A Positive Note on the Infertility Experience: Timing Treatment

Infertility is incredibly disheartening. Aside from the volumes of emotional growth you can get (some patients say they've "got character up to here!") and the wealth of biology and medical knowledge you can accrue (that you never knew you'd need), what good can be said of the infertility experience?

Some patients have found that they can make the experience work for them from an unlikely angle -- timing is everything.

Nobody knows like people who struggle to get pregnant just how important time is to the miracle of conception. So many come to fertility specialists in their 30's or later, having spent their young adulthood pursuing other dreams and finding that they've unintentionally diminished their chances of another -- parenthood. They thought time was on their side.

Some resilient patients are determined to make the best of what life's handed them and make time their ally once again -- through scheduling their treatment to optimize both conception chances and enjoyment of life.

"I've had several patients who try to time their treatment," says Brandi Oude Alink, ARNP. Alink, who works as a nurse at Reproductive Resource Center of Greater Kansas City, says a common group is teachers who want to use their summer off to try an IVF cycle or patients who want to aim for a particular due date. Especially for patients who come to treatment with a sense of failure, requests for specific treatment timing are not made lightly.

"They’re often embarrassed to ask for a particular due date," Alink elaborates, "but I tell them it’s okay to find some advantage to doing fertility treatment!"

At Seattle Reproductive Medicine, Tammy Nolan, RN, hears patients requesting scheduled treatment for several reasons. "They vary," she says, "but it usually has to do with wanting to time their anticipated due date around holidays, family birthdays, or sometimes, insurance coverage issues."

While some in the general public may see such requests as over the top, women and men who've arrived at the point of considering fertility treatment have already had to emotionally work their way through a lot of obstacles in order to see medical intervention as an acceptable path to having a child.

Patti Bradley, WHNP, of Reproductive Resource Center of Greater Kansas City, recalls seeing articles in women's magazines that infer the use of Lupron, a drug sometimes used in timing IVF cycles, is primarily for the benefit of physicians' convenience. "Actually," Bradley explains, "Lupron is used for suppression of the ovaries, and patients need to understand that is an important part of their infertility treatment." In addition to the injectable Lupron, oral contraceptives ("birth control pills") can also be used to help plan treatment cycles.

Bradley sees the use of these medications as benefitting both patient and physician. "Many, many times patients ask us to work around vacation, travel or business trips, while not wanting to lose another 'precious month' by delaying their treatment until after their travel."

Such timed delays work by adjusting the number of birth control pills taken prior to starting suppression of the patient's natural cycle with Lupron.

Dr. Sharon B. Jaffe, board certified reproductive endocrinologist at the Center for Reproductive Medicine in Orlando, recommends that patients remember the importance of flexibility -- for the sake of their own stress levels and resulting fertility.

Jaffe agrees that, generally, patients have good reasons for making timing requests. "But putting so much thought into the planning process can cause additional unneeded stress." On the other hand, however, she cites the common example of teachers who may choose to go through their treatment during the summer months, when they are less stressed. "In those situations," says Jaffe, "timing of infertility treatment is a good thing."

On a practical note, Patti Bradley strongly encourages patients to keep their treatment team updated on planned travel season activities.

"Please tell your IVF coordinator the dates of your travel prior to their planning your protocol and IVF schedule. Patients can be proactive and discuss travel plans upfront, and see if the cycle can be manageable." Bradley shares that it can be unnecessarily frustrating for everyone involved to find out after complex scheduling of medication and procedures that the patient will be unavailable during that time. Patients should know that it is usually possible to work around a summer trip as long as there is upfront discussion with treatment coordinators before the protocol is finalized.

After struggling unsuccessfully to get pregnant and then coming to the conclusion that intervention is needed, some patients are relieved to find there may actually be something of a bonus to using fertility treatment.