Surrogacy 101

Over the Counter Sperm Test Provides Incomplete Information to Measure Male Fertility

In April, Walgreens and CVS will begin selling the SpermCheck Fertility test, a $39.95 over the counter test that determines whether men have a normal sperm count. Fertility experts share that there are other critical factors such as motility (movement characteristics of sperm) and morphology (appearance of sperm) as equally important which are not tested. Additionally, the test measures a normal sperm count at 20 million or more sperm per milliliter of semen while the industry standard for optimal fertility is 15 million, potentially causing unnecessary concern for men with a negative test result. When taking the test, men who test positive for 20 million or more per milliliter of semen see a reddish line in their test results, while those who have less than 20 million per milliliter do not see a result. The test is 96 percent accurate and will be sold at 7,800 stores across the US in April.  

Dr. Ed Marut, Medical Director of Fertility Centers of Illinois, is concerned men will be misguided with their test results. “SpermCheck Fertility exploits the reluctance of men to be evaluated for their fertility properly and may give couples a false sense of hope or cause unnecessary anxiety. The test gives a very simplified result without taking into account additional health conditions. A negative test result may really be normal, while a positive test tells nothing of the other critical parameters of a real semen analysis, such as motility and morphology. Men need to receive a thorough, accurate semen analysis interpreted by a reproductive endocrinologist to accurately maximize chances of pregnancy success.” 

In order to understand male fertility, it is critical to understand the main components involved, which are illustrated below. Couples are also encouraged to complete basic testing for fertility if they have trouble conceiving. Fertility Centers of Illinois offers a fertility check-up for couples which includes bloodwork and a semen analysis evaluated by a board certified reproductive endocrinologist for $90. 

Sperm Health: What Men Need to Know 

• Sperm Count:

It is critical for men to have a healthy sperm count for optimal fertility. Men with at least 15 million sperm per milliliter are well within a normal, healthy sperm count. The average human ejaculate contains about 180 million sperm (66 million/ml), but some ejaculates contain as many as 400 million sperm.

• Morphology: (appearance)

A healthy sperm has an oval head and long tail, allowing for the sperm to be propelled forward effectively. When a sperm has a small, large, misshapen, crooked or tapered head, its ability to fertilize an egg is decreased. Sperm with tails that are doubled, curled or kinky are also unlikely to fertilize an egg. Fertile men have a normal shape and structure to 14 percent of their sperm, but at least four percent is thought to be the lower limit of fertilizing capacity.

• Motility: (movement)

The ability of a sperm to propel itself and move forward is imperative to successful conception. Sperm that are immobile, slow or have inhibited motility due to morphology abnormalities are unable to reach the egg for fertilization. Fertile men have 40 percent or more of their sperm exhibiting healthy motility.

Men with a lower sperm count, low morphology or low motility may need the assistance of reproductive endocrinologists to optimize fertility odds. This can be accomplished through a variety of infertility treatment methods such as methods such as semen processing for intrauterine insemination and In Vitro Fertilization using ICSI (the injection of a sperm into an egg.)

# # #

Fertility Centers of Illinois, S.C., is one of the nation's leading fertility treatment practices, providing advanced reproductive endocrinology services in the Chicago area for more than 30 years.  FCI physicians, embryologists and support staff are stringently chosen based on educational background, medical skills and their ability to collaborate. With a team of 11 nationally and internationally recognized reproductive physicians who treat thousands of patients each year, the practice has earned a reputation for overcoming hard-to-solve fertility issues. FCI is dedicated to medical and clinical excellence and continues to invest in the latest technologies and research. FCI offers a comprehensive range of fertility treatment options including intrauterine insemination, in vitro fertilization, donor egg, gestational carrier, and preimplantation genetic diagnosis, as well as extensive resources to address financial and emotional needs. Fostering a culture for continuous innovation has made FCI home to the annual Midwest Reproductive Symposium which attracts experts in the field of reproductive endocrinology from around the world.  FCI has 10 offices conveniently located throughout the Chicagoland area (Buffalo Grove, Chicago/River North, Crystal Lake, Glenview, Highland Park, Hoffman Estates, Lindenhurst, Naperville, Oakbrook Terrace, and Orland Park). FCI is a member of the Attain Fertility Network which provides discounted fertility treatment programs. For more information visit www.fcionline.com

 

NCHS Issues Data Brief on Increase in Twin Births via the ASRM

Today, the U.S. Center for Disease Control and Prevention’s National Center for Health Statistics (NCHS) released a data brief on the increase of twin births over the last three decades. Among the key findings reported by the NCHS:  

 

• In 2009, 1 in every 30 babies born in the United States was a twin, compared with 1 in every 53 babies in 1980.

• The twin birth rate rose 76 percent from 1980 through 2009, from 18.9 to 33.3 per 1,000 births.

