Frequently Asked Questions (FAQs)

Age and Fertility
Q. I am older, what are my chances of becoming pregnant?
A.

It depends on test results of ovarian function, which include blood tests done early in the menstrual cycle and an ultrasound of the ovaries.

Q. What does "take home baby rate" mean?
A.

It means the likelihood of actually giving birth, not getting pregnant. It excludes patients that have a miscarriage.

Q. Do you offer a donor egg program?
A.

Yes, our clinic does offer a donor egg program, either with anonymous or known donors.

Q. Does your center have an age limit for using donor eggs?
A.

Yes, you must be under age 50 to be a recipient of donor eggs.

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Q. How do I start the process of becoming an egg donor recipient?
A.

It starts with a consultation with one of our physicians, followed by a visit with Cheryl, our Egg Donor Coordinator, to review the process and pretesting required.

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Cost Sharing Plus
Q. Are there financing options?
A.

Mid-Iowa Fertility requires that all fees be prepaid.

Q. Are there any services not included in the program fee?
A.
  • Any expense related to the treatment of medical complications, such as ovarian hyperstimulation, infection, tubal pregnancy, or spontaneous abortion (miscarriage).
  • Any costs related to the acquisition of donor semen, if needed.
  • Counseling or psychological assistance related to infertility issues.
Q. Can I terminate this agreement?
A.

The agreement can be terminated, but there are some limitations. It can not be terminated in the middle of an active cycle. If it is terminated between cycles, the couple will be billed for all services received at the standard retail price in effect at the time that services were provided. Patients will receive a refund of the remaining program fee balance.

Q. How much does the program cost?
A.

The program fee is $21,000.00 for women age 35 and under and $27,000.00 for women ages 36 and 37. For this fee, the couple receives up to three (3) stimulated IVF cycles and as many frozen cycles as is feasible/medically indicated in a one year period.

If additional services are required, such as ICSI or assisted hatching, there are additional charges.

Q. What if I get pregnant in the first cycle? Do I get a refund?
A.

No. It is possible that if a pregnancy is achieved in the first cycle, the couple will have spent much more than they would have otherwise by paying for the cycle individually. That is an element that must be considered when looking into program participation. While there is the possibility that it would cost more if success is achieved in the first cycle, the program also provides significant savings if pregnancy is not achieved or is achieved on a later cycle.

Q. Do I get a refund if I have a miscarriage?
A.

If a miscarriage occurs before eight (8) weeks gestation, the cycle is simply considered unsuccessful and the couple can continue in the program if additional cycles are available. If a miscarriage occurs between eight (8) and twelve (12) weeks gestation, the cycle is considered unsuccessful and the couple may continue in the program, but there is a special additional withhold. If the pregnancy extends beyond twelve (12) weeks gestation, no refund is available. There is no refund because Mid-Iowa Fertility is no longer participating in the care of the patient and does not control the factors that may cause a miscarriage. When miscarriages do occur, the vast majority occur before twelve weeks.

Q. I've heard some concerns about the ethical implications associated with this type of program. What is Mid-Iowa Fertility's position on this?
A.

Ethical considerations were of the utmost importance when this program was being developed. The guidelines of both the American Society for Reproductive Medicine (ASRM) and the National Advisory Board on Ethics in Reproduction (NABER) were strictly followed.

Q. What are your participation criteria? Am I eligible?
A.

The criteria that determines preliminary eligibility is as such: the female partner must be under age 38 at the time of the egg retrieval(s), the female can not have had a previously unsuccessful in-vitro fertilization (IVF) cycle, the female Body Mass Index (BMI) must be under 30, and her Follicle stimulating hormone (FSH) test under 10.

If you meet these criteria, you are eligible to enter the program and begin the prescreening process. There are a number of criteria that might cause a couple to be ineligible for the program. The criteria for the female are:

  • Acceptable uterine function (e.g. no fibroids, polyps, or other abnormalities) as defined by a sonohysterogram.
  • Follicle stimulating hormone (FSH) blood test with a result of less than 10. This test is predictive of the female's ability to produce eggs.
  • An acceptable Clomiphene Citrate Challenge Test (CCCT). This series of two blood tests measures the female's response to infertility medications and can predict whether successful treatment is possible.
  • A negative screening for HIV (AIDS) and Hepatitis.The criteria for the male are:
  • Acceptable semen analysis (count) and morphology (study of sperm shape, size, etc.) The morphology must be normal and the count must be greater than 10,000,000.
  • An acceptable Immunobead Test (showing no existing antibodies).
  • A negative screening for HIV (AIDS) and Hepatitis.

