Most patients don't know they'll need fertility treatment until a problem occurs. "It's our work to do before going into the IVF process to give ourselves the best odds," a renowned fertility researcher told us.
“What I Wish I’d Known About IVF”: A Patient’s Story and an Expert Doctor’s Wisdom
Updated Aug. 28, 2024
In 1978, Louise Brown in the UK was the world’s first documented child born through in vitro fertilization. Over the past four decades, assisted reproductive technology (ART) has become a common path to parenthood.
In fact, in 2021 alone, statistics from the US Department of Health and Human Services suggest 86,146 U.S. infants were born using ART, with in vitro fertilization (IVF) being the most common method. IVF is a medical technique that assists with conception by combining eggs and sperm outside the body in a laboratory setting, usually led by an embryologist or other trained specialist with doctoral credentials.
IVF is implemented in a variety of scenarios, including with patients who have had trouble conceiving, patients who have conceived but have lost multiple pregnancies, patients who have experienced medical issues or treatments that may have affected their reproductive health, and patients who are of advanced maternal age. When a doctor—often a reproductive endocrinology and infertility doctor or “REI”—has recommended IVF as a course of treatment, this can help the patient ensure her reproductive system and uterine environment are optimally prepared for a healthy pregnancy. IVF also presents the possible advantage of genetic testing of the embryo to help ensure the success of carrying to full-term and delivering a healthy child.
Cleopatra Kamperveen, PhD is a scientist, tenured University of Southern California professor, and pioneer in the field of fertility biohacking. Known as Dr. Cleopatra to her clients and followers, she explains a few reasons that in today’s world, conceiving, maintaining a pregnancy, and ensuring the birth of a healthy baby are more challenging than ever. Dr. Cleopatra cites a statistic from the World Health Organization: Approximately 17.5% of adults globally, or one in six, struggle with infertility issues (which include miscarriage, based on definitions within the medical community). Additionally, nearly half of all children are affected by chronic mental or physical health conditions. Just two examples of factors influencing this effect are the chemicals we’re exposed to in modern society, and the stresses of our high-pressure, fast-paced times.
However, Dr. Cleopatra shares a valuable insight that even many fertility doctors don’t discuss: “The beautiful thing is that almost every challenge children face, and almost every challenge of fertility and reproduction, is more epigenetic in nature than it is genetic in nature.” What Dr. Cleopatra is suggesting is that based on her research, many cases of infertility aren’t forever doomed. That’s because epigenetics is the study of how your behaviors and environment can lead to changes that affect the function of your genes. Unlike genetic changes, epigenetic changes are reversible and don’t alter your DNA sequence, but they can influence how your body interprets a DNA sequence.
To overcome these obstacles, Dr. Cleopatra stresses the importance of a paradigm shift. We can’t stick to the old ways in this new era, which is vastly different from the one our grandparents experienced. Even before you’re ready to start a family, it’s vital to know how to take care of your fertility and the future health of your children.
Ahead, you’ll discover why Dr. Cleopatra believes proper preparation is key for natural conception and if you’re considering IVF. She discusses some of the toughest challenges couples face during this journey. Also, Francesca, a 42-year-old woman who was undergoing her second IVF cycle at the time of this interview, shares her personal experiences.
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Preparation for IVF
We often talk about the journey of pregnancy as being those critical 40 weeks, but according to Dr. Cleopatra, the 120 days leading up to conception deserve just as much attention. She’s developed a trademarked process she calls the “Primester protocol,” a method rooted in science that goes well beyond the nutrition recommendations that many obstetricians or reproductive doctors make. Dr. Cleopatra suggests this preparation period is all about enriching your emotional well-being, strengthening relationships, and tuning up biological aspects—all to spark desired epigenetic changes.
These changes can reduce your biological age and improve the quality of your eggs. An appropriately guided preparatory period can lay a strong foundation for your health (and your baby’s) right from the start—even before conception. Dr. Cleopatra explains: “In the case of our biology and our reproductive biology, it’s preparing our systems, our organs, our cells, our DNA, to function in the way that they are intended to in the best way possible.”
IVF success depends on “healthy raw material”
IVF is sometimes perceived as a miraculous fix for fertility challenges, but it still depends significantly on the quality of the eggs and sperm—the “raw material,” as Dr. Cleopatra describes it. Even with its advanced technology, IVF doesn’t promise a surefire success; about 65% of individuals manage to take a baby home after enduring up to six cycles. Each cycle can cost as much as $30,000 and take a year to complete.
