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For Black History Month, we’re recognizing pivotal Black leaders in healthcare who’ve paved the way forward for our country and the Black community.

Services that reduce travel and encourage social distancing are now more essential than ever, not only for vulnerable populations but all of us as members of our communities. Alto’s free same-day doorstep delivery ensures you have safe and reliable access to medications in this time of uncertainty. 

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Reverend Stacey, who is also the Executive Minister at Trinity United Church of Christ in Chicago, sat down with us to share more about the challenges of fertility in the Black community, what fertility care providers can do to create more inclusive experiences, and some of her favorite memories in the history of FFCG. 

Rev. Dr. Stacey L. Edwards-Dunn on Her Mission To Improve Black Fertility Care

When it comes to fertility, there is a lot to navigate—from deciding which treatment option is right for you to figuring out how to afford the costs. In the U.S., about 11% of women experience infertility, and studies suggest that Black women are twice as likely to face infertility as white women. 

Rev. Dr. Stacey L. Edwards-Dunn is trying to change this. After working as a health educator in Chicago and an education director at Planned Parenthood, she founded Fertility for Colored Girls (FFCG) in 2013. As a 501c3, FFCG’s mission is to provide education, awareness, and support to Black women/couples and other women of color who struggle with infertility—something Stacey wished she’d had when she was on her own infertility journey. 

With 14 chapters across the country spanning urban and suburban communities, and with more opening each year, FFCG provides services including educational programs, grant opportunities, counseling, and monthly support groups where women can share their experiences and receive support.

What are the reasons Black women are almost twice as likely to experience infertility as white women?

There are a few factors behind this. The first is that in the Black community, infertility is a taboo topic. And it’s not something we expect to experience. In our communities, we have believed the hype that Black women are hyper-fertile. Much of this comes from breeding myths during slavery around our ability to be able to give birth. But the reality is, these myths are incorrect. So it begins with how we have been socialized and educated around our own reproductive health and our Black bodies. 

A second reason is that there are many Black women and couples who don’t trust the medical system. And because of this distrust, we’re not accessing health care. We think doctors don’t take us seriously and impose their biases on us. And even today, we still hear stories of Black women and couples having surgeries done on them and being sterilized without permission.

A third reason has to do with research. Most of the research around reproductive health and treatment has primarily been done on white women. So when research shows that in vitro fertilization (IVF) is not as successful with Black women, it’s because the trials haven’t included Black women. Once we start seeing more research done that includes black and brown women and other ethnicities then we’ll be able to tailor treatments better. 

A final reason has to do with marketing. We still have a number of fertility clinics that aren’t including women and babies of color and other ethnicities in their marketing. So Black women and couples don’t see themselves in the marketing and if you can’t see yourself, it makes it harder to feel welcome and to trust that you’ll get quality care. 

In addition to marketing and staffing, what other recommendations do you have for clinicians and fertility care providers to create a more accessible and equitable experience? 

I would say education. The staff working with women of color need to be educated. They need to be equipped with tools on how to be culturally sensitive to the Black women and couples that are coming into their spaces. Something I hear from Black women and couples is they want the doctor and team to partner up with them in their treatment—not to look down on them or talk at them. They want someone to walk with them on their journeys. 

Education can also help staff understand their own biases which, a lot of the time, they’re unaware of. It’s important they know what to say and what not to say to make sure they aren’t deterring Black couples. In addition, Black and other ethnicities need to be represented in executive roles and throughout the organization —from doctors to nurses to lab technicians. Making sure staff is inclusive, diverse, and culturally-educated.

Finally, they need to work with organizations like FFCG, who have their pulse on the community and can help them create relationships with the Black community. And they should be open to having these conversations not just during Black History Month, but all the time.

For the communities you work with and those who might not understand their family building options and the resources available to them, what do you want them to know? 

I want them to know there are multiple paths to parenthood. And though they are all different, they are not deficient. When I educate the women and couples I coach and that come to me, I help them focus on the goal, which is to be parents and to build a family. When you know the goal, then you can understand that you have other natural options, like IVF, intrauterine insemination, donor eggs or donor sperm, domestic adoption, et cetera. 

There is an option and a path that has been designed for everyone and I help them see that. Because when you have options, there are possibilities. I am very intentional about helping to open up the minds of the women and couples that I work with to help them see the goal. Because when you reach the goal of becoming a parent to a child, the reality is that you’re not going to love them any less because it is the child that God has sent you.

Is there a particular memory or moment that stands out for you since you founded Fertility for Colored Girls?

A powerful moment for me was when we gave away our first free IVF [cycle] to a couple. After experiencing a few unsuccessful IVF [rounds], they didn't have any money left and their state of Mississippi doesn’t have insurance toward infertility treatments. So they put their name into our raffle and won. They took the Megabus from Mississippi up to Chicago, Illinois to meet everybody that they had been talking to on the phone during prayer time. 

At this time, I was also one month away from giving birth to my daughter after seven in vitro cycles, so I really felt for them. Now they have five-year-old twins. This was significant because it was the first time we were able to provide physical resources to a couple in need. 

In addition to this, I am always so honored when women and couples call me and tell me they got a positive pregnancy test after IVF, or that their surrogate is pregnant, or their adoption just got approved. Often, I end up finding out before anyone else in their family does. I’m so honored that these women and couples trust me to share their journeys and their hearts. And most of them have never met me in person, they’ve just talked to me on the phone. 

