When IVF fails, what’s next?

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These women found IVF failed to fix what was really wrong, and sought NaPro instead

Infertility, defined as the inability to conceive after one or more years of sex without any type of contraception or barriers, affects approximately one in five women in the United States [1]. Whether it is primary (the couple have never conceived a child) or secondary (the couple has had at least one previous pregnancy), medical literature on infertility suggests that couples suffering from it may experience emotions typical of bereavement [2]. One study cites infertility as “the fourth most dramatic life event in the lifespan of a woman, compared with the death of parents and the unfaithfulness of a partner” [3]. 

While on the one hand, assisted reproductive technologies (ART) like in vitro fertilization (IVF) have never been more popular and widely accepted, on the other hand, a growing number of women and couples are dissatisfied with the failure of IVF to address the why behind their infertility. For these women, restorative reproductive medical solutions like NaProTechnology may provide the hope and healing they need–if only they knew about it.

Assisted reproductive technology (ART) is the dominant treatment approach for infertility

The birth of Louise Brown in 1978 by means of IVF heralded a new era in the field of reproductive medicine and in the treatment of infertility. ART has since become the dominant approach to the management of infertility, primarily through intrauterine insemination (IUI) and IVF. Although ART procedures such as IVF are celebrated as having created greater reproductive opportunities for women and infertile couples, these approaches are very costly and can also negatively impact women’s psychological and emotional well-being. As discussed in a recent Natural Womanhood article, the use of ART also comes with the possibility of serious health risk for mothers and their children.  

The need for a woman-centered approach 

A hallmark of ART–which is reflective of the current state of women’s healthcare as a whole–is bypassing or suppressing women’s natural reproductive functions, that is, “overriding the system” without addressing the root causes of infertility. 

In stark contrast to this approach, some women’s health advocates have pointed out that a woman-centered approach to healthcare ought to have as its central goal, the screening, diagnosis, and management of conditions that are more common, serious, or unique to women. Women-centered healthcare should also promote the holistic wellbeing of women, rather than treating their reproductive system as separate from the woman herself [4]. 

Proponents of this approach to women’s health have raised concerns that health issues specific to women, such as polycystic ovary syndrome (PCOS) and endometriosis, which can seriously impact fertility and quality of life, have not received enough attention, and have expressed their desire for more preventative and restorative approaches to infertility and women’s health issues.  

Couples share their lived experience of infertility  

In my doctoral research, completed in 2018 [5], I conducted in-depth interviews with women and couples in the United Kingdom on both their experience of infertility and their subsequent use of NaProTechnology, “a women’s health science that monitors and maintains a woman’s reproductive and gynecological health… [and] provides medical and surgical treatments that cooperate completely with the reproductive system.” 

In the treatment of infertility, the primary goal of NaProTechnology is to identify and treat underlying health problems that prevent couples from conceiving a child or maintaining a pregnancy. All 28 study participants in my study had experience in mainstream medicine in their infertility treatment journey. Some had engaged in consultations with fertility specialists, or had recourse to ART prior to the use of NaProTechnology.

Even when IVF results in a live birth, underlying problems remain

The overwhelming takeaway from my study was that assisted reproductive technologies, such as IVF, are failing to serve women’s legitimate health interests. 

Study participants communicated that one of the most challenging aspects of ART is that it does not address underlying conditions that affect a couple’s ability to conceive or maintain a pregnancy, many of which can significantly impact a woman’s short- and long-term health, and her quality of life. 

Even if IVF leads to a successful live birth, the root causes of infertility often go unresolved, and in many cases, are left undiagnosed. In the event that IVF treatment fails, not only do women and couples suffer the pain of a failed cycle, but they are no better off health-wise, and many times, the reason for failure is not understood.  

Infertility expert: Most women referred for IVF “would be better served by alternatives”

Some prominent healthcare professionals have publicly recognized the limitations and challenges of ART. Professor Robert Winston, a British infertility expert, has argued that, strictly speaking, IVF is not a “treatment” for infertility, as it does not address or resolve the underlying causes of infertility. Significantly, he has asserted that “more than half of the women referred to IVF clinics would be better served by alternatives” and has underlined that doctors are failing to diagnose the root causes of infertility and are using IVF as a “blanket treatment” [6]. 

Sharing Professor Winston’s sentiments is Professor Adam Balen, former Chair of the British Fertility Society, who expressed concern that “IVF is sometimes embarked upon before all other treatment modalities have been exhausted…” Professor Balen also stresses that “the notion that IVF is the high-tech modern answer to every couple’s infertility is erroneous” [7].  

“Unexplained infertility” is an unsatisfactory catch-all term 

What was particularly difficult for some participants in my doctoral study was being told that they had “unexplained infertility.” This was the case with one participant, Moya*, who felt she was referred to IVF too quickly, without a comprehensive investigation into the reasons for her infertility. For Moya, not knowing the reasons behind her failure to conceive a child increased her mental and emotional anguish. 

She explained the following: 

“If I had known what was wrong and that there was an issue, and known that they were treating it, then I would have been happy to know that something was being done. But, every time I went [to the clinic] they would say, “We can’t see a reason why you shouldn’t be [getting] pregnant”… If they would have said to me, ‘We found that there is a problem and you can’t have children,’ well, I would have learnt to deal with that and would have accepted that. But the fact that they weren’t coming up with anything made it so much worse for me.”  

