Welcome to a new feature from PREG where our doctors weigh in on a variety of fertility-related issues designed just for you!
Dr. Karenne Fru, MD, PhD
Reproductive Endocrinologist
Answers questions about Patient Education & Fertility Preservation
Dr. Fru, you’ve stated that one of your biggest roles is that of educator for your patients. Can you share more about that role and its importance?
“I’m typically starting from scratch with the patient. I am first an educator/advice-giver and second a doer if that makes any sense {chuckle}. The patient needs to be educated enough to make a decision that I can then act on.
The very first conversation that I have with them is to commend them on their valiant efforts. Second, the conversations that we have center around what their goals are personal, because what I’ve noticed is that a lot of them have never been asked what their goals are in regards to establishing a family, most of them have most certainly never been asked about their ideal family size, so the first conversation usually centers around dreaming a little bit. And I say, If you had to tell me what your idea of family size was, what number of children would that be, what combination of genetic versus other offspring would you be envisioning? That usually starts us on the conversation of what exactly do we need to do to achieve that goal?”
So, you are like a personal fertility coach in some respects?
“So, every patient that comes into my office, I tell them that we are a team, and it’s not one size fits all. It’s never one size fits all. This is patient-driven care and my job is to make recommendations, couch it in reality and some data, laboratory data, and maybe we do some tests and then we base what the treatment is going to be on that. It is so very much customized right down to the individual’s worldview, their religious constraints, financial constraints, ideas of morality and all of it done with the highest ethics. All of it very much right down to the individual.”
How important is that initial conversation about asking about patient goals from your perspective?
“Oh extremely, because it sets up an idea for me what that patients priorities are and how realistic they are in regards to what age they are when we encounter each other versus their goals.
For example, if a 30 yr. old comes in and says I would like to have a couple of kids that’s more realistic than a 42 yr. old with the same plans. A couple of genetic offspring. Now, if somebody comes in and says I would like one child, one genetic offspring and then I plan on adopting, or something like that, it may be possible, but maybe not if they are coming in at age 45. It’s a way for me to scale what we can do to take care of the patients to what is actually realistic and achievable based on their age and other factors.”
Explain the timeline for patients from the initial conversation to the point where you are saying, “We are ready to go!”
“The data we get on the female is good for about a year, six months is even better, but can be extrapolated up to a year depending upon the woman’s age so the younger, the better. I usually tell people the sooner they can get treatment the better because time is ovary, meaning the longer you wait the more challenging the outcomes get and the older you are the faster the challenges can become worse. My patients are accustomed to my plainspeak.
If someone came in today and we could get their workup completed within 4-6 weeks typically and then, if they were looking at oocyte cryopreservation for example because they wish to delay having children then that can be accomplished within the next six weeks. “
Why is fertility preservation so important to women, especially those delaying childbirth for one reason or another?
“It’s good that it’s become an option. It is not a panacea. It will not solve every potential problem out there. These are women with unproven fertility so we don’t know if in the future if they had attempted pregnancy, if they would meet the definition of infertility. At least it gives you an option that doesn’t cross off the possibility of having genetic offspring. This is important because many women are delaying childbirth until later and focusing on the next career milestone, the next personal finance milestone and this is one area that has been neglected as a society. I think 20% of new moms are over age 35 now; that’s just the way things are moving. The pregnancy and birth rates are falling among younger women and that has been largely due to economic, and societal pressures. So having an option that allows you to reproduce when the timing is right for both. For me, as a woman and a reproductive endocrinologist, I am excited to be able to offer my patients the possibility of motherhood, whether it’s now or in the future.”
PREG has offices in Greenville, Spartanburg, Asheville and Columbia. We offer highly personalized fertility care and management. Dr Fru is based at the Columbia, SC, office. For more information on reproductive options call, or contact us today at 866.725.7734, or online at http://www.pregonline.com/contact-us.php
Dr. Karenne Fru, MD, PhD
Reproductive Endocrinologist