 

Q. What services are included in the program fee?
A.
  • Patient education and injection teaching
  • Blood tests and folliculograms (ultrasounds) to monitor ovarian response
  • Any and all drug costs associated with any cycle (stimulated or frozen)
  • Retrieval of oocytes performed in the clinic under anesthesia
  • Fertilization of egg(s) with male sperm (ICSI, if required)
  • Incubation in embyro laboratory
  • Cryopreservation of any excess embryos to facilitate potential frozen cycles, including storage for eighteen (18) months following a successful cycle.
  • Transfer of embryos
  • Follow up testing, including quantitative blood pregnancy tests and ultrasounds to confirm the success of the cycle.
  • All services related to frozen embryo transfers (FET). The number of possible FET's as part of this program is limited by the number of embryos available and the medical indications.
Q. Is there any reason that Mid-Iowa Fertility might terminate the agreement?
A.

On occasion, it will be determined by MIF that continuation in the program is not in the best interest of the patients. Events that might cause MIF to terminate the agreement are:

  • Poor ovarian response
  • Poor oocyte quality
  • Patients no longer accepting of risk of multiple pregnancy
  • Medical complications
  • IVF becomes an inappropriate treatment option

If the CSP is terminated by MIF, the patient will receive a full refund of their program fee, less the prescreening fee, the withhold amount for the cycle(s) attempted, and any unpaid fees for services provided to the patients which are not included in the program.

Q. I have insurance coverage. Does this program make sense for me?
A.

Generally speaking, no. If the couple has any insurance benefits for treatment, it is most likely not advantageous for the couple to participate in this program. Please note that if insurance benefits do exist and the couple wants to participate in the program, the couple is required to waive their right to file claims with that insurer.

Q. Do I get a refund if I have a miscarriage?
A.

If a miscarriage occurs before eight (8) weeks gestation, the cycle is simply considered unsuccessful and the couple can continue in the program if additional cycles are available. If a miscarriage occurs between eight (8) and twelve (12) weeks gestation, the cycle is considered unsuccessful and the couple may continue in the program, but there is a special additional withhold. If the pregnancy extends beyond twelve (12) weeks gestation, no refund is available. There is no refund because Mid-Iowa Fertility is no longer participating in the care of the patient and does not control the factors that may cause a miscarriage. When miscarriages do occur, the vast majority occur before twelve weeks.

Q. What if I am determined to be ineligible after the screening tests?
A.

Treatment can certainly continue—just not under the Cost Sharing Program (CSP). Successful treatment is possible, even if the CSP screening criteria are not met

Q. Why do you have additional or special withholds?
A.

Because there are some circumstances where Mid-Iowa Fertility incurs additional risk or when things occur outside of Mid-Iowa Fertility's control. The special withholds help offset some of those risks.

Q. What if I have other questions?
A.

Simply contact Monica, the Financial Coordinator in our office at 515-222-3060 extension #103 in the Des Moines area. Outside the Des Moines area, couples can call toll-free at 888-306-3060 or you may email her at financial@midiowafertility.com

Q. Why do you offer this program?
A.

Many couples desire to have children, but are unable to conceive. Unfortunately, some insurers don't cover infertility treatment (or cover it at reduced levels). As a result, they must pay for services out of their own pocket. Especially in the case of advanced treatment, they simply can't afford it. Even for those that can obtain the finances, some are hesitant because there is no guarantee that treatment will be successful. This program helps couples to (1) specifically define the costs they will incur related to treatment, and (2) drastically reduce their total out-of-pocket expense if treatment is not successful. That leaves them a significant sum of money to pursue adoption or any other expenditure that they might choose.

