Here's something of a surprise for most women: If they and their partner are in a room with 24 other couples, statistics say that 4 of them will be having problems conceiving a child. That's 1 in 6. Put it another way, over 7 million Americans have fertility problems. Why? Well it's like putting together a very complicated jigsaw puzzle, but suffice it to say it could be a female thing, a male thing or a combo male/female thing.
About 6o percent of infertility is due to one partner and 40 percent due to a more than one factor or (that dreaded word) is "unexplained". Which means they just don't know. So, when do the experts say couples should call a halt to "doing it alone" and call in the experts? Generally, if they've spent a year of regularly trying for a baby and have not become pregnant, it's time to call in reinforcements.
For women over 35, whose biological clock is ticking away, give it six months and then ask for help. Start with an OB/GYN. There will be tests, lots of tests. What's his sperm count and motility? Are there any physical problems with the woman? If it's a hormonal issue she (and maybe her partner) could be prescribed fertility drugs.
If there is an issue with say, blocked fallopian tubes, surgery on the woman may be recommended. There are lots of avenues to explore before you opt into IVF. The golden rule here: Don't go for IVF unless and until a fertility doctor recommends it. There are lots of different fertility doctors that a regular OB/GYN can recommend, from reproductive endocrinologists (RE's) who specialize in the female side of things to andrologists, who take on male fertility issues.
IVF clinics spend a lot of money advertising and will almost certainly promise couples the moon. Beware. Here are 15 things women should wanted to know about IVF -- and maybe were afraid to ask.
15 How Does IVF Work
Louise Brown, the first "test tube" baby, is nearly 40-years-old. So, In Vitro Fertilization (IVF) has been around since the late 1970's. The basics are pretty simple: Take eggs and sperm, bring them together in vitro ("in glass" in a lab) to produce fertilized eggs (zygotes), grow fledgling embryos in a growth liquid for 2 to 6 days, and then implant those embryos into the woman's uterus.
What comes before that are regular injections to stimulate egg production, with the woman's progress being monitored every few days with blood tests or ultrasounds. The general rule of thumb is that the more eggs produced the better. It ups the chances of a successful fertilization. So, in the run up to the procedure itself, the goal is to turn you into a super-producer of eggs.
Now, the big question is: Do you trust your partner enough to let him jab you or do you do it yourself?
14 Younger Is Better Than Older
It's a simple fact: The older a woman gets, the less likely she is to conceive and successfully carry a baby to term. And the magic number seems to be 35. And by the time you hit 40-years-old, get ready to see a lot of fertility experts shaking their head at you. It's something to do with the state of your eggs, which get more fragile, "stale", as you age.
There's also the issue of health problems, everything from being overweight to high blood pressure, that come with getting older. Let's put it another way: In your twenties, you have a 20% chance of getting pregnant during any given cycle. By your mid-thirties, that drops to 15% and by the time you are 40, it's 10% chance per cycle. By 45? It's 3%.
Donor eggs are one way around the "stale" egg problem. But for women who are putting off having a family, they should look into the state of the eggs they have now so they can make fertility decisions for the future.
13 The Costs? Think Second And Third Mortgage
The thing is, it's so complicated and there are so many variables, it's hard to say. A figure of around $12.000 a cycle is a reasonably good benchmark, but it could be more. It could be less for couples who are lucky enough to have gone to a clinic that offers to give you part of your money back if you are not successful after three or four attempts.
Very rarely, insurance may cover some of the costs. And it almost always takes more than one attempt. So the costs start spiraling out of control fast. Are there alternatives? One thing couples can do is talk to your fertility doctor about before going for IVF, maybe look at doing intrauterine insemination (IUI), where a concentrated dose of sperm is placed into the woman's uterus while she is ovulating.
At around $1,000 per try, it's worth looking at.
12 The Hormones Could Drive You Nuts?
Think about IVF hormones like your PMS on steroids, the phenomena is called PMT (Premenstral Tension). The doctors have one goal: To produce as many eggs for harvesting as they possibly can. Hence, hormone shots, lots of hormone shots. You need to plan your schedule around one to three injections a day for the first two weeks of your cycle. But there's a price to be paid.
