ONAÏ: frequently asked questions
What is ONAÏ?
ONAÏ helps you understand what may be affecting your fertility beyond your reproductive system and where to focus next. We look across your labs, health history, symptoms, and treatments to connect the dots, uncover potential gaps, and identify what matters most. You’ll receive a personalized report with clear priorities and recommendations. And if you want help putting them into action, our team can coach and guide you over three months, with personalized nutrition, lifestyle support, and ongoing check-ins to help prepare your body for what’s next. We work alongside your fertility doctor, not in place of them. ONAÏ provides patient education and clinician decision support. We do not diagnose or treat, and all medical decisions remain with your care team.
What’s included in my ONAÏ Fertility Readiness Report?
A personalized, whole-body assessment that connects the dots across your test results, symptoms, and health history to identify what may be affecting your fertility. You’ll get a clear, prioritized plan tailored to your biology, fertility goals, and where you are in your journey, including what may be contributing (factors across your body that may be affecting your fertility), tests to consider (what else may be worth investigating), questions for your doctor (what to ask at your next appointment, including options that may be worth discussing based on your results), food and supplements (personalized guidance based on your results), your action plan (what to focus on first, why it matters, and next steps to consider), and a partner plan (recommendations to help address your partner’s role in fertility). So you’re not left wondering what to try next. You know what deserves attention and have a plan to move forward.
Who is ONAÏ for?
ONAÏ is for anyone trying to conceive who wants their whole picture read together. Most people come to us after a failed IVF cycle or transfer, after pregnancy loss, with unexplained infertility, while preparing for a frozen embryo transfer, or with a diagnosis like PCOS or endometriosis. We also work with people trying naturally.
What does ONAÏ look at beyond standard fertility testing?
Your fertility clinic focuses on your reproductive system, including your ovaries, hormones, and pituitary function. ONAÏ looks at other systems that may influence fertility, including gut health, metabolism, immune function, inflammation, cardiovascular health, and nutrition. We connect the dots across these systems to identify potential gaps and additional testing worth discussing with your doctor.
How does ONAÏ decide what matters most?
We weigh every finding three ways. Impact asks how much it may affect your fertility. Leverage asks how much you can change it. Timing asks whether there is time to act on it before your next step, since some changes, like rebuilding iron, take months. Everything is then ranked, so you know what to focus on first instead of getting a long list.
Do you work with people outside the United States?
Yes. ONAÏ works with people in many countries. Everything happens online over video calls and messages, and prices are in US dollars. We can also plan meals around the food and grocery stores where you live.
How much does ONAÏ cost?
There are two ways to work with us. The ONAÏ Fertility Readiness Report gives you a personalized, whole-body fertility report, your top priorities ranked by potential impact, a clear action roadmap, suggested follow-up testing for you and your partner, questions for your doctor, and a 60-minute, one-on-one results review. The 90-Day Program includes everything in the Report, plus 90 days of weekly nutrition coaching, monthly expert check-ins, and a plan that adjusts as your body responds, timed to the roughly 90 days it takes an egg to mature. We go over pricing on your free call, so you can choose what fits you.
What’s included in both packages?
Every package starts with a personalized, whole-body fertility report. We connect your health information, identify potential gaps, and rank what matters most for your fertility goals. You’ll receive clear priorities, recommended next steps, suggested testing for you and your partner, questions for your doctor, and a 60-minute one-on-one review of your results.
Which package is right for me?
The Fertility Readiness Report is for you if you want to understand what may be affecting your fertility, know where to focus, and have a clear plan you can follow on your own. The 90-Day Program is for you if you want to turn what we find into real change. Our team coaches you week by week and adjusts your plan as your body responds, over the roughly 90 days it takes an egg to mature, so you go into what’s next prepared. If you want a team by your side from day one, choose the 90-Day Program.
How long does it take to get my report?
Your report is usually ready about three days after we have all of your records. Gathering records from clinics is often the slowest step, so we help with that too, including writing the request to your clinic for you. If you have a transfer or cycle coming up soon, tell us on your free call so we can plan around it.
Do I need new bloodwork before getting started?
No. We start with the test results and medical records you already have. If we identify important gaps, we’ll explain which additional tests may be worth discussing with your doctor, why they matter, and how they could help us better understand your fertility. Your doctor can order any additional testing you decide to pursue.
