IVF & REI Fertility Clinics

A no-show on retrieval day doesn't just cost a slot. It costs the entire $15–25K cycle.

IVF cycles run on biological timelines that can't be moved. When a patient misses their trigger shot window, skips the NPO requirement, or shows up without an escort — the cycle is lost, not postponed. CaseFlow is the only patient communication system built for that reality.

A 100-cycle/month clinic losing 8–10% to retrieval day no-shows absorbs $1.92M–$2.4M in annual cycle revenue at risk.
IVF & REI — The Retrieval Day No-Show Economics
$15–25K
Per IVF retrieval cycle value — one no-show = entire cycle lost
8–12%
Retrieval day no-show rate (national REI average, pre-CaseFlow)
1–2h
Trigger shot window — after that window closes, the cycle is compromised
72%
Retrieval no-shows traceable to missing escort confirmation (sedation required)
14–21 days
Pre-cycle clearance burden: hormone panels, ultrasound clearance, infectious disease screens
48h
Donor-recipient sync window — donor trigger and recipient lining synchronization is unforgiving
How CaseFlow Works

Every failure point in the IVF cycle — handled automatically

IVF is unforgiving. Biological timelines don't flex. CaseFlow handles the pre-cycle clearance burden, trigger shot confirmations, escort coordination, and donor-recipient sync — so your coordinators stop chasing patients and start preventing cancellations.

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Trigger Shot Timing Confirmation

Retrieval day is set by the trigger shot — and the trigger shot window is 1–2 hours. CaseFlow sends a T-36h reminder with the exact time and medication instructions, a T-12h confirmation ("Have you taken your trigger shot? Reply YES / NO"), and a T-2h arrival reminder. Non-responses trigger a coordinator alert with the patient's phone number — not a generic text, but an explicit flag before the window closes.

T-36h → T-12h → T-2h trigger confirmation sequence with coordinator escalation before window closes
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Escort Coordination Loop — #1 Retrieval No-Show Driver

Seventy-two percent of retrieval day no-shows trace to missing escort confirmation. Anesthesia requires a driver at discharge — no driver means the cycle must be cancelled, not postponed (the patient already triggered). CaseFlow sends a T-24h and T-2h escort confirmation: "Your retrieval requires sedation. A driver must be present at discharge. Please confirm your escort." Non-confirmed patients flag the coordinator with enough lead time to problem-solve — not at 6am when the patient is already on their way.

T-24h + T-2h escort confirmation — coordinator alerted if unconfirmed at T-4h
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Pre-Cycle Clearance Tracker

Every IVF cycle requires 14–21 days of pre-cycle clearances: hormone panels (estradiol, FSH, LH), baseline ultrasound with follicular count, infectious disease screens (HIV, Hep B/C, syphilis RPR), and sometimes saline sonogram or mock transfer. CaseFlow tracks each requirement with patient-facing SMS reminders and coordinator dashboards showing who is clear, who is pending, and who has an overdue item — with enough runway to chase before the cycle start date.

Clearance dashboard: who's cleared, who's pending, who's overdue — with T-7d coordinator chase cadence
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Donor-Recipient Sync Engine

Donor egg cycles require synchronized timing between the donor (trigger → retrieval) and the recipient (trigger → lining sync → transfer). A timing mismatch on either side costs the cycle. CaseFlow manages separate reminder sequences for donor and recipient patients, with coordinator alerts when either side has an unconfirmed action. The sync dashboard shows both timelines in one view — with a clear red/green/yellow status on the critical path items for each cycle.

Dual-timeline sync dashboard — donor and recipient status at a glance, with lead-time coordinator alerts
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Day-of-Retrieval SMS Confirmations

CaseFlow sends a T-24h and T-2h confirmation SMS on retrieval day: procedure time, arrival instructions, NPO requirement ("Nothing by mouth after midnight — this includes water"), and a one-tap confirmation button ("Confirming my retrieval at [time] ✓"). Non-responders get a coordinator alert at T-90 minutes — catching the patient who double-booked, forgot, or is at the wrong location before the OR sits idle.

Day-of confirmation → non-responder triage → coordinator alert within 90 min of no-reply
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Network Rollup Dashboard — PE Platform View

For PE-backed fertility platforms managing 20+ clinics, CaseFlow provides a network-level view: cycle volume, no-show rates, clearance turnaround time, and waitlist fill rates across all practices. Benchmark performance against national REI averages. Executive-level reporting at /network — built for the CFO and COO who need to justify platform-wide deployment across acquisition targets.

Multi-clinic network dashboard — benchmark against national REI no-show rates, clearance turn times, and recovery rates
What CaseFlow Protects

Every high-stakes cycle type in the fertility workflow

Fertility cycles vary in complexity, value, and biological urgency. CaseFlow adapts its reminder cadence and escalation logic to each one.