Q. Why do you have these guidelines?
A.

The purpose of the guidelines is to help determine which patients have a substantial opportunity for success. As you might imagine, Mid-Iowa Fertility is assuming some financial risk by offering this program. The practice simply can not afford to offer this type of program if the couple comes in with factors that limit the possibility of success.

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Diagnosing Infertility
Q. Am I infertile?
A.

Couples should be evaluated for infertility if they have not conceived after one year of unprotected sex if the woman is less than 35 years old.  In the case of the female older than 35, six months is reasonable due to the impact of age on fertility.  In addition, if a woman does not have regular periods, she should be evaluated right away as this is a sign of anovulation/PCOS (not putting an egg out).  Other problems, such as family history, endometriosis, painful periods or pain with sex, and maile issues may also prompt a more immediate need for evaluation. 

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Q. What do the results mean?
A.

Based on results from our laboratory, we use cut-offs of FSH >10, Estradiol >75, and AMH <0.8. However, this information needs to be put in context with each woman's age, health history, etc.  The results are most informative when they are abnormal.  A normal FSH in a 50 year old is obviously different than a normal FSH in a 30 year old.

If the results are abnormal, a more aggresive approach to treatment may be suggested, such as super-ovulation with artificial insemination, in-vitrofertilization, or donor eggs.  The use of donor eggs result in extremely high pregnancy rates.  The eggs may come from either a known donor (sister, friend), or anonymous. 

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Q. Is my age an issue?
A.

Female age plays a very important role in conceiving and having a successful delivery. A woman reaches her peak fertility at age 27 and then decreases through her 30's, more rapidly after age 35.  Evaluation of egg quality (ovarian reserve) includes a blood test on day 3 of her cycle (first day of full flow is cycle day 1) combined with a vaginal ultrasound. The blood test currently measures FSH (follicle stimulating hormone), Estradiol, AMH (anti-mullerian hormone), Thyroid and a few other hormones.  The ultrasound is to count the number of egg sacs in each ovary (basal antral follicle count).  This testing can be made more accurate by then taking the fertility drug Clomid (clomiphene citrate) cycle days 3 thru 7 and another blood test on day 10.  This is called a clomiphene citrate challenge test (CCCT).

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Q. What is ovulation?
A.

Ovulation is the process of an egg being released from a woman's ovary.  Most women who are not ovulating do not have regular periods (less than 25 days apart or greater than 35 days).  Tests to evaluate ovulation include ovulation predictor kits (Clear Blue Easy digital), ultrasound, and hormone tests (progesterone).

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Q. What about problems with my tubes?
A.

Tubal disease can be corrected either with surgery or in-vitro fertilization (IVF).  Surgery may help with mild scarring of the tubes but if severe damage is found, it may be nexessary to remove one or both tubes and proceed to IVF.  Treatment with IVF involves stimulating a women's ovaries with medicines, extracting the eggs through an office ultrasound procedure, combining the eggs and sperm in a dish to make an embryo, and then transferring the embryo (s) to the uterus with a small straw (catheter).  This is all done in our office under sedation. 

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Financial
Q. What questions should I ask my insurance company?
A.

Please Click Here to download worksheet that will guide you through the questions you will want to ask your insurance company.

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Q. How do I know if my insurance will pay for my fertility medications?
A.

It is always best for the patient to hear firsthand from their insurance company a quote of benefits. When calling your insurance company you should ask if infertility medications are covered under the health plan or should you use your prescription drug card.

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Q. My insurance company states I have benefits but the services require a prior approval. Is this something Mid-Iowa Fertility will do?
A.

Yes, Monica will take care of your prior approval when necessary. It is ultimately the patients' responsibility to determine if prior approval is required. You must contact Monica if your insurance company informs you that precertification is required.

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Q. My insurance company states they will pay for only testing, what does that mean?
A.

This usually means that any diagnostic lab work, ultrasounds, diagnostic surgery done by the physician to determine the factor of infertility is covered under the plan. Once you begin treatment, the use of infertility medications, either oral or injectables the benefit plan will not pay for any further care.

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Q. I don't have insurance coverage, what will the consultation cost me?
A.

The physicians determine their own fees based on medical necessity, decision making and recommendations. A good estimate would be between $175.00 to $275.00.

