Frequently Asked Questions
Terra Policies & Practices
We hope this information is helpful in guiding your journey beyond office visits and communications with your care team.
The information provided on this website is intended for general educational and informational purposes only and should not be considered medical advice. Every individual’s medical history and circumstances are unique, and the information presented here may not apply to your specific situation.
Age cutoff
At Terra Fertility, we follow age guidelines designed to support the safest care and best possible outcomes.
- Egg Retrievals:
- For IVF: up to age 44 for most patients
- For egg freezing/fertility preservation: up to age 40 for most patients
- Use of Previously Frozen Embryos or donor egg: If embryos were frozen at an earlier age, they may be used for treatment up to age 52.
These limits reflect both natural changes in fertility and important considerations for maternal health and anesthesia safety.
Please note that many insurance plans set their own age limits for fertility coverage, which may be stricter than Terra Fertility’s policies. Even if you are medically eligible for treatment, your insurance provider may not cover services after a certain age
BMI cutoff
For patient safety, Terra Fertility has a BMI cutoff of 45 for any surgical procedure in the OR under anesthesia (including egg retrievals and operative hysteroscopy). Patients with a BMI above this threshold face higher anesthesia risks, particularly in an outpatient facility setting, where resources differ from those in a hospital. This policy ensures we can provide the safest possible care during procedures requiring anesthesia.
For intrauterine insemination (IUI) procedures, there is no BMI limit, as these procedures do not require anesthesia and can be performed safely across all BMI ranges
Our Team-Based Care Model
At Terra Fertility all our doctors are fully trained and experienced in managing all types of patients—regardless of background, diagnosis, or medical history. While you will meet with one of our physicians for your initial consultation and ongoing treatment planning, you may also see one of our other physicians during monitoring visits, procedures, or other aspects of your care.
They follow the same clinical guidelines and treatment protocols, ensuring that every patient receives consistent, evidence-based care. This approach allows us to provide seamless coverage, shared expertise, and the reassurance that—no matter which physician you are with—you are receiving the same high standard of compassionate, coordinated treatment.
Because of this unified approach, we do not offer inter-office physician changes. Patients can feel confident knowing that every physician at Terra Fertility provides the same high level of care, guided by the same principles and protocols.
How do I move my eggs, embryos, or sperm to Terra Fertility?
We partner with a specialized company called CryoFuture to coordinate the safe transport of eggs, embryos, or sperm. Your current clinic will have you sign release paperwork to allow the gametes to be shipped. At Terra, we’ll guide you through our importing consent forms. From there, CryoFuture manages all communication and transportation to ensure everything arrives securely.
**Please note we do not accept embryos from other IVF clinics for transfer. Exceptions are made for prior patients wishing to have continuity of care with their Terra physician.
What insurances do you take?
We are currently taking:
- Aetna
- Blue Cross Blue Shield – HMO & PPO
- Cigna Healthcare
- Commonwealth Care Alliance
- Harvard Pilgrim Healthcare
- Maven
- Tufts Health Plan Commercial
- Tufts Medicare Preferred SCO
- Tufts Medicare Preferred HMO
- Tricare/Humana
- United Healthcare
- United Healthcare SCO
- United Healthcare Medicare Advantage HMO
- Wellpoint (FKA Unicare)
- Wellfleet Group, LLC
Do you take Progyny insurance?
Unfortunately, we do not accept Progyny at this time, but we plan to add them in the future.
Do you offer interpreter services?
Yes! At Terra Fertility, we’re committed to making sure every patient feels fully supported and understood. To help bridge any language barriers, we utilize a professional translation platform that offers phone interpretation services, free of charge. This ensures that you can communicate comfortably with your care team in real time. Most languages are available, allowing us to provide clear, accurate, and compassionate care no matter your preferred language
What if I don’t want my partner to be at the consultation?
At Terra Fertility, we believe consultations are most meaningful when all decision-makers are present. If you are partnered and planning treatment together, we recommend your partner be present and participate in the initial consultation. This allows our team to gather a complete medical, personal, and family history, answer questions for both of you, and ensure that all treatment recommendations are based on the full picture of your circumstances and goals. NOTE: If they are unable to join your initial consult, partners must still must complete their registration and medical history prior to your consult.
What if I don’t want my partner tested at this time?
We believe that fertility care is most effective when we have a full understanding of both partners’ health. If you are partnered, we strongly encourage both partners not only attend the initial consultation but also complete their individual fertility workups. This ensures we have all the necessary information to create a treatment plan that is accurate, comprehensive, and tailored to your shared goals.
If you are partnered but considering egg freezing only, then your partner does not need to register or get any testing done.
How does testing and monitoring work at Terra?
At Terra Fertility, all testing/monitoring currently takes place on Mondays, Wednesdays, and Fridays. We’ve intentionally designed our protocols to avoid unnecessary overmonitoring, which many clinics do without adding any proven medical benefit. The treatment approaches we use allow for less frequent, but equally effective monitoring, keeping your care safe while reducing extra visits.
