Potential parents need ask important questions before paying thousands for failed fertility treatments

Would-be parents struggling with conceiving often have to navigate the increasingly complex road of fertility treatments when considering medical intervention to expanding their families.

Fertility Clinics Will Become Big Business In The Next Decade

Infertility affects about one in every six couples. As more stories emerge about the declines in fertility rates, large scale investors are banking on a growing demand for fertility services and the fertility industry is preparing for an increase in business over the next 10 years. A recent story in STAT News reports that venture capitalists put more than $178 million into startups in the fertility business in 2017. In vitro fertilization (IVF) can cost as much as $18,000 per cycle (though sometimes thousands more with the additional costs for medicines). Some fertility clinics are now offering multiple cycles per package and financing options. There is a huge potential for profit.

Knowing all of the possible causes of infertility, the solutions available and who to ask for guidance on all of the above is important to ensure that the investment made by the prospective parents also has the best possible chance of success.

GYN Conditions That Affect Fertility

In many cases of infertility, some underlying causes can be treated before beginning the expensive IVF process. In many cases, treating these conditions can improve IVF success rates, but removing these barriers can also help some women get pregnant naturally. Damage to the female reproductive system caused by undetected or untreated GYN conditions like endometriosis or fibroids is a significant cause of female infertility. Unfortunately, many women with these common gynecological conditions are not initially screened or referred to a GYN specialist for evaluation prior to agreeing to fertility treatments.

In the case of endometriosis, this condition is not visible via ultrasound or MRI, and must be officially diagnosed via laparoscopy. In many cases where women have this disease, it can continue to cause problems conceiving and carrying to term if left untreated. Endometriosis can cause an inflammatory response making the uterus an inhospitable place for a fetus to develop.

In cases of fibroids, if an embryo tries to attach to the uterine wall when a fibroid is present, both the embryo and the fibroid can compete for the same blood supply. Separately, if the fibroid grows very large due to the influx of hormones, the baby and the fibroid end up competing for space within the uterine cavity.

Treating Fibroids With Laparoscopic Myomectomy Improves Pregnancy Outcomes

Current estimates show that women who have a myomectomy have a higher chance of conceiving after surgery. A National Institutes of Health study on laparoscopic myomectomyshowed that approximately 50% of women with infertility and fibroids were able to get pregnant after a myomectomy (fibroid removal surgery) and that laparoscopic procedures had lower post-operative pain. In a study of women with fibroids who averaged 37 years of age, the percentage of success after a myomectomy was shown to be 31%.

A survey conducted by The Center for Innovative GYN Care (CIGC) found that 60 percent of patients who want to have children but had fibroids were told they needed an open myomectomy, which can cause scarring to the uterus and the surrounding pelvic structures, making conception and delivery more challenging. Patients in the survey who attempted to conceive after getting a Laparoscopically Assisted Abdominal Myomectomy (LAAM) performed by a CIGC minimally invasive specialist (as opposed to the open procedure), had success rates equal to or better than those within the NIH study.

“It is imperative that expensive fertility treatments are predicated by a thorough medical review of a mother, surrogate or donor,” said Paul MacKoul, MD. “Both parents should undergo appropriate testing, but if underlying conditions like fibroids, polyps, or endometriosis, or physical abnormalities like uterine septum are not treated in advance, there is an increased likelihood of a failed pregnancy, or risk of pre-term birth. Partnering with a GYN surgical specialist to correct these obstacles can ensure candidates for fertility treatments are given every opportunity to make their investment count.”

Dr. Paul MacKoul continues: “What we have seen with many of our patients is that the current fertility clinic protocol shows that they are more likely to recommend multiple rounds of expensive IVF treatment first, as opposed to discovering and addressing underlying problems that are the root cause of infertility.”