Infertility Awareness Week: It's Time to Have the Talk with Your Doctor

Infertility Awareness Week: It's Time to Have the Talk with Your Doctor

Nearly 79% of survey respondents have never had a discussion with their doctor about fertility.

The Reproductive Medicine Associates of New Jersey conducted the 2018 Infertility Trends National Survey including more than 1,000 respondents. The survey revealed that many people facing infertility issues are unaware of the huge advancements that have been made in this field because they are too focused on the cost being a barrier.

Almost 8 out of 10 participants had never had a discussion about their fertility with their primary doctor without the doctor bringing it up first, according to the survey.

Navigating infertility treatment can be incredibly difficult, so here's where you can start:

Choosing an Infertility Clinic

Women younger than 35 should seek the care of a reproductive specialist if they are unable to conceive after 12 months of trying, according to the American Society for Reproductive Medicine.

Of the 1,289 participants in the 2018 Infertility Trends Survey, 44 percent said cost was the biggest barrier for undergoing treatment and 23% cited lack of insurance deterred them from pursuing infertility treatment. Luckily, New Jersey is 1 of 15 states in the United States that has mandated infertility insurance coverage, according to Thomas A. Molinaro, M.D., M.S.C.E., F.A.C.O.G., board-certified reproductive endocrinologist, obstetrician, and gynecologist at RMANJ.

"At RMA New Jersey, we don’t want finances to be the reason you don't come in and get the services you need," says Dr. Molinaro.

RMANJ's CareShare program is designed to reduce the financial stress and worry that many infertility patients face. The program offers full or partial refunds to patients who go through IVF and do not complete the treatment to a live birth. If the patient decides to discontinue the program and they do not have viable embryos stored at RMANJ, they will receive 50% of what they paid. If RMANJ ends the treatment, the patient will have 100% of fees refunded. 

Other factors that are important for patients to consider when choosing a clinic include the clinic's reputation, the delivery rates, the office hours, and location, according to the 2018 Infertility Trends Survey. At all infertility clinics, doctors are required to report their delivery rates to the Society for Assisted Reproductive Technologies as well as the Centers for Disease Control and Prevention, making the delivery rates and success rates accessible for anyone choosing a place for infertility care.
    

It is important to remain as informed as possible throughout your infertility treatment. Ask your doctor questions and be fully transparent about any concerns. According to RMANJ, some questions patients should ask when considering IVF care include:

  • Has the center consistently reported to the CDC and SART with delivery rates at or above the national average?
  • Does the center routinely perform comprehensive chromosome screening (CCS) for embryonic testing?
  • Does the center routinely perform trophectoderm embryo biopsy when genetic screening is indicated?
  • Does the center account for endometrial synchronization during time of embryo transfer?
  • Does the center limit the number of embryos transferred to one or two in all patients at all times?

"For any given practice, the strength lies in the embryology lab," says Shefali Mavani Shastri, M.D., F.A.C.O.G., board-certified reproductive endocrinologist, obstetrician and gynecologist at RMANJ. "How strong is the embryology lab? How strong is the research the practice is conducting? Is this a leading practice that has established the new standards or one that is lagging behind clinically five or ten years? All of these factors, and more, make a patient’s experience."
    

Options for Infertility Treatment

Infertility treatments and processes available today include frozen embryo transfer, endometrial synchronization, and comprehensive chromosome screening.

"The goal of infertility treatment is for each patient to have one healthy child at a time," according to the American Society for Reproductive Medicine. The rate of twin pregnancies is 20 times greater when using assisted reproductive technologies than when naturally conceiving. In order to focus on the safest and most viable goal of one healthy child at a time, RMANJ has been trying to pioneer and perfect the art of Single Embryo Transfer, according to Dr. Molinaro.

"Patients always ask, 'why don't you just put back two embryos,'" says Maria F. Constantini-Ferrando, M.D., P.H.D., F.A.C.O.G. board certified reproductive endocrinologist, infertility specialist, and obstetrician and gynecologist at RMANJ. "The basic answer is that we don't have to. We used to put back multiple embryos because we wanted to increase pregnancy rates, but now we're all about safety, delivery, and making families."

Another area of advancement is freezing eggs. What a lot of women don't know is that the entire process of freezing your eggs only takes less than two weeks and can cost as little as $100 a month, according to Dr. Molinaro.

"Freezing eggs is an opportunity for women to empower themselves to have a family when they're ready to," says Marcy F. Maguire, M.D., F.A.C.O.G., board-certified reproductive endocrinologist, obstetrician and gynecologist at RMANJ. "You can reserve your fertility at whatever age you're at—hopefully late 20s to mid 30s—and delay childbearing to when you're ready."