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It’s normal to feel overwhelmed with egg freezing, but thankfully there are individuals on the other side of it who are willing to share their experience. Read on to hear what egg freezing was like for two members of our team.

Two Women Share Their Egg Freezing Journeys

It would be a serious understatement to say that we are living in uncertain times. For those interested in parenthood, the unpredictability of COVID has, in some cases, delayed starting a family. It’s no surprise, then, that more and more people are now considering egg freezing, a process that allows you to freeze unfertilized eggs, store for future (or later) use, and leave open the possibility of starting a family in the future. 

And with ample room for reflection and planning, not to mention work-from-home arrangements conducive to frequent doctor’s appointments, the pandemic has proven to be a convenient time to start the process. Clinics across the country saw a significant uptick in egg freezing during 2020. 

While egg freezing can be an empowering process that provides otherwise hard-to-find control over your future, it’s also a significant emotional and financial investment, with an intensive medication schedule, too. It’s normal to feel overwhelmed or unsure of what to expect, but thankfully there’s lots of individuals on the other side of it who are willing to share their experience. Read on to hear what egg freezing was like for two members of our team, and view our previous post on egg freezing and IVF for an overview of the process.

“It was always in the back of my head, and now I have the relief of knowing I’m preserving multiple options for the future.”

Grace, 27, a provider success specialist on Alto’s fertility team, knows firsthand how convenient it is to work from home while going through the process of freezing your eggs. “The pandemic was actually a great time to do it,” she says. “It was a lot more manageable to do the injections at home and be uncomfortable and bloated in my own space rather than at the office.”

Grace’s professional background in fertility motivated her to reflect on her own reproductive goals. She knew she always wanted kids, but since she didn’t see herself starting a family in the near future, egg freezing felt like an appropriate next step in her journey. 

Grace first started the process at 24, taking an AMH blood test to learn more about her egg count. She had fewer eggs in her ovarian reserve than the average for her age. After completing two egg freezing cycles in January and April of this year, she did not retrieve the minimum number of eggs she was aiming for and thus plans to do a third cycle to reach her goal of at least ten frozen eggs.

While the outcome isn’t what she had hoped for, she’s grateful that the test helped manage expectations, and to have learned earlier rather than later that her fertility journey will involve multiple rounds of egg freezing.

“After the AMH, I wasn’t sure if this would even work for me,” she says. “The results from the retrievals are better than nothing, and I’m really grateful I found out at age 26 and not at 30.”

Here’s more about Grace’s egg freezing journey, in her own words.

What was your experience of the egg retrieval like?

Grace: In my experience, the retrieval itself was actually the least intimidating part. By that point, your body has already done everything it needs to do. All that’s left is showing up for the quick procedure, which takes twenty to thirty minutes. It was all out of my hands so I tried my best to just relax. Because of COVID, no one else could come with me, which isn’t usually the case. Fortunately I had the added comfort of working with doctors I already knew since I completed the process at the clinic where I was working at the time.

What was the hardest part of the process?

Grace: For me, it was getting the numbers back after the first retrieval and learning that there weren’t as many eggs as everyone expected for my age — I got a total of nine eggs from my first two rounds combined and the typical range for a woman my age is fifteen or more. I’ll have to go through the process again if I want to reach a goal of a certain number of eggs for the future; generally the target is at least ten frozen eggs. 

It can feel isolating to have a low egg count if you know other people who went through the process and had a different outcome, like I did, which can feel as if your body isn’t working the way it’s supposed to. As disappointing as it is, at least I have this information early so I’m able to plan for other options.

What do you wish others knew about egg freezing?

Grace: I wish more women knew about the AMH test — which tells you the number of remaining eggs in your ovaries — and the importance of getting tested as early as possible. Knowledge is power. No one expects to have low numbers. From both my own journey and my work with lots of patients over the years, I’ve seen firsthand how devastating it can be to get this information when you're ready to start a family, at which point it may or may not be too late. 

The earlier you know your fertility status, the better. That way you can make an informed decision and plan ahead.

Grace: Candles and music got me into a calm headspace before the injections, when my anxiety would spike. Also, honoring what my body was telling me, taking naps when needed, and talking to coworkers who had gone through the process.

Why did you choose Alto for your fertility pharmacy?

Grace: Egg freezing medications can change on the day of a doctor’s appointment depending on ultrasound results, so being able to schedule same-day delivery, even on weekends, without paying extra was really important. It gave me greater peace of mind during what can be a stressful process.

And even though I worked in the field and was familiar with the process, Alto’s injection videos were so helpful, and the reassurance of knowing I could reach out to a pharmacist for support at any time made the whole experience more manageable.

“I wanted a safety net, and this was one thing I did have control over. It was a decision that was only mine to make.”

For Jess, 36, another member of our fertility team, turning 35 was the final push to move forward with egg freezing. “It was always in the back of my mind, but then other life events kept taking precedence and before I knew it, time was running out to make it worth the investment,” she says.

Since the idea of starting a family soon was unpredictable, she decided it was the right time to start the egg freezing process. It didn’t hurt that the experience would double as some user research, as she explains, “I was familiar with the pharmacy aspect of egg freezing through my work, but I wanted to understand the personal experience of actually going through the process.”