Our in-cycle monitoring is also scheduled ahead of time, so you can better plan work, family, and life around your treatment. We believe fertility care should support your life, not disrupt it—and our streamlined, thoughtful approach to monitoring reflects that philosophy.
If you are undergoing initial hormone testing that is cycle-specific, we will bring you in during cycle days 1–5, and uterine cavity evaluations between cycles day 5-12, as that timing is important for accurate results.
Where can I do my cycle monitoring?
You have several options for monitoring, and we’ll help you choose the location that works
best for your schedule:
- Terra Fertility – Dedham Office (our main physician office)
Mondays, Wednesdays, and Fridays
6:15 – 9:15 AM - Terra Fertility – Seaport Office (our satellite office)
6:15 – 9:15 AM
Do you offer outside monitoring?
At this time, we do not.
When do you do egg retrievals/embryo transfers?
At Terra Fertility, egg retrievals and embryo transfers are thoughtfully scheduled on set days each week.
This approach allows us to optimize our team and resources so that every patient receives the highest level of attention during these important moments in their treatment. By having a predictable schedule, you’ll know your expected procedure dates well in advance—making it easier to plan work, travel, and daily life with greater confidence. While our schedule is structured, your care is never compromised—your safety, outcomes, and experience remain our top priority. This model ensures smooth coordination, predictability, and the same individualized, patient-centered care that defines Terra Fertility.
What are Terra Fertility’s IVF protocols?
At Terra Fertility, we use several IVF protocols tailored to your individual needs. Many patients start on our Provera or Antagonist protocol, which involve daily injectable medications to grow eggs, with a carefully timed “trigger shot” (Lupron, hCG, or both) to prepare for egg retrieval. These approaches work well for first-time patients, typical responders, and those with PCOS.
For patients who prefer gentler stimulation or lower medication costs, we sometimes use a Clomid-based protocol, which combines pills with lower-dose injections. For patients with very low ovarian reserve or who haven’t responded to standard protocols, we may use a Microdose Lupron Flare protocol, which involves higher doses of injectable medication and a different timing strategy.
Your doctor will recommend the protocol that best balances effectiveness, safety, and your comfort, based on your test results, history, and goals.
All of our initial testing came back normal; why am I not getting pregnant?
Fertility can be complex, even when everything looks normal. Infertility with normal initial testing is called “unexplained infertility.” This typically means that the issue is at a more microscopic level, requiring a higher level of treatment to overcome. The good news is that there are effective treatment options, and we’ll guide you step by step.
When will my genetic blood test for carrier screening be available?
Carrier screening results usually take about 2–3 weeks. As soon as they’re back, a genetic counselor from Natera will review them with you.
Can I use my hot tub/sauna or do hot yoga during treatment and/or pregnancy?
It’s best to avoid these during treatment, as high heat can affect egg quality, sperm, and early pregnancy.
Is this really my period? What is cycle day 1?
Cycle day 1 is the first full day of red flow requiring a pad or tampon, not just spotting.
Why am I bleeding between periods? Is this normal?
Light spotting between periods can happen and may not be a concern. Still, let us know so we can review your history and make sure everything is on track.
Should I stay on all my prescribed meds during treatment for high blood pressure, thyroid, depression, etc.?
Yes—never stop prescribed medications without talking to your doctor. We’ll coordinate with your other providers to make sure your treatment plan is safe.
Can I drink coffee during treatment or other caffeinated beverages?
Yes, in moderation. One to two small cups of coffee (or up to about 200 mg of caffeine) per day is considered safe.
Do I need to get a flu shot? Does it need to be without preservatives?
We recommend getting the flu shot before or during treatment. The preservative-free version is preferred when possible, especially if you’re pregnant.
Do I need to get the COVID vaccine?
Yes, we recommend it. The COVID vaccine is safe in fertility treatment and pregnancy, and it helps protect you and your future baby.
Why do I need to take low-dose aspirin?
Low-dose aspirin can improve blood flow to the uterus and may lower the risk of certain complications. Your provider will let you know if it’s recommended for you.
Is it okay to go to the dentist?
Yes, dental care is safe and important during fertility treatment and pregnancy
Can I get Novocaine at the dentist?
Yes, Novocaine (and similar local anesthetics) are safe. Be sure to tell your dentist you are in fertility treatment.
Is it OK to get my hair colored?
Yes, hair coloring is safe during fertility treatment. In pregnancy, we typically recommend limiting exposure to potential toxins, especially in the 1 st trimester, but we defer to your OB.
Is it OK to get a manicure and pedicure?
Yes, those are safe. Choose a well-ventilated salon for comfort
Is it OK to get a body massage?
Yes, massage is safe. Just let your therapist know you’re in treatment so they can avoid deep pressure on your lower abdomen.
Is there a restriction on herbal supplements?
Yes, we recommend stopping herbal supplements unless they’ve been approved by your doctor. Many haven’t been studied for fertility and could interfere with medications. Of note: high dose biotin (hair/skin/nails supplements) can interfere with our lab assays and should be stopped prior to treatment.
Are there any services available to help me (and my partner if applicable) through this very stressful fertility journey?
