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Infertility - Endocrinology Services


Welcome to the Infertility and Endocrinology Services information site! You will find our site helpful in answering some common questions about the referral process and treatments offered with the Reproductive Endocrinology and Infertility clinic at Womack Army Medical Center.

Services Offered:
  • Reproductive Endocrinology
  • Treatment for Recurrent Pregnancy Loss
  • Treatment for PCOS-Polycystic Ovarian Syndrome
  • Treatment for Developmental Reproductive Issues
  • Treatment for Diminished Ovarian Reserve/ Premature Ovarian Failure
  • Unexplained infertility
  • Extended Fertility Work up and Medical Counseling
  • Tubal Reversal
  • * In Vitro Fertilization to include ICSI-Intracytoplasic Sperm Injection and PGD/PGD-Genetic testing of embryos.
Andrology and embryology services are provided by an outside laboratory and not a portion of Womack Army Medical Center. Andrology services include sperm wash for IUI, in depth semen analysis, and sperm cryopreservation.  Embryology services include In Vitro Fertilization These services are not covered by Tricare and can cost anywhere from $250 to over $10,000 depending on the services needed.
 
IVF is offered 4 times a year and patients are placed on a wait list for an average of 6-12 months. Please contact the IVF coordinator at 910-643-2589 for more information. Please select the IVF link below for more details for the work up required.
 

Purpose: To improve the referral process to the infertility clinic and expedite the initiation of the basic work up on patients prior to their initial appointment to specialty Reproductive Endocrinology and infertility care. 

  • Immediate referral: all female patients 35 years of age interested in fertility, or any age with previous failure of in vitro fertilization at an outside clinic or hospital. 
  • Immediate referral :Reproductive Endocrinology Referralmmediate referral :Reproductive Endocrinology Referral.
    Refer any patient with reproductive endocrinology conditions (per provider's judgment)

  • Immediate referral: Reproductive anatomic abnormality
    1. Intersex conditions
    2. Abnormalities of sexual  differentiation

  • Immediate referral: Developmental reproductive issues. 
    1. Reproductive developmental delay 
    2. Precocious reproductive development

  • Immediate referral: All female patients with over 2 miscarriages.

  • Infertility Referral: (1 year unprotected intercourse <35 years old) Detailed referral to the GYN/Infertility Clinic in CHCS. Referring providers outside of the military charting system may fax referrals to 910-907-7825.

  • Bilateral tubo-tubal anastomosis-BTA (Tubal Reversal) referral: Females age less than 39 years old at time of referral are candidates for BTA.  The basic infertility work up for both male and female partners will need to be completed prior to scheduling the initial visit. The female will need to complete the lab work as well as the HSG and a current pap smear. The male partner will need to complete the labs and semen analysis. Once the work up is completed the patient may call 910-907-9270 to schedule initial appointment.

    The patient will need to have the following:
    • Lab, Pap, HSG results current with in the last 12 months. 
    • Semen analysis results in last 12 months. 
    • Current complete medical history and physical exam performed by physician or nurse practitioner, including a pelvic exam. 
    • Copy of the operation/surgical report and pathology (tissue) report from the hospital or physician who performed the surgery. 
    • A cover letter from the patient stating the reason(s) why she wants this procedure done. Information to include in the letter: Total number of pregnancies, number of live births, number of c-sections, number of miscarriages, ectopic pregnancies, other abdominal/pelvic surgeries, and current medical problems. The letter will need to include the signature of both partners.
  • Basic Infertility Work up current within 12 months
    • Female Order Set: (Local) CHCS ORDER SET “Infertility Referral” has all the required labs. At MINIMUM, patient is to have cycle day 3 FSH,LH, Estradiol, and AMH lab work and TSH and Prolactin levels,
    • AND HSG (Once ordered patient calls radiology on CD 1 to book appointment) OR other proof of fallopian tube status such as laparoscopic chromopertubation. 
    • Basic Male Order Set: CHCS ORDER SET “InfertM Referral” has all the required labs, to include lab work and semen analysis.
    • Additional labs for patients with a history of Recurrent Pregnancy
      Loss (>2 losses):

      CHCS ORDER SET “Inf-SAB new ref” ANTI-CARDIOLIPIN , HEMOGLOBIN A1C , TSH SENSITIVE , PROLACTIN, BETA2-GLYCOPROTEIN I IGG/A/M,  LUPUS ANTICOAGULANT REFLEX for the female and  a CHROMOSOME ANALYSIS for both female and male  
  • Nutrition Consultation for BMI>30 for weight loss prior to referral. Patients with a BMI > 35 will not be accepted into program.

  • Referral to specialty services for specific medical, social, psychological, or surgical condition requiring consideration prior to implementing infertility treatments or subsequent pregnancy (includes genetic counseling).  Patients with recent history (6 months or under ongoing treatment) that is contraindicated in child bearing or family building MUST be cleared by treating provider prior to acceptance into program.     
               
  • Prenatal Vitamins/Folic Acid supplementation
      Fertility diagnosis and treatment and treatment for recurrent pregnancy loss are available through Womack Army Medical Center including all advanced reproductive technologies. Patients are financially responsible for services not covered by Tricare. Infertility services are dedicated to support the families within the military health care system, surrogacy services and tubal reversals are not available at this time.

     Womack Army Medical Center is committed to the long term health of all patients and requires any patients with a BMI in excess of 30 to participate in a weight reduction program prior to initiation of infertility treatment.  We strongly encourage all patients (BMI 25 -29) to actively engage in a weight reduction/health maintenance program during or prior to infertility treatment.

     Also, patients who smoke or use tobacco are strongly encouraged to quit smoking prior to starting fertility treatment. Smokers much be actively enrolled in smoking cessation class prior to receiving ovarian hyper stimulation medications for infertility treatment.

     Patients may choose to self-refer to a civilian infertility specialist; however they assume all financial responsibility related to fertility care not covered by Tricare.
           
 
Patient's Fact Sheets
Please click on each topic to view the following facts:
 
 
Websites to explore for more information on Infertility:

CDC Statistics
:
 
Association for Reproductive Medicine:
Society for Assisted Reproduction Technologies:
 
National Infertility Association:
 

 

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Telephone
Contact Information
Phone: 910-907-9270
Hours: Mon - Fri : 7:30 a.m - 4:30 p.m..
Location: Bldg 4-2817
First Floor, Clinic Mall
All American Expressway Entrance
Fort Bragg, NC 28310