan your family and secure appropriate donor sperm, eggs or gestational carriers from our network of stellar agencies.

Let’s find a plan that works for you.

Single Moms by Choice and Choice Moms are two excellent community groups that support women seeking to have a family on their own.

There are many causes of infertility. For a successful pregnancy to occur, a healthy egg needs to meet healthy sperm, fertilize, develop and find a good place to grow (a receptive uterus). Problems at any of these steps can cause difficulties in getting pregnant. A woman’s body might not release an egg each month due to hormone imbalances, or perhaps the man’s body isn’t producing enough motile sperm. The fallopian tubes can be blocked or non-functional, preventing the egg and sperm from meeting. Or maybe infertility is because of abnormal uterine conditions like polyps, fibroids, or infections.

Not necessarily, and at Spring, there’s no such thing as “most people”. While we work with proven protocols, everyone is an individual and each treatment plan is customized to each patient. In order to determine which treatment options are right for you, we’ll conduct a thorough review of your medical history and assessment of both partners to evaluate what’s happening. Then we’ll form a plan to move forward. To get started, book a consult.

PGT-A allows patients the highest chance of success (a live birth) with each embryo transfer. Regardless of age, a chromosomally normal embryo has about a 50% chance of live birth. This allows us greater confidence with each embryo transfer such that most patients transfer only one embryo at a time. Keep in mind that while PGT-A helps us more easily identify the healthiest embryos to transfer (resulting in a higher live birth rate per transfer), it does not increase the chances overall.

The Pros: Highest implantation and live birth rate per transfer, fewer miscarriages, and you are less likely to experience (and pay for) an unsuccessful embryo transfer.

The Cons: Higher upfront cost in order to perform the procedure on the embryos and genetic analysis on sampled cells. And although this procedure is considered safe and effective, the test is about 90% accurate: 4% of cases will result in a "False Positive" (calling a potentially normal embryo "abnormal"), about 4% in a "False Negative" (embryos are determined to be "normal" but later miscarry and are found to have an abnormal chromosome complement), and approximately 2% of the time we do not get sufficient amplification of DNA for the scientists to make a determination on your embryo.

Lastly, it’s important to understand that with PGT-A, it’s possible that you will not have any normal embryos to transfer. Although this is very disappointing to experience, it also means that you did not have to endure a transfer that resulted in a miscarriage, with the associated pain and lost time before a successful transfer.

We take enormous pride in delivering the highest chances of successful IVF, anywhere. Your success will depend greatly on your age at the time your eggs are retrieved. Nationally, women under 35 have nearly 50% success rates, while women over 42 have a 5% chance of success with each attempt using her own eggs. As women age, the number of eggs available declines and the miscarriage risk increases due to ovarian aging, making it harder to conceive. Many women require multiple attempts with IVF. Our job is to help you achieve a live birth in as few attempts as possible. Although aging is the biggest predictor of success, this is due to the age of the eggs and not the uterus. Success rates with donor eggs are over 50% per attempt and depend on the fertility and age of the egg donor.

There are many causes of infertility. For a successful pregnancy to occur: A healthy egg needs to be meet healthy sperm, fertilize, develop and find a good place to grow (a receptive uterus).

Problems at any of these steps can cause difficulties in getting pregnant:

  1. A woman’s body might not release an egg each month due to hormone imbalances.
  2. The man’s body might not produce enough sperm for successful fertilization.
  3. The fallopian tubes can be blocked or non-functional (for example, as a result of scarring from previous infections or inflammatory conditions like endometriosis). This would prevent the egg and sperm from meeting.
  4. It’s also possible that the uterus might not be receptive to implantation due to abnormal conditions like polyps, fibroids or infections.

It’s important to note that 30-40% of infertility cases are due to male factors. We need enough motile, swimming sperm to fertilize an egg. A “normal” ejaculate has over 18 million motile (swimming) sperm. Some men produce fewer or no sperm. Other men produce plenty of sperm but have obstructions in their tubes (the vas deferens), preventing sperm from being released. Just because a semen sample appears normal, doesn’t mean that there are sufficient numbers of sperm inside. We need to check with a microscope.

A woman’s ovarian reserve is directly related to age and potential to produce multiple eggs with ovarian stimulation. Ovarian reserve, or egg supply, begins to gradually decline beginning at the age of 30. The amount of medication required to stimulate the ovaries will increase and the number of follicles and eggs produced from the ovaries declines. These factors lower a woman’s chances of pregnancy with our best treatments. Several tests are used to determine a woman’s fertility potential, including blood tests such as Anti-Mullerian Hormone (AMH), FSH and Estradiol and a pelvic ultrasound to evaluate Antral Follicle Count.

Normal ovulation requires a well-choreographed interplay of numerous hormonal events involving the brain, pituitary gland and ovaries. Stress, medical conditions and other events can throw these off and cause hormone imbalances that affect ovulation. If you are not ovulating every month, we will need to screen for conditions like Polycystic Ovarian Syndrome (PCOS), Hyperprolactinemia, Thyroid Problems, as well as other less common conditions. In order to evaluate your case, we may test for additional hormones.

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The long answer is that the optimal number to ensure a single healthy pregnancy varies by age, reproductive history (have you been pregnant before?), and other factors that could make it easier or harder to get pregnant in the future.

The short answer: we recommend having at least 20 mature eggs frozen before your 37th birthday. Why? The largest study to date looking at the average number of mature eggs needed per live birth in patients using IVF suggested that 20 eggs were needed, up until age 37. Beyond age 37 the number was higher (about 40 eggs per baby at age 40 and 60 eggs by age 42). These numbers correlate very well with the national IVF success rates in the United States, as reported by the CDC.

EGG FREEZING CALCULATOR

 
A mature egg (a.k.a. an “M2 oocyte”) is an egg that has completed the first stage of meiosis (reducing its DNA by half to prepare for fertilization with sperm). Not every egg that is retrieved is mature and therefore not every egg can be used. An egg must be “mature” to fertilize successfully.

Although there are several molecular tests of uterine receptiveness, most current tests are not very predictive. The most important tool right now is to make sure the uterus is free of any lesions like polyps or fibroids. This is best done by either a Sonohysterogram, also known as a Saline Infusion Sonogram (SIS) or hysteroscopy. Occasionally, an endometrial biopsy can be performed to rule out chronic infections, or to perform experimental molecular testing.

For men, the evaluation is even simpler. We perform a Semen Analysis to see if there are enough motile (swimming) sperm to reach and fertilize an egg. Low or absent sperm counts can be due to problems producing sperm or in a blockage preventing the sperm from being released. Appearing to ejaculate normally does not mean there are enough quality sperm being emitted.

The basic male evaluation can be addressed with two key questions:

Do you produce a sufficient number of “swimming” sperm to total sperm?
Fertile men typically produce tens of millions of sperm per ejaculate. It’s not enough to produce sperm; the job isn’t done until they reach the egg and fertilize it. Unfortunately, it’s a long journey, and therefore nature provides millions of sperm in the hope that one is able to make it to the egg, attach and fertilize.

