Should I take the statistics seriously?

Today I talk to my OB on the phone about our next steps. Mostly we are just going to discuss what tests she will order for me and when to schedule the HSG. I have been wondering about that as I wasn’t sure if we could try the cycle when I get the HSG done. I thought maybe if it happened early enough in the cycle I could still try that month but I’m prepared to have to take the month off.

Actually, I’m more than prepared. I’m realizing that whether or try or not doesn’t really matter anymore. Evidently my chances of getting pregnant are so low at this point, missing a month or two doesn’t really matter.

At least that is what “my” RE told me.

My dad has a friend, a very nice RE that he met on this six day hike in the high Sierras. I guess my dad told this friend about how we’d been trying to get pregnant for a while and were getting concerned. This hike was in September so at that point we were about eight cycles in.

I so clearly remember–when my dad got home and mentioned this friend and told me he wanted to hook call him–how completely I blew it all off. I was just so sure we would be getting pregnant in the next few months, I didn’t entertain the idea of contacting him at all. That is very sweet of my father, I thought huffily, but I am not going to need to see an RE.

Fast forward three months and yesterday found me white knuckled, clutching the phone, calling this complete stranger who my dad assured me wanted to help.

He was a very nice guy and during our ten minute conversation he did two things I really appreciated: (1) he listened to–and validated–my concerns (evidently 23-25 day cycles are short for a woman my age and could be a symptom of diminished ovarian reserve) and (2) he gave it to me straight.

At the end of the conversation I inquired about the HSG and whether I could try during the cycle I had it done. He mentioned something about X-ray exposure to the egg–which I hadn’t even considered being an issue–and how he didn’t think it was an issue since a later egg would be exposed too, but that if my doctor suggested I take that month off I shouldn’t fight it because at this point, the chance of me getting pregnant was so slim anyway, it wasn’t really a big deal if I didn’t try.

I have to admit, that really took me aback.

Then he gave me the getting-pregnant-statistics, and I will admit it was a different set of numbers than those I saw in that book, the ones I quoted here before. “My” RE’s are the same statistics Kaiser showed us, in fact, and I had been thinking a lot about them since I saw the slide in their class.

The statistics he quoted me where that in the first three months of trying over 50% of couples will get pregnant (Kaiser had this number at almost 60%). By six months 75% of couples will be pregnant. By the end of the year, 85% will be pregnant and in the next year 7% more will conceive, leaving only 8% in a lurch after two years of trying.

{AUTHORS NOTE–50-60% OF COUPLES GET PREGNANT WITHIN THREE MONTHS OF TRYING?!?!? WHAT THE EVER LOVING FUCK!? HOW IS THAT EVEN POSSIBLE?!?!? No wonder everyone seems so fertile, if over half of the motherfuckers get pregnant in three fucking months!!!!}

Anyway, It’s funny those numbers hit me so hard because they are basically the same as the ones I already knew, at least the most important end game statistics were the same. I mean, I knew I was coming up on that 85%. And I knew only around half of the couples left would get pregnant in the next year. But for some reason I never put it all together in my head, not in a way that made any sense.

So basically, this kind RE was explaining how the fact that I’d been trying for 12 cycles meant that I was effectively in the 85% and every month that I tried after this my chances of getting pregnant experienced “diminishing returns.” Basically, trying now is like some kind of fucked up statistical Hail Mary; that’s how slim my chances of getting pregnant on my own actually are.

It’s weird because I already knew these numbers, I guess I just hadn’t yet internalized what they mean. Honestly, I have been going through the motions on these tests and possible treatments because I felt we had completed some arbitrary waiting game created by insurance companies and once you got to the end of it, you took these next steps. I didn’t actually realize that we are doing all this because our chances of conceiving without these treatments is so low as to be almost non-existant. I guess I felt like were taking these steps because we ought to, not because we had to.

I don’t know. The whole thing has really fucked with my head, and my hope. This, coupled with the sad news of so many bloggers in my reader, has me wondering what the fucking I’m even doing here, trying to play my hand against what feels like an already determined fate. Who the fuck am I to fly in the face of these kind of numbers?

I don’t know. I really don’t. Do I take these statistics seriously? Do I let them govern my heart? How do I keep trudging through the timed sex when I know our chances of conception are so dismally low? And what happens if we can’t afford even a few IUIs? Is this the end of our road?

After hearing those statistics, it sure feels like it.