Although she completed her egg freezing cycle before the pandemic, she understands how empowering it is to be able to take your future into your own hands, something that’s taken on new importance over the past year. “I realized I couldn’t rely on a partner to be the person I’d start a family with,” she says. “This felt like the one thing I did have some control over.”

The retrieval went smoothly, yielding more eggs than expected, but Jess, who has also considered adoption, is still keeping her options open. For her, that’s one of the biggest benefits of egg freezing: not having to make any immediate decisions about parenthood, but knowing that there’s multiple possibilities still on the table. Below, Jess shares more about her experience with the process.

Jess: There were some delays and the retrieval date got pushed back a few times. I went in on the weekend, and it wasn’t my regular doctor, but I felt confident in my clinical team based on past conversations. I had some complications with blood pressure, but in general the process went well. I ended up with more eggs than expected.

I remember feeling alone afterwards and wanting to sleep all day, but I ended up meeting a friend at the beach, which lifted my spirits. Egg freezing is such an interesting experience because it’s super emotional for two weeks leading up to the retrieval and then it’s just done.

Jess: It’s a really emotionally intense process to navigate on your own. I was thankful to have coworkers who’d been through it to talk to. The delays were hard, too. There was one day when I had to get my blood drawn and it just wasn’t happening even after five tries. By the end, it felt like waiting itself had become such a big part of the process.

Jess: With egg freezing, medication can be complicated. The specific dosages can change based on hormone levels, which are measured through bloodwork and ultrasounds. It’s not uncommon for your doctor to change a prescription the day of an appointment, so if you get all the prescriptions filled ahead of time, there’s a chance some of the medications may not be used. If you use a pharmacy that manages your deliveries as you confirm you need the medications and offers same-day delivery, like at Alto, you can save a lot of money and avoid wasting the medication.

Also, definitely do some research on finding a pharmacy that will help you navigate insurance benefits and potential medication cost savings options.

Jess: I tried not to put my life on hold during the process and stayed active with camping and hiking. As long as I had my medication, I was comfortable. I also got a puppy just before starting the process, which was a big benefit and distraction.

Jess: I wanted to experience firsthand our fertility service, and it was also really important to have a reliable pharmacy partner that made it possible to avoid wasting medication. My clinic had been working with Alto for years, and it was comforting to know that they were in lockstep with each other. Being able to track deliveries in the app was also really reassuring. I didn’t have to worry about where my medication was when it was in transit.

Choose a pharmacy partner with flexibility for your egg freezing journey

Having a reliable but flexible fertility pharmacy partner is especially important during egg freezing, which can involve last-minute changes with medication. Alto offers free, same-day delivery and expert guidance on fertility medication. Our dedicated fertility specialists are also here to guide you through your first injections and work with your doctor to ensure your egg freezing treatment plan is followed correctly.

Visit us at alto.com/fertility or reach out via phone or the app to learn more.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Here’s a quick overview on PrEP access and affordability in light of recent updates.

Getting PrEP for HIV prevention at an affordable cost

Pre-exposure prophylaxis (PrEP) is a medicine that prevents people who are HIV-negative but at high risk of getting HIV from contracting the virus. If you have a partner who is HIV-positive or unsure of their HIV status, or if you have multiple partners, PrEP may be right for you. It also reduces HIV risk in those using intravenous drugs. If taken daily, it lowers the risk of getting HIV from sex and intravenous drug use by about 99% and 74%, respectively.

Cost can be a barrier to starting PrEP, but the life-saving medication is now more accessible than ever, thanks to the recent arrival of generic options and changes to private insurance coverage. Still, given the complexities of navigating healthcare, getting PrEP at the best cost may require a bit of legwork and some familiarity with the landscape. Here’s a quick overview on PrEP access and affordability in light of the recent updates.

There are two FDA-approved medications for PrEP: Truvada® and Descovy®. A generic for Truvada called Emtricitabine/Tenofovir disoproxil fumarate became available in October 2020. 

In general, as more generic options become available, the additional competition typically drives down the price of all options, which is already the case with generic Truvada: a 30-day supply of the brand-name version comes out to $1600-1800, while Alto carries a generic option that currently runs at $36.60 a month out of pocket.

Given that generic medications can cost 85% less than their brand-name equivalents, it’s understandable to wonder if the cost disparity is a reflection of quality. Rest assured that generic Truvada is therapeutically equivalent to the brand-name version: generic medications use the same active ingredients as their brand-name counterparts, and they must meet the same standards for safety, quality, and results in order to get FDA approval.

Read the difference between generic and brand-name medications.

Patient Assistance Programs for Brand-Name PrEP

Despite the equivalent nature of generic and brand-name PrEP, your doctor may choose to prescribe a brand version instead of a generic option for various reasons. If that’s the case, there are resources to help reduce the cost of brand-name PrEP. Patient assistance programs have helped many people access these medications at a low cost or even for free. 

