- Why is WINFertility an excellent choice for patients seeking treatment?
WINFertility provides patients with the most direct route to the most
effective fertility treatment, at a single, discounted, bundled price that is up
to 50% less than fee-for-service treatment and retail medication rates. There
are no hidden requirements or criteria and patients pay only for the individual
treatment cycles and medications they receive…never for multiple cycles they
may not need. Each patient has a designated FertilityCoach Nurse to
advise, explain and monitor progress throughout their treatment process.
- Why are your bundles less expensive than other programs?
WIN is the only Infertility Management Services company that contracts directly
with drug manufacturers, specialty pharmacies and fellowship-trained Fertility
Specialists on a large scale that covers thousands of patients annually. We are
now able to pass along the volume discount savings directly to patients for each
treatment cycle they require. Even if patients require more than one cycle, our
WINFertility Treatment Program Bundles are less expensive.
- What are the advantages of bundles?
As infertility treatment is so complex, determining actual costs has been a
confusing experience for patients. Because the WINFertility Program consolidates
the costs into treatment packages or 'bundles', patients have a simpler way to
approach and decide on infertility treatments. Discounts of up to 50% off of
fee-for-service treatments and retail medication costs and pricing
predictability offer patients additional peace of mind while pursuing their
dreams of building a family.
- What happens if I’ve already started treatment somewhere else?
No matter where or what type of fertility treatment you may have undergone,
there are no qualifying criteria for enrollment in the WINFertility Program.
Simply, patients must have no infertility insurance coverage and be recommended
for treatment by an WINFertility provider to participate in the program.
- When will you have a practice in my area?
Even though WINFertility has been providing our management services program to
major insurers and employers for more than a decade, our WINFertility
Program for Consumers is new. We are working quickly to expand our
highly-qualified Fertility Specialist Provider Network. If we do not yet
contract with a credentialed fertility center in your area, contact our Care
Management Team. We will attempt to locate a local, qualified provider in your
market, soonest possible. If there is a practice in your area you would like to
recommend, let us know.
- Can you help with fertility financing?
YES! Although the WINFertility Program offers deeply discounted prices for
fertility treatment and infertility medication bundles, we want to make
achieving your dreams of parenthood the most manageable and convenient possible.
We offer extensive options to control IVF and IUI cost. Having researched the
lending and financing market, we have partnered with a global
financing leader to administer loan transactions for WINFertility Program
participants. Loans may be used for both fertility treatments and infertility
medications included in the WINFertility Bundles. Fertility financing options
include: secured loans with preferred discount rates and unsecured loans with
terms up to 60 months and competitive interest rates. All financing is at the
sole discretion of and subject to the lending institution's credit approval.
- How long should a woman wait before seeking advice from a fertility specialist?
Couples are generally advised to seek medical help if they are unable to achieve
pregnancy after a year of unprotected intercourse. If the woman is over the age
of 35, a medical evaluation of both the male and female may be recommended after
only six months.
- What is a reproductive endocrinologist?
- Before getting pregnant, how can you optimize the chances of a healthy, safe pregnancy?
Getting yourself into optimum condition prior to pregnancy involves the
establishment of a healthy lifestyle and screening for disorders or genetic
carrier state. Healthy lifestyle requires eliminating habits that may be
detrimental such as cigarette smoking or excessive alcohol or caffeine intake.
Proper diet and exercise are recommended as well. Women with diabetes or
hypertension should see their medical doctors about getting these diseases in
the best control possible before conceiving. Women who are obese should strongly
consider weight loss prior to getting pregnant.
Folic acid intake has been
shown to reduce the risk of certain birth defects (neural tube defects). This
may be accomplished by the daily intake of at least 400 micrograms of folic
acid. Genetic screening may be recommended based on ethnicity.
- What is the standard testing that is performed in an infertility investigation?
A complete history and examination is usually the first thing that is done upon
seeking assistance from a fertility specialist. Information about past
pregnancies, menstrual cycles, prior gynecologic problems, medical disorders,
prior surgery, and environmental exposures like tobacco and alcohol, are all
critical in assessing the cause of infertility. Testing includes the semen
analysis, hysterosalpingogram (HSG), and ovarian reserve testing (for women over
- How is a semen analysis performed and what information does it provide?
Semen specimens for analyses are usually collected on-site or locally, as they
need to be evaluated within 1 hour of production, and not exposed to excessive
heat or cold. All it is usually recommended that specimens be collected after an
abstention from ejaculation for two to five days prior to providing the sample.
Shorter or longer periods of abstinence may yield suboptimal semen specimens.
Semen collection instructions usually recommend avoidance of use of any
lubricants due to concerns about their effect on the sperm parameters.
semen analysis includes evaluation of the volume of the ejaculate, the
concentration of the sperm (count), the % of the sperm that are moving
(motility), and an assessment of the % of normal appearing sperm (morphology).
Additionally, the presence of increased numbers of white blood cells may be an
indication of an infection in the male reproductive tract. The findings are
compared to the normal values determined by that laboratory. Sometimes, a second
semen analysis will be requested if the initial one is abnormal to confirm that
the findings are persistent. The finding of semen abnormalities may be an
indication for a referral to a male infertility specialist or urologist.
- What is a hysterosalpingogram (HSG)?
