When we are talking about your chance to get pregnant, mostly, there are unasked questions in your eyes like 

Can I get pregnant? What if not? Is it possible at the first attempt if not when? What is this medicine all, any side effects? Long-term effects? Why not natural therapy? I heard that it could be natural without any medicine. Did this doctor see any cases the same as me? What happened to them?

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In 1991 when I first began to work at a fertility center, in vitro fertilization success rates were only 5%; for severe male factor cases in which the sperm count and motility were very low, we were so hopeless in that days,, spilling sperms on each egg and waiting for them to pass the egg shell and fertilize eggs were like a hell of waiting all night long till the next morning, Mostly the day after embryologists telling us ‘fertilization failure’. 1992 Dr. Palermo from Brussels announced his first sperm injection to egg, the case was pregnant, what a revolution, we run to Brussels same year, learned the technique, it was now a new era, but still, there were cases like zero sperm count at ejaculate, 1995 Dr. Schoysman from Brussels declared the first case of testicular Sperm isolation and using for microinjection at IVF laboratory and was successful, one milestone was passed, then many medicines changed, injection become much more painless, user friendly like instead of intramuscular just subcutan with little tiny needles, mainly patients can do it by themselves, we also began to use specially designed catheters to transfer embryos, these catheters were visible under ultrasonography so we can see the tip of it and directly release the embryo to the point where it  has to be, incubators changed enormously, mediums that we put eggs and sperms and embryos in it had a considerable evolution, using laser energy for assisted hatching of egg shells if necessary instead of mechanical or chemical hatch was another technical evolution, when we needed to fereze eggs or embryos it was slow freezing technic and when we thaw them almos half were damaged, then we began to use vitrification..very fast freezing, victory came, 99 percent intact cells at thawing, almost zero loss. All these years, the gynecologic instruments had a very fast evolution also. Hysteroscopy cameras changed a lot, and it became possible to make it in office settings; polyps, septums, adhesions, almost 90 percent of cases now were easy targets to solve the issues at the office in a few minutes … 

 

Last 5 years, our pregnancy rates have been about 60-65% overall. What progress!

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We are after 99 ! though we know, it can take another 30 years or maybe less.

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Teamwork

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Of course, it's impossible to tell all our patients on their first visit the history of  fertility treatment for the last 30 years. After seeing more than 12.000 cases at 32 years, feeling still young and ambitious is good; there must be a fast and easy or better way to explain my optimism to my patients. Talking to much technical details is boring, I know 60 % hope still contains 40 percent fail, but the empathy between the couple and I is between truth and trust. It sounds simple, but it's not that easy and takes time; I learned at the very beginning of my profession 41 years ago. I prefer to tell my patients we have now become a team; this is like a marathon run; we as a team will try our best, share everything with you, the good or bad, and decide together what to do, when, and how.