IVF is not always necesary. Read this Glamor Health artilce about alternatives.
Most of us spend years trying to avoid getting pregnant. But, when you actually want to conceive, it can be harder than you thought.
If it’s taking time for you to get pregnant, doctors stress that you shouldn’t freak out and assume you need in vitro fertilization (IVF). Not that there’s anything wrong with IVF, of course—it can just be costly, doesn’t have a guaranteed success rate, and can be tough on you and your partner.
Luckily, there are many other things doctors can try first. “IVF is not necessary in most cases,” says Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine and author of Sex Rx: Hormones, Health, and Your Best Sex Ever. “There’s a protocol we go through. Nobody goes straight to IVF.”
Board-certified ob-gyn Pari Ghodsi, M.D., also points out that a third of fertility problems can be attributed to the guy, and another third are due to unknown factors, so it takes some trial-and-error. “There are many tests to diagnose the problem and each has individualized treatments,” she says.
Most doctors won’t want to have the fertility talk unless you’ve been having regular, unprotected sex for a year without getting pregnant, Dr. Ghodsi says. (But, if you’re 35 or older, they’ll want to talk after six months.) At that point, there are a variety of options they can look into:
Track your ovulation: “Just because you’re having regular periods doesn’t mean you’re ovulating,” Dr. Streicher says, which is why she recommends that women use an ovulation predictor kit to see if they’re ovulating. Your doctor may also monitor your cycle with blood work (to make sure your hormone levels are correct) and an ultrasound to see if there’s a follicle forming and the lining of your uterus is thick enough. Then, you may have your blood progesterone level checked to see if you actually ovulated. “From that first basic set of tests, we’re really looking at ovulation—if they’re doing it and when,” Dr. Streicher says. “You can’t assume.”
Test his sperm: It takes two people to make a baby, and that can mean your difficulty getting pregnant may not be due to something on your end. “I don’t do anything that’s painful or invasive until we do a semen analysis,” Streicher says. “If there’s a man in the picture, too often we find the guy has no sperm or it’s moving in the wrong direction. For me, that’s part of the initial fertility evaluation.” If everything on his end looks good, doctors will then move on to the next step.