Absolutely. At Terra, we can connect you with counselors, support groups, and wellness resources to help you and your partner feel supported through every step of this journey. Take a look at our Wellness page to learn more.
Are kids allowed at office visits?
We love kids! However, out of respect for those still on the journey we ask that all in person visits be adults only.
Medication & Supplements FAQ
What supplements do you recommend for patients trying to conceive?
Prenatal vitamin with at least 400mcg folic acid + vitamin D 2000iu daily.
What supplements do you recommend for egg quality?
CoQ10 600mg daily is our favorite – your doctor will review any supplements that are appropriate for your clinical picture at your consult. These may include NAC and SeroVital.
What supplements do you recommend for PCOS?
Inositol, NAC, Metformin (prescription); your doctor will review any supplements that are appropriate for your clinical picture at your consult.
I’m on a GLP-1 medication (Ozempic, Wegovy, Zepbound); can I continue this?
These medications should be stopped at least 2 months prior to trying to conceive (or starting fertility treatment if planning a pregnancy). If only planning egg/embryo freezing, it must be stopped with the start of your stimulation injections prior to your egg retrieval, then may be re-started afterwards if not conceiving.
When am I going to get my period after Provera/Prometrium?
Most people will see bleeding within 2–10 days after finishing the last dose. If you don’t get a period after two weeks, let us know so we can check in.
When am I going to get my period after OCPs (birth control pills)?
Your period usually starts within a few days after stopping the pack. If you’re on continuous pills, timing may vary—your team will guide you based on your cycle plan.
When am I going to get my period after my trigger injection? (Lupron vs. HCG/Ovidrel)
- Lupron: Bleeding often comes about 5–7 days later.
- HCG/Ovidrel: More like a natural ovulation—your period usually comes about 10– 14 days later.
I have a rash/reaction after injecting Cetrotide®/Ganirelix®…is this ok?
Mild redness, itching, or small bumps at the injection site are common and usually not dangerous. Apply a cool compress and rotate injection spots. If the reaction is spreading, worsening, or you have trouble breathing, call us right away.
Is there any difference in effectiveness between Crinone and Endometrin?
Both support the uterine lining equally well. The difference is mostly in form (gel vs. suppository) and dosing.
Is it OK if I take my stimulation meds (Gonal-F/Menopur) a few hours late tonight because I’m going to a concert?
A small delay of a few hours is usually fine—try to take them as close to your usual time as possible. Just don’t skip. If you’re ever more than 12 hours late, give us a call.
Is it OK if I take my “trigger” shot (HCG/Ovidrel/Lupron) a few hours late tonight because I’m going to a concert?
No—this one is different. The trigger should be taken on time (within 15 minutes) for your egg retrieval to be safe and successful. Please plan around this—set multiple alarms, and if timing is ever in question, call us before making changes.
Can I take ibuprofen/Motrin®/Aleve® (NSAIDs) after egg retrieval for pain? Or still only Tylenol? Freeze-all cycle vs. Fresh embryo transfer?
- If you’re doing a fresh embryo transfer, stick with Tylenol only, since NSAIDs may affect implantation.
- If you’re doing a freeze-all cycle (no transfer this month), short-term NSAID use like ibuprofen for discomfort is generally OK.
The label on the HCG trigger says to take IM (intra-muscular), but the nurse told me SC (sub-cutaneous) like all my other IVF cycle meds. Which do I do?
We will always have you administer your trigger injection via subcutaneous injection
I missed my dose of birth control, estradiol, Crinone, Clomid, letrozole; should I double up? Or just keep going?
Don’t double up unless we specifically tell you to. In most cases, just take the missed dose as soon as you remember and then continue as scheduled. Let us know so we can advise you for your exact medication.
What if I need to get more medication?
Please reach out to the pharmacy as soon as possible to request a refill and avoid any interruption in treatment. If you encounter any issues with the refill process or prior authorizations, inform your nursing team right away. Many fertility medications are classified as specialty drugs and are only available through specialty pharmacies. Because of their specific locations and shipping restrictions, it’s important to allow at least 2–3 business days for processing and delivery.
Do I have to take my fertility medications at the exact same time every day?
We recommend taking your medications at roughly the same time each day to keep hormone levels steady. You do have a two-hour window, so they don’t need to be exact to the minute (except for the “trigger” injection), but keeping them consistent helps your treatment run smoothly.
What if I forget a dose?
If you miss a dose, don’t panic. Call our nursing team right away, and we’ll guide you on what to do. Each medication is a little different, and the safest approach is to confirm with us before making up a dose.
Are there side effects I should expect?
Yes—fertility medications can cause bloating, mood changes, headaches, or injection-site soreness. Most are temporary and manageable. If you experience anything severe—like shortness of breath, sudden swelling, or significant pain—call us right away or head to your local emergency department.
Can I travel while on medications?
Yes, but planning is key. You’ll need to keep medications refrigerated, travel with your supplies, and stay close enough for monitoring appointments. If you’re considering travel, let us know early so we can help you prepare.
Can my partner help with injections?
