Frequently Asked Questions

We are a full service Reproductive Endocrine & Infertility Clinic. Dr. Duke treats patients for any or all of the following:

• Amenorrhea (absence of periods for greater than 6 months)

• Endometriosis (if the patient has been referred by a Gynecologist)

• Future Fertility Planning & Fertility Preservation in men, women & LGBTQIA+ patients

• Hormonal abnormalities (e.g thyroid, prolactin, low testosterone) that are affecting male and female reproduction

• Infertility in men, women and non-binary patients

• Menopause (if the patient has been referred by an Ob/Gyn)

• Oncofertility – we offer fertility preservation (egg freeze, sperm freeze, embryo freeze) services for patients facing a cancer diagnosis. We are the only full-time egg and sperm freeze program for Cancer patients in Nevada! We can get a cancer patient in to see the Doctor, as soon as 48 hours from the initial time of consult request!

• Pediatric Endocrinology (hormone problems in pediatric and adolescent patients such as early periods before age 8 or never had periods)

• Polycystic Ovary Syndrome (PCOS)

• Recurrent Pregnancy Loss (RPL) or Miscarriages – this is defined as 2 or more miscarriages/still births/neonatal deaths in a woman’s lifetime

• Use of a Gestational Carrier or Surrogate – we have a third party reproduction program. The Program Director is Christine Obrien, Nurse Practitioner

• Use of Donor Eggs or Sperm

• Uterine Cavity Adhesions/Scarring – this is known as Asherman’s Syndrome

• Uterine Fibroids

18% of the US population has trouble conceiving or is LGBTQIA+. 12% of the US population has dangerous genetic disorders. No matter the unique treatment plan, we make fertility simple.

• Consultations

• Egg Freezing

• Embryo Banking

• Genetic Carrier Screening & Testing. (we work with Natera, Cooper Genomics, SEMA4 & Invitae to name a few of the national genetic carrier screening companies)

• Hysterosalpingogram (HSGs).

• Intrauterine Inseminations (IUI) which is also known as artificial insemination

• Ovulation Induction (OI)

• In vitro Fertilization (IVF)

• Preimplantation Genetic Testing (PGS/PGD/PGT) including testing for Family Balancing

• Semen Analysis

• Sperm Freezing including for patients planning vasectomy and for cancer patients

• Surgeries (hysteroscopy, laparoscopy, myomectomy, tubal cannulations); Dr. Duke does not currently perform tubal ligation reversal surgery

Dr. Duke does not currently perform Tubal reversal surgeries. This is in part because the results can vary significantly depending on the patient’s medical history, their age and the specific details of how the patient’s tubal ligation was performed. However, Dr. Duke is happy to review your specific case with you and discuss all available options for you to get pregnant. Would you like to schedule an appointment to see her?

If you are coming in to see Dr. Duke, please go ahead and request that a copy of the operative report for your tubal ligation surgery be sent to this office BEFORE the day of your appointment, so that Dr. Duke may have adequate information to advise you during your visit with us.

Yes! If you are a good candidate for tubal reversal surgery, Dr. Duke can make a referral. We advise that you come in to chat with the Doctor to review if tubal ligation reversal may be your best option. The doctor is very thorough and she can help advise you on all of the options available to you. Would you like to schedule an appointment?

Dr. Duke can assess to see whether your Essure needs to be trimmed down. Would you like to schedule an appointment with Dr. Duke to discuss further?

If you are coming in to see Dr. Duke, please go ahead and request that a copy of the operative report for your Essure tubal ligation surgery be sent to this office BEFORE the day of your appointment so that Dr. Duke may have adequate information to advise you during your visit with us.

Yes. Dr. Duke performs surgeries, as needed, on her patients. Surgeries that she routinely performs include:

Hysteroscopy: a non-invasive type of surgery to remove things like endometrial polyps, sub-mucosal fibroids or treat scarring inside the uterus/womb.

