RAN Process

Seattle Reproductive Medicine cares for patients in our community and from mostly the Pacific Northwest from states like Alaska, Wyoming, Idaho, Montana and Eastern Washington. Our regional access system allows patients to begin their workup and evaluation with a recognized provider closer to their home without ever traveling to Seattle.

The first step is to begin an evaluation with one of our providers. Please refer to the list based on the state or network provider that is most convenient for you. Once seen by these recognized providers, they will determine whether services provided by SRM are necessary. This mostly involves the necessity of in-vitro fertilization, IVF, for short.

Seattle Reproductive Medicine is conveniently located near downtown Seattle, making it easy for you to travel in and out for your IVF treatment. Once your schedule has been finalized, SRM staff can work closely with you by offering suggestions and alternatives for accommodations, restaurants, and transportation.

Coordinating Your Infertility Treatment

Initial Consultation
The initial consultation can be done with any one of our network providers. These providers have a special interest in reproductive endocrinology and infertility services and have special training regarding the pre-IVF evaluation and management. Patient receiving care with our network providers enjoy similar success rates as if they lived in a major city such as Seattle.

Infertility Evaluation
This consultation will determine whether you will need to have blood work done to evaluate hormone levels, such as FSH and estradiol levels. The results of these tests will help your doctor assess your level of ovarian function as well as to identify other potential obstacles that may interfere with the IVF cycle. You may also need a semen analysis, blood tests for infectious disease, ultrasound and a uterine evaluation (make sure your uterine cavity is normal) if these have not already been performed.

Treatment Plan
After the consultation and evaluation, your network provider will send the appropriate evaluation and workup information to SRM to be reviewed by our Reproductive Endocrinology and Infertility Specialists. SRM specialists have completed a general OB/GYN training program and further sub-specialized in the special needs of infertility patients. They have received specialized training that general OB/GYN's generally do not get trained in, i.e. in-vitro fertilization.

Any further workup as suggested by the SRM physician will be performed and completed by your network provider. Once completed, SRM nurses will coordinate with our network providers to determine when would be the best time to perform the IVF cycle. Usually a 2 week process, our network system can reduce the time you need to spend in Seattle to about a week to 10 days.

Education About IVF
Our staff will work closely with your network providers to educate couples. Education brochures, booklets, etc. have been provided or can be provided to help answer all your questions prior to initiating an IVF cycle.

You and your husband/partner will be required to sign and notarize so-called IVF consents regarding the freezing of embryos (if you choose to do so) and the in-vitro fertilization process PRIOR TO YOUR ARRIVAL IN SEATTLE. Originals will need to be brought to Seattle .

Injection Training
Again, our staff can assist in educating couples to self-administer the injections required. There are many education tools available (DVDs, written literature, video, pharmaceutical educational material) that the infertile couple can use at their discretion.

Purchasing Medications
You will next be asked to purchase the medication required during your IVF cycle. At your discretion, you can purchase the medication from your local pharmacy or they can be sent to you from a discount national mail-order pharmacy. Your network provider (or SRM staff depending on your local provider) can assist you in getting the appropriate prescriptions mailed, faxed or delivered to the pharmacy of your choice. We, of course, can provide the names of commonly used national mail-order pharmacies. Please note that prices can vary and can change frequently, so frequently that SRM can not be responsible for any price that we quote to you.

Initiating the IVF Cycle
Once your IVF cycle begins and you start taking your medications, the early stages of IVF will be coordinated by your local physician. This doctor will arrange early serial ultrasounds and blood work to monitor your response to the fertility medications. These monitoring results are communicated to us on the day they are completed and evaluated by our physicians. SRM will then communicate back to your network provider staff to communicate to you regarding any adjustment to your dose and when you should return to your network provider. PLEASE NOTE THAT THE SRM PHYSICIAN MAY RECOMMEND YOUR TRAVEL TO SEATTLE TO BE SOONER THAN PLANNED. PLEASE DO NOT BE SURPRISED IF THIS HAPPENS.

We communicate directly with network providers and their staff ONLY to keep them in the loop and perform the proper documentation that is required as they manage your IVF cycle.

Arriving At SRM
BRING ORIGINAL CONSENT DOCUMENTS.

An ART Cycle can progress very quickly. You will need to be prepared to leave for Seattle on short notice, and arrive 20 minutes before your first visit (to register and sign "permission to treat" consents). You will travel to Seattle approximately 3-7 days prior to egg retrieval, depending on your response to the injections. Your total stay in Seattle can be up to 10 days depending on what type of embryo is transferred.

What to Expect in Seattle
Starting on your first day in Seattle, you MAY come to the clinic as frequently as every day for an ultrasound and to have blood drawn. Each afternoon after your visit, you will receive instructions from an SRM nurse reviewing your medication dose and next appointment time. You will need to have a reliable messaging system or phone number where we can reach you in-person while you stay in Seattle .

Egg Retrieval
Final ultrasound studies and blood hormone evaluation will be performed during this period to pinpoint the exact time of optimal egg development. When your eggs are ready, you will be scheduled for egg retrieval in our office.

Most patients will have an ultrasound-guided egg recovery procedure under anesthesia. This means you will be asleep for the procedure. We will be arranging for a pre-anesthesia assessment during your time in Seattle. This is a quick procedure (usually 15') and recovery is quick (you will recover in 15-30').

Embryo Transfer
Our staff will be in close contact with you following the egg retrieval, updating you on the fertilization, development and quality of the embryos, whether to proceed with a day 3 (after egg recovery) or day 5 embryo transfer and what time to come in.

After 3-5 days of growth in the laboratory following your egg retrieval, you will return to our Center for your embryo transfer. You may plan to return home soon after the embryo transfer, if you wish. At this time you will receive instruction about which medications you may need to begin or continue taking.

What to Expect for Your Partner
Your husband or partner is welcome and encouraged to accompany you during ALL clinic visits.

Your partner will need to be available prior to the scheduled egg retrieval so that we may answer any questions he may have and obtain his written consent for the procedures.

Your partner will also need to be available on the last morning of the monitoring prior to egg retrieval (about 48 hours before the procedure) so that instructions for intramuscular injections can be reviewed.

If we are using his sperm, your husband/partner ABSOLUTELY NEEDS to be present on the day of egg retrieval to provide a semen specimen that will be used to fertilize the eggs.

Your husband or partner will not be with you in the procedure room for the egg retrieval but should be able to escort you and stay with you for the 24 hours following the procedure.

Your partner should be present for the embryo transfer (three or five days after retrieval) to participate in the final decision regarding number of embryos to transfer.

Pregnancy Test
Approximately 14 days after embryo transfer, you will have a blood pregnancy test performed by your network provider. These tests will be sent to us the same day for our records. Your local network provider will provide you with the results.

If you are pregnant, we will continue to work with you and your network provider to coordinate the ultrasounds, lab work, and medications that are necessary to maximize your chance of maintaining a successful pregnancy.

If you are not pregnant, work with your local network provider in regards to the appropriate follow-up necessary. Phone consultations with your designated primary SRM physician can be made at the discretion of your local network provider.

Revised December 23, 2008