Does insurance cover ONAÏ?
ONAÏ does not bill insurance. Whether you can use HSA or FSA funds depends on your plan and how it treats education and coaching, so check with your plan administrator before you pay.
Do you offer payment plans?
Yes. Payment plans are available for the 90-day program. Ask about them on your free call and we will walk you through the options.
Can I upgrade to the 90-Day Program later?
Yes. If you already have your Fertility Readiness Report, you can upgrade to the 90-Day Program, as long as there is space in the program. We will walk you through the cost on a call.
Is ONAÏ medical advice?
No. ONAÏ provides patient education and clinician decision support. It is not a substitute for professional medical advice, diagnosis or treatment. Everything we share is meant to help you understand your results and have better conversations with your care team.
Does ONAÏ replace my fertility doctor?
No. ONAÏ works alongside your fertility clinic. We do not diagnose, prescribe, order tests, or change your protocol. We help you understand your own data and bring better questions to your appointments, and every medical decision stays with you and your doctor.
What questions should I ask my fertility doctor?
Good questions include what is most likely behind our difficulty conceiving, which tests have and have not been done and why, what the plan is if this cycle does not work, and whether anything in my history should change the protocol. The most useful questions are specific to your results, which is why every ONAÏ Fertility Readiness Report ends with questions written for your case.
Can you get my records from my clinic?
You have a right to your own medical records, and we help you get them. ONAÏ can write the records request for you to send to your clinic, and we can work with whatever you are able to collect, including screenshots and patient portal downloads.
Can a nutritionist help with fertility?
Research links diet quality with fertility. For example, studies have found that women following a Mediterranean-style or "profertility" diet had better IVF outcomes, and nutrients like vitamin D and folate matter. A nutritionist helps turn that research into meals you will actually eat, which is the hard part for most people.
What’s included in ONAÏ’s nutrition support?
The 90-day program includes your own fertility nutritionist, a meal plan built around the foods you love and the ones you cannot stand, your culture and the stores near you, one plan for your whole household, nutrition that shifts with your cycle, your medications and your transfer timeline, live one-on-one sessions as often as every week, and messaging for everyday questions.
Is the nutrition plan based on my labs?
Yes. The gaps found in your Fertility Readiness Report become targets in your meal plan, so the plan is built around what your own results show rather than a generic diet for a diagnosis. It also changes as you move through your cycle and treatment.
Do I have to count calories or grams?
No. If counting is stressful or not your style, your nutritionist plans the meals and portions for you. Changes are made one step at a time, so you are never asked to overhaul everything at once.
Does ONAÏ look at both partners?
Yes. Every ONAÏ package includes the male partner’s results, such as semen analysis and hormones, read together with yours, along with supplement and lifestyle recommendations for him. If his results do not affect your current plan, for example when donor sperm or ICSI is already planned, we will tell you rather than add busywork.
Can my partner join the calls?
Yes. Partners are welcome on the walkthrough and on coaching calls, and the meal plan in the 90-day program is built for your whole household, so no one is cooking two dinners.
Is my health information private?
Yes. ONAÏ does not sell personally identifiable data. You can ask us to delete your information at any time by emailing hello@onaifertility.com.
What if my results are hard to hear?
Not knowing is often the hardest part. Your report gives you clear, ranked priorities and leaves out what you can’t act on, so you come away with next steps rather than more questions. Your 60-minute results review is there so we can walk through every finding together and answer what’s on your mind.
My bloodwork is normal. Why would I need to look further?
“Normal” doesn’t always mean optimal for fertility. Most standard lab ranges are based on the general population, not specifically on women trying to conceive. For some markers, research suggests that levels within the normal range may still be worth a closer look when it comes to fertility. ONAÏ evaluates your results through a fertility-focused lens, helping you understand where your levels fall, what the research tells us, and whether there’s an opportunity to improve your health before you try again.
Why am I not getting pregnant when all my tests are normal?
Normal results on a basic workup do not mean everything has been checked. Standard testing looks at ovulation, open tubes and a semen analysis, and many other factors, such as thyroid levels inside the normal range but not the optimal one, insulin, vitamin D, inflammation, immune or clotting factors, are often never tested. That is the gap ONAÏ is built to find.
What causes unexplained infertility?