Laparoscopy: a minimally invasive type of surgery to treat issues affecting the ovaries, uterus, fallopian tubes or pelvis. This includes surgery to treat pelvic scarring, tubal scarring and endometriosis.

Myomectomy: a surgery to remove uterine fibroids while preserving a person born with a uterus’ chances to carry children. This can be either hysteroscopy or open surgery, depending on the specific patient case.

We offer a full range of family building services which include Intrauterine insemination (IUI) where we help the patient time ovulation of an egg and then perform insemination of specially prepared donor sperm into the uterus; all the way to Reciprocal in vitro fertilization (IVF) where we can use eggs from one partner and donor sperm to create embryos that the other partner will then carry! Or, for same sex female couples, both partners can also use their eggs to create sibling embryos, via in vitro fertilization (IVF) with Donor sperm, that either partner can then carry during a pregnancy! Talk to our Fertility Counselor Today, to learn more!

We work with our patients to help them source donor sperm from FDA approved sperm banks across the United States. Here is a list of sperm banks.

We offer a full range of family building services which include assisting with the sourcing of donor eggs for embryo creation using in vitro fertilization (IVF) with the patient and/or their partner’s sperm, sourcing of gestational carriers via surrogacy agencies and more!

We can also work with HIV Positive patients to help them safely achieve pregnancy, using a gestational carrier (surrogate), via the proven Bedford protocol.

We offer a full range of fertility preservation and family building services which include egg freezing, sperm freezing, embryo creation and more!

You will meet with our Fertility Expert, Dr. Duke to discuss your fertility journey thus far, health and medical history, and goals. From there, Dr. Duke will create a customized treatment plan for you.

Once you receive your personalized treatment plan from Dr. Duke, your concierge will reach out to discuss your plan, including all financial information. If you decide to proceed with treatment, your treatment concierge will book your first in-office appointment to begin treatment, as well as provide your treatment calendar via your patient portal account. This is where you can schedule appointments, coordinate prescriptions, and chat 24/7 with your care team.

In general, patients do not need a referral to be seen at our clinic. However, for patients with certain insurance plans such as Health Plan of Nevada (HPN), Sierra Health and some Aetna plans, you will need to have a referral submitted to your insurance by your primary ob/gyn, before the day of your new patient visit for insurance to cover your testing or other fees/charges which may originate at our clinic.

Our Financial Concierge can help you determine if a referral is needed Before your first appointment with us!

Yes! As a leader in Telefertility, Nevada Fertility Institute has dedicated Video medicine services which facilitate the safe and thorough evaluation of patients who are local to Nevada and those who live further away.

Video/Telemedicine consultation appointments are generally performed by Dr. Duke or Christine O’Brien, NP. The cost for the new patient (virtual) appointment is $199 — payment is due at least 24 hours before the visit starts, and we strongly encourage having your medical records and patient intake questionnaire completed at least 24 hours prior to the appointment or we may need to reschedule your appointment.

Please note that all foreign records need to be translated into English (and notarized if not originally in English) before sending them to Nevada Fertility Institute.

**Notarizing is an attestation that the records received match the name/photo of the person whose medical records we have received.

Dr. Duke does not typically do routine Gyn visits like annual examinations or pap smears. However, if during the course of her treating you for another reason, it is found that you need any of these, she may be able to perform such services or she may refer you to one of the many highly skilled general gynecologists in Town, with whom she maintains a wonderful relationship.

At present, we do not have any active clinical research studies going on at NFI.

It would be my pleasure to assist you with this! We appreciate you calling in. Please allow me to put you in touch with a member of our nursing Team (say the Name of the person on Phones that day) who can assist you further.

You can also send requests for further information about your surgery through your patient portal or by email to nursing@nevadafertilityinstitute.com

Costs are determined by the following question: Are you seeing Dr. Duke to discuss options for getting pregnant or treating a fertility issue?

