Healthy Living

Wednesday, October 8, 2008

Finding Fertility: Don't Rush to IVF if...

One of the problems with many fertility centers is their rush to treat couples with the most advanced reproductive techniques—like IVF—often when it’s not necessary. They may jump to IVF because patients are anxious for a pregnancy and time is of the essence, or because they simply don’t take the time to try look for subtler problems that may be affecting a couple’s fertility nor do they take a whole-body approach. Overall, less than 15 percent of all couples having fertility problems need IVF to successfully have their own biological children.

More proof comes from a recent study published in the journal Reproduction. The study found that couples who were waiting for treatment had on average a 9 percent chance of becoming pregnant within a year--without treatment. But for some couples the chance was as high as 25 percent. The researchers included couples who were registered on a national waiting list for IVF in the Netherlands (to get on the list, couples have to meet strict criteria of severity or length of infertility and have tried more basic treatments). Of the 5,962 couples, 316 became pregnant while they waited (718 had not begun IVF and not gotten pregnant in a year).

Those with a better chance of getting pregnant without treatment were couples diagnosed with unexplained infertility (one of the most common diagnoses of infertility), male factor infertility or infertility caused by immunological factors as well as those who had been infertile for less time and couples with secondary infertility. Chances lowered with the woman’s age as well as for women with tubal infertility or endometriosis—though it’s worth noting that endometriosis is graded on a continuum from minimal to mild to moderate to severe, so that women with minimal or mild should not assume that they need IVF to conceive. Previous, yet smaller, studies have found the rate of spontaneous pregnancy in infertile couples to be even higher.

The research suggests how important it is to be certain that you really need the most aggressive type of treatment available today. In my book, Perfect Hormone Balance for Fertility, my co-author, Dr. Greene, and I discuss ways of assessing your fertility factors and determining the level of treatment you need—some couples can start with basic treatments like using ovulation stimulation and intrauterine insemination, rather than jumping to the most costly and invasive IVF.

If you fall into one of the categories with the greater chance of success without treatment, take three months to balance your hormones by making lifestyle changes—eating healthier (less meat, please), losing weight if you need to, reducing stress, doing some yoga, exercising—and checking for any untreated conditions like diabetes, PCOS, or thyroid problems. Taking these steps, which we spell out in our book, will improve your chance of pregnancy, with or without treatment.


For more ways to reduce stress (including improving sleep), see my book, Perfect Hormone Balance for Fertility.


Laurie Tarkan is the co-author of Perfect Hormone Balance for Fertility and Perfect Hormone Balance for Pregnancy. She writes for the New York Times and national magazines and is also the author of My Mother's Breast: Daughters Face Their Mothers' Cancer.

Check out Laurie's recent post on the Huffington Post.
Toxic Wombs
and infertility related articles:
Lowering Odds of Multiple Births
and
Are Men Overlooked at Fertility Centers

as well as her co-author, Dr. Robert Greene's bulletin board on www.haveababy.com

[photo credit: Getty Images]

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From the Community…

Comments 1-6 of 6
  • jen's Avatar
    Posted by jen Fri Jul 18, 2008 11:39am PDT

    Great article and advice!

    I too, am surprised at how fast some couples decide to do IVF (mostly because of the cost). We, on the other hand, went through it all (lifestyle changes, too many tests to count, 5 clomid/iui's, 7 injectible/iui's) before coming to the conclusion that it's time to do IVF. After 4 years of heartbreak, we are more than ready to move on to pregnancy and babies!

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  • dkcurls's Avatar
    Posted by dkcurls Sat Jul 19, 2008 12:30pm PDT

    So if you did all of those things and none of it worked, why wouldn't you have wanted to do IVF initially and get positive results without all of the heartbreak?

    My doctors started off slow, but I knew the importance of time if I wanted to have a successful pregnancy before the age of 45. I pushed for them to do IVF after a failed IUI. I'm glad I did because it took 2 IVF treatments before we were successful.

    The longer you wait the more you lessen your chances. Each month is crucial. I suggest a great website for more info and support. www.ivfconnections.com

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  • Parveneh's Avatar
    Posted by Parveneh Sat Jul 19, 2008 2:18pm PDT

    The earth is over populated. More couples should consider adoption. With the money couples spend on having their "own" children, think of how many orphaned children can be adopted and loved. A child is the same whether its blood or not. If you have the love to give, there's plenty of children out there that need it.

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  • Laurie Tarkan's Avatar
    Posted by Laurie Tarkan Sat Jul 19, 2008 3:45pm PDT

    Dkcurls,

    Yes, you're right. For some people, especially women in their late 30s or early 40s, it's important not to wait too long if you need IVF. But getting a really good assessment of your fertility factors can determine what level of treatment you need. Certainly some couples will just want to go straight to IVF, but many couples may want to try less invasive and expensive treatments. The most important point to remember is that each couple is unique and has to make their decisions based on their fertility factors, their age, how many children they want and what they're comfortable with, not to mention what they can afford. Sometimes decisions are made based on a fertility clinic's protocols instead. My co-author, for example, went through infertility treatment, had a cycle of IVF, which failed, and then decided they might not need to be that aggressive based on the number of embryos they had during their first IVF cycle and other markers of fertility, and he and his wife became pregnant simply with IUI.

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  • Cursed Romantic's Avatar
    Posted by Cursed Romantic Sat Jul 19, 2008 10:56pm PDT

    No offense to you Parveneh. But I don't think every couple can just adopt that way. I think its sort of biological a bit to want to have your own children. Because you are kind of more than likely to know what to expect from that offspring than of one you may not know. I know it sounds like a double standard but for most children that have been in the system for a long time, may have some issues with trusting adults again if they haven't been adopted in a long time. Not only that but most couples, I think, don't really feel they have much left to give with dealing with a unruly child that they have adopted. I mean most can love a kid that isn't theirs because they have a strong desire to do so. But most couples that have tried nearly everything, just may not be in the best emotional state of mind to handle tantrums for that adopted child and may want to give up and start resenting the child, because they deem them as not really theirs. And they likely feel that if they had their own kids it wouldn't be so hard. So in all honesty I think there are alot more factors that people need to consider before just adopting a child. Because really to just adopt a kid to do the "right" thing by the world, could cause more problems than solutions for the couple and that child.

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  • jen's Avatar
    Posted by jen Mon Jul 21, 2008 9:33am PDT

    dkcurls,

    To answer your question... We were hoping to conceive as natural as possible (like everyone.) Plus, we have great medical coverage for injectibles, but no coverage for IVF. We were exhausting our resources before taking the leap. I'm 31, so my Dr said we had time. If we were older, we would've done IVF sooner. It's just so expensive and not guaranteed. Anyway, Congratulations!!! I'm so glad you were successful! Us long time ttc'ers love stories of hope like yours! :) (ivfconnections.com is a great resource. I've been a member of idob.org for 5 years)

    Parveneh, Your comment isn't appropriate in this forum. You are entitled to your opinion, but unless you've been through a journey like ours, it's insensitive of you to dismiss our desire and God given right to have bio children. Yes, adoption is a wonderful option, but it may not be for everyone. In many cases, adoption is more expensive than fertility treatments and can be even more heartbreaking (if the baby you've loved for 6 months is taken from you because the mother changed her mind, etc.) There are more things to consider than you realize.

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