Infertility in the News
- A new study by scientists at the University of Birmingham in England looking at 124,351 IVF pregnancies found a link between lower number of eggs produced during IVF treatments and increased risk of miscarriage. It was found that "about 20% of pregnancies in women who produced fewer than four eggs after the ovarian stimulation phase of IVF ended in miscarriage...The miscarriage rate fell to 15.5% for women who produced between four and nine eggs, and 13.8% for those with between 10 and 14 eggs." Additionally, it was shown during the study that a woman's age was a factor in this as the ability to produce a lot of healthy eggs does decrease the older she gets. Read more here.
- Barriers to Treatment for Fertility Problems: The purpose of this study is to learn about the psychosocial aspects of treatment for problems with fertility. It will take about 10 minutes to complete. Your participation is completely anonymous. Women who are between the ages of 18-45, not currently pregnant, and have difficulty conceiving naturally through unprotected intercourse, and/or carrying a pregnancy to live-birth delivery are invited to participate in this study. You must also have an in-person source of social support. In appreciation of your participation, two $100 donations are being made to the American Fertility Association and Resolve: The National Infertility Association by the research team to thank you for sharing your experiences and to benefit others who struggle with fertility problems. If you have any questions about this study, you may contact the Principal Investigator, Dr. Pamela Geller, Ph.D., or the research coordinator, Mitra Khaksari, B.S., at 215-553-7121215-553-7121
Click here to participate in this anonymous survey.
- Exciting new research published in The New England Journal of Medicine and Human and Molecular Genetics journals, demonstrates that both Premature Ovarian Failure and azoospermia (very low or absent sperm count) have a genetic connection caused by a mutation of a specific gene. Mutations to the STAG3 gene have been associated with POF and azoospermia in mice, but these studies confirits association in humans.
- James and Melissa Perry (from the MHP Show on MSNBC) recently welcomed a new bundle of joy, a daughter, on Valentine's Day. She has just released an article where she talks about how she and her husband decided that using a gestational surrogate was the best option. Although Melissa conceived a daughter when she was 28 years old without any complications, trying for baby #2 turned out to be a different story. Read her story "How We Made Our Miracle" here.
- What's a miscarriage really like? It's not always like what you see in the movies or a 30 minute TV show; there are so many emotions that you go through during the process; and it doesn't necessarily happen quickly as is how it is often portrayed on TV. Sometimes you're left in pregnancy limbo while your body slowly goes through the process of miscarriage. Check out Slate article of a personal account of miscarriage. Read the full story here.
- Reproductive Medicine Associates of New Jersey is trying to decrease the number of multiple births resulting from fertility treatment. Almost half of children born with the help of ART are twins, and multiple births have a significantly higher risk of being born premature and other pregnancy complications. Historically, multiple embryos are transferred during IVF to increase the odds of conception, but according to the RMANJ’s BEST Trial, women with one embryo implanted after chromosome screening had the equivalent delivery rates as women with two embryos implanted with no chromosome screening. By screening and selecting the most viable embryo, a single embryo has a the same chance of resulting in a live birth while decreasing the risks of pregrancy complications. This new technology could help improve the health of both mothers and children, and we are proud that the Reproductive Medicine Associates of New Jersey are sponsors of Creating a Family.
- Great article talking about the practicalities of talking to children conceived via donor egg, donor sperm, donor embryos or surrogate. I loved the 20 year old donor conceived young woman's take on it. I also thought it was helpful to think of ways to help our kids respond to any negative comments, such as the one she mentioned about being a "science experiment". Great food for thought.
- One of the great things about the American Society of Reproductive Medicine conference is that it encourages the mass media to focus on infertility once a year. As a result we see a host of news articles the weeks surrounding the conference. This article, "Fertility clinics offer gay couples new pregnancy options," in the Christian Science Monitor explores a new option for lesbian couples to both share in the creation of their child. In the "two-mom" approach, eggs from one partner are mixed with donor sperm in the lab, and then implanted in the other woman, who carries the pregnancy. While not necessarily cheap, since it involves IVF, it is an option for those who have the money or will have to do IVF for other reasons.
- House of Surrogates is a BBC documentary about Dr. Nayna Patel’s Akshanka clinic in rural India. Commercial surrogacy was legalized in India in 2002, and at Dr. Patel’s clinic, up to 100 surrogates live in dormitories while pregnant. Commercial surrogacy is controversial and Dr. Patel has her critics who call her clinic a baby factory and claim she is exploiting the poor – surrogates receive only a small fraction of her heafty fee – but Dr. Patel claims she is empowering the local women with life-changing amounts of money. The documentary and accompanying articles are fascinating and thought provoking look into the lives of the surrogates and the couples who hire them to carry their children.
- Michael Ravitch and his partner’s son via surrogacy died at 20 weeks and this article is a beautifully poignant look at the experience. Ravitch writes movingly about how men and women interact with miscarriage differently – “And the pain of feeling that life snuffed out – of nurturing something with your bodily essences – and feeling it die inside you – how can a man’s experience compare to that?" – and his family’s grief. The last works are especially haunting. “He has a name, he has a grave. We saw his face. These things were real. He has left his trace on me, like a fossil embedded in my flesh. He never existed – but he still exists. I have nothing to remember, and yet I can’t forget. I can’t quite put him out of me.”
- Selling the Fantasy of Fertility is a interesting op-ed piece by Miriam Zoll and Pamela Tsigdinos in the New York Times about the unsuccessful side of fertility treatment, selling hype in reproductive medicine and the need for transparency from the ART community. Make sure to also check out the letters to the editor in response to the piece.
- Jimmy Fallon has announced that his first child was born via a surrogate. Fallon and his wife Nancy have struggled with infertility for years before daughter, Winnie Rose, was born on July 23rd. They chose not to announce that they were expecting until after their daughter’s birth.
- Great article in the New York Times Motherlode column on secondary infertility. The grief and pain over the inability to have a second or third child is so often minimized. After all, you have one child already, why complain? Right? Wrong? Understanding what was wrong helped this woman move forward.
