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It’s official: Alto Pharmacy is a great place to work! We’re honored to join the community of Great Place to Work-Certified™ companies based on team member feedback and a rigorous assessment of our company’s culture and benefits.

Join us in delivering our industry-leading pharmacy care to millions of people across the country. As a member of the team, you’ll play an integral role in improving our customers’ quality of life and redefining what’s possible in pharmacy. 

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Read the latest Alto blog posts covering healthcare, family health, managing diseases, and other Alto highlights.

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We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Learn more about his passions both in and outside of work and what drew him to Alto.

Introducing Christopher Tidball, Director of Product Management - Supply Chain & Fulfillment

We’re excited to welcome Christopher Tidball to the Alto team as Director of Product Management, Supply Chain & Fulfillment. Most recently, Christopher led a large team of product managers, engineers and program managers at Amazon to power the company’s most complex fulfillment operations. 

As Alto continues to expand our geographic footprint and customer base, Christopher’s nearly 20 years of industry experience will support us in scaling our systems, so that we can continue to deliver the same high standards of care and service to even more communities.

We recently sat down with Christopher to learn more about his passions both in and outside of work, what drew him to Alto, and the operational opportunities he’s most excited about. 

Welcome to Alto! What inspired you to join the team?

Before a recruiter ever reached out to me about a role at Alto, my wife and I were very satisfied customers. We had been on a long journey of trying to start a family, and that ultimately led us to a fertility clinic that recommended Alto. We had a great experience from day one: the app was easy to use, the same-day deliveries from couriers were always on time, and Alto’s pharmacists walked us through the various medications in our delivery and answered all of our questions. 

Alto’s focus on the customer experience was immediately clear, and I made a mental note that this was the type of company I’d like to work for. Fast forward a few months later, a recruiter reached out and introduced me to the leadership team whose passion and experience sold me on leaving Amazon to come here.

As the Director of Product Management - Supply Chain and Fulfillment, I'll focus on the technology investments that can help us continue to grow and offer exceptional service to our customers. “Supply chain” covers a lot of ground: procurement, inventory, pharmacy operations, delivery, and more. There are tons of opportunities to automate processes to make it easier for Altoids to run the business, especially as we grow and expand. 

What areas of the business are you most excited about?

The operations side has always been exciting to me—it's where the magic happens. At the end of the day, if we don't have sustainable, efficient ways to fulfill the promises we make to our customers, we won't survive. 

Alto has a great business model, and many happy customers to show for it, but there’s always room to continue to innovate and improve the delivery experience. It's one of the few in-person interactions we have with the customer and we want to make it exceptional.

Tell us about life outside of Alto. Are you doing anything interesting at the moment?

I'm a pilot in training — I'm about 75% of the way to getting my single-engine license. I live in Seattle so the aerial views of the city, Puget Sound, and the Cascade Mountains are absolutely breathtaking. Flying gives you a sense of freedom that reminds me of when I first got my driver's license.

You can find more information about Christopher or connect with him directly on LinkedIn. If you have any questions about Alto, or are interested in joining our team, please visit alto.com/careers.

Infertility is often thought of as exclusively a women’s health issue, but the truth is that it can affect anyone regardless of gender. We explain more including male infertility causes, symptoms, and treatment options.

Male Infertility: Causes, Symptoms, and Treatment

Infertility is often thought of as exclusively a women’s health issue, but the truth is that it can affect anyone regardless of gender. About one-third of infertility cases include factors related to male reproductive function.

If you’ve experienced infertility, you’re not alone: about 9% of men and about 11% of women in the U.S. have experienced fertility challenges. And while these challenges may feel overwhelming, they do not necessarily mean that you won’t be able to start a family one day — there are a variety of fertility treatment options for both men and women to support your family building journey.

Below, we explain more about male infertility, including causes, symptoms, and treatment options that can help you build or add to your family.

Male infertility most often stems from issues with sperm production. In some cases, it may be a problem with the quality of your sperm, like how fast or how well your sperm move. In other instances, it’s a matter of sperm quantity: you may not be able to produce any sperm, or you may have a low sperm count (the threshold is typically a sperm count under 15 million sperm per milliliter of semen.)

Sperm production problems may also occur as the result of other health conditions, including hormone, pituitary gland, or immune system problems or genetic conditions like cystic fibrosis, a progressive disease that makes it difficult to breathe, and hemochromatosis, a condition in which you have an excess of iron in your system.

