I vividly remember when I met her. I was 20 and it was a perfect, blue-sky day. My friend Liz introduced me to Amy, a gorgeous, red-head who could not stop smiling. She laughed easily. She was delightful. I was intrigued that science could create such a wonder – a real, live “test tube” baby.
I lost track of Amy after college. But the Internet brings people together, so I can probably stalk-find her if I want to. To say thanks.
Because when I met her, I was staring at my future.
Can you imagine the courage her parents and doctors had to muster to give IVF a try? And what about the terror? IVF was a novel and innovative, last-ditch effort. With human lives, hopes and dreams hanging in the balance. In 1978, IVF was the brave new world.
But these days millions of babies are welcomed into the light across the world thanks to IVF.
I cannot stop crying as I write these words. Because my little family is part of that global bond.
My own “test tube” baby is now 8. (You can read about my infertility journey in this post.)
So many things have changed in the field of reproductive technology since the late 70s – and so many things have changed since my kiddo was born!
In 2018, I got the chance to reconnect with and interview my amazing reproductive health specialist, Dr. Yalcinkaya, about advances in infertility treatment. I’m thrilled to share some snippets from our conversation. Especially his tips for success for those of you pondering the next right step to take in your family planning journey.
IVF is pretty common now
For years, 1-2% of babies were conceived via IVF – these days that number is up to 4-5%.
Why? Because: Google.
Social media and the Internet (and blogs like this one) bring stories of hope and mountains of data to folks who need it. Just reading a post like this lets you know you’re not alone, that other people have gone through the same thing – and are bouncing a baby on their knee right now.
Dr. Google empowers, giving you access to information, and fosters connection to others who know exactly what it’s like to be you. Because struggling with infertility can be a lonely, soul-aching venture.
Picking the right fertility specialist
Dr. Y recommends that you find a clinic with a good success record and one that’s affordable. AND that you consider these additional things when picking your doctor.
1. Personalization
Go to a facility where the doctors – AND STAFF – care and where they offer personalized treatment. You need to be calm throughout this process, so staff interactions shouldn’t increase stress levels. (I left another clinic and discovered Dr. Y BECAUSE a nurse gave me incorrect instructions – and then argued with me about it.)
Personalization is important because what works for your best friend might not work for you.
IVF is expensive (not gonna lie!) You wanna make sure your dollars go towards the right procedures for YOU, not the procedures the hospital or clinic are pushing due to cost considerations.
Reproductive success isn’t based on a 9-to-5 schedule. Sometimes you gotta give yourself a shot at 2am. And you really want your doctor on the phone with you RIGHT THEN to guide you through it. If your doctor can’t offer you this personal touch, go find another one. Because getting lost in the shuffle or feeling like you’re low on your doctor’s priority list can affect your morale.
2. Turnkey service
Find out if the practice offers ALL aspects of reproductive endocrinology. So staff can create the best possible environment for IVF success FOR YOU.
Do you need surgery first to remove scar tissue or fibroids? Can the clinic do this? Or do you have to go to another specialist? If the practice does everything, your doctor can monitor the ENTIRE journey and won’t have to rely on other vendors who may have vastly different standards of care.
Plus, if you have to go elsewhere for surgery, this interrupts your care. Another doctor has to get up to speed on your specific situation – and data and information can get lost in translation between clinics. There’s also the headache of dealing with several providers: juggling bills from multiple places, learning different office policies, keeping up with appointments at several locations. This can add to your stress level.
When the same doctor treats you for everything, that doctor is responsible for your surgery care, understands how the surgery went, and knows your reproductive system intimately. This brings you consistent quality of care throughout your journey.
3. Optimism
It’s important (and difficult) to be positive when you’re having trouble getting pregnant or you’re dealing with multiple miscarriages. Seek out a POSITIVE AND ENERGETIC provider. Develop a positive outlook towards the process and seek that same attitude from the entire medical team.
Dr. Y tells his staff:
Go the extra mile. We are a TEAM. One negative interaction with a team member can ruin the entire experience for a patient. The leader’s demeanor and positive attitude should filter throughout the entire team.
And enthusiasm brings success:
Treatment that’s given out of necessity subliminally affects success.
Patients need to understand that there’s real success out there. There are real challenges, and you have to be very upfront about it, but success is possible!!!!!
Patients think maybe they’re not meant to be parents. They are terrified of this. Even if they are only 25 [with years ahead of them]. I can say to them, “Look, this is going to happen. IVF is an affordable, expeditious process to make that happen. Let’s work to discover HOW.”
This is a message you have to repeat over and over, to keep morale high.
Natural conception is possible
After the birth of my son, we ditched the birth control and I got pregnant naturally. I was still breastfeeding at the time and never got a period. Which meant I didn’t know I was pregnant for 4 months (eek!)
Apparently this isn’t unusual – the getting pregnant naturally part, not the not-knowing-for-4-months part.
Here are some things to consider if you’re hoping to “get lucky” with baby #2.
1. Irregular ovulation
When you have an ovulation problem, where ovulation isn’t regular or you don’t ovulate, you could definitely find yourself in a sticky (hooray!) situation with an “oops baby.” Because you never know when you’re most fertile. So skip the birth control and go for it!
