In this insightful episode of 'Taco Bout Fertility Tuesday,' Dr. Mark Amols explores the emotional and psychological journey of finding closure after an IVF cycle. Aptly titled "Finding Closure After IVF: Understanding the Journey Beyond the Cycle," this episode delves into the importance of post-treatment consultations, emphasizing their role in providing clarity and emotional peace, regardless of the cycle's outcome.
Dr. Amols discusses the complex reality of IVF, highlighting that even with advanced techniques like genetically tested embryos, success is not guaranteed. He explains the science behind the statistics, bringing to light why some cycles may not result in a live birth and addressing the common feelings of self-blame among patients. The episode stresses the value of follow-up appointments, where patients can understand the specifics of their cycle, from egg stimulation and fertilization to embryo quality. This understanding is crucial in alleviating unnecessary guilt and offering a path to emotional closure.
With compassion and expertise, Dr. Amols addresses the challenges and frustrations that come with unsuccessful cycles. He encourages patients to ask all their questions, however trivial they may seem, and emphasizes the importance of these discussions for moving forward, whether it's to continue with fertility treatments or to find closure in their journey.
"Finding Closure After IVF" is a must-listen for anyone navigating the complex waters of fertility treatments. It's a blend of medical insight, emotional support, and encouragement, aiming to provide listeners with the understanding and peace they need to either continue their journey with hope or find solace in their decisions.
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Join us next Tuesday for more discussions on fertility, where we blend medical expertise with a touch of humor to make complex topics accessible and engaging. Until then, keep the conversation going and remember: understanding your fertility is a journey we're on together.
Today we talk about closure and the. Importance of it in your fertility journey. I'm Dr. Mark Amos, and this is taco. About fertility Tuesday. You've heard me state it before. IVF, is not just a treatment. But is also a test. It's probably the best test you're ever going to do, and it's going to be able to give you information that you never knew about. The thing about IVF, though, is that when you go into it, you just assume it's going to work. And that's because it seems like it should. I mean, you're taking an embryo that's alive, possibly even genetically tested, and you're. Putting it directly into the best home. It can be, which is your uterus. But what's interesting is even with a tested embryo, we find that about 40% of people will not have a live birth. Again, those numbers can vary a little. Bit, can be as high as 70. Could be a little bit lower at 50. But in general, 60% of people will come away with a live birth and 40% of people won't. Now, it's important to understand that pregnancy. Rate is slightly different. That's whether you just have a positive pregnancy test and that's going to be. Higher in the 75, 80. Sometimes even the birth rate seem to. Not be as high because there are miscarriages and things that can occur. Now, when you hear closure, and we're. Going to be talking about closure, I'm not talking about the type of. Closure which is like a closure cycle. That's, for another podcast in the. Future where someone wants to have, let's. Say, one last IVF cycle to have. Closure to be done. What I'm talking about is closure after any type of treatment, meaning it's really important for you to make sure to follow up with your doctor so you get some type of closure. Because the thing is, it's not like you completely know why things happened. And so you want to have those answers. Now, I can't guarantee you that you're. Going to get those answers, but what I can definitely guarantee is if you don't follow up after, let's say, a bad cycle, or maybe even a cycle that wasn't as good as you want, you're never going to understand why and you're not going to have that closure to understand what's going on. We're human. And what that means is you're going to blame yourself. You're going to think something you did caused it. You're going to think that thing you. Picked up was a little too heavy, or maybe because you took too hot. Of a shower that made things not work. And the reality is, it doesn't matter. If you've read something saying it doesn't cause a problem. It doesn't even matter. If I tell you right now that it didn't cause a problem, you will think about it, you will blame yourself, and you're going to wonder if there's even hope moving forward. And the thing is, sometimes when you go through IVF, there are things we see that actually bring more hope, even. When it fails, because there are things. We see that we realize we can fix. Thing I always talk about, the best thing about IVF is it's the one. Treatment you can actually see the problems. And then you can fix them, versus something like iuis. When you do an iui, nobody knows why it didn't work. I don't know. You don't know. And that's because we can't see anything. But in IVF, it's different. We can see the eggs, we can. See the shape of the eggs. We can see if they're dark, what their polar bodies look like. Then when they fertilize, we can