BONUS 246: IVF Add-Ons: Fact vs. Fiction

February 14, 2020

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Infertility Coaching with Heather Huhman

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Njeri had one successful pregnancy at age 33. From three IVF cycles, she has three frozen Day 6 embryos remaining and is considering one more retrieval. She asks about thawing and testing those frozen embryos or moving ahead with the retrieval first and then testing either the newest embryos or all of them.
  • Jamie has two children with no trouble conceiving them. She asks several questions about childhood chemotherapy impacting AMH levels, monitored cycles with a blocked tube, low AMH and poor egg quality, C-sections, and tube cannulation.
  • Eunis has recurring angioedema flare-ups on her whole face and tongue, which her doctors suspect is hormone-related. She asks Dr. Rodgers about her recommendations moving forward with Letrozole and timed intercourse.
  • Kaley has unexplained infertility, but she got pregnant with her first fresh transfer at age 37 and has a 20-month-old son. After two unsuccessful frozen transfers, she asks about her receptivity window and an ERA test.
  • Riti has low AMH, Hashimoto’s, a history of polyps and chronic endometritis, homogenous MTHFR, elevated autoimmune markers, and normal karyotypes. As she prepares for the next FET, she asks about any additional diagnostic tests she should request.
  • Shagun has a two-year-old son conceived with IUI, and now she’s dealing with secondary infertility. After six IUIs and two IVF cycles, she only has one normal embryo. She asks why she’s not responding well to stims, if she should investigate a possible endometrioma, and what protocols can be followed in a third IVF to get a better response.

In December, the New York Times published an op-ed trashing IVF add-ons and accusing fertility clinics of profiting off of them. Dr. Rodgers and Heather continue the episode by discussing the op-ed, as well as the pros and cons of potential IVF add-ons:

  • Let’s address the New York Times op-ed first. Do reproductive endocrinologists profit from offering “desperate patients” IVF add-ons?
  • Egg activation
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Embryo glue
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Time-lapse imaging
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Platelet-rich plasma
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Elective freeze all cycles
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • ICSI
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Uterine biopsy (chronic endometritis, ReceptivaDx, ERA, scratch, etc.)
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Assisted hatching
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Preimplantation genetic testing
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • Reproductive immunology treatments (intralipids, Prednisone, etc.)
    • What is it?
    • What are the pros and cons?
    • What does the research say? Is it safe and effective?
    • What patients would benefit the most and which should pass on this option?
    • Is there anything else you’d like to add?
  • What words of hope would you offer to patients who are starting their first or next IVF cycle?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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