The Rise of Invitro and How Doulas Can Help
In the age of the “career woman,” more and more prospective mothers are choosing to delay conception for a variety of socioeconomic reasons. In spite of this widespread social and economic trend, pregnancy biologically favors the young. It is universally understood that egg quality and number decline and the uterine environment grows increasingly hostile with maternal age. Increased rates of conception via in vitro fertilization (IVF) have run parallel to this shift in maternal age at the time of conception. According to the Society for Assisted Reproductive Technology (SART), more women are choosing to undergo IVF than ever before1.
A population of women undergoing IVF in the United States is doing so alone. As IVF can be a physically and financially taxing process, often requiring more than one stimulation cycle, it is important that a woman receive adequate support even if she chooses to embark on her maternal journey without a romantic partner. Whether the prospective mother presents with female infertility or is simply seeking sperm donation, this is where having a doula present throughout the various pre- and post-natal steps could make all the difference in the world.
For a woman grappling with the emotional and physical hardships attributable to infertility, a support system is key. Sub-fertile women who choose to pursue IVF treatment often experience feelings of inadequacy and fear at the prospect of never being able to experience the unique and primal bond of motherhood. Considering the looming possibility of failure, the choice to make the physical and financial investment inherent to IVF treatment is courageous and should be met with equal, if not more, support and encouragement.
There are various stages unique to the IVF process, each of which requires patience and strength. The first stage, controlled ovarian hyperstimulation, can cause unwanted side effects including bloating, nausea, diarrhea, enlarged ovaries and tender breasts2. The second stage, transvaginal oocyte retrieval, is a procedure done under general anesthesia, which often leaves patients without pain, but certainly encumbered and groggy. Over the course of the next week or so, women have to play the waiting game while embryologists discard unviable eggs, fertilize mature eggs, and culture them into blastocysts that are subject to a grading system. Only the best embryos will be transferred, and embryo viability is not guaranteed. Finally, an embryo(s) is transferred and once again, the waiting game commences to determine whether or not it implants and results in a clinical pregnancy. Having a doula present throughout each stage could alleviate much of the fear and anxiety that can further hinder a woman’s mental and physical capacity for conception.
Finally, the support of a doula during parturition and the postpartum period has been shown to improve the quality of the birth as well as the initiation of breastfeeding (but we all know that). It is of the utmost importance that women seeking IVF treatment with or without the support of a partner explore their options, specifically with regards to including a doula in their life-altering journey.
Ariela is a recent UCLA graduate, having majored in English with an emphasis in pre-medical studies. For the past two years, she has worked under the mentorship of Dr. Daniel Dumesic, Chief of Reproductive Endocrinology and Infertility at UCLA. During this time, she has co- authored five publications in peer-reviewed journals, presented her research in the form of an oral abstract at the 2013 Conjoint Meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine and has had the great honor and privilege of receiving the first Women’s Reproductive Health Research scholarship. Her current research project examines the potential implications of follicular fluid cortisol and cumulus cell lipid metabolism on oocyte maturation in women undergoing ovarian stimulation for IVF and has been accepted for presentation at the 2014 meeting of the American Society for Reproductive Medicine. In 2013, Ariela traveled to Guatemala for one month to study medical Spanish at the Pop Wuj school and to expand her clinical experience at their medical clinic. While abroad, she spent much of her time studying under a legendary, indigenous midwife at her home. Together, Ariela and Dona Ana delivered four babies and provided countless consultations to members of the local, native community. Ariela is currently applying to medical school and plans to pursue a career in Obstetrics and Gynecology with a specialty in Reproductive Endocrinology and Infertility.