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Have to Have a Baby Fast- Expedited Fertility Treatment/ Success Rates Matter
Dr. Mary Hinckley describes the process of expedited fertility treatment plans and how to find success.
Featuring:
Learn more about Mary Ramie Hinckley, MD, REI
Mary Hinckley, MD, REI
Dr. Hinckley is a board certified Reproductive Endocrinologist who completed her training at Stanford University Medical Center. She says her greatest joy is helping patients to realize their dreams in creating a family, but she also enjoys participation in clinical and laboratory studies.Learn more about Mary Ramie Hinckley, MD, REI
Transcription:
Bill Klaproth: So you want to have a baby fast? Well, how can you expedite fertility treatment? Well, let's find out what Dr. Mary Raimie Hinckley a physician at Reproductive Science Center of the San Francisco Bay Area. This is Fertile Edge, a podcast by the Reproductive Science Center of the San Francisco Bay Area. I'm Bill Klaproth, Dr. Hinckley, always great to talk with you. So what scenarios are involved or a woman would want to have a baby fast?
Dr. Mary Raimie Hinckley: Well, we all know it takes a good nine months to cook that baby. So nothing can happen too fast in this world, but there are lots of scenarios where I have patients who come in and say, Dr. Hinckley help me, I need to have a baby fast. Because they really have found themselves in a situation that they never anticipated being in. And perhaps it was their own health that kept them from being able to move forward right away. Perhaps it was job, it often is finances or waiting for insurance benefits. Sometimes I see actually that someone's about to change insurance or change their job or move, and they want to expedite treatment as quickly as possible. These are all scenarios. Of course, we have patients that have been diagnosed with cancer and are looking at chemotherapy and wanting to move forward with treatment very quickly, not so much to have a baby but to create the embryo. So we're used to moving fast in our world. We like that we are not scared of that. But we also like to give patients options so that they really know how fast do they have to move and they don't add extra stress onto their already stressful life.
Host: So for a woman who finds herself in this position with this sense of urgency, does she really need to rush?
Dr. Hinckley: Yeah. So figuring that out is part of what I'm there to do is to help them see, do they need to move forward in a very expedited fashion, but do it in a well-organized way? Do they need to feel that panic? And sometimes that's really helping them understand age. You wouldn't believe how many people feel that pressure because of their parents. And the society telling them they need to have a baby. And when they come to me, I can help them see that maybe that's not so critical, they have a little more give than they thought based on their age. On the other hand, sometimes I see patients that because they're so fit and healthy and have been, you know, Kickboxing and running marathons. They think that their age doesn't matter when really that, that clock does matter. And that those ovaries do age, even if they're keeping themselves in at most health. And usually, that's around 38, we start to see that shift. I also am able to say, okay, what is the, what are your options, and what are your treatment, and what's your goals? So if I see someone who's in their mid-thirties, but wants to have three or four children, that's a situation where yes, we do need to get a move on. We can't lollygag around. We have to keep going and try to get you moving because we know each pregnancy takes nine months. Then it's about a year until most doctors would recommend for you to try again. And a lot of people wanted to, Oh, can I have twins and have them quick? Well, what we now know is even though a lot of those twins are so cute that they don't all have, I have such good health records in terms of getting to a full-term delivery and getting out of the hospital without having to pay a visit to the NICU or in potentially have some complications from prematurity. So twins is not the answer to having your instant family. The answer is to get pregnant efficiently with baby number one, turn right back around and be ready to be pregnant with baby number two, that's going to be the safer, healthier option. And then there's a situation too, where I have patients who have a known problem and that might be the tubes are blocked or they don't ovulate, or there's a sperm problem. And those patients don't need to rush, but they really shouldn't wait around because ultimately, they are going to need to do something more aggressive to get pregnant. The problem is not going to solve itself. And for those patients, it's important for me to help them understand that being aggressive early, when you're younger or have better ovarian reserve is always going to give you a higher success rate. So even though you may not be ready to have a baby today. If you know, you're going to need to do fertility treatment, like IVF to have a baby, because your tubes are blocked, you might as well do it when you're young, cause you're more likely to be successful. And when you're ready to try, that will help you expedite your treatment.
Host: Yeah, that's a smart point for a woman who knows that she will need IVF in the future. It's a good, smart way to think about that and plan ahead. So for a woman who, for whatever reason has waited too long, what choices can she make to expedite treatment?
