Many couples today are unsure as to the options available to them when they are starting to work with fertility methods. Here at the Sher Fertility Institute New York, we make each journey a very personal one. There are general rules and theories that are followed in deciding the best course of action for our patients and in his latest blog, Sergio Oehninger, MD, PhD discusses them.
In assisting childless couples, our main goal of treatment is to correct the causes of infertility. With proper evaluation and therapy, most women (approximately two thirds) will conceive!!!!
- Success can follow modification of simple life-style factors, treatment of ovulatory disorders, corrective surgery for polyps and fibroids, and occasionally treatment of endometriosis, or through assisted reproductive technology (ART).
The use of ART can therefore follow failure of other therapeutic interventions, or in many occasions can be the treatment of choice from the onset. The first U.S. infant conceived with ART was born in 1981, and since then the use of ART services have dramatically increased. ART includes fertility treatments in which eggs or embryos are handled in the laboratory (i.e., in vitro fertilization [IVF] and related procedures such as ICSI, embryo and egg freezing, and embryo biopsy for PGS. Due to the multifactorial nature of IVF treatment, success is dependent on many variables. Therefore, it is important to examine how each variable can be optimized to achieve the best possible outcome.
Although most infants conceived through ART are singletons, women who undergo ART procedures are more likely than women who conceive naturally to deliver multiple-birth infants. Multiple births pose substantial risks for both mothers and infants, including obstetric complications, preterm delivery, and low birthweight infants. Consequently, although ART helps millions of infertile couples to achieve pregnancy, ART is associated with potential health risks for both mothers and infants.
That is why we recommend that women aged <35 years, who are typically considered good prognosis candidates, consider an elective single embryo transfer (eSET). Increasing the use of eSET when clinically appropriate helps reduce multiple births and related adverse health consequences.
Delayed child-bearing has increased greatly in recent decades and is associated with an augmented risk of infertility, pregnancy complications, and adverse pregnancy outcome. Maternal age is the most important determinant of fertility, and obstetric and perinatal risks increase with maternal age. Many women are unaware of the success rates or limitations of ART when women are of advanced maternal age. So, fertility counseling is critical to these patients and the aim should be not to delay treatment.
We are firm believers that when social elective egg freezing is offered it should be accompanied by clear discussion of current statistics about success rate, usage rate, cost, and risk. When thinking about elective fertility preservation, age is strongly related to the probability of pregnancy, with better chances when women are younger than 35, and still probably cost-efficient at 37-38 years. Egg freezing via vitrification does not guarantee success but increases the possibilities of having a biological child in the future.
Contact Sher Fertility Institute New York at 646-792-7476 or click here to schedule an appointment with one of our fertility doctors. Our Patient Care Specialists will contact you within the next 24 hours.