For example, Gilead, the manufacturer of brand-name Truvada, has the Gilead Advancing Access® program, which offers a copay card for those with insurance and a Medical Assistance Program for those who are uninsured. Alto will automatically conduct a thorough price investigation to identify these potential sources of financial assistance and ensure you're getting the lowest possible price.

Most private insurers are now required to cover at least one PrEP option

As of this January, most private insurance plans must cover PrEP for HIV prevention without charging any out-of-pocket costs. PrEP has received an “A” recommendation from the U.S. Preventive Services Task force, and as such, it must be covered by most private health insurance plans without copays or deductibles.

However, getting approval for a specific brand of PrEP medication may require some additional legwork. The law requires health plans to cover at least one of the available PrEP options without copays or deductibles. That means if your private insurer covers the generic version of Truvada but you need the brand-name version — or vice versa — you’ll need to go through an additional approval process called a prior authorization. This is a request to your insurance company for coverage of certain medications.

After the arrival of generic Truvada, several insurance companies have decided to stop covering Descovy. While these two forms of PrEP are both effective at preventing HIV, they are not identical. Some people may need one version over the other for preexisting health issues. In these cases, you may need prior authorization approval and could potentially face higher out-of-pocket costs. Alto’s dedicated support team will coordinate closely with your doctor’s office on filing prior authorizations to avoid delays with starting PrEP.

Check your formulary for a breakdown of your plan’s PrEP coverage

Every health insurance plan has a list of covered drugs, called a formulary, which you can locate online or by calling your plan. This is where you can find details about which PrEP medications your plan covers. If a medication isn’t on your “open” formulary, you may have the option of submitting a prior authorization. On the other hand, if you have a “closed” formulary, a prior authorization won’t be approved. Your pharmacy can let you know about your options and whether you have an “open” or “closed” formulary.

One thing to be mindful of is that formularies can change as part of insurance renewals every year. When this happens, an insurance plan can request you to switch from one brand to another, or to a generic version. You may want to ask your healthcare provider if there’s a cheaper version of your medication available. If you fill your prescription with Alto, we’ll do the investigating for you and keep you updated on your best options.

Read our previous post on insurance changes to look out for when renewing your plan.

Get the medication you need without delay

At Alto, we believe that financial wellness plays an important role in your overall well-being. We go above and beyond to ensure that we’re providing the most affordable option, so that you can stay on track with the plan your doctor recommends. We’re here to help you understand which PrEP options your insurance covers, and we’ll do the legwork to make sure you get the lowest possible price.

Switch to a better pharmacy for insurance support, price investigations, and same-day delivery. Feel free to reach out any time via phone at 1-800-874-5881 or in-app messaging.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Getting PrEP for HIV Prevention at an Affordable Cost

With heart disease being the leading cause of death in the United States, knowing your family’s health history and the extent of your risk is key to managing your heart health.

How Your Family History Affects Your Heart Health

While you know that traits like the color of your eyes and hair, as well as maybe your love of coffee, have been passed down through your family, you might not realize the extent to which heredity can also influence aspects of your health. With heart disease being the leading cause of death in the United States, knowing your family’s health history and the extent of your risk is key to managing your heart health. Here’s how having heart disease in your family can affect your own heart’s health, what you can do, and everyday ways to keep your heart beating healthy. 

When people talk about heart disease, they’re usually referring to coronary heart disease (also referred to as coronary artery disease).This is the most common type of heart disease and leads to more than 370,000 deaths in the United States every year. 

Coronary heart disease results when plaque builds up on the walls of the arteries that lead to your heart. This buildup narrows the arteries, making it harder for blood to pass through, which can ultimately lead to a heart attack or stroke.

Common risk factors for heart disease include high LDL cholesterol, low HDL cholesterol (the “good” kind), stress, high blood pressure, obesity, diabetes, physical inactivity, smoking, being post-menopausal for women and being older than 45 for men.

According to the American Heart Association, your risk of heart disease is strongly linked to your family history. That means that if someone in your family has diabetes or high LDL cholesterol, for example, then you may be more prone to these heart disease risk factors as well. Similarly, if someone in your family has had a stroke, that makes you more likely to have one. 

To understand your genetic risk of heart disease, you need to first take a look at your family’s health history. You may not know the health history of your entire extended family and that’s okay. A key first step is to start learning the health history of your first-degree relatives: first your parents, then your siblings. Did either of your parents or siblings have a heart attack or stroke, or die from one, at an early age? If they did prior to age 55 for males or age 65 for females, then you’re at an increased risk of heart disease.

Additionally, there are other genetic factors to be aware of that can increase your risk of heart disease. Statistics from the American Heart Association show that African Americans are at a greater risk of high blood pressure, diabetes, and stroke; and about one in three Hispanics will have high blood pressure.

Your family’s home lifestyle and environment can also play a role in your heart health. Living in a household of smokers, for example, can increase your risk of heart disease, while a regular diet of fast food can trigger inflammation in your body and lead to an increased risk of high blood pressure and type 2 diabetes. 

Where you live can also be a factor. City and urban environments can expose you to more air pollution as well as poor water or food quality, which can all contribute to heart disease. 