Are the sperm able to leave your body?
Just as women have tubes that can be blocked (the fallopian tubes), the same is also true with men. The vas deferens is the tube that carries sperm from the testes to the penis. Sometimes these tubes can be blocked or congenitally absent. With an obstructed vas deferens, a man’s ejaculation may appear normal but lack sperm.

We evaluate sperm with a Semen Analysis, which tests the percent motility, or the number of sperm per ejaculation. We also examine direction and speed, shape, and other factors that can give your doctors insight into your ability to conceive without assistance.

The typical fertility assessment of both partners can be completed within a month (or one menstrual cycle) of an initial consult.

We are one of only a handful of clinics across the country to offer everything onsite, including HSG, AMH testing, and semen analysis. Doing so allows us to shorten your wait for results. We know your time is important, so we’ve designed our workflow around your needs.

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The IVF process is a series of steps that we’ll help you understand so you know exactly what to expect. Typically, the first 8-12 days encompass ovarian stimulation leading up to the egg retrieval. The egg retrieval coincides with preparing sperm for fertilization.

Then, depending on your situation, we’ll decide on what’s best for next steps:

Fertilization: Conventional IVF or ICSI?
When to plan your transfer: How long should we care for your embryos before transferring or freezing them? 2-3 or 5-6 days?
Embryo Transfer: Fresh or frozen? If frozen, do we transfer them in the future using a controlled or natural cycle?
Genetic testing: Do we test your embryos before transferring them?

We can help you decide what to do for each step based on your unique case and requirements.

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A pregnancy requires one healthy embryo to be delicately transferred to a receptive uterus at the optimal time. Unfortunately, most embryos are not able to implant successfully, even under the best circumstances. Here’s what we know: A healthy embryo (called a “euploid embryo”) has 46 chromosomes. Too many or too few and it’s unlikely to implant or might implant and miscarry. “Euploid” embryos have approximately 50% chance of implanting and developing into a healthy baby. So on average, we need two euploid embryos to have a successful pregnancy.

Women under 35 have a 2 in 3 chance of having chromosomally normal blastocyst, so would need about 3 blastocyst stage embryos (on average) per live birth. As women age, the chances of having a chromosomally normal blastocyst decline.

At 40, women have a 1 in 3 chance of having a chromosomally normal embryo at the blastocyst stage, so would need about 6 blastocysts for a successful pregnancy. At 42, women have a 1 in 4 chance of having a chromosomally normal blastocyst, so might need about 8 blastocyst stage embryos (on average) per live birth. Women over 42 years have a 1 in 5-6 chance of finding a chromosomally normal embryo. This is why many women over 42 are using donor eggs, unless they froze their own eggs earlier.

For women using donor eggs, the chances of a successful pregnancy depends on the age of the donor. Since most donors are in their 20’s, far fewer embryos will be required per live birth.

Please don’t despair! Although the numbers above may seem discouraging, everyone is an individual and we have patients that beat the odds and have successful outcomes with a 2% chance. The above numbers are to give you a sense of overall probability. Please discuss your case with your doctor to get more individualized answers.

You do not need to transfer every embryo. After you transfer your desired and recommended embryo(s) we can cryopreserve any additional embryos with the potential for implanting. These are saved for a future pregnancy or if this attempt isn’t successful. Embryologists have been cryopreserving embryos since the 1980s. Today, embryo survival is better than 98% and many studies have shown the outcomes with frozen embryo transfers to be as good or better than with fresh embryos. See how we prepare your embryo for transfer:

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Several recent studies have been published that suggest frozen embryos may have higher pregnancy and live birth rates and may even have better live birth outcomes. Our interpretation: For some patients a frozen embryo transfer is going to be safer and result in a higher pregnancy rate. However, not all patients benefit from this approach so we do not recommend freezing all embryos to every patient. We believe we can identify the patients who will benefit from a “freeze all” approach and frozen embryo transfer during their monitoring. In these cases, we recommend cryopreserving all of your embryos without transferring them in order to increase your chance of a successful and healthy pregnancy.

Reasons we might cryopreserve without transferring an embryo:

Elevated early progesterone. The uterus has a “window of receptivity” when it will allow a good embryo to implant. Before and after that window, even a good embryo won’t be successful. Sometimes, the elevated hormone levels seen with ovarian stimulation can “confuse” the uterus into thinking the embryo will be arriving before it is ready. By the time the embryos arrive, the uterus is not receptive to implantation. So, instead of transferring a good embryo into a uterus that is no longer “receptive,” we’ll wait and use a frozen embryo when the timing is better.


New concerns about the uterine lining. Rarely, we detect a new polyp or bleeding that was missed before starting the IVF process.


Ovarian hyperstimulation syndrome. In patients who produce many eggs and embryos, ovaries can become hyperstimulated and need time to ‘cool down’ to allow for successful implantation. This is quite rare, and although it’s disappointing to experience an unplanned delay, it usually means there’s a good chance at a successful pregnancy the next month with a frozen embryo transfer.


Patient choice. One of the most common reasons is that a patient or couple wants to create embryos to transfer later, either for medical or personal reasons.

Embryo freezing has been performed since the 1980s. Sperm cryopreservation has been successfully performed since the 1970s. We have seen many births from embryos cryopreserved for over 10 years and even some births from sperm cryopreserved for as long as 19 years. Animal studies suggest that cryopreservation is possible for even longer without detectable consequences but beyond 10-15 years, our experience is limited.

One decision we’ll consider together is whether you’ll want to do a natural or controlled (medicated) frozen embryo transfer.

If you’ve decided to get genetic testing or are otherwise using frozen embryos, then we’ll work with you to time your transfer. Compared to a “fresh” IVF cycle with ovarian stimulation, a frozen embryo transfer is much easier. Depending on your preferences for timing and your medical history, we can do a controlled cycle or a natural cycle.

  • Controlled Cycle: We give you medications to prevent your body from ovulating. We provide all the estrogen and progesterone you need for about 10 weeks.
    • Advantages: You can schedule the transfer to your convenience and have more control over the process.
    • Disadvantages: Cost and inconvenience of taking medications for 10 weeks.

  • Natural Cycle: We allow your body to ovulate on its own. As a result, you produce your own estrogen and progesterone and require minimal additional medication.
    • Advantages: Lower cost of medication.
    • Disadvantages: There is more initial monitoring to make sure we know when you ovulate and as such, it’s more unpredictable. We cannot control the exact date of the embryo transfer, since your body will ultimately determine when we need to transfer the embryo. We are also unable to give supplemental estradiol before you ovulate, so patients with thin lining may do better with a controlled cycle to supplement endometrial growth.
Unfortunately, miscarriages are very common and related to the age of the woman whose eggs are being used. While only 10-15% of pregnancies in your 20’s will end in miscarriage, this risk increases substantially during your mid to late 30’s. For women over 40 years of age over half of pregnancies will end in miscarriage. By age 45, nearly 75% of pregnancies will end in miscarriage.
While IVF alone cannot prevent a miscarriage, it does allow for embryo testing, which can minimize the risk of miscarriage after embryo transfer. After embryo sampling and PGS, the subsequent miscarriage rate is very low (3-8%) if the embryo has been tested and shown to be euploid.