Lifestyle and environmental factors can also play a role: heavy smoking (20 or more cigarettes per day), consistent heavy drinking or binge drinking (for men, five or more drinks in a two-hour timeframe), drug use, and exposure to toxins like endocrine disruptors contained in plastics and pesticides have been linked to male infertility.

Beyond issues with sperm production, anything that blocks a reproductive organ can interfere with the flow of semen, including inflammation from a sexually transmitted infection, scar tissue from surgery, or swollen veins in any of your reproductive organs. Additional factors in male infertility include erectile dysfunction, premature ejaculation, liver or kidney disease, and treatment for seizure disorders.

You may have a greater chance of experiencing fertility issues if you have had any of the following:

Inflammation of your prostate or genital infections

Certain prescription medications may also increase your risk of infertility, including:

5-alpha-reductase inhibitors, a medication class used to treat prostate enlargement and hair loss, which includes finasteride (Propecia®) and dutasteride (Avodart®)

Alpha blockers like silodosin (Rapaflo®), tamsulosin (Flomax®), alfuzosin (Uroxatral®), terazosin (Hytrin®), doxazosin (Cardura®), which are used to treat prostate enlargement

Some selective serotonin reuptake inhibitors (SSRIs) used to treat depression and anxiety, including sertraline (Zoloft®) and paroxetine (Paxil®)

Spironolactone, which may be used to treat high blood pressure or acne

Cimetidine, which is used to treat acid reflux and Gastroesophageal reflux disease (GERD) 

If you and your partner are unable to conceive after trying for at least a year, one or both of you may be experiencing infertility. If you have experienced any of the following symptoms, you may wish to consult with your doctor about a potential diagnosis of male infertility:

Problems with ejaculation, including delayed ejaculation

If you have previously had surgery in your genital area, you should also consult with a doctor about potential infertility issues.

To evaluate you for an infertility diagnosis, your doctor will first ask questions about your medical history, including your sexual history and any other factors that may affect your reproductive health and fertility. They may also do a physical exam to check your genitals for any abnormalities.

The next step is typically a semen test, sometimes called a sperm count. Your doctor will ask you for a sample of semen. During their evaluation, they will look at how many sperm you produce and whether the sperm are normal in shape and movement — healthy sperm have an oval head and long tail.

Your doctor may recommend additional tests, including blood tests to evaluate your hormone levels and to rule out other health conditions and genital ultrasounds to identify potential reproductive health issues.

Thanks to the medical community’s advances in fertility treatment and technology, infertility issues do not mean that you won’t be able to build a family. There are a range of treatment options that can help increase your chances of conception. Your doctor will make recommendations for the best course of treatment based on the underlying cause of your fertility issues.

In some cases, hormone imbalances or problems with how your body uses hormones may impact your sperm production. If that’s the case, your doctor may recommend hormone treatments or medications such as gonadotropin therapy or antibiotics to increase the number of sperm in your semen.

Gonadotropin therapy may be used to treat both male and female infertility and is typically administered via injections. Common side effects of gonadotropin therapy for men may include pain, redness, and swelling at the injection site, stomach pain, nausea, and vomiting. In some cases, it may lead to the enlargement of male breast tissue.

Since lifestyle habits like heavy smoking or alcohol use can affect sperm production, you may be able to increase your sperm count with healthy choices like exercising regularly and abstaining from cigarettes, alcohol, and drugs.

There are several fertility treatment options that can increase your chances of conceiving a child, including in vitro fertilization (IVF) using a technique called intracytoplasmic sperm injection (ICSI) and different forms of artificial insemination like intrauterine insemination (IUI).

In intracytoplasmic sperm injection (ICSI) a single sperm can be injected directly into an egg. This procedure is often incorporated into an IVF cycle for many couples affected by male infertility. IVF is a process in which eggs and sperm are fertilized in a laboratory and then placed into the uterus with the potential outcome of a pregnancy. Women trying to conceive may undergo IVF treatment if their partner is experiencing male infertility to increase their chances of conceiving. ICSI can be the fertilization method used in IVF.

In IUI, sperm that have been washed and concentrated are placed directly into your partner’s uterus around the time that they are ovulating, helping your sperm reach an egg more easily.

A fertility pharmacy partner you can rely on

At Alto, we understand that there are many paths to parenthood, and that each individual or couple’s needs are different. Our team of pharmacists is experienced in male infertility treatment options, and we’ll be here at every step of the way if fertility medications become part of your plan. 

Reach out any time by phone at 1-800-874-5881 or in-app messaging.

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.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use. Read on for more information about these devices.

