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What to Expect on Your First Visit

Couple on beachAt Fertility CARE we strive to educate our patients because we believe knowledge empowers the patient. Your first visit with us will allow you to better understand your own body which will help us to determine the best treatment option for your specific needs.

All of us at Fertility CARE work to strengthen our bond with our patients. We provide individualized patient care and are always available to answer questions and offer emotional support.

Although everyone’s journey is unique these tips can help you feel more prepared for your first visit. We also encourage you to contact us with any questions or concerns you may have before your appointment.

What Should Patients Expect When They First Meet With Us?

During your first visit, we will take an extensive medical history of you both. Then, we will perform a physical examination plus a pelvic ultrasound of the woman’s reproductive organs. We will also recommend any necessary diagnostic testing, discuss management options, review coping strategies and stress reduction and answer additional insurance and financial concerns.
BBT charting is one of the many ways to check for ovulation however it is not the most accurate. We recommend using an ovulation predictor kit which you can purchase at any pharmacy. Please bring your BBT charts and any other information about your ovulation history to help us evaluate you.
There are a variety of options for fertility treatment. It’s important to keep in mind that no two patients will have the same problem or an identical approach for treatment. Therefore, we individualize patient care but usually proceed with some form of ovulation induction with intrauterine insemination (IUI). Treatment may involve oral medication alone, a combination of oral and injections, or only injections depending on the diagnosis. (These injections use insulin-like needles and are easily placed directly under the skin.) There are also those patients that are best assisted by in vitro fertilization (IVF). We will work with you to determine which treatment option provides you the best chance for a successful pregnancy. Most importantly, we continue to analyze your cycles to make changes for improvement, if subsequent cycles are necessary.

Intrauterine insemination involves the simple process of washing sperm in the laboratory to enhance fertilization. Then, using a small catheter, the sperm is gently placed into the upper uterine cavity. Since IUI passes through the vagina and bypasses the cervix, a high concentration of total moving sperm is placed closer to the fallopian tubes where fertilization normally occurs. This procedure is performed in the office without the need for sedation since a woman rarely experiences more than a mild menstrual-like cramp.

In vitro fertilization (IVF) is the Assisted Reproduction Technology (ART) advancement that revolutionized the fertility treatment of women when the first baby born was using this process in 1978. IVF literally means “outside the body fertilization.” After stimulating a woman’s ovaries (with medication) to produce multiple follicular cysts– each containing an egg– ultrasound is used to guide a needle through the woman’s vagina into the ovary to puncture the cysts, aspirate the fluid and collect the eggs. The eggs then are immediately analyzed in the laboratory and eventually inseminated later that day for fertilization. This procedure is usually performed in an office procedure room while the woman is under sedation and takes less than 30 minutes. Originally developed to assist women with damaged fallopian tubes, IVF has now emerged as the fertility treatment offering the highest monthly chance for a successful pregnancy above all other treatment options, regardless of diagnosis.

The cost of diagnostic testing and management will vary among patients due to the individualized treatment approach at Fertility CARE. Our financial coordinator works closely with patients to utilize their maximum insurance benefits for services.

Fertility CARE is a member of Advanced Reproductive Care, Inc. (ARC), the nation’s largest network of Reproductive Endocrinologists (physicians medically certified in reproductive medicine and infertility treatment) who are committed to making the cost of fertility treatments predictable and affordable to assist couples with their challenges of building a family. Patient options include: affordable and predictable package pricing, financing options and 100% refund guarantee.

And we also offer “The Family Fee Plan” by Capital One where you can work out monthly payments for your treatments.

Fertility medication to induce ovulation will cause an increase in a woman’s estrogen production by her ovaries. This results in increased symptoms that mimic ‘pre-ovulatory’ feelings such as abdominal bloating, breast tenderness and nausea. The most common risk of any medicine that induces follicle development for egg production is a multiple pregnancy. Using clomiphene citrate tablets, the risk of a multifetal pregnancy is estimated at 5-10% of pregnancies. This risk increases significantly when a patient uses gonadotropin injectable medication, approximately 15-20% of pregnancies with a 5% risk of triplets.

Although most patients believe IVF increases the multiple pregnancy rate, this is not necessarily accurate. The percentage of multiple births from infertility treatments in this country is essentially the same when IUI is compared to IVF. Actually, the risk can be lower with IVF when responsible decision making and education is applied. At Fertility CARE we counsel couples extensively about ways to reduce the risk of multiple births including offering a single embryo transfer for good prognosis patients and this can provide above average pregnancy rates.

Other risks of fertility medications are even more rare. These include the risk of:

  • Ectopic pregnancy – A potentially life-threatening pregnancy occurring outside the uterus,usually in the fallopian tube. This situation can be treated medically in the early stages, but may require surgery if severe.
  • Ovarian torsion – An ovary containing cysts that gets twisted on its blood supply, possibly requiring surgery. In very rare cases, an ovary must be removed.
  • Ovarian hyperstimulation syndrome – This is a rare but potentially fatal condition resulting from excessive cyst production by the ovaries in response to fertility medication, causing fluid accumulation in the abdomen but, at the same time, severe dehydration. In serious conditions, patients require hospitalization. Fortunately most cases resolve within one to two weeks.
  • Ovarian cancer – A major study in the journal of Obstetrics and Gynecology, April 2004, demonstrated NO association and a possible reduction of risk after women were exposed to fertility medication compared to infertile patients never receiving these medications.

