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Transitioning To New Treatment

Medical Contribution By Dr. Ricardo Yazigi

Let’s face it – nobody starts the path toward parenthood wanting to need fertility treatment. But while most people aren’t nearly as squeamish about consulting a fertility specialist as maybe in the past, there’s still quite a bit of emotional adjustment that has to occur when the need for treatment becomes apparent.

While most couples begin their fertility journey by doing their research online, the wealth of information on the Internet is both empowering and anxiety provoking. With the constant flow of news about high-tech assisted reproductive techniques such as in vitro fertilization, it’s easy to think that walking into a fertility specialist’s office means you’re destined for IVF treatment. But that’s not always the case.

Dr. Ricardo Yazigi, who sees patients at Shady Grove Fertility’s GBMC facility in Baltimore, describes the reality that “IVF is more like a safety net for a large number of people. For others, it may be the only option.”

IVF Is Not Always The First Option

At Shady Grove Fertility, physicians take a “stepped care” approach to fertility treatment by balancing the goals of achieving the best possible chance of success with using the simplest and most cost effective approach.

While IVF is one of the most successful fertility treatments ever created, and has the highest per cycle success rate, many patients who pursue treatment at Shady Grove Fertility will be able to achieve a pregnancy with less intensive therapies. In fact, approximately one-third of the pregnancies conceived by patients at our Center are achieved with either ovulation induction (OI) or superovulation, coupled with intrauterine insemination (IUI).

Dr. Yazigi explains that determining the path of treatment can be a delicate matter for patients, and it’s not always best to bring out the most aggressive therapies first.

“Occasionally, we’ll have a first consultation with patients who are already sold on the idea of using IVF though I may feel like they’ll likely be more successful with other treatments,” said Dr. Yazigi. “While some patients may feel like they’re being encouraged to take a step back, our goal is to tailor a treatment plan that we feel provides the best success for the patient.”

If First You Don’t Succeed…Be Flexible

Besides those first very tough choices to consult a specialist and then decide on an initial treatment plan, it’s important to maintain a perspective of flexibility. If the beginning treatment option is unsuccessful, your physician may recommend transitioning to a new type of treatment.

Often patients are unaware that using the same fertility treatment protocol over and over without success can be like spinning your wheels. Each type of treatment, from simple ovulation-induction with medication like Clomid to the more advanced IVF, has its own highly measured rate of success. Included in those success rates are time periods or number of treatment attempts. Experts are able to gauge not only what type of treatment works best for different conditions, but also within what time frame.

“For any given treatment modality, a patient’s chances of pregnancy continue to increase over time to a certain point, at which time the success rate goes flat,” says Dr. Yazigi.

At that point, patient and physician will discuss alternatives for moving forward in changing their protocol toward conception success. Dr. Yazigi says that it’s not uncommon for some patients to feel the urge to resist treatment transitions at first; it’s just a matter of educating them on the fact that this is the proper direction for them.

“Many patients concerns about moving to a new treatment type are related to their expectations,” Dr. Yazigi explains. “Sometimes they’re influenced by friends and stories they heard or read about infertility conditions and treatments. Our goal is to educate them about the uniqueness of their case and clarify misinformation. Comparisons to other patients’ situations often aren’t accurate or helpful.”

Besides one-to-one conversations with physicians, patients are also provided opportunities to speak with their assigned primary nurse, professional counseling staff, and make use of resources on Shady Grove Fertility’s website such as online webcasts and other educational resources.

Still, Dr. Yazigi emphasizes that equal attention is paid to the prospect for success with each and every patient’s plan.

“You might say that we conduct all of our procedures and treatments with a ‘high-tech mentality’,” said Dr. Yazigi. “The thoroughness that goes into each treatment is extreme. ‘Low-tech’ doesn’t imply ‘less important’ or that it’s handled with any less concern than IVF.”

Focusing on the end goal – a baby – can make the transition through each step feel like the labor of love that it is.

To schedule an appointment to discuss your fertility options with one of our physicians, please contact our patient liaisons at 888-761-1967, or fill out our online request form.

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