Is it time to do IVF/ICSI?

There is no one standard answer to this question for all patients because individual circumstances determine the best option.
However, what we do know is that ultimately the single most important predictor of success when using assisted reproduction is the age of the wife.
There is a steady decline in the number of eggs from approximately 7 million in the fetus to 400,000 at the onset of puberty! The rate of this decline becomes more quickly at the age of 37 years. This is coupled with the increase in the incidence of chromosomal abnormalities with increasing age of the egg after 35, explains scientifically why fertility potential declines as rapidly as it does with increasing age.

* Unlike sperm which continues to be produced well into old age, a woman is born with all the eggs that she will ever have. By the time the eggs reach age 35, there is a clear measurable decrease in the chance of a successful birth which is mirrored by an increase in chromosomal abnormalities. If you are over the age of 35, time becomes a major factor, and moving on to assisted reproduction becomes necessary.
* The following situations should prompt more rapid consideration of assisted reproductive techniques like IVF/ICSI. The reason for accelerating the process relates directly to the decreasing success as the eggs become older. For example, if there are already known factors that decrease the natural chance of pregnancy like poor semen characteristics or damaged fallopian tubes, continuing on with a treatment that carries a very low chance of success just postpones the time at which IVF/ICSI is performed. This may decrease the overall chance of having a baby. These following factors should prompt early evaluation of IVF/ICSI as the best option for treatment:
* - Age of the wife > 35 years
** - Known factors like
* damaged tubes
* poor semen parameters
* endometriosis
* Polycystic Ovarian Syndrome (PCOS) that was not treated by other methods - No known factors but trying for more than one year. - More than 3 failed ovulation inductions with clomiphene citrate/injectable medications with IUI. Because 85% of pregnancies that result from IUI, happen within the first three cycles, we do not recommend more than three cycles of each before moving on to IVF/ICSI.