• If the rate of twin births had not changed since 1980, approximately 865,000 fewer twins would have been born in the United States over the last three decades.

• Over the three decades, twin birth rates rose by nearly 100 percent among women aged 35–39 and more than 200 percent among women aged 40 and over.

• The older age of women at childbirth in 2009 compared with three decades earlier accounts for only about one-third of the rise in twinning over the 30 years. The remaining increase is assumed to be from an increase in the use of infertility treatments.

 

The report highlights the impact that the rise in the rate of twins has had on perinatal health and rates of preterm birth and low birthweight.

 

To view the data brief, go to:  http://www.cdc.gov/nchs/data/databriefs/db80.htm

 

On Fertile Ground, Healing Infertility by Helen Adrienne LCSW: A LaMothe Book Review

On Fertile Ground, Healing Infertility by Helen Adrienne LCSW is truly a great addition to any fertility professionals lending library and a wonderful asset for anyone going through infertility. I especially liked The Lifestyle Profile, and The Self-Esteem check list which includes a beliefs inventory. You don't have to be infertile to appreciate many of the chapters in this book. Helen addresses the impact infertility can have on a marriage and relationships with family and friends. With real life examples and an intimate look at the medical and emotional process I felt that On Fertile Ground had something that everyone could relate to. Easy to read for minds that are often overwhelmed, this book offers some very real help and solutions for coping with infertility.

A Great Symposium for Infertility and Reproductive Professionals: START ART

Infertility is a challenging and rewarding field of nursing, and one that is evolving rapidly and dramatically, requiring nurses and other healthcare practitioners to constantly remain current with the latest state-of–the ART technology. Those in practice, as well as nurses in transition, accept that this ever changing arena requires an ongoing commitment to pursue new information, techniques, and best practices. And, equal in priority, is the IVF nurse’s sensitivity to parents’ quest to create families and the fragility of early embryonic life.

 The Annual REI Nursing Congress: Scientific & Therapeutic Approaches To Assisted Reproductive Technology (STARTARTSM) provides a unique and comprehensive educational opportunity, featuring critical updates on the latest advances in reproductive medicine, from procedures and protocols to psychosocial and legal issues. The goal of this Congress is to provide late-breaking information and cutting-edge techniques to improve ART outcomes - a goal that is matched by the IVF nurses’ skills, compassion, and caring that make this field so remarkable.

This activity is intended for the education of nurses, nurse practitioners, and other healthcare professionals specializing in reproductive medicine and assisted reproductive technology. (It's great for surrogacy and egg donation agency owners too!)

During lunch on both Thursday, August 4 and Friday, August 5, participants will have the opportunity to join accredited sessions of interactive roundtable discussions. Topics will be posted at the meeting registration desk, where participants may sign up for discussions of issues of special interest. A moderator or faculty member will lead each group. (I am, once again, planning to lead a round table on the topic of Gestational Surrogacy.)

Register HERE https://www.123enroll.com/STARTART

I hope to see you there!!

 Sharon

Sharon LaMothe of Infertility Answers and LaMothe Services to Attend the ASRM Meeting in Denver

The American Society of Reproductive Medicine is holding it's 66th annual meeting in Denver this month! I will arriving in Denver Sunday the 24th and staying until Wednesday the 27th. I am thrilled to be attending the Opening Ceremony Sunday evening and networking with some of the most hard working and knowledgeable professionals in the Infertility Field. Some of the  seminars I will be attending include Open Vs Closed Gamete Donation, Wrinkled Parents; Medical, Ethical and Psychological Issues of Parenting at an Older Age, and Infertility as a Public Health Priority. There are so many opportunities to meet people that I have "friended" on Facebook or accepted into my network on LinkedIn. If you would like to meet with me, just send me an e-mail at SurroMatchFL@aol.com or give me a call at 727-458-8333.

 

As for MY clients that I consult with, please know that I attend these events, meetings and seminars around the country so that I can share what I have learned with you through my blogs, posts, and conversations. In this time of social networking, spending hours online and answering e-mail,  I believe that it is so important to have face-time with clients and other professionals in this ever growing field of infertility.

 

Please contact me if you plan to be attending the ASRM or visiting Seattle, WA where my offices are located. If you need my consulting services remember that our first conversation is free so that we can assess how best to use my expertise to help you reach your goals.

 

I hope to hear from you soon or better yet meet you in person!

Sharon LaMothe

727-458-8333

Your Period and Cycling Through the Decades by Stacie Colino

 
As you get older, your period, like the rest of your body, evolves. Here’s what to expect.

