If you and your partner have been trying to get pregnant for a year without results, reproductive medicine considers you to be infertile — and now would be the time to find out why.
The three most common reasons for infertility are:
- Ovulation issue: You don’t ovulate every month.
- Blocked fallopian tubes: Normally, fertilization occurs in the tubes; if they’re blocked, this process can’t happen.
- Sperm problem: About 40% of the time, there’s an abnormality in sperm count, motility (its ability to move forward), or morphology (size and shape).
When Should I Think About In Vitro Fertilization
If one or more of these problems is found, should in vitro fertilization (IVF) be the next step? IVF is the process of fertilization by extracting eggs from the female, retrieving a sperm sample, then manually combining an egg and sperm in a laboratory dish. The embryo (or embryos) is then implanted in the uterus.
- If ovulation irregularity is the culprit, the first line of treatment is medication to stimulate ovulation. This approach is tried for three to six menstrual cycles; if it doesn’t work, that’s an indication to move on to IVF.
- If a patient has blocked tubes, there’s simply no way she can get pregnant naturally, making this an absolute indication for IVF.
- And if there’s a sperm issue, intrauterine insemination (IUI) or IVF may be an option. IUI is a simple procedure that puts sperm directly inside the uterus, helping it get closer to the egg.
Does My Age Matter?
Another factor reproductive endocrinology and infertility (REI) physicians consider when it comes to IVF is a woman’s age. About half of women under age 35 will have a baby with IVF. At age 37, that drops to about 40%. At 39 and 40, it drops to 30% and 20%, respectively. And at 42, the success rate is only about 2%. This is due mainly to the fact that older eggs result in poorer quality embryos.
As a result, once a woman is in her thirties, the earlier, the better to begin the IVF process to ensure the best possible outcome.
Another option REI experts can offer is to freeze embryos from IVF. For example, if a couple undergoes their first IVF when the woman is 37, and she gets pregnant, we can freeze some of the unused embryos for future use — say, two years down the line. This way, younger eggs are being used, and there’s a better chance of pregnancy when she’s 39. And more than one pregnancy can be achieved with a single cycle of IVF — which is also cost-effective.
This freezing technique — called cryopreservation — is also indicated for women who have been diagnosed with cancer and must undergo chemotherapy, which can compromise fertility. A woman’s eggs can be harvested and frozen before her treatment. Then, when she’s ready to have a baby, the healthy eggs are taken out of the freezer, fertilized with her partner’s sperm, and the embryo is implanted in her uterus.
The egg preservation technique can also be used for the woman who simply isn’t ready to have a baby at age 30, for example, but is concerned that her egg count will drop the longer she waits, making getting pregnant at age 40 more difficult. With this approach, she can wait until 40 but use her 30-year-old eggs, enhancing the chances of a successful pregnancy.
With our newly expanded IVF Center at UMass Memorial Medical Center, we’re able to offer all these services right here, all in one convenient location. If you have any questions, we’re here to help! Request a consultation by calling 855-UMASS-MD (855-862-7763) or visit www.umassmemorial.org/IVF.
This blog post is part of our Simply Women initiative that caters to the unique health care needs of women and their families.
Guest Bloggers: Shaila Chauhan, MD, and Armando Arroyo, MD, (coming fall 2020) Reproductive Endocrinology and Infertility Specialists, UMass Memorial IVF Center