The dynamic between a primary care doctor and a patient is the pathway to constructive and beneficial communication on fertility options.
Rudy Quintero, MD
About 1 in 8 couples have trouble getting pregnant or sustaining a pregnancy; it is critical that healthcare professionals be aware of innovative treatment methods that could help patients struggling with infertility.
The discussion around infertility continues to grow as more women and couples are realizing how truly common it is. And now more than ever before, patients are more openly willing to discuss their unique journeys to starting a family. Primary care physicians (PCPs) are gatekeepers who are often at the front lines of patient care; they can therefore play a crucial role in raising awareness of evolving alternative therapeutic options for women and couples most in need of such information.
Their familiarity with the intricacies of each of their patient’s lives creates unique opportunities to initiate critical conversations about exploring diverse treatment options, as early as possible.
Infertility is highly personal. Every individual’s needs, expectations, and experiences are different. The special, honed, and personalized patient-PCP relationship offers a rare window into each struggling woman or couple’s experiences with fertility. The well-informed PCP can thus have a huge impact on their patient’s lives by presenting them with all available treatment options early in their journey to create a family.
When facing fertility challenges, patients are commonly offered treatment options including timed intercourse, intrauterine insemination (IUI) and in vitro fertilization (IVF). While these established methods with very diverse success rates and costs have helped many couples start or expand their families, they may not fit each individual woman or couple’s unique spectrum of needs that hold them back from realizing their dream of having a baby.
An alternative option that may not be widely known to many women and couples or their health care providers is an Intravaginal Culture (IVC) System. An IVC system is a prescription device intended for preparing, holding, and transferring human gametes or embryos during intravaginal in vitro fertilization or intravaginal culture procedures.
The device is then placed intravaginally allowing a woman's body to be used as an incubator. After an incubation period, the device is removed, and an embryo is selected for transfer. The IVC procedure may be offered by fertility clinics at a price point between IUI and traditional IVF, making it appealing for patients looking for an alternative option.
Because IVC may not always be presented to patients, PCPs have an opportunity to bring more awareness to this option. While they may not be able to offer the service to their patients directly, PCPs can readily provide referrals to a reproductive endocrinologist (RE) practice or fertility clinic that does. Ultimately, patients will need to work with their doctor to determine if IVC is the right option for them.
Since a PCP often has the ability to be more intimately connected to families of patients who they treat over time, it is typical for them to be the first physician in contact with patients before they go to specialists. PCPs therefore have a unique opportunity to see the full picture and thereby provide holistic recommendations that are clinically and socially most relevant to individual women and couples on their path to creating a family.
They can also proactively share information about when it may be time to seek additional help, discuss various treatment options, or refer them to specialists, such as REs.
The goal of always putting a patient’s interests first means that no one should ever have to compromise their expectations and abilities to achieve the highest possible success rates or miss out on the chance of having a child, just because of a lack of awareness of all available treatment options. By arming PCPs with this knowledge, we can hopefully help shed light on all available fertility treatment methods to help more women and couples realize their dreams of having families.
Rudy Quintero, MD, FACOG, is the founder and Medical Director of CARE Fertility. In addition to practicing as a reproductive endocrinologist, he currently also teaches the OB/GYN residents at White Memorial Center and Family Practice at Glendale Adventist Medical Center. The piece reflects his views, not necessarily those of the publication.Healthcare professionals and researchers interested in responding to this piece or contributing to MD Magazine® can reach the editorial staff here.