- Carrie Grady, a graduate student at Drexel University, is working on a research project that studies African American women's coping after miscarriage and stillbirth. African American women experience miscarriage and stillbirth twice as often as any other racial/ethnic group, but there is almost no research dedicated to African American women's experiences of coping after this loss. This study was designed to address this inequality. Participants, African American women specifically, are asked to fill out an anonymous online survey, which asks women about their pregnancy loss experiences and how they coped and healed from this event Hopefully, this information will help doctors and nurses improve their quality of care for African American women who have had a pregnancy loss. Carrie Grady can be reached at cmg349 at drexel dot edu and the advisor for this research, Dr. Pamela Geller, can be reached at pg27 at drexel dot edu.
- Almost half of the 7.3 million people struggling with infertility, almost half are male. For a third of couples trying to conceive, the problem lies with the man. There are scores of resources and dialogues about infertility catering to women, but there is little support and plenty of cultural shame for infertile men. The Washington Post has a great look at the world of male infertility.
- We owe a debt of gratitude to Dr. Robert Edwards, nobel laureate & pioneer of IVF (along with Dr. Patrick Steptoe) for his work that brought over four million children into the world and changed the lives of approximately 8 million happy parents. Dr. Edwards died Wednesday, April 10, 2013, at 87. May he rest in peace after a long successful life. He will be missed.
- Hugh Jackman, star of Les Miserables, talked about infertility and adoption on the ABC day talk show Katie. He and his wife, Deborra-Lee Furness, suffered through IVF and miscarriages before turning to adoption to build their family. "I'll never forget it the miscarriage thing -- it happens to one in three pregnancies, but it's very, very rarely talked about. It's almost secretive, so I hope Deb doesn't mind me bringing it up now. It's a good thing to talk about it. It's more common, and it is tough. There's a grieving that you have to go through." From the moment their son was born, Jackman said, "all the heartache just melted away." They adopted two children: Oscar, now 12, and Ava, now 7.
- In the midst of all the news coverage of Hurricane Sandy, did you happen to think of the infertility patients that were scheduled for egg retrieval for IVF the day of the storm? What happened to the frozen embyros, eggs, and sperm when the power went out? I loved this article that talked about how doctors and staff at various centers worked together to make sure these patients didn't lose their cycle and that the frozen embryos, eggs, and sperm remained in cryopreservation. Differnt fertility centers worked together, staff worked overtime, people pulled together. Nice story.
- Fascinating article in Slate on gender selection. There is a lot more gender selection going on than most people realize. It is legal in the US, and most people are selecting for a female baby. Keep in mind, that the focus of this article was not on sex selection as part of fertility treatment, but for fertile couples. The same technology can and is used with infertility treatment.WE did a Creating a Family show on Gender Selection which covered the legality, ethics, is it possible to sex select without IVF, and how to do it with IVF.
- Lisa Maxwell, Loose Women star, talks bout how the pain of miscarriages & too much work almost broke up her relationship. Celebrity is no protection from recurrent pregnancy loss.
Lesley Brown, the first mom through in vitro fertilization, died at age 64 in England of undiscolsed causes. It's hard to remember back to a time when IVF children were called "test tube babies" and people were afraid for the survival long term. Lesley Brown was one brave woman! She ultimately went on to have two daughters via IVF. Her eldest daughter, Louise, said, "Mum was a very quiet and private person who ended up in the world spotlight because she wanted a family so much." We would all be lucky to have that as our epitaph.
New research on how infertility affects women long term who do not go on to become a mother through infertility treatment, adoption, or third party reproduction. "[Infertility] is, essentially, an assault to a woman’s identity. Although most women are forever changed by the infertility experience, many issues begin to resolve once you have a child. For those who decide not to have children after ceasing treatment, this issue –- this assault to identity -- remains very much alive.”
Over time, most of the women in the study reported tremendous growth after stopping fertility treatment. “Several ongoing issues remain, of course, but most participants had integrated the loss into their narratives, had actively reimagined their lives and were embracing life once again.”
The study found that on average it took three to four years for study participants to fully emerge from feeling like infertility was their primary identity. http://www.upenn.edu/pennnews/news/penn-researcher-looks-infertility-s-impact-women
Good article on infertility affecting women under the age of 30. It's good to see some media attention on infertility in younger women. So often we hear about women over 40 who are trying to conceive and it leaves the general impression that infertility is exclusively a disease of age. Nothing could be further from the truth.
Neil Patrick Harris, star of How I Met Your Mother, acknowledged that he struggled with bonding to his twins with his partner David Burtka. "When they’re so little and they’re just crying," he admitted. "I just didn’t -- I don’t know what’s wrong." Harris even talked to a therapist about his struggles in connecting with them. The twins were born through anonymous egg donation and surrogacy. Boy-girl twins: Gideon and Harper. A cute video of the dads with their children. Adorable.
- As worldwide demand grows, U.S. sperm exports become a thriving business. The article leads with the quip that was just too good to be passed up “America’s hottest new export is made by hand.” Demand for American sperm is surging — up by as much as 40 percent in the last five years — as other countries clamor for genetic material with the “Made in America” label. U.S. sperm sales are highest in the United Kingdom, Canada, France, Israel, Australia, Chile, Spain and Sweden, and demand is set to increase even more in the years ahead. The US had a well-developed network of banks, and laws that allow for men to make donations anonymously. May 2012
Acupuncture Ups ertility & Pregnancy Rates – New Research Article acupunture increases pregnancy rates with infertility treatment summarizing some of the latest research on the effectiveness of acupuncture to increase pregnancy rates with those undergoing infertility treatment. The first study focused on a small group of women on Clomid. Those who also used acupuncture had a significantly higher pregnancy rate. The second study summarized in this article was much larger.The study of almost 6,000 women found that acupuncture improves clinical pregnancy rates and live birth rates for women receiving IVF (in vitro fertilization). May 2012
- Thoughtful article in the NYT, A Daughter Too Young — and Too Old — to Freeze Eggs, by a grand-mom wanna be on talking with her 2 daughters (aged 32 and 28) about the advantages of freezing their eggs while young in order to preserve their options if they choose to wait. I'm not sure the mother has her infertility facts straight (32 is likely not over the hill for egg freezing), but what I found particularly fascinating about the article was the response by her 28 year old daughter about why 20-somethings don't want to be encouraged by their parents to freeze their eggs.