2. Low egg supply
If you have low egg supply, don’t wait. Start trying naturally and consider doing IVF again as soon as possible. Especially when you’re 35 or older.
3. Breastfeeding
You can definitely breastfeed baby #1 for 6-12 months and try for baby #2 at the same time. But here’s the thing: prolactin, the nursing hormone, can alter ovulation function and decrease fertility. This means you might not have a period at all while breastfeeding – or it might be irregular. Talk to your doctor about “ovulation assistance” (otherwise known as “drugs”) that won’t affect breastfeeding.
Recent IVF breakthroughs
I went through IVF in 2012 and Dr. Y says LOTS has changed since then. Here are 3 key breakthroughs in the field of IVF.
1. Embryo transfer
Transferring embryos on Day 5 is now standard practice. Several years ago, embryos were transferred on Day 3. Waiting til Day 5 gives the embryos TWO MORE DAYS TO GROW and doctors can see which ones got it going on with cell division. That means the odds are in your favor that the BEST embryos will be transferred. Which (fingers crossed!) will lead to successful implementation AND A BABY!
For me, Dr. Y waited til Day 5 to transfer two embryos. And then his team monitored several other embryos til Day 6 to see if any of them were good candidates for freezing. Nope, they were not. We would have started IVF from scratch for baby #2 if we had needed to go that route. Had they transferred embryos on Day 3, they might not have picked the one that would grow to be my son.
2. Incubation improvements
Embryos are sensitive to gas and pressure changes, and acidity. Manipulating them is risky. Nowadays, fertility teams monitor them remotely via an EmbryoScope. The embryos never have to leave the cozy, protective environment of the incubator. Just like they never have to leave your womb.
With the EmbryoScope and time-lapse photo imaging, your doctor can determine which one is the healthiest – and just transfer that SINGLE embryo. Reducing the possibility of twins. This one change has led to a 60-80% increase in IVF success rates.
3. Embryo screening
Dr. Y says infertility treatment is a “process of elimination – and IVF is a procedure of last resort.”
There could be issues with your eggs and IVF gives you access to your healthy eggs more quickly than via “Nature.” With IVF, doctors can harvest 19 eggs AT THE SAME TIME and determine egg quality. This would take 19 MONTHS naturally, since your body releases one egg each month.
Dr. Y says, “IVF is actually a QUICKER solution that bypasses frustration and miscarriage of poor quality eggs.”
And embryo screening really benefits those of us with “advanced maternal age,” ahem, women over 35. Genetic screening can reduce the risk of miscarriage and Trisomy 13 & 18. Testing embryos prior to transfer increases success rates. A healthy embryo can mean a HEALTHY BABY!
Tips for the men
Hey future dads! Dr. Y has some advice for you when your partner is going through IVF. About how you can best support her.
1. LAY OFF THE ALCOHOL AND CIGARETTES
Infertility is NOT a female problem. Tobacco, excessive alcohol, and recreational drugs can affect sperm quality. Which can increase the risk of miscarriage. Anabolic steroids also impact sperm count and quality – they trick the body into producing less testosterone, which can make the testicles shrink. (Ain’t nobody got time for ball shrinkage. Just sayin’.)
2. Provide psychological support
Be present throughout the treatments. Your partner needs support and understanding.
Says Dr Y:
With a heterosexual couple, the woman can feel her husband doesn’t understand what she’s going through, or he’s getting angry about all the contributing factors. This increases stress. People cope with stress in a variety of ways. Be mindful of how your wife needs you to help her cope. And how you cope.
3. It’s a joint venture
Attend ALL appointments and do ALL shots together.
Raising a baby, from conception to birth and for years to come is a cooperative endeavor – whether conception happens naturally or with medical assistance.
Final thoughts
In closing, I asked Dr. Y what he loves most about his work. I love his response.
The coolest thing is helping couples. They are facing one of their biggest life events (reproductive failure), and I get to guide them through this and very quickly see positive outcomes that will bring them benefits (it’s a boy!) for years to come.
And for fun, I asked him how he got into this line of work.
I can trace it all back to AP Biology in high school [at the prestigious Robert College in Istanbul] when I was learning about reproductive physiology and the menstrual cycle. I can still picture the diagram and I just thought, “This is the coolest thing!”
I had a Biology teacher [Ayfer Yenicag] whom I idolized. She had such enthusiasm as a teacher. We have kept in touch over the years.
In other words, there’s a Biology teacher in Istanbul I need to thank for my son. To quote Dr. Y, “Teachers… Their work is so valuable. I really appreciate them. They are underappreciated with their pay, and people don’t realize how amazing they are.”
Thank you, Dr. Yalcinkya, here in the US. Thank you, Mrs. Yenicag, over in Turkey. Words are not enough.
And many thanks to Amy from my college days for showing me the real life embodiment of a science that would save my future dreams of family.
Share your infertility struggles and joys below or on Facebook at MothersRest.
Photo credit: Colin Maynard on Unsplash.com