.Do you need IVF?

There is a short list of reasons why IVF is necessary, another list of why it might be a good idea and then a longer list of situations that people are rushed into this expensive and energy sucking treatment unnecessarily.

 The problem is that as a fertility patient you have basically three options:

 

Ovulation induction with timed intercourse

IUI

IVF

 

It’s a short jump from the least expensive and invasive treatment to the most.

 

As I observed in my time shadowing a fertility doctor (as part of my doctoral training in 2019), there are many situations where IVF is probably not necessary, and conservative treatments for both partners is likely enough to increase the likelihood of natural conception.

 

When you need IVF:

 

  • Significant male factor infertility like azoospermia or history of vasectomy (no sperm, donor sperm needed for advanced urological procedures to extract sperm from the testes)
  • Third party reproduction, needing donor eggs or sperm or a gestational carrier. This could be due to a variety of reasons.
  • Tubal factor infertility
  • There is a known, inheritable genetic condition that needs to be screened for in embryos
  • That’s pretty much it; I told you it’s a short list

 

When IVF may be a good idea:

 

  • You want multiple children and are a woman in her mid-late 30s+. A great benefit of IVF is that you can bank eggs or embryos which means any future offspring will be from younger eggs. It can give peace of mind that multiple children are possible at any age since your uterus does not age.
  • You have unexplained infertility and do not want to “waste time”.
  • Some cases of “advanced maternal age”. It’s certainly possible to be fertile into your late 30’s and early 40’s but IVF may decrease the timeline and help reduce the likelihood of miscarriage through genetic testing.
  • You have multiple smaller things working against you. I often see this as mild to moderate male factor problems which do not improve with conservative treatment and a condition like PCOS or endo which, combined, decreases the likelihood of conception without intervention.
  • You just want to. We are all about body autonomy here. Some folks feel best taking action towards their goals instead of waiting for “nature to take it course”

 

When IVF is probably not necessary:

 

Time and time again when I was at the fertility clinic I saw a patient with a clear opportunity for DRAMATIC health improvement who was doing IVF. I wanted to both hug them and scream at them that fertility will improve when health improves.

 

  • Unexplained infertility that has not been holistically assessed. The work-up for fertility is limited to the reproductive system when infertility is a whole-body condition.
  • Male factor fertility is ok but not great. The male partner’s lifestyle is not great, use of harmful substances like alcohol, cigarettes, tobacco, nicotine, cannabis, illegal drugs
  • Conditions like PCOS or Endo which have not been treated with lifestyle and conservative care.
  • You don’t have the budget or emotional energy to undergo expensive treatment that will not guarantee you a baby
  • There are obvious problems with the health of 1 or both partners.
  • Menstrual problems like irregular cycles, really painful periods, scanty menstrual flow, pelvic congestion, pain with sex
  • Sexual dysfunction, difficulty with erection, ejaculation, libido
  • Any health condition or symptom that is not being considered as part of a fertility workup

 

I spend many days wondering how many people are pushed to do IVF necessarily without being given the information and opportunity to improve their fertility first. I’ll never know the exact answer but I know it’s a lot. My hope is that by arming you with information, the only people who will undergo invasive, exhausting and expensive medical care are the ones who really need it, or really want it. Everyone else can see their fertility acupuncturist 😉

 

If I’m missing anything from any category, let me know! I’m always happy to make updates and adjustments based on feedback.

 

 

Have more questions on this subject?

Dr. Emily Rea is here to answer your fertility questions and walk with you on your fertility journey. Send us a message any time!