Patient P., aged 37, came to me to be evaluated after being diagnosed at a local area fertility clinic with low ovarian reserve, .25, and a couple of failed IUIs.

With incomplete labs, she was retested and was found to have several issues that needed improvement, including high FSH, high estradiol levels, high BMI/overweight, low vitamin D, iron, and B12.

What's interesting to note, is that fertility doctors, nearly across the board, will tell patients that there is nothing they can do to improve their fertility status. They will tell you the bottom line is, it's going to be IVF that gets you a baby, and the sooner the better, without ANY regard to the patient's general health, or ability to respond to the IVF treatment itself.

Some doctors will make a half-assed attempt to recommend a few supplements, usually not in meaningful dosages, and they are certainly not going to take time to discuss food, lifestyle habits, or chemical exposures in day-to-day life that contribute to subfertility.

I suggested patient P to make a consultation appointment at CNY Fertility, a clinic that accepts low ovarian reserve patients, and offers PRP treatment which improves IVF success rates for the low ovarian reserve patient population ( a treatment that is currently unavailable at any local area reproductive clinic).

The wait time for the initial consultation appointment at CNY Fertility Clinic is typically 2-3 months, and so we got an opportunity to do everything possible to improve her fertility status, and her response potential to IVF, before she would begin the IVF process.

After three months of treatment which included improving vitamin levels to optimal levels, working with a dietitician to improve elevated estrogen levels, weekly acupuncture treatments, and Chinese herbal medicine selected specifically for her fertility presentation, we retested her hormone levels.

AMH /Ovarian reserve had doubled from .25 to .50, and FSH had moved from 30 to 15. With these improved numbers, we canceled her IVF consultation appointment at CNY and decided to pursue IVF at CCRM, where she had initially been rejected beause of poor labs.

With CCRM's higher success rates (some of the highest in the country), and diagnostics FAR exceeding that of ANY local area clinic, I always try to steer a patient to where they have the BEST chance of success. Of course there are many variables in selecting a fertility clinic when the indication that one is needed, but I am always considering the patient's potential for successful outcome as the guiding factor.

CCRM would not accept patient P with the original set of labs, unless she was willing to accept a donor egg, to which she was opposed. However, with the new, improved numbers on the labs, they allowed her to proceed.

After her initial visit to Denver, where she was retested yet again, she returned home to Cleveland with her list of medications and an IVF calendar. Due to a delay in beginning the cycle, she never started the drugs, although they had been purchased. Incredibly, it was discovered she was pregnant, on her own.

Over the years of being in fertility practice, I have observed many of such situations. Patients who resigned themselves to IVF, and made a real effort to prepare for success, achieved pregnancy on their own, just before starting the IVF journey.

Important takeaway points to learn from this synopsis:

1. Diagnostic testing is imperative to make a meaningful effort towards fertility optimization.

2. Retesting is also important. While its nice to see weightloss and outwardly improved health benefits, retesting to measure hormonal improvements is important! Give yourself THREE full cycles to see benefits that are measureable.

3. Fertility optimization takes time and effort, and leadership, which is why working with caring professionals IS the fast track.

Don't believe anyone who says that your efforts to improve yourself are wasted. Medicalized fertility treatments always have better outcomes with patients who have worked to put their best foot forward. It's not a waste of time, as many doctors would have you think.

Rushing into IUI OR IVF is a fool's errand, make sure you are at your fertile best before engaging in any medicalized treatment! Find weaknesses and correct them. For many patients, that will be enough!

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