If you are struggling with infertility, you may have heard of endometrial testing options, such as the ERA (endometrial receptivity analysis), CD138 for chronic subclinical endometritis, or Receptiva Dx which claims to diagnose patients with endometriosis. All these tests boast strong claims of significantly improving patients' chances of carrying a successful pregnancy. Please know that your Spring providers will always recommend any test or intervention that they think will help you be successful. While we are our patients' strongest advocates, we are also data-driven scientists. For a full breakdown on how these tests work, the validity of their claims, and to learn more about specific cases in which we may recommend, you can read more here.

At Spring, we counsel patients who are planning for an egg retrieval when they are 45 or older that we suggest that they consider using donor eggs. We have had successful live births from women ages 44, 45 and 46 with their own eggs, and successful pregnancies have been reported above age 46. However, these chances are low and we transparently counsel and educate patients to make decisions that are right for them. We recognize that the decision to use an egg donor requires careful consideration and we are here to support you. Our primary goal is to help our patients in their journey to have a family, and we strongly believe that DNA is only one component of parenthood. An embryo must implant, develop, and spend 9 months in your womb before you deliver your baby and devote a lifetime of care. The primary determining factor of the health and happiness of your future child is your parenting ????

Although protocols can vary, typically the process is two weeks involving:

  1. 8-14 days of hormone stimulation, culminating in a final “trigger shot” 36 hours before the egg retrieval
  2. Usually 5 monitoring appointments
  3. The egg retrieval: a 20 minute procedure under sedation (you are asleep with an anesthesiologist present but you are not intubated or paralyzed).

Some patients may additionally benefit from two weeks of hormonal preparation prior to beginning stimulation. The addition of these medications helps follicles grow at the same rate to optimize the number of eggs retrieved.

Our goal is to obtain the greatest numbers of healthy eggs from your ovaries. The eggs begin in a small “antral” follicle in your ovary. Ovarian stimulation gently prompts these follicles to grow or “mature” a cohort of eggs. You will follow this process and can see how we measure your follicles during your monitoring appointments, which are usually 20-30 minute morning visits leading up to your retrieval. Based on the growth of your follicles (assessed by ultrasound), and hormone levels (assessed by blood tests), we adjust your medications and time your final injection, the “trigger shot” which causes the eggs to complete maturation for retrieval.
Some patients report bloating and may feel tired from the hormones. These effects are usually well tolerated and do not require treatment. While the injections can cause minor irritation and discomfort, our patients make it through just fine. We'll provide instructions and tips to make it easier. During the retrieval, you'll be under anesthesia for 20 minutes. Most patients wake up with minimal discomfort or cramping that does not require additional medication. For the few patients who experience more severe cramping, rarely do they need more than Tylenol.

The idea of giving yourself injections can be intimidating. While many people feel anxious the first or second time, hundreds of thousands of women have safely undergone hormone stimulation and find that they quickly get used to administering their own medications. Some patients have a friend or partner help with the injections. We also work with several nurses who offer home visits to administer nightly injections. 

The night before, you’ll have a hearty dinner and then abstain from any food or drink after midnight. The morning of your retrieval, you’ll check in about an hour before the procedure. Your nurse will guide you over to the lab where you’ll change into a warm robe and place your belongings in a secure locker. You’ll meet the anesthesiologist and embryologist who will be caring for you and your eggs. Under their watchful eye, you’ll fall asleep under anesthesia, while our specialists aspirate your eggs using a very fine needle. 20 minutes later, you’ll awaken in our recovery area.

If a fresh semen sample is used, your partner will produce the sample while your eggs are being retrieved. Otherwise, we will thaw a frozen sample.

Our care team will be there to look after you and ply you with juice and snacks. Most patients walk out the door about 45 minutes later. Most patients take the rest of the day off to rest.

HOW IT WORKS    WHAT TO EXPECT

The transfer itself takes a few minutes and is not painful. The primary discomfort you may experience will likely be from having a full bladder. A full bladder will help your organs stay in the right place so our team can have the best images for transfer.

You’ll arrive early to change and get ready. There’s no anesthesia required, but we recommend Valium to minimize uterine contractions. You’ll watch us on a closed circuit television as we gently draw your embryo into a thin soft catheter for transfer. You’ll then watch by ultrasound as the embryos are returned to your uterus.

HOW IT WORKS

Curious about what you can do to make the most of your treatment plan? Here are some basic modifications we recommended.

In general, considering fertility options or going through treatment can involve a few steps, a bit of a learning curve for most, and some flexibility in your schedule. While you won't need to miss a significant amount of time in your usual routine (aside from a handful of 30-60 min. appointments, travel to get here, and a morning off if you do an egg retrieval), this is a good time to slow down and take it easy, to maximize your mental health and well-being.

More specifically:

  • Food: eat whatever you like! A balanced diet is best.
  • Alcohol: is fine in moderation, or about ~2 drinks daily
  • Exercise: is fine until 1 week before/after retrieval, then you'll want to avoid any activity that involves a lot of jumping. Walking, yoga, biking are fine.
  • Sexual intercourse: is fine with protection until day 5 of ovarian stimulation.
  • Caffeine: in moderation, with a recommended max of about ~2 cups daily.
  • Travel: during ovarian stimulation, you'll be coming in for 5-6 morning monitoring appointments, and will want to get lots of rest. While you can travel if you absolutely must and can do an outside monitoring appointment with a local doctor, we do recommend you staying in town if possible.
  • Socializing: many patients say they benefited from having some quiet time, to take care of to-do's within the home and even enjoy complementary therapies like acupuncture and massage, spa treatments, and whatever else helps them relax.

That said, we know our patients lead very busy lives! Please know our goal is to minimize the impact and ease your care experience however we can. Get in touch to learn more or come to a free monthly info session.

People ask this all the time and unfortunately, you’ll hear varying (conflicting) opinions from different people in and outside of our field. At Spring, we recommend a healthy, balanced diet with proper hydration. Avoiding highly processed foods and anything that doesn’t have nutritional value is always smart. Beyond that, be good to you!
We recommend taking prenatal multivitamins that have a healthy amount of folic acid and Calcium with Vitamin D. Folic acid helps prevent neural tube defects, and is good for spine and brain development. Other supplements to consider are CoQ10 and DHEA, however evidence for these are limited.

Many people find this a good time to pursue their healthiest habits. Alcohol is fine in moderation until 2-3 days before your egg retrieval but should be avoided post-transfer.

