Dr. Ilana Ressler is a board-certified OB/GYN and reproductive endocrinologist who joined the Illume Fertility team in 2017. Dr. Ressler has a special interest in treating patients with PCOS and advocating for ovarian and breast cancer awareness in the Jewish community through advocacy work.
We often see the heartwarming pictures: a tiny baby in a onesie that says, “Made with love and a little bit of science.” We love those photos for so many reasons! Healthy babies are our goal. Love is invaluable. And science is powerful. But what are your real chances of success with fertility treatment?
As a reproductive endocrinologist, I see every day how difficult it can be to build a family. My goal is to do everything in my power to use my skills to bring my patients across the finish line, which in reality, is the start of their lives together with a new baby.
With today’s advanced technology, we are able to be more successful than ever. We have thorough fertility testing, expansive treatment options, and hyper-focused experts in place to make sure on the medical end, the “science” part of it all, we give every patient the highest chance of success.
Add in the immense work, love, and determination each patient provides, and we often receive that special card in the mail introducing a new baby who was “made with love and a little bit of science.”
One of the hardest conversations I have to have as a physician, however, comes well before the injections or the pregnancy tests. It’s when I have to tell every patient that walks through my door that assisted reproductive technology (ART) is not a guarantee for anyone. As an ethical, responsible doctor, I cannot promise you a baby.
I can promise science, innovative technology, and problem-solving. But I can’t give you a guarantee.
The Society for Assisted Reproductive Technology (SART) is focused on providing truthful data, success rates, and clinical options for any patient entering the world of fertility assistance. They collect data from over 85% of the nation’s IVF centers and organize it in clear “snapshot” reports, thus providing patients with an idea of how their age range and cycle type performs at a particular center.
A SART clinic is considered to be an honest clinic, as they must report truthful data, all their successful (and unsuccessful) cycles, and must use nationally-accredited laboratories. These clinics are committed to providing patients with the highest-quality care possible. Illume Fertility is a longstanding member of SART.
Setting the Stage for Success
Before we dig into the data, there are a few considerations to go over so that you truly understand the realistic likelihood of how well these individual treatments work on different groups of patients.
This is a hugely important factor, as the age of the egg is one of the most important predictors of success.
Women are born with a finite number of eggs, and that supply runs out at menopause. Well before menopause, age begins to impact fertility, statistically seen starting in our mid-30s. Being less than 35 years old puts someone in the best prognosis category, and there is a slow decline in success from that point. This is due not only to a decline in the quantity of eggs, but also quality.
Why is that? Well, a normal egg has 23 chromosomes, and as women age, an increasing number of their eggs begin to have more or less than 23 chromosomes. This means that if fertilization occurs, the embryo will be aneuploid (having too many or too few chromosomes).
As we age, the ratio of “good” to “bad” eggs decreases, meaning higher rates of negative outcomes, miscarriages, and aneuploidy. Ultimately, it can be thought of as a numbers game - it’s all about finding that “golden egg.”
What about men? Age also affects male fertility, but in a much slower, more subtle manner. Sperm quality does decline with age, but typically isn't a problem before age 60. Even with these changes, there is no male “menopause” or maximum age to father a child. However, there are additional genetic risks associated with advancing paternal age.
Body Mass Index (BMI)
Having a healthy body mass index (BMI) is important when trying to conceive. A BMI of 19 to 24.9 is considered normal, less than 19 is classified as underweight, between 25-29.9 is overweight, and anything greater than 30 is classified as obese.
Studies have shown that obesity decreases the chances of success with ART. Women with BMIs greater than 30 typically have lower pregnancy rates and higher miscarriage rates. There are additional pregnancy-related risks associated with obesity, including gestational diabetes, gestational hypertension, and preeclampsia, a higher rate of needing a cesarean section, and some birth defects. Obesity in men may be associated with changes in testosterone and other hormone levels, as well as lower sperm counts and motility.
If your BMI is 19 or below OR 30 or above, it is important to discuss it with your physician. Depending on other factors, including age, it might be recommended to attempt safe, balanced weight management prior to fertility treatment and/or seek assistance. You should also consult with your fertility practice on their BMI limitations.
