What Makes a Patient a Good Candidate for Advanced Reproductive Treatments?
By Francis Polansky, M.D.
There are patients whom we barely get to meet. They "fly" through their treatment, conceive, and are referred back to their OB/GYN for prenatal care. Are there some factors these patients have in common?
Advanced reproductive treatments bypass one of the three factors causing infertility: Fallopian tubes function. Of the other two factors, male infertility is almost always also corrected for. That leaves the quality of one’s egg as the most significant factor determining the treatment’s outcome.
Not surprisingly, the egg quality factor is closely related to the patient’s age: Female fertility peaks in the mid-twenties and begins to decline by the age of 32 or 33. By the age of 39 and 40, it can be difficult to successfully conceive (pregnancies not ending in miscarriages).
After the age of 43, it becomes quite rare to conceive successfully with one’s own eggs, and most patients will need to consider Donor Egg In Vitro Fertilization treatment.
After the female partner’s age, the length of infertility, whether she has been pregnant previously, and whether she is having regular menstrual periods are other important factors.
Surprisingly, one’s attitude toward infertility treatment also seems to play a role in the outcome. Over the years, we’ve observed that patient who approach their infertility with an "open mind", and are not excessively stressed over the treatment’s outcome seem to have a better probability of success than couples whose life is focused only on getting pregnant and nothing else.
By the time patients reach advanced reproductive treatments, they have typically been through months and possibly years of infertility and numerous infertility tests. It is not easy to keep one’s spirits up. You may wish to consider counseling by a Marriage & Family therapist, a psychologist, or a psychiatrist. This could be as short as a single session or could take place throughout your treatment and beyond.
As Dr. Alice Domar states:
"The majority of the research thus far does support the theory that the more distressed one is before an IVF cycle, the less likely one is to conceive."
— Alice Domar, Ph.D., Assistant Professor of Obstetrics, Gynecology,
and Reproductive Biology, Harvard Medical School