Getting pregnant naturally
“I want to know how to get pregnant naturally.” This is a commonly uttered sentiment, even from patients who have already decided to take the time and money to come see me for consultation. You would think that by the time someone comes to an RE, they are already fed up with trying naturally. However, some patients find value in coming to me for evaluation and advice, without necessarily wanting to take the step towards actual medical treatment.
I usually start by explaining to them that many couples in the world will end up getting pregnant naturally. Typically, these couples don’t need any help and it just happens. So by virtue of the fact that they have made the effort to see me, it is likely that they have already tried on their own and something about this strategy was unsatisfactory enough for them to make them want to come see an RE. I then acknowledge the fact that some patients who give up on trying to conceive on their own, still have the possibility of doing so. Making the right fertility decision requires a balance between giving an adequate try on your own, when appropriate, vs. knowing when to get help when you’ve already wasted too much time in futility. It might not always be an issue of YES or NO, whether you can get pregnant naturally. It might also be an issue of WHEN. For example, if you are 30 years old and were told that without treatment, you had a 10% chance of getting pregnant in the next five years. But WITH treatment, you had a 80% chance of getting pregnant within the next four months. Even though you still have a chance of getting pregnant naturally, there is ample justification for you wanting to take the treatment route.
So the big question is when is it possible for an infertile couple to still get pregnant naturally? Well, as long as you are developing eggs, as long as there is a reasonable amount of sperm and as long as the tubes and uterus are clear, then there’s the possibility of getting pregnant naturally. In general for average couples, this chance is around 20% per month, but in some super-fertile couples it can be higher, like maybe 25-30% and in sub-fertile couples it would be lower, maybe 5-10% month. For couples who have the label of unexplained infertility, their odds are closer to 2-3% per month. You might wonder why a couple would just settle for a 2-3% per month, when they can boost their chances through IUI and IVF. Well, although IUI (low-tech treatment) and IVF (high-tech treatment) dramatically increase your chance of getting pregnant, you have to take into account the costs of infertility treatment and balance just how badly you want a baby RIGHT NOW vs. how patiently you are willing to wait and/or take the risk of still not being pregnant in three years.
So many times, my new patients and I spend a significant portion of our one-hour initial consultation discussing their situation without ever venturing into the topic of actual medical treatment. Rather, we focus on playing detective to discover their specific fertility problem or problems. Then, for the appropriate candidates, we talk about ways to boost their chances of conceiving naturally.
For these couples, the focus is on these three questions:
1. What can I do to improve my natural fertility?
2. When and how should I have sex?
3. When should I give up and move on to medical treatment?
Some of these issues have been discussed already in other posts, but I will review the rest here shortly.
November 21st, 2008 at 11:53 am
At 34 in a few months I have to admit that I was one of those patients that went for an RE consult with little to no intentions of doing anything but ask questions about how we could improve our chance “naturally” aka “free”. If even saw four RE’s at two separate clinics! There just comes a time when you have to ask yourself if it is money that is keeping you from your happiness. We sat down and thought about it, my husband and I, and decided that since we both are driving new cars (in 2004) that we’d pay them off and not buy new ones (like we have since we were teens about every 4 years) and invest in ART. Recently, I learned of other medications that we could try in the mean time. I appreciate the comment that IVF-MD left because now I can make bigger plans. I am not sure still in IVF is in our future but I just wanted to let you know that it is not because we fear IVF or have moral objections to IVF, but more a concern of how in the heck we will be able to finance such a procedure. Anyways, I appreciate your blog and I have been reading your archives. You are very clear in your posts and I appreciate that! Take care and keep up the good work!