The Role of Insulin Pumps in Diabetes Treatment

Both type 1 and type 2 diabetes involve complications with the body’s production of insulin, a hormone produced in the pancreas that converts sugar into energy. People living with type 1 diabetes do not produce any insulin at all, so they have to take insulin every day to keep their blood sugar levels in a healthy range.

Insulin therapy may also play a role in managing type 2 diabetes, since individuals with the condition do not produce a sufficient amount of insulin to regulate blood sugar levels. However, some individuals with early-stage type 2 diabetes are able to manage their blood sugar with other medications and healthy lifestyle habits — make sure to consult with your doctor on the best course of treatment given your needs.

There are several methods available for delivering insulin into the body, including syringes,  insulin pumps, and pens. Insulin pumps have become increasingly widespread in diabetes treatment in recent years due to their convenience and ease of use.

There are a variety of insulin pump options to choose from. Read on for more information about these devices.

What is an insulin pump and how does it work?

An insulin pump is a small electronic device that delivers doses of insulin at specific times. It mimics the activities of a normally functioning pancreas by delivering small, continuous doses of insulin throughout the day and surges of insulin while you eat. You set the schedule, and it is easy to make adjustments if your dosage changes or if you eat or exercise more than usual on any given day.

While an insulin pump’s consistent delivery of insulin is effective in keeping your blood sugar levels within a healthy range, it is still important to check your blood sugar throughout the day using either a blood glucose meter or a continuous glucose monitor (CGM). Some newer insulin pumps are connected to a CGM, which allows for both automated glucose monitoring and insulin delivery.

Many people who use insulin pumps find them to be more convenient than insulin injections, particularly while on the go. Insulin pumps offer the flexibility to work, socialize, or engage in just about any other activity without stepping aside to give yourself an insulin injection. And their automated, adjustable delivery makes it simple to maintain healthy blood sugar levels: not only do you not have to worry about missing a dose, but you can easily add, remove or modify a dose depending on your calorie intake and level of physical activity.

Most insulin pumps are designed to store dosing data, so you and your doctor’s office will have easy access to details about your insulin regimen should you need to make any adjustments to your treatment plan. 

Depending on the type of insulin pump you have, the device may be able to streamline other aspects of diabetes management. In addition to the automated blood sugar readings offered by CGM-connected pumps, some pumps have tools to help with carbohydrate counting. (Monitoring how many carbohydrates you consume is an important aspect of diabetes management as they increase your blood sugar, and your daily insulin dosage depends on your insulin-to-carb ratio.)

Insulin pumps deliver very precise doses of insulin, so there is a low risk of complications. However, it’s important to make sure you know how to properly set up your pump and to continually monitor your blood sugar levels. Your doctor or a diabetes educator can help you get started.

Choosing between an insulin pump and other delivery methods is ultimately a matter of personal preference, but they are often a good fit for children and anyone who has had difficulty remembering the timing of their insulin injections. You may also want to consider using an insulin pump if you absorb food slowly or if you often experience low blood sugar as a result of insulin use (also referred to as an insulin reaction or hypoglycemia). Consult with your doctor to choose the best insulin delivery method for your individual health needs.

Many women who are pregnant or trying to conceive also benefit from the consistent and precise delivery of an insulin pump, as blood sugar management is especially critical while your baby’s major organs develop. If you are pregnant or thinking of becoming pregnant, you may want to ask your doctor if an insulin pump is right for you.

There are two main types of insulin pumps: tubed insulin pumps (sometimes referred to as traditional insulin pumps) and insulin patch pumps. Tubed insulin pumps deliver insulin from a delivery chamber — in this case a container located within the pump — into a tube inserted beneath your skin, usually on the abdomen. (A healthcare professional like your doctor or a diabetes educator can show you how to insert the tubing.) Manufacturers of commonly used tubed insulin pumps include Medtronic and Tandem®.

Insulin patch pumps combine the delivery chamber and tube into a single “pod” placed on your skin with an adhesive patch. Insulin patch pumps do not have any external tubing and are controlled wirelessly. Commonly used patch pumps include Omnipod® and V-Go®.

You can put a tubed insulin pump in your pocket, on your belt, or attach it to a strap beneath your clothes. Insulin patch pumps are most commonly placed directly on your stomach or arm. Both types of insulin pumps require you to change the tubing or pods every one to three days. A diabetes educator or healthcare provider can answer any questions and help you become more comfortable using the device.

What to consider when deciding to use an insulin pump

When talking to your doctor, here are some considerations that may help you determine if an insulin pump is the most convenient way to manage your blood sugar, or your child’s.

