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Infertility

Advances in the field deliver increased success rates.

Infertility has been called a very lonely and isolating club—a club no one wants to be a member of. As Healthline.com author Brandi Koskie wrote in 2018 about her personal journey, “Infertility is shrouded in taboo and shame, so I felt like I couldn’t talk about it openly. I found that there was little information that I could actually identify or connect with. I was left to manage a primal yearning with broken parts on my own.”

And as author Megan Isennock put it in a piece she wrote for Baltimore magazine, “Even if you have the most supportive, involved spouse. Even if you have a team of health professionals at a world-class institution on speed dial. It all boils down to you, and the fact that you’re still not you plus one.”

According to the U.S. Department of Health and Human Services, out of 100 couples in this country, about 12 to 13 have trouble becoming pregnant. About a third of infertility cases are caused by fertility problems in women, another third due to fertility problems in men, and the remaining third caused by a mixture of male and female problems or by problems that cannot be determined.

Koskie and her husband tried for two years to get pregnant before seeing a doctor. After a long period of tests and saving money and daily injections, their first cycle of the in vitro fertilization (IVF) process in 2009 was successful.

Infertility treatments such as IVF have come a long way since then. Shona Murray, M.D., an associate professor with the department of obstetrics and gynecology at the University of Colorado School of Medicine and medical director of University of Colorado Advanced Reproductive Medicine Colorado Springs, says, “IVF success rates have drastically improved over recent years. When I first started doing IVF, success per embryo transfer was about 17%, and at that time, we usually transferred two to five embryos at a time. Last year, our program had an overall success rate per embryo transfer of about 70% with the majority having one embryo transferred at a time. Now patients frequently can use the extra embryos years later to achieve a second or third pregnancy from the initial IVF cycle.”

IVF, says Murray, “is a process that takes the fertilization and early embryo development out of a woman’s body. To improve the chance of success, the ovaries are stimulated by ultrasound and blood work. When the eggs are ready, they are removed by a surgical procedure where a needle is placed through the vagina into ovaries. The eggs are then fertilized, and some will develop into maturing embryos. Typically, a single embryo is then placed into the hormonally prepared uterus.”

Many folks transition to the IVF option after trying on their own to get pregnant for a period of time. Infertility, says Murray, is the inability to conceive after 12 months of unprotected intercourse. “We ideally would like to see a couple where the woman is under age 35 and has experienced one year of infertility, and a couple where the woman is over age 35 and has experienced six months of infertility. Unfortunately, it is often much longer.”

Murray credits numerous advances in the laboratory with significantly improving IVF success rates. “We have better equipment, better media, and better incubators, all of which have played a role in markedly improved pregnancy rates.”

Some of the advances described by CU Advanced Reproductive Medicine include egg freezing, which was still classified as experimental until 2012, egg-thawing techniques, preimplantation genetic testing, and ovulation induction. Evidence-based research done by CU Advanced Reproductive Medicine includes the following:

Award-winning research that linked omega-3 fatty acids with improved fertility

Research-based proof that smoking harms male fertility

Work with Duke University in 2017, which resulted in the finding that performing an IVF transfer with one embryo greatly increases the chance of a healthy baby

Research on using an existing drug for polycystic ovary syndrome patients, which showed a 45% increase in fertility

Maintaining a focus on the effects of weight on infertility

Genetics are playing a bigger and bigger role in all aspects of medicine, says Murray. “This is definitely true for infertility. However, we need to be careful differentiating what can be done from what should be done. Society needs to define limits on genetics modification.”

Infertility Treatment Benefits As reported by ABC News in 2019

• More than 400 U.S. companies offer benefits for fertility treatments.

• More than seven million women in the United States have used infertility services.

• Starbucks offers one of the best company benefits packages with part-time employees receiving infertility coverage after just one month on the job. Companies including Bank of America, Tesla, and Spotify offer unlimited IVF coverage to their employees.

• A single round of in vitro fertilization can cost upward of $20,000 and often requires more than one try.