Research suggests mild to moderate caffeine intake is not associated with any adverse outcomes. Up to 2 cups of coffee per day are not associated with any worse outcomes. Some studies suggest that 3 or more cups of coffee per day when pregnant may increase the risk of miscarriage.
No. In addition to numerous other health risks, cigarette smoking is a reproductive toxin. It accelerates the loss of eggs and can advance menopause. Less is known about marijuana.
Yes. Exercise is encouraged as part of a healthy lifestyle. At key points, you’ll want to take it easy. Moderate exercise is fine until around day 5 of stimulation, then we recommend low impact activities like biking, hiking, yoga, or walking. After your retrieval, we recommend taking it easy from strenuous activities for about a week. The week before and after your transfer, you’ll also want to rest.
Many of our patients report positive effects of acupuncture and massage on their comfort levels and overall well-being. Even a brief massage can greatly improve relaxation and state of mind, while helping to flush toxins from the body. If you decide to do acupuncture, most herbal remedies should be fine prior to ovarian stimulation, but we recommend stopping them once we begin. Please do not use any herbs or preparations that contain hormones, blood thinning agents, or blood clotting properties. Spring Fertility enjoys productive relationships with several acupuncturists and is willing to work with your acupuncturist to provide integrated and holistic care.
Hot tubs are fine through the egg retrieval, but should be avoided after an embryo transfer. Older studies suggested the potential for elevated core body temperature to affect early embryo development.
Travel is fine, as long as you can make it to your monitoring appointments during stimulation and are local and well-rested leading up to your retrieval and transfer. If you need to be out of town for a few days, you can find a fertility center there to do a monitoring appointment or two. When traveling long distances, you can keep refrigerated meds in a cooler pack and the TSA should let you through airport security just fine (though it’s wise to bring a note from your doctor which we can provide).
Trying to conceive can be one of the most stressful times for relationships and individuals. Research has shown that anxiety levels can be similar to patients who have been diagnosed with cancer, heart disease, and HIV. While acupuncture, yoga, and meditation are helpful for some patients, communicating and supporting your partner is important. There is no “right” way to react to the medicines and process. Respecting each other’s stress and sensitivities is key. Many of our patients can find additional support and strength through support groups or mental health professionals.

Come see us for a fertility consult. Just contact us to book and we’ll send you a questionnaire and medical records release form so we can review your file in advance of our first meeting. Your insurance may require pre-approval in order to cover the cost of the consult.

Not ready for a consult? Come for a free info session. You can meet our team, tour our facility, and get more information about fertility treatments. We’re here for any and all your questions!

Many top employers in the Bay Area offer progressive fertility benefits to support their employees. Contact your HR department to see if yours does.

We accept coverage through fertility-specific benefits providers such as Progyny and Carrot in addition to Cigna and Health Plan Services. For our patients with out-of-network benefits, we can provide all appropriate paperwork to submit claims for reimbursement directly to insurance carriers.

This depends on your specific plan. Group plans are more likely to have infertility coverage than individual plans but each case should be verified.

We accept coverage through fertility-specific benefits organizations such as Progyny and Carrot. At this time, we also work with Cigna and Health Plan Services. Additionally, we can provide all appropriate paperwork for patients with out-of-network benefits to submit claims for reimbursement directly to their insurance carrier.”

What it is: A blood test done at any time during your menstrual cycle. Anti-Mullerian Hormone (AMH) is produced by the cells surrounding the follicles. It correlates well with the AFC and also with the number of eggs your body will produce with ovarian stimulation.

How it helps: The AMH level helps us determine your ovarian reserve (how many eggs you can make), and the appropriate dose of your medications. Spring Fertility offers the AMH test on site as part of a comprehensive fertility consultation for both partners.

All initial visits include a pelvic ultrasound. If this is your first visit, we’ll need to determine the answers to four basic questions:

  • Are you producing and releasing a healthy egg every month?
  • Are there a sufficient number of swimming sperm?
  • Are the fallopian tubes open and allowing the egg and sperm to meet?
  • Is the uterus receptive to implantation?

Initial consult costs range from $250 - $545, depending on market. This appointment with your doctor includes ultrasound, physical exam, and a physician consult. Because most patients want to become pregnant as soon as possible, we can move quickly. Most testing can be completed within a month (or one menstrual cycle) of an initial consult. Based on your availability and the timing of your menstrual cycle, we’ll plan your specific tests.

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Tests

A woman’s antral follicle count (AFC) is a measure of the number of antral (or “resting”) follicles in each ovary. The AFC is performed during a transvaginal ultrasound, which usually takes about 5 minutes, and is included in every initial consultation.

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Hormone tests are simple blood tests that help us understand your ovarian reserve and how hard your body is working to send signals to your ovaries to produce eggs.

 

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A blood test done at any time during your menstrual cycle. Anti-Mullerian Hormone (AMH) is produced by the cells surrounding the follicles. It correlates well with the AFC and also with the number of eggs your body will produce with ovarian stimulation.

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A hormone produced in the brain by the pituitary gland, Follicle Stimulating Hormone (FSH) stimulates development of your antral follicles (hence its name). FSH is determined through a blood test that is performed on the second or third day of your menstrual cycle. We always test the level of another hormone, Estradiol, to tell us if the reading is accurate.

 

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The Hysterosalpingogram is a low dose x-ray of your pelvis to determine if your fallopian tubes are open. A radio-opaque contrast or “dye” is gently instilled into the uterus so that we can see the outline of your uterine cavity and fallopian tubes. The procedure takes only a few minutes and can be performed onsite at Spring, by our fertility specialists.

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A test of the sperm in a man’s ejaculate. The semen analysis tells us the concentration of sperm, how many are moving, how fast they are moving forward, and how many have a normal appearance.

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Also known as a “transvaginal ultrasound”, this test allows us to view the uterus, ovaries, cervix, and fallopian tubes (which we only see if they are swollen with fluid). A small handheld transducer is gently introduced two to three inches into the vaginal canal, using a warmed gel. This typically takes about 5 minutes.

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A pelvic ultrasound is performed while sterile saline is gently instilled through the cervix and into the uterus. The saline neatly outlines the inside lining of the uterus. The procedure takes about 10 minutes.

 

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A minimally invasive procedure in which a thin camera is inserted into the vagina, to examine the cervix and inside of the uterus.

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A soft, thin tube (called a “pipelle”) is inserted through the cervix and takes a small biopsy or scratch of tissue from the lining of the uterus (the endometrium). The tissue is then examined under the microscope for any signs of inflammation or infection.