These are women who have cried so many tears in silence and lived so long in shame, and they’ve found a successful path to starting a family. That is what gives me joy and fuels me to keep doing the FFCG work. It reminds me there’s still hope and the work that we are doing is not in vain. 

Is there anything else you’d like to highlight about your work with FFCG and your mission?

I will add that I think you are able to have peace on your [infertility] journey when the mind, body and spirit are aligned. Because if any of those aspects are not aligned everything can really fall apart. Therefore, my approach, and the mission of FFCG, is to minister to each aspect of a person’s life as they are all equally important. 

In addition, it’s important for people to know the resources that are available to them through FFCG—from grants they can apply for to education to support in our prayer circles. Many Black women and couples struggle with having the resources and support to move forward, so I want to make sure they know this.

To support or donate to Fertility for Colored Girls visit the FFCG site. You can also learn more about the Black Reproductive Endocrinologist and Infertility Specialists making history and bringing hope to their families on 2/25 at 6 pm CT. Register here.

At Alto, we know fertility treatment can be an emotionally, financially, and physically challenging experience. That’s why we believe choosing the right pharmacy can help you avoid additional stress caused by waiting for hours on hold, tracking down your medication delivery, and navigating insurance benefits.

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. In this article, we’ll explore some of the financial options available and how we at Alto can help. 

Managing the Costs of Fertility Treatment

For hopeful parents who are struggling to conceive, the costs of pursuing fertility treatment can often seem insurmountable. Though assisted reproductive technology (ART) makes it possible for many people experiencing infertility to become parents, the emotional and financial stakes are high. 

If you’re considering fertility treatment for the first time, it’s important to understand the financial hurdles you may be facing. However, there are ways to manage or lower the costs so you can move forward on your path to becoming a parent. In this article, we’ll explore some of the financial options available to intended parents pursuing ART and how we at Alto can help. 

If You Have Health Insurance, Start There

Unfortunately, not all insurance plans cover fertility treatments. As you dig into your plan’s details, you may find that some options are covered with contingencies, while others are not covered at all. It’s best to contact your insurance provider for an in-depth explanation of your fertility coverage. 

Be prepared to ask questions about whether your plan covers diagnostic testing, medications, treatments, and consultations. Ask if there is a cap on coverage or a waiting period required to try certain treatments. You want to walk away with a comprehensive understanding of what your out-of-pocket costs might be.

Several states have enacted legislation that requires insurance providers to cover infertility treatments. The American Society of Reproductive Medicine maintains this online database with information by state.

Many fertility clinics now offer no- or low-interest financing. As you seek out the clinic that’s right for you, inquire about what cost-assistance services are available. It’s perfectly reasonable to seek out a clinic that makes you feel confident and fits your budget.

There are also companies that provide personal loans specifically for fertility treatments, with flexible monthly payment options. At Alto, we’ve worked with companies like Lending Club and CapExMD to help our customers get the fertility medications they need. Most companies allow you to apply online and some even provide budgeting tools on their websites so you can get an idea of what your monthly payments might be. 

There are grants available through government programs, nonprofits, and private companies that can help cover fertility treatment costs. Many are designed to benefit intended parents who demonstrate financial need while others were created to support specific groups, such as veterans or the LGBTQ+ community. There are even some that will award money to those willing to share their infertility story. 

These grants won’t usually cover all of your costs, but they can provide a significant boost. CoFertility keeps a database of fertility grants and other funding opportunities, as does RESOLVE: The National Infertility Association. 

Fertility medications can represent a significant portion of your total treatment costs. At Alto, we’ll always advocate for you to ensure you get the lowest possible prices on your medications. We’ll run a thorough insurance benefits investigation and if your insurer requests a prior authorization, we can work with your doctor’s office to submit it on your behalf. Plus, we’ll remind you to collect any available manufacturer rebates with a monthly email.

If you’re uninsured, we can help you apply for income-based assistance programs like the Compassionate Care Program, which could help you save up to 75% off your fertility medications if you qualify. Even if you are still in the planning stages of your fertility journey, the earlier you can apply to the program, the better. Ideally, you will want to have approval before your fertility prescriptions are sent to your pharmacy. 

We accept ACH (direct) payments and offer a one percent discount for anyone who prefers this option over using their credit card. And don’t forget—with Alto, delivery of your medications is always completely free.

With mail-order pharmacies, you usually have to order your fertility medications all at once to ensure your precisely timed doses don’t get hung up in the mail. Because it’s difficult to predict exactly how much medication you will need, you often end up ordering excess. Not only will these leftovers add to your out-of-pockets costs, but you’ll also end up with wasted medication that you'll have to dispose of when you're done with treatment.

When you fill your prescriptions with Alto, we’ll hand-deliver your medications from our local fulfillment centers. That means we can deliver your medications every few days, avoiding overorders and minimizing how much you spend. 

Finally, we know that your time is the most valuable resource you have, so we’re focused on giving as much back to you as we can. Send us a simple text when you have a question, and keep all your medication information—plus expert advice—at your fingertips using our mobile app. You can also schedule refills and track your shipments from our pharmacy to your doorstep in real time. If you suddenly need to add a day of injections, there’s no need to stress or go running to the pharmacy. We’ll handle the details and coordinate delivery to your doorstep. 