In Your 20s

Your biggest concern is probably cramps, since they tend to be worse when you’re younger. The culprit: the prostaglandins that your body produces to stimulate contractions in your uterus in order for the lining to shed, explains David Plourd, MD, an assistant professor of obstetrics and gynecology at the Naval Medical Center in San Diego. Head off pain by taking an anti-inflammatory like ibuprofen just before your period arrives or at the first sign of cramps.

In Your 30s

If you’ve had a baby, it can take 6 months or longer for your period to get back into a groove. Don’t rely on breastfeeding as birth control unless you’re doing it 100 percent exclusively; you can get pregnant even if your period hasn’t come back. Fortunately, menstrual cramps usually ease up after childbirth.

By your late 30s your cycles may become shorter as fertility starts to drop off (the most dramatic decline is from ages 35 to 40). “Your cycles may go from, say, 30 days to 27,” says Barry Witt, MD, medical director of the Greenwich Fertility Center in Connecticut.

In Your 40s

PMS can get worse and your periods may become unpredictable, thanks to hormonal changes as you inch closer to menopause, Dr. Plourd explains. You’re less likely to ovulate, but don’t ditch the birth control. “The second-highest unintended pregnancy rate is in women in their 40s,” notes Dr. Plourd.

In Your 50s and Beyond

Chances are your periods are coming less frequently, if at all. Once you’ve gone a full year without one, you’re officially in menopause (the average age is 51½). That means PMS symptoms are history! Birth control will also be a thing of the past, but if you have a new partner, don’t forget condoms: The rate of STDs is increasing in people age 45 and older. If vaginal thinness and dryness becomes a problem, you can use try vaginal moisturizers and lubricants or vaginal estrogens, which thicken the vaginal wall to combat oversensitivity.

Understanding Your Menstrual Cycle by Stacie Colino for Womans Day

 You’re probably all too familiar with how your period affects your mood and cravings (hello, once-a-month chocolate fest!), but your period is just one part of your monthly menstrual cycle and a snapshot of how well your body is functioning. “Regular periods with no unusual symptoms mean your hormones are working properly, which bodes well for other parts of your body,” explains Nanette Santoro, MD, professor and chair of obstetrics and gynecology at the University of Colorado at Denver.

On the other hand, irregular periods may mean that you don’t have enough estrogen, a hormone that’s essential not only to your reproductive system and fertility, but also to the health of your heart and bones. Too-low levels can affect your risk of heart disease, osteoporosis and even diabetes.

The important bottom line: All those hormonal changes your body goes through affect just about every aspect of your mental and physical health—for good and sometimes not-so-good. To help you understand it all, we’ve put together this comprehensive guide, starting with a rundown of what’s really going on during your monthly cycle.

Days 1–5: Your Period!

The good: The worst of PMS is over. Levels of the hormones estrogen and progesterone drop, and some symptoms, especially breakouts, subside.

The not-so-good: You’ve got cramps and the crankies, and generally don’t feel like yourself thanks to low hormone levels. The cramps are caused by chemicals called prostaglandins, which your body produces to prompt contractions in your uterus so the lining will shed. For some women, prostaglandins can also cause nausea, diarrhea, vomiting and even flu-like achiness, says Dr. Santoro.

Some studies have also revealed that reaction time may be longer (e.g., you may be slower to react when the car in front of you takes a sudden left turn), so be extra-cautious. And exercising may feel more strenuous than usual.

Who knew? “Many writers and artists have reported in their journals that they have more creative ideas during their periods,” says Joan Chrisler, PhD, a professor of psychology at Connecticut College who has researched women’s menstrual experiences.

Days 6–13: Feel-Great Days

The good: Estrogen levels start to rise as your ovaries gear up a “mature” egg for ovulation. This increases concentrations of feel-good brain chemicals, such as serotonin and dopamine, and enhances blood flow to the brain. You’re likely to feel better mentally and perform better physically. One study found that swimmers have their fastest times on the eighth day of their cycles; other studies suggest that cross-country skiers perform better around now. This may be because estrogen helps your muscles better absorb glucose, a sugar in your blood that provides your body with fuel.

The not-so-good: Since your estrogen levels are rising, nothing negative to report here.

Who knew? You may be better able to read other people’s facial expressions and emotional states during this phase.

Days 14–15: Pregnancy Alert

The good: Call it Mother Nature’s way of making sure the species survives: Your sex drive is the highest the few days around ovulation, probably because this is when you’re most fertile. “It’s best to have sex within 24 hours of ovulation, since ideally you want the sperm to be waiting when the egg comes down,” says Dr. Santoro. If you’re using an ovulation kit and seeing high levels of luteinizing hormone (LH) in your urine, expect ovulation to happen about 36 hours later. So get busy! (Or not, if a baby’s not in your plans.)

The not-so-good: Be careful while you’re playing sports. Research has found that women’s knee joints tend to be looser during ovulation, which could make you vulnerable to an anterior cruciate ligament (ACL) injury.