IVF with Own Eggs (Standard Retrieval)

$15,000–$20,000

Baseline cycle with the highest frequency. No-shows at retrieval day represent total cycle loss — there's no rescheduling window, the patient has already invested 2–4 weeks of medications and monitoring. Primary failure modes: trigger shot timing, escort for sedation, NPO compliance. T-36h + T-12h + T-2h cadence eliminates the first two. Waitlist fill (first YES wins) recovers cancelled slots within the same retrieval day cohort.

IVF with Donor Eggs

$25,000–$45,000

Donor cycles carry the highest dollar value and the most complex coordination. Both donor and recipient must clear their respective clearances, sync trigger timing, and show up on the same day. A cancellation on either side compromises the entire cycle. CaseFlow maintains separate but linked tracking for both parties — with a sync dashboard showing both timelines side-by-side and early alerts when either side has an unconfirmed item.

FET (Frozen Embryo Transfer)

$3,500–$6,000

Lower per-cycle value but high cumulative volume across a practice. Lining synchronization and progesterone timing are unforgiving — a late cancellation means the embryo stays frozen and the transfer is delayed to the next cycle window. CaseFlow handles pre-transfer hormone reminder cadence, lining check confirmation, and transfer day escort confirmation for patients under sedation protocols.

IUI (Intrauterine Insemination)

$800–$1,500

Lower individual value but high volume across most REI practices. No-show rate is elevated because patients underestimate the commitment vs. surgical procedures. T-7d + T-1d SMS cadence plus pre-cycle checklist confirmation reduces no-shows to under 9%. High-frequency, high-touch cadence at low cost-per-message — strong ROI even at the lower per-cycle value.

Revenue Recovery Snapshot
A fertility clinic running 100 retrieval cycles/month at 9% cancellation rate
$18,000
Avg. retrieval cycle value (own eggs)
9%
Retrieval day cancellation rate (pre-CaseFlow avg)
9
Avg. cancellations per month
$162,000
Monthly revenue at risk
41%
Expected no-show reduction (CaseFlow benchmarks)
$66,400
Monthly revenue recovered (est.)

Recover 4 retrieval day cancellations per month at $18K each — that's $864,000/year — against an annual cost that's a fraction of that.

FAQ

Common questions from fertility clinic operators and REI networks

CaseFlow sends a T-36h trigger shot reminder with the exact medication, dose, and time window — not a generic instruction. At T-12h, it sends a confirmation check-in: "Have you taken your trigger shot? Reply YES / NO / Not yet." A "Not yet" or no-reply routes a coordinator alert with the patient's phone number and the exact time window closing. At T-2h, a final confirmation SMS confirms arrival readiness. This cadence prevents the most expensive type of retrieval day cancellation — the one where the patient triggers too late and the cycle must be cancelled.
CaseFlow creates separate but linked tracking records for the donor and the recipient. Each receives their own cadence — donor reminders (stimulation monitoring, trigger confirmation, retrieval day prep) and recipient reminders (lining check, progesterone start, transfer prep). The coordinator dashboard shows both timelines in one view, with color-coded status on each critical path item. If either side has an unconfirmed action at T-24h, the coordinator gets an alert — with enough runway to resolve the issue before the cycle is compromised.
FET cycles have a different failure profile. The transfer can't be rescheduled around a cancelled cycle without a multi-week delay — the embryo stays frozen and the endometrial window is missed. CaseFlow handles pre-transfer hormone reminders (estradiol, progesterone), lining check confirmation (T-3d ultrasound), transfer day escort confirmation, and transfer confirmation SMS. The cadence is adjusted for the longer lead time and lower per-cycle value vs. fresh retrieval cycles.
CaseFlow integrates with the major fertility EMRs and practice management systems — including those from MEDITECH, Cerner, and specialized REI platforms — via scheduling webhooks and HL7 patient registration feeds. Patient demographics, cycle type, trigger timing, and contact information sync automatically. Contact us at hello@surgeoncaseflow.com to confirm compatibility with your specific setup.
Yes. CaseFlow includes a network-level dashboard at /network — designed for PE-backed fertility platforms and MSO operators. You see cycle volume, no-show rates, clearance turnaround time, and waitlist fill rates across all practices in one view. Benchmark performance against national REI averages. Executives can export CSV reports for board presentations. Contact us to discuss multi-clinic pricing and implementation.
Most fertility clinics are fully configured within 5–7 business days. We configure CaseFlow with your cycle types, trigger shot protocols, escort requirements, donor-recipient sync logic, and patient contact cadences. You can preview the full patient experience — trigger confirmations, escort check-ins, clearance reminders — in the sandbox before going live. No hardware or EMR integration required beyond your existing scheduling feed.
Live Benchmark — IVF No-Show Economics
The average REI practice loses $1.92M–$2.4M/year to retrieval day no-shows. What's yours?
Run your clinic's actual volume through the CaseFlow ROI calculator — or see the live fertility no-show benchmark and waitlist fill rates at the sandbox.
Calculate your fertility no-show exposure →

Every cancelled retrieval day costs an entire cycle. CaseFlow costs less than three recovered retrievals per month.

See the full patient reminder sequence in action — try the sandbox with a pre-loaded REI clinic example.