Game Plan for Fertility: Timing Your Best Play

When it comes to fertility, timing is everything. In this episode of Taco Bout Fertility Tuesday, Dr. Mark Amols breaks down the "window of opportunity"—the crucial period where certain fertility treatments are most effective.

Using football analogies, Dr. Amols explains why some treatments, like IUI, can be done at almost any age, while others, like IVF, require a stronger ovarian reserve and should be pursued earlier. He also dives into family-building strategy, showing why those who want multiple children may need to think ahead and bank embryos early rather than waiting until options become limited.

This episode covers:
 🏈 Why age matters in fertility treatments
🏈 How IUI and IVF differ in success rates
🏈 The importance of embryo banking for long-term family planning
🏈 Common fertility misconceptions that may cost you time
🏈 How to maximize your window of opportunity for conception

If you’re trying to conceive and wondering whether to wait, try IUI, or move forward with IVF, this episode will help you make the right play at the right time!

Thanks for tuning in to another episode of 'Taco Bout Fertility Tuesday' with Dr. Mark Amols. If you found this episode insightful, please share it with friends and family who might benefit from our discussion. Remember, your feedback is invaluable to us – leave us a review on Apple Podcasts, Spotify, or your preferred listening platform.

Stay connected with us for updates and fertility tips – follow us on Facebook. For more resources and information, visit our website at www.NewDirectionFertility.com.

Have a question or a topic you'd like us to cover? We'd love to hear from you! Reach out to us at TBFT@NewDirectionFertility.com.