“IVF cannot give you healthy raw material,” Dr. Cleopatra explains. IVF stimulates the body to produce as many follicles as possible for egg retrieval. However, the preparatory work can increase the quantity and quality of eggs, which affects their fertilization and development.
Each stage, from fertilization to blastocyst development and chromosomal testing, depends on the strength of this raw material. Weak eggs typically mean lower chances of progression through these stages. “It’s really our work to do before going into the IVF process to give ourselves the very best odds of being able to make it to each of those stages and to have positive results at each of those stages,” she adds.
IVF can be emotionally and physically taxing
“I think there’s a lot of individual variability in how tough the experience of IVF is for people. I would say, on average, it’s really tough, both emotionally and physically. It’s also very time-consuming and kind of all-consuming in life in general,” Dr. Cleopatra says.
Francesca, who is gearing up for her second round of IVF, is familiar with these challenges. She also discusses the costs involved: “It is such a big investment, but it is worth it. My husband and I wish we had saved more. I also had to switch to part-time work from home because undergoing IVF is like having a full-time job and focusing on being as healthy as I can be.”
Francesca also overcame her initial fear of needles with a perspective shift: “I did not know I was going to have to give myself shots…but just thinking how this could be our answer to having a baby helped me overcome that fear very quickly.” She credits the extensive support from her clinic with helping her feel more at ease with the injections.
IVF medications can cause side effects like hot flashes, mood swings, headaches, and bloating. These symptoms can feel like pregnancy signs or a particularly tough period but are temporary, signaling that the treatment is taking effect. At times, ovarian hyperstimulation can occur, which should be supervised by a doctor as part of the egg retrieval monitoring process.
Almost any partnership endures hardships during IVF
“The other thing that I notice is that it’s very hard on the relationship,” says Dr. Cleopatra. Whether the fertility issues stem from the man, the woman, or both, the root cause often remains a mystery, labeled as unexplained infertility. Francesca and her husband faced this when their fertility struggles were deemed unexplained. Reflecting on the experience, Francesca admits, “That really took a toll on our relationship. I was also putting so much pressure on myself because I am the one with the responsibility of carrying the baby.”
Dr. Cleopatra points out that while traditional medicine might stop at calling these situations unexplained infertility, her team digs deeper to find answers. Yet, many still find themselves struggling with uncertainty, which can feel isolating and adds a significant strain on relationships, even with the most supportive partner.
Highlighting the important role of community support, Dr. Cleopatra emphasizes how it can alleviate some of the pressures on couples. When a friend says, “I went through IVF, please let me know it would be helpful for me to share my experience,” take their offer and allow them to become a cheerleader for you. Many IVF patients find support and suggestions in online groups or message boards. Dr. Cleopatra emphasizes how putting oneself in a healthy emotional state of mind is itself an epigenetic strategy that’s demonstrated to increase the likelihood of success. Seeking support, knowing that a partner and even a doctor will have their limitations, is one way to foster an outcome worth celebrating.
Why IVF success rates can be so low with age
“One of the reasons the odds of success get so low with age is because it was not designed to address age-related declines in fertility, which are really about the health of raw material,” clarifies Dr. Cleopatra. She notes that IVF was initially created to overcome physical barriers, such as blocked fallopian tubes, which was precisely the challenge faced by the woman who had the first IVF baby.
Individuals may face issues like diminished ovarian reserve or poor egg quality as they age. These problems can arise not only due to age but also due to a mismatch between the environment our ancestors evolved in and the one we find ourselves in today—complete with its psychological, social, chemical, and environmental stresses. These factors are leading to earlier declines in egg quality and ovarian reserve. Today, these are the primary reasons people turn to IVF, though it was not what the procedure was originally intended to address. “So it’s hard for it to be really successful in those cases, and I’m glad it exists to be able to help women prolong their reproductive span, but really, they have to prolong their reproductive spans. They’re the only ones who can do that.”
Fortunately, just like the brain exhibits plasticity, research suggests so too does our biological age and the age of our eggs. Focusing on this adaptability is key to understanding and improving fertility outcomes.
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Originally Published: August 28, 2024
