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Follow the link below for each section to answer the most common questions:
- New Appointments and Transition of Care to SRM
- Providers and Credentials
- Infertility Services
- Donor Insemination Program
- Donor Egg Program
- Regional Access Patients
- Non-infertility Services
- Financing Treatment at SRM
- Other Services
- Embryology Laboratory/Cryopreserved Embryos
- Other questions
- Vasectomy Reversals
- Financing Treatment
How do I make an appointment?
We are currently scheduling patient appointments. You may either schedule an appointment online or call 206-301-5000 the either the Bellevue or Seattle sites.
Is a physician referral required to schedule an appointment?
No, we also accept self-referred patients. In selected cases based on your particular insurance, a referral may be needed. Please call our financial counselors at 206-301-5000.
What will I need to bring to my initial visit at SRM?
Please refer to the new patient information page for more details.
All new patients (including patients who have been seen at the University of Washington) will be asked to schedule a new patient consultation and provide a copy of their medical records that are pertinent to the reason you are being seen at SRM. We can help you sign the appropiate medical release forms so that your records are at our office on your initial visit.
Patients who have x-rays (e.g., HSGs) should also bring a copy of these x-rays to their initial consultation, if possible.
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What is a Fertility Specialist?
A fertility specialist is a medical doctor who has been specially trained in the complex issues that contribute to infertility and reproductive issues. Trained as an obgyn, a reproductive endocrinologist and infertility specialist, AKA fertility specialist, has completed addition highly specialized training for all aspects of reproductive medicine that a conventional Ob/Gyn physician may not or desire to practice, given the special attention and demands that a typical infertile couple requires.
Below are the school and training requirements that an Ob/Gyn and Reproductive Endocrinologist must complete.
OBGYN - four years of medical school and a 4 year residency program in Obstetrics and Gynecology
REPRODUCTIVE ENDOCRINOLOGIST - 3 year additional subspecialty training beyond what is required above
TO BECOME BOARD CERTIFIED IN OBGYN - pass a written exam in ob/gyn, complete 1 year of clinical practice, pass a 3 hour oral examination in ob/gyn
TO BECOME BOARD-CERTIFIED IN REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY (REI) (additional to above) - pass a written exam in REI, complete 1 year of clinical practice, and pass a 3 hours oral exam in REI
In the United States, there are currently 1000 Board-certified Reproductive Endocrinologists.
Who are the providers at SRM?
Our physicians are Dr. Michael Soules, Dr. Nancy Klein, Dr. Angela Thyer, Dr. Paul Lin, and Dr Amy Criniti. Dr. Dale Mcclure is a urologist, who specializes in infertility and sees patients at SRM with male factor infertility.
Please refer to their profiles regarding their particular interests and Reproductive Endocrinology and Infertility.
Who are our our nurse practitioners?
Tamara Tobias, ARNP,is a nurse practitioner experienced in infertility care exclusively taking care of patients at our Bellevue site.
Lindsay Wood, ARNP, is another experienced nurse practitioner experienced in infertility care taking care of patients at our Seattle site and participating actively in our busy egg donation program and IVF monitoring.
Both are taking new patients and can initiate fertility workups and patients interested in third-party reproduction, such sperm donation. If indicated, follow-up visits and consultation with our board-certified/eligible Reproductive Endocrinologists and Infertility Specialists can then be made.
Both can initiate the federal requirements necessary for our gamete sperm donation and egg donation programs.
To make an appointment with either NP, please call 206-301-5000 or apply online
Are the SRM physicians board-certified?
Dr. Michael Soules, Dr. Nancy Klein, Dr. Angela Thyer, Dr. Paul Lin and Dr. Amy Criniti are board-certified in obstetrics and gynecology.
All have successfully completed Reproductive Endocrinology and Infertility fellowships approved by the American Board of Obstetrics and Gynecology. Dr. Soules, Klein, Thyer and Lin are board-certified in the specialty of Reproductive Endocrinology and Infertility. Dr. Criniti is board-eligible in REI and will be certified in 2008.
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What infertility services are offered at SRM?
