Female infertility – For women having difficulty getting pregnant with IVF

Some case study findings from university supervised research gives reason for hope for thousands of women…

It wasn’t ‘til about six or seven years ago that I first heard what I often now hear several times each week:

‘Everyone knows someone undergoing IVF (In Vitro Fertilisation) and still having trouble getting pregnant.’

Since then, I’ve come to understand just how deeply depressing and utterly soul-destroying repeated failures at trying to become pregnant can be for so many women.

If you’re reading this post, you’re probably experienced female infertility, and/or quite possibly IVF failure, or you sympathise with women who do, and their partners.

Difficulty conceiving is a significant problem in many countries.  For example, in my country, Australia, ‘IVF’ is one of the most searched terms on the internet – after you get past ‘Tinder’, ‘get rich quick schemes’, and the names of reality TV and rock stars, of course!

There is a strong demand for IVF, but the big question to ask about it is….

Just what is the success rate of IVF?

woman pregnancy testIt must be of concern to women experiencing IVF failure that credible government-endorsed statistics from several countries show without doubt that, across all IVF cycles (i.e. for women of all ages, races, family situations etc.) there are far more IVF failures than IVF successes (success being defined as the birth of a live baby, rather than just initial pregnancy).

Some IVF clinics might try to have you believe otherwise and provide figures to prove their point; but there can be several reasons their figures differ from formal statistics by a wide margin, in addition to the fact that success statistics do differ for different age ranges and the reality that some clinics do achieve results above formal overall statistics.

The topic of IVF success rates and the success rates of individual clinics can be quite complicated – even confusing – yet it’s so important for a woman intending to consult a clinic to have a realistic understanding of her chances of success.  For this reason an entire future post will address this topic, and provide a list of questions for you to ask your intended clinic to help you make an informed decision.

The problems of female infertility and difficulty becoming pregnant – even using IVF – have been central to my professional life for a few years now. During that period I conducted a pilot study into a therapeutic approach to help women experience success with IVF.  I also completed a university supervised, ethics controlled, triple triangulated and highly referenced research study (i.e. in research circles, a serious work) which produced some attention-getting results – but more on that a little later in this post.

For now, as a male researcher into what might be seen to be primarily a female problem, let me just say that one of the most powerful insights from my work was the power of maternal drive. I doubt any male, or any woman without children and not trying to get pregnant, would have any real perception of just how desperate and depressed many women who suffer multiple failures when trying to conceive actually feel.  One of the research participants summed it up with the following statement:

The drive for a woman to have a baby is just inordinately strong.  It’s clear and absolute…women will do absolutely anything to get that child.

Another summed it up as follows:

You’re looking at stress – devastating.  You get to the point where you’re saying, ‘What’s going to hurt more, another failed cycle or losing the dream?’

For me these provided incredibly powerful insights!

What triggered my pilot study and research?

IVF treatment.My interest in this topic began when a young woman called my psychotherapy, counselling and hypnotherapy clinic and asked if I could help with a needle phobia because she had to use them in the early phases of her IVF cycle – and there was a problem.  We agreed a session time, and I asked for her name in the normal manner.

That’s when she told me the session wasn’t for her – it was for her husband.  She went on to explain their agreement that he would be with her for all phases of the process, but was not sticking to his end of the bargain – because he fainted every time she gave herself the injection.

It was at that very moment that I decided this had to be a very interesting area of professional practice to investigate further!  And that young woman eventually became the first participant in my pilot study.

However, the case study snippets I am about to present are about other participants, perhaps more typical of the women having difficulty conceiving whom I see in my clinic.

Just before I provide those snippets, let’s provide a couple of important definitions so we’re on the same page with terminology for the rest of the read.

A couple of important definitions

Definition of infertility

Infertility is defined by the World Health Organisation (WHO) as:

“a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse.”

You can check out more on the topic from WHO at: http://www.who.int/reproductivehealth/topics/infertility/definitions/en/

The American Pregnancy Association adopts the 12 months period recommended by the WHO, as does Johns Hopkins Fertility Centre of the USA.  You can read the latter’s definition in full at:

http://www.hopkinsmedicine.org/fertility/conditions/infertility_defined.html

A most important component of the WHO definition is the 12 months time period. In more recent years, that period has been reduced to just six months by many IVF clinics, and this is one explanation of why far better success rates than the government endorsed figures are professed by various IVF clinics.  After all, if you are beginning IVF six months before the WHO would even diagnose you as infertile, your chances of success are probably increased…but the question would always remain, ‘would you have become pregnant naturally in the remaining six months of the recommended 12 months trying naturally.