Who knew? Twenty percent of women can actually feel when they ovulate. They may get slight cramping called mittelschmerz, from the German for “middle pain.”

Days 16–28: Prep for PMS

The good: Your body burns an extra 100 to 300 calories per day the week before your period, so if you’ve ever felt hungrier during that time, it’s for a good reason. Try to get your fill of extra calories with healthy protein-carb combos, like 1 Tbsp of peanut butter on a whole-wheat pita, or a handful of nuts with a few whole-wheat pretzel sticks.

The not-so-good: An initial rise in progesterone can cause your skin to produce more oil, making you pimple-prone. As you get closer to your period, progesterone and estrogen levels drop, causing mood changes and concentration problems. About a week before your period, fatigue, cravings, breast tenderness and bloating get into full swing. In fact, water retention could cause a 3- to 5-pound gain. Cutting back on salt (it makes you retain water) and doing moderate exercise (which helps increase the production of feel-good endorphins) can ease symptoms, says Diana Taylor, RNP, PhD, director of the PMS Symptom Management Program at the University of California, San Francisco. Migraines can crop up just before—and during—your period because of the drop in estrogen. “We often give women who get migraines an estrogen patch for a day or two before their periods as a preventive measure,” explains Diana Dell, MD, an assistant professor of psychiatry and obstetrics-gynecology at Duke University Medical Center.

Who knew? If you crave chocolate, it could be because it has magnesium, which you lose as estrogen levels start to dip.

What is a Mock Cycle/Endometrial Biopsy?

In order to assess the uterus for implantation an endometrial biopsy may be performed on a mock cycle.

Purpose: Assure normal uterine development for Embryo implantation

Endometrial Biopsy

Background

The uterine lining, or endometrium, undergoes a specific sequence of changes after ovulation during the luteal phase of the menstrual cycle in order to develop a receptive environment for the developing embryo.  Estrogen followed by progesterone secretion by the ovaries is crucial for the proper development of the lining.  Abnormalities of uterine lining development, or luteal phase defects, may be documented with an endometrial biopsy.  The may be associated with abnormal implantation.

Patient Protocol

1. Call the office with the onset of menses.

2. Call the office to schedule the biopsy 18 days later.

What to Expect

The biopsy is somewhat like a pap smear.  After introducing a speculum into the vagina, the cervix will be wiped with betadine to cleanse it.  A small catheter is then introduced into the cervix and the biopsy is performed.  It takes a few seconds.  If you would like, you may take some Anaprox or your RE can give you a local anesthetic.

Most patients tolerate the procedure well and feel it is similar to the HSG.

 

All About Sperm Antibodies by Dr. Barry Jacobs

It is possible to develop antibodies to sperm.  Almost always, sperm antibodies are generated by the man producing the sperm.  Most commonly, sperm antibodies are generated after vasectomy.  The areas of the testicles where sperm are formed, and the entire tract that delivers the sperm as ejaculate is immunologically isolated from the rest of the body.  Proteins on the surface of sperm are never in contact with the body to either be recognized as part of “self” or, under normal conditions, be deemed as foreign material.  Performing a vasectomy interrupts the normal barrier between the portion of the body which produces sperm and conducts them to the exterior at the time of ejaculation.  Once the barrier is breached, the body’s immune system discovers a new set of proteins, and believes them to be foreign invaders.  Therefore, the immune system begins to make antibodies.  Antibodies are large proteins which attach to sperm, and can interfere with motility or cover the head of the sperm, so as to interfere with the acrosome reaction. 

To explain the last term, the sperm head is covered by a packet of enzymes called the acrosomal cap.  As part of the process the sperm undergoes to be able to fertilize an egg, the outer membrane of the acrosomal cap breaks down, releasing the enzymes.  Enzymes of the acrosomal cap change the membrane covering the sperm head behind the acrosomal cap allowing the sperm head membrane to fuse with an egg cell membrane.  Once fusion of these 2 membranes occurs, the boundary between sperm head and egg disappears, and chromosomes of the sperm enter the egg to fertilize it.  If the sperm head is covered by antibodies, none of these processes can occur.

Trauma to the male reproductive tract can also cause a defect in the barrier between the sperm production area and the immune system.  Men are vulnerable to sports injuries.  Occasionally, a testicle can twist on its blood supply.  The result can be painful loss of a testicle, but even if the testicle can be saved, there is likely to be damage.  Even less commonly, a testicle my not descend from the fetal abdominal cavity into the scrotum.  In addition to the increased risk of developing an aggressive cancer, if not surgically corrected, there is potential for injury to the structure of the testicle.

