OBJECTIVE: To orient IVF surgical nurses to the ambulatory infertility
nurse role in a short 6-week (fast track) orientation so that they are willing,
oriented, and able to assist in speciﬁc aspects of the ambulatory infertility
DESIGN: The ambulatory infertility nurses decided what speciﬁc tasks
would be most helpful for the IVF surgical nurses to learn. One nurse was
assigned the task of creating and coordinating the fast track orientation
MATERIALS AND METHODS: The nurse assigned to create and co-
ordinate the fast track orientation program put together a list of all the jobs
currently being done by the ambulatory infertility nurses. The list was
reviewed and amended by the ambulatory infertility nurses. They decided
which tasks could be assigned to the IVF surgical nurses. The following
tasks were selected: phone triage, infertility cycle calls, and teaching the
surgical section of the group IVF class. A two-day general orientation
program was held for the 5 IVF surgical nurses. It covered the following
topics: introduction to infertility, common causes of infertility, infertility
workup, therapies for infertility, introduction to phone triage, and introduc-
tion to infertility cycle calls. The nurse coordinating the orientation pro-
duced a template for a 6-week 32-hour a week RN orientation then modiﬁed
it to ﬁt the schedule of the orienting nurse. She also designed manuals to
support the orientation and individual handbooks for the IVF surgical nurses
that include items such as: phone scripts for infertility cycle instruction
calls, routine tests/normal values, and a glossary. At the end of her orien-
tation, the IVF surgical nurse was asked to ﬁll out a survey that covered
areas of satisfaction, perceived competence, and a solicitation of narrative
feedback. Plans for retention of knowledge are: join the nurses’ weekend
shift rotation for making infertility cycle instruction calls, assist in the
ambulatory area when the surgical schedule is light or ends early, and sign
up for extra shifts in the ambulatory area.
RESULTS: Two of the 5 nurses had been oriented before the new
program went into effect. Two nurses have completed the new orientation
program and are able to do phone triage and cycle instruction calls; only one
nurse feels comfortable teaching the large format class. The remaining nurse
is presently three weeks into the orientation.
CONCLUSION: The fast track orientation to date has produced two
nurses who are willing, oriented, and able to assist in the ambulatory
Supported by: None
FAMILY FERTILITY FUND: EASING THE FINANCIAL BURDEN
OF INFERTILITY YIELDS DRAMATIC SUCCESS RATES. E. Jung-
heim, K. Dodds, V. Ratts, K. Moley, T. Krispin, R. Odem. Washington
Univ School of Medicine, Saint Louis, MO.
OBJECTIVE: The ability to afford infertility treatment is tied to many
factors including insurance coverage, place of residence and ﬁnancial status.
The high cost may preclude care for some, while others may pursue
suboptimal therapy. Additionally, ﬁnancial stress can result in relationship
dissolution. Often, the amount of ﬁnancial need is relatively small compared
to the cost of other healthcare issues. This abstract describes the experience
to date of the Family Fertility Fund (FFF) which was established at Barnes-
Jewish Hospital and Washington University by generous individuals donat-
ing money to help offset the cost of infertility therapy.
DESIGN: The FFF is designed to provide partial ﬁnancial assistance to
couples that have not previously had a child as a couple. Physicians identify
eligible couples and the fund that is managed by the Barnes-Jewish Hospital
Foundation will provide up to $5000 per couple. Money may be used to
offset the cost of treatments such as intrauterine insemination (IUI) or in
vitro fertilization (IVF). The FFF balance ﬂuctuates and at times there are
no dollars available, since the fund must maintain a minimum balance.
Couples that receive assistance are asked to provide a photo of their baby(s)
if successful, but it is made clear that this is not mandatory. Patients
beneﬁting from the fund remain anonymous.