An insulin pump may feel slightly more complex than injections, as it involves frequent interactions with technology. Your diabetes care team can help you become more comfortable with the device.

You will need to verify which type of pump(s) your insurance plan covers and decide if those options are the right fit for your needs and budget.

Whether you go with a tubed or patch pump, you’ll have an electronic device attached to your skin, which may take some getting used to. There are lots of ways to make them less visible, if that’s a concern.

If you’re still unsure, remember that you’re allowed to change your mind! While insulin pumps are most commonly used on a continuous basis, the device is not permanently attached to your body, and some people switch to injections for certain periods of time. 

For example, some children with diabetes may use an insulin pump during the school year but take insulin via injections during the summer. There is room for flexibility as long as you discuss your plan with a healthcare professional and follow their recommendations.

Most insurance plans have separate medical and pharmacy benefits. In most cases, professional services provided by your doctor will fall under medical benefits while prescription diabetes medications — including insulin — will fall under pharmacy benefits. 

Pumps, CGMs, and supplies like test strips will likely be covered under a third type of benefits: the Durable Medical equipment (DME) section of your policy. There may be restrictions on the brands or suppliers that are available, and it’s important to check with your specific policy to understand what will be covered and under which sections.

Tubeless patch pumps like Omnipod® and V-Go® are often covered with your pharmacy benefits. If that’s the case, Alto may be able to help you get started with your insulin pump. We will work with your insurance (if applicable) and any third party savings programs so that you can get your insulin pump at the lowest possible price.

A diabetes pharmacy partner you can rely on

At Alto, we believe a pharmacy should be a partner in your diabetes care. We have a dedicated diabetes support team to ensure that you have everything you need to follow through on your individualized treatment plan. Reach out any time by phone at 1-800-874-5881 or in-app messaging.

For nearly 50 years, RESOLVE — a national patient advocacy organization — has been both a go-to resource for individuals and couples experiencing infertility and a leading advocacy voice.

What to know about RESOLVE: The National Infertility Association

Infertility is often misunderstood and stigmatized, and it’s easy to feel isolated when you are experiencing difficulty starting a family. For nearly 50 years, RESOLVE — a national patient advocacy organization — has been both a go-to resource for individuals and couples experiencing infertility and a leading advocacy voice, helping pass laws across the country to make family building options more accessible.

Simeonne Bookal, Senior Manager, Access to Care, and Tracie Sullivan, Senior Manager, Grassroots Outreach, recently spoke with Alto about some of the challenges their organization has overcome, what’s coming up next, and why we need more honest conversations about infertility.

RESOLVE has supported individuals and couples through infertility challenges for nearly 50 years. What’s the biggest obstacle you’ve had to overcome as an organization?

Tracie: I focus on RESOLVE’s grassroots advocacy efforts and help lawmakers understand the challenges of family building and the need for legislation that removes barriers to family building options. I continue to see so much stigma and shame around infertility, even in 2021. Part of that comes from misconceptions about infertility and surrogacy.  

I would say, though, that we are generally moving in a positive direction, with greater awareness of infertility and all the accompanying challenges. In recent years, celebrities and other influencers have come forward and shared their experiences with infertility, which has opened the gate for more conversations.

Simeonne: To build on Tracie’s point, when public figures do come forward and share their experiences with infertility, it’s often after they’ve had a happy ending, not when they’re struggling the most. We’re continually trying to broaden the conversation so that people feel empowered to share when they’re in the most difficult part of their infertility journey. 

On a different note, the pandemic has been one of the biggest challenges we’ve had to tackle as an organization. For us, pivoting to virtual programming isn’t just about moving online, it’s about finding ways to offer the same quality of services and events as we did pre-pandemic. 

We’ve had success with virtual events, including our advocacy day and programming for National Infertility Awareness Week 2021. Many people have found our virtual support groups to be really accessible, and that’s been an opportunity for us to reconsider how we can most effectively bring people together.

What can we look forward to from RESOLVE in the near future?

Simeonne: Like many organizations, RESOLVE is invested in making our programming as inclusive and diverse as possible. Something I’m really excited about, which emerged from our conversations about inclusion and diversity, are more tailored support groups.

We recently launched a men’s support group and a BIPOC (Black, Indigenous, and People of Color) support group. I think we’ll continue to see a trend of more specific support groups over time, in recognition of how many different experiences of infertility exist.

What would you tell someone who’s nervous about joining an infertility support group?