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Treatments

Ovulation induction helps follicles to mature through the use of oral medications. Inducing ovulation is often the only treatment needed for women who do not ovulate or release an egg each month. This treatment involves taking 1-3 pills for 5 days, early in your menstrual cycle. We often use this medicine in combination with Intrauterine insemination (IUI). The idea is to help you release more than one egg at the time of insemination. This increases the chance of a pregnancy but also increases the risk of twins, or multiple gestation.
Controlled ovarian hyperstimulation involves stimulating the ovaries to produce eggs using many of the same medications we use with IVF. Unlike the pills used in ovulation induction, these injections can be used to recruit multiple follicles (and eggs). Since this poses a greater risk for twins and high-order multiple gestations, this treatment is usually reserved for older patients with a lower chance of pregnancy or patients for whom oral medications are unable to help them ovulate.
Intrauterine insemination involves placing a concentrated sperm sample into the uterus. This helps in cases where there is a moderately low sperm count or for cases of “unexplained infertility.” With normal intercourse, most sperm will die in the vagina. IUI preserves most of the viable sperm and gives them a head start on their journey to find the egg. IUI is timed with ovulation. To determine the best time for an IUI, some patients use home ovulation predictor kits while others use ultrasound monitoring and we “trigger” ovulation with an injection. When we feel confident that ovulation is occurring, we prepare a sperm sample and advance it through a thin catheter that is passed through the cervix into the uterus. The concentrated sperm sample is then inserted and given a gentle assist to reach the egg and achieve fertilization. This procedure is usually painless and you can resume your normal activities straight away. Different medications may be used with IUI, most commonly pills for ovulation induction. Some patients may benefit from injectable medications and progesterone supplements as well.  

Normally, one egg matures each month, but when we stimulate the ovaries for IVF or ICSI, we attempt to mature multiple eggs for fertilization. In vitro fertilization (IVF) involves removing eggs from the ovaries and fertilizing them outside of the body (“in vitro”). With conventional IVF, many sperm are placed in a dish with a healthy egg, whereas with Intracytoplasmic sperm injection (ICSI), a single sperm is carefully injected directly into each egg. Ovarian stimulation usually requires 10-14 days of hormonal stimulation and monitoring before the eggs are retrieved. Once the eggs are in our care, we need to consider several key steps:

  • Fertilization: Conventional IVF or ICSI? 
  • When to plan your transfer: How long should we care for your embryos before transferring or freezing them? 2-3 or 5-6 days?
  • Embryo Transfer: Fresh or frozen? If frozen, do we transfer them in the future using a controlled or natural cycle?
  • Genetic testing: Do we test your embryos before transferring them?

Based on your history, assessment, and goals, we’ll help you navigate several steps and decision points depending on your particular situation and requirements.

Did you know that 30-40% of infertility cases are solely due to a form of male factor infertility?

For men, the evaluation is simple. We need to know if there are enough motile (swimming) sperm to reach and fertilize an egg (typically we like to see at least 20 million). The test for this is a semen analysis. Low or absent sperm counts can be due to problems in producing sperm or in a blockage preventing the sperm from being released. Note: appearing to ejaculate normally does not mean there are enough quality sperm being emitted.

While the evaluation for women can be invasive and require multiple visits, the basic male evaluation can be addressed by examining two key questions:

Do you produce a sufficient number of “swimming” sperm to total sperm? Fertile men typically produce tens of millions of sperm per ejaculate. It’s not enough to produce sperm; the job isn’t done until they reach the egg and fertilize it. Unfortunately, it's a long journey, and therefore nature provides millions of sperm in the hope that one is able to make it to the egg, attach and fertilize.

We evaluate sperm count with a semen analysis, which tests the percent motility, or the number of sperm per ejaculation. We also examine direction and speed, shape, and other factors that can give your doctors insight into your ability to conceive without assistance.

Are the sperm able to leave your body? Just as women have tubes that can be blocked (the fallopian tubes), the same is also true with men. The vas deferens is the tube that carries sperm from the testes to the penis. Sometimes these tubes can be blocked or congenitally absent. With an obstructed vas deferens, a man’s semen may appear normal but lack sperm.

Contact us to book your evaluation today.

In order to optimize their chance of having a successful, healthy pregnancy, many patients elect to pursue genetic testing to ensure the most successful procedure and to increase their chances of having a healthy baby. There are three types of genetic testing commonly obtained at Spring Fertility: 

Preconception Genetic screening (before trying to conceive)

What it is: This is a blood test performed before undergoing treatment or trying to get pregnant. The goal is to see if you and your partner carry any recessive genetic traits that could cause severe illness in your child, if you both have the same one. There are diseases that cause death or severe disability in children with two copies of an abnormal gene, but cause no symptoms in an adult if they only have one. Many of us don’t know if we carry these traits. About 40% of our patients test positive for one and then we test their partner to see if they carry the same gene. 

How it helps: Rarely, both partners carry the same recessive mutation (like cystic fibrosis). If you each carry a mutation for the same gene, we can use PGD (Pre-implantation genetic diagnosis) to ensure that you do not have a child that is born sick with the disease. 

Preimplantation Genetic testing (before embryo transfer) 

What it is: This is testing performed on the embryo before transferring it in order to make sure the embryo is healthy. There are two types of preimplantation genetic testing procedures, Preimplantation Genetic Screening (PGS) and Preimplantation Genetic Diagnosis (PGD). Both involve embryo sampling, where 1-5 cells of an embryo are delicately removed in order to test if the embryo is healthy. The sample is usually taken on Day 5 or day 6 of development when the embryo is called a blastocyst. 

How it helps: Testing embryos can identify and prevent chromosomal abnormalities that lead to miscarriages or Downs Syndrome, or lethal mutations that cause severe illness or death in babies. 

Preimplantation Genetic Screening (PGS) 

What it is: This is the most common genetic testing procedure on embryos. This is for patients without any known genetic diseases. A few cells are sampled from each embryo and tested to determine if it has 46 chromosomes (the healthy and normal number). Because we test for all 23 pairs for chromosomes, PGS is also referred to as Comprehensive Chromosome Screening. Embryos with the correct chromosome number are called “euploid.” 

How it helps: The goal of PGS is to increase the chance of pregnancy with each embryo transfer and reduce the risk of miscarriage. Since PGS screened embryos have such a great chance of success, we only put back one at a time, making it most likely that patients will have one baby at a time, (rather than twins or triplets). Once we have a euploid (chromosomally normal) embryo to transfer, age is virtually eliminated as a factor for success. Although older women have fewer and sometime no chromosomally normal embryos, those that do have the same or better success rates as a young woman doing IVF. Euploid embryos have over a 50% chance of having a live birth with only a single embryo transferred. Similarly, these pregnancies have very low miscarriage rates, despite the intended mother’s age. 

Preimplantation Genetic Diagnosis (PGD) 

What it is: PGD refers to testing embryo of parents with a known genetic disease. PGD is performed in cases where one or both parents are known to carry severe mutations that can result in disease or disability in their offspring. In these cases embryos are created and tested to see if they carry the disease. 

How it helps: Two parents carrying the same mutation have a 25% chance of having a severely sick baby. Instead of waiting to find out if their pregnancy is affected by an invasive procedure 14 weeks into your pregnancy, PGD allows families to make sure that only healthy embryos are transferred back to the intended mother.

