Infertility

Infertility is a common problem shared by over 2.1 million women in the United States alone. It is defined as the inability to conceive after 12 months of unprotected intercourse if under the age of 35 and 6 months if over the age of 35. At least 25% of the time more than one factor or reason is contributing. Testing or investigation may be sought earlier if the patient exhibits any history or physical findings such as irregular menstrual cycles/ovulatory dysfunction, known tubal disease, or endometriosis that may indicate earlier intervention.

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The Woman’s Clinic provides quality infertility care for the women of Springfield and Southwest Missouri. The providers at the Woman’s Clinic perform complete infertility evaluations and non-IVF treatments. For patients who require IVF, we work in conjunction with reproductive endocrinology clinics to provide as many services as possible (same day lab, baseline scans, follicle studies) to minimize the need for traveling. We also perform similar monitoring for other outlying clinics as ordered. The Woman’s Clinic does not perform donor intra-uterine insemination at this time.

The first infertility visit will consist of a comprehensive review of the couple’s medical history and explanation of recommended diagnostic testing. Diagnostic testing may include but is not limited to:

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Workup:

• Testing for ovulation (luteal phase progesterone)

• Assessment of ovarian reserve (day 3 labs and antral follicle count)

• Screening for polycystic ovarian syndrome (based on history, physical exam, ultrasound and laboratory findings)

• Screening for male factor infertility (semen analysis, referral to urology as needed)

• Testing for tubal factor (hysterosalpingogram with contrast or via FemVue Sono HSG)

• Surgical evaluation and treatment of endometriosis

• Screening for uterine factor infertility (saline infusion sonogram or sonohysterogram)

• Evaluation of repeat pregnancy loss (laboratory and saline infusion sonogram)

 

Treatment:

After a diagnosis has been established, a treatment plan will be discussed and initiated.

Treatment may include but is not limited to:

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• Ovulation induction with monitoring (follicle studies) using clomid, or letrozole

• Polycystic ovarian syndrome treatment (Metformin or Glucophage, ovulation induction with close monitoring)

• Intrauterine insemination performed seven days per week based on follicular development (donor intra-uterine insemination not available - recommendations/referral available)

• Advanced sperm washing technique

• Weekend services available as needed

• Monitoring for outlying clinics (same day ultrasound and lab)

The need for infertility diagnosis and treatment in Southwest Missouri is high and Reproductive Endocrinology (RE or infertility specialists) are not readily accessible in this area. We do not claim to take the place of an RE, but are available for those who are not able to travel and those who are ‘just trying to figure out’ why they cannot conceive. We do not practice outside the scope of our practice and refer to RE when appropriate or requested. We believe monitoring (with follicle studies) while on ovulation induction medications is important, especially to reduce the risk of multiples and to evaluate both the safety and efficacy of the medications. We also realize that infertility is an emotional rollercoaster ride and that you deserve personalized treatment. Our on-call service directs after hour phone calls to one of our providers for those last minute questions. We do our very best to provide flexibility and accommodate your appointment needs. We have a patient portal available to view lab results and can also be contacted (similar to email) through the portal.

 

Missouri is not a state that has mandates to stipulate insurers to pay for infertility coverage. Unfortunately, there are not many plans that cover infertility services. If you have irregular menses or other associated gynecology problems that need to be addressed, a good portion of the initial workup (lab and ultrasound) can be appropriately filed with your insurance. Once the workup is complete infertility codes will be used and most generally are not covered. We do offer competitive, discounted self pay prices for infertility services and encourage your comparison. We do not offer payment plans for infertility services.