- I Found my Embryos on Craigslist -news video about a couple with 18 excess embryos frozen after having three children via IVF. The mom posted on a Craigslist forum that she was looking for couples to use them. She wanted an open "adoption" with these families. She gave 9 embryos each to two couples, who have not used them yet. This story has so many different levels to it, including the discussion by the RE at the end. Join us over at the Creating a Family Facebook group to discuss it. (May 2012)
- Woman & her surrogate both pregnant with twins. After 10 yrs of trying to conceive, a couple turned to a gestational surrogate. They had 6 embryos and transferred; two to the surrogate and had four transferred to the woman. Both women are due at the same time with twins. I have mixed emotions on this story. In some ways it's proof that infertility often causes us to make poor decisions because we feel desperate. (May 2012)
- Research recently published in the New England Journal of Medicine compared the birth defect rates of various types of infertility treatment. The problem with research on birth defects with infertiity treatment is that it is difficult to determine whether the increased risk is due to the infertility treatment or due to the same biological problems that caused the infertility in the first place. This research attempts to tease out this distinction. this was a large study comparing over 6,000 births from infertility treatment with over 300,000 births from natural conception. Overall, with assisted reproduction methods, the risk of any birth defect was 8.3 percent compared with 5.8 percent for unassisted pregnancies. For in vitro fertilization (IVF), the risk for birth defects was 7.2 percent. For intracytoplasmic sperm injection (ICSI), it was 9.9 percent. Women using clomiphene citrate at home to stimulate ovulation had triple the risk of birth defects, the researchers noted. It appears that a history of infertility may be associated with increased risk, independent of treatment. And using frozen embryos substantially reduced the risks from ICSI. Fascinating!
- Congratulations to Tagg Romney, eldest son of Mitt Romney, and his wife Jen on the birth of twin boys via surrogacy. These are children 5 and 6 for the couple. The first three were born to Jen, and #4 was born via the same surrogate that carried the new twins. This is an interesting twist this election year since various states will be considering legislation or constitutional amendments that would affect the availability of IVF, which, of course, is a necessary first step to gestational surrogacy.
- Good article on the new set of sextuplets born to a Houston couple. It is nice to see an article that distinguished between IVF and IUI and talked about why people often choose IUI--money! However, I wished they had explained that higher order multiples are almost always the result of medicated artificial insemination (IUI) cycles. This article seemed to assume that sextuplets could result from a non-medicated cycle because insemination is more efficient at getting the sperm to the egg. I also wish they had explained, that most good infertility clinics carefully monitor the ovaries prior to the insemination, and should cancel the cycle if they see 6 ripe eggs (or turn in into an IVF cycle). Also, they should talk with the patients before they attempt a medicated IUI cycle to understand the patient's position on selective reduction. Patients that do not want to do selective reduction may not be good candidates for medicated IUI cycles, or at the very least, the cycle should be done in a very very conservative and cautious manner. I know none of the details of this case, so much of what I have said is conjecture--but educated conjecture.
- An English teacher at a Catholic school was fired for undergoing infertility treatment that included IVF. Emily Herx had taught at the Indiana school for 8 years and was well regarded, receiving high evaluations. In 2010, Herx and her husband had the first of two In Vitro Fertilization cycles to try to conceive after receiving a diagnosis of infertility. After the second IVF cycle she was fired by the school priest, who said, according to court documents filed by Herx for unlawful termination, that she was a "grave, immoral sinner" and that if news of her IVF treatments got out it would cause a "scandal" for the church. The priest allegedly said the church disproved of fertility treatments because they require the creation of additional embryos that are ultimately destroyed, a violation of Catholic teachings regarding the sanctity of embryonic life. Herx noted that no embryos were destroyed during her IVF cycles. You can watch a clip from Good Morning America on this stoyr and join in a discussion of this case at the Creating a Family Facebook Support Group. (April 2012)
- Giuliana Rancic, and her husband Bill, are pregnant via gestational surrogate. Ranick, 37, E! News host and Fashion Police cohost, has been very public about her infertility struggles and miscarriage. She was also diagnosed and treated for breast cancer during the time they were trying to conceive. What a fitting story of hope for Infertility Awareness Week.
- By a 7 to 2 vote, the Naperville City Council approved the zoning for an infertility clinic that drew opposition from some who oppose in vitro fertilization for religious reasons and equate it to abortion. We blogged on this controversy last week. There were heated exchanges between the Catholic priest and the infertility doctor as well as between the Pro-Life Action League representative and one City Council woman who took exception to the League's threats of protest. Beautiful sentiment was expressed by Rev. Melissa Bills, who spoke of her troubles conceiving, saying, “the people (in opposition) did not speak for all Christians” and urged the council to only consider the land use issues in the case.
- Article in Slate about immigration risks for egg donation, sperm donation, or surrogacy abroad-Mother Country:The perils of getting an assist abroad on having a baby—for Americans and foreigners both. If you go abroad for fertility treatment via third party reproduction what are the legal and immigration risks and what do you need to do ahead of time to prevent these problems to make sure you can you get your child back into the US? Also check out the March 28, 2012 Creating a Family show on this same topic.