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Q. How do I find out if my employer offers another plan that has some fertility benefit?
A.

Normally, most employers offer an open enrollment period either in May or November. Your Human Resource contact should be able to provide you with that information.

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Q. My insurance plan offers no benefits but my husband has his own policy with benefits, can my services be filed under his plan?
A.

Insurance companies will only consider claims for those covered under that particular plan. If you are not a dependent on the plan they will not process the claim.

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Q. Is payment for fertility treatment required upfront?
A.

Yes, payment is required prior to beginning treatment. If you do have fertility treatment benefits, you are required to pay your estimated co-insurance upfront, before treatment can begin. Monica will assist you in determining what is due prior to beginning treatment.

Springstone Patient Financing offers convenient payment plans.

 


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Q. I do not have insurance benefits for treatment but still want my claim filed to my insurance company, will Mid-Iowa Fertility do this?
A.

Yes, we can certainly file a claim as a courtesy. Remember that you are still required to pay at the time of service.

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Q. How can I find out what my insurance will/will not cover?
A.

We strongly recommend that you contact your insurance company prior to your appointment. Please Click Here to see a list of questions you will want to ask your insurance company. Please bring this form with you at the time of your appointment.

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Q. How much of my IVF cycle will the insurance cover?
A.

Most plans that offer coverage have a lifetime maximum they will cover for fertility treatment. It is best to setup an appointment with Monica so she may review our charges versus your benefits and quote an estimated out of pocket.

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First Appointment
Q. Does my partner or husband need to come with me for the consultation?
A.

Your partner/husband is encouraged to attend the consultation appointment with you. Keeping in mind that testing and treatment options involve you as a couple.

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Q. What do I need to bring with to the consultation appointment?
A.

We will mail patient registration forms prior to your appointment. Please bring the completed forms with you when you come for your consultation. If you are being seen for infertility, you will need to fill out a set of registration forms for both you and your partner.  Please bring your driver's lisence and insurance card to your appointment.  In order to determine what your financial obligation will be for your services, you will need to contact your insurance company to determine benefits. We have provided a worksheet to help guide you through this process. Click here

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Q. Can my consultation or follow-up appointment be on a weekend or evening?
A.

Our office does not schedule weekend or evening consultation or follow-up appointments.

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Q. Do I need a referral to see Dr. Cooper or Dr. Young?
A.

Most insurance companies do not require a referral or authorization to see the physicians.

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Q. How can I find out what my insurance will/will not cover?
A.

We strongly recommend that you contact your insurance company prior to your appointment. Please click here to see a list of questions you will want to ask your insurance company. Please bring this form with you at the time of your appointment.

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Q. What will happen at my first visit & how long will my consultation appointment take?
A.

Your first visit with the physician will include speaking with the physician in regards to your health history, previous treatment, and discussing treatment options for you. It does not usually involve a physical examination.

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Q. Will any testing be done on the day of my consult?
A.

Treatment plans are individualized. It is possible that blood work or other testing may occur at your first appointment. You may request to have the testing done at another time.

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Q. How early do I need to come for my consultation appointment?
A.

Please arrive 10 minutes prior to your appointment.

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Q. If I need to cancel my consultation, will I be charged for this visit if I don't give notice?
A.

Twenty-four hour notice is required for any cancellation or rescheduling of a consultation appointment.  If proper notice of cancellation is not given, you will be charged $100 for the consultation time.

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Q. How do I get to your office?
A.

Click on this link to view a map.

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Q. How can I get my medical records?
A.

Medical record release requires the written signature of the patient unless patient is a minor child. A parent may sign for minor children. Forms to have records released to our office or to have our office release records to another office or yourself are available to download under records release. We are not able to release records or information from another center. Click here to download our medical records form.

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General FAQs
Q. Can I have my blood work drawn at another clinic?
A.

There are times when the blood work the physician is requesting can be done at another clinic. Please ask the nurse or lab technician if you would like to have testing done somewhere other than our clinic. Realize however, that results may take longer through another lab.