Simeonne: Just give it a try. There’s no commitment required, and you can talk as little or as much as you want. It may feel intimidating to share something so personal with a group of strangers, but many people find it easier to discuss infertility in our support groups than with family and friends since you’re speaking with people who understand what you’re going through. 

Also, now is an ideal time to get started, since many of our groups are meeting virtually. You don’t even have to leave the house, you can just log on.

What’s happening in the legislative landscape in regards to family building opportunities?

Tracie: Right now, 19 different states have passed fertility insurance coverage laws, 13 of which include IVF coverage. (Editor’s note: Fertility insurance coverage laws require health insurance providers to offer coverage for diagnosing infertility and treatment. There is significant variation in state-level legislation, and not all states with fertility insurance coverage laws require health insurers to cover assisted reproductive technology (ART) procedures like IVF.)

And 11 states have fertility preservation laws that support people navigating medically-induced infertility, including cancer patients and survivors. (Editor’s note: Fertility preservation treatments like egg freezing and sperm freezing allow individuals to have biological children in the future after changes to their reproductive health. Many individuals living with health conditions that impact fertility explore these treatment options, as do others who wish to delay starting a family.)

RESOLVE is actively working to pass fertility insurance coverage laws in other states, and to improve the legislation that is already in place. For example, in some states with fertility insurance coverage legislation, there are restrictions to coverage access, including marriage requirements and five-year waiting periods for fertility treatment, which don’t align with current medical care standards. 

In other states, coverage is limited to diagnosis and testing and does not include treatment. We also support federal legislation that improves access to family building. Our goal is to make these benefits as inclusive and accessible to as many individuals and families as possible. 

We have a great resource on our website that explains more about infertility insurance and offers a state-by-state breakdown of fertility insurance coverage laws.

View RESOLVE’s guide to infertility coverage by state.

The financial cost of fertility treatment can feel overwhelming. Can you share any resources that help make fertility treatment more accessible?

Simeonne: There are many resources out there that can help alleviate part of the financial burden — from manufacturers’ patient assistance programs to scholarships, grants, and coverage at work programs — but it does require a bit of research. 

We have a list of infertility financing programs and services on our website, which includes some patient assistance programs, and another page with scholarships and grants that you can apply to. 

In addition, RESOLVE’s Coverage at Work initiative was created to support employees and employers in adding fertility insurance coverage to their companies’ healthcare plans.

Tracie: We’ve been happy to see that more employers are offering coverage, even in states that don’t have laws related to infertility coverage. If family building options aren’t covered through your employer’s healthcare plan, we always encourage people to ask for support. You’ll be helping many more people going through the same experience by bringing attention to the need for coverage.

View RESOLVE’s toolkit for employees seeking fertility insurance coverage.

What do you enjoy most about being a part of RESOLVE?

Simeonne: I feel grateful to work for an organization that’s making a direct impact in so many people’s lives. I love getting messages from support group members sharing what this resource means to them. I feel a greater connection to my work and a deeper sense of motivation knowing it touches so many people during a time in their life when it’s easy to feel alone. 

Tracie: I also love seeing the difference that RESOLVE makes for so many people. Many of the laws our community has helped advocate for take years to pass, but when they do, thousands of people get the coverage they need to start a family. And I feel lucky to work alongside such a passionate group. Many of our advocates are people who have completed their family building journeys but want to be there for others.

The importance of seeking support when experiencing infertility 

It is understandable to feel overwhelmed when navigating infertility and exploring your family building options. While each individual journey is unique, there are others willing to share their experience and offer support as you take the next steps to start a family. RESOLVE can help you connect with other individuals affected by infertility and explore your options for financing fertility treatment.

Search for a RESOLVE support group and learn more about how to seek fertility insurance coverage from your employer.

At Alto, we understand the complexities of fertility treatment and the challenges of infertility, and we are here to support you in starting a family if fertility medications become part of your path to parenthood. With Alto, you’ll never have to worry about whether medications will arrive on time, and you’ll have support at every step of the way — we offer a variety of resources including one-on-one consultations with fertility-trained pharmacists to ensure that you’re never alone in navigating fertility treatment.

Learn more at alto.com/fertility or reach out at any time by phone at 1-800-874-5881 or in-app messaging. 

About RESOLVE: The National Infertility Association

Established in 1974, RESOLVE: The National Infertility Association is a non-profit organization with the only established, nationwide network mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility or other reproductive disorders. One in eight U.S. couples of childbearing age is diagnosed with infertility. RESOLVE addresses this public health issue by providing community to these women and men, connecting them with others who can help, empowering them to find resolution and giving voice to their demands for access to all family building options. For more information, visit www.RESOLVE.org.

