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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: 

Omnitrope -  A growth hormone whose main purpose is to help improve the quality of eggs. Not every patient will see this on their protocol. Typical use cases include poor responders to stimulation medications and women who have a decreased ovarian reserve.

As a result of injections it is normal for patients to experience soreness or mild bruising at the site of injection. Bloating, cramping, headaches, breast tenderness and in some cases, temporary allergic reactions are also common side effects. 

During this period patients will continue stims and may start what is known as “antagonists” to prevent premature ovulation (i.e. once eggs are released into the pelvic cavity they cannot be retrieved). These types of medications block the hormone (gonadotropin-releasing hormone-GnRH) that causes eggs to be released from the ovaries. 

Regular monitoring visits will likely include additional ultrasounds and bloodwork and occur around days four and six and every other day after. Visit results will then determine if nightly doses need to be changed or if an antagonist is necessary. In these cases, patients will often have leftover medications or need refills. 

Side effects are similar to those experienced during days one to four. Some patients also experience what is known as ovarian hyperstimulation syndrome (OHS). In this instance there is an overproduction of follicles that can cause extreme swelling or pain in the ovaries. Depending upon the severity, treatment may be cancelled until a future cycle. 

Patients will receive a final ultrasound and bloodwork to confirm if the follicle pack has reached maturity. If so, a “trigger shot” is assigned approximately 35-36 hours before retrieval to stimulate final growth spurt and ovulation. 

Trigger shots are hormones that support the normal development of an egg in a woman's ovary, essentially triggering the egg to go through a final growth spurt, and stimulate the release of the egg during ovulation from the follicles within 36 hours. 

In most cases, patients will discontinue all other medications and are given a deep sedation for the 15-45 minute retrieval process. Following the procedure it’s normal to feel mild cramping or experience some vaginal spotting. 

Keep in mind that follicles may be empty at the time of retrieval or contain an immature egg. This means the number of eggs retrieved after egg retrieval may be lower than the number of follicles seen on the ultrasound or based on bloodwork.

Sperm is collected according to clinic protocol or donor sperm is thawed at the time of egg retrieval.

The retrieved eggs and sperm are combined and monitored for signs of fertilization as the embryo(s) divides into a small cluster of cells.

The quality of embryos are given a grade, often using a common A-D rubric with A = excellent quality, D = poor quality to determine the likelihood of a successful implantation.

“Fresh” transfer: For patients who are seeking to transfer their eggs immediately after retrieval, the embryo can be transferred in 2 different stages of its lifecycle:

1) They can be transferred on approximately day 2 or 3 after fertilization when it is in its cleavage stage.

2) They can be transferred between days 5-7 after fertilization when it is in its blastocyst stage.

The best appearing embryos are then deposited into the uterine cavity using a catheter. Patients may experience cramping, bloating and spotting following this procedure. 

“Frozen” transfer:  In some scenarios for egg freezing, i.e. planning for the future, the embryos are not transferred immediately. In this instance, because the technology does not currently exist to keep an embryo viable outside of the womb for an extended amount of time, embryos are frozen through a process called vitrification. 

After transfer (0-1 days post retrieval), progesterone supplements provide hormonal support for successful attachment of the embryo to the uterine lining using vaginal, oral, or injectable progesterone and in some cases, a combination of methods. Common medications include: 

Progesterone capsules, suppositories, lozenges

And finally - within 12 days to two weeks a blood sample is taken to determine if the transfer resulted in a successful pregnancy. This test measures the hCG (human chorionic gonadotropin) levels, often referred to as the “pregnancy hormone,” which indicates cells are forming in the placenta to nourish the fertilized egg.

Despite how involved IVF medications might be, know that you are not alone in this journey. Alto’s dedicated fertility pharmacists are here to help answer your questions and work with your physician to ensure your IVF treatment plan is followed properly. To learn more visit us at alto.com/fertility or reach out via phone, text or the app. We’re here for you from your first cycle to your last and everything in between. 

Since 2016, Alto has supported over 20,000 patients through their fertility journey. In this post we'll provide guidance on how to select the right fertility pharmacy. In addition, we'll share the benefits of selecting Alto as your fertility pharmacy. 

