Firstly, we offer telephone consultations to patients who prefer this method of initial contact. This is particularly applicable to the long-distance scenario. The phone consult allows patients to gain significant insight about the program and services offered without having to travel hundreds or even thousands of miles to the program. An in-person meeting can then be arranged at a later date.
Following a telephone consultation, and the decision is made to become a patient of USC Fertility, most long-distance patients prefer to have some of their lab work and/or cycle monitoring performed near their home before traveling to Los Angeles.
We have contacts all over the world and are comfortable working with fertility specialists and other physicians in order to make this type of arrangement proceed smoothly and result in a successful outcome. The type of monitoring and long-distance arrangements that need to be utilized depend on the type of treatment that is requested. The information that follows is designed to provide an overview of what might be necessary in a given setting. However, each patient is unique and therefore individualization of care is an integral part of the process.
In Vitro Fertilization (IVF)
Following consultation in our office or over the phone, an individualized stimulation regimen leading up to IVF will be designed. Under most circumstances, the first part of the stimulation regimen may be started when the patient is out of town. Monitoring is accomplished by a local physician and the results are communicated to our office, which then makes decisions regarding treatment modifications. The patient is scheduled to arrive in Los Angeles mid way through the cycle. In this way, the total stay in Los Angeles can be kept to a minimum, which is about one week.
Even though the egg donation cycle is more involved because of the synchronization between the cycles of two women. For long-distance recipients the process is simpler than IVF. After the initial consultation, the recipient is scheduled for a practice cycle which culminates in an endometrial biopsy and practice embryo transfer. It is at this time that the patient comes to the office and completes all of the paperwork associated with the cycle. When the cycle begins, almost all of the management can be done long-distance, since most of the hands-on work is performed on the egg donor. The donor is monitored in our office and the recipient only needs to arrive in town for the embryo transfer. We do need a sperm specimen on the day of egg retrieval. Most couples choose to arrive at this time and stay through the embryo transfer. Others choose to have the male partner fly in for the sperm specimen, then leave and return on the day of embryo transfer.
From a medical point of view, the addition of a gestational surrogate to the fertility cycle does not appreciably add medical complexity. Whereas the coordination between multiple individuals becomes more complicated, the medical process is virtually identical to that of egg donation. Therefore, long-distance intended parents may undergo a fertility cycle with a gestational surrogate without concern. As always, our nurses and physicians are available to talk with the intended parents and/or to provide information about the cycle.
If the intended mother is also the provider of the oocytes, a long-distance surrogate cycle would be similar to that of a long-distance IVF cycle. If an egg donor is also involved, the process would more closely resemble long-distance egg donation. Our office is well-experienced in all aspects of third-party parenting and however complex the scenario might be.