determine. If they're fertilizing normal. We can determine, did they fertilize naturally. Or did we have to use ixy? With IVF, we can watch them grow. And see, do they grow through blastulation and make sure that they go from the single cell all the way to a blastocyst. We can even then, biopsy those. Embryos, and we can test them to find out which ones are genetically normal. And which ones are abnormal. And even a step further, we can. Even determine if the genetic problem is. Coming from the female or the male. The point is, there is a lot of detail, and no one expects you to know it. And so what I want to talk. About is, what are those things you. Would talk to your doctor about? I've had patients who've gone through IVF, and maybe they don't get as many embryos as they want. And so we come back and we talk about it, and we talk about adjustments we can make, and they're very happy with that. But the ones I worry the most about are the ones who have failed cycles. I have seen patients who have gone. Through other clinics who have a failed IVF cycle and never follow up with a doctor. And whether. Whose fault that is, I don't know. But the point is, they never followed up. And so when they see me, they. Have no hope in their mind. They did the best thing there is and it didn't work, which means they're. Never going to get pregnant in their mind. But in reality, if they would have met with that doctor, that doctor could. Have talked to them about things such. As what could be done to be better, could have also made sure that. They understand the things they did didn't cause problems. So it's always important, whenever you've had a failed cycle, to always make sure. You talk to the doctor. It doesn't mean it has to be on the first iui. It could be after three iuis. But at some point, when you feel like you're not moving forward, it's important. To get that closure. Talk to the doctor, find out, is it something expected, for example, when people have unexplained infertility, and they do iuis. We only expect half the people to. Eventually get pregnant, so we're not going. To be worried when it doesn't happen. But as a patient, you are going. To think, something must be really wrong because I'm not pregnant after three of. These, when in reality, the doctor is. Probably in the back of my mind going, yeah, I probably knew it may not work, but we had to do it for, let's say, insurance purposes, or for whatever reason you guys chose to. They knew that half the people wouldn't get pregnant anyways. But with IVF, it's extremely important because. It is the best thing we have. And for most people, it seems like. It should be 100%. That's how it feels. And so when it doesn't work, the feeling of hopelessness is very common. And more so, people start looking towards. Themselves of what they did wrong. I have patients ask me lots of. Questions about, could this have caused me. Not to get pregnant, or could this cause a problem? And what's important is by meeting with them and going over these things, they're. Able to have some type of closure, to know they didn't cause a problem. No one's going to be able to get rid of the pain of the failed cycle. Unfortunately, that's one of the things that. We have to deal with when going on this journey is sometimes disappointment. And it sucks. It sucks a lot because it's not. Like, oh, I'll just try again. Sometimes that's not something you can do. Maybe you don't have the coverage, maybe. It'S just not working. But what I can tell you is rarely is the problem. You usually there's something that we can. Pinpoint to figure, out what's wrong. And so if you have a failed cycle of IVF. Your doctor can sit down with you go through each step of the process, determining, how did the stimulation go? Did you make enough eggs? Did you make less eggs than you expected? They can look at the fertilization and. Say, hey, you know what? You actually did amazing. I have patients where we end up doing an IVF cycle. We'll draw someone, let's say, like, 16. Eggs, but only six fertilized, which is horrible. But of, those six, like, five. Of them go on to become a. Blastocyst, and they think their cycle went horrible. And I explained them, really, when you look at it, it went amazing. It's just that your fertilization was so bad, that's why we ended up with fewer embryos. That's very useful information, because now you get to walk away from that appointment. And realize, I actually didn't do bad. My eggs seem to be working fine, and once I make embryos, they grow out the blastocyst. It's just the fertilization was bad, and. That'S where you make those adjustments to be able to have better fertilization. On the next IVF cycle, if you choose to do one, growth hormone is. Another one of those medications that everyone's always talking about and thinks it's a new thing, but technically been around for many, many years. But there are some people who benefit from it. And so when you're looking through your IVF cycle, and they say, okay, the stem went well, the blastulation went well, but a lot of the embryos were poor quality at the end. When I say poor quality, I'm not talking about genetics, but fragmentation or asymmetry of the cells. And so they may choose to then add growth hormone, which, again, gives you. Some bit m of hope that there. Is some adjustment here that can be made. You're not just trying again, which obviously is