- The" Dear Prudence" column in Slate Magazine ran the following question: "My amazing girlfriend of four years has been told that she will never have biological children. It was devastating to both of us. She is coming to terms with it and saying things like, "We can look into adoption." While I've been trying to support her, the truth is, I'm now wondering if our relationship can make it. The more I think about adoption, the more uncertain I feel, and it would be unfair to adopt a child without being sure. I've researched a bit on surrogacy and donor eggs and all, and it sounds very complicated and expensive, and there's no guarantee. I know this sounds cold and callous, but the whole infertility issue is beginning to look like a deal breaker for me. Am I being a jerk?" You can read Prudence's response and participate in the discussion at the Creating a Family Facebook Support Group.
- Really good CNN News segment on using donor eggs to conceive via IVF. So often the media coverage is either inaccurate or sensational or both, so this was a refreshing change. I thought the editing of the piece didn't make it as clear as I would have liked that they were talking about using frozen donor eggs, but that is a minor quibble. They cited 66% pregnancy rate using frozen eggs. Pretty darn amazing. The two doctors interviewed were both from Reproductive Biology Associates in Atlanta.
- Interesting article in Slate by a 30 yr old single woman on why she would prefer to be a single parent- I Want To Be My Kid’s Only Parent: I crave the closeness of single motherhood—without the complications a husband can bring. She was raised by a single mom and had a wonderful childhood and can't imagine having to share the parenting duties with someone else. She raises the point that this might be a generational shift. (Feb. 2012)
- Good article about how to celebrate Valentine's Day when you are in the midst of infertility treatment and the last thing you want to think about is romance.
- This article in the New York Times on the growing popularity of using DNA testing to find birth family members is just one of the reasons that I think parents through third party reproduction should tell their offspring of their origins. Genetic testing has surged in popularity over the last decade, as the cost of analyzing cell samples has dropped and as Americans have grown more interested in learning about their heritage. More and more people will routinely start using these tests and donor conceived people will likely learn of their origins. Better to hear from their parents than a DNA lab.
- Should there be an age limit on Assisted Reproduction Techniques, such as IVF? Or is parenthood a fundamental human right? This series in Toronto newspaper, The Star, does a wonderful job looking at all sides of the issue, including from the medical standpoint and from the children’s perspective. Is assisted reproduction technology today what birth control was to the 1960s: Irreversible, positive change allowing women to become moms at whatever age works for them without the impediments of biology? The article quotes a woman as saying that egg freezing, which allows a woman to preserve her healthy eggs until she is ready for a child, will “lead to true women’s liberation.” Hummm?!? Also check out the Creating a Family show 2 weeks ago exploring this same question of How Old is Too Old to Become a Parent?
- New study in the Journal of Pediatrics calls for a mandate for single embryo transfers for IVF due to increased risk for babies and cost. Researchers studied one NICU for two years and found that 82 infants (17%), admitted to this NICU were from multiple births resulting from some form of assisted reproductive technology. Of these, 75 were twins or triplets whose mothers used IVF. As Dr. Barrington notes, "Among these 75 babies, there were 6 deaths, 5 babies who developed a brain bleed, and 4 babies who developed a potentially blinding eye condition."
- We are used to thinking about fertility tourism as Americans going abroad for cheaper fertility treatment or surrogacy, but the travel can go both ways. Couples from abroad coming to the US to hire a surrogate. Interesting, the children are born with automatic US citizenship. LA Times "Born in the USA.
- Documentary filmmaker is looking for single midlife women seeking to become first-time mothers willing to share their stories of the heartache, trials, social stigma and joys faced in their journeys toward motherhood. She does not care whether the women are straight or lesbian, nor whether they are seeking to adopt or have a child through donor sperm, donor egg, or surrogacy. The producer is herself a single, midlife woman "with an ever-present desire to become a mother". contact her at rmcclainla at sbcglobal. net.
- Do you remember Carolyn Savage, the woman who had a baby in Sept. 2009 from another couples embryo after an accidental mix-up at their infertility clinic? She and her husband gave the baby to his biological parents. (We did a Creating a Family show on this topic in fall 2009 and caused up to develop a fact sheet for infertility patients "Top Ten Tips for Avoiding Medical Mistakes, Errors, and Mix Ups in Infertility Treatment".) Savage, a mom of three, was unable to carry another pregnancy after the September 2009 birth. She and her husband announced that they are now expecting twins via surrogacy due in August. Talk about a feel good story!
- Elizabeth Banks, of 30 Rock Fame, in a new mom via gestational surrogacy to a beautiful boy named Felix. Her 30 Rock character Avery Jessup is a new mom in the show as well.
- As is often the case, the media reports the sensational, which often doesn't reflect the normal. Such may be the case with the reports of 1 sperm donor producing 150 children. Read this thoughtful blog by Dr. Michelle Ottey , with Fairfax Cyrobank, on how the modern world of sperm donation really works. Patients have a choice. Ask the questions and choose those sperm banks that abide by the ASRM guidelines.
- Ishani Ticinelli, a doctoral student in Counseling Psychology at Fordham University, sent me the following request. "I am working on my dissertation investigating the psychosocial impact of infertility on African American women. If you know of any African American women who, if under 35 years of age have, after one year of well-timed intercourse been unable to ......conceive or carry to term, OR if over 35 years of age have, after 6 months of well-timed intercourse been unable to conceive or carry to term, please have them contact me by email at bhattacharyy @ fordham.edu. I understand that this may be a difficult topic to discuss. All interviews will be private and confidential. Many women have been dealing with this experience in isolation. This study could help better inform medical and mental health professionals who work with women suffering from infertility and create supports for them. All participants who complete interviews will be given $50 for their time. Thank you in advance for your help.
What environmental factors can affect sperm production? Do you need to worry about radiation from the Japanese nuclear disaster. Check out this article.
Absolutely wonderful radio interview on National Public Radio show "All Things Considered" Taming The Twin Trend From Fertility Treatments. One of our repeated messages here at Creating a Family is that twins and higher order multiple births are not the desired goal of fertility treatment due to the risks of twin births. Infertility patients desperate to have a child often overlook these risks, until they happen to them. Please help spread the word with this terrific 8 minute interview and with our Creating a Family podcast on reducing multiple births.