Dr. Hinckley: Yeah, well, some of the things they can do is be very efficient in their workup. So when I have a patient comes into my office and I love patients that actually haven't seen other doctors and I'm the first person I get to go through their history with them and really explain some things. That's one of my favorite things to do, but it does mean it's going to take another whole month till I really have a plan for you because there's some important information that I need. So if you're able to really get your workup done in one month, that's going to help us fast track you into the treatment to help you get pregnant. And that would include doing your ovarian reserve testing, which is typically doing lab tests on day two or three of your cycle. It may include checking your tubes or checking your uterus with a history of Cellfina gram or a saline sonogram. Usually between days five and nine of your cycle. Having your partner get his sperm test during those first two weeks. And then if you wish to go forward with any recessive disease testing, this is a genetic test to look to see if you and your partner might both carry the same rare mutation. Getting all of this done upfront is going to save you time on the back end because those are the things that would slow down your getting into cycle once we're ready to start treatment. So finish those upfront. And then the second thing, the other choices that you can make are really on your treatment. And, you know, traditionally we recommended that patients would start with something simple like Clomid, that's a pill then add insemination. And then only if that didn't work, maybe consider moving slowly towards IVF. Well, what we now know is that success rates with IVF, especially in some clinics in the United States, maybe not all clinics have dramatically increased over the last five to eight years. And that has benefited patients because instead of dallying around in these low, low success rate cycles, so a typical insemination or IUI cycle has success rates between five to 10% for most people. So rather than spending time in those five to 10 percenters to jump straight to IVF where we can optimize each egg, each sperm, and get you more success in a shorter period of time is going to be the choice that you'll be able to make when you're presented with the option. And maybe one that you want to choose. When we do IVF as well, we have choices. And again, this gets a little more in detail than maybe people want to listen to right now, but some of those choices will include whether or not you want to test the embryos. And that can be a time-saving measure for many people, especially over the age of 37. How many embryos to transfer, and whether you want to do one at a time that's been tested, that can be a time-saving measure, and then even checking your uterus with newer tests that are available such as the endometrial receptivity analysis. These are ways to find your window of implantation and treat some of the things that would slow you down getting pregnant in a more traditional sense. Even with IVF where we can get answers quick and then be able to get that treatment on the front end. So that the first time you try, we're putting the best embryo into the best uterus so that it works on the first time.
Host: So there's a lot of ways to expedite treatment. So let me ask you this then, the next level, what specifically can a woman do to expedite success?
Dr. Hinckley: Yeah, so doing good research ahead of time can be really important. You know, it's amazing how much is out there on the internet. And you can really dive deep into a clinic and figure out their success rates by looking at the CDC and the S the SART S A R T success rates online. And while that doesn't tell you everything, it can certainly let you know, if a clinic is performing up to standard. So go to a good clinic, go to a good doctor and make sure there aren't long waitlists at that clinic. Find out if the doctor communicates well with patients and is receptive to moving efficiently and sometimes that means talking to your friends, which is hard to do when you're somewhat still bearing some shame about fertility, which we try to help people not have these days. But many people are still hesitant to talk to friends and family about infertility and the best treatment, but that can help them get to the right place first. And then while they're doing that, they're optimizing themselves, be getting in the best shape they can be in with a BMI less than 28, a good diet, maybe low inflammation, some general exercise, good sleep. Those sorts of things make you ready to go. And then to really listen to the doctor and the way in which they want you to do the workup and the cycle, to be available to your nurse who's getting you and says, go do these labs go when you're supposed to, do those things, if you don't do them at the right time and the right place, all of a sudden we have to wait for the next period. And with women's cycles, you can't just jump in in the middle. You have to wait. And that weight feels so long when you're wanting to start something like fertility treatment. So again, I really encourage people to take charge of it themselves and unlike maybe other doctors they've been to in the past that tell them what to do and they go do it because to really understand what's needed being, keep a little notebook, write things down, keep your records, follow up, make sure things are done. And I think that's going to help you navigate this new territory, and help you find your way through to get to the treatment that's going to give you the greatest success in the shortest amount of time.
Host: Well, Dr. Hinckley, thank you for your time we always appreciate talking with you. So any final thoughts on expediting fertility treatments for a woman who wants to have a baby fast?
Dr. Hinckley: Oh, you're welcome. And you know, it is so rewarding to have someone come in and be able to come through a cycle quickly, make a good embryo, get pregnant, and then be able to go on with their life because usually, they've spent a good, good deal of time thinking about this prior to even coming in my office. And so while I might feel like it's a fast cycle, I know in their minds, it's not always, but it's nice to be able to then put this behind them and focus on the future and that pregnancy and taking care of themselves and getting a healthy baby and beginning that life they've always wanted.
Host: Absolutely great thoughts and the perfect way to wrap this up again, Dr. Hinckley, thank you so much for your time. We appreciate it.
Dr. Hinckley: You're welcome. Take care.