Unexplained infertility means the standard tests came back normal, not that there is no reason. The American Society for Reproductive Medicine estimates it affects up to 30% of couples having trouble conceiving. Possible factors include egg or sperm quality issues that basic tests do not measure, subtle hormone, metabolic or immune factors, and conditions like endometriosis that can be missed without surgery.
What is a good TSH level for fertility?
Many fertility specialists aim for a TSH under 2.5 mIU/L when someone is trying to conceive, even though a typical lab range goes up to about 4 to 4.5. The American Society for Reproductive Medicine says the evidence for treating levels between 2.5 and 4 is limited, so this is a decision to make with your doctor based on your antibodies and history.
What is a good AMH level, and can low AMH be improved?
There is no single good AMH number, because AMH reflects how many eggs you have, not how good they are. It mainly predicts how you might respond to IVF stimulation, and research has found it does not predict the chance of conceiving naturally. AMH itself is hard to raise, but other factors that affect egg quality and your overall plan are often worth looking at.
Does vitamin D affect fertility?
Research suggests it may. A 2018 meta-analysis in Human Reproduction found that women having IVF with enough vitamin D had higher odds of a live birth than women who were low. That is an association rather than proof, but vitamin D is an inexpensive test to ask your doctor about if it has never been checked.
Does insulin resistance affect fertility?
Yes, insulin resistance can affect ovulation and has been linked with higher miscarriage rates, especially in women with PCOS. It often goes unnoticed because a fasting glucose test can look normal while insulin is high. Tests like fasting insulin or HbA1c can be worth asking your doctor about.
What should I do after a failed embryo transfer?
Give yourself time first, then ask your clinic for a follow-up appointment to review the cycle. It helps to bring your embryo reports, lining measurements, protocol and lab results, along with a written list of questions. This is a common time to get a fresh set of eyes on the whole picture, alongside your doctor rather than instead of them.
Why did my embryo transfer fail?
Often there is no single clear answer. Embryo factors such as chromosomal problems are the most common reason, but the uterine lining, hormone levels, immune or clotting factors, thyroid, and timing can all play a part. A failed transfer is a reason to review everything together, including tests that may not have been run yet.
Why did my IVF fail with good embryos?
A good grade describes how an embryo looks, not whether its chromosomes are normal, so even top-graded embryos can fail to implant. When good embryos fail more than once, many doctors look more closely at the uterus, hormones, immune and clotting factors, and the protocol itself. Those are the areas an ONAÏ Fertility Readiness Report checks.
What questions should I ask my doctor after a failed IVF cycle?
Useful questions include what you think was most likely behind this result, whether anything about the protocol should change next time, which tests have not been done yet and whether any of them could help, how the lining and embryo quality looked, and how long to wait before trying again. Every ONAÏ Fertility Readiness Report ends with questions written for your specific case.
How soon can you try again after a failed embryo transfer?
Many clinics let you start the next cycle after your next period, while others suggest waiting a cycle or two. It depends on your protocol, how your body recovered, and whether any testing is planned in between. Your clinic will tell you what is right for you.
What is recurrent implantation failure?
Recurrent implantation failure is when good-quality embryos are transferred several times without a pregnancy, often after three or more transfers. Guidance from ESHRE, the European fertility society, defines it based on the chance of success the transferred embryos should have had. It is a signal to look beyond the embryos at the uterus, hormones, and immune and clotting factors.
What tests are done for recurrent miscarriage?
Guidelines from ASRM and ESHRE generally support testing after two or more losses. That can include imaging of the uterus, antiphospholipid antibody testing, thyroid testing and, in some cases, a diabetes check, and sometimes genetic testing of both partners or of the pregnancy tissue. ONAÏ shows you which of these you have had and which you have not.
Should men get fertility tested?
Yes. Male factor is involved in close to half of couples having trouble conceiving, according to the American Society for Reproductive Medicine, so testing both partners early can save time. A semen analysis is usually the first test, and a doctor may add hormone tests or a DNA fragmentation test depending on the results and history.
What does a sperm analysis tell you?
A semen analysis measures how many sperm there are, how well they move, and how they are shaped, along with volume and other basics. It does not measure DNA damage inside the sperm, which is a separate test. A result inside the normal range is a good start, but it is not the whole picture.