Alexis Stewart, 45, Martha Stewart's daughter is the proud mom of a daughter, Jude, born via surrogacy on March. Alexis, who is single, started IVF in 2007 and acknowledged that she was spending around $27,000 a month on fertility treatments. Grandma Martha said, "Martha, 69, told her fans: 'I stopped in last night after a business trip and I got to see her when she was about 36 hours old - she is very alert and doesn't cry. Ideal baby." Sounds like what a grandmother would say. :-)
The Center for Disease Control (CDC) has a new texting service, Text4baby, where pregnant women and new moms can receive free text messages each week with information for a healthy pregnancy and a healthy baby.
How do you define family? Read one gay man's definition in a touching article in Newsweek: Meet My Real Modern Family.
This National Institute of Health website provides information on clinical trials on Primary Ovarian Insufficiency/ Premature Ovarian Failure (POI/POF). It also has some great resources explaining why the name change from POF to POI.
An Iowa House Subcommittee has advanced a bill, HF 153, which would give constitutional rights to embryos. A good article in the Iowa Independent explains the ramifications of this bill. (My thanks to Reproductive Law attorney Amy Demma for pointing out this article.) The bill now goes to the Human Resources Committee, and then very likely to the full GOP-controlled House, where it has a good chance of being approved. The American Society of Reproductive Medicine and the Society of Assisted Reproductive Technology sent a thoughtful and well reasoned letter to various Iowan officials. They laid out the reasons why this type of legislation is harmful to many and helps few. It is so worth the read. We have reprinted it in full on our Advocacy page.
Interesting article in Pittsburgh Tribune-Review titled "Debate swirls around overseas surrogacy". Although it is less about the debate and more about the actual practice, it is still worth the read and is a good summary of why US couples often turn international surrogacy.
- Many women either need to or want to wait until later in life to start a family. They know that their biological clock is ticking away and that their fertility decreases with age.There is a growing demand for in home “pee on the stick” type tests for predicting how many reproductive years a woman has left., Since a major cause of reproductive aging is the aging of the ovary, most of the focus has been on looking at markers of ovarian aging -- such as FSH or AMH -- as a potential fertility test.New research calls into question the effectiveness of such tests.
Great and insightful article in the Huffington Post titled Infertility: The Disease We Need to Start Talking About “It seems that for most men and women facing infertility, it's easier to deal with something so emotionally, physically, and financially draining without having to field questions and opinions from every well-meaning friend, co-worker, or family member. Such comments like "Just go on a vacation, relax, and you'll get pregnant," or "You can always adopt," are far too painful to even acknowledge, so people figure that by remaining silent they'll avoid opening themselves up to such commentary in the first place.
It doesn't help matters that there's no general consensus on how to label infertility. In 2009, the World Health Organization officially defined infertility as a disease. Yet many individuals, organizations, and insurance companies still say that having children is a lifestyle choice and that infertility is not a serious medical issue. Some even liken fertility treatments to cosmetic surgery. But ask the millions of couples desperately trying to get pregnant whether or not having children is a necessity. Why would they subject themselves to months or years of such turmoil if, to them, it weren't essential that they try?”
Should Infertility Treatment be covered under new federal health care law? Is health insurance coverage of fertility treatments an essential benefit to help people manage a medical disorder? Or is it a life-enhancing benefit, nice to have perhaps but not essential because it doesn't sustain a person's life? In other words, is infertility a disease worthy of coverage in the new health care law passed by the Obama administration in 2010? A panel of experts convened by the Institute of Medicine (IOM) is wrestling with this and other issues raised by the new health-care law. Members are trying to determine what essential health benefits should be included in polices available through the state-based insurance exchanges where individuals and small businesses may buy coverage starting in 2014. The IOM recommendations will go to the Department of Health and Human Services. This debate was not reported on the IOM website, but was reported in Kaiser Health News Jan. 24, 2011.Parentdish also covered this news.
Recent research by Dr. Ali Domar suggest that those patients that reported higher scored for stress and anxiety before an IVF cycle had a greater chance of pregnancy, especially if they had good coping skills for handling the stress during the cycle. These finding were supported by one other study also reported at the ASRM conference in Oct. 2010. Check out the Jan. 19, 2011 Creating a Family show where we interviewed Dr. Domar.
A New York Times article reports that recent census analysis shows that child rearing among same-sex couples is more common in the South than in any other region of the country. In fact, Jacksonville, Florida is home to one of the biggest populations of gay parents in the country. Also, the data shows that Black or Latino gay couples are twice as likely as whites to be raising children,
Congratulations to Nicole Kidman and Keith Urban, both 43, who welcomed their new daughter Faith Margaret Kidman Urban. News reports state that she is the biological child of the couple and was carried by a gestational carrier. She joins big sister Sunday Rose, who was born to Kidman 2 1/2 years ago. Kidman also has two children through adoption from her previous marriage to Tom Cruise, Isabella and Conor. What's most amazing is that the baby was born on Dec. 28, 2010 and the couple was able to keep the pregnancy and the birth away from the news until Jan. 17. Hats off to them for that feat and for their new daughter. You can also read about the story here.
"Google Baby", a documentary on egg donation and surrogacy, is airing Wednesday, Jan. 5, on HBO 2. Focusing on the international nature of the egg donation and surrogacy. i.e. egg donor from the US, surrogate from India, intended parents Israel. See trailer here. I haven't see the full documentary, so can't say how fair or well rounded the presentation.
Recent research published in the Lancet journal indicates that gaining excessive weight during pregnancy increases birth weight and the risk for obesity in the offspring later in life. This was a large study of over 500,000 women and 1.1 million children. Weight gain of over 50 pounds was found to be detrimental, compared to women who gained between 17 and 22 pounds.
I saw the article on the front page of the New York Times and sighed. The title, Meet the Twiblings, promised in my mind another one of those articles focusing on the new fangledness of third party reproduction: Gosh darn, look what they've done now. I was sure it would start tongues wagging of designer babies. Well, I was wrong. This one is worth the read. I real story of a real mom through egg donation and surrogacy. My full review can be found here.
