Making Fertility Treatment Decisions: A Framework for Choosing Your Next Step

Choosing the next step in your fertility journey can feel overwhelming — IUI or IVF? Wait or escalate? Dr. Erica breaks down the exact framework she uses with her patients and clients to cut through analysis paralysis and make evidence-based, values-aligned decisions about treatment.

In this episode:

• Why every treatment plan has to start with your desired family size — and why this question gets skipped so often
• The history that actually matters: how long you've truly had sperm-and-egg exposure (not just "trying")
• Red flags that move IVF up the timeline: tubal disease risk factors, genetic conditions, and more
• Why the difference in success rates between trying 6 months vs. 12 months under 35 is smaller than you'd think
• The “two to three follicles” rule for IUI cycles for unexplained infertility or endometriosis — and why hitting that goal can take you from under 5% to 10–15% success per month
• Letrozole vs. Clomid: side effects, success rates, and why letrozole is often the better first choice
• "Hybrid therapy": using a baby dose of FSH with letrozole in women in their late 30s — the physiology behind why it works
• When IVF makes sense from the start: large desired family size, genetic risk, tubal factor, or PGT-M/PGT-SR indications
• Why "less is more" isn't always wrong, even when IVF feels like the safer bet
• Reframing scarcity mindset around embryo numbers and aneuploidy risk