MATERIALS AND METHODS: Case Series
RESULTS: From January, 2005 through March 2006 funds were made
available to 20 couples. One couple elected to pay out of pocket and
withdrew; a second couple stopped therapy. Three couples have put treat-
ment on hold while they save funds for the balance of expenses. The other
15 couples have begun treatment and 13 have completed therapy. All 15
women are nulliparous and none had any insurance coverage for the
proposed therapy. The average age was 31.4 years (y) (24-40) and the
average duration of infertility was 4.75 y (1.5-14.7). The treatments in-
cluded IUI alone (nϭ1), IUI with clomiphene citrate (1), donor IUI (1),
injectable medicines (1), and IVF (11). The diagnosis included anovulation
(nϭ 2), diminished ovarian reserve (1), endometriosis (1), male (2), tubal
(5), unexplained (3) and one couple had male and tubal factors. The two
patients that have not completed treatment are about to start IVF cycles. Of
the 13 that have undergone the proposed treatment, two have delivered, six
have ongoing pregnancies, two have had ﬁrst trimester losses and three
failed to conceive. Thus, 77% of these 13 patients established a clinical
pregnancy and it appears likely that most of these patients will proceed to
delivery. The average amount of money spent from the fund for each of the
13 patients was $2,989.
CONCLUSION: Infertility treatment is frequently an uncovered expense
and since it often impacts young ﬁnancially disadvantaged couples, the lack
of funds may spell an end of treatment for many. This observational study
demonstrates the powerful impact seen when couples are provided funding
to allow them to pursue therapy. The population offered funds were repre-
sentative of a general nulliparous infertility population in a referral center.
Pregnancy rates seen for those that underwent treatment are undeniably
impressive. Although impossible to study well, it appears that the unex-
pected lessening of the ﬁnancial burden of care may have a positive impact
on success rates. It is hoped that the FFF will continue and that this work
may lead to comparable funds in other geographic locations.
Supported by: None
GONADOTROPIN INJECTION TRAINING: GIVING THE PA-
TIENT THE OPPORTUNITY TO TAKE CHARGE, BE IN CON-
TROL AND MAKE CHOICES. N. Weiss. Portola Valley Women’s
Health, Portola Valley, CA.
OBJECTIVE: Fertility treatment is often considered by insurance com-
panies to be an elective decision by the patient. With the exception of
mandated states, treatment is not always covered and is a cash expense.
Often patients, acting as educated consumers, research treatment, medica-
tion, and resource options available to them. Educating and training patients
in the administration of injectable gonadotropin (Gn) products empowers
the patient to select a medication delivery system which meets their needs
while giving the patient some control in decision making process of their
treatment plan. Exposure to product information such as hands-on demon-
strations, written and visual examples of all products increases the patient’s
conﬁdence and ability to select a product of their preference as opposed to
the practitioner choice. The aim of this study was to determine if patients
develop a product preference after receiving training, demonstrations and
manufacturer’s resource aids in the preparation and administration of fol-
licle stimulating hormone (FSH) injectable medications.
DESIGN: Prospective survey
MATERIALS AND METHODS: Injection training in three FSH prod-
ucts (Bravelle®, Follistim® AQ Pen, Gonal-f® RFF Pen) and correspond-
ing injection devices were performed by the same nurse in classes of2-5
couples. Respective pharmaceutical companies provided training materials
utilized for each product. A questionnaire was given to patients at the
completion of their training to assess the effectiveness of the teaching,
written and visual aids. The questionnaire also queried the participants as to
product preference. Participants were not forewarned that a questionnaire
would be offered at the completion of training.
RESULTS: Forty-ﬁve patients, 17 (37.8%) male, 27 (60.0%) female and
1 (2.2%) undeclared, participated in the injection training questionnaire.
The number of patients preferring a pen device (33) was signiﬁcantly higher
from those preferring traditional syringe administration (5) as well as those
that were undecided (7), (73.3% vs 11.1% vs 15.6%; PϽ0.0001, respec-
tively). More patients, 20 (44.4%), surveyed preferred the Gonal-f® RFF
Pen when compared to those preferring, Bravelle® (5, 11.1%), Follistim®
AQ Pen (9, 20.0%) or those, 8 (17.8%), with no product/device preference.
3 (6.7%) preferred the pen but did not state which manufacturer. Table 1
addresses categories why one product/devise was preferred over another.
FERTILITY & STERILITY