Absolutely. Many partners find it meaningful to take part in this step. We encourage you both to review the EngagedMD videos so that whoever gives the injection feels confident and safe.
Do I need to stop vitamins or supplements while on fertility meds?
We recommend continuing a prenatal vitamin with folic acid. Other supplements should be reviewed with your doctor, as many fertility-branded supplements are not proven and could interfere with your treatment.
Can I drink alcohol while taking fertility medications?
It’s best to limit alcohol before an egg retrieval or IUI to 0-2 drinks per week and then stop completely after IUI or transfer.
What happens if my pharmacy gives me the wrong medication or dose?
Call us right away before taking anything. Mistakes are rare but can happen, and we’ll verify everything for your safety. Always check labels when you pick up your medication.
How long will I need to be on medications?
It depends on your treatment plan. For IVF stimulation, medications usually last 8–12 days. For IUI cycles, protocols can be shorter. We’ll map out the timeline for your specific plan so you know exactly what to expect.
Why are fertility medications so expensive?
The cost comes from the complexity of production and the fact that insurance coverage can vary. We can connect you with pharmacy programs that may help reduce the cost.
Can I use generic medications instead of brand names?
In some cases, yes. But not all fertility drugs have generic equivalents, and sometimes mixing brands can cause confusion. We’ll help determine the safest and most effective option for you.
Do fertility medications increase my risk for cancer?
Current research shows no increased long-term cancer risk with fertility medications. Safety data has been closely followed for decades, and we will always keep you informed of the most up-to-date studies.
Will I gain weight on fertility medications?
You may notice temporary bloating or water retention, but most people do not have significant weight gain. These changes usually resolve once medications stop.
How do I store my medications?
Some medications need refrigeration, while others can stay at room temperature. We recommend reviewing the packaging closely and asking either the pharmacy or your nursing team for clarification, and we encourage you to keep everything organized in one spot for easier use.
IUI FAQ
What is IUI?
IUI stands for intrauterine insemination. Washed sperm is placed directly into the uterus at the time of ovulation to help increase the chances of pregnancy.
Who is IUI recommended for?
IUI is often recommended for patients where the partner has mild male factor infertility, or unexplained infertility, or when donor sperm is being used.
How do I know if I’m a candidate for IUI?
Your doctor will review your history, testing, and goals. If your fallopian tubes are open, your uterus has a healthy shape and lining without fibroids, polyps, or scarring, and sperm quality is reasonable, IUI may be an option.
When do you do IUIs?
At Terra Fertility, intrauterine inseminations (IUIs) are performed Monday through Friday, excluding holidays. We coordinate your monitoring carefully so that your IUI can be timed at the optimal moment—most often by scheduling ultrasound and lab checks and using a trigger medication to precisely time ovulation
What is a typical IUI cycle timeline?
An IUI cycle at Terra Fertility usually begins with your period. If oral medications are part of your plan, they start on cycle day 3. Around cycle day 10–12, you’ll come in for monitoring to track follicle growth. Once a follicle is ready, you’ll take a trigger shot, and the insemination is done approximately 24–36 hours later in a quick, simple office procedure. About two weeks afterward, we check for pregnancy with a blood test and guide you on next steps.
What can I expect the day of the IUI?
When you arrive for your IUI, you’ll check in just as you would for a monitoring appointment. If your partner is providing a fresh semen sample, this will usually be collected that morning in our office and then prepared in the lab. If you are using frozen donor sperm, the vial will be thawed and processed in advance.
Once the sample is ready, you’ll be brought into an exam room. The procedure itself is very similar to a Pap smear: a speculum is placed in the vagina so we can see the cervix, and then a thin, soft catheter is gently passed through the cervix into the uterus to place the prepared sperm. The process takes only a few minutes. You may feel mild cramping or pressure as the catheter passes through the cervix, but most patients find it very tolerable. Afterward, there are no restrictions on activity, you can return to work, exercise lightly, and resume your normal routine.
Do I need a full bladder for the IUI?
For IUI we ask that you have a comfortably full bladder. This may make the IUI easier. Emptying your bladder an hour before, then drinking 16-20 ounces of water is usually sufficient.
Will I need to be off from work on the day of my IUI?
Most patients are able to return to work the same day. The IUI itself is a quick procedure, similar to a Pap smear, and recovery is minimal.
How many IUIs should I try before considering IVF?
Most patients attempt 3 IUIs before moving to IVF, but this is personalized based on your age, diagnosis, and response.
Do I need to take medications for IUI?
Some IUIs are done naturally, while others use oral or injectable medications to stimulate the ovaries. Your doctor will recommend what’s best.
Can I resume normal activities after IUI?
Yes, you can return to work, exercise, and daily life right away unless instructed otherwise.
Do I have to take time off from work?
Usually not. The visit takes less than 30 minutes, including check-in.
What happens with the sperm sample?
Sperm is washed and prepared in our andrology lab to concentrate the healthiest sperm before insemination.
Can we use frozen donor sperm for IUI?
Yes, we regularly work with donor sperm banks. The vials are thawed, washed, and used just like a fresh partner sample.