Cytomegalovirus (CMV) is the most common infection present at birth in the U.S. (1 in 750) and can cause serious disabilities. If you are pregnant or thinking about getting pregnant, the Center of Disease Control has a great resource to tell you how to protect your baby from CMV.
Exciting research into endometriosis shows a genetic connection for moderate to severe endometriosis. Next step--a CURE. Please.
Calling all parents through gamete(egg and sperm) donation. The great organization Parents via Egg Donation is developing a document to distribute to the media for preferred language to use when talking about egg and sperm donation. They need your input on what language you prefer. Take this anonymous survey.
Ethics of Outsourcing Pregnancy to India. Thoughtful video exploring the ethics of using a foreign surrogate, specifically surrogacy in India. This is part of a lecture with philosopher Michael Sandel. Unfortunately, it is only a short excerpt from a larger lecture, so will leave you wishing for more. Approx. 5 minutes.
Household Chemicals Linked to Early Puberty & Infertility Evidence is mounting that exposure to everyday toxins found throughout our lives may cause infertility and early puberty. The list of chemicals includes phthalates, the plastics chemical bisphenol A (BPA), perfluorinated compounds found in nonstick cookware, flame retardants, the antibacterial agent triclosan, and mercury. We will have a radio show on this subject within the first couple of months of 2011.
Swiss researchers tested four common vaginal lubricants, Felis Lubricant, Replens Vaginal Moisturizer, Aquasonic Ultrasound Gel, and Pre-Seed. All four lubricants are labeled as "not spermicidal", but the researchers found that only Pre-Seed was non-toxic to sperm. The other three lubricants reduced sperm movement by up to 88 percent. The study was funded by Hygis, a Swiss company that resells pharmaceutical compounds but does not produce Pre-Seed.
According to Harvard researchers, men who eat foods high in mono-unsaturated and saturated fats, have a lower sperm count than those who eat foods high in poly-unsaturated fats. High intake of mono-unsaturated correlated with a 46% reduction in sperm; high intake of saturated fats correlated with a reduction of 40%. Mono-unsaturated fats are found in vegetable oils such as olive oil, canola oil, peanut oil, sunflower oil, and sesame oil. Saturated fats are found mostly in foods from animals such as beef, veal, lamb, milk, and cheese. Poly-unsaturated fats are found in fish, whole grains, and some seeds and nuts. Summary of this research can be found here.
Obesity is associated with lower pregnancy and higher miscarriage rates during fresh in vitro fertilization procedures; however, when frozen embryo transfer is used, pregnancy, live birth, and miscarriage rates are not significantly different from those of nonobese women, according to research presented here at the American Society for Reproductive Medicine in Denver. For fresh embryo transfers, 1367 women were studied, 82% (1126) were not obese, and 18% (241) were obese. undergoing fresh embryo transfers. The pregnancy rate for nonobese women was 59.6% compared with 56.0% for obese women.
179 women had frozen embryo patients, 79% (141) were not obese, and 21% (38) were obese. The pregnancy rate in the nonobese women was 56.0% compared with the higher rate of 63.2% among obese women.
The miscarriage rate among obese women in the fresh cycles group was nearly twice as high (12%) as among those women who were not obese. However, in the frozen cycles group, the live birth rate for nonobese women was 29.1% vs 26.3% for the obese group, which was not a statistically significant difference.
Medscape http://www.medscape.com/viewarticle/731933 has a good summary of this research, including an interview with the lead researcher where he gives some theories on why obese women have a higher success rate with frozen embryos. Registration is required to read the article, but it is free.
What motivates egg donors? How do they feel a year after they donate? Interesting research presented at the ASRM conference gives us some insight. This article in US News and World Report summarizes it well.
Several states have introduced amendments or legislation that will severely restrict an infertile couple getting appropriate treatment. Recently, a number of states have proposed legislation that would define human life as beginning at the moment an egg is fertilized. As shorthand, such bills are often referred to as "Personhood Legislation." In Colorado, an initiative to amend the state Constitution to adopt this definition was defeated by the voters in November, 2008, but has reappeared for a statewide vote in November, 2010 (the “Personhood Amendment”). This Constitutional amendment would give all persons, "from the beginning of [their] biological development," i.e., from the moment of sperm-egg fertilization, inalienable rights, equality of justice, and due process of law protection under the Colorado Constitution. Georgia, South Carolina, and Arizona also have bills pending that would have the same effect. Although careful not to mention the infertile, these bills would significantly affect a couples treatment. Check out the Resolve site for more information on this threat.
Celine Dion gave birth to twin boys conceived through IV. the boys were early and will remin in an incubator for several dayls, but both weighed 5+ pounds. Mother and sons are doing fine.
A fascinating study out of Standford University on how to determine which embryos to transfer was released recently. In my opinion, one of the greatest need for advancement in infertility treatment is determining which embryos are more likely to implant. If we knew this, we could transfer fewer embryos and also give patients a better idea of their chances of success. The study developed the technique of filming the embryos starting within hours of fertilization. Three factors were the most predictive of robust embryos: 1) the time that the embryos took to complete their first cleavage, splitting into two equal cells in no more than 33 minutes, 2) dividing again anywhere between nearly eight hours and 14 hours later, from two cells into four cells, and 3) then cleaving again from four cells into eight cells within six hours after the last division. Embryos can be ranked based on these factors. With more research it may be possible to predict which embryo is most likely to implant within 24 hours, thus allowing for transfer on Day 2. The lead researcher, Dr. Renee Reijo Pera, director of human embryonic stem cell research and education and a professor of obstetrics and gynecology at Standford, was a guest on the Jan. 6, 2010 Creating a Family show talking about the need for couples to donate unused frozen embryos for research. She discussed this research.
