*Please read over this thoroughly prior to calling the office with any questions or concerns. If you still have a question that needs to be addressed, you may call (919) 782-5911. If you leave a message on the nurse line, your phone call will be returned within 24 hours with the exception of weekends/holidays. Make sure your inbox is not full so we can leave you a message. Please do not leave multiple messages or send multiple emails to multiple personnel. Leaving multiple messages will only slow down the response time.

Questions Regarding Pregnancy, Medical Concerns and Treatment Plans

Why is a “baseline” ultrasound necessary?
We do these to rule out ovarian cysts. If the cyst is not hormonally active (estrogen less than 100), then the physician will likely start your cycle.
Can I have sex during my treatment cycle?
Yes, intercourse is fine. However, if you are in an IVF cycle and doing PGS/PGD testing, it is recommended that you refrain from intercourse during your stimulation cycle.
Can I exercise during my treatment cycle?
If you are doing IVF, it is recommended that you decrease your exercise activities at this time. Less strenuous activities such as walking is fine, however it is best to limit any exercise that involve strenuous movement of the abdomen during your stimulation cycle. 
I’m experiencing bloating/cramping/fatigue/etc. Is this normal?
These symptoms are all common and normal side effects related to fertility treatment. The most common symptoms include bloating, cramping, fatigue, nausea, and headaches.
I’m experiencing constipation. Is this normal? What can I take for it?
Constipation is common. You may take Colace (over the counter), and increase your water & fiber intake.
How soon after my embryo transfer can I take a pregnancy test?
We do not recommend testing at home with a urine pregnancy test after your transfer, as it can potentially result in a false read. It is recommended that you wait until your scheduled blood test in our office.
I just finished my first treatment cycle and had a negative at home pregnancy test (for patients doing TIC and IUI). What do I do next?
You may continue with the same treatment plan for up to three cycles. If you have had three failed treatment cycles with the same plan, you should schedule a follow up with your MD to discuss alternative options for you. 
I am currently pregnant, but I have been having some spotting and cramping. Is this normal?
Spotting and mild cramping during pregnancy is common. If the bleeding becomes bright red & heavy, or if your cramping is intense, let us know and we will likely perform an ultrasound to evaluate the pregnancy if you are over 5 weeks pregnant.
I am currently on birth control pills, but I have been having some spotting and cramping. Is this normal?
Spotting/breakthrough bleeding and cramping while on birth control is normal. Up to a third of women will have irregular bleeding or spotting while on birth control pills.  Spotting will have no impact on success in your upcoming cycle.
How can I get into a class sooner than my scheduled class date?
We have a set schedule for a specific number of nurse injection classes that we teach per day. If you are unable to get into a class that works best with your schedule, you may call the front desk to get put on a waiting list for any potential cancellations. Please be aware that we try our best to accommodate for all of our patient’s busy schedules, however this is not always possible.

Questions Regarding Medications

How do I know if my insurance will cover my medications or treatment?
The best way to find out what insurance coverage you have regarding fertility treatment is to call and ask your insurance company. Coverage varies based on treatment and insurance providers, so be sure to specify whether you are doing timed intercourse, IUI or IVF and what medications your doctor has prescribed.
I have not heard from the specialty pharmacy regarding my medications. What should I do?
Please contact the pharmacy that your medications were sent to. If they did not receive the prescriptions, you may call the nurse line to have us re-send any medications to them.
How important is it that I have sex or do the IUI 36 hours after I take my trigger injection (Ovidrel/HCG)?
The 36 hour timing is the suggested time for sake of discussion, but sex or IUI 34 to 40 hours later is fine.
Can I switch to a vaginal form of progesterone instead of doing the injections?
It is recommended that our patients start with IM injections in the beginning of their frozen embryo transfer cycle. If you are having issues with the injections, you may consult with your doctor about switching to a vaginal form, once a pregnancy is established.  Vaginal forms of progesterone can be used for any other form of treatment.
I’m having some soreness and lumps from the progesterone injections. Is this normal?
Soreness at the injection site and lumps are normal when taking IM progesterone. You can try icing the area before you inject to numb the area, and applying heat & massaging the area afterwards to alleviate any soreness.
The Cetrotide/Ganirelix injection burns. Is this normal?
Stinging, irritation and redness is normal after injecting Cetrotide or Ganirelix.
What medications are safe to take during pregnancy?
You may look up a particular medication to see if it is safe for use during pregnancy. Medications listed as Category A or B are safe to take.
I was instructed to add additional estrogen during my FET cycle. Now that I am pregnant, do I need to continue taking this amount?
If your estrogen dose was increased during your FET cycle, you must continue taking this amount until 10 weeks of pregnancy.
How long will I continue my medications (estrogen, progesterone and aspirin) if I become pregnant after my transfer?
You will continue taking these medications until 10 weeks of pregnancy, unless otherwise instructed by your MD. These medications do not need to be “tapered off”.
I have just completed one treatment plan. Do I need another prescription for all of my medications?
Most of the prescriptions we order should have at least 2 refills. If you are unsure, please contact the pharmacy where you originally got your medications from and see if they have any more refills listed. If you are out of refills, you may ask the pharmacy to send over a refill request form.
Can I donate my leftover medications?
Yes! We accept UNUSED medications and supplies for donation. Please do not bring in used or medications, as we cannot donate those medications to other patients.
What do I do with my full sharps container?
You may throw your full sharps container into the trash, once you have sealed the lid closed. Please do not bring them into our office, as we are not able to discard them for you.

Questions Regarding Lab Results

I have not gotten my standard lab results yet. What should I do?
Certain lab results can take up 2-3 weeks before they come back. If it has been longer than 3 weeks and you still have not yet gotten your results, you may call the nurse line.
I have not gotten my genetic carrier screening test results back. What should I do?
Our office does not directly relay genetic tests results. For that information, you will be contacted by or need to get in touch with the company that your blood work was directly sent to to get those results.
What does my AMH level indicate?
AMH levels indicate your ovarian reserve, and can tell us how well you may potentially respond to treatment. A normal range is between 1-4, however a higher or lower number outside of that range does not necessarily indicate you will have a better or worse response.