RESOLVE: The National Infertility Association

The Providers Team at Alto is charged with building the tools and service components necessary to deliver an exceptional pharmacy experience for healthcare providers. Read on to learn more.

Get to Know the Team That Has Doctors Calling Alto “The Pharmacy of The Future”

Editor's Note: The post was updated on November 8, 2021 to reflect the rebrand of AltoMD to Alto Connect.

Alto Pharmacy’s mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. The healthcare professionals who prescribe medications to Alto and the clinical teams that support them are critical partners in making our mission successful. To this end, the Providers Team at Alto is charged with building the tools and service components necessary to deliver an exceptional pharmacy experience for healthcare providers.

Every day, clinical teams -  including prescribers and other clinical staff like nurses, practice coordinators, and billing specialists - spend hours tracking down insurance information, coordinating approvals and appeals, discussing options with their patients, and playing phone tag with pharmacies. The Providers Team enables these healthcare providers to spend more time on patient care and less time on back office tasks. 

Alto’s provider communications platform, Alto Connect, and related services, including insurance benefits coordination and prior authorization management, remove clinical blockers that traditionally slow down or prevent an individual’s access to treatment. Practices that share Alto with a majority of their patients can save three or more hours per day on pharmacy and insurance administration tasks, with less time spent waiting on hold, fewer faxes and improved employee satisfaction (not to mention happier patients!). 

Anu Kashyap, a Product Manager on the team says, “I joined Alto to make a contribution to people’s health using technology, and the Providers Team is working on specific, painful healthcare problems that are critical to solve. These challenges have been incredibly fulfilling to work on.”

How does the Providers Team play into the overall growth of Alto Pharmacy?

The Providers Team is fairly new, as they were originally part of a larger Growth team within Alto. Kjersten Elias, Engineering Manager, explains: “Alto's growth model is driven by conversations about pharmacy choice in the doctor’s office, and in the fall of 2020, we dedicated an engineering team to optimizing our product offerings and improving the experience for the healthcare providers having those conversations.”

Anu adds, “The key for our business’ continued growth is having healthcare providers trust that we are the best pharmacy for their patients and leverage us as their pharmacy of choice. This type of growth channel is much more powerful than anything direct to the consumer. We can only do this however, if our providers have an excellent experience with us, and we’ve only scratched the surface here.” 

Being part of a newer team has distinct advantages. Software Engineer Dereck Quock notes, “We have unique opportunities to modernize how we build apps and define our infrastructure and technical needs. With the freedom to utilize cutting edge tech and new frameworks, there is so much room for innovation.”

What is the culture of the Providers Team like?

The engineers each raved about a small-but-important recurring calendar invite each Friday: Team Time. This protected time is a space to catch up, banter about anything other than work, and, if folks are feeling brave, face off with Anu, former Teen Tournament champion, in a rousing game of Jeopardy.

It's not hard to see why Kjersten and her team light up when they talk about team culture. Amy Chen, a Software Engineer on the team, shared that  “Kjersten is an incredible manager. Everyone is empowered to ask for and share feedback, fine-tune our processes, and check in with each other.”

“When I joined, I could tell right away this team really lifted each other up and had each other’s backs,” said Dereck. “It’s one of the greatest teams I’ve worked on.”

The Providers Team is hiring! Learn more about open positions here.

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology.

Spotlight on Men Having Babies & Dr. Guy Ringler

There are many ways to start a family and raise a child. And as recent decades have brought forth milestones in marriage equality and the fight for LGBTQ+ rights, the options for LGBTQ+ family building have also expanded.

According to 2019 data from the Williams Institute, almost 29% of people who identify as members of the LGBTQ+ community are raising children, up from 16.2% between 2014 - 2016. That includes a growing number of gay men who’ve had children through surrogacy, a process in which a woman who is not related to the child — a gestational surrogate — carries a baby who is biologically related to one of the fathers and an egg donor.

Breaking down barriers to LGBTQ+ family building

Reproductive endocrinologist Dr. Guy Ringler — a former faculty member at UCLA and an advisory board member at Men Having Babies — was one of the first doctors in the world to help gay men have children through assisted reprodutive technology. Throughout the twenty-five years that he’s been in practice, he’s seen how scientific advances and cultural changes have broken down barriers for gay men interested in parenthood.

“Over two decades ago, when I began my career, people barely understood the concept of surrogacy for gay men,” he says. “It wasn’t as easy to find women who wanted to become surrogates for gay couples. There was still fear about HIV, and there were questions about the impact of surrogacy on a child’s development.”

