Never Give Up: Finding Hope in Fertility Challenges

In this inspiring episode of Taco Bout Fertility Tuesday, Dr. Mark Amols shares his personal fertility journey, reflecting on the fears, challenges, and triumphs of building a family. Through heartfelt stories and compelling statistics, he highlights the significance of perseverance in fertility treatments. Whether it’s overcoming financial obstacles, navigating setbacks, or exploring new advancements in reproductive medicine, this episode serves as a beacon of hope for anyone on their fertility journey. Discover why persistence, coupled with science, can lead to life-changing outcomes.

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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.

Transcript

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Today we talk about the significance of never giving up. I'm Dr. Mark Amols, and this is Taco about Fertility Tuesday. Today is a special episode, not just because it's the first episode of season seven of talking about Fortilnity Tuesday, but today is my daughter's birthday, and today they'18 years old. Like many of you, I face the fear of never having children. Yet I stand here now, 18 years later, filled with gratitude and joy. So today, at the start of this new year, I want to share the significance of never giving up and how science shows us the value of perseverance. Throughout your journey, there's always going to be a point where you're going to be scared, and there's going to be a point where you feel like you might want to give up. It may feel like it's insurmountable, that, there is no chance of ever having success. And what we're going to talk about is there is success, even when it looks dismal. I remember when I found out I had severe sperm and we weren't going to be able to get pregnant naturally. I thought, maybe this means we're not supposed to have kids. And I remember thinking, how are we ever going to be able to afford this? Remember if we couldn't? It was only because of where I worked and because of a great program they had the letuce pay it over two years that we'even able to try. And then, even then, when we started the process right from the beginning, things weren't going great. And when we found there was another problem and we had to stop, I didn't want to give up. But all of this pressure runs on me from, this feeling of, is it even going to be working? We're about ready to go in debt, and I don't even know if this is going to work. Luckily for me, I did have some friends in the industry was able to help me out with some of the medications that we've already spent thousands on. And we were able to do it again. Now you know how this story ends because as I mentioned, my daughter's birthday today, and they're both 18 years old. Yes, I have twins. I was fortunate enough to not just be able to get pregnant from that cycle, but to have twins. But as I, look back now, I really appreciate the fact that even through all those hard times, my wife found the strength to do things again. That, even though we started feeling hopeless, we never gave up. Now, I'm not going to pretend that there aren't bad stories out there. Yes, there are people who have tried and unfortunately have not been successful. I wish it could be 100% and everyone could always end with the story I ended with. Honestly, most of the time, the reason for people having to stop is more financial than really is just not being able to keep going on the journey. It's one of the reasons I really hope we can have a national mandate that will give fertility to everyone and recommend reaching out to your local politicians to tell them that's what you want. I can give you countless stories of where this has come true. If you've listened to my podcast, you've heard about times when I said, usually we recommend three IUIs and then'not successful to move on to IVF or some other type of testing. And I tell my patients this and I practice this method, and I remember patients I've had who have come to me and failed three IUIs, sometimes even four IUIs, and say, what do I do? I can't go on ivf. I can't afford it. And maybe they have insurance for IUIs and they say, can I do another one? I, tell them, absolutely, there's no reason you can't. I mean, Statistically speaking, yes, 90% of the people who get pregnant are pregnant in those first three. That doesn't mean you can't try anymore. And lo and behold, I've had many patients who decide they want to stick with IUIS for whatever reason that is religious, financial, but they eventually get pregnant, even though statistically it says only 10% of people are going to get pregnant. In that situation, perseverance, it paid off because they kept trying. I have numerous stories. A patient who has gone through IVF and maybe didn't get a normal embryo, and we keep trying and trying and eventually get that normal embryo. Now, it's obvious if you do more than one IVF cycle or more than one iui, your chances go up cumulatively as you keep doing them. Because obviously, whatever that chance was, you get that chance again and it has a cumulative effect. But there's more to it than that. We know that when you do an IVF cycle, as I've mentioned many times before, IVF is not just a treatment, it's test. And you get to learn something