If you’re interested in learning more, you can request a price quote online. Our care team and fertility specialists would be happy to answer your questions about navigating fertility medications. We know that the start of your ART journey can feel full of uncertainty, but we’re here to do whatever we can to make the process easier and more affordable. 

For more on choosing the right fertility pharmacy for your journey, read, “What to Consider When Selecting a Fertility Pharmacy.”

While it’s not always possible to predict the course of your fertility treatment, it can be helpful to set goals and parameters. Is there a maximum number of in vitro fertilization (IVF) cycles you’re willing or able to try? Are there other options you’d like to pursue first, such as intrauterine insemination (IUI)? What are the scenarios where you might try using donors or a gestational carrier, or consider fostering or adoption?

Once you have an idea of your budget, coverage options, and potential out-of-pocket costs, create a roadmap that outlines your treatment goals in relation to your financial, physical, and emotional well-being. 

Remember—dealing with infertility issues can take an emotional toll, especially if some options feel out of reach financially. Know that you are not alone, and there is a community of other hopeful parents you can lean on. Support groups like RESOLVE and The Fertility Tribe offer virtual meetups and online community groups. It’s also essential to lean on loved ones for emotional support during this time. The journey you’re taking isn’t easy, but you certainly won’t be walking it alone. 

Would you like to learn more about how Alto can help you manage your fertility treatment costs? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday, and 10 am - 6 pm PT on weekends. We’re ready to be your partner through it all, from your first cycle to your last. 

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

What to Look for in a Prenatal Vitamin

Whether you have recently found out that you are pregnant or are just starting to consider the possibility, prenatal self-care can feel a lot more complicated. Everything you do now has implications for two (or more!). 

The good news? A simple prenatal vitamin can help put your mind at ease. It’s one of the easiest and most effective ways to ensure you get the key vitamins and minerals needed to nourish your baby through a healthy pregnancy. 

Whether you’re pregnant, trying to conceive, or thinking about adding to your family, experts recommend starting to take a prenatal vitamin right away. By beginning early, you’ll help seed your body with the nutrients it needs for the earliest stages of fetal development. Here’s what you should know if you’re ready to take a prenatal vitamin for the first time.

With a wide range of over-the-counter prenatal supplements to choose from, we recommend consulting with your healthcare provider about the ideal choice for you. In some cases, your doctor might even prescribe a prenatal vitamin based on your unique nutritional needs. If you’re starting to do your research, here are the key nutrients your doctor will likely recommend supplementing. 

As you tour the ingredient label on any prenatal supplement, folic acid should be your first stop. This B vitamin helps the body make new cells and prevents congenital disabilities that affect a baby’s brain and spinal cord. 

Folic acid’s role in fetal development is crucial, so the CDC recommends all women of reproductive age take at least 400 micrograms per day. Birth defects of the brain and spine, known as neural tube defects, usually occur during the earliest weeks of pregnancy, often before many women know that they are pregnant.  

You will find that most over-the-counter prenatal supplements contain between 400 and 800 micrograms of folic acid. Sometimes, your provider may want you to take a little more, however any product with 1,000 micrograms of folic acid or more requires a prescription. 

You may also see this vitamin listed as “folate,” a general term for vitamin B9. Folic acid is a synthetic version of folate that is more stable when exposed to heat and easily absorbed by the body. 

Iron is a mineral that helps your body make blood cells that supply oxygen to your growing baby. It also helps prevent anemia, which occurs when your blood has too few healthy red blood cells. Your body needs more iron than usual during pregnancy because your total blood volume increases. The Mayo Clinic recommends supplementing with 27 milligrams of iron a day. 

Developing babies need calcium for bone growth. If you’re not getting enough, your own bone density could suffer. The general guideline is to take 1,000 milligrams per day while pregnant or nursing, which is the equivalent of three to four servings of dairy. Calcium can also be found in greens like spinach and broccoli. If you’re concerned that you’re not getting enough calcium in your diet, be sure to look for this mineral in your prenatal supplement. 

Vitamin D helps with calcium absorption and bone growth. The Mayo Clinic recommends that you get 600IUs of Vitamin D per day. 

Omega-3 fatty acids include docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). These essential fats support heart and neurological health. DHA, in particular, is known to support fetal brain development. 

While dietary sources like fatty fish are the best source of omega-3’s, this can present an issue if you want to limit fish consumption while pregnant. Some fish contain high levels of mercury, which can impair brain development in babies. For that reason, researchers at the Women's and Children's Health Research Institute advise that you take the recommended 200 milligrams of DHA a day in supplement form. 

The Mayo Clinic also suggests looking for a prenatal vitamin that includes vitamins C, A, and E; B vitamins; zinc; and iodine. Penn Medicine created this helpful chart to find the recommended daily allowance while you’re pregnant or lactating, but it’s important to consult with your doctor about your needs. 

The Mayo Clinic cautions against taking extra doses of your prenatal vitamin or doubling up on multivitamins as this could be harmful to your baby. You should always take your prenatal vitamins as directed by your doctor. If you forget to take a dose, don't worry, there is no need to double up. Just take your next dose at your regularly scheduled time.

A quality prenatal vitamin combined with a healthy, balanced diet is the best way to ensure your body and growing baby get all the nutrients they need. Talk with your healthcare provider to develop a plan to eat well and supplement your nutrition before and during pregnancy. 

