Individualized Fertility Care

In our Orange County fertility center we believe in the importance of individualized fertility care

The treatment of infertility, especially when using in vitro fertilization, can be a difficult process. After more than 20 years in the field, we know the best approach is one that involves individualized fertility care. By taking into account the fact that each woman is different, we’re more likely to achieve success.

There is tremendous variation in the fertility potential among women

9V3A0187Fertility potential refers to the ability of an individual to get pregnant. Age alone is not a very good way of determining this fertility potential. After all, women start life with varying numbers of eggs. At any given time in their lives, an individual may have more or less than the average number left. We have seen women barely out of their 20s who have few eggs remaining. Occasionally, women in their mid-40s who have more than 20 eggs retrieved during in vitro fertilization. As such, it makes little sense to treat all women with the same protocol if the goal is to maximize success.

The number of genetically normal eggs available varies

It is important to take this into consideration when determining whether to start treatment in a given month and how to conduct this treatment. We use the number of follicles present in the ovaries and the FSH and estrogen levels to determine whether to start an IVF cycle. The number of follicles correlates with the number of eggs we can retrieve that month. The FSH level is an indication of how easy or difficult it will be to stimulate the follicles to grow. These both can vary month to month. Sometimes it is necessary to monitor a woman for several months. This is especially important in older women who have fewer eggs.

Some center place all women on birth control pills at the start of IVF

This may be fine for women with a lot of eggs. However, it does not work very well for the women with fewer eggs. Birth control pills can help coordinate the start of an IVF cycle. But for the women with fewer eggs, the suppressive effects of the birth control pills can limit the number of retrieved eggs. The end result is a less successful and costlier treatment.

By using birth control pills you are also losing the benefit of starting a cycle during a time when the number of follicles is maximal. We see even with younger women like egg donors who have been on birth control pills for a long time, their ovaries have many fewer follicles than they do after stopping the pills for a month. For this reason, we seldom use birth control pills at the start of an in vitro fertilization cycle. Instead, we prefer to monitor each woman in a natural cycle. This allows us to retrieve the maximum number of eggs. This not only makes the chance of success better, but also keeps the cost of medication down.

The other important component of individualized fertility care is the process of close monitoring during stimulation

Every woman responds differently to the medications. For this reason, it is important to monitor frequently with ultrasounds and bloodwork as the treatment progresses. This is the only way that we can make important changes in the medication dosage and schedule the retrieval. In some centers, they schedule the egg retrieval procedure before giving any medications.

Some centers perform only one or two ultrasounds during the entire process. This completely ignores the individual differences that exist among women. It can also lead to either retrieval of too few, immature eggs or hyperstimulation of the ovaries We have always monitored at least every other day during the early stage of ovarian stimulation and then every day at the end, so that we can ensure that the eggs are retrieved at the best time for them to be fertilized. This also keeps the procedure as safe as possible at all times.

When consideration is given to the many ways in which an IVF cycle can progress among different women and even in the same woman at different times, it is easy to realize the importance and benefits of individualized care. Although the delivery of individualized care often means that convenience for the doctor is sacrificed, the end result greatly justifies the extra effort. We have always believed that when couples have to sacrifice so much to undertake an IVF cycle in the first place, we owe them the best effort possible. The results we have enjoyed over the years due to this approach have made it more than worth it for everyone involved.

Our Mission Statement

The Southern California Center for Reproductive Medicine is a team of premier fertility specialists focused on providing patients with personalized care.  The Center has been bringing the most advanced fertility treatments to its patients for over 20 years.  Today, the team is focused on making the “one embryo, one baby” approach a reality.  The combination of the staff’s dedication and optimization of today’s leading laboratory techniques in their state-of-the-art facility are at the core of the Center’s unprecedented 85% success rate.

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