Robert G. Edwards, an English biologist who with a physician colleague, Patrick Steptoe, developed the in vitro fertilization procedure for treating human infertility won the Nobel Prize for medicine. Since the birth of the first test tube baby, Louise Brown, on July 25, 1978, some four million babies worldwide have been conceived by in vitro fertilization. Dr. Edwards, a physiologist who spent much of his career at Cambridge University in England, devoted more than 20 years to solving a series of problems in getting eggs and sperm to mature and successfully unite outside the body. This NY Times article reported on some of the controversy that surrounded their research and implied that it was this controversy that was responsible in the delay of over 30 years in getting this award.
A fascinating study was recently published in BJOG: An International Journal of Obstetrics and Gynaecology on how different assisted reproduction techniques affect the gender of the resulting babies. Researchers in Australia studied all live births following fertility treatment in clinics in Australia and New Zealand between 2002 and 2006. 13,368 babies were born to 13,165 women who underwent single embryo transfer (SET) in that period. The study was undertaken to find out if there is a link between the type of ART used and the sex ratio at birth, defined as the proportion of males in all babies born alive (also known as the secondary sex ratio - SSR). Deliberate sex selection is banned in Australia. In this study, the SSR for babies born from single embryo transfer (SET) was 51.3%, which is comparable to the SSR for the general Australian population (51.5%). However, the results also show that specific ART regimes do indeed influence the SSR. There were fewer male babies born after ICSI SET (50%) and more after IVF SET (53%). The stage at which the embryo was transferred had even more effect; 49.9% for cleavage stage SET and 54.1% for blastocyst SET. The highest SSR was in the IVF SBT transfer group – 56.1% males – and the lowest in the ICSI cleavage SET group – 48.7%.
Good article in the New York Times on the often rocky mix of professional athletics and motherhood. A Dream Deferred, Almost Too Long It explores how intense physical training and delaying conception can result in infertility. Although this story will not come as a surprise to those who are infertile it does serve to explain why some woman postpone motherhood.Pro tennis player, Gigi Fernandez, says
“As an athlete, you have this attitude, ‘I can do anything with my body. That’s how you think. So your biological clock is ticking, but you’re in denial.” She acknowledges that she would not have gone through egg freezing for fear of tinkering with her body through hormone injections. She and her partner are not the parents of twins through egg and sperm donation.
I loved this blog by Mel Ford (aka Stirrup Queens) about the recent report that linked stress to infertility. Why "Just Relax" is Still Not Helpful Advice in the World of Infertility In addition to the whole chicken and egg debate (did infertility cause the stress or did stress cause the infertility), there is plain old common sense. Most folks are pretty darn relaxed when they first start trying. So if stress alone causes infertility, everyone who pops the champagne and ditches birth control would be pregnant.
Researchers at Stanford University have developed a test to help determine a woman's chances of conceiving on her second IVF cycle if the first cycle failed. Doctors perform nearly 150,000 in vitro fertilization treatments in the United States each year, but fewer than 1 in 3 results in a live birth. The treatments cost $10,000 to $20,000, with health insurance only rarely covering the expense. A test that would help couples decide to pursue a second round would be immensely helpful.
Neil Patrick Harris, star of the TV show How I Met Your Mother and guest star on Glee, is expecting twins with his partner David Burtka via donor egg and surrogacy. No information on due date has been released.He made the announcement via Twitter.
I loved this article in Self magazine about the hidden impact of infertility--the "aloneness", the shame, the embarrassment. We need to get the message out that infertility is a disease. We need not be silent or ashamed about having a disease.
Reproductive Technology and Its Impact on Child Psychosocial and Emotional Development by Dr. Susan Golombok is a good introductory summary of what the research shows on how children conceived through IVF, ICSI, donor egg and donor sperm are doing from a cognitive and psychological perspective. It was published in 2003, but the information is still relevant.
An infertility clinic in Spain, which treats patients from around the world, donates unused frozen embryos to other couples without the express consent of the biological parents. In the US, couples must give informed consent before their embryos can be donated to another couple or donated for research. In addition, due to strict anonimity laws, the biological parents will not have information on these children and the children will not have access to information on their biological parents when they are adults.
New reports of screw-ups by Octomom's doctor, Dr. Michael Kamrava. One mistake clearly took place before the birth of Nadya Suleman's octuplets and it is not clear whether the other incident was before or after the octuplets. The first case involved the transfer of 7 blastocysts (day 5 embryos) into a 48 year old woman. Four implanted. One died and another has significant disabilities due to a premature birth at 33 weeks. The second case involved failure to detect advanced ovarian cancer.
Interesting article, and as always the following comments, on becoming a single mother by choice. I'm a single mother ... by choice. I second the author's endorsement of Mikki Morrissette's Choosing Single Motherhood. It is a must read, and so is her website.
Just saw a trailer to a fascinating new documentary on single motherhood by donor sperm. SINGLE CHOICE: MANY LIVES It looks wonderful. It is semi-autobiographical and follows the documentarian's journey on deciding whether to pursue single motherhood through donor insemination. She describes it as a "bittersweet journey - my own investigation of these concerns from the varied viewpoints of those whom this choice most deeply affects." She doesn't gloss over some of the uncomfortable aspects of this decision.
This article on stem cell research may be of interest to those couples with unused embryos that they want to donate to research. NIH rejects use of dozens of stem cell colonies by federally funded researchers. The National Institutes of Health refused to approve the use of dozens of colonies of human embryonic stem cells by federally funded researchers. President George W. Bush had severely restricted the use on stem cells derived from human embryos for research. President Obama relaxed the policy somewhat, but issued rigorous ethical guidelines for their use, including a strict interpretation of what type of consent must be obtained from the donating couple. The NIH found that consent forms permitting use of the embryos contained unusually broad language and those who signed the forms gave up all rights to sue the clinic for any reason, and thus did not follow the new ethical guidelines. The lines in question had been obtained from embryos donated by couples who were undergoing treatment for infertility and had decided not to use them because tests showed the embryos carried genetic defects. The NIH did approve eight other new lines, bringing to 75 the total number of embryoinc stem cell lines now eligible for federal funding.