How do we go about testing for antibodies?  The really reliable test is a kit available to specialist in male fertility.  It is the ImmunoBead® test.  Antibodies to the 3 basic groups of human antibodies are coated on microscopic latex particles.  A suspension of these latex particles are incubated with sperm form the male patient.  If there are antibodies on the sperm, the latex particles are caused to clump together by antibodies to the antibodies on the sperm.  This direct ImmunoBead® test is very sensitive and specific for antibodies made by a man to his own sperm.

Very rarely, a woman will make antibodies to her husband’s sperm.  The cause of such circumstance is highly speculative.  We really do not know the cause.  There is a test for that.  If a woman does have antibodies to sperm, those antibodies will be in circulation in her blood.  If we incubate her serum with donor sperm that are known not to have antibodies, her antibodies will attach to the donor sperm.  Now, we can perform an ImmunoBead® test to look for antibodies.

Problems with sperm antibodies can be overcome.  By far, the most reliable way to do that is to use the technologies of in vitro fertilization (IVF).  If we remove sperm and eggs to the laboratory, antibodies a woman may make to her husband’s sperm will not have a chance to attack the sperm.  Just performing intrauterine insemination to bypass cervical mucus is not very reliable.  Antibodies will be in her uterus and fallopian tubes, too.  Much more commonly, the man has produced antibodies to his own sperm.  In such a case, it will likely be necessary to really help the sperm by literally injecting them into the eggs.  This process is called intra-cytoplasmic sperm injection or ICSI.  ICSI is commonly performed today for a variety of male factor issues.  

We have come a long way from the early days of the Franklin-Dukes test to try to identify problems related to antibodies to sperm.  We have a much better understanding of the problems, and much improved means of treatment.  Even so, many myths endure, often delaying meaningful management.    

 

      

Dr. Jacobs is a Reproductive Endocrinologist, practicing in Carrollton, Texas, a northern suburb of Dallas.  He completed his residency training in obstetrics and gynecology at Baylor College of Medicine in Houston, and remained at that institution to become its first fellow once Baylor achieved accreditation for an advanced training program in Reproductive Endocrinology and Infertility.  Dr. Jacobs has served on the faculty of several medical schools and was director of Reproductive Endocrinology at Texas Tech Health Science Center in Amarillo.  Currently, in addition to his clinical activities caring for infertile patients and those with recurrent pregnancy loss, he is Chairman of the IVF committee at Baylor Medical Center in Carrollton.  

Barry Jacobs, M.D., 4323 M. Josey Lane, Suite #201, Carrollton, TX 75010 www.texasfertility.com
Phone: 972-394-9590 Fax: 972-394-9597

What is Implantation Bleeding?

 
I hear this question again and again and there are several places on the web that offer pretty much the same answer I have pasted below. I have always been upset with RE's and their nurses for not warning Surrogates or anyone going through IVF that implantation bleeding may happen...this bleeding can occur even while becoming pregnant naturally. I hope that this calms some fears!

If you are trying to get pregnant, you may hear about implantation bleeding. The term implantation bleeding implies that you would see the amount of blood that you typically see with your period, but this generally isn't the case when you are experiencing implantation. Implantation bleeding occurs when an egg has been fertilized and implants into the lining of the uterus. Because the lining uterus is made up of blood, there can be a bit of blood expelled in some women.

Implantation will appear before you expect your period and many people mistaken it for spotting before their period begins. As mentioned before, most women do not experience a full on bleeding with implantation. Instead, they may experience a bit of spotting in their panties or even some pinkish or brown discharge. This usually is usually not a flowing type of blood, so if that is what you are experiencing it might be better to assume that you have your period. If you happen to get a positive pregnancy test and you are experiencing a flow of blood you might want to get in touch with your doctor to ensure that all is well.

Because there is typically so little and it is before you would expect your period it would be normal to think you are just getting ready to start your period. But, if you are attempting to get pregnant and you know that you ovulated and you had sex around that time it might be a good indication that you are in fact pregnant. Of course, you can't confirm pregnancy with the presence of a bit of blood, but it may be a very good indication that you'll get a positive pregnancy test in the very near future.

It's important to remember that you will usually experience implantation a week or more before you would expect your period, depending on when you ovulate. Also, if you don't happen to see any spotting around this time you shouldn't assume that you aren't pregnant. While a big deal is made about implantation bleeding in a lot of books and all over the Internet, there are actually very few women that actually report experiencing the phenomenon. This could be because most of us assume that we are just spotting before our period starts or it could just be so little blood that it goes unnoticed.

Implantation bleeding is something that many women assume that they will experience, but generally doctors believe that it is the exception not the rule. Knowing this, you probably shouldn't watch for implantation bleeding. Because you know that it does happen every so often you also do not need to be alarmed if you do experience it!