very frustrating. Trying again, you feel like it's going. To be the exact same results. But in my mind, the most important thing is to talk about why it wasn't you. You hear me say this all the. Time about how it's important to get. Your questions answered, and you need to walk into that appointment with your doctor and have a list of questions, even. If you think it's dumb. You're like, hey, I was watching American Idol last night. Could that have caused a problem? Hey, you never know, okay? Simon Cowell, he's very mean. Sometimes it could cause your emotions change. I get it. But the point is, ask the questions. There's no stupid questions, because you didn't come away with a baby, and now you have to have the courage to try again. And that courage is only going to. Come if you feel comfortable knowing that. When you try again next time, the. Chances are still good. What you're not going to end up. Doing is being able to have success if you don't ever try again. And so I truly, truly mean this when I say closure is so important, even if you're never going to do it again. I've had patients who have no plans. To do IVF again, and we tell. Them they have to have a follow. Up for a closure cycle and a. Lot of patients will get upset and we even tell them we won't even charge you for it. It's that important to be able to have that. And even though they weren't going to try again, when I get done talking. To them, they feel very relieved because they thought it was something wrong with. Them or they thought it was something wrong that they did. And so they're able to at least say, hey, we're not moving forward, but at least we feel that we did our best. And that closure of knowing you did. Your best, even though it didn't work. Can at least let you know, moving forward, you're never going to second guess it. You're never going to wonder, what if. And that's why, regardless if you're going to move forward, regardless if you're even switching to another clinic, make sure you. Follow up with your doctor to find. Out why they think it didn't work. And to answer all those questions you have. Because again, there are no dumb questions. In the end, you're not going to be happy that it didn't work, but. You'Re going to be happy that at least you know why it didn't work, or at least have some comfort in knowing it wasn't something you did. And that way, it's going to give. You the courage to move forward again, to have success with either another cycle or if pure closure. And you're going to stop, at least. To have the confidence to know that. When you had closure, you did your best and you can feel good that you're not going to keep moving forward. This is a topic that's really important to me. I really do take the time to. Always remind patients how it's not their fault. I, know, I've even done podcasts of talking about it's not your fault, but it's really important for you to know that. And like I said, make sure you follow up with your doctor and hopefully, like us, they don't charge for a follow up if you have the failed cycle, because it's that important to do it. And most don't, by the way, because it's really important. And like I said, even if you're not going to do it again, don't worry. The information gathered from it is only. Going to help you at least have closure, even if you're not going to move forward. Hopefully this was helpful to someone, or maybe someone who's going through IVF right now and at least knows in the future what to maybe do. Maybe you're someone who actually stopped. Maybe you never had closure and you're. Thinking, wow, I've always thought it was. Me, and I never really did follow up to find out that it's something that can easily be fixed. And so what I'd recommend is listen. To this, go back to your doctor, talk to them, or if you have. A friend who's going through it, let them know this, too. One of the best examples I have. Of this was I had a patient who went through IVF, and unfortunately, the fertilization was horrible, and they did rescue Ixi, and their embryo quality wasn't that great. And they didn't have success on their first two transfers. They had a, pregnancy, positive, but not success. And they were basically going to give up. And I kept asking her to have a follow up, and she didn't want. To because she was just frustrated. And I get it. But eventually I sat down with her and I explained to her what happened. And she said, well, obviously my aches are bad. And I had to explain to her that, no, you had rescue ixy. That's not the same as, having ixy. And she didn't know that. She thought it was exactly the same chances. I told her, no, it lowers your chances that if we did this right and now did Ixy, you're going to have a much different response. You'll have better blastulation, more embryos. And so we did it again, and. This time she got lots of embryos, very big quality. And with the first transfer was successful. The point is, closure is important. As always, thank you so much for listening to us, and please tell everyone about us. And if you have a topic you want me to talk about, send me a message on either facebook, send it to me through email at tbft@newdirectionfertility.com, and if you really like it, give us a five star review, your favorite podcast medium. As always, I like talking to you guys every week. And look forward to talking to you again next week on Taco belt Fertility Tuesday.