Another participant, Leah, was also offered IVF after being told that she had unexplained infertility. She highlighted her frustration with this “diagnosis,” and with what she felt was a lack of interest in providing her with the answers she so desperately sought: “There is no illness called ‘infertility,’” she stated. “[I thought] there must be something behind [it] and they aren’t able to tell me what it is.” It was only later, through NaProTechnology treatment, that she discovered she had celiac disease, polycystic ovary syndrome (PCOS), Vitamin D deficiency, and potential endometriosis.  

For Ruth and her husband, who were facing secondary infertility, the proposal to use IVF in the absence of any in-depth investigation into the causes of their infertility, felt like “going from zero to a hundred.” Their desperation for answers, alongside the ethical concerns related to IVF, led them to pursue NaProTechnology in their quest for another child. Ruth told me: 

“I hope that there is an answer at the end of it… I think for me that’s why we contacted the [NaProTechnology] clinic, because we just wanted to know, rather than go every month hoping and then being crushed, and then hoping and then being crushed, and thinking, ‘Well, we’ve had three children, why can’t we have another one?’ It just doesn’t make any sense, but there’s obviously a reason, and I just hope we discover what the reason is.”  

Major knowledge gaps regarding the cause of miscarriages

Participants emphatically described this hunger for answers when speaking about previous miscarriages. All participants who had suffered a miscarriage wanted to know what had caused it and what they could do to prevent this painful loss in the future

Take the case of Ivy and Tom, who experienced a miscarriage at eleven weeks of pregnancy. They got married in their early forties, started trying for a child soon after marriage, and wasted no time in approaching Ivy’s physician for medical advice because of her irregular menstrual cycles. But the doctor was dismissive of their concerns. Following a miscarriage, they were keen to find answers about any potential causes, but they were met with the same indifferent attitude:  

“The doctors were very unsupportive of the miscarriage and they said, ‘Oh, it happens,’ which I understand, but you are kind of looking for something to explain why.”  (Ivy) 

Unanswered questions as to why they suffered a miscarriage left them feeling abandoned by the medical establishment and fearful that future miscarriages would occur. For Ivy, charting her cycle as part of infertility treatment through NaProTechnology was revelatory. At the time of the interview, her doctor had already been able to identify–thanks to her cycle charting–that her progesterone levels were very low and could have been a contributory factor to the infertility and miscarriage. Ivy said of her experience charting her cycle: 

“My cycles were so irregular, and lots of things were identified while I was doing the charting… the charting gives signs that something isn’t right somewhere… You get to know your body so much, things that you take for granted, things that you should know but you are not concentrating on every day or every week, and you don’t see the signs. It’s really interesting.”  

Couples need to know before experiencing IVF failures, there are better alternatives

Like many study participants, Ivy and Tom hope that other couples facing the heartache of infertility will gain knowledge of, and have access to, therapeutic and restorative approaches to infertility like NaProTechnology. A recurring theme in the interviews was disappointment and frustration with the lack of awareness of alternatives to ART

As one participant, Sarah, explained, 

“I was very much told, ‘it’s IUI or IVF or nothing else, you know. There are no other options.’…There are lots of people who need to know that there are options.” 

Restorative options such as NaProTechnology offer a positive departure from “one-size-fits-all” approaches to women’s reproductive healthcare, by providing more individualized treatment and by aiming to identify and address issues that can seriously affect a woman’s health and daily life, as well as her ability to conceive a child. 

*Pseudonyms have been used in the study.  

References:  

[1] Seepana, S. and Allamsetty, S. “Infertility.” Innovait, vol 3, no. 2, 2010, pp. 76-82 https://journals.sagepub.com/doi/abs/10.1093/innovait/inp242 

[3] Harvard Medical School. “The psychological impact of infertility and its treatment.” Harvard Mental Health Letter, vol 25, no. 11, 2009, pp. 1-3 http://www.mindingmatters.com/wp-content/uploads/2017/03/PsychologicalimpactofIFanditsRx.pdf 

[3] Lykeridou et. al. “The impact of infertility diagnosis on the psychological status of women undergoing fertility treatment.” Journal of Reproductive and Infant Psychology, vol. 27, no. 3, 2009, pp 223-237 https://www.tandfonline.com/doi/abs/10.1080/02646830802350864 

[4] See also: The Boston Women’s Health Book Collective. 2011. Our Bodies, Ourselves. NY, USA: Simon and Schuster, Touchstone Books. 

[5] Butau, L. 2018. An Analysis of the Lived Experience of Infertility and NaProTechnology in the Context of Catholic Theological Ethics, University of Surrey, England.  

[6] Winston, R. 1999. The IVF Revolution. NY, Crown Publishing Group 

[7] Balen, A.H. 2008. Infertility in Practice. 3rd Ed. London, Elsevier.

Additional Reading:

FAM in the UK: Obstacles to fertility awareness education and restorative reproductive medical care

IVF and restorative reproductive medicine stories: What they have in common, and how they differ

The affordable, effective alternative to IVF no one talks about

The dark side of the IVF industry, from a survivor

Routine infertility treatments may harm mother and child, large study shows

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