Sharon

www.InfertilityAnswers.org

How to Treat Secondary Infertility by Guest Blogger Tania Tod, RN

Secondary infertility is described as a couple that has naturally conceived a child and is not able to do so again.  The condition is not as uncommon as people might think and just because of having one child naturally does not mean it will happen again just as easily.  When couples have been trying to conceive  a second child, the thought of secondary infertility may not have even entered their mind. 

There are millions upon millions of couples in the country that have to face an enduring and heartbreaking battle with secondary infertility.  The problem generally remains a silent and unacknowledged condition and until more research is done, the battle to treat it will continue.  Physicians are not exactly sure of how to treat secondary infertility and until more advances are made, many of the methods used to treat primary infertility will be the standard protocol for handling the condition. 

When a couple goes through the emotional battle surrounding secondary infertility, it can take awhile for the reality to sink in and hit home.  Feelings of jealousy, failure, anger, grief and depression are very common and must be handled in order to not influence the existing child.  When thinking of conceiving a second or third child, the couple must consider every possible angle and whether or not they are ready to make the emotional, financial and personal commitment required. 

When trying to conceive an additional child and going through secondary infertility, a couple may not experience the same consideration or attention as the first time, which could be hard to deal with.  The long term goal of any couple experiencing secondary infertility is to one month get a positive result on a pregnancy test.  When this finally happens, the couple will feel a sense of elation and joy at finally embracing the reality of their dream of having a second baby is finally coming true. 

For a couple that has had an ongoing battle with secondary infertility, there will be many different things which must be dealt with.  In order to better increase the chances of conception, it is important for a couple to find a physician that knows how to treat secondary infertility.  When everything is taken into consideration regarding secondary infertility, a couple should never give up hope that with medical treatment pregnancy is entirely possible.  Through finding the best care possible, secondary infertility can become a thing of the past and a couple can soon welcome a new baby into the family.

---

 "Tania Tod is RN, working as certified Personal Fitness and Aerobic Trainer for the past 9 years. She has entered a road of trying to conceive a baby, and her newest blog is Trying To Conceive where she shares her thoughts and experience with the world."

Girlfriend to Girlfriend, A Fertility Companion by Kristen Magnacca~ A LaMothe Book Review

 

I was thrilled to have the opportunity to read Girlfriend to Girlfriend after reviewing Love & Infertility: Survival Strategies for Balancing Infertility, Marriage and Life (2004) last year. Girlfriend to Girlfriend, A Fertility Companion by Kristen Magnacca was published in 2000 but the story and insights are still relevant today. Kristen shares her own infertility journey along with her frustrations and experiences and at the end of each chapter she shares tips that she learned along  the way. Some examples are learning to temper your optimism and remain hopeful, be your own advocate, having a fertility game plan, and nurturing yourself before during and after every procedure and surgery. Thoughout the entire book, Kristen tells you like it is and at the very end something magical happens, she is pregnant! And because she is pregnant, don't expect information on how to move past being childless and onto the land of acceptance. That just isn't part of this book...at least not from a personal prospective.  

 

Kristen Magnacca, is an author, speaker and consultant who over the last decade has had a wide range of experiences with both individuals and organizations. Kristen has developed the reputation as a valued resource and an expert on helping companies, individuals and couples clarify what matters most to their success and then creating the plan of action for achievement.

 

Girlfriend to Girlfriend, A Fertility Companion by Kristen Magnacca is a great read especially if you feel the need for extra support  while you are going through your own treatments. Knowing someone who has actually walked the path of infertility and won while learning from that experience can be invaluable as well as inspiring and comforting.

 

 

Reasons for Secondary Infertility by Guest Blogger Tania Tod, RN

 
The reasons why a couple can conceive and have a baby the first time and experience secondary infertility are unclear at the present time.  Most people think that once they have conceived a child, it should be just as easy the second time, but this is not always true.  Reasons for secondary infertility in a couple trying to conceive a second or third child are unclear, but the problem can account for more than 60% of all infertility cases.

Secondary infertility is medically defined as the inability to naturally conceive or sustain a pregnancy to term after experiencing one or more children previously.  A recent scientific study confirmed that approximately 3.3 million women experience secondary infertility which is an increase over previous statistics which sited 2.7 million females.  Unlike a couple facing primary infertility, people facing secondary infertility are less likely to seek infertility treatments  in order to alleviate the problem.

Reasons for secondary infertility are never clear cut and precise, it could be related to a physical problem for either the man or the woman or it could be idiopathic in nature.  Only after consulting with a medical professional and undergoing testing for the problem can couples determine what is keeping them from becoming pregnant.  Medical professionals that have no previous experience treating secondary infertility may not have the right training to help a couple and this may result in a delay of receiving the proper type of assistance.