Note: At Illume Fertility, we require a BMI of less than 45 prior to starting an IVF cycle and less than 50 prior to starting an ovulation induction cycle to decrease the risk of medical complications.
A fertility nurse answers the question:
Optimizing overall health is important for increasing your chances of success with fertility treatment, as well as a healthy pregnancy and healthy baby. The key is a good balance of the necessary vitamins and nutrients. It is important to be on a prenatal vitamin while trying to conceive and throughout pregnancy.
Some studies also suggest that the “Mediterranean diet” is helpful for fertility. Other basics include eating food rich in antioxidants and omega-3s and avoiding processed foods and trans fats. Balance is key, restriction is not. Maintaining good nutrition and achieving a healthy weight can increase fertility success.
As we all know, exercise has many benefits! It helps reduce long-term risks such as heart disease, Type 2 Diabetes, metabolic syndrome, and even some cancers. It also has a more immediate benefit on bone and muscle health, weight management, and brain health. Lack of exercise may be associated with obesity, which is linked to several reproductive issues as outlined above.
Movement is important, but modifications of your usual routine may be needed while trying to conceive and pregnant, so always discuss with your doctor. There isn't one perfect exercise routine that is best for fertility (or for PCOS or other conditions), the key is simply finding something you enjoy so that you actually want to do it!
Smoking & Drinking
It's no secret that smoking and excess alcohol intake are not good for us - there are a plethora of health issues they can both cause! Well, add a negative impact on fertility to the list. Smoking in women is associated with lower pregnancy rates and increased risks of miscarriage and ectopic pregnancy. It also speeds up the rate of egg loss, leading to earlier menopause (by 1 to 4 years).
Smoking in men can negatively impact semen parameters. It may also decrease the sperm’s ability to fertilize eggs. Heavy alcohol consumption (>2 drinks per day), use of recreational drugs and heavy caffeine consumption have all also been associated with reduced fertility.
In addition to the above, there are many other factors that can directly or indirectly affect your family-building success. We continue to gain understanding of how the below categories might influence your outcomes as more studies are performed each year. Here are some things to keep in mind:
Disorders & Diseases: Depending on the disorder or disease, a multitude of systems within the body could be affected. Consult with your doctor to better understand how your health history and current status can impact your success.
Genetics & Natural Occurrences: Sometimes, what you're born with can work against you. It's important to conduct genetic testing and compare your personal genetic panel with your partner or donor.
Low AMH:Anti-Mullerian Hormone (AMH) is a commonly used marker of a woman's fertility potential and ovarian reserve. The hormone is secreted from the egg follicles within the ovary and can be measured at any point in a woman’s cycle, even if she’s on birth control pills.
Low Egg Quality: AMH can indicate the quantity of eggs, but it can't measure quality. Quality can be affected by a number of factors, many listed here in this article - but age is the most important factor for egg quality, and affects all women universally.
Note: The external factors below continue to be studied and better understood in the landscape of fertility. We will continue to advise our patients according to all available data.
Occupational Hazards: Certain jobs may expose you to physical or mental interferences to pregnancy or conception.
Location (Environmental Hazards): Yes, even your living situation and location can affect fertility. Think: chemical agents, stress, noise, etc.
Medications or Other Treatments:Certain treatments have the potential to harm fertility, like radiation and chemotherapy, often used in cancer treatments. Additionally, there are herbs and supplements we advise against when trying to conceive.
Anxiety & Other Emotional Stressors: We still don't know exactly how stress affects fertility, but some studies suggest a correlation between stress and fertility, and we always encourage patients to care for their mental health. We know coping with the realities of fertility treatments and news can be very difficult at times, and we want to help you manage those feelings any way we can. If you are a patient at Illume Fertility, please reach out to your patient navigator to get connected with more resources.
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Your Odds for Success with Fertility Treatment
So, back to SART and how you can use this data to better understand the realistic chances of having a baby…
Let’s walk through what the data says about different age groups, different hurdles, and different pathways together. We will keep in mind the above influencers of fertility so that you can more accurately see where you might fall on the spectrum.
What are Illume Fertility's IVF success rates?
