Fertility Consulting
At Esse Care, we deeply empathize with the unexpected hurdles you may encounter on your journey to parenthood. We understand that facing fertility changes can be an emotionally and physically draining experience. It’s important to remember that you are not alone.
You are not alone.
The likelihood of getting pregnant each month with perfect anatomy and perfect fertility is only 20% (if less than 35 ‘years old).
In the second year of trying, 5-10% who did not conceive within the first year will get pregnant, (again assuming no other pathology like endometriosis).
At ESSE Care we provide a non-biased starting place or sounding board for your fertility journey. We do not perform egg retrievals or IVF, however we will direct you to the best Drs for your situation. Dr. Karli Provost Goldstein herself went through 10+ rounds of IVF, miscarriage, 2nd trimester loss and surrogacy journey and multiple endometriosis surgeries before achieving her miracles.
She and the team are passionately committed to making sure you are in the right hands for your fertility journey and if your team does not seem to be listening or individualizing your care for endometriosis then she is happy to help give you the best resources. We provide a meticulous case review of what you have been through and then go through the many reasons why infertility may exist and the different options and approaches there are.
Don’t let any team tell you the same protocol is necessary 10 times in a row and you are just a number.
Every loss is significant. Every embryo is significant. Each one is a heartbreak and we understand that.
Are you feeling overwhelmed by your fertility journey, trying to conceive, finding and going to a fertility clinic, starting IVF treatments or looking for your ideal path to building a family?
Fertility Planning Options
Option 1
Second opinion and detailed review regarding your fertility journey. If you have had multiple rounds of IUIs/IVF/Fertility assistance or you have had miscarriages and failed attempts on your own Dr. Karli Provost Goldstein and the team will analyze all your records and obtain fertility blood work before your visit. Sonogram will be done ahead of visit if telehealth or in person in the office with Dr. Karli Provost Goldstein. She will personally connect you with the best specialists in the field and help collaborate on your plan.
Option 2
For patients who have been recommended by their fertility practice to have investigation for endometriosis or if they are suspicious endometriosis is contributing to their fertility trouble (50% of unexplained infertility) ESSE Care is happy to offer investigation for endometriosis with fertility lab panel review or order, MRI and pelvic sonogram as well as surgical diagnosis and excision of endometriosis.
Option 3
Fertility restorative surgery with advanced hysteroscopy and endometrial biopsy for chronic endometritis. Tubal patency will be assessed and the fallopian tubes flushed, adhesions will be removed from the tubes or ovaries or both and any abnormality of scar tissue/inflammation or endometriosis will be carefully excised. If you have had recurrent failed transfers or painful transfers, the uterine anatomy can be assessed and optimized during surgery.
Option 4
Dr. Karli Provost Goldstein recognizes collaborative efforts greatly helped her in her journey with infertility over 10 years. She will coordinate the best in the field for you according to your goals. Whether this is a young patient for fertility preservation in the setting of endometriosis, adenomyosis guidance, or complementary therapies like acupuncture, diet work and Eastern medicine providers to help you with the stress of treatments we are here.
1,200+
SURGERIES
Dr. Karli Provost Goldstein, D.O. FACOG
Real stories from real patients.
Dive into our patient stories which illuminate the struggles they have been on and their path to healing with ESSE. Discover touching tales, significant experiences, and instances of patients finally finding relief after years of feeling unheard, disbelieved, and misdiagnosed. These narratives beautifully demonstrate the life-changing impact of empathy and attentive care.
Looking for something particular?
Endometriosis
A disorder in which tissue similar to the tissue that lines the uterus grows outside the uterus in places where it doesn't belong.
Fertility Consulting
Exploration (surgical or non-surgical coaching through the journey or investigating options).
Hormone Balancing
Whether in peri-menopause, menopause or seeking optimal balance throughout life ESSE Care provides hormone knowledge and customized approaches to help you feel your best.
Teenage intro to Gynecology
A comfortable place to talk about what is normal and what is not regarding periods and the menstrual cycle. Hormone and vitamin panel can be drawn ahead of the visit and transabdominal sonogram can be done ahead for those who do not need or want a pelvic exam.
Book Appointment
For a case review or to find out if you are a candidate please call or email us using the form below:
You’ve got questions, we’ve got answers.
What causes unexplained infertility?
Fertility patients can feel lost when told all their labs are normal and everything looks fine. In up to 50% or more cases of unexplained infertility the root cause can be endometriosis. As late as the 1990s when patients couldn’t get pregnant a diagnostic laparoscopy was performed to look inside the pelvis and make sure the anatomy was normal and there was no adhesions or endometriosis. Now that IVF technologies have improved (rapid vitrification/freezing improving) fertility Drs do less surgery and more IVF or egg retrievals. They often claim surgery is invasive. Because adhesions and endometriosis are not typically seen on MRI or ultrasound until they are at an advanced stage many patients are left in the dark until their best fertility years are over.
Have you been told all is normal and just stop stressing/ have a glass of wine/ go on vacation/ do yoga/ get a dog/ adopt a baby? Then you will get pregnant?!
Unfortunately while people have well intentioned guidance they may have no idea the psychological and physical stress infertility puts on your body and your relationships. They do not understand the 5am wake ups before work to make it to monitoring. The endless blood tests trying to be optimistic only to get an email or call it failed again. They do not understand the blind optimism and hope you feel each time and then the heartache with each failure. At ESSE, we get it. We’ve heard all these things and Dr G has been through those pains. Our goal is to help guide you through the process and make sure you are in the best hands in all aspects of care.
Have you been told to just adopt?
While this may be a great option for many families when people make statements like this they have no idea how difficult even adoption is. It is a process. It involves a lot of money unless using the foster system and even then attorneys fees and other hurdles are involved. Your home and finances are all reviewed. The wait can be long or painful if it doesn’t come to the end you want. We understand this. There are options available and agencies to help. There are patient advocates we can connect you with and have beautiful stories, but don’t be made to feel less than for wanting to deal with IVF or try a certain path for your family.
Have you been told to just get a dog? Then you will surely get pregnant…
These comments are frustrating and hurtful when going through the stress of infertility. The stress levels studied are similar to those of a patient going through cancer treatment. You must be optimistic when doing transfers or during the 2 week wait. Then you must hide all emotion at work or get togethers during each loss. While we love dogs, please don’t equate these concepts or act like they are magic tricks to produce babies.
Have you fluctuated from a size 0 to a 14 during infertility treatments?
While many practices will claim the hormones do not cause weight gain when you do this for years on end this is not true. The combination of hormones, exercise restriction (or being forbidden from exercise), progesterone injections and repetitive stress on your body can cause inflammation and stress. At ESSE, we are convinced, supported by extensive research, of the benefits of a holistic approach to wellbeing. We incorporate methods like acupuncture to enhance the success of your IVF treatment.