Sometimes the uterus can develop abnormalities like polyps, fibroids, adhesions and blockages that can cause infertility. A hysteroscopy is a minimally-invasive outpatient procedure where our specialists use a thin, fiber-optic scope inserted through the cervix into the uterus (endometrial cavity). This procedure enables our team to diagnose and treat a variety of conditions that are preventing pregnancy or causing recurrent pregnancy loss. A hysteroscopy usually takes less than 30 minutes and no incisions are made. Patients usually recover within a day or two.

Donor sperm can help achieve pregnancy for people who either do not have sperm or are experiencing male infertility. Spring Fertility is committed to helping everyone bring healthy children into the world. We work with sperm banks and agencies to help our patients obtain donor sperm to achieve their parenting dreams. Donor sperm is carefully handled and secured before it is transported for fertilization here at our IVF lab. Whatever your needs, we are here.

Although IVF and assisted reproductive technologies have made tremendous advancements, we still rely on having sufficient numbers of healthy eggs. Sometimes we find that despite the best protocols and efforts, there are not enough good quality eggs. In these cases donor eggs (usually from a healthy woman in their 20s) have been used to help thousands of families achieve their family-building goals. Success rates with donor eggs are around 60% per attempt.

How common is it to use donor eggs? 

For over 30 years, egg donation has made parenthood possible for people having difficulty conceiving. In the US alone, there are over 18,000 egg donation cycles every year, and nearly 1 in 10 babies born annually from IVF in the United States were conceived using donor eggs.

But donor eggs don’t have my DNA, is it really my baby? 

Yes. While it’s true that donor eggs will have different DNA than the intended mother, your connection is no less intimate or meaningful. Carrying a pregnancy from donor eggs gives mothers the opportunity to nurture the baby for nine months in utero and have tremendous influence on how the baby’s DNA is expressed. Recent studies have shown that the time in utero can vastly influence how DNA works for the rest of one’s life. These recurring observations have led to a whole new field of epigenetics, and a field of study regarding “The Fetal Origins of Adult Disease”.

Who donates their eggs and why do they do it? 

Egg donors are bright, motivated, and healthy women aged 21-30 who donate their eggs because they want to help other people have families. These women go through extensive medical, physical, and psychological screening in line with FDA guidelines. While many women apply to be egg donors each year, only 3% usually qualify.

Spring Fertility’s EggShare Program lets eligible women donate eggs while freezing some for their own future use.

How will I find the right donor? 

Choosing an egg donor is a personal decision, with many factors to consider. Your timeline and goals will influence whether you turn to an egg bank for frozen eggs or a donor agency with candidates who will provide fresh eggs. We can talk you through how to navigate this and connect you with the best donors and eggs. We’ll support you every step of the way.

 

*If you’re interested in working with an egg donor, email our team at [email protected] to learn more

A gestational carrier is a woman who agrees to carry a baby to term for intended parents who cannot safely carry a pregnancy. An embryo is created by the intended parents through IVF and transferred to the gestational carrier.

California is one of the most favorable environments for parents who need to use a gestational carrier. We work with top agencies to help our patients identify healthy women to achieve healthy, successful pregnancies. Northern California has great health care and no Zika virus, making it a great place for women seeking this option. Email [email protected] for information. We can help.

Egg Freezing FAQ

Options. You may not be ready to be a mom yet but want to preserve that option. Egg freezing provides the greatest opportunity to have a baby using your own eggs instead of donor eggs in the future. Freezing your eggs is about giving yourself some peace of mind and minimizing stress, so you can pursue your goals. It’s okay, now we can hit snooze on that biological clock.
Yes. Numerous studies investigating the long term consequences of ovarian stimulation show little to no significant risk. Serious complications are rare. Most women report mild bloating and fatigue.

We recommend numbers of eggs based on your age, reproductive history, ovarian reserve and family building goals. Everyone is different and your unique situation will help us arrive at an appropriate number for you, but we generally recommend 20 eggs for women under 35 and more for women over 35. For older women, this may mean multiple cycles, depending on your ovarian reserve.

What are your chances? Estimate your outcomes with this tool:

EGG FREEZING CALCULATOR

 

 
When you’re ready, your eggs are thawed, fertilized with sperm, and ultimately transferred back to your uterus as embryos.

No. Most women can get pregnant naturally and their eggs become a backup plan or insurance policy. We encourage you to think about how many children you want when freezing your eggs. Although it may be easy to get pregnant naturally the first time, depending how many children you want, consider freezing eggs for that second, third or fourth child (if that’s your desired plan). You can use our egg calculator to help you plan accordingly.

Cryopreservation places cells into a “glass-like state” where all biologic processes stop by rapidly changing the temperature to -196°C using liquid nitrogen. The cell can be maintained in this state for years without aging. Your doctor will determine a protocol that’s right for you. Bioidentical hormones are used to help the ovaries produce multiple eggs from multiple follicles. These eggs are then retrieved from your body and cryopreserved a few hours later.

 

A woman’s age at the time an egg is released is the single most important factor affecting fertility. Beginning in your 20s, there's a gradual decline in the ability to become pregnant. Around age 35, fertility begins to decline more rapidly. Freezing your eggs gives you more options for the future by preserving your eggs (and their current quality) today.

Two factors lead to this decline: fewer and lower quality eggs.

Fewer: eggs, unlike sperm, are only produced before a baby is born. At birth, a female is born with 1-2 million eggs. These eggs are called primordial follicles and are suspended in a state of partial maturity that is not completed until ovulation (often decades later). They are gradually released over the next 50 years. Total eggs remaining in the ovaries:
At birth: ~1-2 million
At puberty: ~400-500,000
At age 35: ~25,000

Quality: While the total number of eggs available declines daily, egg quality also starts to drop as the long term effects of minor environmental damage add up. The cumulative effects of aging become apparent by your mid 30s, when eggs are more likely to produce chromosomal errors (called “aneuploidy”), leading to miscarriages and infertility.

Egg freezing (or 'oocyte cryopreservation') stops eggs from aging by placing them into a state of 'biologic pause' (vitrification) until a woman is ready to get pregnant. The health of those eggs is safely maintained at the age and time they were frozen.
Your uterus is amazing and is not affected by age the way eggs are. In fact, many women have conceived after menopause with donor eggs and a little estrogen to support the uterus.

Turns out, cryopreservation of eggs takes lots of expertise. Prior to freezing, the embryologist safely replaces all the water from an egg with cryoprotectants. Your embryologist then rapidly moves the egg cell through different solutions and then must freeze (vitrify) the eggs in 1 microliter of water (that is 1/1000 of a milliliter). The whole process is still done by hand, and the best protocols are still considered trade secrets. At Spring, we’re proud to work with the best embryologists who have the best equipment to innovate and improve existing protocols.

