by Kimball O. Pomeroy, PhD
Two weeks ago, I saw a young couple in the hallway of Arizona Reproductive Medicine Specialists beaming with excitement. This couple had gone through several IVF cycles and had just found out that they were pregnant. It is hard not to get excited each time we hear of another patient’s success in becoming pregnant or delivering a child. After all of the sacrifices and the stress, it is exciting to finally reap success.
I remember meeting with the couple prior to their first pregnancy attempt here at ARMS. They said they were willing to do anything to have a child. They asked us about using donor egg or donor sperm to increase their chances, but had reservations about it. They explained that none of their embryos made it to the blastocyst stage during a prior attempt elsewhere. I explained to them that I felt they could succeed with their own sperm and eggs based on their history and their workup. I also explained that I felt we could get embryos to the blastocyst stage.
Their first attempt with us resulted in embryos that developed to the blastocyst stage, but there was no pregnancy. We met again and once again they wanted to know if they should switch to either donor sperm or donor eggs. They felt they should do “something different” since their prior IVF cycle did not work.
I explained that there are several reasons why IVF sometimes does not succeed. Sometimes there is something wrong with the husband or wife that makes it almost impossible to have a pregnancy – these are cases of no sperm or abnormal eggs due to age. I told them that trying to get pregnant is an event that involves probability – like throwing of dice. Most patients have a die with maybe 10 or 20 sides and they need to throw a 1, for example, to get pregnant. At times, we may be able to decrease the number of sides from 20 to 4, or even to 2 (like a coin toss), but a patient could still be unlucky and not get pregnant despite having what appears to be a “perfect” cycle (lots of eggs, lots of great looking embryos, and a great uterine environment). When a patient begins fertility treatment we unfortunately cannot assure success. With all fertility treatments, there is always an element of chance. All we can hope to do is decrease the number of sides on the patient’s fertility die to give them a better chance of having a baby than they would have on their own.
In all honesty, if we can increase a patient’s odds without increasing their risks, we do it. Because of the stresses and costs involved in IVF, patients are often desperate to do “something else” to increase their odds. At times, instead of trying unproven new treatments that could decrease a patient’s odds, the fertility dice just need another throw. There are no magic answers, solutions, or secret methods. We use what has worked in the past, and modify things to increase each patient’s chances. No matter how perfect the treatment goes, success rates still usually hover at around 70%.
This couple trusted the knowledge and skills of their physicians and embryologist at Arizona Reproductive Medicine Specialists, with each expert carrying over a decade of experience. In this case, the couple was gratified that we did not want to try some new, unproven technology that could easily hurt their chances for a child. We could not guarantee success to this couple but we did advise them that all of the information we had on them indicated they could get pregnant with their own sperm and eggs – and thankfully, they did.
Kimball O. Pomeroy, PhD is Laboratory Director at Arizona Reproductive Medicine Specialists (ARMS). Dr. Pomeroy is a research physiologist and embryologist. He has been involved in the development of IVF in Bolivia, China and the Bahamas and currently serves on the Executive Board of the Society for Assisted Reproductive Technologies. To schedule a consultation at ARMS call 1-602-281-9032.