The Motherlode column in the NYT did it again. Read this simply beautiful essay titled A Father’s View of Infertility by Mike Adamick. I think we, as a society, focus on how women are impacted by infertility and the guys are often overlooked.
Actress Constance Marie writes about her struggles with infertility and 3 IVF attempts.
Editorial in The Telegraph loosely based on the article mentioned in the prior Infertility in the News entry about the number of abortions in the UK following IVF. The editorial is titled "Spare us the hypocrisy of the IVF industry". As is unfortunately always the case, the comments are depressingly insensitive.
The headline reads “Dozens of woman are having abortions following fertility treatment”. The article in The Telegraph is on a recently released study in the UK. I have concerns about both the study and the article. The study found that an “unusually high” number of abortions (80 per year) were performed in England and Wales on women who have undergone IVF treatment. Doctors expressed surprise at the figures, and several critics accused women of treating babies like 'designer goods'.
Around half of the abortions are carried out for women aged between 18 and 34, who are less likely to suffer complications in their pregnancies or conceive babies with abnormalities, raising the question that they “may have had abortions for 'social reasons'”. Towards the end of the article, they reported that selective reductions of fetuses in multiple pregnancies are included in the figures.
Any pregnancy termination is a tragedy, but I question the glib conclusions that women who conceived through IVF were treating the decision lightly. From what I read, the attributed motivations were purely speculative. Selective reductions can and should be avoided by careful consideration of the number of embryos transferred, but are seldom a quick or callous decision. Listen to a truly insightful Creating a Family show Fetal Reduction to Reduce Risk or Triplets and More.
Researchers at Michigan State University have found that the use of intracytoplasmic sperm injection (ICSI) reverses the natural gender ratio at birth. The usual ratio of boys to girls at birth is 105 boys to 100 girls. Boys are considered more fragile and likely to not survive childhood, thus the higher percentage assure a more even ratio by early adulthood. When ICSI is used, this ratio was reversed. In many clinics ICSI is standard for most IVF cycles regardless of the cause of infertility. "The sex ratio of singleton offspring in assisted-conception pregnancies" Fertility and Sterility Volume 92, Issue 5, Pages 1579-1585 (November 2009)
Thought provoking article in the NYT titled The Birds and the Bees (via the Fertility Clinic) about a recently released report on how young adults conceived via sperm donation have fared. (My Daddy's Name is Donor: A Study of Young Adults Conceived Through Sperm Donation) The Op-Ed questions our current system of egg and sperm donation. Here's an excerpt: "Americans conceived through sperm donation also are more likely to feel alienated from their immediate family than either biological or adopted children. They’re twice as likely as adoptees to report envying peers who knew their biological parents, twice as likely to worry that their parents “might have lied to me about important matters” and three times as likely to report feeling “confused about who is a member of my family and who is not.”...
Some of these burdens are inherent to a process that replaces natural conception with scientific technique. But some of them could be eased if the legal system treated sperm and egg donation with the gravity it deserves — as a process that’s far closer to adoption (and potentially more traumatic for the child involved) than our culture cares to admit."
I plan on summarizing this report on our Infertility Research page and hope to interview the lead investigators in July. Stay tuned.
Celine Dion, 42, is pregnant with twins on her sixth IVF cycle. She was public last year about an early pregnancy loss. The babies are due in November.
New hope for women cancer patients to preserve their fertility. Nine healthy babies have been born to women who had some of their ovarian tissue removed and frozen before undergoing chemotherapy. The tissue was thawed and successfully transplanted to the women.
Article with some good advice on what to say when someone tells you they are infertile. Sometimes, the best is the simplest. "I'm so sorry this is happening to you."
Several prominent Rabbis have stated in rabbinic rulings on fertility treatment that a child conceived through in vitro fertilization is Jewish only if the egg came from a Jewish woman. The Wall Street Journal article is aptly titled Fertility Treatment Gets More Complicated .
Donating unused frozen embryos to research is not easy. Read the article in Newsweek about one woman's failed attempt.
A new study, published in a report from the Hastings Center, a nonpartisan bioethics institute, compares egg-donor advertisements placed in 306 college newspapers with the American Society of Reproductive Medicine guidelines which suggest a limit of $10,000 for egg donation with payment amount not related to characteristics of the donor. The study showed that nearly a quarter of the ads placed by egg-donation agencies and private couples exceed the $10,000 guideline. Compensation often varied based on SAT scores. For each 100-point increase in scores, compensation offers in the ads increased by $2,350, the study found. One ad in the newspaper for Brown University offered $50,000 for “an extraordinary egg donor.”
In a separate commentary published with the study, John Robertson, chairman of ASRM’s ethics committee, questioned why there should be ASRM guidelines on choosing eggs based on the characteristics of donors. “After all, we allow individuals to choose their mates and sperm donors on the basis of such characteristics. Why not choose egg donors similarly?”
Sean Tipton, a spokesman for the reproductive medicine society, said that the group had little authority over egg brokers and that concerns expressed about donation smacked of sex discrimination. “It’s interesting to me that people get upset about egg donation in ways they don’t get upset about sperm donation,” he said. “You never hear discussions about, ‘Oh, the sperm donor is going to regret it some day that they have a child.’ ” In all due respect to Mr. Tipton, egg donation is significantly more invasive than sperm donation thus raising the concern over payment unfairly inducing young women to take this risk. The Wall Street Journal and the New York Times have reported on this study. (March and May 2010) See also the article below that shows what happened in the UK when compensation for egg and sperm donors were significantly limited by the government.
The Pew Research Center reports a trend toward mothers who are older and better educated. One in seven babies -- or 14 percent-- were born to women over 35 in 2008, and almost one in four were first-time mothers. The vast majority, 71 percent, had at least some college education before giving birth. By contrast, births to women younger than 20 declined to one in 10 babies. This trend affects all ethnicities. Older age at marriage and societal acceptance of delayed motherhood are cited as possible reasons.
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