Routine evaluation of primary and secondary infertility are available, as well as second opinions regarding previous treatment and treatment options. Fertility assessment are available to all who desire information regarding fertility prognosis. Our SRM providers are experts in all aspects of infertility, i.e. fibroids, endometriosis, uterine anomalies, ovulation difficulties, fallopian tube problems, tubal ligation reversals, endometrial polyps, previously failed IVF cycles, etc.
A full range of infertility treatment are also available, including ovulation induction with oral medications and injections, intrauterine insemination (husband and donor sperm), reproductive surgery, assisted reproductive technology including in-vitro fertilization, embryo cryopreservation and transfer, egg donation with donors obtained in-house or from donor agencies, on-site accunpuncture, genetic counseling, fertility counseling, a mind-body program, gestational carrier (for women with medical conditions precluding pregnancy or with abnormal or absent uterus), and pre-implantation genetic diagnosis for patients with known genetic risks or high risk of aneuploidy, i.e. down's syndrome.
Is there an age limit for accepting/treating infertility patients?
Patients will be accepted for consultation until their 49th birthday. However, our age limit for IVF treatment is 45th birthday and our age limit for egg donor recipients is 50. Whether or not one is eligible for IVF treatment is more complex than merely age or FSH values. For individualized care and discussion of all options, please call 206-301-5000 or apply online.
Will SRM physicians perform tubal ligation reversals?
Yes, click here for more information.
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Is there a donor sperm insemination program at SRM?
Yes. Single or married women requesting donor sperm insemination will be offered consultation and treatment with donor sperm insemination with our nurse practitioner or any of our physicians. SRM does not maintain a sperm bank; therefore, donor sperm specimens will be supplied by an established approved sperm bank that follows FDA guidelines for donor screening.
SRM will provide information regarding donor sperm procurement and will assist patients in choosing a sperm donor, ordering, and shipping sperm samples. The frozen donor sperm can be stored in our facility.
Known sperm donors [i.e., who are known to the patient but are not her partner or an intended parent of the resulting child(ren)] will be required to undergo screening, sperm cryopreservation and quarantine for at least 6 months at an established sperm bank before their samples may be used for insemination at SRM.
Consultation with our certified Nurse Practioners, Tamara Tobias or Lindsay Wood, to complete the medical history and examination, education and appropriate consents to be signed and required bloodwork will need to be scheduled. Call 206-301-5000 or online.
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Is there a donor egg program at SRM?
There is a donor egg program, accepting patients with both anonymous and known or agency egg donors. There is extensive information on being an egg donor and being an egg recipient.
How do I apply to be an egg donor?
Apply online or call Amy Smith at 206-301-5013
What is the compensation for an anonymous egg donation?
Egg donors will be compensated $3500 per completed donation cycle. Repeat egg donors will be compensated $4000.
What does the SRM Donor Egg Program consist of ?
We have increased the support staff for the donor egg program. We will continue to recruit and provide anonymous egg donors in addition to working with agency donors. Our egg donor medical coordinator is a nurse practioner with extensive fertility experience who will supervise and approve pre-cycle testing, scheduling, and cycle initiation. Our donor egg team will help coordinate the pre-cycle egg donor testing required as by the FDA, and facilitate the education process.
Dr. Angela Thyer is the medical director of the SRM Donor Egg program. Your primary SRM physician will however be intensely involved in the preparation of the cycle and will formalize a treatment plan.
How do I get started if I am interested in a donor egg or want more information?
Call 206-301-5020 or make an appointment online with one of our SRM physicians.
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What if I do not live in Seattle?
At SRM, we have an extensive network of Ob-Gyn physicians and Nurse Practitioners in Montana, Alaska, and Eastern Washington.
Called the regional access network (RAN), you can find a local regional provider in your area by clicking here and calling their office to establish fertility care. Such providers have a special interest in treating infertility and its related issues.
If our services here in Seattle are required, such as in-vitro fertilization (IVF), these providers can perform all the pre-IVF workup necessary and reduce the time spent in Seattle during an IVF cycle by up to 50%.