Can my partner be present for the IUI?
Absolutely. We encourage partners to be there to support and share the moment.
What if my partner can’t produce a sample on the day of IUI?
Backup frozen samples can sometimes be arranged. Discuss this in advance with your care team.
What are the risks of IUI?
IUI is generally very safe, but like any procedure it carries some risks. These may include a small chance of infection (less than 1%), light spotting or cramping afterward, and the possibility of multiple pregnancy if fertility medications are used. Some patients notice temporary medication side effects such as bloating, mood changes, or hot flashes.
What are the chances of success with IUI?
Success depends on age, diagnosis, and treatment plan. On average, pregnancy rates range from 10–20% per cycle.
Is it possible to have twins with IUI?
We don’t ever intentionally aim for twins, but it can happen—especially if fertility medications are used. Your care team will monitor you closely to reduce this risk and prioritize a safe, healthy pregnancy.
How often will I need monitoring during an IUI cycle?
You’ll possibly have 1–3 monitoring visits for ultrasounds and/or bloodwork to track follicle growth and timing.
What medications might be prescribed for an IUI cycle?
Options include Clomid/Letrozole (oral) or gonadotropins (injectables), sometimes paired with a trigger shot to time ovulation.
Can IUI be done with my natural cycle?
Yes. If you ovulate regularly and your doctor recommends it based on your clinical picture, an unmedicated IUI may be indicated.
Can I have intercourse after the IUI?
Yes, it’s fine to have intercourse after the procedure, but it’s not necessary for success. The insemination itself provides the needed sperm for fertilization. Note: this is different than IVF or an FET, where you CANNOT have intercourse during the cycle.
Does it help to have an orgasm the night before my IUI? Or after the IUI?
There’s no medical evidence that orgasm before or after an IUI improves success rates. It’s completely up to you.
Should I rest after the IUI?
There is no medical need for rest after the procedure.
Can I exercise during my IUI cycle?
Light to moderate exercise is usually fine. Avoid high-impact or strenuous activity after ovulation.
What if the IUI cycle doesn’t work?
It is typically reasonable to try more than one IUI cycle if it isn’t successful right away. At any time, if you’d like to shift gears, you can meet with your provider to explore other options such as IVF.
Can I do back-to-back IUIs in the same cycle?
At Terra, we follow evidence-based practice and do not recommend double IUI within the same cycle, as research shows it does not increase pregnancy rates (and carries insurance/financial implications). A single, well-timed IUI gives the same chance of success.
Do I need progesterone after IUI?
For most patients, no; progesterone isn’t routinely needed after IUI. If you have a specific history or diagnosis that makes it helpful, your doctor may recommend it for luteal support.
IVF FAQ
Why do you track my estradiol (E2) level?
Estrogen reflects how your follicles are growing. Rising levels show your ovaries are responding to medication, and we use this to fine-tune your protocol.
My estrogen seems low—should I worry?
Not necessarily. Everyone responds differently. We look at the whole picture—bloodwork plus ultrasound—to guide decisions.
My estrogen is very high—does that mean better results?
Not always. Very high estrogen can mean many follicles, but it can also increase risk of side effects like bloating or OHSS. We monitor closely for safety.
Why is my progesterone checked before retrieval?
We sometimes check progesterone levels, especially if a fresh embryo transfer is planned. If it rises too early, it may affect the uterine lining, so we sometimes adjust the plan or recommend freezing embryos.
What does LH tell us?
Luteinizing hormone (LH) helps us know if your body is trying to ovulate on its own. A significant rise in LH just before ovulation is called the “LH surge.” We want to avoid a premature ovulation before the egg retrieval.
Why do you count the number of follicles on ultrasound?
Counting follicles gives us an estimate of how many eggs might be retrieved. We also measure their size, since follicles need to reach a certain maturity before they’re ready. Not every follicle will contain a mature egg, but tracking both number and size helps us plan the best timing for retrieval.
Why do some follicles grow faster than others?
That’s normal. Not every follicle matures at the same pace. We focus on the majority reaching maturity together.
What size do follicles need to be before retrieval?
Typically 17–20+ mm, but a range from approximately 14-24mm can often result in an egg being retrieved. We look for a group of mature follicles before giving your trigger shot.
Do you always do blood work and ultrasound on the same day?
Sometimes we check just bloodwork, sometimes just ultrasound, and other times both. It depends on where you are in your cycle and what information is most important that day. This way, we get exactly what we need without unnecessary testing.
Why didn’t I have to do a baseline scan and labs?
At Terra, we don’t require baseline bloodwork or ultrasounds before every IVF cycle. Many clinics do them by routine, but research shows they rarely change outcomes. Our protocols are designed so that you can start stimulation without the extra step, making the process simpler and less disruptive while keeping safety and efficacy front and center.
When will my PGT (embryo biopsy) results be available?
Results are typically ready about 2 weeks after embryo biopsy. We’ll notify you as soon as they are available and guide you through what they mean for your treatment plan.
What are the success rates for me?