Prenatal vitamins pack a powerful punch, which can make them tough to stomach for some people. The iron in prenatal vitamins can cause constipation, so it helps to drink plenty of fluids, get physical activity daily (if your healthcare provider gives you the okay), and eat more fiber. If constipation becomes a problem, talk with your doctor. Trying another form of iron or a stool softener can help with constipation. 

Some people become nauseous when taking vitamins. If you’re already feeling queasy during your pregnancy, this can present a significant hurdle. Try taking your prenatal vitamin with a meal and experiment with different times of the day. Some people cut their pill in half and take one piece in the morning and the other at night. You might also consider trying a different vitamin brand as each will vary in size, shape, and smell. A gummy, chewable, or liquid option might provide a more palatable option as well. 

If you just can’t seem to stomach your daily pill, don’t give up on your prenatal completely. Your healthcare provider can help you find a solution that won’t sacrifice your nutritional needs. 

The Mayo Clinic recommends that you do not use additional nutritional or herbal supplements during pregnancy. The FDA does not review dietary supplements for safety and effectiveness, and some ingredients could be harmful during pregnancy. 

The Mayo Clinic notes that one possible exception is ginger, which has been shown to help with nausea and is safe for pregnancy. 

If you are considering taking any supplements, always talk with your healthcare provider first. And remember that supplementation—your prenatal vitamin included—should not replace a well-balanced diet full of healthy vegetables and fruits. 

Think of your prenatal vitamin like any medication—more isn’t necessarily better. Stick with the recommended daily dose unless your doctor advises a more significant boost or suggests additional supplements. 

If your doctor recommends a prescription prenatal, you can have the prescription sent straight to Alto, and we’ll hand-deliver it to your home for free. Plus, our pharmacists will only be a phone call, text message, or in-app chat away if questions come up. You’ve likely got plenty on your mind right now, so allow us to handle all the details of your medication needs. 

If you’re considering IVF or freezing your eggs and unsure of what to expect, this article will break down the basics and offer suggestions for how to prepare. 

IVF and Egg Freezing: What to Expect and How to Prepare

These days, egg freezing and IVF, or in vitro fertilization, are fairly common routes on the journey to parenthood. Yet, that doesn’t mean these fertility treatments are always an easy road. While both treatments helped millions of women conceive, they can require a significant investment of emotion, resources, and time. 

In vitro fertilization is a type of fertility treatment where:

The retrieved eggs are combined with sperm outside of the body in a laboratory 

The embryos (fertilized eggs) are then placed into the uterus with the potential outcome of a pregnancy. 

The main difference between egg freezing and IVF is the timing. Rather than attempting to get pregnant right away, egg freezing gives you the option to store your unfertilized eggs for a later time. When and if you decide you are ready to have a baby, your eggs will be thawed in the lab and the rest of the IVF process will be completed. Freezing healthy eggs at a younger age allows women more flexibility in their family-planning timelines.  

The initial screening and prescribed medications are very similar for IVF and egg freezing. After completing an initial ultrasound and bloodwork, your doctor will prescribe fertility medications to stimulate follicle growth. Follicles are fluid-filled sacs in your ovaries that potentially contain an egg. Your prescription will involve self-injecting hormones on a precisely timed schedule and regular check-ins for additional ultrasounds and bloodwork. For a more detailed understanding of the timeline and medications used during an IVF cycle, see our article,  IVF Medications: Schedule and Side Effects Explained. 

Once your follicles have reached maturity, your doctor will gently guide a thin needle through your vaginal wall and use suction to draw the eggs from the follicles. The 15-45 minute procedure is minimally invasive, and you’ll be sedated to ensure there’s no pain. The retrieved eggs are either frozen and stored for later use or placed in a petri dish with sperm cells so fertilization can take place. The fertilized eggs, or embryos, are then transferred to your uterus through a quick, non-surgical procedure using an ultrasound-guided catheter.  

IVF may include a variety of other parties at each stage. In some cases, an egg donor undergoes the egg retrieval process. The resulting embryos are then transferred to the intended parent’s uterus. Sometimes a gestational carrier carries and delivers a child for another couple or person. The embryo is created via IVF using the eggs and sperm of the intended parents or donors and then transferred into the gestational carrier’s uterus. In all of these cases, the sperm used to fertilize the eggs may come from either a male partner or donor. Your unique fertility journey may or may not include one or more of these variations.

From a biological standpoint, the American Society for Assisted Reproductive Technology recommends being at a healthy weight and avoiding smoking or alcohol use. It’s also important to mentally prepare, as this journey may take more than one cycle and be physically demanding on your body. Here are a few tips to keep in mind when it comes to your emotional well-being: 

Don’t let staying “stress-free” stress you out 

During any type of fertility treatment, it’s natural to feel anxious or apprehensive. You are emotionally invested in the outcome, after all. So the standard advice to avoid stress during IVF may only serve to catch you in a cycle of worrying about your worries. It’s true that stress isn’t good for your health and it negatively impacts your quality of life; however, recent studies have offered reassurance that your stress level is unlikely to affect your chances of IVF success. 

We recommend that you include stress-relieving techniques in your fertility self-care plan, but it’s important to know that some stress is expected and perfectly okay. Rather than trying to avoid anxious thoughts altogether, try to acknowledge whatever hopes and fears arise, then work to let them go through practices that help you feel calm. The key here is to be gentle with yourself. Try light, low-impact movement practices like yoga, walking, or tai chi, or lay in bed and listen to a guided audio meditation. There are meditation programs that focus specifically on supporting the fertility journey, like Expectful and Circle + Bloom, as well as free fertility meditations on Insight Timer. 