What to Consider When Selecting a Fertility Pharmacy

Your Choice of Fertility Pharmacy Matters

Chances are if you’re reading this you’ve made a decision to undergo fertility treatment or know someone who might be soon. To begin with, know that you are not alone. Approximately 1 in 8 women in the US are affected by infertility, and more than 20,000 women have now decided to have their eggs frozen. 

Since 2016, Alto has supported over 20,000 patients through their fertility journey, and several team members have gone through the journey themselves. We know this 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.

Think of your pharmacy as an extension of the care you receive from your physician. You wouldn’t choose just any fertility clinic, right? The same goes for where you choose to receive your fertility medications. Fertility treatment is stressful enough. Your pharmacy partner should provide the reassurance and reliability you deserve.  

In this post we'll share guidance on how to select the right fertility pharmacy. First, we’ll explain why it's important to use a pharmacy with a strong fertility focus (versus any neighborhood or mail-order pharmacy). And since not all fertility pharmacies are the same, we’ll also offer five considerations to make sure you have the smoothest experience possible. Finally, we’ll share the benefits of selecting Alto as your fertility pharmacy. 

At a minimum, credible and experienced fertility pharmacies will employ:

An expert clinical team: This includes pharmacists who are knowledgeable on and experienced with the medications and dosing unique to fertility treatments.

Temperature controlled packaging: Medications can go bad if they are not shipped or stored at the proper temperature. Fertility pharmacies will provide the appropriate packaging to ensure your medications arrive in good condition. This is especially important in warm climates. 

Proper supplies: Fertility pharmacies will be familiar with the variety of needles/syringes that you may need for your injection. This is crucial because it can be stressful if incorrect supplies are included which may lead to a missed dose. In addition, supplies such as alcohol swabs and disposal containers should always be included.

Learn more: [The View From Both Sides of the Fertility Pharmacy Experience]

Here are five additional things you should consider when selecting a pharmacy partner: 

1) Easy, proactive communication - After your clinic sends your prescription to the pharmacy you’ll likely have questions related to insurance, what to expect when receiving your medications, and most importantly, when they will be ready. For that reason it’s important to take into account what types of communication are offered - phone, text, email, mobile app - and typical response times and operating hours. Pharmacies with weekend/evening support hours are most beneficial in ensuring you’ll get live support when you actually need help.

2) Affordability assistance - Fertility benefits are confusing and it can be hard to understand just how much you’ll need to spend on medications. Most fertility pharmacies will work with leading financing and loan providers and can administer manufacturer discount programs if asked. A great fertility pharmacy will go above and beyond to connect you with financial assistance programs for qualifying prescriptions.

3) Local, timely delivery - Your medication protocol can change even after you start your injections - perhaps your physician wants to add a different trigger shot to prevent over-stimulation or decides to add days to your schedule because of the rate at which your follicles are growing. You can avoid these stressful situations if you select a pharmacy that is local and can promise fast same-day delivery. The last thing you need to worry about is mail-order delays or waiting in line at a pharmacy for hours. 

4) Pharmacist support - You’ll most likely have questions about your fertility medications (i.e. How do I know I’m injecting correctly? My clinic just changed my medications, what do I do?) so think of your fertility pharmacist like an extension of your #TTC community in that they should be an advocate on your side. Make sure the pharmacy you choose offers support and expert resources like guidance on injections, tools for managing your protocol and help understanding medication options - including late at night and on the weekends!

5) Community reviews - Just like you researched clinic and physician reviews, you should do the same with your pharmacy choice. Head to Yelp, Facebook, and any other feedback platform that showcases patient testimonials. Pharmacy experience matters but so does the experience of others. See if any reviews or blogs exist that mention specific fertility pharmacies. You’ll thank yourself (and those before you) for taking the time to do your due diligence. 

The fertility team at Alto will reach out as soon as we get your prescription so you don’t have to worry about waiting on hold or standing in line at a pharmacy. We’ll proactively investigate your insurance coverage, provide options to maximize your benefits and offer qualifying rebate programs. 

And because we know you’re busy with life, we offer a mobile app that allows you to securely schedule your delivery or message a pharmacist if you aren’t able to call us. You can take care of your pharmacy needs wherever you are and on your schedule. Alto pharmacists are always available until 9 pm each night (including weekends) to answer questions. 

