A forum for you. At Fora, we believe that no two families are alike. We are committed to supporting you on your journey, no matter what family looks like to you, now or in the future. We are proud to support everyone and anyone on their family planning journey – unpartnered, lesbian, gay, bisexual, transgender, queer, and intersex persons. FORA is here to help you achieve the family of your dreams without bias, discrimination, or judgement…this is your forum.
The essential parts of reproduction include a healthy egg, healthy sperm, and a uterus for an embryo to implant. Depending on your goals, this may require that we work with an egg donor, a sperm donor, and/or a gestational carrier (sometimes referred to as a surrogate). Other essential services for our community may include gamete (egg or sperm) preservation prior to gender transition and reciprocal IVF, where one partner provides the egg and one partner provides the uterus for the pregnancy. At FORA we want to understand what your ideal family will look like and we can help you achieve that goal.
Donor sperm allows those who lack a sperm source to conceive. Prior to selecting a sperm source, FORA will provide a fertility assessment and consultation to finalize our treatment plan and optimize sperm selection. Conception with donor sperm can include intrauterine insemination (IUI), INVOcell, in vitro fertilization (IVF), and reciprocal IVF.
All donor sperm IUI cycles include ultrasound monitoring to evaluate ovarian response to optimally time ovulation with insemination. The donor sperm sample is processed into a highly concentrated specimen and then the IUI procedure involves passing a small guide through the cervix and placing sperm directly into the uterine cavity.
AT FORA, our physicians were involved in some of the initial trials of INVOcell in the United States and we are thrilled to offer this option to our patients.
INVOcell is a lower cost, lower complexity version of IVF. INVOcell is also called “in vivo fertilization” and this technology allows sperm and eggs to meet inside the female body without in vitro fertilization (IVF) which occurs in the IVF laboratory. During INVOcell, women undergo ovarian stimulation with a minimal medication protocol, limiting potential side effects from medications. Ultrasound monitoring helps to determine when eggs (oocytes) are mature and ready for collection. These mature eggs are mixed with sperm and placed in the INVOcell device, which is then inserted into the vagina for incubation, allowing sperm and eggs to form embryos. After vaginal incubation for 5 days, the Invocell device is removed and the best embryo is selected for transfer into the uterus. Any remaining embryos will be preserved for future embryo transfers.
For same sex couples, our clinical data suggests that INVOCELL results in achieving pregnancy in a shorter period of time for an overall lower treatment cost when compared to sequential donor sperm inseminations. However, INVOcell is not perfect for all people, and a complete fertility consultation and evaluation will help identify patients who could benefit from treatment with INVOcell.
IVF (in vitro fertilization) has the highest success rate of any available fertility treatment. IVF can be accomplished using donor sperm, donor eggs, or both, depending on your treatment needs. Eggs and sperm are combined in the IVF laboratory to form embryos. The goal is then to grow (culture) embryos in the lab until they reach the potential implantation stage, called the blastocyst stage. At the blastocyst stage, most often embryos are sampled for genetic rearrangements which would make them unable to form a baby, and thus, unsuitable for embryo transfer. This testing technology is called PGT-A (preimplantation genetic testing for aneuploidy). Embryos found to have the correct chromosomal complement with PGT-A (euploid embryos) have the highest chance of becoming a baby upon embryo transfer. Under certain circumstances, embryos may also be transferred to the uterus without such testing or frozen for later transfer to the uterus.
Reciprocal IVF allows same sex female partners to play different roles in their family building process. Reciprocal IVF involves collecting and fertilizing eggs from one partner with donor sperm to form embryos. A resulting embryo is then transferred into the uterus of the other partner for pregnancy. Some couples choose to both create embryos using their own eggs and to then each carry their partner’s baby. At FORA, we are proud to have assisted many couples in building their families this way.
Donor eggs allow those who lack an egg source to conceive. Egg donation involves obtaining eggs from egg donors, who are healthy women between the ages of 21-30. Donor Eggs and sperm are then combined in the IVF laboratory to form embryos. The goal is then to grow (culture) embryos in the lab until they reach the potential implantation stage, called the blastocyst stage. At the blastocyst stage, most often embryos are sampled for genetic rearrangements which would make them unable to form a baby, and thus, unsuitable for embryo transfer. This testing technology is called PGT-A (preimplantation genetic testing for aneuploidy). Embryos found to have the correct chromosomal complement with PGT-A (called euploid embryos) have the highest chance of becoming a baby upon embryo transfer. Under certain circumstances, embryos may also be transferred without such testing or frozen for later transfer.
Family building with donor eggs can sometimes seem like a daunting task. That is why we at FORA have partnered with Simplify Egg Bank to simplify this process for our patients A multi-ethnic donor population, concierge patient care, and guaranteed PGT-A chromosomally normal (euploid) embryo for transfer are only some of the reasons FORA celebrates this collaboration.
Dr. Skillern has a special interest in egg (oocyte) donation as a family building option. She has authored peer reviewed articles on the ethics of egg donation and has presented at numerous invited speaking engagements in support of her interest.. With her guidance, FORA has composed a world class team to assist you through the egg donation experience. At FORA, we know there are many pathways to a family, and egg donation is one option that we are poised to discuss further should the need arise.
Some people may need to build their family with surrogacy. Gestational carriers can be helpful for people who do not have a uterus or who have gone through failed cycles in the past or uterine trauma to have a child. Although the task of finding a gestational carrier can seem overwhelming, we can make the process easy. We work with a select group of professionals in the fertility space who all have your top goal in mind. We require all carriers to be undergo a complete medically assessment, to meet with our reproductive mental health professional, and we have a reproductive lawyer who can help simplify this process. Conception with a gestation carrier can occur with either gametes from an intended parent, donor eggs, donor sperm, or donated embryos. We work to make your family building dreams a reality.
Some individuals may wish to preserve their fertility when waiting to start a family or when undergoing a gender transition. Options for fertility preservation include sperm and egg freezing.
Sperm preservation (freezing) allows those who may wish to block testosterone to save sperm for use in future conceptions, since medications which stop testosterone production also stop sperm production. Egg preservation (freezing) involves the removal of eggs prior to testosterone hormone treatment, so that these eggs can be used in future family planning (egg cryo freezing).
At FORA, we believe that there is no one way toward a family. We want to understand your goals and dreams, and help guide you on the best path toward parenthood.