Why a New Generation of Greater Philly Parents Are Approaching Pregnancy Differently

Daily life has changed a lot since the Philadelphians who are now having children were born, a group that includes Millennials of all ages and even the first wave of Gen Z parents. The rise of smartphones and social media in the ‘00s goes without saying, but even in the past five years, life has changed rapidly. A competitive economy and the rise of remote work, a renewed focus on public health, and a more conscious support of diverse populations, just to name a few factors, have changed daily routines and long-term goals. And that means parenthood looks different as well. 

The new generation of Philly parents are often having kids later, being more open in their pregnancy journey, and making important decisions around their health and the health of their child. This is particularly true for the rapidly increasing number of parents who are receiving help in the form of fertility care, where technological advancements and new approaches in the field are enabling greater control over big life decisions, and making treatments like in-vitro fertilization, or IVF, a first-choice solution for more couples, rather than a last resort.

“Patients are feeling more empowered to take control of their future fertility potential while they continue to live their current lives,” says Dr. Allison Bloom, reproductive endocrinologist at Main Line Fertility in Pennsylvania. Main Line Fertility is the largest fertility network in the region, with six locations and eight providers across the southeast of the state. So, to get a sense of what the modern Greater Philly parent looks like, and why more parents are opting for fertility treatments, we spoke to their physicians about how their patients are making decisions about their future. 

From the accounts provided by these fertility experts, fertility care is seeing a wave of new parents taking control of their pregnancy for the better, and expanding the range of choices that young parents-to-be can make about their future. 

The Changing Age of Parents

Different aspects of modern life appear to have led to a change in the typical age for Philly-area parents. The workforce has become more competitive and time-consuming, and post-pandemic social life (and therefore dating) has become more distanced and arguably complex. Whatever the exact cause, many people who desire to be parents are choosing to wait to have kids. At the same time, there’s greater awareness of the drivers behind infertility.

“In general, younger patients are more aware than ever of possible fertility barriers in the future,” says Dr. Shannon Alexa, OB/GYN specializing in reproductive endocrinology at Main Line Fertility. However, they more often “defer starting a family until much later than previous generations.”

That means fertility services are increasingly in demand. And today’s fertility experts have the ability to confidently support these patients.

“Societally, people are delaying childbearing and finding partners. Our parents were typically in their early ‘20s when they had our generation of kids, and now people are looking to start families in their mid to late ‘30s,” says Dr. Stephen Somkuti, reproductive endocrinologist at Main Line Fertility. “There’s no doubt that there have been some fantastic improvements over the last decade in IVF to meet their needs.”

An increasing number of young women are choosing to freeze their eggs without a partner, and modern egg-freezing procedures, involving a technique called vitrification, have made it so that this decision makes a lot of sense.

“Years ago, when you froze an egg, you might have had a ten-percent survival rate. Now it’s up to 90 percent,” Somkuti says. “So you can now freeze your egg, and five to ten years from now, when you’ve found the right partner, or you want to use donor sperm to create an embryo, you’re always going to have the success rate of the age that the egg was created. If you come in and you’re 28, and you come back and you’re 38, your success rate is always going to be the success rate of someone with a 28-year-old egg.” As Somkuti explains, not only does this mean your chances of a successful birth are “frozen in time,” but so are the risks of any genetic abnormalities in the fetus, which normally increase with the parent’s age. 

Couples, too, are deciding to wait longer, which has led to a rise in embryo-freezing. Somkuti explains that there are advantages to this approach, but patients have to think carefully. 

“Freezing embryos is always preferable to egg freezing because the survival rates are 97 percent compared to 90 percent,” Somkuti says. “Couples can continue to build their family in the future with the advantage of using the healthier embryos they banked at a younger age.”

Because Pennsylvanians are choosing to freeze earlier, that also means the potential for older patients having a child has increased. At Main Line Fertility, they’ve made advancements in making sure a healthy pregnancy is possible for these older adults. 

“The uterus doesn’t seem to age, so you can use hormones to create a receptive uterine lining for the embryo to bed down on, and an older patient can still carry the pregnancy to full term,” Somkuti says. These patients have to make sure their body as a whole is healthy enough for pregnancy, and Main Line Fertility takes substantial precautions in that regard. Somkuti works with OB/GYNs to take more frequent ultrasounds and blood pressure monitoring, for example, to make sure not just the embryo, but the parent, stays healthy.