What to do once you know your family’s health history

Once you have some idea of your immediate family’s health picture and any history of heart disease or risk factors, you’ll next want to assess your own risk. There are various heart attack risk calculators that can help you do this. These take into account your genetics as well as current diet and lifestyle habits to predict your chance of having a heart attack.

Sharing your personal heart disease risk and family history with your doctor is important because it can allow them to come up with a plan to help you lower your risk. Your doctor may also suggest certain medical tests to provide a more accurate diagnosis. A blood test, for example, can look for certain biomarkers in your bloodstream, like LDL cholesterol, that increase your heart disease risk. A heart scan, also known as a coronary calcium scan, can detect any calcium on the walls of your arteries.

You’ll also want to make sure you’re aware of any early heart attack warning signs to watch out for. If you experience symptoms such as chest pain or discomfort, shortness of breath during daily activities, or pain or discomfort in your arms, back, neck, or jaw, you should call 911 to get proper care as soon as possible.

If you discover that you have an extensive family history of cardiovascular disease or you’ve calculated your risk to be higher than average, does that mean you will end up with cardiovascular disease yourself? Not necessarily. Here are some of the things you can do to help reduce your risk. 

Once you have the results of any blood tests, your doctor will factor these into your family history and lifestyle habits to come up with a strategy to help you manage any heart disease risk. They’ll also discuss with you any risks and benefits of taking certain cardiovascular medications, if necessary. 

Adopting a heart-healthy lifestyle will also be a key part of any heart disease management plan. This includes avoiding foods that are high in saturated fat, salt, and sugar, as well as adding more healthy foods to your diet like nuts, fruits, vegetables, beans and fish. You’ll also want to make sure you’re getting enough sleep, managing stress, and staying active. For physical activity, the Department of Health and Human Services recommends at least 30 minutes of heart-pumping exercise such as brisk walking or riding your bike at least five days a week.

If you have any other health conditions such as high blood pressure or diabetes, control these by staying on top of your regimen prescribed by your doctor. You’ll also want to be aware of the other factors you might not realize can influence your risk of heart disease.

While it’s essential to be your own advocate when it comes to your health, we’re here to support you with exceptional pharmacy care every step of the way. If you are prescribed medications for your heart, our pharmacists would be happy to walk you through dosage instructions and answer your questions. We’ll look for any available savings to help you get the lowest price, and we’ll deliver your medications to your home for free. Simply tell your doctor to send your new prescription to Alto or contact our team - we’ll take care of the transfer for you.

Alto Pharmacy is recognized by Forbes as one of America’s Best Startup Employers in 2021, ranking 13th among 60 healthcare startups.

Alto Pharmacy Announced as One of Forbes Best Startup Employers

After discovering that half of all prescriptions aren’t even picked up—resulting in 125,000 avoidable deaths every year—we set out to build a new kind of pharmacy that focuses on the person behind every prescription.

Here at Alto, we’re transforming a $500 billion industry by reinventing what a pharmacy can do—from hand-delivering medications for free to offering on-call help by text or chat. Our customers are at the center of everything we do, and it shows. After delivering more than one million prescriptions, we have an NPS score of 86 and over a thousand five-star reviews on Yelp.

In addition to delivering a better pharmacy experience for everyone who needs medicine, we’re committed to cultivating a better workplace for for our team, every day. That’s why we’re honored to be recognized by Forbes as one of America’s Best Startup Employers in 2021, ranking 13th among 60 healthcare startups. Inclusion on the list was based on professional reputation, employee satisfaction, and growth, among other criteria. 

This accolade follows several others in recent months including LinkedIn’s Top Startups in 2020 and San Francisco Business Times Largest Bay Area Digital Health Companies in 2020. In addition, Alto’s CEO, Matt Gamache-Asselin, recently received recognition as one of The Top 25 Consumer Health Tech Executives of 2020 by The Healthcare Technology Report. 

“We have a lot to be proud of in the past year, especially in light of the challenges presented by the COVID-19 pandemic,” shared Gamache-Asselin. “I’m so proud of the hard work and commitment exhibited by every member of our team in providing exceptional pharmacy care in our communities. As we continue to expand our services to more and more people, we’ll also be growing our team of incredibly knowledgeable and caring professionals.”

Are you passionate about shaping the future of pharmacy? Join us as we  deliver our industry-leading pharmacy care to millions of Americans. 

For the full employers list and an overview of the selection methodology, head to the Forbes site. .

Alto Pharmacy Announced as One of Forbes Best Startup Employers 

Forbes 2021 America's best startup employers

Starting Friday, March 12, residents of the greater Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs.

Hello, Dallas-Fort Worth!

Alto’s launch in the Dallas-Fort Worth market extends our industry-leading patient care model to even more Texans. 

Starting Friday, March 12, residents of the Dallas-Fort Worth metro area can now choose Alto’s same-day doorstep delivery for their pharmacy needs. 

At Alto, we believe it’s our job to ensure you have your medications at the best price, on time and with the support you need. We bring pharmacy to you - no more waiting in line, making an extra trip, or finding out your prescription isn’t ready to be picked up after you’ve already arrived. Our free doorstep delivery means your medications come directly to you on the day and time you select, and most medications are available the same-day. Stay up to date on your courier’s progress with text alerts or in our mobile app. 