11 responses

  1. Statistics can kiss my ass! ha. that’s what i’ve learned from my IF journey. sure they hold some weight, but I’m the girl how has been on both crazy ends of the stats. IF at 25, got preg at first IUI (not likely), m/c (20% chance), 3rd IUI pregnant (ectopic, what, 3% chance? you’re here with me on this one), got pregnant w/o assistance on my 28th cycle trying (what, 3% chance?).

    Anyway, yes, probability and statistic say something and those states look really really shitty, but the way it plays out in our lives is so crazy and unexpected. I try to focus on is each cycle that goes by is a cycle closer to my child, however far away that might be (and I fail miserably at times at keeping this in focus).

    HSG has shown to up pregnancy rates in that cycle and the cycle after it. I’ve been told to definitely TTC afterwards (thought is the dye in the tubes may help open them up a bit), but go with what you and your doc feel is right. Interesting that different docs say different things, but both REs I’ve seen and my OB said it helps a bit!

  2. Statistics: a bunch of numbers thrown together by a bunch of people who have been doing this for a while, but still have no clue what they’re doing. They gave me a 32% chance of getting pregnant with my IVF, but the embryologist gave us a 95% chance with the ONE embryo we transferred. And we got knocked up. With my FET they said I had a 50% chance with a single embryo transfer, and we didn’t get pregnant. Now they say a 50% chance with transferring 2 embryos. We’ll see what happens, but at this point, I firmly believe statistics are just numbers and the whole thing, no matter how you go about it, is just a crap shoot….don’t get caught up in the numbers, just know you’ve done everything you can to make it happen on your own, so now you’re getting “professional” help.

  3. Statistics also change based on your age. According to much of what I have read and my RE in your early 30s the odds that you will conceive in any given month are 10-15%. It takes an average of 6.7 to 10 months to conceive.

    Also, I have short cycles as well. I’m not sure what day you usually ovulate, but for me it’s usually Day 17 or 18…leaving me with a short luteal phase. My bloodwork comes back just fine so no diminshed ovarian reserve for me. Maybe you just have a short luteal phase as well?

  4. We are so many standard deviations from the mean on the bell curve of infertile couples that I’m not even certain we’re ON the bell curve anymore. I get you.

    The thing with statistics: it takes groups of people and lumps them together, looking at a cycle retroactively.

    Get the tests done, and you have DATA. You’ll know if Mi.Vida has low count, or you have a short luteal phase (which, honestly, is more likely than diminished ovarian reserve. What will tell you if you have diminished reserve is a pretty easy blood test – FSH levels) or diminished reserve. A HSG will tell you if you have scar tissue in your tubes from your ectopic, or like me, a structural issue with your uterus.

    What you’re doing is getting more DATA. From there, you can make the decision if it’s worth the cost of doing assisted cycles.

    One step at a time, sweetie.

    xoxo

  5. Your post struck a chord with me today.

    I remember being gobsmacked by the statistics as well — and just the sense of … well, but not me…if I just held out for another cycle…

    I was two years into trying (and 34) when I went to an OB/GYN — it would be another year and a half of trying dietary changes and acupuncture — before I saw an RE and got answers.

    FWIW my OBGYN did an HSG but never identified my issue, which remained unexplained for the time I was there — it turned out that my husband was subfertile (perhaps a result of his cortico-steroid asthma meds…not sure still what the factors at play were/are) — and I had PCOS-like ovaries — something that was never mentioned until the RE did my ultrasound on the first cycle with her even though I was overstimulated during a follistim cycle at the OBGYN and had to skip a cycle and the nurse practioners were all like “huh, weird, I wondered why this happened…” (ummm because I am POLYCYSTIC…something that should have been seen immediately upon viewing my very first ultrasound)

    I STILL can’t believe the statistics apply to me. Even though I am not trying and not on birth control (three years now after Z’s birth) — I still think, when my long cycle comes round again…that I might, just might be…

    I just wanted to say that I hear you — and too that everyone has their own timeline on the IF journey — but that said I really wish that I had gone to my RE first — I feel like I had the best advice and information in having seen an expert in the field of IF. It wasn’t easy to hear — and even when I heard it I took some time before acting … but I think of my time at the OBGYN rather bitterly — I hate that they can claim to “specialize” and treat IF — and get money for doing so — but just apply a one-size fits all protocol to the women coming through the doors…makes me crazy.

    Thinking of you,

    P

  6. This is the way I’ve heard the statistics before. And yes, they are discouraging. The way my RE put it, once you’ve been trying for a year, the chance of getting pregnant on your own is 8% a year, but it’s not zero. I chose to focus on the “it’s not zero” part. And of course, with some assistance, that number goes up.