The landscape looks a lot different today. Thanks to cultural shifts and greater understanding of the science behind surrogacy — and to awareness-raising organizations like Men Having Babies — there are now more options than ever to become a parent regardless of your sexual orientation or gender identity.

“Greater acceptance of the LGBTQ+ community and marriage equality has opened people’s minds and allowed them to see that gay families can thrive, just like any family,” Dr. Ringler says. “Gay men are now able to plan for a future that we once didn’t know was possible.”

Getting to meet prospective fathers at Men Having Babies’ annual conferences is one of Dr. Ringler’s favorite things about working with the organization. He’s observed a greater number of gay men pursuing parenthood at an earlier age.

“I’m so inspired by the next generation of gay men, who are planning their families in their twenties. That simply wasn’t an option when I was their age.”

Men Having Babies and financial assistance for IVF and surrogacy

There are many steps on the road to parenthood for LGBTQ+ individuals and couples: fertility treatments, legal consultation, and financial planning are all required to start a family.

“Having a baby doesn’t just happen for gay men,” Dr. Ringler says. “It takes thoughtful planning and there are many decisions along the way.”

That’s why support from organizations like Men Having Babies is so critical. The organization started as a program at The Center (formerly the NYC LGBT Center) in 2005 and officially became a nonprofit in 2012. Today, Men Having Babies supports thousands of gay men and couples around the world in starting their families through surrogacy, with monthly workshops, annual conferences and financial resources. 

Determining how to pay for IVF and surrogacy is an important part of planning your family. As part of the process, Dr. Ringler suggests mapping out a vision for your family. Knowing how many children you want can help you prepare for the cost: “When you’re making the commitment to start a family as a gay man, think about how you will financially support the decision. It may feel overwhelming, but it’s similar to the process of buying a house. If it’s really important to you, you can find a way to make it work.”

There are many resources to help alleviate the cost, including Men Having Babies’ Gay Parenting Assistance Program (GPAP) . The program offers different forms of financial support, including:

Discounted and free services donated by more than one hundred leading IVF, surrogacy, egg donation, and legal service providers to prospective parents (Stage I support)

Discounted and donated ancillary services, including fertility medication, escrow services, and insurance resource services (Stage I support)

Cash grants for approved prospective parents based on income eligibility (Stage II support)

Learn more about the criteria for applying to Stage I or Stage II support from the GPAP.

You must be a member of Men Having Babies to receive financial assistance. You can become a member by making an annual donation of $150 or more. Learn more about the membership process.

In addition, EMD Serono offers financial assistance for fertility medications and Family Equality has a list of family-building grants that help LGBTQ+ families afford fertility treatment. Be sure to also ask your fertility clinic or pharmacy about available financial assistance programs and payment plans.

The importance of researching your options

As Dr. Ringler emphasized, gay men building a family through IVF and surrogacy have many decisions to make throughout the process. For that reason, it’s important to thoroughly research your options and to work with a medical team that you trust. Here are some additional considerations to be mindful of as you plan your family.

Understanding the process of IVF and surrogacy

In IVF, eggs and sperm are combined in a laboratory. When gay men conceive through IVF, the sperm will come from one of the fathers and the eggs will come from a donor. Then the fertilized eggs, or embryos, are placed into the uterus of a gestational carrier who will carry the baby to term.

Not only is this an exciting time for expectant dads, as Dr. Ringler notes, but surrogates can play a big role in raising awareness of LGBTQ+ families.

“In my experience, surrogates who are asked when their baby is due while out in public may feel comfortable sharing that they’re having a baby for a gay couple. This helps open up more people’s minds to the possibilities for LGBTQ+ parenthood.”

Understanding your goals for your relationship with your surrogate is one of many key decisions, and there is a spectrum of options. Some couples cultivate intimate relationships with the surrogates while others prefer to remain more detached. There’s no one right choice — it’s all about understanding what’s best for you.

“If your surrogate wants a little distance, that does not mean that they are any less committed to the process,” Dr. Ringler says, adding that it’s important to discuss your preferences in an open discussion with your surrogacy agency.

Deciding who will be biologically related to the child

Another important decision for same-sex male couples is deciding which parent will be genetically related to the child. When heterosexual couples have babies through IVF, both parents can contribute their genetic material, so that the baby is biologically related to both, even when using a gestational carrier. 