Starting a new medication or doing an injection for the first time? Message a pharmacist with your questions, even in the evenings and on weekends. And we’re a full service pharmacy - we stock all major brand, generic, over-the-counter and specialty medications, meaning your entire family’s pharmacy needs can be managed in the Alto app and coordinated into one delivery.

Courier delivery windows
Monday - Friday: 

12:30 pm - 3:30 pm CT (1:00 pm - 4:00 pm CT for outlying areas) 

6:00 pm - 9:00 pm CT(7:00 pm - 10:00 pm CT for outlying areas)

2:00 pm - 5:00 pm CT (3:00 pm - 6:00 pm CT for outlying areas)

Walk-in hours
Monday - Friday: 9:00 am – 7:00 pm CT
Saturday - Sunday: 8:00 am - 4:30 pm CT

Dallas-Fort Worth residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). 

Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

Need to pick up? Our pharmacy is located at 475 State Highway 121, Suite 150, in Lewisville.

General customer support hours are Monday - Friday 9 am - 11 pm CT and Saturday - Sunday 10 am - 7 pm CT. Patients can reach out to Alto via phone/text at 1 (800) 874-5881, email or app.

Founded in 2015, Alto is a patient-centric digital pharmacy based committed to the health and wellbeing of you and your family. We provide free same-day delivery to your door seven days a week for prescriptions, but, more importantly, offer cost transparency, personalized in-app and phone support, and real-time coordination with doctors and insurance companies to get you the care that you need. Alto is headquartered in San Francisco with offices in Denver and Dallas, and currently delivers across the greater Bay Area, Los Angeles, Orange County, San Diego, Seattle, Denver, Las Vegas, New York City, Houston, Dallas and Austin.

Editor’s Note: This post was originally published in March 2020 and has been updated for accuracy and completeness.

Here’s why healthy habits are key to improving your health and six ideas to try when you need some “me time.”

6 Science-Backed Ideas for Healthy Living

We know that taking care of our well-being is important, but when work deadlines are calling or the family needs your attention, your own wellness can easily fall to the bottom of your priority list. Fortunately, many healthy lifestyle habits don’t require much time or money, and can even be an enjoyable break from your everyday to-dos. Here’s why healthy habits are key to improving your health and six ideas to try when you need some “me time.”

When we’re overworked, stressed-out, or exhausted, it can be difficult to take care of our own daily maintenance tasks, let alone do activities we enjoy or make time to help others. And when we neglect our own care, it can leave us feeling burnt out, anxious, or depressed—states that affect everything from our performance at work to our relationships at home. 

Studies suggest that carving out “me time” is a key part of a healthy lifestyle. Healthier habits and lifestyle adjustments have been linked to lower levels of stress and higher quality of life, as well as lower levels of morbidity and reduced healthcare costs. And it can start with just a few minutes a day and cost nothing. Here are five science-backed lifestyle practices that your current (and future) self may thank you for. 

1. Practice meditation and mindfulness. 
You don’t need to ascribe to a certain religion or spend a month on a far-flung retreat to meditate or reap its benefits. Numerous studies suggest that even a few minutes a day of meditation can have many health benefits—from helping reduce anxious and stressful thoughts to curbing insomnia. Apps like Headspace or Insight Timer offer meditation basics at low or no cost. You can also ask at your workplace to see if services like Modern Health are offered. 


2. Try breathing practices. 
We know breathing is essential to life, but since it happens automatically, many of us don’t pay much attention to it. But research suggests that certain breathing techniques can help improve everything from your focus to your sleep. Studies have also found that practices like nasal breathing and pursed-lip breathing, as well as the deeper diaphragmatic breathing involved in yoga practices can be helpful in managing symptoms of chronic obstructive pulmonary disease (COPD) as well as asthma. 


3. Cook a meal at home. 
From picking out a new recipe to gathering all the ingredients, cooking at home for yourself or for others can be a relaxing multi-sensory wellness practice. It’s also often a healthier option than grabbing take-out. For this reason, studies suggest it as a top self-care practice to help those with diabetes avoid hospital visits and other health implications.


4. Do something creative. 
When it comes to the arts, you don’t need to have mastered a craft to enjoy it. The act of expressing in an artistic way can be enjoyable regardless of the outcome. And studies show that doing something creative—strumming a guitar, singing to yourself in the shower, or writing creatively—can boost your mood and emotional health as well as contribute to reducing stress and feelings of depression.

5. Stay on top of your medications. 
While this may seem obvious, forgetting to take essential medications is more common than you might think. In fact, studies have shown that up to 20-30% of medications are never filled, and that nearly 50% of medications for chronic disease aren’t taken as prescribed.  Alto can help make sure your prescriptions are delivered on time, as well as connect you with a pharmacist to answer any questions about dosage or side effects.

It's essential to be your own advocate when it comes to your health and well-being, and we’re here to support you with exceptional pharmacy care every step of the way. Talking with your healthcare provider about healthier habits and lifestyle adjustments can be just as important as discussing your medications. 