Side effects will certainly vary among patients and most tolerate the medicine very well.

Once you are in a treatment cycle, the number of trips to the office will vary according to your medications. Visits are usually 15 to 20 minutes (unless you have questions for the nurse and/or physician). In general, patients using clomiphene citrate require approximately two to three ultrasound visits plus an IUI. Gonadotropin injectable cycles require three to four visits, not including IUI. After you and your physician decide on the type of treatment, the nurse will go over the number of office visits expected for that particular cycle.

Since programs are now required to report their statistics through the Society of Assisted Reproductive Technology to the Center for Disease Control and Prevention, only our IVF statistics are maintained and reported by Fertility CARE. Dr. Trolice’s programs have consistently been above the national average for IVF pregnancy rates. Although reported pregnancy rates are often used by patients to compare the quality among clinics, this approach may not be accurate since patient prognosis and criteria for acceptance into an IVF program may vary.

Alternatively, the national average for IUI pregnancy rates is approximately 10-15% per cycle.

For your convenience, and to ensure consistency and accuracy, we offer all the reproductive medicine diagnosis and testing you will usually need for your evaluation and management. This includes blood drawing and hormonal testing, pelvic ultrasound, hysteroscopy, hysterosalpingogram (HSG), comprehensive sperm testing and preparation for IUI, and In-vitro Fertilization (IVF).
Yes, please feel free to contact us or call us at anytime for any questions you may have whether it is nursing, insurance or general questions regarding your Reproductive Health care. Additionally, our physician is on call 24 hours a day.
We recommend you complete our history questionnaire and have all your pertinent medical records forwarded to our office prior to your appointment. You may also find it helpful to bring a list of questions to your visit and please allow approximately 90 minutes during this time.

A Message from Dr. Trolice

Trolice - Fertility CareOur first goal at Fertility CARE during a first visit is to place the patient at ease. We explain our approach to patient care, our availability to answer all questions and how our treatment plans are individualized. Our program does not merely focus on the medical aspect of fertility because we realize the significant physical, emotional and financial investment a patient makes during this process.

By the time patients have a consultation with a reproductive endocrinologist, she or he probably has already gone through a significant amount of worry about getting pregnant. So, we begin by discussing how their fertility problem is impacting their lives and we review stress reduction and coping strategies. Sometimes, the majority of a time during a new patient visit is spent on discussing the psychological effect of fertility.

Following a thorough medical interview, the doctor does a comprehensive physical examination and pelvic ultrasound (for the woman), explaining to the patient her reproductive anatomy and any findings which may be contributing to a fertility problem.

The patient then reviews her evaluation and testing with one of our specialized nurses. Patient education materials are provided, along with our web site, to supplement information shared during the office visit.

Finally, patients spend time with our financial counselor to determine fertility benefits coverage and a follow-up appointment is scheduled to begin treatment.

By the time patients have a consultation with a reproductive endocrinologist, she or he probably has already gone through a significant amount of worry about getting pregnant. So, we begin by discussing how their fertility problem is impacting their lives and we review stress reduction and coping strategies. Sometimes, the majority of a time during a new patient visit is spent on discussing the psychological effect of fertility.

The IVF Center – Why Fertility CARE is Unique

Dr. Trolice and the team supporting Breast Cancer Awareness month.

Dr. Trolice and the team supporting Breast Cancer Awareness month.

At Fertility CARE we recognize the process of IVF can at times be overwhelming.

To address this issue, we have an IVF Nurse available 24/7 to answer questions, guide you through the process, and provide emotional support. We also offer a Reproductive Health Psychologist to help couples develop their best coping strategies along their journey.

Success of the IVF Program at Fertility CARE is due to our scientific and technological excellence coupled with our compassionate and highly personalized approach to patient care.

Fertility CARE is committed to each couple’s success by providing individualized and supportive care along the way. We consider each couple part of our family as we attempt to help them create their own.

What our Patients are Saying

“There are no words to explain sheer joy. It just has to be experienced through this great staff and doctor.”

Fertility CARE Patient, Facebook Review

“I couldn’t be happier with the treatment I received from Dr. Trolice and his staff. Every question I had was always answered in a timely manner and I was always felt comfortable talking with both Dr. Trolice and his staff.”

Fertility CARE Patient, RateMds.com Review

“After struggling with infertility and feeling hopeless, Dr. Trolice quickly comforted us and provided outstanding care. He is compassionate and committed so I felt we were in excellent hands. His staff are all warm and caring. Success came and we are grateful to him!”

Fertility CARE Patient, Vitals.com Review

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