Finding the Right Infertility Treatment: Expert Advice on Choosing the Best Option for You
Clomid, IUI, IVF, egg donation, CoQ10, sperm donation, DHEA, trying naturally, these are all the big terms that we hear when we are trying to conceive, but it’s hard to know which one of those things we should be doing or what is the next step we should be moving towards when we’re on our fertility journey. The actual definition of infertility treatment is the use of medical procedures to improve a woman or a couple’s ability to conceive. So in this video, we’re going to be talking about all of these things and the information you need to know to make the best decision on your next steps on your fertility journey.
Hi, I’m Dr. Marc Sklar, also known as a Fertility Expert, and I’ve been working with couples for close to 20 years through my online coaching programs and here in San Diego at my clinic. So if you’re here locally in San Diego, you can visit me there. So as we start this video, and this is a really important topic because trying to make these decisions to transition from one procedure or one method of trying to conceive to the next is really a difficult choice, and I’m telling you from working with couples for all these years, it’s not easy and there’s a lot of heartache that goes into it. But what I want you to know, first and foremost, is that for some of you, trying naturally is the way to go. And for others trying with medication, with ovulation induction or moving on to IUI or potentially even IVF, maybe donor, maybe ovarian rejuvenation, these all have their place and they each have their place for some of you watching right now.
But the biggest thing and the most common thing throughout all of you who might be using any one of these different procedures or methods to conceive is that you all are unique and you all need a path and a process and a plan that is unique for you based on your circumstances. So just because your best friend or your sister or someone you saw online conceived one way, doesn’t mean that that is going to be the way for you or the method that you need. And that is one of the first and most important things that you all need to recognize, that you need to find the right path for all of you, and finding and understanding what the right method is for each one of you, that might be a journey in and of itself. And I want to make that easier for you, and that’s partly why I’m doing this video today.
Before I dive into the meat of the video, I do want to share this little story or comment from one of the members of my Hope Fertility Coaching Program, and I think it’s really pertinent to what we have going on today and what we’re discussing today. And so she says, “Fertility Win.” We always ask for your fertility win. And she said, “Had my one-on-one today, feeling hopeful that there is a chance to resolve all the health issues finally. Feeling unburdened that it’s not all up to me to make sense of all of these lab results and what to do with them next. Thank you for being so thorough and encouraging. One less stressful thing to carry on my shoulders.” And this is so important for all of you.
So regardless of the method that you choose, regardless if you’re trying naturally or IUI or IVF or donor or whatever it might be, you all need support. Someone to lift you up, someone to guide you, someone to see through the forest of all the complicated labs and history that you have, to make things easier and allow you to have less stress and less worry. And that’s my hope with these videos and my coaching program. So there are some important questions that I can’t answer for you, only you can answer for yourself as you are going through this process and need to make these important decisions about when to transition to the next stage or the next procedure. And I think these questions are really pertinent for you to contemplate, not only on your own individually, but with your partner. Okay?
So the first one is, if what you were doing was working, wouldn’t you be pregnant? Yeah, and on top of that, because I’m going to put a little add-on to it, is have you given that enough time? Have you given whatever process that you’re in right now, enough time to see change and be able to conceive? Often what I find is many of you are changing from month to month when you don’t get a positive and you’re not giving it enough time. So that is a key piece as well. And then also, how do you feel with the approach of your current doctor, the person that you’re currently working with, how do you feel about the approach that they’re taking? Does it resonate with you? Do you feel heard by them? Is it a team approach or are you just following along? And do you spend a lot of time still looking for answers online even though you’re working with a doctor?
These are clues that you might not be in the right place and you might need to be working with somebody else or get some additional support. Additionally, is your partner doing their part? Hopefully you’re watching this together, but if you’re not, then you guys need to have a conversation. Are you both on the same page? Are they doing their part to support you in whatever that means? Sometimes that means they have to be making a lot of changes, sometimes they just have to be there to support you, but are they doing those things? Are you comfortable taking hormones, or doing the procedures that you’re contemplating doing or that have been referred to you or recommended to you? Are you comfortable with them? And it’s okay if you’re not, and it’s also okay if you have questions that you need to learn more about them so that you can become more comfortable and familiar with them.
Are you really doing everything you can be doing on your own for you personally to be as healthy as you can? Have you addressed all the necessary areas that need to be addressed? Have you looked at your diet, your lifestyle, your sleep, your hormones, your environment, what’s going on physically and structurally with your uterus, your partner, all of these things have they been looked at properly and have you actually taken the necessary steps to address them, and have you done that long enough? Hopefully the answer is yes, but if not, then that is definitely the place for you to start. It’s important that you understand what’s wrong on your end and what you can be doing about it to make sure that it’s no longer a factor for you.