    I also read somewhere that the human mind really can’t comprehend statistics. If we hear “75% chance of getting pregnant within 6 months”, we think we ARE going to get pregnant, because 75% is a high number. If we hear “8% chance of getting pregnant in the next year”, we think we are NOT going to get pregnant, because 8% is so low. We just can’t wrap our brains around the way statistics work.

    But it is great that you’ve been able to talk to an RE, and that your OB will start doing testing. Once you have some answers, you’ll have a much better idea of what to do next.

    (and fwiw, apparently around 30 years ago, they used to do a procedure where they’d clean out women’s tubes to see if it would help them get pregnant. my mom did it and got pregnant with my little sister on the next cycle. So there is a chance the hsg could help.)

  7. I feel like statistics aren’t a lot of help because that’s everyone lumped together, not split out by condition (if there is one) and each person is so individual and weird, there’s no way of knowing which side of the stats you’ll hit. Infertility is a mess of things going on, and to lump it all together into “does or doesn’t get pregnant” isn’t helpful, in my opinion. I’m young(er than you… is that helpful?), it took me a year go conceive (twice) and then 6 months, and with zero help (which we’d figured was impossible, because surely we’d be in that 92% not pregnant after two year-long waits). Once you’ve got your personal data, you can figure out your personal odds better than just the global stats. Maybe it’s as simple as convincing your luteal phase to be longer with some drugs or the HSG clears things up. I’d say take them seriously but not until you have a diagnosis (or no diagnosis).

  8. I agree with what everyone else has said, and I know those stats so well, and yes, they totally fuck with your head. After I hit the 2-year mark of TTC what blew me away the most was the feeling of being part of such a small percentage. It just didn’t make sense to me. It felt so wrong, and yet it was very, very real. But the fact of the matter is, the whole IF industry, for better of worse, survives off of trying to work with those of us in the small percentage. After 2 years trying on our own and 3 IUIs, I got pregnant on my first IVF attempt. I don’t know where that puts me in the statistics but what it does tell me is that you can always keep trying because really, unless you literally don’t have a uterus, ovaries, or set of balls near by, there’s always some chance of pregnancy, no matter how slim. No matter how bad the statistics get, it takes A LOT to get that chance down to zero.

  9. I’ve been thinking about this post all day. Should you take the stats seriously? I don’t know. I know I did. I am a realist and wanted the reality in my face at all times. But that’s not how everyone works and the truth is – you never know where you’re going to fall. We fell on the wrong side of the stats over and over again, but then with this latest pregnancy, we fell on the right side so instantly that it truly makes me feel guilty. You just don’t know where you’re going to land – quick and lucky or slow and painful?

    It all depends on what you feel YOU need to prepare. I agree with the other commenters – knowledge is power. Once we had a diagnosis, I could query the SART scores for IVF based on our diagnosis, my age, etc. and that helped – I felt much better informed with those stats versus the general 85% stats. Leading up to the diagnosis, all you can look at is the genearl stats and they’re scary.

    My RE said that pregnancy rates after a D&C are higher for infertiles than prior to a D&C because it helps to get everything cleaned out. I would think the HSG works the same way – but that’s just my guess. I would totally try if my doc said it was OK.

    I’m really sorry you’re facing this right now. I am glad, though, that you got to talk to someone who knows a thing or two about IF. That’s a big win!

  10. I think he’s given you entirely the wrong message. The diminishing returns apply to the population taken at the start. Your individual returns remain constant. Or put it this way: he forgot to remove from the population each month those who had achieved pregnancy. If he had done that, he would have found a full 25% getting pregnant eight months in. The numbers only look small because the total population has shrunk, but the proportions remain the same. If you keep comparing the numbers to the original population, then of course it will look grim!

    Now of course this applies to normally fertile couples. The real meaning of the numbers is that the longer you go on, the less likely you can attribute things to chance. For many people the game is rigged from the start. But again – that’s from the start. Their actual chances aren’t changing from month to month, it’s just you start wondering if you’ve placed yourself in the right group.

    A better question to ask is, of those still trying at this stage, what proportion end up with what diagnosis and outcome?

  11. And to answer my own question: 50-60% of normally fertile couples who have failed to fall pregnant within the first nine months will achieve pregnancy by the one year mark. So same as the proportion of normally fertile couples who fall pregnant at the start, or during months 6 to 9.

    But that doesn’t mean you shouldn’t get checked out at some point to make sure it’s still reasonable to assume you’re in that group.

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