Frequently Asked Questions about the Special Program of Assisted Reproduction
How do I begin?
Thoroughly review the information provided, and return the Consult Request Form and payment in the enclosed return envelope. The Program Coordinator will contact you to confirm your consult.
At the consultation, Dr. Kiessling will review your specific circumstances with you, the risks associated with the procedures, the treatment options available for you, and answer your questions. She will be your advocate with fertility clinics and your infectious disease physician, if necessary. Should your semen analyses be problematic, she will recommend urologists or fertility specialists who can help you. The cost of this service is $525, and is applicable to your total SPAR program cost.
For information on beginning the process with a surrogate or gestational carrier, please start by watching our surrogacy video, here.
Can I do a consultation over Phone/Skype?
We strongly encourage every client to come to our facility to do the SPAR consultation in person. Our 20 years of experience has shown that clients who have an in person consultation navigate the SPAR and IVF process with less stress, are more informed, and save money because they met with Dr. Kiessling and SPAR staff at the beginning of the process.
If you are using a Gestational Carrier or Surrogate, you must come to Bedford for an in-person consultation.
Do both my partner and I have to be present for the consultation?
It is strongly recommended that both parties be present for the consultation so that all parties understand the SPAR process.
How will I know if my semen specimen is “normal”?
Within a day or two after the lab receives your specimen, preliminary results will be mailed to you and your doctor, as you wish. The results will state if the semen specimen is judged adequate to survive freezing and thawing.
How will I know if my specimen has an undetectable viral burden?
You will be notified by mail approximately four weeks after you initially submitted your specimen for testing. Results are not reported over the phone or by email.
How many specimens need to be tested?
Because half of the specimen is used for the tests, sperm from a minimum of 2 semen specimens must be cryopreserved before beginning a fertility attempt. There is a possibility that one half of one specimen may not survive the freezing/thawing, so a second specimen is stored as a back-up. Whether you store more than 2 specimens will depend on the sperm count and the fertility procedure that you plan to undergo.
How long does it take to get 2 to 3 sperm specimens stored for use?
Viral testing is performed by laboratory staff every two to four weeks. Since a minimum of two specimens are necessary (three specimens for Gestational Carrier or Surrogate clients), we recommend submitting two specimens, one week apart (Gestational Carrier or Surrogate clients can submit three over the course of a week to match with bloodwork being done for FDA requirements, see surrogacy for detailed video). If both specimens are normal and have an undetectable viral burden, it is possible to complete the sperm testing and storage requirements within four to six weeks.
It is not uncommon, however, for one specimen to test positive for virus and the other to test negative. In this event, a third specimen should be submitted.
If two specimens test positive, Dr. Kiessling will review your circumstances and help you work out a plan for decreasing the virus in your semen. This may involve a conference with your infectious disease doctor or a visit to a urologist should you have symptoms of infection in one of the semen producing organs.
If my partner is HIV negative, will he/she need to be tested?
No. Only people who are HIV/Infectious Disease positive need to be tested though the SPAR program. All clients should discuss their cases with their infectious disease specialist. SPAR staff is more than willing to talk to your infectious disease Doctor to answer any questions and help you find the best course of treatment.
For what length of time will you store my specimens?
Cryopreserved sperm from specimens with an undetectable viral burden will be stored until you require them or up to two years. The sperm are viable for longer than two years, so should you wish to continue to store them, you need to notify us and sign a consent form for continued storage. If we do not hear from you, the sperm will be discarded two years from their freezing date. After the six months of storage, you will be billed a monthly charge for this service.
Do I have to come to Boston to collect my semen specimens?
If you are using a Gestational Carrier or Surrogate, then yes you need to come to Boston for your consultation and to collect your specimens to be blood matched per FDA requirements (as explained in the surrogacy video here). If you are not using a surrogate, then it may not be necessary to come to Boston to collect your specimens, although we strongly recommend coming for your consultation in person, as it will answer many questions, and make for a much smoother SPAR and IVF experience.
Do I have to come to Boston for these fertility treatments?
No. There are several clinics throughout the country currently collaborating with the SPAR program. Depending on your location, one of these clinics may be an option for you. Other options may be found available for you during your conference with Dr. Kiessling. Many physicians and clinics are hesitant to help. Several states, such as Florida, have laws preventing the transfer of bodily fluids from infectious persons.
If I have fertility treatment in Boston, how long will I be there?
You will have to come to Boston for an initial visit with one of our collaborating gynecologists. You would return at a later date for a fertility procedure. The oligospermia cup procedure requires a stay of four to five days. The In Vitro Fertilization procedure requires a stay of ten to twelve days.
If I go to a clinic outside of Boston, how does my sperm get there?
Frozen sperm can be shipped to any clinic anywhere in the world in a special container that keeps the sperm at liquid nitrogen temperatures. You and your partner must sign a consent form to release the sperm to the clinic and the laboratory requires thirty days notice to complete all the paperwork and plan for the shipment. Coordination between the clinic and the laboratory is important to ensure safe delivery of the sperm. The first shipment is included in the cost of specimen processing. Additional shipments may incur fees per shipment. Specimens can be shipped to any cooperating clinic. A consent form and 30 days notice is required.
How much do the fertility procedures cost?
Costs vary according to the clinic. The cup insemination procedure costs about $2,000 to $3,000 per attempt in Boston; IVF in Boston costs $8,000 to $10,000. You need to make arrangements with the clinic in advance.
Does insurance cover any costs?
Insurance coverage varies by patient, policy, and location. Patients have reported being told by their insurance companies that having an infectious disease is not a diagnosis of infertility, so their infertility treatment will not be covered by insurance. Other patients have had some routine lab costs, such as semen analyses and blood hormone tests covered by insurance. The test for virus is not FDA approved and is not eligible for insurance coverage. Bedford Research Foundation does no insurance billing.
What are the risks of this program?
The risk of the mother or baby contracting HIV/ HCV disease from this procedure is less than it would be if a pregnancy were attempted by using unprotected sex or sperm from untested specimens. As of August 2015, no one using tested semen has become infected.
The risks of the infertility procedures themselves will be fully explained by the gynecologists.
How successful is this program?
Pregnancy success depends upon the clinic. As of June 2013, 178 babies have been born through SPAR, with the help of collaborating IVF clinics. All mothers and babies are HIV infection- free.
What if I have any other questions?
If you have any other questions that haven’t been covered in the information we have provided you, please email the program coordinator at firstname.lastname@example.org. If you do not have access to email, please contact us by phone at 617-623-7447.