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Age is the #1 Factor Impacting Fertility Success, So Why are Women Waiting to See a Fertility Doctor?
November 20, 2014
Approximately 7 million couples in the US have infertility, a disease which is defined as the inability to conceive within a specified period of time (age dependent) or to carry a pregnancy to term. The American Society for Reproductive Medicine (ASRM) advises couples to see a fertility specialist, also known as a reproductive endocrinologist (RE), after six months of trying to conceive if the female is 35 or older, or after one year if she is younger than 35. Other factors, including health history or miscarriage history, may expedite the timeline.
FertilityAuthority recently conducted an online survey to better understand the average actual wait time before seeking an expert’s advice and examination, as well as uncover possible reasons for waiting longer than the advised 6 to12 month period of trying to conceive. 245 respondents participated.
* After how many months trying to conceive did you go to an RE?
22% of respondents waited 12 to 18 months to see a fertility doctor, and 35% of respondents waited from 18 months to more than two years.
* So why did more than half, 57%, wait longer than the recommended time period?
Respondents were able to select more than one answer. The majority, 68%, indicated that they hoped to get pregnant naturally. The irony is that during a two-year period, a woman’s fertility can greatly decline. Increasing age is a contributing factor to infertility, chromosomal abnormalities of eggs/embryos and failed infertility treatment.
Additionally, the percentage of IVF live births by age are as follows:
- Under age 35: 40.5%
- Age 35-37: 31.1%
- Age 38-40: 22.2%
- Age 41-42: 11.7%
- Age 43-44: 4.5%
- Over age 44: 1.8%
Another 37% of respondents waited to see a fertility doctor out of financial concerns or costs. There’s a misconception that IVF (in vitro fertilization) is the go-to treatment proposed by fertility doctors. Our data found that following an appointment with an RE, 57% said they had or were scheduled to have IUI (intrauterine insemination). An IUI is a procedure that typically costs $2,000 to $2,500 including medications, and delivers the sperm through the cervix to the uterus to better enable it to reach and fertilize an egg. It’s a less invasive and less expensive option compared to IVF, and for those who have unexplained infertility, mild male factor infertility, or a cervical condition, IUI treatment can be successful.
For those who need IVF, the costs can certainly be a challenge. There are financing packages, like IVFAdvantage, that can assist. IVF is typically recommended for patients with male factor infertility, women with damaged fallopian tubes, ovulation disorders, premature ovarian failure, unexplained infertility or genetic concerns for their offspring.
* The remaining patients were unsure about which RE to go to. We asked, “How did you choose your RE?”
The majority of respondents chose their RE based on a referral from a medical doctor (58%), while 30% found their RE online and 22% through word of mouth
* When choosing your RE, what factors did you consider?
Survey respondents were able to select as many factors as were important to them in the selection of an RE. Fertility treatment success rates were the primary factor (41%), followed closely by reputation and proximity to home.
Fertility clinics are required to report ART (assisted reproductive technology) cycle outcomes to the Centers for Disease Control and Prevention (CDC) annually; the Society for Assisted Reproductive Technology (SART) also publishes fertility clinic success rates. However, using IVF success rates as the primary criteria in choosing a fertility doctor is ill-advised.
According to the CDC, “A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches vary from clinic to clinic.”
Additionally, fertility clinics are able to inflate or manipulate their success rates by not accepting cases that are less likely to result in pregnancy or by doing “freeze all cycles” where outcomes are currently not reported1. What may be helpful for a patient choosing a fertility clinic is to review the number of cycles for women with their condition in their age group.
Conclusion: The majority of women who are trying to conceive are waiting 12 months to more than two years before seeing a fertility doctor. Education on the correlation between age and fertility - and the importance of seeing a fertility doctor when timed sex is not resulting in a pregnancy – is paramount. The chance of conception decreases as a woman ages, and rapidly once she reaches her mid-30s.
The chance of success with fertility treatment decreases too. The probability of a live birth with IVF is 18% less for women ages 38 to 40, compared to women under 35.
In order to facilitate treatment, patients also need to be apprised of cost savings available for treatment.
And while most patients use IVF success rates as a determining factor in choosing a fertility clinic, that is ill-advised. Success rates can be manipulated and clinic-to-clinic comparisons may not be accurate.