There are many variables
which influence the success of infertility treatment
and many infertile couples are aware of the importance
of healthy eggs , sperm, uterus and tubes in making
a baby. They factor these into their calculations, but
one of the most important variables in baby making is
one which many infertile couples ( and their doctors)
often overlook - and this variable is time . Infertility
specialists , on the other hand, are acutely aware of
a woman’s biological clock, and the impact of
reproductive aging on reproductive efficiency is a key
concept of infertility treatment today.
However this is often something many patients and doctors
overlook This is why they often end up treating a 40
year old woman exactly the way they would treat 25 year
old woman . However this is not good medical practice
.
Younger women have the luxury of time they can afford
to experiment and try and this treatment options even
those with lower pregnancy rates or experimental treatment
protocols because they can afford the luxury of doing
so
However for the older woman , time is at a premium
, and they cannot afford to fritter away their precious
time on treatments with low pregnancy rates or untried
treatments. They need to focus their energies on treatments
which will maximize the chances of getting pregnant.
This is what I am always upset when I see 40 year old
women being treated with options such as intrauterine
insemination, which were designed for much younger women
Remember that whether you're dealing with fertility
or fitness, age does play a role. Whether you feel like
you're 15 or 50, whether you look your age or not, your
body knows how old you are, and your ovaries do too.
As regards your fertility, it’s not your calendar
age which is important, it’s the age of your eggs,
or your “ovarian age “!
Another important concept is that of "trying time"
, or how long you have been trying to have a baby. If
you have been trying to conceive for over 3 years and
have failed to do so , the chances of your succeeding
on your own without medical treatment are very slim.
For women, optimum fertility occurs at the age of 18.
It stays pretty constant in the early part of the 20s
and then begins a gradual downward turn from 30 onwards.
By the time you turn 35, the process has accelerated
and when you approach 40, the slide becomes even more
dramatic. One third of women over 35 have difficulty
conceiving, and this increases to two thirds when they
are over 40. The live birth rate in women more than
44, is less than 1%. As usual, Mother Nature is very
unfair, and men have it much easier . Their fertility
generally remains constant throughout their 40s. It
does begin to decline after the age of 60, but at a
much slower pace than for females.
Unfortunately many infertile couples waste a lot of
time. They get paralysed into inactivity ( “paralysis
by analysis” ) because they are confused by their
treatment options, and they don’t know how to
proceed . This often means they end up doing nothing
, which is the worst possible treatment option of all.
Many will hang on to the unrealistic hope of having
a “natural “pregnancy ; while others will
change doctors at the drop of a hat . Neither of these
are constructive strategies – you need to retain
focus on your end-goal, which is having a baby.
Unfortunately many doctors also waste their patient’s
time . This is true specially for gynecologists rather
than infertility specialists , who contribute to this
inefficient use of their patients’ precious time.
Common examples of time wasting treatment include using
danazol to treat patients with mild endometriosis; or
using antibiotics to treat pus cells in the semen .
Others will insist on repeating a laparoscopy –
“to see for themselves”; or repeat the same
treatment which the previous doctor has given This often
means that patients get fed up and frustrated and lose
confidence in themselves and in their doctors.
Studies presented by Dr Leridon at ESHRE in July 2004
have shown that under natural conditions, 75% of women
starting to try to conceive at the age of 30 will start
a successful pregnancy within one year. This falls to
66% for those who start at 35 and drops to 44% for women
starting at age 40. Unfortunately, assisted reproductive
techniques will make up for only half of the births
lost by postponing a first attempt at pregnancy from
age 30 to 35 and fewer than 30% after postponing from
35 to 40 years. Referring to women 35 or older, Dr Leridon
has found that even ART "will not fully compensate
you for the years, and the chances of conceiving, that
you have lost."
When trying to make sense of these figures, remember
that human reproduction is a very inefficient process
at any age. Ultimately, you are the only statistic that
counts when you're trying to conceive. Again, the statistics
provide probable outcomes, not facts – they apply
to populations, not individuals, and you are unique
!
Everything in life comes back , except for time. “
For all sad words of tongue and pen, the saddest are
those 'It might have been.'" But kicking yourself
later doesn’t help . You need to factor in time
as an important variable when formulating your treatment
plan, so you have peace of mind you did your best. You
need to know when it’s time to move on –
on to the next stage of treatment, or the next stage
of resolution.
Infertile couples need to take a proactive approach
in their treatment, and have a treatment plan in their
mind , so that they can maximize their return on investment.
This is why IVF is such a useful option– it maximizes
your chances of conceiving in a short span of time,
and by magnifying your fertility, it telescopes time,
allowing us to accomplish in one month what Nature would
ordinarily take 3-6 months to do !
Time management for infertile couples is important,
not only to maximize your chances of conceiving, but
also to maximise the pleasure you get from
parenting ! After all, the time and energy you can devote
to your child when you are 35, is far more than when
you are 45 !
Also Read
| 