An HSG is a test that can demonstrate whether the fallopian tubes or open
(patent) or blocked (occluded). It involves the injection of x-ray contrast into
the cervix with a catheter under x-ray fluoroscopy. The procedure is often
associated with some cramping and discomfort, and many practitioners recommend
taking ibuprofen or another pain medication prior to the procedure. Most
patients do tolerate the procedure well, however. If the test shows that the
tubes are blocked or abnormal, then further testing may be necessary. Treatment
of tubal blockage at the beginning of the tubes (proximal tubal occlusion) may
be done radiologically (recanalization) by inserting small wires or catheters
into the tubes directly transcervically, or sometimes may be done surgically
(hysteroscopic tubal cannulation). Treatment of distal tubal occlusion (at the
ends of the tubes) may require a laparoscopy or IVF.
- What is ovarian reserve and how is it evaluated?
The term ovarian reserve describes a woman’s reproductive potential with respect
to the number of ovarian follicles and egg quality. The levels of FSH and
estradiol on day 2 or 3 of the menstrual cycle are often used to test for
ovarian reserve. Elevations in FSH or estradiol may indicate decreased ovarian
reserve and may predict a poorer prognosis in women of older reproductive age.
More recent ovarian reserve tests are being evaluated for clinical use including
ultrasound evaluation of the number of visible follicles (antral follicle count)
and measurement of a substance called anti-Mullerian hormone (AMH).
- How does age relate to infertility?
Fertility declines with increasing female age, beginning as early as the late
20’s and early 30’s, and is most pronounced in women over 35. This is believed
to be related to a decline in ovarian reserve and a higher incidence of oocyte
(egg) abnormalities. The decline in fertility is accompanied by an increase in
the rate of miscarriage. Evaluation and treatment of infertility should not be
delayed in women over 35 who have attempted conception for over 6 months.
- What are the causes of anovulation (failure to ovulate)?
Anovulation may be caused by several endocrinologic disorders. Screening for
abnormal thyroid function or elevations in the hormone prolactin is typically
required. In these cases, specific treatment of those disorders is necessary.
Many women who are anovulatory have polycystic ovarian syndrome (PCOS) which is
diagnosed when there is evidence for elevations in androgen levels (like
testosterone) and ultrasound findings of many small immature follicles in the
ovaries. These women may be benefit from clomid treatment or in some cases with
insulin sensitizing medications like glucophage.
Women who don’t menstruate
at all (amenorrhea) require investigation to assess the cause of the problem
that may relate to abnormalities of the brain (hypothalamus and pituitary gland)
or the ovaries. These women may require more involved treatments, like
injectable fertility medications.
- What is unexplained infertility and how is it treated?
After the initial infertility evaluation, if nothing specific cause is found;
“unexplained infertility” is diagnosed. Approximately 20% of fertility patients
are diagnosed with unexplained infertility. Treatments for unexplained
infertility include intrauterine insemination (IUI) with either oral or
injectable medications like clomiphene citrate (oral medication) or with
(injectable) FSH stimulation, or in vitro fertilization (IVF).
unexplained infertility, the monthly conception rate without clinical treatment
is low (under 5%). Thus, treatments that improve upon that are utilized. The
chance of becoming pregnant after 3 or 4 treatment cycles of IUI with clomiphene
is about 20 to 25%; with IUI with injectable FSH is about or 30 to 35%, and with
IVF is as high as 75 to 85% in young women.
Age is important with regard
to success rates. Usually, treatment begins with IUI with clomiphene for 3 to 4
cycles. If that is unsuccessful, either IUI with FSH or IVF is considered. This
choice is made after weighing the costs, success rates, and especially multiple
pregnancy rates, given the high risk involved. IVF may be chosen because of its
higher success and lower risk for triplets. In addition, there is more control
over multiple pregnancy risk since one may choose to transfer fewer embryos.
With more liberal use of elective single embryo transfer, the multiple pregnancy
rate with IVF will continue to diminish. The goal should be to arrive at a
singleton pregnancy in the safest way possible and as quickly as is appropriate
for that couple.
- What is recurrent pregnancy loss (RPL) and how is it evaluated?
Recurrent pregnancy loss is a disease distinct from infertility defined by 2 or
more failed clinical pregnancies (a visible gestational sac on ultrasound).
Evaluations of RPL may include blood tests, uterine exams, and genetic
screening. The purpose of the evaluation of recurrent pregnancy loss is to
identify causes that may be treated prior to achieving another pregnancy.
Specific causes are identified in approximately half of patients. The
investigation usually includes several blood tests and an examination of the
Genetic testing of both the male and female is performed in order
to identify the presence of a chromosomal translocation. In such cases, a small
piece of the chromosome in one of the parents is “broken off” and located on
another chromosome. That parent is normal; however, when an egg or sperm is made
it may contain the extra piece, which upon fertilization may result in an embryo
with abnormal chromosome content. This can result in recurrent miscarriages.
Future fertility treatment is possible with IVF and PGD.
Evaluation for the
antiphospholipid syndrome or for thrombophilia requires several blood tests. If
any of these are abnormal, treatment may be necessary during pregnancy that may
prevent further miscarriages.
Testing of the uterine cavity is typically
accomplished by a hysterosonogram (HSN) which is a simple office procedure
requiring the installation of saline into the uterus with a catheter and an
ultrasound. If a fibroid, polyp, or uterine anomaly is discovered, these may be
surgically treated prior to further pregnancies.