The below data points are pulled directly from the 2018 Clinic Summary Report, meaning they are specific to Illume Fertility from all IVF cycles performed during the 2018 year. That may seem outdated, but the 2018 data set is actually the most current and accurate set SART has to date.
Keep in mind that it takes a long time to fully acquire the data from a year’s worth of cycles - some people freeze embryos for later usage and pregnancy itself takes a while. So all the cycles conducted in 2018 won’t have been necessarily completed for quite some time after 2018. Knowing that the 2018 numbers are the most up to date, let’s dig in!
Live singleton births per new patient, using own eggs at Illume Fertility (in other words, the odds of you having a baby using your own eggs in an IVF cycle at our practice, are as follows):
Age 35 or younger = 68.2%
Ages 35-37 = 68.2%
Ages 38-40 = 39.8%
Ages 41-42 = 17.4%
Ages 42+ = 4.2%
If you'd like to dig a little deeper into the data or to see national averages of these same demographics, I highly recommend visiting SART and utilizing their interactive data tool. You can specify if you are using your own eggs or donor eggs/embryos, look up information on implantation rates, and even use the success rates of various clinics to help determine which practice you choose to help with your family building.
Be sure to evaluate each clinic’s data against the SART National Data, as locations, demographics, and other situational factors aren’t the same across the board, and therefore offer an unclear comparison clinic to clinic.
What about IUI success rates?
SART does not currently collect data about the success rates for intrauterine insemination (IUI) cycles. However, IUI success rates typically range from 5-15% per cycle, depending on the patient's situation. Once again, age plays a big role in predicting success. Other important factors include the underlying diagnosis, a patient’s specific medical history, and the medication being used to stimulate the ovaries.
How do I increase my chances of success?
The best way to increase your chances of success is to focus on what is in your control. Allow your lifestyle choices, nutrition, and physical movement to work for you instead of against you. Together with your fertility team, you can come up with a plan to increase your odds.
At Illume Fertility, patients have access to our Integrated Fertility and Wellness (IFW) program, which offers holistic support by taking care of your mind and body. We believe acupuncture, counseling, nutritional guidance, and movement (all disciplines within our IFW team), are critical to the overall experience, and ultimately, success.
If your practice does not have an in-house team dedicated to treating the whole person beyond the typical protocol, ask them for local recommendations for these types of mind/body connectors. Not only is it scientifically proven to help your treatment (laser acupuncture before and after embryo transfer can increase your chances of implantation by 15%), it’s a great help in clearing your mind, connecting with others, and learning more about yourself.
Preimplantation Genetic Testing (PGT) is another good tool for many patients, particularly those who are older. PGT can help provide you with an assessment of your embryo quality during IVF and detect chromosomal and other structural abnormalities that might impact successful implantation or your future child.
How can I predict my outcome with IUI or IVF?
It’s important when beginning a fertility journey and using treatments like IVF or IUI to know that science, your doctors, and your support systems will do everything they can to help you achieve your dream of growing your family. And while there is no guarantee with any procedure, understanding the data is helpful to maintaining a hopeful, yet realistic outlook.
After absorbing all of this scientifically-backed data, you may want to dig deeper by checking out this tool on SART's website to better understand what your personal odds might look like. Remember, this is just a simple online tool and never a substitute for a full fertility evaluation. Only after a full diagnostic workup and an appointment with a fertility specialist can you understand the full scope of what your personal odds are.
Rest assured that even if your likelihood of becoming pregnant with your own eggs or sperm is 1%, our team at Illume Fertility will do everything we can to make it happen.
Staying Hopeful About Your Future
All this data speak is nothing without hope and love. That’s why it’s so important to take care of your mind and body while going through treatment, because sometimes, these numbers can feel overwhelming and diminish hope. I strongly encourage you to pursue acupuncture, counseling, movement, and support groups as you navigate your fertility journey to try to maintain balance and care for yourself.
If you bring the passion, your reproductive endocrinologist will bring the science. And if your hope is completely broken (which we understand), we will help you pick up the pieces, because that’s our job, and we love what we do. Helping you build your family is why we all come to work every single day.
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