Success rates vary depending on your age, diagnosis, and treatment type. Your physician will review your personal chances based on your history so you have realistic expectations.
Is acupuncture helpful? Is it recommended?
Some patients find acupuncture relaxing and supportive during treatment. While studies are mixed, it is safe if done by a licensed provider. Whether or not you choose it is entirely up to you. There are many wonderful, local acupuncturists who are experienced in working with fertility patients. A list can be found at: https://www.terrafertility.com/wellness/
Why do I need to take progesterone after my embryo transfer?
Progesterone in some form may be used in your cycle as part of luteal support, which hormonally supports an early pregnancy before the placenta takes over. Your doctor will determine which protocol to use and what, if any, progesterone support will be used.
Can I fly during IVF stimulation? Can I fly/travel after embryo transfer during the 2- week wait before my first pregnancy test? Can I fly/travel after I find out I’m pregnant?
During stimulation, short travel may be possible if monitoring and injections are not interrupted. After embryo transfer, light travel is usually fine, though we recommend avoiding very strenuous or long trips until after your pregnancy test. Once pregnancy has been established, travel is generally safe in early pregnancy.
Is it ok if I exercise/run after IUI? After ET or FET?
Light activity is fine after IUI. After an embryo transfer, we recommend avoiding vigorous exercise until after your pregnancy test. Gentle movement, like walking or stretching, is safe and encouraged.
Is it ok for me to lift my toddler while on stimulation medication and after the egg retrieval or embryo transfer?
Lifting your child occasionally is safe, but we encourage you to avoid heavy or repetitive lifting during stimulation and right after retrieval or transfer. Listen to your body and use caution.
Can we have intercourse during IVF treatment?
Yes, though we advise using protection during stimulation. Around the egg retrieval we ask that you abstain to avoid multiple pregnancy and/or risk of ovarian torsion.
Can I just bring in my partner’s sample for him?
No. For safety and uninterrupted chain of custody to prevent error, we require the person providing the sample to come in, present unexpired photo ID, and confirm their identity at the time of collection or drop-off.
Do I need a ride home after my egg retrieval?
Yes. Because IV sedation is used, you need a ride home with a known adult (though a support person is not allowed in the operating room). For safety reasons, we cannot discharge you to a rideshare service.
Do I need a ride home after my embryo transfer?
No sedation is used, so you can drive yourself home afterward. Your partner or a support person is welcome for the embryo transfer if you wish.
Do I need a full/empty bladder for a vaginal/abdominal ultrasound?
For vaginal ultrasounds, your bladder should be empty. For abdominal ultrasounds (often used during embryo transfer), we ask that you have a comfortably full bladder to help us see clearly. Simply not emptying your bladder prior to the embryo transfer is typically sufficient.
What is embryo grading? What does it mean as far as being genetically normal?
Embryo grading looks at the appearance of the embryo under a microscope by a trained embryologist or lab scientist. It gives us some information about the embryo, but it does not guarantee whether the embryo is genetically normal. Only PGT can provide that information.
For treatment with IUI/IVF/IVF with PGT-A: what are my chances of success?
Your chances depend on many factors, especially your age and diagnosis. We’ll review your personal outlook with you, using clinic and national data, so you know what to expect.
In general, IUI aims to restore your chance of success by age as if you did not have a fertility issue, therefore success rates are no higher than 25% per month for the youngest patients using donor sperm, and closer to 8-10% per month for older patients or those with unexplained infertility. IVF success rates are typically higher, and up to 60-70% per euploid (tested and chromosomally normal) embryo transfer.
What is the risk of miscarriage with IUI/IVF/FET?
The risk of miscarriage is similar to natural conception and increases with maternal age. IVF with PGT-A may lower this risk by helping us select chromosomally normal embryos.
I had one embryo transferred; why am I pregnant with twins?
Very rarely, a single embryo can split after transfer and result in identical twins. This is uncommon (approximately 1-3% risk) but possible with IVF.
What’s the chance of having an abnormal embryo with PGT-A?
The chance of an abnormal embryo increases with age. Even younger patients may have some abnormal embryos, but older patients see this more frequently.
I had PGT-A done and a normal embryo was transferred; why didn’t I get pregnant?
Even when we transfer a chromosomally normal embryo, other factors—like implantation, uterine environment, or embryo biology can affect the outcome. Unfortunately, PGT-A cannot guarantee pregnancy.
I’m under age 40—why are my embryos abnormal?
All people, regardless of age, make some abnormal embryos. While it’s more common as we get older, younger patients can also have abnormal embryos due to natural variations in egg and sperm development.
Should I add PGT-A to my IVF cycle?
Most data that show benefit with PGT-A are in patients over age 35-37. However, some younger patients may also benefit or feel strongly about testing their embryos, for example due to a history of recurrent miscarriage or implantation failure with untested embryos. PGT-A has not been shown to overall increase chance of pregnancy, as it does not change your embryos, but rather as a selection tool may increase efficiency. PGT-A is often not covered by insurance and pricing is listed on our website if your insurance does not cover it.
What options are available for my remaining embryos?