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 window of opportunity in ferility. Making the right move at the right time can make all the difference. I'm, Dr. Mark Amols and this is Taco about Fertility Tuesday. Just like in football, where a quarterback and a running back have different career spans, fertility treatments have their own windows of opportunity as well. Today we are going to break down how timing can make all the difference in your journey to parenthood. Now, although you may not, like football, you can at least appreciate this analogy. And that is, quarterbacks can play into their 40s because their skill relies on precision strategy, whereas running backs in NFL usually have to retire by 30 because their role depends on speed and endurance. So if you were lucky enough to make it to the NFL and you had to pick a position, you would likely want to pick being, a running back first because you have a window of opportunity to do that. After age 30, you won't be able to do it because it relies on the speed and endurance. But when it comes to being a quarterback, you really don't need to have the speed endurance. Instead you need the precision and strategy. And that can still occur after age 40. And so the window of opportunity for being coming a quarterback is much longer. So what does this have to do with fertility? Well, when it comes to fertility, similarly, IUIs can be done at almost any age, but IVF requires a healthier ovarian reserve. So overall, making the right play at the right time is key to winning the game. And the same applies to fertility treatments. So the question comes up, what determines your window of opportunity? At what age do you need to put one treatment ahead of another? Well, it's not that simple. For every person, it's going to be different. Now, there's a general trend. We know that as people get older, they are going to have lower end quality and quantity. But we also know that there are people out there who are young who can have poor, ovarian reserve. And so each person is going to need to know their ovarian reserve to know where their window of opportunity is. That fertility window may be different for two people at age 35 or two people at age 38 or 42. But what we know is that for some people, if they're 38, starting with IUIs could be a poor decision because their window of opportunity for IVF is then and they do IUIS first, they could be postponing the IVF and losing their chances. If you think about it kind of makes sense for an IUI to be successful. You want around two, three eggs. You don't want six eggs. That's actually dangerous. But in ivf, two or three eggs is kind of a poor amount. I'm, not saying people don't get that few eggs. Many people do. My wife did. But the point is, most people want more than that. And that's kind the benefit of ivf, right? The benefit is that you can get lots of eggs. And by getting lots of eggs, you have a chance then of using a year or two worth of eggs to try to get pregnant. Now, not surprisingly, like the running backs in fl, the younger you are, the better chance you have at getting all those eggs. But as you get older, you don't make as many eggs. And so if you wait, you can lose that opportunity. Let's consider a hypothetical case. You're 38 years of age. Now, IUIs and IVF are both options. You make around 10 eggs when you're given medication. So both are an option. And let's say you choose to do IUIs. It's easy, it's natural. Why wouldn't you do it? You go, when you get pregnant, fantastic. And now you come back and you're 40, maybe even closer to 41, because timing is never right. But now you go to do IUIs, and let's say it doesn't work. So then you say, okay, we're going to have to do ivf. I didn't want to do it, but we're at that point now. But there's a problem. Now you can only make three to four eggs. And not only can you make less eggs, but now even the quality of those eggs are lower than when you were 38. So you can see how that window of opportunity was missed. If that person would have known ahead of time that they wanted a second or third kid, they could have made the decision to do IVF earlier to preserve their fertility, then did IUIs, and then in the end, they needed more embryos. They would already have them preserved. So sometimes waiting too late can hurt your chances. Now, the opposite is also true. Meaning if you're going to use something like donor eggs, it doesn't matter if you'thirty five, forty eight, fifty. The chances are about the same. And so in that situation, you don't have to worry about your winow of opportunity because it's the same pretty much for everyone. So if we look at the success rate of IUI versus IVF, what we find is at age 35, IUI has about, a 10 to 15% success rate per cycle, whereas IVF at age 38 is around 35 to 40%. By age 42, I ris only have about 3 to 5% chance per cycle, but IVF is 5 to 10%. So what do you notice here? Well, you notice that IVF is always better, but it's not that much better as you get older. And that's because there are so many more, abnormal eggs and you're able to make only a certain amount of eggs. And there truly is a point where IUIs might be more cost effective than even doing IVF. I've made this analogy once before in the past where I said it's always obvious that IVF is the best, but it doesn't mean it's always the best option for you. My analogy would be if you were going to go multiple miles, then you probably want to use a vehicle, but if you're only going 50ft, a skateboard may be more practical. And so the same point, if you're only able to make one or two eggs, sometimes IUI is just as good of an option. Now, I truly am simplifying that. It's important to understand that if you're young and you only make a few eggs, absolutely do IVF. But if you're 42 and you're only making one or two eggs, unless you have an absolute reason that you cannot get pregnant without ivf, it's not unreasonable to say, I think I'm just going to do IUIs because spending all that money just to get one or two eggs isn't worth it if I can only do one IVF. But if I do IUIs, I can maybe do it 5 times and 1 to 2 times 5 is 5 to 10x and that might give you a better chance. So the key takeaways right now are IUI remains an option even at older ages, but has low success rates. IVF offers better chances, but it's highly dependent on your ovarian reserve and egg quality. Whereas IUIs, because you only need a couple eggs, is about the same now. sometimes when trying to make the right play call, you have to understand it's not just about pregnancy. Sometimes it's about building your family that you want. See if youe willing to have six kids but you only have, lets say, so many years left, like youre age 34, then spending years trying IUI may eventually get you to the age where now you have to do IVF and it won't work as well. So it actually makes more sense. The bank embryos for the future and then start trying IUIs or try IUIs later, because banking the embryos will give you a better chance of building your family later. I deal with this all the time. I have couples come to me who are 36 to 38 and they want to build a whole family of four to five kids. And I tell them that's great and I tell them we can try IUIs, but there's no way you're going to get five kids from that. That's just impossible. So if they really want that, what they really need to do is preserve their fertility by making embryos, freezing them, then they can do an iui. If they wanted to get pregnant, great. Do it as many times as they can. That IUIs will work. And then when they get to the point it won't work anymore, then we jump to IVF and they can solve kids past age 42 because those embryos will be preserved. The point is, IVF is the most effective treatment when you are starting earlier than wait until lateryer. Because you have a higher quality embryos and can make more embryos. Those banked embryos can give you the flexibility. So you can either try with IOI or even naturally, but still have the embryos as a backup. Avoid the trap of waiting too long only to realize your ovarian reserve is too low forvf later. The key point here is if you're family building and that's the goal, it's even more important to have strategy. As I always like to say, don't just plan for your first pregnancy, plan for the family you want. One of the myths when it comes to IVF is that IVF guarantees pregnancy. Well, it does not. In reality, ivf, success is dependent on the age and your ovarian reserve. This is why it's important to talk to your doctor and find out where your ovarian reserve is. And if you are getting close to 35, absolutely find out what your ovarian reserve is to find out what your window of opportunity is. Another common myth is IUI is always worth trying first. Well, yeah, I mean, who wouldn't want to try it first? It's easier'cheaper less hormones for you. But in reality, at some ages, it can be a waste of valuable time for most purposes. If you were age 40 and you are wanting more than one kid, never start with IUI if you're age 40, but, you're okay with just one kid, you might be a candidate for just doing IUI because you only want one pregnancy. This is again why it is important to talk to your physician and come up with a game plan. Another common misconception is as long as I have a period, I can do IVF with my own a. Well, it's true if you have a period, you are making an egg, but the problem is egg quality declines long before menopause. And so although you may feel young and you get your period like you did when you're young, your egg quality could be significantly lower and your ability to make a lot of eggs may be completely unable to do so. I think one of the things that's hard is the emotional state of pressure that you get from wanting to do everything. Prior to ivf, I had people come into my office from the very beginning and say, I want to do the least invasive option. I don't want to do ivf. It's the last thing I want to do. And that's a pretty good way to look at things. I don't think anyone should want to do ivf, but we have to remember our goal is to bring a home a baby. And so although you may want to do the least invasive options, the goal is not to just go through treatment options. The goal is to get you that family. And so if you're in one of those situations where you come in wanting a certain plan, but it's not the best plan for you, you could be wasting valuable time. And that really takes me to the final portion, which is you need to know your personal window of opportunity. This is something you need to discuss with your doctor to determine what yours is because it's going to be slightly different for everyone. But generally, if you are past 38, that window of opportunity is closing and could be closing very fast. So don't delay IVF if it's your best chance. Make sure you seek early treatment to make an informed decision. Infertility, just like in sports, it'all about making the right play at the right time. Don'miss your window of opportunity. If you're unsure about your own window of opportunity, talk to your fertility doctor, get your ovarian reserve tested and make a plan that maximizes your chances. Hopefully you like this episode. Maybe you're going through this process or a friend is and you can tell them about this episode. The most important thing is to always talk to your doctor so you can determine your own window of opportunity. If you liked this show and like this episode, give us a five star review on your favorite medium and tell all your friends and family about us. And the most important, as I always say, you love us, keep coming back and I look forward to talking to you again next week on Taco Bel Fertility Tuesday.