If a couple has been trying to conceive a second child after naturally conceiving a first, the reasons could be due to secondary infertility.  Some of the causes of secondary infertility may be due to the same reasons that cause primary infertility or because of something else.  If there have been physical changes between the couple since the last baby was conceived, it could be preventing them from becoming pregnant.

It is always advisable for a couple to see a fertility specialist when having trouble conceiving a baby.  If a woman is under the age of 35 years old and has been having regular sexual intercourse and not using birth control and not become pregnant, it is probably time to see a medical professional to figure out why it is not happening.  If a woman is over 35 and has been trying to get pregnant for more than six months, an appointment with a specialist should occur sooner rather than later.  Because secondary infertility is a mostly unrecognized problem, it is important for it to be addressed as quickly as possible in order to keep any further issues from going untreated and preventing conception.

 

Tania Tod is RN, working as certified Personal Fitness and Aerobic Trainer for the past 9 years. She has entered a road of trying to conceive a baby, and her newest blog is Trying Tt Conceive where she shares her thoughts and experience with the world.

Making Babies: The Definitive Guide to Improving Your Fertility and Reproductive Health by Jason Jackson N.D. ~A LaMothe Book Review

Some books that come to me in the mail don't hold much of a surprise for me. They are just what they seem, at least if you judge the book by it's cover. Making Babies: The Definitive guide to improving Your Fertility and Reproductive Health by Jason Jackson N.D. certainly has a lot more to offer then I expected. To start, Jason Jackson runs a successful Natural Medicine practice from Brisbane, Australia. He has lectured and consulted extensively on numerous health topics throughout Australia and overseas. Mr Jackson specializes in reproductive health and infertility and is recognized as one of Australia's leading Naturopaths in this area and is an authority in the field of Clinical Nutrition and Herbal Medicine.

 

The introduction is what really captured my attention: "Over the thousands of years that humans have been able to reproduce, it has been only the last fifty years or so in the industrialized world, with its nutrient-depleted foods, genetically engineered agriculture, chemical processing, drugs, radiation and pollution, that we are now observing massive impacts on our ability to bear offspring, particularly in affluent Western societies." The last fifty years?

 

With chapters on Male and Female Reproductive Overviews, Preparing for Conception, Stress and Fertility, and yes, Medically Assisted Reproductive Technology (which is considered 'Plan C') I found that Jason Jackson was very adept at covering everything that one would need to know to do just that, Make Babies.

 

What I was really happy about were the detailed black and white photos depicting not only the human anatomy but also of fibroids, PCOS, IVF Procedure and quite a few more that add value to each chapter.

 

I recommend Making Babies The Definitive Guide to Improving Your Fertility and Reproductive Health by Jason Jackson N.D.  as a guide to your fertility wellness as well as a great infertility resource.

Chinese Herbs & Assisted Reproductive Technology (ART) By Teri Calandra and Kristine Ward

China has been using herbs to treat diseases for thousands of years. While there are many current studies that show the benefits of using Chinese herbs and acupuncture, it is hard to argue with millennia of trial and error. Gynecology and women's health are two of the oldest branches of Chinese Medicine. Consequently, formulas geared toward fertility and women's health have been finely-tuned and modified for modern times. The use of multiple herbs comprise a formula. The formulas are developed to treat diseases by treating the whole pattern. It is very rare that a single herb is recommended by itself. The reason for this is to prevent any single herb from "over doing it". For example: if you have a thin light period of shortened duration, a healthy period can be accomplished by taking a formula geared toward nourishing and moving blood. There may be three herbs in a formula that focus on nourishing but one or two that are going to keep your cycle regular.

Chinese herbs are all natural and are essentially berries, roots, twigs, nuts, and seeds. The herbs help to enhance the effects of the acupuncture treatment. They also treat the presentation on a deeper level, and often help a person to obtain gynecological health and increase the chances of pregnancy faster. Herbs/ formulas can be taken in the form of raw (which have to be cooked then the strained liquid drank), granules (powdered herbs dissolved in warm water and drank), pills, or tinctures (herbs steeped in wine or alcohol). For more information regarding different types of formulas and dosage please see http://southloopacu.blogspot.com/.

That can Herbs do for ART?

A common question is, "Are herbs safe to be taking with my already prescribed medications?" Chinese herbs have been around for a long time. When a well trained practitioner of Chinese Medicine and Herbs recommends a formula to someone we generally know what kind of reaction to look for. We are taught to recognize the possible reactions associated with each individual formula, as well as education in conventional medications and hormone therapy (ex. Clomid). You should not have adverse reactions on any formula. If you do, it means that it is not the right formula for you, or that it has to be adjusted to your needs. Unfortunately, there are not many studies out there that show herb vs. drug interactions. However, because we know what our formulas do, and because we are treating underlying conditions, we can take into account what your medications do and build a formula around your current medications. Generally speaking, being treated with acupuncture and Chinese herbs, before starting your conventional fertility treatments, menstrual cycles are often regulated within three to six months. Once your cycle is regulated your chances of getting pregnant will increase in conjunction with your conventional fertility treatments.