• If the answer is “YES”, the self pay (non insurance) cost for the visit is $199 and this includes the cost of your first follow-up visit. Please note that if you have insurance, your insurance responsibility (co-pay or deductible) may be different (more or less) than $199.

• If the answer is “No”, then it depends on your insurance pricing or if self pay, the cost of a routine 60-minute new patient consultation.

The self pay (non insurance) cost for a return visit is $100. However, if you have insurance, the cost of the return visit is the co-pay or deductible which is determined by your specific insurance policy.

Our customized packages start at $6500 per cycle/all in bundle pricing without hidden fees and are further personalized to meet your unique treatment needs and family building goals.

We offer a number of very affordable packages for IVF, including Mini IVF! However, to be honest with you, the type of package is dependent on the patient’s specific case and recommendations from our doctor. I would highly recommend that you schedule a consult visit to review your specific case with Dr. Duke. We have a no fee Financial Concierge who will also meet with you after your consult appointment to help design a payment/financing plan that works best for you.

If you have seen another fertility specialist within the past 6 months, we are able to offer you a FREE second opinion consultation with Dr. Duke, if you are able to provide us with the medical records from the other fertility specialist BEFORE your appointment with us.

Yes! We offer treatment for up to 60% less than traditional fertility clinics and accept:

• Employer benefits

• Insurance coverage

• B + C credit scores

We also have unique in-house financing which features:

• No required credit check

• Family friendly “pay as you go” options

Our dedicated Financial Concierge team is happy to coordinate a no charge financial consult for you. Feel free to call or text us at 702-936-8710, to request a financial consultation.

We strongly recommend that you contact your insurance provider to determine what services may be covered. With regards to fertility benefits, it may be helpful for you to ask specifics about whether your individual policy covers diagnostics or treatment and if they do, what specific services do they cover?

Our Financial Concierge will also perform a verification of benefits prior to you having any particular service performed at our clinic. We just ask that you always make sure we have updated insurance information for you, by texting us or uploading a copy of the front and back of your health insurance card.

-What do my benefits cover for infertility diagnosis and infertility treatment?

-Are infertility diagnostic procedures covered (ex: office visits, blood work, ultrasounds, hysterosalpingogram (HSG), hysteroscopy)?

-Are infertility treatments covered (ex: intrauterine insemination (IUI), in vitro fertilization (IVF), oocyte cryopreservation (egg freezing) or sperm freezing)?

-Are fertility drugs covered or reimbursable on my insurance plan? Are there any exclusions to my fertility medication coverage? Can I use a fertility specialty pharmacy of my choice?

-What is my annual or lifetime maximum benefit for infertility treatment?

-Is there an age limit by which I need to complete specific infertility treatment?

Our mission is to provide you with the most modern infertility medical care in Nevada within a warm and caring environment.

We are located in Las Vegas, Nevada across from IKEA. Our Address is 8530 west sunset road, suite 310 (third floor), Las Vegas NV 89113.

We have staff who are fluent in English, Spanish and Tagalog.

In addition, we utilize a telephone translation/interpreter service which allows us to facilitate conversations and visits in all languages.

If you require an ASL (American Sign Language) interpreter, we recommend that you bring one along with you to your visits.

• We are generally open from 8AM to 4PM on Mondays through Thursdays and from 8AM to 1230PM on Fridays. We also have select weekend availabilities, by appointment only!

• Our new patient appointments are usually scheduled on Monday through Friday.

• Our Semen Analysis Appointments are Mondays through Thursdays between 830AM and 130PM. We do not do Walk-in Semen Analysis Appointments.

• Our weekend appointments are on an as needed basis, for patients actively undergoing fertility treatment.

Our fax number is (702) 936 - 8711

We highly recommend that our patients use our 2-way texting system or the patient portal to send all nonurgent questions/requests to the office.

Other forms of contact with our office are:

Text/Call: 702-936-8710

info@nevadafertilityinstitute.com for patients who are not registered with NFI.

nursing@nevadafertilityinstitute.com for nonurgent nurse messages from established NFI patients.

