Planning your family: guiding thoughts when considering your options

As a fertility specialist for over 20 years, I have seen our treatments evolve from “hoping to achieve a pregnancy” to effectively assisting people to have the family of their dreams. Whether you are in a stable relationship or single; same-sex, hetero or even gender-fluid—there is a strategy available to assist you in achieving your reproductive goal. The first step is to define your vision of your ideal family.


Fertility rates in the U.S.A. are at a record low; but not for those with a plan! A new analysis has found that birth rates are up for women that have delayed childbirth. Today, 86% of women between age 40 and 44 are mothers; that is up from 80% in the same group only 10 years ago. With the new treatment options available, family size is increasing as well. Most notably, the women that are driving this trend are women that had traditionally delayed having children for career purposes, educational pursuits or lack of a male partner.

Pew 2018 after decades of decline family size is ticking up

That’s why it is more important than ever to start planning your family early in your journey. For instance, one study found that healthy women attempting to conceive through donor insemination had about a 70% chance of success; but that it typically took four attempts. Today we can do much better.


Now that we understand that a woman’s ovarian reserve and egg quality are the most limiting factors to success; we have shifted our focus to creating and identifying healthy embryos. With the process of in vitro fertilization (IVF), we are able to optimize the number and quality of eggs that woman can produce at any given time. Then through the process of Intracytoplasmic Sperm Injection (ICSI), we can be certain that each egg is entered by only one perfect looking sperm. Each egg that fertilizes and then develops properly can undergo genetic testing (CCS) and then be frozen (vitrified) for later use. Once frozen, we now know that embryos can remain viable for over twenty years!


At our center, we find that each individual embryo that passes the genetic testing provides women with a greater chance of a livebirth than four attempts at more traditional treatments. That’s why we now encourage our patients to think of their last pregnancy at the same time that they are considering their next one. By shifting treatment paths, women can reduce frustration and cost while optimizing their chance of completing their ideal family.


Fertile thoughts,



Robert Greene, MD, FACOG

Conceptions Reproductive Associates

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