Q. My home pregnancy test is positive! What do I do now?
A.

Call the office during regular business hours to schedule a blood pregnancy test. This test will give a number to let us know how well your body is producing the pregnancy hormones. If you are pregnant we will repeat this test in 2 days to watch the increase in the levels. This information is helpful in watching for early miscarriage, a tubal pregnancy, or a healthy pregnancy.

Q. Can I bring someone with me for my appointment?
A.

It is strongly suggested that you bring your significant other or spouse with you to your appointment so that we can address questions that either of you may have. If you are having an obstetrical ultrasound we request that you not bring additional people with you.

Q. What happens if I begin my period over the weekend and require testing?
A.

Our office has a designated on-call person to answer the call phone for emergencies & to report the results of your ovulation kit requiring an insemination. We encourage calls not related one of these situations to occur during regular business hours. Please arrange to speak with a nurse or physician if you are concerned you may need weekend assistance.

Q. What if my period begins after 5 PM?
A.

For testing and planning purposes, if your period begins after 5 PM we will count the next day as cycle day 1.

Q. How long will my appointment take?
A.

The majority of your testing is done in our office. We will try our best to limit your wait time. However, the time you are in the office will vary dependent on the test that is being performed. An ultrasound takes 20 minutes. To have your blood drawn about 5 minutes.

Q. Can I eat or drink liquids before I have blood work done?
A.

It is usually not necessary to be fasting before testing. We will make every attempt to make you aware if the test you are having done requires you not eat or drink before the test be performed.

Q. Do I need a full bladder for an ultrasound?
A.

Generally your ultrasound will be performed transvaginally and we prefer an empty bladder for this type of ultrasound. The only time we need your bladder full is when we do an embryo transfer. 

Q. What happens if I have my ovulation surge over the weekend and we are planning to have insemination?
A.

Do your ovulation detection kits using first morning urine. The morning that you have your positive surge call our office between 8-10 AM to schedule the insemination for the following morning. If this is a weekend, we will have a nurse or physician available during these times to take your call. If you reach the call phone voicemail, please leave a detailed message including phone number where we can return your call and we will call you back.

Q. Directions to Bauder's Pharmacy?
A.

38th & Ingersoll in Des Moines, Iowa Take I-235 to 42nd Street in Des Moines; south on 42nd Street; left at stop light on Ingersoll Avenue; it will be on right hand side of road.

Q. Do you call me with test results?
A.

We call patients who have had a pregnancy test on the same day. The length of time it takes for us to receive test results depends on what testing is done. Some results are available the same day; others may take days to weeks. If it has been longer than one week since your test results were anticipated please call the office to request your results.

Q. Can I use any pharmacy or do you recommend a pharmacy?
A.

You may use your current pharmacy but some pharmacies may offer a lower price for certain medications. Please feel free to ask one of our staff if there is a pharmacy that may offer a lower price on your medication. We most commonly use Bauder's.

Q. Is there any procedure that I will have done that requires I have a person to drive me home?
A.

The only procedures that we require you have a driver are the in vitro fertilization egg retrieval and the embryo transfer. Some women prefer to have a driver after minimal office procedures. If you are concerned, it is better to have someone available to drive you.

Q. Can I bring children to the office?
A.

Please keep in mind that bringing children to our office may be emotionally upsetting to some of our patients struggling with fertility issues.

Q. What is PCOS?
A.

Polycystic ovary syndrome is a condition in which the ovaries contain many cystic follicles that are associated with chronic anovulation.  The cystic follicles exist presumably because the eggs are not expelled at the time of ovulation.  Symptoms associated with PCOS may include irregular menstrual periods, obesity, excessive growth of central body hair, and infertility.

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Hysterosalpingogram (HSG)
Q. What is a hysterosalpingogram (HSG)?
A.

It is an x-ray that allows assessment of both the fallopian tubes and the uterine cavity.

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Q. Will an HSG hurt?
A.

There may be some cramping while the dye is instilled. Technique is important in minimizing discomfort, which is why we perform our own HSG's. Taking 2-3 ibuprofen 1 hour before will minimize any discomfort.

Q. Where are they done?
A.

The majority of our patients have their HSG done at Iowa Radiology. Each of our physicians have a reserved day at Iowa Radiology for this procedure.

