Is My OB/Gyn Right: I Have All The Time In The World?

It's no longer unusual for women to delay pregnancy until well into their 30's or even early 40's. Many young women want to dive into parts of life that are easier to do without children and then settle down with kids later. But plenty still want to grow their families first. Fertility specialists often hear from women in their 20's who've been told by their gynecologists to "be patient":

"We started trying to have a baby as soon as we got married. And even though it's been a year, my OB/Gyn says I'm just overly worried. He says I'm healthy, I have a period every month, there's no reason for concern. Should I really just kick back, relax, and I'll get pregnant, finally?"

Dr. Sonja Kristiansen, Medical Director of Houston Fertility Center responds:

You're not alone! I often talk to young women who want to get pregnant and feel like they're more frantic about it than everyone else. Sometimes, they've heard and read too many over-simplified stories about infertility. But there are times when they may be "on to something" -- a lot of women understand their bodies intuitively, even if they aren't physiology experts.

The unfortunate truth: there are many conditions that can cause you to be infertile and you never know until you try to get pregnant. If you've ever had abdominal or pelvic surgery of any kind, you could have internal adhesions or scar tissue -- most of which cause no pain -- that can be an obstacle for conception. The same is true of several infections, including sexually-transmitted ones and other, less stigmatized infections.

If you're only in your 20's and you've tried for a year to get pregnant without any luck, I and other fertility experts recommend you have some basic fertility testing done. You might not need the assistance of reproductive technology at all. But if you do, it's best to find out sooner than later.

Women's fertility naturally declines as they get older. So of course, older women's response to fertility treatment is generally not as optimal as that of younger women. If you're ready to have a baby, you've tried for a year already, and you're in your 20's, find out now if there's a real problem in the way. Then you can decide whether or not to proceed with fertility treatment.

~ Dr. Sonja Kristiansen MD

If I'm Using Donor Egg or Sperm, Does Everyone Have to Know?

There's a big leap in the minds of a fertility patient between IVF and third-party IVF. Just the thought of using another person's sperm or eggs to conceive a baby brings up the biggest questions about reproduction, namely, whose genetic material is being passed down the line of time. Compassionate fertility specialists understand the larger weight of decision that their third-party reproduction patients are under. Here's one of the common questions that may come up:

Now that it looks like we'll have to use a donor to help us have a baby, I'm wondering about our family and friends and how they'll react. Some people have very strong opinions, and I have enough on my plate to deal with -- do we even have to tell them? Are there laws that would reveal our use of a donor at some point down the road?

Sonja Kristiansen, Medical Director of Houston Fertility Center responds:

Nearly every scientific or technological advance in reproductive medicine is met with both elation (on the part of patients who may finally have that baby they've wanted for so long!) and worry, sometimes by the rest of the world, including family and friends. Their worry is an indication of their concern for you. So one of the first things you can consider when talking to anyone about your impending fertility treatment is assure them that it is indeed safe, to both you and your resulting offspring.

Next is the matter of what to tell your child who may be the result of using a donor with IVF. That's an issue you and the other parent must discuss and decide. There are a number of books and studies that have been written on the topic of what is believed to be best for donor offspring. I encourage my patients to do their homework before the child is born.

Finally, there's the question of disclosure. It's hard enough to go through infertility and feel like the whole world is involved in this very private choice. When you have loved ones who are adamant or even just a little expressive of their fears and opinion, it can make you want to toss in the towel.

Essentially, the choice of who to tell is yours to make -- so far.

The good news is that, unlike some other countries in the world, the U.S. government will not reveal your use of a donor. The unsettling news is that each state can regulate this disclosure, and change is in the wind. The state of Washington is about to enact a law that would change things a bit. Donors there can no longer donate sperm or eggs anonymously, and any resulting offspring, once they turn age 18, can request their donor's information -- including identifying data and medical history -- from the fertility clinic. There's a caveat, however: The donor may sign a document that would prevent identifying information from being given out. A donor's medical history, especially related to genetics, is already routinely revealed to fertility patients. You and your child have a right to know of any potential health conditions that could arise.

For now, Washington is the only state that has such a law, and it's so new, many of us are interested to see how things will pan out as a result. But here in Texas, where I practice at the Houston Fertility Center, there are no laws mandating this new kind of family relationship. So it really is up to you who knows that you've used donor sperm or eggs.

~ Dr. Sonja Kristiansen MD

A few more details for patients using donor egg or sperm:

Talking to Your Children, by Carole Lieber Wilkins, MA, MFT on the RESOLVE website

Balancing the Rights of Donor Offspring With Those of Donors: But What About Parents?, an opinion piece on Forbes by Todd Essig

RESOLVE's list of professional members who provide counseling services to patients