A couple sits close to each other while looking down to read a pregnancy test.

Fertility Series: Treatment Options

With celebrities documenting their day-to-day progress of their in vitro fertilization (IVF) journeys on their TikTok accounts and wellness gurus touting homemade fertility tonics on Instagram, this might beg the question for some women: what are my options for fertility treatments?

We asked Dr. Laura Detti, director of the Division of Reproductive Endocrinology and Infertility at Baylor College of Medicine, about fertility treatments, the latest advances, and when women should check their fertility.

Question: What is one thing you wish patients knew about fertility treatments?

Answer: There are more options than just IVF for improving fertility. Sometimes it’s the education we can provide so that the patient can conceive easily. Other times we can do less invasive procedures to achieve the goal. Fine tuning of thyroid function and metabolism might be enough to achieve pregnancy, or we can induce ovulation with oral agents. We can also improve the function of sperm by washing it and injecting it into the uterus. I want patients to know that we can help them achieve their fertility goals even if the conditions aren’t optimal.

Q: How have fertility treatments/technologies changed over the past five years?

A: In terms of technology, we are now much better at detecting genetic abnormalities in embryos. We offer preimplantation genetic testing for aneuploidy (PGT-A) that looks for chromosomal abnormalities. Another option is preimplantation genetic testing for monogenic diseases (PGT-M). This is where we can detect small genetic or molecular changes that can cause types of conditions like cystic fibrosis.

In terms of fertility treatment options, they are still more or less the same as when they were created in the late 90s, but we are now able to customize treatment for each patient. Micromanipulation in the IVF lab has allowed us to become more efficient in performing fertilization and embryo implantation, with intra-cytoplasmic sperm injection, embryo hatching and embryo biopsy. embryos.

Q: It seems that more and more people have been more open with their IVF journey in recent years. What kind of impact does this have on people currently doing IVF or considering doing so?

A: There are about 8 million children born from IVF in the world, and only a few years ago there were 6 million children. It shows you that this approach to fertility is growing. Until a few years ago, IVF was seen only as a method for an infertile couple. These days, IVF is seen more as a way to achieve pregnancy faster or when the “time is right” for the couple – for example, the growth of this approach may allow people to postpone pregnancy until a later age. more advanced.

Q: With new advancements, what impact does this have on when women can have children?

A: As women age, their ability to get pregnant decreases. For example, a 40-year-old woman has about a 15-20% chance of getting pregnant with an IVF cycle. When we do the genetic analysis (we only recommend it for women over 37) and transfer a genetically normal embryo, a woman’s chance of getting pregnant at any age is between 55-60% .

The key here is the genetically normal embryo. For women 40 or older, it is more difficult to find these genetically normal embryos. As women age, ovarian reserve decreases and the number of genetically abnormal eggs, and therefore embryos, increases.

Q: Is there a certain age at which you recommend women test their fertility?

A: There are two cases in which we see women wanting to test their fertility. One is when women consider having children now but are unsuccessful in their attempts, and another is when women consider delaying having children. In either case, you can then make decisions based on those results. For example, there are women who have reduced ovarian reserve at a younger age, and these women would benefit from doing some kind of fertility preservation early on. They can do egg freezing in their twenties; then, when they are ready to have a child in their thirties, they have a backup plan if natural conception does not occur.

Learn more about our Reproductive endocrinology and infertility services.

By Anna Kiappes

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