Thank you Ohio Health for featuring our own Dr. Laura Londra in a blog post on A Guide To Navigating The Complex World Of Fertility
Couples and individuals navigating the complex journey of infertility know that it can be long and full of twists and turns. From common misconceptions to advances in treatment options and practical advice for those on their fertility journey, learn what to expect and how to proceed with confidence on your journey to parenthood.
“The path to starting a family looks different for everyone. It can be difficult to know what you need to be on the right side of a positive pregnancy test,” says Laura Londra, MD, OB-GYN and specialist in reproductive endocrinology and infertility at OhioHealth. “Fertility challenges can be stressful. It’s very rewarding for me to be able to guide my patients on their journey to becoming parents.”
Common causes of infertility
Couples of all ages struggle with infertility. However, Dr. Londra says there’s no question that fertility declines with age. Because conditions that affect fertility impact men and women equally, Dr. Londra says it’s important to examine and evaluate both partners at the same time.
Infertility in women can be due to a mix of issues, including irregular menstrual cycles, ovulation problems, uterine fibroids, endometriosis, polycystic ovary syndrome (PCOS) and ovarian insufficiency. Infertility in men is often caused by low sperm production and poor sperm motility, or anatomical problems such as undescended testicles, dilated veins in the testicles and hormonal issues.
“Medications and treatments to aid in fertility and conception won’t work unless we address any issues at once,” says Dr. Londra. “Unfortunately, we don’t have a test for everything. Sometimes we can’t identify why a couple isn’t getting pregnant, known as ‘unexplained infertility,’ until we move on to in vitro fertilization (IVF.) In those cases, we often see what the problem was once we can observe the eggs, sperm and embryo development progress in the incubator.”
When to see a specialist
Knowing when to see an infertility specialist can be difficult. For women under the age of 35 who have regular menstrual cycles, normal annual exams and no pelvic inflammatory disease or pain, Dr. Londra says after one year of unprotected intercourse without a positive pregnancy, it’s time to see a specialist. For women over the age of 35, she says the time to wait before seeking treatment drops to six months. If a woman has a history of pelvic pain, endometriosis or pelvic surgery, an even earlier consultation would be best.
“There are general guidelines for when to see a specialist, but if you feel like something is off or if you don’t want to wait, you should make an appointment sooner,” says Dr. Londra. “Navigating infertility is difficult, and each month can feel like a missed opportunity to start or expand your family.”
For individuals or couples who want to postpone having a family, egg and sperm freezing makes that possible. Dr. Londra says that sperm freezing can be done at any time. However, egg preservation involves a minimally invasive procedure that takes 10 to 12 days to complete.
Lifestyle factors
There are some steps that both men and women can take to increase their chances of conception, either naturally or through fertility treatments. Dr. Londra explains that, in some ways, pregnancy is a stress test for the body, which is why properly managing health conditions such as diabetes, anxiety and depression is so important. In addition, she says that taking folic acid supplements, eating a healthy diet, not drinking alcohol, quitting smoking and getting regular exercise can all help reduce risk factors for infertility problems.
Procedures and treatments to aid conception
An initial evaluation with a fertility specialist will include blood work, a hormone analysis, an ultrasound for women and a sperm analysis for men. A couple’s results will determine the next steps for treatment. Options can range from simpler interventions, such as medications to boost ovulation and timed intercourse, to more involved procedures, including intrauterine insemination (IUI) and in vitro fertilization (IVF).
“In some cases, a push in the right direction with medications or getting the egg and sperm closer together through artificial insemination (IUI) will result in pregnancy,” says Dr. Londra. “However, the overall success rate for those procedures is low at about 5 to 15% during any given cycle when compared to IVF.”
If a woman is over the age of 35, Dr. Londra says that she is less likely to recommend simpler treatments for more than three months. This is because sometimes it’s best to move straight to IVF, which is typically 3 to 5 times more successful than IUI. Because IVF allows your physician to evaluate embryos before they are placed in the uterus, it provides the opportunity to choose those that have the best chances of resulting in a successful pregnancy. This can reduce the likelihood that the baby will carry a chromosomal abnormality, and it can also reduce the risk of a miscarriage.
Fertility treatments sometimes result in a pregnancy with multiple babies, but this is much less common now than it was in the past. In addition, some women who have IVF might have an increased risk of developing diabetes or high blood pressure while pregnant. Maternal-fetal medicine specialists who have experience managing high-risk pregnancies are often involved in the prenatal care of women who conceive through fertility treatments.
Hope for the future
Advances in fertility treatment mean that more couples than ever before have the chance to start a family. The future of fertility treatment means more personalized care and advances in identifying optimal timing for egg retrieval and embryo placement, as well as the selection of embryos.
For couples who are struggling to cope with the emotions that come with waiting for a healthy pregnancy and baby, Dr. Londra says a support network, even if it’s small, can make all the difference.
“There’s no need to struggle in silence, and you might be surprised to learn how many people have traveled similar paths to the one you are on now,” says Dr. Londra. “Even if it’s a parent or just one friend you trust, having someone to share your feelings with can help you to feel more hopeful. And there’s every reason to hope.”
This article was published on – https://blog.ohiohealth.com/a-guide-to-navigating-the-complex-world-of-fertility/