Why do some clinics recommend commencing IVF after six months of unsuccessfully trying to get pregnant, mainly for some women, when WHO maintains its 12 months standard?  Well, the changing attitude of some respected organisations is often taken out of context.  Take for example the Mayo Clinic of the USA…

The Mayo Clinic defines infertility in a similar fashion as WHO, with the exception that it states that infertility could be diagnosed after six months of failing to become pregnant despite frequent unprotected sex at the right time of the cycle. The clinic defines the six months aspect of their definition to apply in special circumstances.  For more details visit http://www.mayoclinic.org/diseases-conditions/infertility/basics/definition/con-20034770

The National Centre for Biotechnical Information of the USA seems to indicate that the six months diagnosis point might be regarded to be more IVF clinic driven than formal organisation (such as WHO) driven when it states that:

Infertility is customarily defined as the inability to conceive after 1 year of regular unprotected intercourse. The infertility evaluation is typically initiated after 1 year of trying to conceive, but in couples with advanced female age (> 35 years), most practitioners initiate diagnostic evaluation after an inability to conceive for 6 months.

(More at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505167/)

At this point I should mention that, in this blog, I will be dealing primarily with female infertility, which in the context of the material just covered, simply means that the inability to conceive over the period of time in the definitions can be found to be caused by a problem with the female physiology.  However, it is important to keep in mind that males contribute to a significant number of infertility issues for couples, and combined problems with both the male and female in the relationship also contribute to fertility challenges (which is my preferred term).  I will address these issues in a future post.  For now, let’s return to our definitions:

Definition of ‘unexplained infertility’

Infertility. Medical Concept on Blue Background.Another common term heard when discussing IVF failure and female infertility is ‘Unexplained Infertility’.  Wikipedia defined it as follows:

‘Unexplained infertility is infertility that is idiopathic in the sense that its cause remains unknown even after an infertility work-up, usually including semen analysis in the man and assessment of ovulation and fallopian tubes in the woman.’

‘Idiopathic’ simply means the cause is unknown or cannot be explained by current medical knowledge.  In other words, if your doctor tells you that your problem is unexplained infertility, it effectively means that you meet the definition of infertility, but there is no known medical reason for your condition.

So just what does cause ‘unexplained infertility’?

From my clinic experience, I believe that two possible reasons behind unexplained infertility (at least to some extent) are;

  • Stress from a number of sources, and my formal research identified several specific sources, which I’ll address in a future post
  • Mental blocks or ‘imprints’ from an earlier experience in your life that might contribute to your difficulty becoming pregnant. (If you’d like to know more about these imprints you can get free access to an e-version of Imprints for Success, a book I co-authored on the subject with Gold Coast medical general practitioner, Dr. Gerry Flynn, at https://alanpatching.wistia.com/medias/gswflyoeb9

Now these assertions may well attract debate from some doctors because most research on the subject to date has concluded there is a link between stress and IVF outcome but there is no clearly definite proof that stress definitely causes IVF failure.

However, the objectors might be a little out of date regarding recent research. A ground-breaking world first research study published in the USA in 2014 (by Lynch and others) used objective stress bio-markers in saliva, rather than the usual survey questions seeking subjective opinion responses, to conclude that high levels of stress:

  • Reduced one’s chances of becoming pregnant, and
  • Increased time to pregnancy

The Lynch research focused on women trying to become pregnant naturally, but I believe it’s reasonable to conclude that, if stress has a negative effect on women becoming pregnant naturally, then the often strongly stress-laden circumstances associated with an IVF cycle might well be a reason that many women have trouble becoming pregnant using IVF.  It just seems like a common sense conclusion to me, and it’s certainly one endorsed by my clinic observations, and pilot study findings.

So now let’s return to those key case study snippets.

Key points from pilot study cases

  • In the full pilot study, 13 out of 15 participants became pregnant
  • A few got pregnant naturally on the cycle following their beginning to use the study programme to deal with the above-mentioned stress and mental imprints, as a last resort before commencing IVF
  • Eight women from the pilot study agreed to participate in a follow-up formal qualitative research study to determine the stressors that might have contributed to their difficulty conceiving (I will provide details of the categories of stress identified by the research study in a future blog)
  • These eight women had collectively experienced 51 previous IVF failures
  • Seven out of the eight became pregnant within three cycles using the programme to address stress and negative mental imprints in concert with their IVF programme
  • Those figures are well in excess of any credible published results concerning IVF outcomes
  • Four of these became pregnant on the first round of using that programme
  • Four of the seven were in their late thirties or early forties, with the oldest being 43
  • One of these women had undergone 14 individual previous embryo transfers without success
  • Another, from the younger group (aged 30) had undergone a dozen ART (Assisted Reproductive Technologies) cycles. ART includes IVF but also simpler procedures including Intra Uterine insemination (IUI) procedures and similar
  • Overall 13 of the 15 women who underwent the programme (most in concert with IVF and a couple while trying to get pregnant naturally) became pregnant and delivered healthy babies. There also were some withdrawals from the programme, notably one because of a death in the family, and one following a relationship breakup

These points summarise key pilot study and follow-up research outcomes from a programme that addresses both stress and negative imprints for women undergoing IVF.

For access to a summary infographic of the research and a detailed video case study of one of the ‘difficult case’ study participants, visit www.ivf-assist.com and click the purple banner in the right hand column.

