Posted on July 13th, 2020by Katie Bergin, Patient Experience Manager

Optimizing Your Morning Monitoring Visit

Going through infertility treatments is likely not something you planned to do. You might not know about the types of procedures performed or the protocols to follow and that’s okay. RMA of New York doesn’t expect you to have it all figured out when you arrive to your first appointment. We want to provide you with information to support you during your journey so you know what to expect during a time that can sometimes feel unpredictable. This information will empower you during this journey and, ultimately, set you up for success.

‘Monitoring’ is a general name for the morning activities of ultrasound and bloodwork testing to evaluate how you are responding to treatment. The results of the ultrasound and/or bloodwork are reviewed each day by your physician and further instructions for continued treatment are shared by your nurse over the phone. Monitoring is part of every treatment plan, whether you are having a natural cycle (no medication) with timed intercourse, an intrauterine insemination (IUI) cycle, in vitro fertilization(IVF), or donor egg treatment so that your doctor can closely track your body’s response to fertility medications, make changes to your treatment protocol, and keep a close watch on your progress while being able to give you realistic expectations throughout this process.

No matter what type of treatment you are embarking on, monitoring will include two factors: blood estrogen level testing and ultrasound to view your uterus and ovaries. In treatment cycles involving ovarian stimulation, blood estrogen (also known as estradiol) is produced by the developing follicle. The estradiol level helps correlate appropriate growth of the egg follicle. Blood leutenizing hormone (LH) is also sometimes measured as this hormone indicates when you are about to ovulate. This helps with timed intercourse and IUI treatment cycles. The transvaginal ultrasound is used to monitor follicular growth or growth of your eggs and how your ovaries are responding to medications prescribed by your physician. In cycles involving frozen embryos or donated eggs, you will most likely be taking estrogen pills, but the monitoring process is the same.

At RMA of New York, we approach your treatment using a team approach. In addition to your physician’s team consisting of your nurse, IVF coordinator, and financial representative, there is an entire morning monitoring team whose daily focus is to ensure you have a safe, efficient, and caring appointment. This team consists of patient services representatives who check you in and out and phlebotomists who draw your blood. Electronic medical records make it easy for your primary care team to follow you no matter which RMA location you go to for your cycle monitoring. For Monday through Friday appointments, you can visit any of our 6 offices for morning monitoring and even switch sites if one location is more convenient for you. On the weekends only our Eastside location is open for morning monitoring.

Monitoring in the office can be quite different from an initial consultation. It occurs early in the morning, before work hours, to best accommodate your schedule. Your time is valuable and the clinical and administrative staff works efficiently to get you in and out in a timely manner. An additional advantage of having early morning monitoring hours is that your results are returned within the same day. Your doctor and clinical team can review your results, asses your progress, and decide the next steps to take in your treatment protocol. This is crucial because it allows your doctor to provide the best next steps for your individualized care.

Since RMA of New York starts multiple new treatment cycles each week, monitoring hours are precisely scheduled. In order to prevent crowding, you will be given a specific time to arrive. You might see your physician or one of our team of physicians, but rest assure that your physician is reviewing your care!*

So how you can you optimize your visit to monitoring hours at RMA of New York? There are several steps that you as a patient can undertake to ensure that the next visit with your fertility doctor is efficient and meets your needs without causing unnecessary stress.

First, remember to show up on time to monitoring with everything that you may need, including your ID and insurance card. Please sign in at the front desk and clearly print the first and last name that appears on your legal ID on one of the sign-in labels. Showing up on time to monitoring ensures a shorter wait time and a faster progression through the entire process. You will be able to move more quickly into lab testing, receive your results faster, and have more time to pick up new medications from the pharmacy if needed.

Wearing loose-fitting clothing can also optimize your morning monitoring visit to RMA of New York. You will most likely have your blood drawn during monitoring and loose clothing will make it easier for the technician to access your arms. Loose fitting clothing is particularly important if you are having an ultrasound. Another note about the blood draw – if this process makes you anxious, be sure to let the technician know ahead of time. Point out if you would like to lie down, if you have a preferred arm for the blood draw, or if getting blood from you is difficult. The technicians want to ensure that this process is as quick and painless for you as possible. Let them know how they can help you through it.

Finally, remember that this is your treatment and it is the team’s job to help you through this process and alleviate as much stress as is possible. Ask questions about the tests you take and the treatment you receive. Take charge of the steps in your treatment that are in your control and monitoring hours should run efficiently. Ultimately, the staff at RMA of New York is prepared to help you in any way it can. Your clinical team is always available so never hesitate to reach out with questions or concerns.

*As we continue to monitor global developments related to the coronavirus (COVID-19), RMA of New York’s priority remains the same: the health and safety of patients and staff, as well as providing you with a positive experience. RMA of New York is taking extra precautions and enforcing social distancing guidelines. Instead of the previous first come first serve basis, you will now receive an email with a set appointment time for your morning monitoring appointment. The nurses will do their best to accommodate preferred time slots. On the day of your appointment, you should wait outside of the office building so as to prevent crowding in waiting areas. Once the office is clear, you will receive a text notification alerting you to come upstairs for your appointment. When you come into the office, please inform the sign in desk that you have arrived. You will then be screened by a staff member who will ask you a few questions and take your temperature. After this screening, you can sit in the waiting room where chairs are positioned 6 feet apart. You will be called in for your appointment shortly thereafter. Once your monitoring appointment is complete you are free to leave. You are no longer required to sign out, however, if you have any questions, you may alert the staff and they will have the appropriate person follow up with you by phone that day.

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