If possible, we suggest surrounding yourself with caring individuals who can provide emotional support or assist with injections when needed. Talk about your feelings with your loved ones. And If you know someone else who has gone through egg freezing or IVF, perhaps you can schedule a weekly phone chat or walk through your neighborhood. 

Finding this type of support isn’t always easy, however. If you’re feeling isolated or struggling to find someone to confide in, know that you are part of a community of women who share similar challenges. Your fertility clinic may offer counseling or support groups, or you can find one through Resolve, the National Fertility Association. No matter your circumstances, you don’t have to navigate fertility and family planning alone. 

Many people also find support through blogs and online communities centered around fertility and IVF, like IVF Babble and Pregnantish. While these can be excellent resources, be mindful that not everything you read online will be completely factual or apply to your unique circumstances. Your doctor or pharmacist should be your source for any medical advice. The stories others share will range from joyful to heartbreaking, so check in with where you’re at emotionally before you start browsing. Remember: whether good or bad, these are the experiences of others. Your journey will unfold in its own way. 

Because treatment can change from one day to the next, it’s helpful to have a pharmacy partner that can be just as flexible and deliver medications as needed. For that reason, we recommend selecting a pharmacy that offers free, same-day delivery and expert guidance on fertility medications. 

Alto’s fertility pharmacists are accessible by phone, text, or messaging in our mobile app. We understand that protocols can change with little notice, which is why you will always receive a confirmation and updates from us after we receive your prescription. You can also view your delivery status in our mobile app until our courier team hand-delivers your medications. You can even designate a safe place for us to place your medications for contactless delivery (we can facilitate contact-free signatures as well). 

For more tips on how to select your pharmacy, read “What to Consider When Selecting a Fertility Pharmacy.” 

The IVF journey can be challenging, but we’ll be with you every step of the way. Alto’s dedicated fertility specialists are here to answer your questions, guide you through your first injections, and work with your physician to ensure your egg freezing or IVF treatment plan is followed correctly. Visit us at alto.com/fertility or reach out via phone, text, or the app to learn more. 

Lesbian, gay, bisexual, transgender, and queer parents-to-be have many options to become parents today. In this blog post we'll share an overview of the options as well as how Alto can help you in the path to parenting.

A Guide to LGBTQ+ Family Building

Assisted reproductive technology (ART) has expanded the paths to parenthood for all types of family structures. Whether exploring fertility as a single person, within a couple, or as a family unit, parenthood is now possible for more people than ever before.

A 2018 study found that 48% of LGBTQ+ millennials (aged 18-35) were actively planning to grow their families, compared to 55% of non-LGBTQ+ millennials. Researchers noted that this gap had narrowed significantly compared to older generations—the result of advances in technology and the movement for equality. 

Still, LGBTQ+ families confront unique challenges in an industry that often fails to center their needs. However, as more and more LGBTQ+ people seek to become parents through ART, the face of fertility is shifting. 

Lesbian, gay, bisexual, transgender, and queer parents-to-be have many options to become parents today, including using a donor or surrogate for one or more components of biological conception (eggs, sperm, and uterus).

That being said, many options come with formidable costs so determining how to pay for treatment is an important part of planning. Family Equality Council shares this list of family-building grants that can help make ART more affordable. Your clinic may also offer financial assistance programs and payment plans. If prescription fertility medications are part of your treatment, we’ll comb through the available discount and rebate programs to ensure you get the lowest possible price. 

To clarify which of the many paths-to-parenthood might be right for you, it can help to seek out an organization such as Family Equality Council that can provide specialized advice for LGBTQ+ families. It’s also essential to choose a clinic and doctor who can understand your needs and put you at ease. 

For LGBTQ+ couples exploring using a donor, it’s also essential to research the laws in your state regarding legal parentage procedures after your baby is born. For a starting point, you can learn about the laws in your area through Movement Advancement Project’s interactive ART law map; however, you should also speak with an experienced LGBTQ+ family lawyer in your state. 

Every budding family follows a unique path. It may include natural conception, adoption, foster care, or ART. For those considering the latter, here are some of the places your ART journey might take you. 

For those whose bodies cannot produce sperm or are experiencing infertility, a donor can be used. There are two ways to obtain donor sperm: from someone you know or from a sperm bank.

If you use a known donor—often a friend, family member, or other acquaintance—it’s crucial that you fully discuss the relational complexities involved and consult with a lawyer who specializes in working with LGBTQ+ families in your state. When choosing an unknown donor through a sperm bank, the donation’s legalities are less complex because the donor has already surrendered their parental rights. 

If you or your partner plan to carry the pregnancy, donor insemination is the process of placing the donated sperm inside the vagina or uterus to facilitate fertilization. There are two methods of insemination that may be used: 

Intrauterine insemination (IUI) is a simple medical procedure performed by a medical doctor where the sperm is placed directly into the uterus by using a very small tube passed up through the cervix.

With intravaginal insemination (IVI), the sperm is placed directly into the vagina. You can often perform IVI at home; however, many people choose to have a medical professional complete the insemination to increase the chances of success. 

