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Question
I didn't have success with my ivf.  is it ok to try to conceive naturally now.
I read eggs take 90 days to develop so they'd conceivably be adversely affected
By fertility drugs. Should I wait a full three months? Any data on women who conceived
Naturally soon after a failed ivf? The whole process took a big toll and before
I can do this again finAncilly or emotionally need to give natural a chance
I was told my chances were good bc the embies looked great so did all so I really got my hopes up.
But I want to know it's safe to try now. I just finished a failed ivf attempt.
Second question- if a baby implants does that mean it's less likely to hAve genetic problems
Trying to understand why bad embryos even implant.  Also if your hcg numbers and progesterone
Are excellent is that a positive sign. If a pregnancy was bad could it last past first trimester even w
Genetic problems. Why do Down syndrome babies not abort naturally. I'm not saying they should I just am trying
To understand the process.  I'm Close to 40 and know that a genetic problem
Is a big chance at my age.

Answer
Hello Kira from the U.S. (New Jersey),

Eggs do not take 90 days to develop, sperm does.  Eggs are always present and mature (not develop) with each cycle.  You certainly can begin trying for pregnancy right away and some studies have shown increased pregnancy rates within the first 6 months of miscarriage, so your should still have a chance to get pregnant.  Your age is the biggest factor and I'll explain that briefly below.

In terms of your second question, your chances of having a genetic disorder is the same and is an age based risk.  At your age, the risk of Down's syndrome is 1:100 pregnancies.  IVF has been shown to decrease the chances a bit because more eggs are retrieved and only the strongest ones reach good embryo development.  However, this is not a sure thing and so statistically, the chances are still the same for genetic abnormalities.

The "age factor" is part of what is causing you not to get pregnant.  It is basically an "egg factor" that has been affected by age.  A woman is born with all the eggs she will have for her life, and as she ages, the eggs age with her.  As in all cells in your body, the cells decrease in quality as it ages and so the eggs become debilitated.  This leads to more spontaneous breaks in the chromosomes, as well as, decreased embryo quality because of the other structures within the egg.  This leads to decreased pregnancy rate with increasing age, even with IVF.  IVF helps by getting more eggs out at a time and thereby increasing the chances of finding a good egg.  So you can increase your chances by increasing the number of eggs you get at a time or increasing the number of times you try.  Sometimes it takes both, even with IVF.  IVF is NOT a perfect technology, even if you might think it is.  Just like it takes normal women several months to get pregnant naturally (most don't get pregnant on their first try), it can take multiple attempts with IVF.  IVF is just assisting the normal process up to a point.  It helps with 7 of the 10 steps in the reproductive process.  So, because of your age, you have to expect that it may take several attempts to be successful.  The only way to short cut this is to use younger eggs, known as donor IVF.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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