Okay, approach number one, trying naturally. This is the way we all want to do it. The old-fashioned way, right? So how do you know if this is the right path for you? First and foremost, if you’re just starting to try, then absolutely you should be trying naturally. And if you are only trying for a few months, we want to give it at least a year, if you are under 35 or 38, to try naturally. The only caveat to this one is if you already know there’s issues, then you might need some additional support sooner. That doesn’t necessarily mean you’ve got to go to medication or IUI or IVF, it just might mean that you might need to find support sooner, but without just trying at home naturally on your own. Also, I think if you’re under 40, I’m a firm believer that you should be trying naturally on your own at home.
If there’s no structural issues, no hormonal issues, no reason that you should be trying with assistance of medication or more advanced procedures, then absolutely you should also be trying naturally. And the other reason is if you have no intention of ever trying IUI or IVF or any medication, then far be it from me to tell you otherwise, keep trying naturally or make sure you start trying naturally now. Some pros and cons about this. The pros are that you get to be more intimate with your partner. You get to learn a lot about your body, your hormones, your cycles. And this is the way that Mother Nature intended it to be is to try naturally with your partner at home without any additional assistance. So those are the pros of it.
The cons. Well, you might not always be trying or timing things appropriately. You might not know when you’re ovulating and you might not know enough about all of that to know when to try. And hopefully you’ve been watching my videos that you have learned enough about all of those things that this is not a variable, but you might not know when to time things appropriately. You may feel like it’s just taking too long when you do it this way and you’re just spinning your wheels without knowing enough and feeling like there could be something else that you could be doing. And you’re doing this alone without any guidance or support to lead you down the path and coach you the way you should be going. If you’re on this path, then what can you do to maximize this?
Well, I do think that all of you can be using or getting additional support to maximize this approach. Trying naturally can take a lot of nuance and detail to understand your hormones, your cycles, your ovulation, what you should be taking, what you shouldn’t be taking, what you should be changing at home. These are all things that need additional support and guidance, and I know that many of you aren’t getting that. So if you want that additional support, if you feel like you’re on this journey alone and you need some guidance, or you just feel like you’ve been doing this too long and now’s the time to get more guidance and support, then I want to invite you to join my Hope Fertility Coaching Program where my team and I are going to guide you through every step to help you get the results that you deserve. All you need to do is use the link in the description below.
Number two, ovulation induction. How do you know that this is what you need? That this support is what you need? Now, first I should say ovulation induction means typically taking medication like Clomid or letrozole or injections, but usually you start with Clomid or letrozole, to help you ovulate so that you can time intercourse appropriately. So who is this for? Well, if you are 35 and younger and trying for at least a year, then you might want to consider this. If you’re over 35 and trying for at least six months, then you also may want to consider this. But for sure, if you are 40 and above or maybe even 38 and above and you’ve been trying for a bit of time and haven’t seen the results that you’d like, then this is also something to consider.
If your cycles are irregular, meaning you don’t know when they come, they’re not predictable, then this is also something that you might want to consider. And if you’re anovulatory, meaning you do not ovulate regularly or predictably on your own, then this is absolutely something that you should consider. Again, this also might just be the next logical step on your journey because you’ve been trying for a while and you’ve tried naturally, and now it’s time to take it up a notch and try something different. Again, the caveat here is if you haven’t done all the things that I just mentioned in number one for trying naturally, getting the proper support, making all the necessary changes that you need to make on your own and getting the guidance that you need with a plan that treats you as an individual, then you might want to go there first before you take this leap.
The pros of this approach is that you’re going to be monitored more closely by your doctor to help guide you a little bit more directly in terms of when you should be having intercourse. We’re going to know that you’re going to be ovulating because you’re taking ovulation induction medication, right? It’s to induce ovulation. You’re still going to have to time that appropriately, but it should be a little bit easier to time intercourse as well because we know you’re going to be ovulating, so as long as either if your doctor tells you when to time intercourse or you take an ovulation predictor kit and it is positive. That whole process is going to be, should be much easier because of the medication. The cons of this is you’re on hormones and hormones can have a side effect, especially the longer you take them. So that might not be something that some of you want.
It’s obviously less natural because you’re taking medication to induce ovulation, and it feels a little bit less intimate and personal because of that piece of the process. Now, you are hopefully still trying naturally and having intercourse at home through this process because you’re only taking the medication. Now, if you do take it up a notch from here and do IUI, intrauterine insemination with the medication, then certainly that definitely feels less natural and more intervention is happening. So what should you do if this is something you’re doing or you’re about to move into? Well, adding in, if you’ve already done the medication to induce ovulation and you haven’t added in IUI, like I just mentioned, that certainly might be something that you want to consider if you’ve tried for at least three cycles with Clomid or letrozole, then you might want to add in IUI into that process to see if that makes it a little bit easier.
