The in vitro fertilization process (IVF) can affect every area of your life: finances, health, emotions and your relationship with your partner. There can be physical discomfort, hormonal swings, feeling a loss of control, disappointment, fear of futility, and scheduling logistics that seem to turn your life upside down. All this takes its toll, and that is why many couples drop out before experiencing success.
What women don’t know — and what I want to tell them — is that about 40 percent of women who give up after two IVF cycles would have gotten pregnant in the third cycle. This is according to the research at my prior company, Celmatix, which analyzed the records of 6,000 patients. Wired magazine wrote, “They compared outcomes from patients who discontinued treatment after two cycles to those who kept going. In the end, the study found that if those women had stayed in treatment one more month, 40 percent of them would have gotten pregnant.”
Something that I do as a fertility concierge is to give women the support to keep trying. I do that in multiple ways:
Psychologically, patients all begin the fertility process believing they can become pregnant, or they wouldn’t be trying. What a fertility concierge can do is set realistic expectations based on research, so that if there are disappointments, you aren’t blindsided and you can handle them with more strength and resilience. Throughout the process, I am your consultant and advocate.
We can look at your age (or the age of the egg donor), your lifestyle, your fertility diagnosis and the number of embryos you hope to transfer to help understand how many cycles you may need in order to achieve success. Of course, there are no guarantees, as every woman and the health of her partner’s sperm will vary. Success rates among fertility clinics and laboratories will vary as well. With my years of practice in Maryland, Virginia and Washington, D.C., I have insights into local clinics and laboratories.
IVF is a new language, and a fertility concierge like me can translate what your doctor says. Also, there is so-called “emotional distortion,” that makes it hard to remember what was discussed. You may be excited or anxious, and that gets in the way of understanding what you’re being told in that moment. Then you walk out of the office and your questions start piling up. A fertility concierge can take the time to answer all of those questions, and can even go to an appointment to be a second set of ears and ask questions that wouldn’t cross your mind. Plus, they can offer a second opinion.
The field of infertility is constantly changing, including new technologies. If a patient tried IVF more than five years ago and still wants to conceive, it is worth speaking with a reproductive endocrinologist like myself. With 15 years of experience, I have learned how mistakes and miscommunications can occur and can stand in the way of success. There are also changing policies and legalities over time that are set by the fertility clinics and the cryogenic storage facilities that may impact your case.
A fertility concierge can take more time than a traditional doctor to understand the patient’s unique situation. That can range from mental health to the couple’s relationship, to past assisted fertility experiences; and that helps a concierge physician understand where a patient may be coming from emotionally. Sometimes one partner may be ready to quit and the other wants to keep going. I have offered additional support to one partner when they feel overwhelmed and don’t want to burden the other partner. Or they may have doubts or concerns they can share with me, and I can provide them with science-based advice. If more medical history is needed, I can quickly get in touch with their doctor and speak in “their language,” which facilitates better communication.
I also tailor the way I provide advice. I ask my patients how much they want to know. Do they want all of the what-ifs, do they want frequent updates, or do they prefer to focus on the big picture? I can lessen the burden of knowing the details and then offer opinions on what steps to take next or what they could do differently next time.
If you have tried IVF in the past, but feel like you don’t have closure or have unresolved questions, a fertility concierge is someone who can help guide you. Do you still have what-ifs? Do you wonder if there is something else you could have done then or could do now? If you find yourself answering yes to any of these questions, I hope you will contact us.
For gay men looking to become parents, gestational surrogacy has become a popular option. In the past, it was more common for a surrogate to be artificially inseminated and then carry the baby to term. With gestational surrogacy, one woman donates the eggs and a second woman carries the baby. In this case, the success rate can be influenced by selecting both the healthiest eggs and the healthiest gestational carrier. One or both men can contribute the sperm that is used to form the embryo (or embryos).
Dr. Wolff is the founder of Pelex, a concierge fertility practice where she educates her patients in the complexities of assisted reproduction and serves as their advocate throughout their journeys toward parenthood.