Parents-to-be who were not born with ovaries or are experiencing infertility can use an egg donor. Like with sperm donors, an egg donor can be a known donor or be found through an agency. Again, when using a known donor, be sure to thoroughly discuss the arrangement’s details and consult with a lawyer who specializes in working with LGBTQ+ families in your state.

With both known and unknown egg donors, the egg must be fertilized in a lab and placed in a uterus through a medical procedure known as in vitro fertilization (IVF). 

Intended parents who cannot or will not be carrying the pregnancy for any reason can use a gestational carrier. The gestational carrier will have the embryos (eggs fertilized by sperm) transferred into their uterus, then carry and deliver the baby.

Choosing a gestational carrier is a critical decision that can take time. After all, your relationship will last the better part of a year. An agency can help you meet and screen candidates until you find the right match. 

IVF  is one of the most common fertility treatments. It involves combining an egg and sperm in a laboratory dish then transferring the resulting embryo into a uterus. IVF can be performed with donor sperm, donor eggs, or donor embryos. 

Reciprocal IVF, also known as co-maternity, is a specific instance of IVF where one partner provides the egg and the other carries the pregnancy. In this way, one partner is genetically related to the child while the other becomes biologically bonded through pregnancy. 

Egg or sperm freezing, also known as cryopreservation, is available to preserve future fertility for those looking to delay pregnancy or undergo gender affirmation treatment. Because gender affirmation treatment may affect fertility, it’s important to discuss the possibility of freezing your sperm or eggs with your doctor before undergoing treatment if you may want children who share your DNA in the future. For those currently undergoing Hormone Replacement Therapy (HRT), there may still be options available to preserve your fertility. Talk with your doctor about which choices may be right for you. 

There are many routes available to expand your family. Ultimately, every journey has the same destination in mind: the beautifully chaotic, utterly unique, yet completely universal journey of parenthood.

As you assemble a team you trust to guide your path forward, we’ll be here to support you if prescription medications become part of your plan. Our team of specialists has experience working with the LGBTQ+ community and receives training on how the nuances of the fertility experience may vary for each individual. We’d be happy to manage your medication needs so you can focus on your family during this life-changing time. Visit us at alto.com/fertility or reach out via phone, text, or the app to learn more. 

Beginning your fertility journey can feel like arriving in a strange new world. Your conversations are suddenly full of unfamiliar terms and mysteriously strung together letters. The good news: these terms represent the wide range of procedures available to help hopeful parents conceive.

Fertility Acronyms, Explained

Beginning your fertility journey can feel like arriving in a strange new world. Your conversations are suddenly full of unfamiliar terms and mysteriously strung together letters. The good news: these terms represent the wide range of procedures available to help hopeful parents conceive. Some of them can be a mouthful, so a convenient shorthand has evolved. 

No need to worry about achieving full fluency—the hope is that your stop in the world of fertility will be brief. But if you don’t yet know your TTC from your ART, this fertility acronym decoder can be your guide. 

A Quick Guide to Common Fertility Acronyms

An individual or couple is said to be “trying to conceive” (TTC)  during the period of time in which they are intentionally trying to become pregnant.  

Assisted Reproductive Technology (ART) is an umbrella term used for infertility treatments that handle the egg or embryo in a laboratory. An example of non-ART fertility treatment would be using fertility medications to stimulate ovulation without having the eggs retrieved from the ovaries.

In vitro fertilization (IVF) is a fertility treatment that involves combining an egg and sperm in a laboratory dish, and then transferring the resulting embryo into the uterus. 

“In vitro” is Latin for “within the glass,” meaning fertilization, or the process of combining an egg with a sperm, occurs outside of the body. In vitro fertilization is the most frequently used ART technique. 

Intrauterine Insemination (IUI) is a medical procedure in which sperm that has been washed and concentrated is placed directly into the uterus to facilitate fertilization. This non-ART fertility treatment is done around the time of ovulation to maximize the chances for conception.

A Frozen Embryo Transfer (FET) occurs when a cryopreserved embryo that was created during an IVF cycle is thawed and transferred to a uterus. 

Male Factor Infertility (MF) is the term used when the cause of infertility stems from a male partner.

Polycystic ovary syndrome (PCOS) is a commonly diagnosed condition caused by an imbalance of reproductive hormones. This hormonal imbalance can cause a woman to have irregular menstrual periods, excess male hormone levels, or small fluid-filled sacs in the ovaries, all of which can lead to abnormal ovulation. PCOS is one of the most common causes of female infertility. 

Controlled ovarian hyperstimulation (COH) occurs when the ovaries are stimulated by fertility medication to produce multiple eggs. 

Luteinizing hormone (LH) is produced within the pituitary gland and stimulates follicular growth and ovulation. In the female body, a sudden spike in LH production induces ovulation. 

Human Chorionic Gonadotropin (hCG) is a hormone produced during pregnancy. When used as an injectable, hCG facilitates the final maturation phase of the eggs and triggers ovulation of the mature eggs from the ovaries approximately thirty-six hours after it has been injected. This is commonly referred to as the "trigger shot."

Follicle-stimulating hormone (FSH) is produced by the pituitary gland and stimulates the growth of eggs in the ovaries. FSH levels are tested to evaluate a woman’s ovarian function and egg quality. Also, FSH injections may be used during fertility treatment to promote the growth of multiple follicles in the ovaries. 

