Infertility Services

Sadly, many couples struggling to conceive are led to believe that “infertility” is their diagnosis. This can be incredibly disheartening, and is actually misleading.

At Reply, we recognize that when couples cannot get pregnant naturally their infertility, or subfertility, is not a diagnosis, but rather a symptom or sign of underlying conditions. Our focus is to identify those underlying conditions, treat them, and help patients optimize health and conceive naturally.

How We’re Different–Answering Why?

If you are experiencing fertility challenges, the first question is “why is this happening?” We know that infertility typically is multifactorial, and can include female factors, male factors, or both. That’s why it is so important to get a thorough evaluation to identify underlying conditions, and why it is so disturbing when couples’ underlying conditions are glossed over or even ignored.

Patient after patient who has come to see us at Reply has suffered for years from conditions such as polycystic ovary syndrome (PCOS), endometriosis, or out-of-range metabolism/hormones—all major culprits for infertility—and have never been diagnosed, much less treated. Moreover, some factors that contribute to infertility also can contribute to miscarriage. At Reply, we reject the approach of trying to force a pregnancy on a body that may not be ready. Instead, we aim to optimize your health for natural conception and a healthy pregnancy. We are committed to restorative reproductive medicine (RRM).

Our Finding & Fixing Program for Infertility, Subfertility, & Recurrent Miscarriage

What many of us think of as “infertility” is actually a spectrum of infertility, subfertility, and recurrent miscarriage. Our Finding & Fixing program at Reply addresses this spectrum by comprehensively considering factors in these areas:

•  Anatomical
•  Metabolic
•  Hormonal
•  Autoimmune
•. Inflammatory
•. Ovulatory
•. Gamete
•. Lifestyle
•. Emotional health

The Finding Phase

Since proper care begins with a diagnosis, our program starts with a Finding Phase. This phase of care typically lasts 1-3 months and includes evaluation of both female and male factors.

At the end of the Finding Phase, you receive a personalized Patient Finding Report that summarizes our team’s findings and recommendations. You have the opportunity to review this unique report in-depth with your clinician in a one-hour appointment.

The Fixing Phase

Care continues with the Fixing Phase, when your care is focused on treatments, monitoring improvements to your health, and making adjustments to your care. This phase of care lasts up until pregnancy or until your health is optimized. This typically can take up to 12 months, or, in more complex cases, up to 18 months. Average time to conception at Reply is 7.5 months.

What Causes Fertility Problems?

Studies in the medical literature show that couples typically have multiple factors causing or contributing to their fertility struggle—usually more than four factors. Common factors include:

Female Factors
•. Polycystic Ovary Syndrome (PCOS)
•. Prolactin abnormality
•. Pituitary dysfunction
•. Endometriosis
•. Endometrial polyps
•. Uterine septum
•. Uterine fibroids
•. Blocked or damaged fallopian tubes
•. Endometriosis
•. Endometritis
•. Premature follicle rupture
•. Luteinized unruptured follicle
•. Corpus luteum/luteal phase deficiency
•. Premature ovarian insufficiency
•. Low ovarian reserve
•. Limited cervical fluid

Male Factors
•. Varicocele
•. Erectile dysfunction
•. Premature ejaculation
•. Semen infection
•. Azoospermia (no sperm)
•. Oligospermia (low sperm count)
•. Poor sperm motility
•. High DNA fragmentation
•. Testicular exposure to high heat
•. Anabolic steroid use

Female and/or Male Factors
•. Vitamin D deficiency
•. Thyroid dysfunction
•. Insulin resistance/diabetes
•. Adrenal dysfunction
•. Sexually-transmitted infections
•. Eating disorders
•. Sleep disorders
•. Chronic Stress
•  Substance use (tobacco, alcohol, marijuana)
•. Poor diet/nutritional status
•. Under/overweight (BMI)
•. Certain product or supplement usage
•. Environmental toxin exposure
•. Timing of intercourse

How Does RRM Work?

RRM is highly personalized care that works by seeking to understand and treat your health as an individual patient and as a couple trying to conceive. We collaborate with the International Institute for Restorative Reproductive Medicine (IIRRM) to understand the latest RRM insights and medical findings, and to ensure that no patient is left with “unexplained infertility.”

In addition to the comprehensive work-up for female and male factors, we use fertility awareness cycle tracking to gain important clues about what is happening with your health each month. This tracking allows us to provide precise interventions for female factor disorders, and also equips you to understand and leverage your fertile window—the exact days of the month when intercourse should be timed when trying to conceive.

Finally, RRM care prioritizes your overall health and well-being. Apart from treating underlying conditions to help you realize your goal of having a baby, we want to treat your underlying conditions to optimize your health for its own sake. Patients deserve nothing less, and we endorse the growing chorus that women’s reproductive health has for too long been “ignored by science” and “dismissed by the establishment.”

Are We a Good Fit for You? Addressing Infertility

For couples facing fertility challenges, our approach offers a hopeful, three-pronged approach that includes patient education, RRM clinical care, and on-going attention to medical research. We have helped patients become pregnant between the ages of 26 and 52, including couples who have:

•. been trying for more than a year
•. suffered multiple miscarriages
•. been told they waited until they were “too old”
•. previously failed with IVF/IUI
•. been diagnosed as high-risk or “infertile”
•. nearly given up hope


“Not until I found Reply, did I feel confident that I would ever have a child of my own.”

Watch to learn how the Reply Fertility “Finding and Fixing” Program helped Pamela to address her PCOS, to conceive, and to have a happy and healthy pregnancy. We have helped many patients who struggle with PCOS, endometriosis, recurrent miscarriage, uterine fibroids, and many other risk factors. Click here to view more patient stories and provider insights.

Schedule Your Free Consultation to Learn More 

Finding the right medical team and support system can make all the difference in your fertility journey. We are welcoming new patients and would love to hear your questions and learn more about you. To schedule an appointment, please click below or call [919] 443-6000.