There can be mood swings, depression, not to mention anxiety and stress. Your whole life is turned upside down, plus you're full of rampaging hormones. Let's face it, you also might get more than a little snarky. Prepare your other half, so he knows what's coming. Otherwise, it could just get a lot more stressful. Knowledge (and understanding) is power.
During this time, it would be good for you to do things that relax you, or plan to take any stressful events out of your agenda.
11 The Woman's Life Gets Hijacked
Back to producing those eggs. Lots of eggs. Over two weeks, you have hormone shots, leading (hopefully) to a bumper crop of eggs when you ovulate. TV personality Guiliana Rancic was reported to have had 63 injections a cycle.
Yikes, that's a lot of jabs!
Again, that's over two weeks. Want to meet a friend for lunch? Forget it. It's time for another shot. Go out with your partner for dinner? Not unless you want to sit in the stalls in the ladies, syringe in hand. Then every day or so, you go in for blood tests or ultrasounds. And you sit and wait your turn.
This may be a tall order, but try to clear the decks as much as possible. Clear up your "to do" list and keep it simple. On the bright side, all of this will prepare you for when you do have a baby, because instead of jabs, you'll be breastfeeding, instead of waiting to see the doctor about your egg count, you'll be waiting for your little one to fall asleep.
10 The Dirty Little Secret About Success Rates
Clinics will advertise their success rates. Some "top" clinics will claim they produce live births 60 or 70 per cent of the time. And they may say things like, "The only thing you need to worry about is the baby's name". But, beware. Some clinics will avoid older women who are less likely to conceive or women with health issues that make them a risky prospect.
So those advertised numbers can be skewed in a way you might not anticipate. The best source of information? Find a support group of women, either online or maybe at a local church. Also, talk to your OB/GYN. He or she will be a great source of relatively unbiased information. Other sources? Try Parents.com or the website for the Society for Assisted Reproductive Technology (SART).
Both are a great source of information on clinics and best practices. The simple fact is that a woman under 35 who produces seven to ten eggs over a given cycle stands around a 50 percent chance of success. In IVF, eggs are where it's at.
9 Fancy Having Multiples?
Think about it. Depending on where you live (and the legal regulatory structure), you might have three or more embryos implanted into your uterus. The reasoning goes something like this: The more embryos, the greater your chances of becoming pregnant with one, two, even three or more babies.
Now, the other side to this is that the risk of problems increase as the babies you are carrying go up in number. According to uscfertility.org, "There is overwhelming evidence that multiple pregnancies represent a major threat to the health of the mother and the fetuses."
Major risks include pre-eclampsia and preterm (premature) labor. And even if everything goes well, are you ready for triplets?
Not every woman who goes through IVF will have triplets, but the chances of having twins is real. The rates look something like this, 25% likelihood of having twins and a 4% chance of having triplets. The good news is that couples are at least 24-30% likely to have just one baby.
8 Frozen Versus Fresh Eggs
Success! On your first attempt at IVF, four eggs are harvested and fertilized and you end up with four embryos. In consultation with the clinic, you decide to implant two of those embryos, leaving two. What happens to them? Well, they are frozen and stored.
Down the line, you might decide to have those embryos implanted. So, which is better: Fresh or frozen? The answer may surprise you. Remember all those hormone injections you subjected yourself to in order to produce a bumper crop of eggs?
Well, those hormones cause changes in the uterus which may adversely affect the chances of your becoming pregnant. Sounds pretty counterproductive doesn't it, you might think about asking your doctor to wait until the hormones injections have passed through your system before implanting your embryos.
If you have implants done on what is called a "frozen cycle", those injections are not necessary and your womb is in a more "natural" state.
7 Do You Know About Blastocysts?
This is one women should definitely not skip discussing with their doctors. Normally, when eggs are harvested and fertilized, they are left in a growth liquid for two or three days, during this process some embryos are produced. One development in the world of Assisted Reproductive Technology is a thing called a blastocysts.
Well, simply put it's an embryo that has been left to grow for five or six days before being implanted. So, the obvious point is that the embryo is a little more mature and in some cases, using blastocysts can increase your chances of becoming pregnant.
Is there a downside? Well, you might end up with fewer embryos, as the less strong ones may not survive the longer growth period. So it's more risky to try to grow the stronger blastocysts, not many women are comfortable with the idea of throwing away their hard earned eggs.
