Thursday, April 20, 2017

Healthy Habits: 10 Questions Fertility Doctors Always Hear

During National Infertility Awareness Week, April 23 through April 29, we are joining millions of women and men struggling to build a family in an effort to promote greater awareness about infertility. According to the CDC, one in eight couples in the U.S. experience infertility and it has been reported that infertility affects 45 million couples worldwide.
After trying unsuccessfully to conceive on their own, patients walk through our doors with a lot of questions. In an effort to help others and shed light on infertility, I am sharing the 10 most common questions we hear:
“Why can’t pregnancy happen ‘naturally’?”
This can happen due to one issue or several. For example, factors including medical diagnoses, lifestyle habits, cancer treatment, prescription medication and excess body weight can make conception a challenge. In other cases, the cause of infertility is unexplained. For women, common infertility issues can include ovulatory disorders, poor ovarian reserve, PCOS, endometriosis, or fibroids. For men, hormonal imbalances and semen issues are common infertility diagnoses.
“Am I too old?”
With age, the quantity of healthy eggs decline and perimenopausal hormone changes begin, making conception and pregnancy difficult. It is also important to note that the most common pregnancy outcome at any age is a healthy baby. As men age, the prevalence of obesity, diabetes, cardiovascular disease, and high blood pressure increases. Both these health issues and the prescribed medicine used to treat them can cause infertility. 
“Is pregnancy loss rare?”
Pregnancy loss is very common with half of all pregnancies resulting in a loss, and most losses occurring before a woman misses her period. Of all known pregnancies, 15-25% will result in a loss.
“Is infertility uncommon?”
One in eight couples experience difficulty in achieving or sustaining a pregnancy. The odds are that you know several people who have experienced fertility challenges.
“What are the risks and side effects of treatment?”
Overstimulation of the ovaries is the main risk of treatment, which is why regular ultrasound monitoring is required during the stimulation phase. To assess stimulation response, patients undergo ultrasound monitoring daily or every other day.
“Are we having problems because we are ‘missing’ the fertility window?”
Trying for a baby must occur preceding or during ovulation in order for pregnancy to occur. To pinpoint the timing for ovulation, it is helpful to use an ovulation prediction kit or log menstrual cycles. Getting help shouldn’t happen right away - couples where the woman is under 35 should try for one year before seeing a physician, and couples with a woman over 35 should try for six months prior to medical assistance.
“What are the costs involved?”
Costs will vary based upon insurance coverage, where a patient lives and state mandates. The average out-of-pocket cost of an IVF cycle is $10,000-12,000 including medication. To defray costs, patients can enroll in a medical study or apply for a grant through the Kevin J. Lederer LIFE Foundation or CADE Foundation. Self-pay patients also receive discounted services, and physicians may have access to discounted medicine. 
“What are my chances of success?”
There is no magic answer that will fit everyone. The chances of success will vary widely based upon age, medical diagnosis and previous medical and treatment history. Your physician should be able to discuss your personal odds of conception after a detailed assessment.
“What does my insurance cover?”
Again, this will vary based upon individual insurance plans and state law. Illinois mandates fertility coverage, but this is limited to employers headquartered in Illinois with at least 25 employees. To confirm coverage, ask your benefits department whether your employer is self-insured or exempt from fertility coverage, then confirm specific coverage with your insurance company.
“How much time do I have to take off?”
You will need to take very little time off or none at all. Monitoring appointments are short and can occur prior to working hours. An IUI procedure, egg retrieval or embryo transfer can be scheduled on a weekend, but may require a weekday appointment based on cycle progression. After an egg retrieval, patients need to take the day off but usually head back to work the next day.
Hopefully these answers have offered a bit of hope and help to you on your journey. The journey is difficult, but the rewards are oh so sweet. Some get lucky quickly, and many have their patience and perseverance tested. We’re fighting side-by-side with you to overcome the fertility battle.
Remember - you are not alone.
Christopher S. Sipe, M.D. with Fertility Centers of Illinois
To learn more about five free National Infertility Awareness Events, take a 10-question true/false fertility quiz or to learn more about booking a free Fertility Awareness Checkup ($90 value) please visit https://fcionline.com/niaw.

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