about that cycle. And with ivf, you can change things. And so what we find is in those cumulative cycles, people do have success, because now you can make changes. Now, it's really important to understand, even if you make zero changes, which seems crazy, why would you do the same thing that didn didn't work. But even if you did, statistically speaking, you have a higher chance and you will become successful if you just keep trying. If you're just looking at regular IVF without even doing any type of genetic testing. Looking at the Victorian Assisted Reproductive Treatment Authority, they found that women after one IVF cycle their age, 35 had a 48% chance of having a live birth. After two cycles it was 61%. And after three cycles, was almost 70% chance of having a live birth. So just doing the same thing can increase your chances of having a live birth. But as I mentioned, you can actually make adjustments and those adjustments are what allow you to even increase the chances, increasing your overall cumulative pregnancy rate. But what about the situation where you're talking about you pl embryos? What if when you go through ivf, all your embryos come back and app employed? My first thought as a patient would be great. None of my eggs are good, they're all bad. And you can really feel that way. Imagine if you get seven or eight eggs and you get from that four, six embryos and all the embryos come back genetically abnormal. You may feel, are there any good ones in there? Well, in the real world, obviously when you do something exactly the same, you expect to get the same result. But when it comes to the human body, things are different. Things are happening that we don't even realize that're happening internally. Even though externally we are doing things the same, we can end up having different outcomes. There was a article titled the chances of obtaining a euoid embryo and subsequent live birth remained consistent with a national age based rates after an IVF fertilization cycle that produced only anibloid embryos. Essentially the question was if you had a cycle that had only unemled embryos, what was the chances of you then coming away with a successful cycle when doing it again? In other words, are all your eggs bad or does the past not predict the future? Well, surprisingly, it was actually quite positive. What it found is this study found that among patients who had only anemlid embryos in their first IVF cycle, 56% obtain EUOID blastocys in their second IVF cycle. And the likelihood was even higher if they were younger. So for example, if you were under 35, even with all unemloid embryos on the first IVF cycle, 81% had euoid embryos on their second IV cycle. And if you were women who were over 42, even up to 25% of them had a euupoid embryo on their second IVF cycle, even in the face of devastation of all the embryos being abnormal, they never gave up and they were able to get euoid embryos. I remember this one case, and it was quite amazing. This patient went through IVF two times, and two times she had un employed embryos. Now that doesn't sound too impressive. If she only had maybe two embryos each time, but she was about 38 and she was getting around eight embryos each time. That's 16 embryos and still not a normal embryo. And, I do remember talking to her, telling her, yes, it is possible someone could have maybe more abnormal embryos than what would expect for their age group. But I said, there's always a normal embryo there eventually. And so they persevered. They did it again and did get their normal embryo and did have success. They never gave up. But what about the situation where you have embryos and you've done the transfer and it didn't work? At what point do you feel like it's never going to work? Well, there was a study done on that too. In this study called the rate of true recurrent implantation failure is low, results of three successive frozen EUoID single embryo transfers. What they found is that even when there is failure, things do work over time. Overall, this study concluded that recurrent implantation failure is rare, with less than 5% of patients failing to achieve a, clinical pregnancy after three successive transfers of euuploid embryos. In this study, the key findings found that after one transfer there was at least a 69.9% implantation rate. After 2, 87.9 and by the third one 95.2% implantation rate. Now if you look at that from a cumulative live birth rate, after one transfer it was 64.8%, two transfers, 83.9 and by the third transfer, 92.6%. It's important to understand again, this is just looking at the cumulative rates. There are even other tests you can do to find out there are problems. And so in this situation, this was just doing transfers. Now this doesn't mean that you should just keep doing transfers and never look back and see if there could have been something wrong. Even after just one fell transfer with, one embryo, I always look back to see if there's anything that I noticed that could be changed to help improve the transfer. But what this tells us is, is, it just even trying again, we go from a 64.8% live birth rate all the way up to almost a 93% Birthra. This essentially means that no one really is born without the ability to have implantation. Now, of course, you can have pathology that prevents