Once you have scheduled a new patient appointment, you will be granted access to the patient portal. Via the portal, you can make payments, see your verification of insurance, review your payment plans and much more!

Yes, via our patient portal that is open 24/7, you will be able to connect with your counselor for questions, concerns or information outside of your scheduled appointments.

If you wish to talk to a nurse in person, during normal business hours, you can text and request a call back or you can call 702-936-8710 and select “option 4”.

I would be happy to transfer you to the member of our nursing Team

Yes. We highly value our patients’ time and strive to keep appointments on schedule. Therefore, we ask that you arrive at least 15 minutes prior to your scheduled appointment time. If you arrive more than 15 minutes late for your appointment, we will likely need to reschedule you to another date.

We are happy to provide you, or a facility of your choosing, with your medical records. In keeping with HIPAA requirements, please complete and sign our medical record release form and get it back to us by either fax (702-936-8711) or email (info@nevadafertilityinstitute.com). Once we receive your signed medical records release request, please note that it usually takes 30 business days for the record release process to be completed.

Please let us know how you would like to have the records sent: Email? Fax? Regular mail? If requesting that the records be sent by mail, we ask that you cover the cost of shipping. *We cannot guarantee security of emailed or mailed medical records.*

We encourage you to text your prescription requests to 702-936-8710. Texting is the fastest. You can also call that same number or can you email it to nursing@nevadafertilityinstitute.com

Our Providers are willing to complete FMLA forms on a specific case by case basis, if the patient is actively under their care and repeated visits with Dr. Duke are needed.

It takes 14 working days, from the date of receiving the forms at our office, for FMLA forms to be completed.

Due to the nature of treatments performed at NFI, the period of time covered by a FMLA form filled out by Office will not usually exceed 90 days. If your form needs to cover a time frame longer than 90 days, we recommend that you have the form completed by your primary care provider.

Dr. Duke is Board Certified in Obstetrics and Gynecology. She completed her residency training in Gynecology & Obstetrics at Johns Hopkins Hospital in Baltimore, Maryland and her subspecialty training (fellowship) in Reproductive Endocrinology & infertility at Yale University School of Medicine in Connecticut. She is an active Fellow of the American College of Obstetrics and Gynecology (hence the FACOG).

She attended medical school at the University of Rochester School of Medicine and Dentistry in upstate New York.

Yes! Dr. Duke is a trained, published and award winning Physician Scientist who also holds a Master of Science and a Ph.D. in Microbiology and Immunology with a focus on Virology. In fact, Dr. Duke is America’s ONLY Fertility Expert and Virologist!

She is still actively involved in clinical research studies with different collaborators.

Dr. Duke has been practicing in Las Vegas since November, 2016. Her family resides here on the west coast and they really love living here!

Dr. Duke was practicing in New Haven, Connecticut, at Yale School of Medicine prior to coming to Las Vegas. Dr. Duke is originally from the sunny Caribbean islands and so she really loves this Vegas weather!

Click here to watch Dr. Duke review In Vitro Fertilization!

Click here to watch Dr. Duke talk about the concept of IUI, how it works, and what it really is for.

Click here to watch Dr. Duke discuss the foundations of why, when and how to obtain a Semen Analysis or do Ovarian Reserve Testing!

Click here to watch Dr. Duke joined by Katherine L. Provost, Esq to discuss issues pertaining to LGBTQIA, as well as single male and female patients, who are considering their legal options for achieving pregnancy!

Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse. Because age can have a significant impact on fertility, women who are 35 years or older should see a reproductive specialist after six months of trying to conceive without success. Other reasons for seeking a fertility evaluation may include:

- regular menstrual cycles (less than every 25 days or more than 35 days), which may suggest that a woman is not ovulating

- Previous pelvic surgery or infection(s), which may suggest fallopian tube disease

- Painful periods, which may suggest endometriosis

- Recurrent Pregnancy Loss

- Elective/Social Fertility Preservation

- Fertility Preservation for Cancer Patients

- If you or your partner have a known reason that may complicate the ability to conceive

Approximately 30% of the population needs fertility treatment. 12.5% of all couples medically require fertility treatment, while on average, 30% of straight couples require fertility treatment due to male factor infertility.

Several factors can contribute to female infertility, including age, anovulation, tubal, and cervical-uterine issues.

Several factors can contribute to male infertility, including varicocele (dilated or varicose veins in the scrotum), sperm volume (amount), motility (movement) and morphology (shape) of the sperm.

Yes, for fertility preservation and oncofertility

We maintain consistently above national average success rates through our partnerships!

We offer immediate consultation for cancer patients, within 24 hours. All other patients are seen typically within 1-2 weeks, depending on availability. We would be happy to get you in ASAP, do you prefer morning or afternoon appointments?

10-12 weeks with heartbeat

Yes, please let us know if Dr. Duke can assist with these- she would be happy to!

An embryo that has developed for approximately five days after fertilization. At this point the embryo has two different cell types and a central cavity. The surface cells (trophectoderm) will become the placenta, and the inner cell mass will become the fetus.

A technique which uses extremely low temperature to preserve live tissue in storage for long periods of time. Cells are partially dehydrated and rapidly brought to a temperature at which all cellular metabolic reactions cease (vitrification). Upon thawing, cells are rehydrated and brought back to body temperature.

A procedure used to obtain eggs directly from ovarian follicles for use in IVF (In vitro fertilization). With the patient under monitored Anesthesia care and comfortable, the eggs are retrieved through the vagina under ultrasound guidance.

The result of the fertilization of an egg with sperm is known as a zygote and then as an embryo. After implantation in the womb and the subsequent formation of a pregnancy (ie conception), an embryo becomes a fetus.

A cause of infertility, in which the lining of the uterus migrates to other regions of the body, usually in the pelvic region, causing scarring and sometimes damaging the fallopian tubes and ovaries.

Procedure by which the embryo (usually aged 3 to 6 days) is placed into the uterus.

An x-ray that allows the physician to view the size and shape of the inside of the uterus and fallopian tubes. It is also known as the tubal dye test.

A minimally invasive procedure, where there are no cuts or incisions on the patient’s belly and whereby the womb cavity is visualized using a special telescope, as it passes through the vagina and cervix into the womb. This procedure allows for the diagnosis and removal of intrauterine pathology such as endometrial polyps, submucosal fibroids, uterine scar tissue and more.

A micromanipulation procedure whereby a single sperm is captured in a thin glass needle and injected directly into the egg. This procedure allows fertilization to be possible, even when a patient has sperm that do not move.

A painless procedure in which washed semen is injected into the uterus, near the openings to the fallopian tubes, using a specialized soft catheter.

In Vitro Fertilization is a process by which eggs are harvested from the ovaries and mixed with sperm outside of the body and allowed to fertilize. Fertilized eggs, or embryos, can be cultured for up to 6 days in the laboratory. At that point, embryos or blastocysts are transferred to the uterus.

Laparoscopy is a surgical procedure, performed under a general anesthetic, where a tiny camera is introduced into the abdominal cavity or pelvis through small incisions (usually 0.5–1.5 cm) located around the belly button. Laparoscopy can be used to inspect and diagnose a condition or to perform surgery. Common laparoscopic procedures performed by Dr. Duke include excision of endometriosis, chromotubation, excision of pelvic scar tissue and excision of ovarian cysts.

Refers to genetic profiling of embryos prior to implantation (as a form of embryo profiling). PGT can be used to detect abnormalities of both chromosome number and/or specific gene content.

A laboratory test used to assess semen quality: semen volume, sperm quantity & concentration, sperm morphology (shape), and sperm motility (movement)