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Yom Kippur, Infertility, and the Wrong Path Taken

By Tracey Minella and David Kreiner MD

October 7th, 2011 at 9:25 pm

Today is Yom Kippur, the holiest day of the year in the Jewish faith. It’s a day of atonement for Jews. A day when they look back on the choices they’ve made and the goals they’ve set and ponder things like what mistakes or wrong decisions they may have made that have led them down a path they did not intend to take.

Sometimes, mistakes may have landed patients on the path of infertility.

Dr. Kreiner, of East Coast Fertility examines a common situation he encounters where poor decisions…or indecision…on behalf of patients and their GYNs leads them down a path they certainly did not intend:

A friend of mine was complaining to me about the trouble he got into with his homeowner’s association because he did not hide his empty garbage cans in his garage but left them behind his cars in front of his house.  It was 20 feet from the curb, he claimed, still distraught that he should have been scolded for breaking the rule.  “I didn’t know”.  That phrase, “I didn’t know” clicked in my brain as a recurrent declaration from the frustrated patients who I see every day.

My infertility practice is filled with patients who spent years of their lives all the time assuming that their fertility would be there when they were ready.  Some even mentioned their failed attempts at conceiving to their gynecologist who may have reassured them or if it were a more aggressive clinician, he may have put them on clomid for 3 to 6 months.  Meanwhile these women got older, many over 40 not realizing that time was chipping away at their fertility.  “They didn’t know”.

A fertility screen is a good way to assess annually what is happening to your fertility independent of your age.  This is accomplished by getting day 2 or 3 FSH and estradiol levels as well as an ultrasonographic antral follicle count.  An AntiMullerian Hormone level can be checked at any point in the cycle and likewise reflect the relative number of eggs left giving some reassurance about a person’s remaining fertility.

What do I as a reproductive endocrinologist who sees the damage done by this benign neglect on a daily basis do to wake people up to the fact that fertility is a temporary state that needs to be taken advantage of when the time is right?  Recently there was a report of doctors taking ovarian tissue/eggs from a child to preserve her fertility.  It’s hard for me to imagine that this is the future solution for the masses.  However, egg freezing technology is shortly becoming acceptable therapy with ever increasing success and lack of problems being noted.

Patients who are not in a position to execute their reproductive rights while they are still fertile should consider egg freezing when they do not have a partner to share in conception.  With a willing and available partner, freezing embryos is the most viable option.

But without question, couples who are ready to start a family, should seek assistance from a reproductive endocrinologist who specializes in helping those such as yourselves build your families.  Even when not covered by insurance, there are affordable options such as minimal stimulation IVF ($3900 at East Coast Fertility), grants and studies that make the process within reach of most people in need.   So do not become another victim to “I didn’t know”.  Take action, see a reproductive endocrinologist and get on the right path to building that family of your dreams.

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