When To Start Thinking About IVF

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. An in vitro fertilization (IVF) expert can help. 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 IVF?

If one or more of these problems are found, should IVF be the next step? IVF is the process of fertilization by extracting eggs from the female, obtaining 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, and for many patients will result in a pregnancy. If ovulation stimulation works but no pregnancies occur, then IVF should be considered. If a patient has blocked tubes, there's no way for the egg and sperm to find each other to make an embryo. IVF is absolutely indicated here. 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?

As women age, egg quality slowly deteriorates, and it becomes harder to become pregnant naturally or with IVF. Because of this decrease in egg quality, REI doctors encourage patients with infertility to undergo assessment earlier than later. The success rates using IVF change with age. Keep these facts in mind:

• About half of women under age 35 undergoing IVF will have a baby.
• At age 37, that drops to about 40%.
• At 39 and 40, it drops to 30% and 20%, respectively.
• If a woman is 42, the success rate is only about 2%.

The IVF process is only as good as the eggs and sperm used to create the embryo. Older eggs tend to make poorer-quality embryos.

Can Eggs and Embryos Be Saved for Later?

Another option reproductive endocrinology and infertility 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 a 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 IVF Center at UMass Memorial Medical Center, we offer all these services right here in Central Massachusetts. Learn about our personalized service in one convenient location. Request a consultation by calling 855-UMASS-MD (855-862-7763), or visit our website.