But with gay men, only one father can contribute his sperm per pregnancy, so it’s important to discuss this decision with your partner if having a child as a couple. Some fathers fertilize multiple eggs so that both can have a biological connection with one of their children. Taking time to identify your family building goals will allow you and your partner to plan for the financial cost of more than one round of IVF, if you choose to pursue that option.

Keep in mind that you can establish a legal paternal relationship with your child even if you are not biologically related to them. It’s critical to research your state’s laws about legal parentage procedures once your baby is born. Movement Advancement Project’s interactive map on parental recognition laws is a good starting point. 

Be sure to speak with an experienced LGBTQ+ family lawyer in your state before starting the IVF and surrogacy process. There are many forms of financial support to help alleviate the cost of these legal services, like Men Having Babies’ Gay Parenting Assistance Program.

There's a wide selection of available egg donors, and one of the factors to consider as you choose yours is whether they will be anonymous or open. With an open donor, you can more easily answer any questions your child may have about their genetic background. However, some families prefer anonymous donors, and sometimes an anonymous donor’s physical or personality traits better fit your goals. Both paths are viable options, and it all comes down to what’s right for your family.

Regardless of which option you choose, Dr. Ringler notes that you should be prepared to share information with your child about how they were conceived. You can even get creative with how you share their journey: some of Dr. Ringler’s patients have created story books for the whole family to read together, which helps children understand their background and feel proud of who they are.

Seeking support for your family building journey

While there are many paths to take, and many decisions to make, as you build your family, all will lead to the same destination of parenthood.

“I personally had a very close relationship with my mother growing up, and as gay men, we can’t guarantee our children that same experience,” Dr. Ringler says. He notes that if you have an open donor, your child’s biological mother may be able to have a presence in their life, which is another important factor to consider when planning your family.

But regardless of your chosen family structure, “I’ve seen again and again throughout my career that all you need to start a happy, healthy family is love and fun.”

One thing that’s certain: family building as a gay man is much easier to navigate with support from organizations like Men Having Babies. If you’re feeling overwhelmed while planning for a family, remember that you don’t have to go through this journey alone. Men Having Babies understands the challenges specific to building a family as a gay man, and their resources can help you fulfill your dreams of becoming a parent.

Learn how to become a member of Men Having Babies.

At Alto, we’re proud to support Men Having Babies, and we’re happy to be a part of your family building journey if fertility prescription medications become part of your plan. Reach out any time to get started though the Alto app  or phone at 1-800-874-5881.

In recent years, dry powder inhalers have become increasingly common in asthma treatment thanks to their ease of use and portable size. Read on to learn how to use a dry powder inhaler correctly.

What to Know About Dry Powder Inhalers

Medications play a critical role in managing asthma by reducing the frequency and severity of symptoms and allowing for a more active life. There are a variety of asthma medications that your healthcare provider may prescribe for you, including quick-relief medications to treat acute symptoms and long-term control medications to prevent flare-ups.

Most asthma medications are taken via an inhaler. There are three types of inhalers used for asthma treatment: hydrofluoroalkane (HFA) inhalers, sometimes referred to as metered dose inhalers, dry powder inhalers (DPIs), and the less commonly used respimat inhalers.

In recent years, dry powder inhalers have become increasingly common in asthma treatment thanks to their ease of use and portable size, which makes them convenient to use if symptoms flare up unexpectedly. As with any device, proper use of your DPI is essential to receiving the full benefits of your medication, and it’s important to be mindful of several differences between DPIs and other inhalers. Read on to learn how to use a dry powder inhaler correctly.

A dry powder inhaler is a handheld device that allows you to inhale your asthma medication in the form of a dry powder. It is a breath-activated device, so it will activate and release your medication automatically as soon as you start inhaling. Unlike HFA inhalers, which use a chemical propellant to deliver a dose of your medication in aerosol form, DPIs do not contain any ingredient other than the medication itself.

Your doctor may prescribe a DPI because of  dosage reliability. With an HFA inhaler, it may be difficult to know that you’ve received the entire metered dose. In contrast, most DPIs are specifically designed with a spinning technology that ensures you receive the full dose of your medication. DPIs also typically give you a visual indication that the full dose has been delivered. For example, the Advair Diskus® has a built-in dose counter which updates after each use.

If your doctor prescribes your medication to be administered with a DPI, your prescription will include both the DPI device and the medication. Commonly prescribed DPI medications include the Advair Diskus®, the Pulmicort Flexhaler®, and the Asmanex Twisthaler®.

How to use a dry powder inhaler correctly

Here is a step-by-step breakdown of how to use a dry powder inhaler correctly.

Remove the cap from your dry powder inhaler if there is one.

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