Our team of patient care pharmacists at Alto is available to chat whenever questions come up. Feel free to reach out any time via in-app secure messaging or phone at 1-800-874-5881.

5 Science-Backed Ideas for Healthy Living

Reverend Stacey, who is also the Executive Minister at Trinity United Church of Christ in Chicago, sat down with us to share more about the challenges of fertility in the Black community, what fertility care providers can do to create more inclusive experiences, and some of her favorite memories in the history of FFCG. 

Rev. Dr. Stacey L. Edwards-Dunn on Her Mission To Improve Black Fertility Care

When it comes to fertility, there is a lot to navigate—from deciding which treatment option is right for you to figuring out how to afford the costs. In the U.S., about 11% of women experience infertility, and studies suggest that Black women are twice as likely to face infertility as white women. 

Rev. Dr. Stacey L. Edwards-Dunn is trying to change this. After working as a health educator in Chicago and an education director at Planned Parenthood, she founded Fertility for Colored Girls (FFCG) in 2013. As a 501c3, FFCG’s mission is to provide education, awareness, and support to Black women/couples and other women of color who struggle with infertility—something Stacey wished she’d had when she was on her own infertility journey. 

With 14 chapters across the country spanning urban and suburban communities, and with more opening each year, FFCG provides services including educational programs, grant opportunities, counseling, and monthly support groups where women can share their experiences and receive support.

What are the reasons Black women are almost twice as likely to experience infertility as white women?

There are a few factors behind this. The first is that in the Black community, infertility is a taboo topic. And it’s not something we expect to experience. In our communities, we have believed the hype that Black women are hyper-fertile. Much of this comes from breeding myths during slavery around our ability to be able to give birth. But the reality is, these myths are incorrect. So it begins with how we have been socialized and educated around our own reproductive health and our Black bodies. 

A second reason is that there are many Black women and couples who don’t trust the medical system. And because of this distrust, we’re not accessing health care. We think doctors don’t take us seriously and impose their biases on us. And even today, we still hear stories of Black women and couples having surgeries done on them and being sterilized without permission.

A third reason has to do with research. Most of the research around reproductive health and treatment has primarily been done on white women. So when research shows that in vitro fertilization (IVF) is not as successful with Black women, it’s because the trials haven’t included Black women. Once we start seeing more research done that includes black and brown women and other ethnicities then we’ll be able to tailor treatments better. 

A final reason has to do with marketing. We still have a number of fertility clinics that aren’t including women and babies of color and other ethnicities in their marketing. So Black women and couples don’t see themselves in the marketing and if you can’t see yourself, it makes it harder to feel welcome and to trust that you’ll get quality care. 

In addition to marketing and staffing, what other recommendations do you have for clinicians and fertility care providers to create a more accessible and equitable experience? 

I would say education. The staff working with women of color need to be educated. They need to be equipped with tools on how to be culturally sensitive to the Black women and couples that are coming into their spaces. Something I hear from Black women and couples is they want the doctor and team to partner up with them in their treatment—not to look down on them or talk at them. They want someone to walk with them on their journeys. 

Education can also help staff understand their own biases which, a lot of the time, they’re unaware of. It’s important they know what to say and what not to say to make sure they aren’t deterring Black couples. In addition, Black and other ethnicities need to be represented in executive roles and throughout the organization —from doctors to nurses to lab technicians. Making sure staff is inclusive, diverse, and culturally-educated.

Finally, they need to work with organizations like FFCG, who have their pulse on the community and can help them create relationships with the Black community. And they should be open to having these conversations not just during Black History Month, but all the time.

For the communities you work with and those who might not understand their family building options and the resources available to them, what do you want them to know? 

I want them to know there are multiple paths to parenthood. And though they are all different, they are not deficient. When I educate the women and couples I coach and that come to me, I help them focus on the goal, which is to be parents and to build a family. When you know the goal, then you can understand that you have other natural options, like IVF, intrauterine insemination, donor eggs or donor sperm, domestic adoption, et cetera. 

There is an option and a path that has been designed for everyone and I help them see that. Because when you have options, there are possibilities. I am very intentional about helping to open up the minds of the women and couples that I work with to help them see the goal. Because when you reach the goal of becoming a parent to a child, the reality is that you’re not going to love them any less because it is the child that God has sent you.

Is there a particular memory or moment that stands out for you since you founded Fertility for Colored Girls?

A powerful moment for me was when we gave away our first free IVF [cycle] to a couple. After experiencing a few unsuccessful IVF [rounds], they didn't have any money left and their state of Mississippi doesn’t have insurance toward infertility treatments. So they put their name into our raffle and won. They took the Megabus from Mississippi up to Chicago, Illinois to meet everybody that they had been talking to on the phone during prayer time. 

At this time, I was also one month away from giving birth to my daughter after seven in vitro cycles, so I really felt for them. Now they have five-year-old twins. This was significant because it was the first time we were able to provide physical resources to a couple in need. 

