Fertile Ground
Couples struggling to conceive turn to local fertility centers to realize the joy of becoming parents
by Bill Donahue


Lauren Figg* never wanted children. Until the day she did.


Figg and her husband, both originally from the Philadelphia area, decided not to move back home after finishing college. Instead, they got jobs working in other cities, traveled to Europe and the Caribbean, figured out who they were. Quite simply, they had fun. Their jobs enabled them to stay fairly nomadic, and kids never factored into the equation.


Eventually, however, something tugged at Figg—something from within—making her think she might want kids after all … some day. The arrival of Facebook turned the gentle tug into a clear and definitive pull she could no longer ignore.


“I saw all these people I knew and had grown up with, settling down and starting families, all looking deliriously happy,” she says. “I would sit at the computer for hours, looking at pictures of my old friends and their kids. I would imagine myself in their shoes. That’s when I knew I wanted a family of my own.”


(Click here for some of the region’s top fertility specialists and other physicians devoted to keeping local women fit and healthy.)


At about the same time, Figg also acquired an urge to return to her hometown, so she and her husband quit their jobs in Arizona and returned to the Philadelphia area—to nest—settling on the western edge of Montgomery County. Figg insisted they start trying to have a baby almost immediately.


Months passed and the world kept spinning around them. On the plus side they both found good jobs—she in real estate, he in financial planning—yet on the minus side, despite their efforts, she just wasn’t getting pregnant.


Figg married her husband in their mid-20s, and nearly 10 years later she found herself wondering if her age—closer to 40 than she wanted to be—was somehow muddying their plans. Her child-bearing window seemed to inch nearer to a close with each passing day, and she began wondering if “it” would ever happen.


The Figgs have plenty of company among “older” couples who struggle to conceive. Approximately 7.3 million U.S. women ages 15 to 44 have impaired fertility, according to the U.S. Centers for Disease Control and Prevention. (Statistics suggest another 2.1 million married women in the same age bracket are infertile.) Men and women in pursuit of education, career and/or life experience are choosing to wait to start a family, which can be a challenge if they wait till after the age of 35—so-called “advanced maternal age” for women.


“The major reason behind the increasing need for what we do is that women and men tend to be waiting longer to start a family,” says Jennifer Nichols, D.O., of Abington Reproductive Medicine, which has multiple locations throughout the suburbs. “The average age of people when they were ready to enter into marriage used to be in the early 20s; now it’s closer to 26 or 27, and that’s playing a large role because a woman’s reproductive health is based strongly on age. As a working female physician, I see that more women are driving toward education and achieving what they desire in life—the right partner, the right job—but the biological clock is always there.”


Women who are younger than 35 should see a fertility specialist after trying to conceive without luck for a year, sources suggest, while and women age 35 or older should seek the advice of a qualified physician after trying unsuccessfully for six months. A woman approaching 40 or over 40 should consult a specialist as soon as she knows she wants to start a family. Besides age and the so-called “male factor,” infertility can be attributed to a range of issues, from hormonal problems that can disrupt ovulation to fallopian-tube abnormalities to something as simple as poor health and diet.


“The first time we meet with patients we listen to the journey they have had that brought them to us and make a personal connection with them,” says Dr. Nichols. “It’s nice to discover who they are as a couple and as individuals. On the medical side a thorough medical history is taken, do a review of any prior records or tests and have a detailed discussion of infertility and the tests done to determine the cause for their infertility.”


At Abington Reproductive Medicine, initial tests include blood hormonal assessment of egg quantity/quality (ovarian reserve testing), procedures such as an ultrasound to determine if the uterus is normal and an ultrasound with bubbled saline infused through the fallopian tubes to see if they are open, according to Dr. Nichols. Additionally a semen sample is done to evaluate the male. The initial testing and diagnosis are typically covered through most health-insurance providers, though the total costs can span a wide range depending on the needs of each couple.


“Although the female is the main determinant of success, we have seen dramatic increases in take-home baby rates over the years,” she says. “Typically oral or injectable fertility medications can more than double a couple’s monthly chance of pregnancy, while in vitro fertilization has by far the highest chance of success. In general IVF success rates for couples under 35 are 50 percent to 60 percent, and this [statistic] trends down to 20 percent for women in their early 40s.”


Beating the Odds

In 2010, U.S. fertility centers conducted 146,693 cycles of IVF, according to the Society for Assisted Reproductive Technology in Birmingham, Ala. Of the 39,173 nondonor (using the patient’s own eggs) cycles for women ages 35 or younger, 47.7 percent resulted in pregnancy, while, as Dr. Nichols suggests, just 20 percent of the 9,549 nondonor IVF cycles for women ages 41 and 42 achieved pregnancies.


Several notable fertility centers in the Philadelphia suburbs are outperforming the national average in this regard. For example, King of Prussia’s Reproductive Medicine Associates of Philadelphia scored 63 percent in terms of the percentage of nondonor IVF cycles resulting in pregnancies for the under-35 set; Wayne’s Reproductive Science Institute scored 59.2 percent; and Bryn Mawr’s Main Line Fertility and Reproductive Medicine scored 54.6 percent.


In Montgomery County, Figg and her husband can count themselves among the people who once struggled to conceive but can now call themselves “happy parents.”


In 2010, at the suggestion of a workplace friend, the couple decided to enlist the help of a prominent fertility specialist on the Main Line. After thorough testing of husband and wife, the physician prescribed a treatment that included, among other things, oral medications design to release hormones that would regulate Figg’s ovulation. Within a few months, the couple had successfully started down the road of the nine-month miracle known as pregnancy.


Figg had the good fortune to have skydived, sailed the azure waters of the Caribbean and traveled extensively for her job in her 20s and early 30s. Now, as the 38-year-old happily married mother of a 1-year-old son, she is embracing what could very well be the most exhilarating—and most gratifying—adventure of them all.


“Not every day is a barrel of monkeys,” says Figg, “but I couldn’t be happier that we had our son when we did. You sacrifice sleep, you sacrifice some of your life to a degree [in starting a family], but there’s no better feeling—and maybe nothing scarier—than the moment they hand you your baby and knowing nothing is ever going to be the same. I’ll always remember it.”


* Name changed to protect privacy