So, what do these study outcomes mean for you?

egg is holding by a pipet and a neeldleMy research didn’t involve a large group of women – that was unnecessary for a pilot study and would have extended the time to an outcome by too much.  We wanted to be able to present some hope to women experiencing IVF failure at the earliest reasonable time possible.  It’s important to realise that this decision was mainly motivated by the fact that all participants were classified as ‘difficult cases’.  This was primarily because of one or a combination of the following factors:

  • Their age
  • Previous health history that might make conception difficult
  • Multiple previous IVF (or ART) failure/s

Scientifically speaking, the obvious next step would be to follow up with a double blind ‘randomised controlled trial’ (research jargon for a much different research approach using quantitative (numbers and analysis based) rather than qualitative (narrated opinions and feelings etc. based) research methods, and one the medical profession loves) involving a much larger sample of women, and compare the IVF outcomes of those using my (research) programme while undergoing IVF with those who did not.  I will probably progress to this study in due course.  However, to delay publication of the work to date would simply make no sense.  There are several reasons for this:

  • The next step in research would require what is called quantitative analysis, and frankly, I’m still contemplating the real value of doing this. For a quantitative study, every woman would have to undergo precisely the same programme in order for the results to be regarded as scientifically valid.  This works for medical studies where every person can be given the same drug or test procedure in a treatment regime treatment standardised for a wide range of people.  However, for addressing what gives rise to stress in people’s lives and for addressing their earlier life experiences and potential imprints, there simply cannot be one protocol that is 100% precisely the same for every participant, simply because we are dealing with very different life experiences for each participant in the formation of the very stress and imprints the programme is designed to address
  • While the study and research conducted to date involved a relatively small number of participants, they were, for the most part, difficult cases (for the reasons defined earlier) and the results achieved by those difficult case participants were significantly higher than any published figures from credible government-recognised sources
  • It simply makes sense that, if these results could be obtained with difficult case women, then it might be possible to help many more women, who might be clinically regarded as less difficult cases, to achieve their dream of pregnancy as well, without delaying that potential outcome by first completing a lengthy quantitative research study. Of course, with such a small study group, it’s not possible to predict the same results would be achieved with a repeat of the programme, any more than an IVF clinic could guarantee results from its protocols  However, with the study results achieved, we’d expect many women would sensibly want to test the programme for themselves

There is value in concluding this section with a direct quote from my final research report (which, by the way, was published in a double peer reviewed, international journal on psychotherapy and psychiatry in February 2016):

This research sought to explore perceived effects of psychological stress before, during and after IVF, from the perspective of women who experienced the process in concert with IVF–Assist.  Participants all reported significantly reduced stress at all stages of IVF.  All seven participants who became pregnant prior to research completion credited IVF-Assist with contributing significantly to that outcome.  It is reasonable to conclude that IVF-Assist can be regarded as an effective multi-phased intervention to manage stress approaching, during and following undergoing IVF.  Two non-participant clients of the researcher also became pregnant on their first IVF cycle with IVF-Assist since completion of data collection for this study, and these cases stand as further anecdotal support for the conclusion drawn in this paragraph.

Conclusion

In this post, I’ve explained definitions of female infertility and unexplained infertility, and listed some important findings from my pilot study and research into stress effects on IVF outcomes.  The programme the pilot study and research participants underwent was the IVF-Assist programme described on this web site.

You can get a brief video description of the programme at http://ivf-assist.com/products/ivf-assist

The women on the pilot study who became pregnant naturally used a version of the programme that was adapted from the IVF-Assist programme and which we now refer to as Fertility Assist.  For a brief video overview of that programme, feel free to visit http://ivf-assist.com/products/fertility-assist

The ART of Getting Pregnant

There is an interesting story behind the artwork illustrating this blog post and the next several posts I write.  AND there’s a chance for you to win valuable prizes, including a free version of your choice of the IVF-Assist or Fertility Assist programmes, and an original piece of art from one of our posts.

The illustrations on the blog are the result of a collaboration between the blog author, a former professional photo-journalist (from a long, long time ago) and up and coming Gold Coast artist, Olivia Heath.

OLYMPUS DIGITAL CAMERAOlivia approached me, a lover of art, and asked was there any way she could undertake an internship with my business.  We met for a brainstorming session and came up with a creative solution.

Olivia will complete several pieces, which you will see illustrating this blog in the weeks and months ahead, and each one fits her interpretation of a theme of nature, fertility, mind-body connection and flow. In addition, we wanted to include reference to the importance of specific female body parts into the process of nurturing a baby. The hands to embrace and provide bonding and security, the breast for nutrition, eyes and ears for vigilance and protection etc..

OLYMPUS DIGITAL CAMERATo accomplish this last part of the brief, Olivia arranged for one of her friends to model in a manner where that friend became the ambassador for women trying to get pregnant, and physically integrated herself into the art work and was photographed in that situation, that action itself a metaphor for the woman trying to get pregnant integrating herself into both the flow of the IVF process and the natural aspects that it aims to parallel and enhance.

I trust you will enjoy Olivia’s creative interpretations as much as I hope this blog will help you in your endeavours to become pregnant.

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