IVF Best Option
Bay IVF - Advanced Reproductive Care                                Palo Alto  650-322-0500


Is IVF the Best Treatment for You?

By Francis Polansky, M.D.

You may not need In Vitro Fertilization to conceive. There may be alternative and less expensive treatment options for you.

You and your partner should have sufficient "exposure" to pregnancy before spending time, money, and emotional energy on fertility tests and treatment. On the other hand, it is very important that you do not wait too long. Please note that there is no distinction between having unprotected intercourse and "trying" to conceive. They both represent "exposure" to conception.

The following table illustrates the recommended length of "exposure," as it relates to the female partner’s age, before consulting a Reproductive Endocrinology and Infertility (REI) specialist.

Length of "Exposure" before Consulting an REI Specialist
Female Age No
1 to 3 months 4 to 6 months 7 to 9 months 10 to 12 months 13 or more months
35 or Less Begin sexual activity Continue sexual activity Continue sexual activity Continue sexual activity Continue sexual activity Consult
36 to 37 Begin sexual activity Continue sexual activity Continue sexual activity Continue sexual activity Consult
38 to 39 Begin sexual activity Continue sexual activity Continue sexual activity Consult
40 to 41 Begin sexual activity Continue sexual activity Consult
42 to 44 Consult


The selection of the most appropriate treatment option for you will be primarily based on the length of your infertility, the age of the female partner, the presence of male factor infertility, and the condition of the Fallopian tubes.

You should consider In Vitro Fertilization treatment if any of the following apply to you:

  • History of pelvic adhesions, blockages of the Fallopian tubes, or tubal pregnancy.


  • Presence of male infertility:

    The following treatment modalities are used for couples with male factor infertility:

    • In Vitro Fertilization
    • IVF treatment with Intracytoplasmic Sperm Injection (ICSI)


    Intrauterine inseminations are not usually a useful treatment for male factor infertility.

  • You did not successfully conceive with “basic” reproductive treatments i.e., Clomid or Femara pills, intrauterine inseminations-IUI.


  • Long-standing infertility:

    If you have a history of 18 months or longer of no contraception and no successful pregnancy, your probability of conceiving spontaneously or with basic infertility treatments has become low.


  • Decreasing "ovarian reserve":

    The decrease in female fertility potential is due to the loss of high-quality eggs. As a woman ages, the remaining eggs in her ovaries also age, rendering them less capable of fertilization and of being able to develop into normal embryos.

    Treatment with Clomid or Femara pills or intrauterine inseminations should not be used if the female partner is 38 years or older. At this age, the remaining reproductive time has become too "valuable" for these basic fertility treatments.


  • Unexplained Infertility:

    Up to 25% of all infertile patients will have a diagnosis of unexplained (idiopathic) infertility. This diagnosis means that, in spite of exhaustive fertility evaluation, there is no apparent cause of infertility.

    The majority of these patients do have infertility factor(s) involving the eggs, sperm, and the Fallopian tubes, but their testing has not yet uncovered this information. Infertility related to the egg quality factor represents most of the "unexplained" infertility since it is the most difficult one to diagnose.

    In Vitro Fertilization is the most common treatment for patients with unexplained infertility.


April 2018



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