When it comes to the time sensitive nature of your treatment, being locally-based makes a critical difference. Medications may be increased, decreased, or stopped altogether. At Alto, patients always receive free, same-day delivery by our own Alto courier team, even on weekends. 

We also offer the ability to select the 2 to 3-hour delivery window that works best for you either at home or work. Once your delivery is scheduled you’ll receive text updates along the way so you know exactly when your courier will arrive.

Your medications are packaged to give you the necessary information to avoid common mistakes (e.g.which meds go into the fridge). And Alto’s dedicated fertility pharmacists are always just a phone call or text away to answer your questions about injections, supplies, and more. So if you're about to inject and suddenly forget something, you don't need to wake up your physician - you can give us a call.

We’ll also follow up with you to remind you about qualifying rebates and provide instructions on how to apply. Our patients find this especially helpful given they have enough to remember. 

Sam shares why serving fertility patients is so rewarding

What to Consider When Selecting a Fertility Pharmacy 

How My Experience as an IVF Coordinator Showed Me the Importance of Alto’s Care Model

The View from Both Sides of the Fertility Pharmacy Experience

I knew from a very young age that I wanted to work with moms and babies. My mother ran a daycare from our home throughout my childhood, and for my sixth grade report on “what I want to be when I grow up,” I interviewed a well baby RN at a local hospital. After completing my Bachelor’s degree, I started working as front desk staff at a fertility clinic and I knew immediately that I had found my spot. I could work with soon-to-be moms and new moms every day.

I quickly shifted from the front desk to being a Medical Assistant for a physician where I was able to participate in ultrasounds, retrievals and transfers. The first time I was in a pregnancy ultrasound and heard a baby’s heartbeat, I was in tears and overcome with emotion. Eventually I transitioned into the role of IVF Coordinator where I was a key part of a patient’s — and their partner’s — journey to building a family.

I really got to know my patients — in fertility, you become a trusted confidant. Their loss is your loss, and their win is your win. While you might not bring your work home physically, emotionally the job never really leaves you — IVF coordinator was the most emotionally taxing job I’ll ever have. But each time we received a positive pregnancy test, it made up for all the ups and downs.

Alto’s model shouldn’t be so revolutionary, but it is. Clinics and patients don’t have to be okay with today’s standard pharmacy experience — Alto offers a fundamentally better model.

Fertility pharmacy plays a key role in a patient’s fertility journey. Medications need to arrive on time, in the correct assortment, with all necessary ancillary supplies. Often, the decision to change a dose or initiate a trigger shot means that medications are needed that same day or on the weekend. As an IVF coordinator, helping my patients make a decision about pharmacy was tricky — each pharmacy option offered some of the service qualities I was looking for, but no pharmacy offered all of the things I wanted for my patients. Remembering which pharmacy checked which boxes was really challenging.

It was so important to me that my patients were taken care of and receiving the highest quality of care. When they had questions, I was always available and responsive, even in the evenings and on weekends. What was most frustrating about working with fertility pharmacies was that when I’d send a prescription out, I’d have no control over the quality of the patient’s experience with the pharmacy.

For my patients, I wanted a pharmacy option that was accessible, responsive, cost conscious, and accountable for making sure nothing was getting lost or off track. For my clinic team, I wanted a pharmacy partner that didn’t require me to micromanage everything about a patient’s medications. I hated being the middle person between the patient and the pharmacy. The first time a pharmacy [Alto] came in and told me I could send any patient with any insurance to them and they would triage it, I thought, “We’ll send everything to them.”

Alto Pharmacy’s patient care model checked all those boxes. When I first heard about their same day delivery, evening and weekend hours and benefits coordination, it sounded too good to be true. Having access to a local fertility pharmacy with same day delivery was simply unheard of.

But if this was all true, it was clearly something that I wanted to be a part of. I knew from my experience as an IVF coordinator that this model served a crucial need for both patients and their care teams. I wanted to bring my knowledge and experience to help make the Alto care model even better than it already was.

What I quickly learned after joining Alto Pharmacy to help build partnerships with fertility clinics was that while same day delivery is extremely practical and necessary in fertility, it’s our patient care team that is the most standout quality. Our patient care staff have the same drive and commitment to helping build families that initially drew me to work in fertility. They genuinely care about the success of the treatment and making sure that the patients are being taken care of. This focus on the patient is unmatched in the pharmacy space — fertility pharmacy is not a truly personalized experience anywhere else but Alto.