And then again, as I also mentioned earlier, if you haven’t done all the things that I discussed in step one, then you want to do those in conjunction with this second piece or this procedure because we still need that integrated. You still need to address all the natural things that you need to be doing. Just because you’re doing medication doesn’t mean you can’t eat properly or you shouldn’t be eating properly, that you shouldn’t be getting restful sleep, that you shouldn’t be taking care of yourself, that you shouldn’t be exercising, that you shouldn’t be ridding your house and life of toxins and chemicals, these are all things that are still very important even if you’re using ovulation induction medication.
Number three, IVF. When do we move on to IVF? Well, the first thing is if you’ve been trying for a while, you’ve already tried naturally, you’ve already tried IUI, you’ve already tried the medication with IUI or naturally on its own, then at some point you’re going to say to yourself, we can’t keep doing the same thing and expecting a different result, we’ve got to take it up a notch. I always say, can’t keep doing the same thing and expect a different result. If it’s not working, it’s not working, so at some point we might need to change it. Now, the only caveat is, again, maybe you need to find a new physician or something like that, but assuming all those things are all in order, then I do think that if you’ve tried all those things, then it may be time to move to IVF and it might be something to consider.
Additionally, if you already know that you are predisposed to moving towards IVF because either you have some sort of medical condition, hormonally there’s an issue, maybe there’s some sort of structural issue in the uterus or something going on on the male side with the sperm, these are all reasons that you should be moving forward towards IVF or moving to IVF sooner and not waiting, right? So don’t just do IUI or take medication and try naturally if you already know there’s a reason for you to move forward with IVF. But certainly if you’ve been trying for a while and you haven’t been getting those results, then IVF is certainly something that you should be considering.
So the pros as to why IVF might be a good approach for you is, one, you get to have the guidance and support of your reproductive endocrinologist, who’s done this thousands and thousands of times hopefully, and knows how to guide you through that process. So that can be reassuring and take some of that burden and stress off, assuming you find the right clinic for you. Number two, you have the benefit of working with an embryologist who’s going to choose the best egg and the best sperm and the best embryo to transfer into the uterus to be successful. And the other pro here is that you get to sidestep any issues that you already know are there. If there’s any structural issues, if there’s any male factor issues, these are all things that can potentially be side-stepped and worked around with IVF, and those are all real good reasons why this should be considered.
The cons, well, there unfortunately are many cons to doing IVF. One is the cost, it’s expensive. It’s a process, it’s not something that happens so easily or quickly, although many of you, I think, believe that it can be done quickly or easily. That’s not necessarily the case from what I see. It’s certainly less natural or not natural at all. It’s less intimate, right? It’s not how we thought it would be. We thought we’d be doing this at home in our bedroom to create our child. So these are all real reasons why. Additionally, the side effects from all the hormones could be a reason why you don’t want to do it. And on top of that, it’s not a guarantee. Many of you may believe that IVF has a 100% success rate, but that’s not the case.
In most instances, it’s not even 50%. Okay? So at best, the percentage of success with IVF at most clinics is going to be anywhere between 25 and 45% depending on your age, your condition and circumstances. It can be higher if you’re using donor sperm and egg, but assuming that we’re not doing that, then certainly those are the percentages that we should be mindful of and have reality with because many of you don’t understand that when you move towards IVF. Things to consider if you are doing IVF or about to do IVF. One is you got to make sure that you’re at the right clinic with the right doctor, with the right embryologist for you. Just because your best friend or sister went one place, doesn’t mean it’s the right place for you. We’re all different and unique, as you’ve heard me say millions of times, and that doctor might not be suited for you. So you need to make sure that you’re working with the right clinic.
You all still need answers for you as an individual, so make sure you understand the why to your fertility troubles and make sure that you are getting the support that you need for those things before you start IVF. And hopefully you’re doing all the things that I mentioned in number one, naturally to support yourself in getting the proper guidance and support that you need, so that you could make IVF more successful and more effective when and if you decide to go that route. Again, if you don’t know what your underlying issues are, if you’ve been trying too long, and if you want support to find those answers, create a unique plan for you to hopefully get the results that you deserve, whatever path you choose, then my team and I are here for you and if you want our support and you want to join our Hope Fertility Coaching Program, just use the link in the description below.
What did you find useful and helpful about this video? I want to hear from you, so comment below and let me know. In addition, I want your questions. What fertility questions do you have? I want to hear from you, so comment below, post your questions, and I’ll do the best I can to answer those for you. If you like this video, give it a thumbs up. If you’re not already a subscriber to my YouTube channel, hit that bell right there to subscribe and get notified when I put out another video. And until the next video, stay fertile.