Everyone has different plans, and when egg freezing fits for one person might not be the right time for another. There's no clear answer and this is a personal choice, but we know that eggs are healthiest when women are in their mid 20's. This is when women have the most follicles and eggs free of chromosomal abnormalities. This is why most egg donor programs only work with women between the ages of 21 to 30. Everyone has different reproductive horizons: some women go through menopause at 51 while others might have their last menses at 41. Freezing eggs can seem expensive for younger women who are earlier in their careers, but the process is actually less expensive when you are younger. Older women commonly need to do more cycles at a greater expense because they produce fewer eggs and require more medication.

The best way to decide on whether and when to freeze your eggs is to have an initial consult. During this 60 minute appointment, we'll perform a pelvic ultrasound and blood test to assess your ovarian function. Then we can discuss your treatment plan. The plan we choose depends on your unique situation. We want to understand your goals and concerns, and provide the best option for you.

This all depends on your “ovarian reserve” (or the number of eggs present in the ovaries at any given time). Younger women usually have more follicles (immature eggs) and can retrieve and preserve more good quality, mature eggs per stimulation cycle. At your first consult, a pelvic ultrasound with an antral follicle count gives us a good idea of how many to expect.
Again, this all depends on your age and antral follicle count, as well as your family-building goals. Some women retrieve all the eggs they need in one cycle. Others may require several cycles, especially if they think they might like to have multiple children when they’re ready. Your initial consult is the best way to get started. We’ll assess your ovarian reserve, and discuss your options. Together we’ll make a plan.
Since egg freezing is a relatively new procedure, there isn’t a lot of data on the long term storage of frozen eggs. Reports comparing eggs frozen for four years with those frozen for short durations do not show any adverse effects of longer storage. Animal studies and human embryos have shown good outcomes after over 20 years of being cryopreserved. So while we can never say with complete certainty, it seems that storage for up to 20 years can be both safe and effective.
Yes. Studies of over 5,000 children born from thawed/frozen eggs show no increased risk for congenital abnormalities or adverse pregnancy outcomes.
Your eggs are safe at Spring. Our building was constructed to meet or exceed modern seismic standards, including all California and local guidelines, and will easily withstand any anticipated tremors or quakes in the area. In the event of a large and prolonged power outage, all of our critical equipment is connected to a large Uninterruptible Power Supply (UPS) system (with over 16,000 pounds of batteries!) located on site, so we are never subject to a power surge or failure. Our UPS immediately sends us an emergency alert and can maintain power for over 8 hours, allowing plenty of time to fire up our backup generator, which is also regularly maintained and tested. As with everything at Spring, we have backup systems for our backup systems, and we take nothing for granted.

At Spring, we believe it’s our responsibility to provide our patients with transparent and realistic expectations as to the likelihood that freezing your eggs will result in a successful future pregnancy. The oldest reported woman to successfully freeze and warm an egg that resulted in a live birth was 42 at the time she froze her eggs. Therefore, our age limit for egg freezing is 43 (before a patient’s 43rd birthday).

For women aged 43 and up, the probability of having a baby from frozen eggs is too low and the success rate unproven. Patients over 43 years old and under 47 will be counseled to consider embryo cryopreservation in order to give them the best possible chances of success.

Protocols can vary but egg freezing is typically a two week process involving:

1. 10-14 days of hormone stimulation, culminating in a final “trigger shot” 36 hours before the egg retrieval
2. Usually 5 monitoring appointments
3. The egg retrieval: a 20 minute procedure under sedation (you are asleep with an anesthesiologist present but you are not intubated or paralyzed)

Some patients may additionally benefit from two weeks of hormonal preparation prior to beginning stimulation. The addition of these medications helps follicles grow at the same rate to optimize the number of eggs retrieved.

HERE'S WHAT TO EXPECT

Our goal is to obtain the greatest numbers of healthy eggs from your ovaries. The eggs begin in a small “antral” follicle in your ovary. Ovarian stimulation gently prompts these follicles to grow or “mature” a cohort of eggs. You will follow this process and can see how we measure your follicles during your monitoring appointments, which are usually 20-30 minute morning visits leading up to your retrieval. Based on the growth of your follicles, assessed via ultrasound, and hormone levels, assessed via blood tests, we adjust your medications and time your final injection, the “trigger shot” which causes the eggs to finally mature in preparation for retrieval.
Some patients report bloating and feel tired from the hormones. These effects are usually well tolerated and do not require treatment.
For the most part, no, though injections can cause minor irritation and discomfort. We'll provide instructions and tips to make it easy. During the retrieval, you'll be under anesthesia for 20 minutes. Most patients wake up with minimal discomfort or cramping that does not require additional medication. For the few patients who experience more severe cramping, rarely do they need more than Tylenol or ibuprofen (Advil).

The idea of giving yourself injections can be intimidating. While many people feel anxious the first or second time, hundreds of thousands of women have safely undergone hormone stimulation and find that they quickly get used to administering their own medications. Some patients have a friend or partner help with the injections. We also work with several nurses who offer home visits to administer nightly injections. 

We’ve created medication instruction videos in case you need extra support during the process. You can browse our full library of videos here.

People ask this all the time and unfortunately, you’ll hear varying (conflicting) opinions from different people in and outside of our field. At Spring, we recommend a healthy, balanced diet with proper hydration. Avoiding highly processed foods and anything that doesn’t have nutritional value is always smart. Beyond that, be good to you!

Alcohol is fine in moderation (1-2 drinks per day) until 2-3 days before your egg retrieval. Abstinence is fine too. Many people find this a good time to pursue their healthiest habits.

Research suggests mild to moderate caffeine intake is not associated with any adverse outcomes. Up to 2 cups of coffee per day are not associated with any worse outcomes.
In addition to numerous other health risks, cigarette smoking is a reproductive toxin. It accelerates the loss of eggs and can advance menopause. Less is known about marijuana.
Yes, but we recommend using a condom as your follicles grow. You may have many eggs developing and toward the end be at a high risk of pregnancy if any ovulate before retrieval. We recommend abstinence the week before and after your retrieval, as the ovaries may be enlarged and sensitive.
Yes. Moderate exercise is fine until around day 5 of stimulation, then we recommend low impact activities like hiking, yoga, or walking. After your retrieval, we recommend taking it easy from strenuous activities for about a week.
Hot tubs are fine if you are egg freezing. They should be avoided after an embryo transfer.
Egg freezing doesn’t require isolation! For your convenience and peace of mind, you may want to be local for stimulation through retrieval. However, travel is fine, as long as you can make it to your monitoring appointments. If you need to be out of town for a few days, you can if necessary find a fertility center there to do a monitoring appointment or two. When traveling long distances, you can keep refrigerated meds in a cooler pack and the TSA should let you through airport security just fine (though if you’d like a doctor’s note, we are happy to oblige).
Every relationship is unique. We believe that egg freezing is a positive, practical choice, and that families and partners should be supportive. Many patients tell us that going through the experience with their boyfriend or partner actually made them closer, and that sharing with their family members gave them comfort too.
You know your workplace dynamics best. We’ve noticed that as egg freezing becomes more common (and even covered by some employers), more and more patients feel comfortable sharing their experiences at work which we think is great. Most report being pleasantly surprised at how supportive their colleagues are of this choice, and by how many coworkers have done this themselves. Practically speaking, many people like inform their work in case of scheduling commitments or the need to stay local around the time of the actual egg retrieval.