Q. Where is Iowa Radiology?
A.

Iowa Radiology is located at 12368 Stratford Drive Suite 300, Clive, Iowa 50325. Their direct phone number is 515-226-9810.  Click here for map.

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Semen Analysis
Q. Will I need to do anything after I drop off the semen analysis?
A.

If you have not completed registration forms you will first be asked to do so. Upon checking in at the front desk you will complete the "chain of custody" form.

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Q. Is there a storage fee to cryopreserve sperm?
A.

Yes, there is a storage fee. Please contact our financial department to find out the charges.

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Q. Can my wife or significant other drop off my semen sample?
A.

No.  All semen samples must be dropped off by the male partner for positive identification of the sample.

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Q. How much does a semen analysis and morphology cost?
A.

The complete semen analysis cost is $295.00 The semen analysis is $100 and the morphology (intensive assessment of sperm appearance) is $195.

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Q. What do I collect my sample in?
A.

Please use the collection kit provided by our office. The basic collection kit is free of charge. Other collection kits or items you have at home may affect your sperm sample.

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Q. How long after I collect my semen sample do I have to deliver the sample to the office?
A.

Your sample should arrive at our office not more than 45 minutes after collection.  If you live further than 45 minutes away, you may schedule a time to use the collection room in the office.

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Q. Where do I drop my off my semen sample?
A.

You will need to schedule an appointment and bring your sample to the receptionist/check-in desk at the scheduled time. You will need to complete paperwork at the office. Be sure to completely fill out the label that is included in the collection kit and attach to specimen. Please do not remove the sample from the bag.  All specimens must be delivered by the male partner.  Specimens will be discarded if delivered by someone other than the name on the label.

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Q. Do you have a place in your office to collect the sample?
A.

Our office has a private collection room available by appointment only. Your wife or significant other can accompany you.

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Q. What if I am not able to collect a semen sample?
A.

Our office has a special collection kit available for purchase to use with natural intercourse to collect your sample.  The cost of this kit is $27.

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Q. How do I order donor sperm?
A.

Please call the office and speak directly with Holly or Kepler. Our clinic does not accept sperm if our staff did not place the order.

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Q. So I need an appointment to drop off a semen sample or insemination sample?
A.

You will need to call ahead to schedule an appointment for semen analysis or insemination. If you plan to collect your sample in our office we need to know that information at the time of scheduling your appointment. If you do not reserve the collection room, we will assume you are collecting the semen sample at home.

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Q. How long can cryopreserved sperm be stored for?
A.

Frozen sperm can remain viable for over 25 years when stored properly.

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Sonohysterogram
Q. When is it done?
A.

It is best to do this procedure between menstrual cycle day 6 and 13.

Q. Where is it done?
A.

Sonohysterogram procedures are done in our office.

Q. What is a Sonohysterogram?
A.

A Sonohysterogram is a vaginal ultrasound with instillation of sterile water that is done to evaluate the cavity of the uterus. This may be done if you have abnormal vaginal bleeding or in preparation for in-vitro fertilization.

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Tubal Reversal
Q. What are the pregnancy rates after a tubal reversal?
A.

Pregnancy rates after a tubal reversal are 80-90% with ideal circumstances.

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Q. Will I be admitted to the hospital for this procedure?
A.

Most tubal reversals are done as an outpatient surgery. This means you are not admitted to the hospital. At the Lakeview Surgery Center we can schedule an overnight stay if you prefer.

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Q. How is a tubal reversal done?
A.

A tubal reversal is done microsurgically through a minilaparotomy (small bikini line incision).

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Q. When can we try to become pregnant after a tubal reversal?
A.

You may begin trying to conceive the first month after a tubal reversal. The majority of women become pregnant within the first 18 months after the procedure

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Q. How long is the recovery after a tubal reversal?
A.

You will be off work for about 10 days and it will be 4 weeks before you are able to do heavy (> 20 lbs.) lifting.

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Office Hours:

Monday 8 - 5

Tuesday 8 - 5

Wednesday 8 - 1

Thursday 8 - 5

Friday 8 - 4

The office is closed from 12 -1 pm for lunch


 

Our Location:

1371 NW 121st

Clive, Iowa 50325

 


 

 

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