Host: That's Dr. Mary Raimie Hinckley. And to get connected with Dr. Hinckley or another physician, please visit RSCBayArea.com. That's RSCBayArea.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Fertile Edge by Reproductive Science Center of the San Francisco Bay Area. I'm Bill Klaproth. Thanks for listening.
Bill Klaproth: So you want to have a baby fast? Well, how can you expedite fertility treatment? Well, let's find out what Dr. Mary Raimie Hinckley a physician at Reproductive Science Center of the San Francisco Bay Area. This is Fertile Edge, a podcast by the Reproductive Science Center of the San Francisco Bay Area. I'm Bill Klaproth, Dr. Hinckley, always great to talk with you. So what scenarios are involved or a woman would want to have a baby fast?
Dr. Mary Raimie Hinckley: Well, we all know it takes a good nine months to cook that baby. So nothing can happen too fast in this world, but there are lots of scenarios where I have patients who come in and say, Dr. Hinckley help me, I need to have a baby fast. Because they really have found themselves in a situation that they never anticipated being in. And perhaps it was their own health that kept them from being able to move forward right away. Perhaps it was job, it often is finances or waiting for insurance benefits. Sometimes I see actually that someone's about to change insurance or change their job or move, and they want to expedite treatment as quickly as possible. These are all scenarios. Of course, we have patients that have been diagnosed with cancer and are looking at chemotherapy and wanting to move forward with treatment very quickly, not so much to have a baby but to create the embryo. So we're used to moving fast in our world. We like that we are not scared of that. But we also like to give patients options so that they really know how fast do they have to move and they don't add extra stress onto their already stressful life.
Host: So for a woman who finds herself in this position with this sense of urgency, does she really need to rush?
Dr. Hinckley: Yeah. So figuring that out is part of what I'm there to do is to help them see, do they need to move forward in a very expedited fashion, but do it in a well-organized way? Do they need to feel that panic? And sometimes that's really helping them understand age. You wouldn't believe how many people feel that pressure because of their parents. And the society telling them they need to have a baby. And when they come to me, I can help them see that maybe that's not so critical, they have a little more give than they thought based on their age. On the other hand, sometimes I see patients that because they're so fit and healthy and have been, you know, Kickboxing and running marathons. They think that their age doesn't matter when really that, that clock does matter. And that those ovaries do age, even if they're keeping themselves in at most health. And usually, that's around 38, we start to see that shift. I also am able to say, okay, what is the, what are your options, and what are your treatment, and what's your goals? So if I see someone who's in their mid-thirties, but wants to have three or four children, that's a situation where yes, we do need to get a move on. We can't lollygag around. We have to keep going and try to get you moving because we know each pregnancy takes nine months. Then it's about a year until most doctors would recommend for you to try again. And a lot of people wanted to, Oh, can I have twins and have them quick? Well, what we now know is even though a lot of those twins are so cute that they don't all have, I have such good health records in terms of getting to a full-term delivery and getting out of the hospital without having to pay a visit to the NICU or in potentially have some complications from prematurity. So twins is not the answer to having your instant family. The answer is to get pregnant efficiently with baby number one, turn right back around and be ready to be pregnant with baby number two, that's going to be the safer, healthier option. And then there's a situation too, where I have patients who have a known problem and that might be the tubes are blocked or they don't ovulate, or there's a sperm problem. And those patients don't need to rush, but they really shouldn't wait around because ultimately, they are going to need to do something more aggressive to get pregnant. The problem is not going to solve itself. And for those patients, it's important for me to help them understand that being aggressive early, when you're younger or have better ovarian reserve is always going to give you a higher success rate. So even though you may not be ready to have a baby today. If you know, you're going to need to do fertility treatment, like IVF to have a baby, because your tubes are blocked, you might as well do it when you're young, cause you're more likely to be successful. And when you're ready to try, that will help you expedite your treatment.
Host: Yeah, that's a smart point for a woman who knows that she will need IVF in the future. It's a good, smart way to think about that and plan ahead. So for a woman who, for whatever reason has waited too long, what choices can she make to expedite treatment?