Remember—you don’t need to be an expert to be successful on your TTC journey. Your doctor will walk you through the treatment options that are right for you, one step at a time. With each stop along your path, you’ll naturally find that your fertility fluency improves. Before you know it, you’ll be discussing FSH levels and IVF cycles with ease.

The world of fertility medications can seem complicated, but Alto’s dedicated fertility pharmacists are here to answer your questions. Our team of specialists will ensure that you receive the right medications at the right time—delivered by hand to your door. To learn more visit us at alto.com/fertility or reach out via phone, text, or the app. 

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

This fall, we had the opportunity to meet Tiffany Remington and her husband Caleb, who spoke to us about the importance of having a pharmacy partner they could rely on through their own infertility journey.

Fertility Patient Story: Tiffany Shares Her Experience with Alto

How One Couple Navigated Their Infertility Journey

Facing fertility issues can feel like entering completely unfamiliar territory. From deciding when and how to pursue treatment to navigating the ensuing procedures and medication protocols, uncertainties can surface at every turn. However, while no two journeys are completely alike, there is so much to be learned from the many hopeful parents who have traveled the various paths of infertility treatment before. 

This fall, we had the opportunity to meet Tiffany Remington and her husband Caleb, who spoke to us about the importance of having a pharmacy partner they could rely on through their own infertility journey. Read on to learn more about how the process unfolded in Tiffany’s own words and her advice for others going through a similar experience. 

My husband, Caleb, and I love to seek out adventure in almost everything we do. For the past two years, we’ve been living full-time in an RV that we renovated into the coziest home on wheels. Before pursuing our wild dreams of living tiny, we created a one-off event called The Greatest Wedding Ever Donated, where we turned our wedding into a gala and benefit concert and raised $207,000 for charity. 

So what’s next in our books? Starting a family. To our surprise, it took us a year and a half to start our journey of growing our family, and most of the waiting was out of our control. When we had our initial visit with our reproductive endocrinologist back in May of 2019, we thought things were going to happen fast—boom, bam, baby in the utero in one month. We quickly found out how intense the process is and how little we fully understood. All we knew was that we needed help. 

My husband was born with a condition called cystic fibrosis (CF), a genetic condition that creates a thick buildup of mucus in his lungs and other organs of his body. 98% of men with CF are also born infertile due to the absence or underdevelopment of the vas deferens (think of it as the highway for the sperm). After trying to conceive for two years on our own, we had a gut feeling that the lottery win for natural conception was not in the cards. We are a couple affected by male factor infertility.

After choosing a clinic, we had blood work done within the month. We then planned for Caleb’s microTESE, a surgical procedure to extract sperm from the seminiferous tubules of a male’s testes and epididymis. Unfortunately, that was round one of delays. We had to wait five months for an open spot for surgery. The initial disappointment rapidly turned into gratitude knowing that we had more time to fully wrap our head around this process, find a community for support, and educate ourselves in the decisions we would have to make along the way.

In February of 2020, we joyfully celebrated the eleven vials of sperm that were collected and were ready to start our IVF protocol. To ours and the world’s dismay, COVID-19 restrictions were put into place and our clinic shut down in March, just as we were about to begin. Due to Caleb’s health and the nature of the virus, we decided to move our IVF funds back to his medical emergency savings in case something happened. 

For five and a half months, we waited. We finally came to a place of comfort to move forward once our clinic allowed for new patient protocols to resume. We officially started our IVF stimulation protocol for egg retrieval at the beginning of August. After fifteen days of shots, we pulled the trigger and were able to produce seventeen beautiful mature eggs. Of the seventeen eggs, fourteen were fertilized, thirteen made it to Day 3 Blastocysts, four to Day 5 Blastocysts, and two to Day 6. We ended up with a total of six embryos that got sent off for PGS testing. A week later, we found out that of the six embryos, three came back genetically normal.

We wanted to keep the momentum going, so we opted to transfer our first frozen embryo as soon as possible. I had surgery to remove a couple of polyps and by the beginning of October, I was in the clear with a healed uterus, ready to welcome our baby home. With the transfer protocol moving rapidly, I knew I had to find a new pharmacy that I felt like I could rely on. 

During egg retrieval, I ordered from my clinic’s partnered pharmacy without realizing that I had much of a choice otherwise. My medication was delivered to the wrong address, and the idea that it might happen again stressed me out because timing is everything in this process! When speaking with some of my IVF friends, I kept hearing about Alto Pharmacy. I took a deep dive to see what all the “buzz” was about.

I could feel the grin stretch across my face when clicking enter on the URL. The website was already drawing me in. This is a pharmacy? Free delivery, advice, price investigation, and they work with your insurance? I’ve been managing my husband’s medication for years. I know first-hand how time-consuming all of the things that Alto provides can be—it’s a full-time job. This isn't just a pharmacy, it's a care team.

When I saw that Alto would take the burden off my shoulders, I was INSTANTLY sold. No need for spreadsheets, no need to play phone manager while connecting insurance and pharmacies, no need to Google down a rabbit hole. They would take care of all the details and that in itself is priceless.

I had my nurse place my next order with Alto and within the hour I had a text message to my phone prompting me to download the Alto app where I could manage deliveries and medications, connect with a pharmacist, and track my orders. Again, mind blown. An app? For a pharmacy? Can someone bring Alto their crown? One of the best parts is that the delivery windows were only a couple of hours—not like most other pharmacies where you have to wait the entire day to receive your medications. They also have one of their own courier team members HAND-deliver it to you.