6 The Thing About Baby Showers
Be honest with yourself. What kind of IVF patient do you picture yourself being? The answer depends on how well you handle stress or are able to deal with stress later. Knowing the answer to this, are you hopeful, but realistic? Or are you desperate to get a result?
You might find that even going to baby showers or meeting friends with infants for a coffee can cause a reaction that you aren't expecting. And depending on how the hormones are treating you, there might be some social engagements you'll have to excuse yourself from.
Some women who are having difficulty getting pregnant find it difficult to be around kids, even pregnant women. The bottom line is that you've got to do what is best for you, not your friends. If the thought of a baby shower freaks you out, don't go. Be as honest as you can with your friends. "Look, I am sorry, but I am just stressed out by this IVF thing . . . " If they don't understand, that is okay too.
5 It Could Nuke Any Relationship
It's a fact: Couples undergoing IVF unsuccessfully are three times more likely to break up than non-IVF couples. Why? In a word: Failure. You "both" have failed to produce a child. You have spent a lot of money, your focus has been shifted from the two of you to the pursuit of parenthood and you have come away empty handed.
If the goal was children, you have both "failed" that can turn a relationship sour. It's not fair, but you, as a wannabe mom, are probably going to be a lot more invested in getting a result from IVF than your male partner. He may think you care less about him and more about producing a baby.
It sounds trite, but try to strike a balance. Try to talk about it honestly with your partner. Making an effort to reconnect in the end no matter what the results are can make the difference between happily ever after and splitting everything 50-50.
4 There Are Different Kinds Of IVF
In conventional IVF, you are treated with hormones during the first two weeks of your cycle with a view to producing as many eggs as possible. Natural IVF does not use stimulating drugs. Natural Modified IVF uses drugs for around seven days. But the thing to remember is this: Success in IVF is directly tied to egg production.
The more eggs you produce, the greater you chances of success. "Natural" IVF is going to leave you in the same position as before you did the treatment. In other words, your egg production probably won't increase. Does Natural IVF have any advantages over simply doing it for yourself?
The major thing is the in vitro fertilization, the test tube baby thing, meaning that eggs are fertilized, embryos are produced and implanted into your womb. Even getting to that stage is probably an improvement on past results.
3 Dealing With Unexplained Fertility
Doctors are hesitant to admit they don't know the answer to a health question. For example, take that demon "unexplained fertility". The doctor has run tests, but nothing has shown up. Your fertility situation is unexplained.
Know this: 30 per cent of female infertility is unexplained. So, is IVF is an option for you? Yes it is. Remember we said an average under 35 couple just doing "it" on their own, stands around a 20 per cent of conceiving in any given cycle. But with "unexplained fertility" that number plummets to around 3 per cent.
For those couples, IVF is a kind of rolling diagnostic treatment. The doctors will be able to spot problems, say in egg quality or difficulty with implantation of the embryo that lower tech fertility treatments like Clomid or IUI wouldn't bring to the forefront.
2 Think Of It As A Process
A lot of times, people have a kind of blind faith in doctors and science. They go to an "expert" who tells them he or she can help them and then do as they are told by the expert without question. Let's go back to the idea that all fertility treatment, including IVF, gives your doctor information on what is going on in your body.
So, let's say that you hopefully go into IVF, finish your first cycle and a couple of weeks or so later, have your period. That's the time to go in and talk to your expert and ask what, if anything, they have learned from the process. And more importantly, what should be done differently next time.
In fact, it's a good idea when you sit down with the staff of the IVF clinic for the first time to make that point. You are doing this to have a baby. But you are doing this to learn about what the issues are.
1 You Are Not Alone
Some women get so tied up in the idea of having children that they lose perspective on what's really important. Your relationship with your significant other is important. As we have said, talking and communicating is key.
Often, women who feel they have "failed" when they don't become pregnant isolate themselves and turn inward. They can't imagine anyone else in the world having the kind of feelings they are having or even going through the fertility woes they're experiencing. Who knows if stress and worry hurt your chances of getting pregnant, but they certainly don't help.
Finding somebody to talk to that is, or has been, in the same boat as you can help tremendously. Ask you clinic. They will probably have former patients who can help mentor you through the maze of IVF and talk about what they went through.