Dr. Hinckley: Yeah, well, some of the things they can do is be very efficient in their workup. So when I have a patient comes into my office and I love patients that actually haven't seen other doctors and I'm the first person I get to go through their history with them and really explain some things. That's one of my favorite things to do, but it does mean it's going to take another whole month till I really have a plan for you because there's some important information that I need. So if you're able to really get your workup done in one month, that's going to help us fast track you into the treatment to help you get pregnant. And that would include doing your ovarian reserve testing, which is typically doing lab tests on day two or three of your cycle. It may include checking your tubes or checking your uterus with a history of Cellfina gram or a saline sonogram. Usually between days five and nine of your cycle. Having your partner get his sperm test during those first two weeks. And then if you wish to go forward with any recessive disease testing, this is a genetic test to look to see if you and your partner might both carry the same rare mutation. Getting all of this done upfront is going to save you time on the back end because those are the things that would slow down your getting into cycle once we're ready to start treatment. So finish those upfront. And then the second thing, the other choices that you can make are really on your treatment. And, you know, traditionally we recommended that patients would start with something simple like Clomid, that's a pill then add insemination. And then only if that didn't work, maybe consider moving slowly towards IVF. Well, what we now know is that success rates with IVF, especially in some clinics in the United States, maybe not all clinics have dramatically increased over the last five to eight years. And that has benefited patients because instead of dallying around in these low, low success rate cycles, so a typical insemination or IUI cycle has success rates between five to 10% for most people. So rather than spending time in those five to 10 percenters to jump straight to IVF where we can optimize each egg, each sperm, and get you more success in a shorter period of time is going to be the choice that you'll be able to make when you're presented with the option. And maybe one that you want to choose. When we do IVF as well, we have choices. And again, this gets a little more in detail than maybe people want to listen to right now, but some of those choices will include whether or not you want to test the embryos. And that can be a time-saving measure for many people, especially over the age of 37. How many embryos to transfer, and whether you want to do one at a time that's been tested, that can be a time-saving measure, and then even checking your uterus with newer tests that are available such as the endometrial receptivity analysis. These are ways to find your window of implantation and treat some of the things that would slow you down getting pregnant in a more traditional sense. Even with IVF where we can get answers quick and then be able to get that treatment on the front end. So that the first time you try, we're putting the best embryo into the best uterus so that it works on the first time.
Host: So there's a lot of ways to expedite treatment. So let me ask you this then, the next level, what specifically can a woman do to expedite success?
Dr. Hinckley: Yeah, so doing good research ahead of time can be really important. You know, it's amazing how much is out there on the internet. And you can really dive deep into a clinic and figure out their success rates by looking at the CDC and the S the SART S A R T success rates online. And while that doesn't tell you everything, it can certainly let you know, if a clinic is performing up to standard. So go to a good clinic, go to a good doctor and make sure there aren't long waitlists at that clinic. Find out if the doctor communicates well with patients and is receptive to moving efficiently and sometimes that means talking to your friends, which is hard to do when you're somewhat still bearing some shame about fertility, which we try to help people not have these days. But many people are still hesitant to talk to friends and family about infertility and the best treatment, but that can help them get to the right place first. And then while they're doing that, they're optimizing themselves, be getting in the best shape they can be in with a BMI less than 28, a good diet, maybe low inflammation, some general exercise, good sleep. Those sorts of things make you ready to go. And then to really listen to the doctor and the way in which they want you to do the workup and the cycle, to be available to your nurse who's getting you and says, go do these labs go when you're supposed to, do those things, if you don't do them at the right time and the right place, all of a sudden we have to wait for the next period. And with women's cycles, you can't just jump in in the middle. You have to wait. And that weight feels so long when you're wanting to start something like fertility treatment. So again, I really encourage people to take charge of it themselves and unlike maybe other doctors they've been to in the past that tell them what to do and they go do it because to really understand what's needed being, keep a little notebook, write things down, keep your records, follow up, make sure things are done. And I think that's going to help you navigate this new territory, and help you find your way through to get to the treatment that's going to give you the greatest success in the shortest amount of time.
Host: Well, Dr. Hinckley, thank you for your time we always appreciate talking with you. So any final thoughts on expediting fertility treatments for a woman who wants to have a baby fast?
Dr. Hinckley: Oh, you're welcome. And you know, it is so rewarding to have someone come in and be able to come through a cycle quickly, make a good embryo, get pregnant, and then be able to go on with their life because usually, they've spent a good, good deal of time thinking about this prior to even coming in my office. And so while I might feel like it's a fast cycle, I know in their minds, it's not always, but it's nice to be able to then put this behind them and focus on the future and that pregnancy and taking care of themselves and getting a healthy baby and beginning that life they've always wanted.
Host: Absolutely great thoughts and the perfect way to wrap this up again, Dr. Hinckley, thank you so much for your time. We appreciate it.
Dr. Hinckley: You're welcome. Take care.
Host: That's Dr. Mary Raimie Hinckley. And to get connected with Dr. Hinckley or another physician, please visit RSCBayArea.com. That's RSCBayArea.com. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is the Fertile Edge by Reproductive Science Center of the San Francisco Bay Area. I'm Bill Klaproth. Thanks for listening.