By Cindy Atoji Keene
Women need to begin thinking about their reproductive options early – in their 20s and 30s – rather than the 40s when it may be too late, said Alison Zimon, a reproductive endocrinologist at Boston IVF, a New England infertility treatment center with locations in Boston and surrounding suburbs. As more and more women delay childbearing, there can be unrealistic expectations that medical science can undo the effects of aging. “I do believe that most women understand age is important but perhaps are unaware that age is the simple most predictive factor for reproductive success,” said Zimon, who offers infertility treatment options, often beginning with IVF (in vitro fertilization) a lab procedure where eggs are fertilized outside of the womb.
Q: Who is your typical patient – I’m assuming it’s a woman in her 40s who has been trying to get pregnant for some time?
A: There is often a feeling that 40 is the time to embark on parenthood, but we see all types of people, from women with longtime partners to those who have just broken off relationships. There are single women debating whether they should consider donor sperm; same sex couples hoping to build a family; those considering a surrogate mother and much more. I’ve seen all social backgrounds and orientations as part of my practice.
Q: How often does treatment result in pregnancy?
A: For in in vitro fertilization, the success rate is good, especially if egg reserve is high – it’s a 50-60 percent pregnancy rate in one attempt. Of course, younger women have a much higher chance of pregnancy. For donor egg – using someone else’s egg – it’s 65 percent in one attempt.
Q: What’s the approximate cost of fertility treatment?
A: These are highly technical procedures. We are talking about injectable fertility drugs, blood work, ultrasound monitoring, and procedures where eggs are extracted from women and handled in the laboratory. The multiple step process can be expensive; we have a financial coordinator that works with the patient. In Massachusetts, fertility is considered to be a medical problem so many insurers include it in the medical coverage, as long as you’re under a certain age. Typically an IVF cycle is a little more than $8 thousand dollars; genetic testing of an embryo, $ 2-5 thousand dollars.
Q; Do you feel that a patient’s psychological health affects their physical ability to get pregnant?
A: The way i see is it that infertility is incredibly stressful. Support groups, massage, acupuncture, and better nutrition are all essential for emotional and mental well-being. A lot of data indicates that perhaps reducing stress may lead to better outcomes, but it’s not definite.
Q: Isn’t infertility medicine is amazing because it evolves so rapidly?
A: We’ve made tremendous strides especially when realizing that the first IVF baby was only 36 years ago. The latest breakthroughs have been in testing of embryos – the number of genes we can test now is almost limitless. Technological advantages have also improved the egg freezing process, making it possible for women to delay motherhood, store their eggs and use them later.
Q: Why did you choose to become a fertility specialist?
A: I loved it instantly because you can really help people. It’s heartbreaking to see women struggle with infertility and very satisfying to offer treatment with such good outcomes. I’ve always been very science-minded – this is a field where application of new science translates into clinical applications very rapidly.
Q: What’s a “success story” that was meaningful to you?
A: Some of our patients overcome tremendous hurdles. Among the most meaningful to me is the story of a nurse with Hodgkins Lymphoma. After a three-year course of chemotherapy and radiation, she overcame her battle with cancer, but developed ovarian failure due to her cancer treatment. Then, after a single treatment cycle using donated eggs, she and her husband became pregnant. She carried a healthy pregnancy to term and gave birth to her daughter, now two years old, who is the joy of her life.
Q: Though you were trained in obstetrics, you don’t deliver babies as a specialist. What is it like saying goodbye to patients once they are pregnant?
A: I remember sharing the good news about a patient’s reassuring ultrasound. Her due date was in 32 weeks so she had now “graduated” from our practice. I was so surprised when she become tearful, hugged me and said, “I feel like we are breaking up!” These are happy good-byes and fortunately life often finds ways for me to reconnect.