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What services will be available to non-infertility patients?
We are accepting patients for evaluation, consultation, and treatment of all reproductive endocrinolgy issue, such as:
- premature ovarian failure and menopausal issues, including hormone replacement therapy
- amenorrhea
- delayed and precocious puberty
- menstrual cycles irregularities
- polycystic ovarian syndrome
- endometriosis and dysmenorrhea
- reproductive tract anomalies (e.g., birth defects of the uterus, vagina, cervix and external genitalia)
- hirsutism
- fibroids
- endometrial polyps (for reproductive-age patients)
Will general gynecology services be available?
In general, SRM will be devoted to the care of women of childbearing age with infertility or other reproductive endocrine problems. We suggest that routine gynecologic and preventive care be accessed through your general gynecologist or primary care provider.
For patients without a primary care provider who are seeking reproductive endocrinology or infertility services at SRM, we can provide basic preventive and primary gynecologic care.
Will obstetrical services be available?
We will provide first-trimester obstetrical services, such as ultrasounds to make sure the pregnancy is doing well, ectopic pregnancy and surgical and medical therapy for pregnancies not developing well, like first-trimester miscarriages.
However, once the pregnancy has been established to be “OK”, we will then refer you back to your referring provider (if you have one) or recommend an obstetrical provider once a normal pregnancy has been confirmed.
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What are my options for financing treatment at SRM?
In general, payment for services rendered will due at the time of the service, with both base fees ("package price") and fee-for-service options. Our financial counselors will assist you in determining insurance coverage, estimated costs, and payment options. Financial options including a Shared Risk Program will be available.
If you have any questions, please call 206-301-5000 and ask to speak to one of our financial counselors regarding your particular financial situation.
How much does it cost?
The cost of your infertility treatment and IVF depends on many variables, including your medical situation, the cause of infertility, the diagnosis code, your particular insurance and how much they will cover.
If your doctor is able to diagnose the cause of your infertility, medical or surgical procedures may be required to correct the problem. Some insurance policies (what insurances do we take?) will cover these surgical procedures or diagnostic tests.
Hormonal treatments require drugs, blood tests, and medical observation. Hormonal treatments in pill form cost several hundred dollars. Injectable drugs are more expensive and require closer medical monitoring. Expect to spend $1000 to $3000 for each treatment cycle with injectable drugs. Intrauterine insemination adds a few hundred dollars to either treatment options.
Assisted reproductive technologies (ART),such as IVF, are improving. The success of IVF or any other treatment depends on your particular medical situation, such as the severity of problem and whether or not multiple problems are present. A full evaluation and consultation with one of our SRM physicians will determine this for you.
IVF and other treatments are expensive because of the complexity of the procedures, the cost of equipment, and the time required of highly trained doctors and assistants.
The cost of an IVF cycle is around $8000-$9000 out of pocket expense (if you do not have insurance coverage), plus $3000-$5000 more for required medicines. Adding procedures such as ICSI, blastocyst culture or freezing embryos can add to the cost.
If you have extra embryos that aren't used in an IVF cycle, SRM will offer to freeze them for you and use them in a future cycle. A frozen embryo transfer cycle still requires medications and monitoring and can cost around $3000.
Will SRM accept my insurance?
SRM is currently in the process of negotiating contracts with all major insurance carriers. Our current list of insurances that we take is:
- First Choice Health Network
- Premera Blue Cross
- Regence Blue Shield
- United Resource Networks
- Uniform Medical Plan
- Group Health Cooperative
All patients will be able to meet with one of our financial counselors at each and every visit to help/assist determine coverage and provide an estimation of costs as well as financing options.
What will your insurance company pay?
More employers and legislative bodies are treating infertility as a real medical condition that should be covered by insurance. In the meantime, while many insurance plans cover the diagnosis of infertility, few cover treatment--where most of the treatment expense lies.
Examine your policy thoroughly and contact your insurance company to see what they will cover. See if you have a chance to upgrade your policy to one with more infertility coverage (perhaps when you start a new job or during open enrollment periods).
When you call your insurance company, take notes--and write down the name of the representative who speaks with you.