The patient care team consistently goes above and beyond to make sure that patients have what they need, when they need it, so that cycles aren’t interrupted. Those same-day medication changes and trigger shot decisions mean that our team is processing late notice prescriptions and frequently staying late to get deliveries out the door. Many members of our patient care team have even driven medications direct to patient’s homes so that cycles stay on track. They know how much going the extra mile is going to relieve the patient’s stress.

What I like to tell people is that we haven’t found some magical secret sauce at Alto — we didn’t create texting, or mobile apps — but pharmacy has been behind the times for so long compared to many other industries and especially within healthcare. Alto’s model shouldn’t be so revolutionary, but it is. Clinics and patients don’t have to be okay with today’s standard pharmacy experience — Alto offers a fundamentally better model.

Alto is the West Coast’s leading fertility pharmacy with more than 15,000 patients served. We’re open evenings and weekends, offer free delivery seven days a week, and will always work to help you find the best price. Interested in using Alto’s services for your fertility medications? Ask your care team to send your prescriptions to Alto or give us a call at 1 (800) 874–5881.

Tina Simon is a Fertility Partnerships Manager for Alto Pharmacy in the San Francisco Bay area.

How Alto Pharmacy provided support and peace of mind during my embryo freezing process

My Fertility Preservation Story

I’m 33 years old and have been married for three years. I don’t have any children yet, but have always known I wanted a family. I have spent much of my career working in healthcare and have most recently worked at an education startup. I’m passionate about doing work that empowers women.

Many of my friends have gone through the egg freezing process, and my husband and I visited a clinic last year to learn more about our own fertility health and to explore the option of egg freezing as a future backup plan. The clinic we chose uses Alto for their fertility pharmacy services and referred me once we decided to go through a round of embryo freezing.

I had a great experience with Alto. The entire journey of learning about fertility preservation, deciding whether or not to go through with a procedure, and then starting the process is really stressful and often left me feeling like I needed a lot more information and guidance than was readily available. With Alto, everything about getting my prescriptions filled and finding answers to my questions was straightforward and dependable.

At my very first appointment, the clinical team decided to start me on medications that same night. I signed up with Alto, and they delivered my medications same-day within the span of a few hours. The customer service reps at Alto were really helpful and worked with an urgency that I appreciated given how out of control I felt in that initial phase of the treatment plan.

What I liked most about Alto was how dependable they were. When you’re going through a fertility preservation process, your prescription and medication needs change every few days for the duration of the treatment. There were several times where I got a prescription in the morning from my physician and needed to get the delivery that same day. Each time, Alto did a great job of making sure the medication was processed, scheduled for delivery and delivered on time. I didn’t have to stress that something would go wrong and the whole process would be messed up.

I also found that I could rely on Alto to help fill knowledge gaps about what was happening with my care. Each delivery included documents to explain exactly what the medications were for, something that wasn’t always clear when I got a prescription from the doctor. I appreciated Alto’s focus on customer service. They proactively reached out to give me updates about what to expect next, ensure my questions were answered, and even did small gestures like including a few caramels in each delivery that, while small, were appreciated.

I used to have a chronic disease, chronic idiopathic urticaria (hives), that required a specialty medication, and I had a really difficult time dealing with pharmacies and ensuring I got my medication correctly. I had to see one doctor to prescribe the medication, go in person to pick up the medication at a specialty pharmacy and then drive it in a cooler to a second, different doctor to administer it. With Alto, it was so much easier and straightforward to make sure I received my medications when I needed them, without having to leave home.

Alto was easy to work with and dependable which is so important and helpful. While the outcomes of my procedure were not what I had hoped for, I have no complaints at all with my experience with Alto. I would definitely recommend Alto to a friend considering egg freezing or IVF treatments.

Alto is the West Coast’s leading fertility pharmacy with more than 15,000 patients served. We’re open evenings and weekends, offer free delivery seven days a week, and will always work to help you find the best price. Interested in using Alto’s services for your fertility medications? Ask your doctor to send your prescriptions to Alto or give us a call at 1 (800) 874–5881.

This post was written by Rebecca G., a San Francisco Bay area operations and community builder, and Alto fertility patient.

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