If you have remaining embryos after completing your family-building journey, there are several options to consider. Depending on your circumstances and preferences, you may choose to continue storing your embryos, discard them, donate them for research, pursue embryo donation (when appropriate), or choose a compassionate embryo transfer.
A compassionate embryo transfer places the embryo in the vagina or cervix rather than the uterus, allowing it to pass naturally without the intention of achieving a pregnancy. Our team is available to discuss each option with you, answer your questions, and help you make the decision that feels right for you.
Pregnancy FAQ
When will I have my first ultrasound after a positive pregnancy test?
We usually schedule your first ultrasound around 6–7 weeks of pregnancy. This allows us to confirm that the pregnancy is developing in the right location, the size/growth of the embryo, and to see the early heartbeat if it’s present.
When should I call my OB to set up care?
We recommend reaching out to your OB or midwife soon after your pregnancy is confirmed, so you’re established with them once your care transitions.
I’m pregnant and spotting. Is this ok?
Spotting can happen in early pregnancy and isn’t always a sign of a problem. Sometimes it relates to implantation, cervical sensitivity, or other benign causes. That said, we always want to know if you are experiencing bleeding during pregnancy. Please reach out through the patient portal or call us so we can guide you and decide if additional evaluation is needed.
If I am not pregnant after my cycle, can I try again right away?
In most cases, yes, you may move right into another cycle if you’re ready emotionally and physically. Sometimes your provider may recommend a brief pause depending on your response to medication, your overall health, or the specifics of your treatment plan. We’ll guide you individually so that your next step feels safe and supported.
I had a miscarriage. Can I try again right away?
In most cases, it is physically safe to try again as soon as the pregnancy has resolved and you feel ready, sometimes even with your very next cycle. Some people prefer to take a little more time to heal emotionally before moving forward, and that’s just as important. We may recommend additional evaluation depending on your medical history or the type of miscarriage, and we will follow your HCG level down to negative prior to another cycle.
Can I eat fish/sushi/unpasteurized cheese/dairy?
Once pregnant, we recommend following general pregnancy safety guidelines: choose cooked fish and avoid raw sushi, limit high-mercury fish (like swordfish or king mackerel), and avoid unpasteurized cheeses or dairy products to reduce infection risk. Many types of cooked fish, pasteurized cheeses, and dairy are safe and provide important nutrients. When in doubt, ask us or double-check with your OB provider.
How many hCG levels (blood tests for pregnancy) do I need? Can I get another hCG level just to be sure?
Most often, we check two hCG levels 48-96 hours apart to confirm a healthy rise. Depending on your numbers and your individual situation, your doctor may recommend additional testing. More hCG tests aren’t always helpful, but we will extend monitoring if it’s clinically appropriate to reassure you and guide next steps.
Why is my hCG rising abnormally? Why do you need to follow so closely/what is the risk?
An hCG rise that is slower or lower than expected can mean different things, such as an early miscarriage, an ectopic pregnancy, or a non-viable pregnancy. That’s why we monitor closely: to protect your health, ensure early detection of complications, and give you clear answers as soon as possible.
My hCG levels are normal; why am I bleeding?
Bleeding in early pregnancy can be unsettling, but it does not always mean miscarriage. Some people experience bleeding with completely healthy pregnancies. We may recommend an ultrasound or continued monitoring to understand what’s happening. We’re here to support you and will guide you through each step.
Will I stay with my doctor throughout pregnancy?
You’ll stay under our care through your first ultrasounds in early pregnancy. After that, we’ll transition your care to your obstetrician or midwife, who will continue with your prenatal care and delivery. We’ll make sure you have a smooth handoff and feel supported every step of the way.
What vitamins or supplements should I take now?
A prenatal vitamin with folic acid to prevent neural tube defects is most important.
Can I travel while pregnant?
Yes, you are able to travel in the first trimester. We recommend travel to areas where medical care is available should you experience any early pregnancy complications.
Testing Questions
What does my FSH result mean?
FSH or Follicle Stimulating Hormone helps us understand ovarian function. Higher levels >10-12 can suggest fewer eggs available, but age and AMH matter too.
What is AMH, and why did you test it?
AMH or Anti-Müllerian Hormone reflects ovarian reserve, or remaining egg pool from a quantitative standpoint. It helps us predict your dosing and response to medication for IVF but doesn’t determine fertility alone.
What is an antral follicle count?
That’s the number of small resting follicles 2-9mm seen on ultrasound at the start of your cycle. It gives us a snapshot of your ovarian reserve.
What does it mean that I have a cyst on my ovary? Is this bad?
Ovarian cysts are common and often harmless. Some resolve on their own, while others may affect your cycle. Your provider will let you know if any action is needed.
Why do you check my thyroid (TSH)?
Thyroid balance is important for fertility and especially pregnancy, where fetal brain development relies on maternal thyroid hormone. We ensure your TSH is in the optimal range before treatment.
Why is my prolactin level tested?
High prolactin can interfere with ovulation, so we may check prolactin if you are not having regular cycles. If your level is abnormal, we’ll repeat the test to confirm, and in some cases head imaging may be needed before starting treatment to evaluate for a benign growth on the pituitary gland in the brain. This is common and can easily be treated with oral medication if it is diagnosed.