In addition to this, I am always so honored when women and couples call me and tell me they got a positive pregnancy test after IVF, or that their surrogate is pregnant, or their adoption just got approved. Often, I end up finding out before anyone else in their family does. I’m so honored that these women and couples trust me to share their journeys and their hearts. And most of them have never met me in person, they’ve just talked to me on the phone. 

These are women who have cried so many tears in silence and lived so long in shame, and they’ve found a successful path to starting a family. That is what gives me joy and fuels me to keep doing the FFCG work. It reminds me there’s still hope and the work that we are doing is not in vain. 

Is there anything else you’d like to highlight about your work with FFCG and your mission?

I will add that I think you are able to have peace on your [infertility] journey when the mind, body and spirit are aligned. Because if any of those aspects are not aligned everything can really fall apart. Therefore, my approach, and the mission of FFCG, is to minister to each aspect of a person’s life as they are all equally important. 

In addition, it’s important for people to know the resources that are available to them through FFCG—from grants they can apply for to education to support in our prayer circles. Many Black women and couples struggle with having the resources and support to move forward, so I want to make sure they know this.

To support or donate to Fertility for Colored Girls visit the FFCG site. You can also learn more about the Black Reproductive Endocrinologist and Infertility Specialists making history and bringing hope to their families on 2/25 at 6 pm CT. Register here.

At Alto, we know fertility treatment can be an emotionally, financially, and physically challenging experience. That’s why we believe choosing the right pharmacy can help you avoid additional stress caused by waiting for hours on hold, tracking down your medication delivery, and navigating insurance benefits.

Starting Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

Hello, New York City!

Alto extends beyond fertility medication support to offer full-service pharmacy operations in New York City.

Starting today, Wednesday, February 24, New York City residents can now choose Alto’s same-day doorstep delivery for all of their pharmacy needs. 

12:30 pm - 3:30 pm ET (1:30 - 4:30 pm ET for outlying areas)

6:00 am - 9:00 pm ET (7 - 10 pm ET for outlying areas)

2:00 pm - 5:00 pm ET (3:00 - 6:00 pm ET for outlying areas)

Walk-in hours
Need to pick up? Our pharmacy is located at 100 Park Avenue - that's 40th between Park and Madison.
Monday - Friday: 9 am – 7 pm ET
Saturday - Sunday: 8 am - 4:30 pm ET

New York residents interested in using Alto’s services for their medication needs can ask their doctor’s office to send all prescriptions to Alto Pharmacy (via ePrescribe, phone or fax). Have existing prescriptions at another pharmacy? Start a transfer online or give us a call at 1 (800) 874-5881, and we’ll handle the switch. 

General customer support hours are Monday - Friday 9 am - 12 midnight ET and Saturday - Sunday 10 am - 9 pm ET. Patients can reach out to Alto via phone at 1 (800) 874-5881 or app.

*Weekday afternoon delivery is only available to residents of New York City's five boroughs at this time.

At Alto, we’re obsessed with our mission to improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Our mission and diversity work are tied together with one word from our mission -- everyone. Too often, only those with significant resources access the best and benefit from innovation in healthcare. We see it everyday in the data. Too many among us continue to struggle with solvable challenges, in our own wellbeing and in the larger healthcare system. These statements and environments have existed in the workplace as well, influencing the products, services, and policies that steer how the organization works for all of us.  Our work is to make Alto different.  Our work is to build and sustain an inclusive culture.  Our work is to attract, develop, reward and retain talent from all the communities we serve as patients and build a product that supports everyone. 

Today marks another step in our diversity, equity, and inclusion journey as we release our first annual diversity report. We share it because this work is central to our mission and in doing so, we use transparency to hold ourselves accountable, as well as hopefully play a part in raising expectations and norms throughout the healthcare and technology industries.

In 2020, across the company we saw a 13ppt increase in women and 7ppt increase in underrepresented groups (Black, Hispanic/LatinX and Native professionals).

As for women in leadership, we saw increases of 3ppts in Women Managers and 1ppt in Product, Engineering and Design driven by both hiring and promotion. At the leadership level, 32% of leaders identify as women.

In 2020, we saw 10ppt increase across our underrepresented managers to 13% Black, 16% Hispanic/LatinX, 2% Native/Indigenious.  In the leadership group, we saw an 8ppt increase to 15% Black and 2% Hispanic/LatinX. 

In 2020, we also established our Alto Advisory Board and our first two anchor members, who will help guide Alto towards our mission, advise on key decisions, and support strategic initiatives. We’ve formed the Advisory Board to support our leadership as we navigate the regulatory landscape, launch new features to modernize the pharmacy experience, and adhere to the highest standards of operational excellence and patient care.  

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College, one of the nation’s oldest and largest private historically Black academic health sciences centers. He received his Bachelor’s degree from Harvard University, his Ph.D. in immunology from Oxford University as a Rhodes Scholar, and his medical degree from Johns Hopkins School of Medicine. He was the first Black American in the 125-year history of Johns Hopkins School of Medicine to earn full professorship with tenure and is internationally known for his influential HIV research.