Better-Informed Decisions

As the technological capabilities in fertility increase, treatments like IVF are having a more significant impact–and becoming an important option even for patients that might not be having major struggles with fertility. 

“Many patients are now considering in vitro fertilization as the first line of treatment for infertility and family building. This is because IVF is efficient and has a high success rate,” Bloom says.

One of the most important developments in fertility in recent decades has been the development of pre-implantation genetic testing, a technique that has made IVF particularly impactful for parents whose children may be at risk for genetic disorders or abnormalities. As more parents opt for IVF, this process is becoming a more common part of pregnancy.

“We can send cells from the embryo to genetic testing during the development of the embryo, and a couple weeks later we receive a response from the lab that can tell us the chances for a healthy pregnancy,” Somkuti says. “Twenty years ago, the error rate was high, but now the reliability is close to 99 percent.” 

This allows physicians to select the embryo most likely to carry to term.

In addition, for patients with a family history of disease, physicians have an increasing ability to work around those conditions. Somkuti has seen it in practice. “Two of my patients, a couple, turned out to be carriers of a genetic disorder,” Somkuti says. “But we tested the embryos and figured out which ones were affected. And they had the birth of a healthy child. It’s a fantastic technology.”

Increased Accessibility 

Another reason behind the rise in fertility treatments has been the fact that treatments like IVF are more accessible than they were before. Main Line Fertility, for one, has found that its multiple locations, ranging from downtown Philadelphia to Reading, are each able to provide the full range of fertility services available, with the exception of egg harvesting and other major procedures that occur at their Bryn Mawr location, where their IVF laboratory is located.

“I primarily work out of the Philadelphia and Havertown offices as well as perform IVF procedures at our main Bryn Mawr office,” Bloom says. “All six of our offices offer daily monitoring, including lab work and ultrasounds.This allows patients to choose the most convenient location for them each visit.”

Extending that accessibility further is the fact that telemedicine use has risen sharply since the pandemic. 

“Before COVID, I couldn’t give a telemedicine appointment away,” says Somkuti. “Now, even though we’re very accessible at our locations in the suburbs and in the city, many people want telemedicine appointments for appointments such as monitoring and follow ups.” That’s useful not just for convenience sake–it makes a real difference for patients with hectic jobs in being able to pursue having a child. 

Of course, accessibility isn’t just a matter of how the appointment happens, but how care is delivered. And fortunately, the process of IVF has gotten easier. Previously, the medication necessary to stimulate egg production required painful, difficult injections. Now, these injections are only skin deep and injected below the belly button, which makes that aspect of the process far more convenient.  

“You can go through the whole process without taking any large needles,” Somkuti says. 

The Shared Journey

There’s also an increasing understanding of the psychological aspect of IVF. On one hand, more young couples are sharing their journeys online and on social media, as the concept has become more accepted. 

“There has been a significant increase in the number of patients who are considering egg freezing,” Bloom says. “The increased awareness and discussion on social media, among peers, and with OB/GYNs have helped to make the process more normalized.”

But the struggles particular to IVF can still be significant, particularly for those historically discriminated against by the medical community. Fortunately, practices like Main Line Fertility have seen an increase in more diverse populations trying IVF, thanks in part to an effort to make everyone feel welcome and safe in accessing these services, which can be particularly important for members of the LGBTQ+ community. Main Line Fertility has an active outreach program that delivers lectures and support groups to provide concrete aid to this end.

“At Main Line Fertility and as a person who has gone through the IVF process with my wife, we take pride in providing exceptional care to our LGBTQ+ community. Our personalized care is available to patients and their partners, regardless of their gender identity or sexual orientation,” Bloom says. “In order to provide better services to our patients, we have expanded our third-party reproduction team, which includes help with the use of donor eggs, donor sperm and gestational carriers. Additionally, we offer fertility treatment and preservation options for trans and non-binary patients.”

Understanding and empathy are qualities that providers like Main Line Fertility have increasingly tried to build into their practice. Even if ultimately couples are overjoyed at the end of the process, the journey can be stressful.

“We understand that there is an incredible physical and mental toll with an infertility diagnosis, and treat our patients as we would a member of our family,” Alexa says. “We also know that there is strength within a community, and work with local mental health specialists to provide support to our patients as they receive care.”

Somkuti himself knows that IVF can be emotionally challenging. And that’s why he’s there for younger couples as they go through their own journey. 

“As a couple, we went through the crying, the depression, the anger, the guilt,” Somkuti says. “So I tell people, you have a sympathetic ear, even if it’s a different experience for you.”