Doctors Break Down Your Options For Having Kids If You Want To Wait - Exclusive
Women have a lot to consider when it comes to getting pregnant. Though the news can sometimes come as a surprise, most prefer to plan ahead. So, what is the perfect age to have a baby? That's a tough question to answer. While it's possible to have babies later and later, it doesn't change the fact that, at some point, many women interested in starting a family fear they've missed their boat.
The older you get, the more complicated it becomes. "Biology is what it is, and that hasn't changed significantly in the last thousand years," Dr. Jacques Moritz, an affiliate associate professor OB-GYN told The Cut in 2016. While biology may not have changed, technology certainly has. The age at which people can conceive isn't so hard and fast anymore. "We've found some pretty effective ways to get around biology," Mortiz added.
Maybe you're planning to be an older mother or fertility issues come into play for you and your partner. To clear things up, Women spoke exclusively to Board Certified Reproductive Endocrinologists Dr. Alison Peck, MD, FACOG, Dr. Natalia Llarena, MD, FACOG, and Dr. Lisa Becht, MD, FACOG of HRC Fertility. As they explained, you have some promising options.
Understand your body
Beginning a fertility journey can seem overwhelming. So, you'll want to take the first step and book an appointment with an OBGYN as soon as possible. A thorough meeting with your doctor or a fertility specialist will give you a general idea of your stats and what options are available to you moving forward. "At a very basic level, in order for conception to occur, we need (1) healthy sperm, (2) monthly ovulation, (3) open fallopian tubes to pick up an ovulated egg, and (4) a healthy uterus," Dr. Natalia Llarena, a specialist at HRC Fertility said when speaking exclusively to Women.
Luckily there are a variety of tests that can account for all these factors. A good place to start is with a blood panel to give you an idea of your hormone levels. This can be done through a doctor or private company. From there, the tests become more intense. "Ultrasound and/or hormone testing can be used to confirm ovulation," Llarena added. "Specialized ultrasound or x-ray tests (hysterosalpingogram) can evaluate the patency of the fallopian tubes and the shape of the uterus."
You'll also want to check your ovarian reserve – or the number of viable eggs still in your egg pool. This is done via ultrasound and/or additional blood work. ORT doesn't tell you anything about your chances of getting pregnant naturally, but it does tell you whether or not you'd be a good candidate for procedures like IVF.
Medication is a good place to start
Once you've assessed your overall reproductive health, you can discuss options. Regardless of your age, several options are available to assist you with getting pregnant. Your choices may range from simple oral medications to invasive surgery.
Dr. Lisa Becht explained exclusively to Women that as a first step, you might be prescribed medication to help with egg growth. "A female may be given a fertility pill for five days in the early part of her cycle such as Clomid or Letrozole, or low dose injections of hormones to help with eggs growing and ovulating," she said. "If she normally does not ovulate, the goal is for one egg to grow. If she does ovulate but has infertility, the goal is to ovulate more than one egg."
Becht cautioned that hormone-altering fertility pills also require regular checkups. "For more information, ultrasounds and bloodwork are done a few times during the process, and sometimes a shot to make the eggs ovulate at the correct time is also given." Your medication regime will also likely coincide with timed intercourse. Between trying to conceive and trips to the doctor, you'll have a packed schedule. But other than a few minor side effects like changes in mood and headaches, medication can be an effective way to start a family.
Options beyond medication
Prescription medication alone may not work for you, so you may end up opting for something more invasive. Depending on your medical needs, that could be IUI (intrauterine insemination). IUI is a good option for people who respond well to fertility drugs, have a partner with sperm issues, or those using a sperm donor. Though relatively easy, IUI isn't a sure thing – especially if fertility is an issue. "For the best-prognosis couples with infertility, monthly success rates with IUI typically do not exceed 8-10%," Dr. Llarena told Women exclusively.
Your doctor may also recommend Invocell, a relatively new and promising procedure. "Invocell is a newer option that is somewhat in between these more traditional methods. It involves hormone shots and the egg retrieval like IVF, but once the eggs are taken out, they are put in a device that is then placed in the vagina for five days," Dr. Becht explained exclusively to Women.
Five days later, the device is removed, and any embryos that have formed are removed by an embryologist. They will then be placed back in the uterus, hopefully leading to a healthy pregnancy. "This is best for patients who just need help getting the sperm and egg together," Becht added, suggesting that a couple using a sperm donor or a woman with a blocked fallopian tube might respond best to this treatment.
IVF may be your best bet
If all of this information is new to you, IVF (invitro fertilization) probably is not. IVF is the most invasive option but also the most likely to yield results. "The best-prognosis patients undergoing IVF will have a 50-60% chance of taking home a baby from a single cycle," Dr. Llarena said during her exclusive interview with Women. "IVF, however, is more costly and requires daily medication injections, as well as an outpatient surgical procedure to retrieve the eggs."
An IVF treatment plan means you'll have to undergo hormone therapy and surgeries before you can celebrate your pregnancy. Doctors typically recommend IVF for older couples, couples who have struggled to conceive with other methods, or women with medical issues. "If there are major sperm issues, blocked fallopian tubes, genetic problems, low ovarian reserve/poor hormones, or other failed treatment cycles, this is the best choice," Dr. Becht said exclusively when speaking to Women. "It involves the female taking shots to get multiple eggs to grow."
After the excess eggs are retrieved (under anesthesia), they are combined with sperm to create embryos which are then frozen and transferred into the uterus at some point in the future. "Pregnancy rates with embryo transfer on average range from 30-70 percent, depending on various factors," Dr. Alison Peck exclusively told Women.
What's next?
As you begin to undergo treatments, it's important to understand potential physical and emotional side effects. "Each method has potential side effects, but all have low risks. Clomid or Letrozole can cause headaches, mood changes, and other side effects," Dr. Becht exclusively explained to Women. It's good to schedule a little self-care if you start taking additional hormones – as they could destabilize your mood. As for physical effects, there is always an increase in developing multiple pregnancies when taking fertility medications.
As for IUI, and Invocell, the risks are minimal. IVF is another matter. "In IVF, the hormone injections can cause injection site pain, headaches, bloating, and cramping," said Becht said. "The egg retrieval procedure is low risk for most patients in terms of anesthesia risk, major bleeding, or infection." With any fertility treatment, it's more than just your health on the line. There are certain risks to the embryo's health as well. "A pregnancy resulting from fertility treatment has been associated with increased risk of certain birth defects," Becht said. "IVF pregnancies can be associated with increased pregnancy complications involving the placenta, blood pressure."
Most importantly, keep sight of your end goal and remember, you have many options available. "My message: there are many ways to make and create a family today," said Dr. Peck during her exclusive interview. "Take advantage of your youth and opportunities in science to help you. May all your dreams come true."