- Ask what your policy covers for infertility treatment, and what is excluded.
- Ask for details on which procedures and drugs are covered.
- Ask whether there is an age restriction or maximum lifetime benefit. Do you need a referral and how can you get one?
- Do you need to use a particular clinic to get coverage and if so, which ones?
Many policies do cover procedures your doctor uses to diagnose infertility. Your insurance may pay for blood tests, a hystersalpingogram, semen analysis, and initial examinations and consultations.
If your doctor finds a cause of the infertility, your insurance may cover procedures to correct it. For example, the cost of surgery to treat pelvic pain or endometriosis, even if it contributes to your infertility, may be covered under general medical treatment.
If your insurance policy covers only a small fraction of infertility treatment, choose the best clinic you can find for the best results. Costs may be remarkably similar between using an in-network or an out-of-network provider.
One of the problems with the convoluted rules of insurance is that certain procedures may be covered even though another, more appropriate--and perhaps even cheaper--procedure is not. Some doctors may try to save their patient money by attempting covered procedures first even if they have little chance of succeeding. This wastes time and may end up costing more in the long run. Ask your doctor to spell out all the options you have--and what odds you can expect--at each step.
Infertility advocates have developed ways to argue with insurance companies to cover treatment. For example, unless your policy specifically excludes infertility treatment, the insurance company should cover expenses.
In stating your case, remember that you have an illness, treatment is medically necessary, and infertility treatment is not experimental.
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Will there be psychological support and other ancillary services available?
Psychological counseling will be available, as well as a MindBody program.
We have acupuncture services on-site for those undergoing fertility therapy.
We have a geneticist on-site to discuss any preconceptional issues or pre-implantation genetic diagnosis, if applicable.
I am not a SRM patient, What if I want a sperm analysis or hysterosalpingogram?
Even if you are not an established SRM patient, with a referring physician/ARNP recommendation, you may have a hysterosalpingogram and/or semen analysis study performed by our practice. Click here for more details.
If you wish to schedule an appointment for the above services, please call 206-301-5000 or click here .
How will SRM support research studies to stay on the cutting edge of IVF treatments?
We will continue to perform clinical research related to ART, infertility, and reproductive endocrinology. Studies will be funded through pharmaceutical companies and other private funding sources.
All studies will be approved by either independent Human Subjects committees and will be offered to all eligible patients.
We will occasionally participate in industry-sponsored studies where free medication or discounted treatment will be available for study participants.
The SRM physicians and many support staff are active members of the American Society for Reproductive Medicine, the Society for Assisted Reproductive Technology, American Association of Gynecologic Laparoscopist, Seattle Gynecological Society, and we will continue to stay active with these organizations.
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What if I have embryos in storage at the University of Washington or another center?
If you have an interest in transferring you embryos to our facility, call and make an appointment with an SRM physician to establish yourself as a patient. (206-301-5000 or online) Our embryology lab administrator will then coordinate with the shipping institution or yourself to have those embryos shipped to our lab.
In all likelihood, you will have to contact your shipping embryology lab to make arrangements to transfer cryopreserved embryos to SRM and sign a notarized consent from the embryology lab that the embryos are coming from, agreeing to ship your embryos to our facility.
You will also need to sign a consent, on our end, to accept the embryos on your behalf.
What will happen to cryopreserved embryos at the UW FEC?
If you have any frozen embryos in the lab, you should have received a letter regarding your options for embryo disposition. If you did not, please contact the UW laboratory at 206-598-8785.
You may elect at any time to transfer your frozen embryos to SRM for future use. Make an appointment with one of the SRM physicians to discuss a frozen embryo transfer cycle.
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Do you have other offices?
Yes, in Bellevue. It is open and you can be seen there as a new patient. As an established patient, you can be seen here as well or interchangeably between sites based on your personal convenience. For directions, click here.
What pharmacy will you work with?
Patients will be free to use the pharmacy of their choice. For cost and convenience, we will probably utilize a mail order fertility-only pharmacy for many patients.
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Revised May 18, 2007. |
