What You Should Know About Infertility and IVF
Modern medicine in general is amazing, and the strides made in helping families dealing with infertility are among those amazing advances.
“Twenty-plus years ago the success rates were in the single digits,” said Dr. Alfred Rodriguez, a fertility specialist and physician on the medical staff at Texas Health Presbyterian Hospital Plano who has been performing IVF in his practice since 1987. “Today, depending on a patient’s age and reason for infertility, the success rate can be as high as 75 percent to 80 percent.”
But if you are considering in vitro fertilization or other fertility treatments as part of the journey toward expanding your family, you may have more questions than answers. And you may also feel alone in your quest.
So what is infertility? According to the American Congress of Obstetricians and Gynecologists, an infertility evaluation should be done if you have not become pregnant after one year of having regular sexual intercourse without the use of birth control, you are older than 35 years and have not become pregnant after six months of having regular sexual intercourse without the use of birth control, your menstrual cycle is not regular, or you or your partner have a known fertility problem.
What should you know about IVF? What should patients considering IVF be prepared for?
“They must be willing to accept the time, emotions and expense involved with treatment,” Rodriguez said. “And both partners must be committed to the process.”
And it is a process.
Rodriguez said that to begin with “a full battery of diagnostic testing must be performed.” Those tests include:
- An endocrine (or hormonal) profile
- Ovarian assessment (antral or resting follicle count)
- Tubal assessment
- Uterine evaluation
- Semen analysis
- Inherited genetic disease screening for things like cystic fibrosis and spinal muscular atrophy
“If the couple plans on IVF with PGS (pre-implantation genetic screening of embryos), then chromosome karyotype screen of both partners” would also need to be done, Rodriguez added.
Once all the testing is complete, the actual IVF cycle can begin. “During an IVF cycle a patient injects daily doses of gonadotropins,” Rodriguez explained, “and interval follow-up is performed over a nine- to 11-day interval.”
That follow-up includes an ultrasound, as well as bloodwork to monitor estradiol levels to monitor the patient’s progress. “The physician can then adjust the medication doses as needed,” he said.
IVF has helped many people become pregnant. Rodriguez says many causes of infertility can be overcome with the procedure, including fallopian tube damage or previous tubal ligation (sometimes known as “getting your tubes tied”), male factors (like low sperm count or motility), pelvic endometriosis, unexplained infertility, recurrent pregnancy loss, and when the prospective parents are known inherited genetic disease carriers that require IVF and/or PGD (preimplantation genetic diagnosis).
There are additional options besides IVF, but Rodriguez said that “those options are for a certain subset of patients such as a female partner 34 or younger with open (fallopian) tubes and the male partner with normal sperm parameters. They may be candidates for ovulation induction with intrauterine insemination or timed intercourse.”
Before picking a doctor, having a quick appointment to meet with him or her and ask questions is a great idea. Rodriguez agrees that while most couples want to know the doctor’s success rates or pregnancy rates, he stresses that “they should begin by asking about the program’s philosophy.
“Also ask what type of diagnostics are required to assess the cause of their infertility prior to initiating treatment. If IVF is required, does the program do fresh versus frozen embryo transfer? Does the program offer preimplantation screening? Do they offer a diverse treatment approach? What and how do they formulate treatment plans for individual couples?”
But dealing with infertility and the rigors of treatment can be a lot, and often couples feel lonely. Two Dallas mothers, Stacie Tatum and Heather Kaplan-Weatherly, found that a good support system of people who understood what they were going through was invaluable.
They found their support system through RESOLVE: The National Infertility Association and its network of peer-led support groups and resources.
“I was having a really hard time with infertility and a therapist strongly recommended that I check out a Resolve group,” Tatum said, adding that she was hesitant at first, but once she attended her first meeting, she knew she’d be back. She went from hesitant attendee to eventual group host. She also hosts a “pregnant and parenting after infertility” support group and is an active RESOLVE volunteer.
Kaplan-Weatherly, who also has led support groups and is an active RESOLVE volunteer, said she sought out support. “Somehow instinctively I knew I needed support and I found a group through asking at my reproductive endocrinologist’s office,” she said.
“I had been going through infertility for three-and-a-half years before I started going to a support group, and it was literally life-changing,” Tatum said. “It’s very lonely to go through that and you feel like every single person around you can get pregnant with no effort. You start to feel like you’re the only one with this problem and it makes it much harder to go through.”
“Most people have no idea what their journey is going to be like when they start treatments and procedures,” Kaplan-Weatherly added. “For some, the process is quick but for many it is not and it involves serious emotional ups and downs and serious decisions with real consequences.”
And it’s not just women that need support. Tatum said that husbands need support from people who are going through the same things. In addition, she said that “I do think they also need help understanding how to support their spouse — even though they’re going through the same thing, the response and emotions can be very different.”
Both feel that couples going through infertility and treatment should seek some kind of support. Kaplan-Weatherly said that while everyone is different, “for me, and I would imagine most people, it was essential. Both support groups and therapy help in different ways. I found my RESOLVE support group helped not only with emotional support during the ups and downs but also for knowledge along the way.”
Kaplan-Weatherly, who went through almost four years of near-continuous procedures, says it was also the knowledge she gained from her RESOLVE support groups that was so helpful. “It is the knowledge I gained from my RESOLVE support groups and the ‘power’ that it gave me to know what questions to ask and what I needed to research, which ultimately led us to learning about a new procedure that would finally give us our miracle baby.”
To find the closest RESOLVE support group near you, check here or call 866-NOT-ALONE (866-668-2566). For more information about the Assisted Reproductive Technology Services and other infertility programs offered by Texas Health Resources, contact your preferred hospital or call 1-877-THR-WELL (1-877-847-9355).