Clarity First.
Confidence Always.

Most fertility practices are organized around treatment: the default is often to move toward IVF as quickly as possible. Kofinas takes a different approach. Before recommending any procedure, the clinical team conducts a thorough diagnostic evaluation to understand what is actually contributing to your fertility challenge. If a structural factor such as endometriosis, fibroids, or a uterine issue is present and may be affecting your chances, surgery is available and integrated with IVF care under the same clinical team.

This means patients who need both surgery and IVF are not referred out or asked to coordinate between separate providers. The same team that evaluates you manages your care throughout. For patients who have been through treatment elsewhere without a clear explanation for what happened, this evaluation-first model often produces answers that prior care did not.

A first appointment begins with a detailed review of your medical and reproductive history, a discussion of your goals, and a plan for initial testing. Testing typically includes hormone blood work and an ultrasound to assess the ovaries and uterus. If you have a male partner, a semen analysis is part of the initial evaluation. If you have records from prior treatment, bringing them, or sending them in advance, helps the team orient quickly to your situation. The first visit is not a commitment to any particular treatment. It is an evaluation. At the end of it, you will have a clearer picture of where things stand and what the options are.

The relationship between endometriosis and fertility is complex, and surgery is not the right answer for every patient with the condition. When endometriosis is affecting the fallopian tubes, creating ovarian cysts (endometriomas), or causing significant uterine distortion, surgical treatment may improve the conditions needed for natural conception or for IVF. Surgical excision, which removes endometriosis tissue rather than simply burning the surface, is the technique generally preferred for fertility-related cases or those wishing to preserve their fertility for the future.

Whether surgery is indicated before or alongside IVF depends on the extent and location of disease, your ovarian reserve, your age, and your overall fertility picture. This is a clinical decision that requires a full evaluation, not a general recommendation. At Kofinas, that evaluation comes before any recommendation is made.

Egg freezing preserves eggs at their current state for potential future use. It does not guarantee a future pregnancy. Whether a pregnancy results, depends on how many eggs were retrieved, the quality of those eggs (which is influenced by age at the time of freezing), how many survive the thaw, how many fertilize successfully, and how many resulting embryos develop and implant.

Age at the time of freezing is one of the most significant factors. Eggs retrieved at younger ages are generally associated with better outcomes when used later. Your clinician can provide age-specific context for what to expect in your situation before you make a decision.

A failed IVF cycle is not always explained by the cycle itself. Contributing factors that are sometimes overlooked include structural issues such as endometriosis, uterine polyps, fibroids within the uterine cavity, or intrauterine adhesions that may interfere with implantation. Immunological factors and sperm quality issues are also areas that warrant evaluation when prior cycles have not succeeded.

A records review and consultation at Kofinas can examine what happened at each stage of your prior cycle, identify patterns, and determine whether something structural or diagnostic was not fully evaluated. Bringing your prior cycle summaries, laboratory reports, and any imaging is the best starting point.

Yes. Infertility involves male-factor contributions in a substantial proportion of cases, and evaluation of both partners is standard practice at Kofinas when a couple is seeking care. A semen analysis is part of the initial work-up. Depending on findings, additional evaluation may include hormonal testing, urological consultation, or assessment for surgical sperm retrieval options. IVF with ICSI (intracytoplasmic sperm injection) is available when male-factor infertility is present.

If you are coming in as an individual rather than a couple, the evaluation is tailored to your situation.

IVF success rates are reported by clinics and through national databases maintained by the CDC and the Society for Assisted Reproductive Technology (SART). These rates are only meaningful when you understand what they are measuring. A rate described as "success" may refer to a positive pregnancy test, a clinical pregnancy (heartbeat confirmed), or a live birth. These are not the same endpoint, and live birth rates are the most clinically meaningful.

Rates also differ significantly by age group, diagnosis, and whether a transfer used the patient's own eggs or donor eggs. A clinic that treats a higher proportion of complex or older patients may show lower aggregate rates than one that selects for favorable cases. Before comparing rates between clinics, ask which outcome is being reported, for which age group, and whether donor egg cycles are included or excluded. Your clinician can help you understand what the data mean for your specific situation.

Kofinas Fertility Group operates five locations across New York City: Upper West Side, Lower Manhattan, Brooklyn, Staten Island, and Long Island. Monitoring appointments and consultations can take place at the location most convenient for you. Surgical and IVF procedures may be coordinated at specific locations depending on the services available there.

For patients traveling from outside the New York area, virtual consultations and remote records review are available.

Costs vary significantly by treatment type, the number of cycles involved, and individual circumstances. Insurance coverage for fertility treatment differs by plan, employer, and state. Some plans cover diagnostic evaluation but not treatment; others cover IVF up to a certain dollar amount or number of cycles.

The Kofinas team can help you review your coverage and discuss options for managing costs.

Yes, and patients who have prior treatment history are welcome to bring all of their records. Prior cycle summaries, laboratory findings, operative reports, imaging, and pathology results all help the team understand what has already been evaluated and what may not have been. A second-opinion consultation begins with what you already know, not from scratch.