Choosing to Skip Sex and Go Straight to I.V.F.

“The older I get, the more risks there are of my baby having something,” she said. “It makes me ask myself, ‘If I use the embryo from when I was 31, will the baby be healthier?’” she said. “The embryos have also been tested, so at least I know the basics are OK.”

Dr. Lucky Sekhon, who also works at RMA of New York, the fertility clinic, noted that though preimplantation genetic testing of embryos is not perfect, it can ensure embryos have the right number of chromosomes, which reduces the odds of miscarriage.

Dr. Sekhon also believes that many couples should view I.V.F. as a backup, not a first, option. Many clients, she said, come to her thinking they have little chance of conceiving naturally when they are actually in good health to do so. “Most of these women can still have very healthy babies,” she said.

An exception is someone like Ms. El-Badry Nance, who has the BRCA gene mutation. “They know something runs in their family,” said Dr. Sekhon, “and those are reasons to avoid getting pregnant naturally.”

Doctors agree that I.V.F. is a numbers game, and the more frozen embryos you have to work with, the higher the chance of success since not all unfreeze or implant properly. Because of that, Dr. Sekhon believes most couples, if they can, should first try to conceive naturally before using frozen embryos.

“It’s much smarter to use your embryos when you really need to,” she said. “Isn’t it better to save them for a rainy day?”

But some couples disagree. As Ms. Hartley put it: “We have the science to do this. Let’s use it.”