Boutique service with savings—I couldn’t be a bigger fan. This whole IVF process can sometimes make you feel like a number. Alto is one of those companies doing it right by honoring you as a human. They show up in your texts. They show up in the app. They show up on the phone. I felt heard and fought for.

If you are walking through this (in)fertility process, or any medical journey for that matter, my advice is: don’t be afraid to advocate for yourself. Speaking as both a caretaker and patient, medicine is often routine and anonymous, and personalized care has not yet been perfected. Pharmacy choice, specifically, matters. Are they reliable? Do they advocate for you as a patient? Can they cut costs? What’s their customer service like? What are patient reviews? Do they deliver on time? You have a choice, even if the options aren’t clear at the start.

The team at Alto is ready to be your partner through it all, from your first cycle to your last. Questions about using Alto? Visit alto.com/fertility or give us a call at 1-800-874-5881. Our team is available 9 am - 9 pm PT Monday - Friday and 10 am - 6 pm PT on weekends. 

To connect with Tiffany and Caleb follow them on Instagram @ustheremingtons. 

Disclosure: Tiffany received medications at no cost from Alto Pharmacy in order to share her opinion about our services. The views expressed are solely her own. 

Fertility Patient Story: Tiffany Shares Her Experience with Alto 

Fertility patients in New York City can now choose Alto’s same-day doorstep delivery and have their medications delivered by our Alto team.

Hello, New York

Alto’s launch in the New York market extends our industry-leading patient care model to the East Coast.

Starting Monday, November 2, fertility patients in New York City can now choose Alto’s same-day doorstep delivery and have their medications delivered by our Alto team.

Our daily delivery windows allow patients to more easily plan to be available to receive their medications. Patients schedule deliveries to the location of their choice — home, work or hotel — and on the day of their choosing. They can even track our couriers in real time on our mobile app and text with a pharmacist for support.

Courier delivery windows
Monday - Friday 

3 – 5 pm ET for Manhattan to 125th Street, 4 - 6 pm ET full service area

6 - 8 pm ET for Manhattan to 125th Street, 7 - 9 pm ET full service area

4 - 6 pm ET for Manhattan to 125th Street, 5 - 7 pm ET full service area

Next-day mail order service is also available for patients outside of the courier zone within New York state.

Walk-in hours
Monday - Friday: 9 am – 7 pm ET
Saturday - Sunday: 10 am - 6 pm ET 

Fertility patients interested in using Alto’s services for their medication needs can ask their care team to send all prescriptions to Alto Pharmacy (via ePrescribe or phone).

Fertility is Complicated. Your Medications Don’t Have to Be.

Alto knows fertility pharmacy. With more than 30,000 patients served, we understand the treatment complexities and concerns of fertility patients. Our dedicated patient care team is available in the evenings and on weekends to walk you through your first injection or answer questions about medication storage, dosing or interactions. Our fertility deliveries include all necessary ancillary supplies, such as syringes, sharps container and alcohol swabs, and are carefully packaged for temperature control. Delivery is always free.

Alto will automatically connect you with all manufacturer-sponsored financial assistance programs for qualifying prescriptions. Alto also works with many fertility benefits programs and many leading financing and loan providers. If we cannot bill your insurance, we’ll find you a pharmacy that can.

 Our customer service team is available to support NY patients and providers from 9 am - Midnight ET, Monday - Friday, and 10 am - 8 pm ET, Saturday - Sunday. 

At this time, Alto is only offering fertility medication services in the New York City market. Any updates to service areas and offerings will be available at alto.com/locations.

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options.

IVF Medications: Schedule and Side Effects Explained

IVF, or in vitro fertilization, is one form of treatment that may help those experiencing infertility to conceive. In fact, at least 8 million babies born today are a result of this procedure. That’s remarkable when you consider the first successful IVF procedure was only conducted in 1978.  

In this article we’ll share what a typical IVF schedule might look like, beginning with medications used to grow follicles, the egg retrieval process, and finally, transfer options. Let’s take a closer look at how one might arrive at each step. 

What Medications Should I Expect with IVF? 

The IVF process itself requires considerable IVF medication use on a precisely timed schedule. For these reasons, it’s important to understand what you might be prescribed as well as any potential IVF medication side effects. 

On the first day of a patient’s menstrual cycle they will typically call to schedule a “baseline” visit for Day 3 of their cycle. This appointment includes an ultrasound and bloodwork. After this visit, if approved, patients will start hormone injections (commonly referred to as “stimulation meds” or “stims”). 

These injections stimulate egg production so a woman’s body produces many follicles in a cycle, not just one (follicles house eggs that contain all the hormones and fluids needed to make an egg mature). Patients with one or more follicles already grown may need to wait until their next period cycle or use a different protocol. 

Stims are typically injected between 6-9PM daily at a consistent time. 

Supportive/adjunctive medications include: 

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What to Look for in a Prenatal Vitamin

IVF and Egg Freezing: What to Expect and How to Prepare

A Guide to LGBTQ+ Family Building

Fertility Acronyms, Explained

Fertility Patient Story: Tiffany Shares Her Experience with Alto

Hello, New York!

IVF Medications: Schedule and Side Effects Explained

What to Consider When Selecting a Fertility Pharmacy

The View from Both Sides of the Fertility Pharmacy Experience

My Fertility Preservation Story

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