implantation. And it would show up in things like irregular menses or thin linings or even very light periods. But in the normal person with a normal lining and euoid embryos, as long as you just try again, your chances are good. Now, adding adjustment even makes it better. Again, I have multiple examples of this. One of my favorite examples of this is when we first started. I remember, like we never had anyone not get pregnant after putting back two euloid embryos. It just never happened. At least there was some type of implantation or something. And this one time there was no implantation. I remember thinking the patient that, this is crazy what is going on? And they have a lot of embryos. And so at this time, the era test came out and I said, listen, there's this new test. Never had this happen. Let's take a look at it. And lo, and behold, it was off. And then they went did another transfer with two youoid embryos. And this time it implanted. But it didn't end in al live birth. At that point, even I was confused. I'm thinking, wow, four embryos and no live birth. And we know by three it should be there. But as I mentioned to them, I said the first time we did it, it was at the wrong time. And that may affected whether there was no implantation. So really it's only been two when you look atumulative pregnancy rate. And so when we did another transfer, this time it worked and they had a live birth. Now, it doesn't mean it takes three tries to work. A matter of fact, for most people, they'going to be pregnant with the very first transfer. But it's important that they never gave up. They kept trying, even when things seemed very dismal. Now, I can tell you on the second time when I went through ivf, it was perseverance. We kept having, to cancel multiple cycles. We started losing faith, but we kept going. Now, I had the advantage of being my own doctor, so the cost was pretty fair. I didn't charge myself much, but I remember just thinking, this is even worth this. And that resilience is what allow us to eventually have a second pregnancy. Now, it's easy for me to say that now because I've had success. But for those of you who feel like you want to give up, it's always important to know that that resilience is what will get you that outcome. And, I'm not saying it has to be blind resilience. It may have to be that you have to go, ah, a different route than what you wanted. But what I can tell you is that in general, if you keep trying, there's a very good chance you'll have success. Now, for some of us, that emotional support might need help. So I would tell you reach out to the support networks that are out there, whether it's Facebook groups, whether it's friends, whether it's meeting up with people, or even just talking to your clinic and finding out if there's some support forums. The most important part is not just not giving up, but not even getting to that point where the stress has got so high that you even are considering giving up. Wanting to give up is normal. That's part of being human, especially when you feel like there's no benefit of moving forward. And this is where it's so important to talk to your doctor because what you see may be dismal and what they see may be optimism. This is where second opinions come in. Sometimes you just need another set of eyes to give you that reassurance to keep moving forward. Or maybe another perspective, like my prior patient. Maybe some new technology has come out. It's always advancing, like where weit e era and so even if you need time off, don't give up. Because there's always something new. And with perseverance, science says you have a better chance of coming away successful. What's crazy is now, 18 years later, I fought so hard to have these kids and it's been amazing. These 18 years have enough joy in them, that will last forever. Because now I'm saddened by the fact that they're adults and I won't have these kids that I work so hard to have over these years. And just like many of you, you'll think about, did you do it right? Could you have done things better? I think one of the things that comes through our minds as parents of infertility patients is we're probably helicopter parents because we work so hard to have these kids that know they're precious to us. It's God's gift to us. But I can tell you, if you're there, you already know it. But if you're not, it is worth fighting for. And I would be the first to tell you, never give up and do whateverever you have to do to stay in the game emotionally and physically and unfortunately financially. Whether that's getting a job at Starbucks as a barista so you can maybe get their fertility insurance. Just never give up. Well, I look forward to go through many more talk about Fertility Tuesdays this year with you and I appreciate everything you guys have done with all the five star reviews and helping make our podcasts quite successful. I don't make any money from this. I purely do it for educational reasons because I know that the information out there isn't always as detailed. And so I want you to be an advocate for yourself and be able to know the information when you're talking to your provider. Thank you again for making this podcast successful. I look forward to talking to you again next week on, tboo Fertility Tuesday. Happy Birthday.