Why do you test my blood type and antibody screen?
It’s standard before treatment and important for safe pregnancy care. If you are Rh Negative, you need a medication called Rhogam during pregnancy to prevent complications for you and your baby.
Why do you check infectious disease labs?
It’s required by the FDA for safety before handling eggs, sperm, and embryos, and to protect both you and your future child.
Why do you test my partner’s labs too?
We ask both partners to complete labs each year to keep treatment safe for you and your future pregnancy, and to give us the information we need for embryo planning.
What medications are safe to take in early pregnancy?
For pain or fever we recommend Tylenol – avoid NSAIDS such as Ibuprofen, Naproxen, Advil etc
For morning sickness we recommend 10-25 mg of Vitamin B6 taken three to four times daily, combined with 12.5-25 mg of Unisom
Over the counter acid reflux, constipation, and allergy medications are all safe to continue in early pregnancy
Frozen Embryo Transfer FAQ
What is a frozen embryo transfer (FET)?
An FET is when an embryo that was previously frozen is thawed and transferred into the uterus. It’s a common next step after IVF when embryos are stored for later use.
What are Terra Fertility’s FET protocols?
At Terra, there are two main ways to prepare the uterine lining for a frozen embryo transfer (FET). Your doctor will recommend the option that best fits your history, preferences, and prior response.
- Hormone Replacement (Programmed) FET This approach uses estrogen and progesterone in oil to build and support the uterine lining. It offers predictable scheduling and is especially useful for patients with a history of thin lining, premature ovulation, anovulation, or those who prefer a fully medication-controlled cycle.
- Modified Natural Cycle FET This approach uses your body’s own ovulation (often supported with letrozole and a trigger shot) to prepare the lining, followed by vaginal progesterone. It avoids daily estrogen pills and progesterone injections, making it a good option for patients who ovulate regularly, prefer fewer injections, or who have not done well with programmed cycles.
Both protocols aim to create the best possible environment for your embryo. Your provider will review which is right for you and tailor the timing and medications accordingly.
Will I need monitoring before the transfer?
Yes. We’ll check your lining by ultrasound and may do bloodwork to confirm hormone levels are in the right range for implantation prior to transfer.
Why is my lining not thick enough yet?
Some people respond slowly. We may adjust estrogen support or extend monitoring until it’s ideal for transfer. We typically aim for an endometrial lining >7mm prior to trigger shot or starting PIO in an FET cycle, but this varies patient to patient. The good news is that there is reassuring live birth data for patients with thinner lining 5-7mm.
What does “trilaminar” lining mean?
It’s a description of how the uterine lining looks on ultrasound—showing three distinct layers. This pattern is often seen in cycles where the lining is developing well, close to the time of ovulation.
What if my uterine lining doesn’t thicken enough?
Your provider may adjust your medications, add additional support, or delay the cycle. Sometimes it’s best to pause and try again in a future cycle.
Is the transfer procedure painful?
The procedure is usually quick and feels similar to a Pap smear. Most people experience little to no discomfort.
How many embryos will be transferred?
Our goal is always one healthy pregnancy at a time. In most cases, we recommend transferring a single embryo to minimize the chance of multiples.
Can I work or exercise after the transfer?
Yes. Light activity, walking, and going back to work are fine. We may ask you to avoid strenuous exercise or high-impact workouts for a short time.
When will I know if the FET worked?
We schedule a blood test about 9–12 days after the transfer to check for pregnancy. At home testing can be inaccurate in early pregnancy, so we recommend waiting for your official blood test.
What happens if the transfer doesn’t work?
You’ll meet with your doctor to review the cycle and discuss next steps. Some patients try another FET cycle, while others may consider adjusting the protocol.
Can I choose which embryo to transfer?
If there are multiple embryos available, we’ll guide you based on embryo grading, genetic testing results (if done), and your personal goals. We’ll always involve you in the decision.
Do I need to have a full bladder for the transfer?
Yes, a comfortably full bladder helps us guide the catheter more easily with ultrasound. Simply not emptying your bladder just before your transfer is typically sufficient.
Is bed rest needed after transfer?
No. Research shows that normal activity is safe, and bed rest does not improve outcomes. Gentle movement and resuming daily life is encouraged.
What if I start bleeding before my pregnancy test?
Light spotting can be normal after transfer, especially if you’re on progesterone. It doesn’t always mean the cycle didn’t work. Call us if you have concerns, and we’ll guide you
What options are available for my remaining embryos?
If you have remaining embryos after completing your family-building journey, there are several options to consider. Depending on your circumstances and preferences, you may choose to continue storing your embryos, discard them, donate them for research, pursue embryo donation (when appropriate), or choose a compassionate embryo transfer.
A compassionate embryo transfer places the embryo in the vagina or cervix rather than the uterus, allowing it to pass naturally without the intention of achieving a pregnancy. Our team is available to discuss each option with you, answer your questions, and help you make the decision that feels right for you.
