What your doctor isn’t telling you about IVF — but should

Smiling for the camera, Elizabeth Katkin, her husband, Richard, and their two kids look picture-perfect. But it took the Katkins nine years, seven miscarriages, a total of 10 in vitro fertilization cycles, five natural pregnancies, four IVF pregnancies, 10 doctors, one surrogate mother and roughly $200,000 to create their beautiful family.

“I look back on the years when I took contraception to avoid getting pregnant and laugh,” Elizabeth says.

Her epic voyage to motherhood led the Yale- and Columbia-educated lawyer to pen the new book, “Conceivability: What I Learned Exploring the Frontiers of Fertility” (Simon & Schuster).

“We had so many bad things happen to us, but a little bit of luck, too,” says the Denver resident.

‘I look back on the years when I took contraception to avoid getting pregnant and laugh.’

Daughter Alexandra, now 11, was conceived and carried to term by working with a top fertility specialist, New York-based Dr. Joel Batzofin, and using a British surrogate whom the Katkins had met when they lived in England.

Three years later, William, now 8, was born via the same surrogate after Katkin’s 10th round of IVF, this time performed in Russia using low-dosage drugs.

On a friend’s recommendation, they’d gone to a specialist in Moscow who had a different approach than American doctors and believed that all of the fertility drugs she had taken had harmed her eggs. Thanks to acupuncture, good nutrition and traditional Chinese medicine, Katkin believes she improved the quality of her eggs, allowing William to be conceived.

“We are so incredibly fortunate to have two beautiful, healthy children,” says Katkin.

Here, she shares her advice on five things your fertility doctor might not be telling you.

You can improve your egg quality with alternative medicine
Women are often told that they only have the number of eggs that they were born with and the doctor will just do the best they can with what’s there, Katkin says. In fact, anecdotally and according to small studies, acupuncture, fertility yoga and Chinese herbs can be helpful. In her book, Katkin quotes renowned endocrinologist Dr. Jamie Grifo, of NYU Langone, who notes that, while acupuncture is “not a panacea,” it does “improve pregnancy rates and quality of life in some people.” Other beneficial effects can be derived from taking supplements, such as vitamins B6 and B12 and omega-3.

Carrying multiples is risky
Most European countries recognize the risks of multiple pregnancies and, during IVF, limit the number of embryos that can be transferred to two. Not so in the US, where there is neither state nor federal regulation. In 2017, nearly 4 in 10 infants conceived through IVF in the US were twins, which Katkin sees as troubling.

“[The mother] faces a higher risk of high blood pressure, preeclampsia, anemia, postpartum hemorrhaging and [early] menopause, while the babies have a heightened threat of cerebral palsy, blindness, retardation and pre-term births,” she says. “I understand parents are desperate and really want babies, but . . . there is [this] risk.”

Drugs are over-prescribed
Since it was FDA-approved in 1967, clomiphene citrate has become the go-to drug for assisting a woman’s body with ovulation because it tricks the body into releasing one or more eggs. But Katkin claims that, partly because of its affordability, it is over-prescribed and given in larger doses than necessary. Its effectiveness may also be overstated. “The pregnancy rates of approximately 10 percent per cycle are underwhelming and have varied little over time,” she says. (A 2015 study, published in the New England Journal of Medicine, found that clomiphene citrate achieved a live birth rate of 23 percent across four cycles.) There are also conflicting results in studies examining potential links to cancer, increased incidence of miscarriage and birth defects.

There are often more options to consider
Many clinics have failed to move with the times and they transfer embryos to the uterus too early, Katkin believes. Five-day-old blastocysts have a much better chance of achieving pregnancy than a 2-day-old embryo. “It ranges from two to three times the success rate,” says Katkin. “And in women over 40, it can be a 10-fold increase.” It also pays to use a clinic that employs preimplantation genetic diagnosis (PGD), which screens for embryo abnormalities ahead of transfer and thus reduces the risk of miscarriage. “I’m not saying that you have to become a scientist, but you need to ask your doctor basic questions about protocols like this,” says Katkin. She is also a proponent of mini IVF (where fewer hormones are used and fewer eggs harvested) and even natural IVF — a process pioneered in Japan more than 20 years ago that involves removing an egg in an unstimulated cycle. “There are options. And it is important to ask about them.”

Not all embryo storage is safe
More than a thousand patients who used either University Hospital’s Fertility Center in Cleveland or Pacific Fertility Center in San Francisco learned the worst in March 2018. Both centers informed clients that their embryos or eggs may have been destroyed as a result of storage tank failures that coincidentally occurred on the same day. “You have to ask how this could happen,” Katkin insists. “Make sure you know that a clinic’s methods and types of storage are as fail-safe as possible and what their records are on that.” Don’t feel intimidated by the doctors’ superior expertise or pushy sales pitch. “Apply the same philosophy to all your interactions with fertility specialists,” adds Katkin. “You are your best advocate.”

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