So we can care for you without delays, we require that both patients fill out the following before calling to make your appointment.
New Patient Packet (All applicable sections, including the partner/spouse section if you going through the journey with someone).
Telehealth Consent
Patient Communication Preferences Form (If Partner/Spouse/Significant Other are participating in the fertility journey, they must complete one in addition to the patient)
Genetic Screening Form
In addition, please note the American Society for Reproductive Medicine recommendations on age and BMI prior to completing the forms.
Age
Data demonstrates poor success rates (less than 2%) with non-donor egg IVF when the patient is age 45 and above. As a result, our program does not offer non donor egg IVF (i.e. IVF wtih your own eggs) to those patients age 45 and above. If you are 45 and above, we will be discussing IVF, only in the context of egg/embryo donation options.
BMI
Based on research in both IVF outcomes and pregnancy outcomes related to elevated BMI, as well as ventilation risks related to anesthesia, we have a BMI prerequisite less than 47 before initiating fertility treatment in our program. If your BMI is greater than 47, we offer the standard, personalized fertility testing and treatment planning. In those with BMI greater than 47, our approach is first to provide comprehensive weight loss (diet, exercise and pharmacologic) planning prior to starting fertility treatment.
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Before beginning this form, please be sure to have your/your partner's (if applicable) insurance card on hand.