Come visit us at Spring Fertility for a consult. Just contact us to book and we’ll send you a questionnaire, so we can review your file in advance of our first meeting. Not ready for a consult? Come for a free info session. You can meet our team, tour our lab, and get more information about egg freezing. We’re here for any and all your questions!

We believe in simple, transparent pricing. If you are self-paying in full, with no coverage:

  • Initial Consult: Initial consult costs range from $250 - $545, depending on market. This appointment with your doctor includes ultrasound, physical exam, and a physician consult
  • Egg Freezing Cycle: (SF) - $9960; Egg freezing cycle (NY) - $9960, includes all monitoring appointments (ultrasounds and blood work), anesthesia, egg retrieval, and cryopreservation.

*Please note, there is also an annual tissue storage fee that varies by location.

The total costs for each patient vary based on insurance and which protocol. Medication Packages from our pharmacy partners range from $3,900-$4,900 in NY and $4,100 - $5,100 in CA, depending on your specific protocol and requirements. 

Because some women require multiple cycles, we offer 10% off successive rounds of egg freezing (self pay only).

Another important financial consideration is the subsequent cost of thawing and fertilizing your eggs, then transferring embryos in the future. This is not included in the initial cost of egg freezing.

Egg Freezing Payment Plan (set up ACH when treatment initiated)

We are pleased to offer the following special payment plan on egg freezing with a no down payment and zero interest.

No Down Payment & No Interest Payment Plan (for 1 cycle)  Includes ultrasound and blood monitoring, monitoring appointments, anesthesia, egg retrieval procedure, and egg freezing.

Cost =

$0 Down

$249/month

Initial consult and hormone medications not included. We’re not a pharmacy, but we do have special package deals and lower rates from our pharmacy partners.

If you’re not successful, we shouldn’t be. Spring Promise is our shared risk program. We offer up to a full refund - that's right, your money back on egg freezing - to qualified patients who freeze 20 eggs before age 35, or 30 eggs before 38, and cannot achieve a successful pregnancy when they return to use them. * IVF, anesthesia and medications do not qualify for money back.

Help a family have a family. Egg donors give the greatest gift of all: they help others achieve their dreams of a family. We’re pleased to support some amazing women willing to donate their eggs to people in need.

Qualifying applicants meet the following criteria

  • Motivated young women aged 21 to 30
  • Nonsmoking and in good overall health
  • No tattoos or piercings in the last year
  • Have not lived in the United Kingdom for over 3 months
  • Have not travelled to Zika endemic areas in the last 6 months

Donors must meet FDA and ASRM guidelines, and undergo a medical and psychological screening process with our team to ensure they’re ready. All ethnicities are welcome and encouraged to apply.

Curious if you qualify? Email [email protected] and we’ll get in touch.

Pay it forward while planning for your future. Help a family have a family, while planning for your own. Our EggShare Program lets eligible women donate eggs while freezing some to keep for their own future use through egg freezing. All costs are covered, including storage of your frozen eggs for three (3) years or until age 30 (whichever is longer). Curious if you qualify? Complete our pre-screening application and we’ll get in touch. Questions? Contact [email protected] to learn more.
Egg freezing is considered an elective procedure not covered by most commercial insurance plans. However, some policies do cover the initial consult and some of the medications, which our team can help you verify.

We accept coverage through fertility-specific benefits providers such as Progyny and Carrot in addition to specific traditional commercial insurance providers, Cigna and Health Plan Services. For our patients with out-of-network benefits, we can provide all appropriate paperwork to submit claims for reimbursement directly to insurance carriers.

Many top employers in the Bay Area offer progressive fertility benefits to support their employees. Contact your HR department to see if yours does.

Curious about egg freezing and whether it's right for you?

Come in for an egg freezing consultation, which includes:

  • One hour with the physician to review your health history
  • Pelvic ultrasound to assess ovarian reserve and antral follicle count

In just one hour, you’ll know your options. Then you can decide what’s right and when’s right for you.

Book a Consult online today or call us at 415-964-5618 to schedule.

You can also learn more about egg freezing at one of our free monthly info sessions. Check out our events page to RSVP. Friends and loved ones welcome.

Not sure just yet and want to learn more? Join us for one of our free info sessions at Spring. You'll be able to meet our team, tour our facility, and learn all about how we approach egg freezing as well as the facts and data to consider in planning for your future. Bring all your questions! Friends and loved ones welcome.

Reserve your spot today. Call us at 415-964-5618, email [email protected]  or RSVP on our events page.

We also hold community events to raise awareness about egg freezing and fertility care. Keep an eye on our events page for the details, and get in touch if you'd like to organize a talk with us.

Host a private info session Curious about egg freezing and have friends who are too? We now offer private info sessions for groups of 6 or more. Each can be tailored to your group’s specific questions and interests. We can even bring snacks.

Contact us today: 415-964-5618 or [email protected].

Tests

A woman’s antral follicle count (AFC) is a measure of the number of antral (or “resting”) follicles in each ovary. The AFC is performed during a transvaginal ultrasound, which usually takes about 5 minutes, and is included in every initial consultation.

Learn More

Hormone tests are simple blood tests that help us understand your ovarian reserve and how hard your body is working to send signals to your ovaries to produce eggs.

 

Learn More

A blood test done at any time during your menstrual cycle. Anti-Mullerian Hormone (AMH) is produced by the cells surrounding the follicles. It correlates well with the AFC and also with the number of eggs your body will produce with ovarian stimulation.

Learn More

Treatments

Our goal is to obtain the greatest numbers of healthy eggs from your ovaries. The eggs begin in a small “antral” follicle in your ovary. Ovarian stimulation gently prompts these follicles to grow or “mature” a cohort of eggs. You will follow this process and can see how we measure your follicles during your monitoring appointments, which are usually 20-30 minute morning visits leading up to your retrieval. Based on the growth of your follicles (assessed by ultrasound), and hormone levels (assessed by blood tests), we adjust your medications and time your final injection, the “trigger shot” which causes the eggs to complete maturation for retrieval.

Dr. Peter Klatsky explains monitoring visits and the general use of tests.

WATCH NOW

The night before, you’ll have a hearty dinner and then abstain from any food or drink after midnight. The morning of your retrieval, you’ll check in about an hour before the procedure. Your nurse will guide you over to the lab where you’ll change into a warm robe and place your belongings in a secure locker. You’ll meet the anesthesiologist and embryologist who will be caring for you and your eggs. Let Dr. Klatsky explain what else to expect during your egg retrieval procedure.

WATCH NOW

You make the plan,
we make it possible.

 

Book a Consult

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