Jennifer Kent served as the Director for the California Department of Health Care Services, where she led the second largest public healthcare system in the nation, with an annual budget of over $100B and serving over 13 million Californians. She oversaw the administration of 24 managed care plans as well as 56 county behavioral health plans. She has also held leadership roles in the Health & Human Services Agency, Governor's Office and has experience in the private sector as a lobbyist, consultant, and association executive. She has more than 15 years of health administration and policy experience in California.

Alto created our DEI strategy with our team aligned to four pillars – Hire, Include, Develop, and Invest.  Each pillar's actions tie to our people and our business. This means the return on investment is clear and goals are aligned to business outcomes.

Medical Health Care Premiums and Part Time Health Care Benefits in SF: 

In order to increase access and affordability to critical health-care services, we asked our broker to offer a special mid-year open enrollment 2020, reducing premiums for most plans by 5%. We reduced out-of-pocket maximums and speciality office visits by an average of 37%. We reduced co-insurance as well as costs for labs, x-Rays, and emergency room visits for our Cigna plan by 50%. Finally, prescriptions copays were reduced by 25% for Brand medications and 75% for Generic prescriptions. This benefits the employee with direct access to care and a better employee experience as compared to direct contribution to the city fund.

We increased our paid parental leave across all US locations to 8 weeks (up from 6 in 2020) for all parents requesting leave as of January 1st.  Throughout 2020 parents and other caregivers were impacted significantly as schools, daycare, and caregivers were closed, isolated, or unable to rely on pre-covid support. We offered laptops to parents who couldn’t afford them for each child to participate in remote learning.  We offered expanded benefits above and beyond FFCRA. Finally, we offered paid sessions for remote learning, tutoring, and experiences for parents and caregivers.

Finally, in December we launched Modern Health with 6 paid coach/therapy sessions and access to a digital wellbeing library and resources to all Altoids.

We launched six ERGs in 2020. Formalizing the work of our original Diversity Committee into six groups: Umoja (Black), Auténtico (LatinX/Hispanic), Women, Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents. These groups are focused on building community with both those who identify and allies. They support our education, development and investment in our communities. Each has been given a budget, an executive sponsor, and access to other company resources.

We recognized as a leadership team that we needed to educate ourselves. We were not going to rely on those from underrepresented communities to educate us. We embarked on four three-hour sessions focused on learning about diversity and inclusive language, naming our privilege, and starting the work each of us wanted to do. It was only after these sessions, with clear self-awareness and awakening; that began the work of empowering other leaders -- managers and other Altoids on this journey. There is more work to be done, as Neil Frye, Chief People Officer, mentioned in his blog post in late 2020 -- this is not a sprint, nor is it a marathon; it is life-long work.

Focus on Latinx Senior Manager to VP talent; with targeted outreach, activation and networking for opportunistic and open hiring

Expand employee resource group events throughout the year supporting inclusive environment, educating and investing in our communities

Get to full participation in DEI Workshops and launch additional sessions like What’s My Privilege and Moving to Action across the company

Explore new partnerships with Community & Higher Ed Institutions (i.e. Historically Black Colleges and Universities, Hispanic Serving Institutions, etc.)

2020 Diversity, Equity & Inclusion Report

Justin Moy, Senior Software Engineer at Alto, explains how the engineering team developed a staging environment strategy that could keep up with our growing organization.

Creating Sandboxes: How to Make It Easy for Your Engineering and Product Teams

When we formed our Infrastructure team in 2020, our charter centered on scale, reliability, and the developer experience. Our first priority? Developing a staging environment strategy that could keep up with our growing organization.

Initially, we had a set of command-line tools for staging environments that could be run from an engineer’s workstation. However, this approach required significant manual effort to create and manage an environment which led to inconsistencies like outdated data and lack of full application coverage and integration. The required workstation dependencies and maintenance added to the overhead. These tools were also different from the ones used to create a production environment, causing drift between the two.

To address these issues, we focused on improving our tooling to create consistent and reproducible results for both our staging and production environments. Here are the five steps we took to get there:

Luckily, we were already here. Our deployment process involved creating and deploying Docker containers and using a Procfile to run specific parts of our applications (think separating out web and workers). Packaging our applications as immutable Docker images allowed us to ship consistent and portable code. These images are run as containers which can be executed on separate hosts and scaled independently of each other.

We wanted to increase our observability, mature our internal monitoring, and maintain our infrastructure in a more consistent and reproducible manner. Kubernetes, and its automated container orchestration (deployment, scaling, and management), allowed us to accomplish all of the above goals.

Blog

Two Women Share Their Egg Freezing Journeys

Getting PrEP for HIV Prevention at an Affordable Cost

How Your Family History Affects Your Heart Health

Alto Pharmacy Announced as One of Forbes Best Startup Employers

Hello, Dallas!

5 Science-Backed Ideas for Healthy Living

Rev. Dr. Stacey L. Edwards-Dunn on Her Mission To Improve Black Fertility Care

Hello, New York City!

2020 Diversity, Equity & Inclusion Report

Creating Sandboxes: How to Make It Easy for Your Engineering and Product Teams

Hello, Houston!

What You Need to Know About Your Insurance in the New Year

Switch to a better pharmacy.