All dose changes of drugs are decided by you and your primary physician. NOT YOUR ACUPUNCTURIST. For those on multiple prescriptions, we will work with you and your medical practitioner to ensure the highest quality of health care.

For more information please contact South Loop Acupuncture

719 S. State St unit 3
Sago, IL 60605
office 312.554.8116
fax 312.554.8117
www.southloopacu.com

Sharon LaMothe
Fertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/

If at First You Don't Conceive: A Complete Guide to Infertility from One of the Nation's Leading Clinics by Dr. William Schoolcraft, MD, HCLD: A LaMothe Book Review

  If at First You Don't Conceive: A Complete Guide to Infertility from One of the Nation's Leading Clinics by Dr. William Schoolcraft, MD, HCLD, will not be available for release until March 16, 2010 but I have had the pleasure of receiving an advanced copy and highly suggest that you pre-order yours now!

There are two hundred and sixty five pages in If at First You Don't Conceive: A Complete Guide to Infertility from One of the Nation's Leading Clinics and each and everyone of them are worth reading. If you have just found out that you have a problem with fertility, this must be the first book you read. Not only does Dr. Schoolcraft talk about being your own best advocate he writes about the most common fertility challenges, the most common solutions for those challenges and covers the emotional challenges as well. I love the fact that he includes stories from his patient's which makes you feel connected to what this book is all about, validation, education, support and solutions.

If you are not familiar with Dr. WILLIAM SCHOOLCRAFT, MD, HCLD, he is a fertility specialist and researcher and is the director of the Colorado Center for Reproductive Medicine.


Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/

Sharon Speaks in Denver! LABS-Inc~Focus on Infertility

I had the pleasure of being invited last month to speak in Denver at LABS Inc. about the Infertility Industry. It was my pleasure to share with the entire executive and marketing staff a power point presentation entitled Focus on Infertility, A Comprehensive Overview.

 

Allow me to share a little about LABS Inc. LABS was founded in 1979 as Immunological Associates of Denver (IAD). The laboratory offered testing to physicians and hospitals in Colorado. Growth occurred as local transplant centers began using IAD services to support organ transplantation. Over the years LABS has become one of the premier transplant medicine reference laboratories in the country. Testing is focused on donor eligibility determination and final product safety; infectious disease testing, microbiology, histocompatibility and environmental monitoring. You can visit their site at http://labs-inc.org/

 

Since LABS Inc. has committed itself to working with infertility clinics, the company wanted to educated its staff on what Intended Parents go through after they are diagnosed with Infertility. They wanted to learn about the obstacles that are faced by all parties involved with Surrogacy, Egg Donation, Sperm Donation and Embryo Donation. A company like LABS Inc. willing to invest in this type of education for their staff really needs to be looked at closely. They are dedicated, educated, FDA compliant, reliable and serious about helping too keep costs down for the clinics as well as Intended Parents who use their services.

 

I had a tour of the Denver lab and was really impressed at how efficiently it was run. They have the test results back in the hands of the Doctors within 24 hours! The people were friendly and obviously interested in helping the infertility patient the best way they could.  

 

Working with companies like LABS-Inc. is truly a pleasure and I thank them for inviting me to share what I know about the people involved in the Infertility Industry!

 

If you would like me to speak at your conference, seminar, or arrange for staff education on the subjects of Infertility, Surrogacy, or all things Third Party Family Building, please contact me at the number below. I would love to hear from you!

 

Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/

727-458-8333

Sharon LaMothe: Editorial Review Board for Pregnancy Corner

 http://www.pregnancycorner.com/about/editorial-review-board/sharon-lamothe.html

 

I have accepted the privilege to sit on the Editorial Review Board for Pregnancy Corner. Launched in July 2009, the goal of PregnancyCorner.com is to provide accurate, up-to-date and unique content related to pregnancy. All content on PregnancyCorner.com is reviewed by top obstetricians and gynecologists, as well as other specialists within the childbirth industry, who have donated their time and experience to ensure Pregnancy Cornor provides consumers accurate and unbiased information.

 

I am looking forward to reviewing articles and watching Pregnancy Corner grow! Please take a moment to check it out! http://www.pregnancycorner.com/

Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/

What do the worlds poorest women do about their sanitary needs?

Until I read the article, below, I have to admit that I never gave a second thought to what the poorest women in the world do during "that time of the month". I didn't think that girls would miss over 50 days of school a year because they had no sanitary supplies and it didn't cross my mind regarding the cost of buying sanitary products  for these poor women. So I am bringing an awareness to all of us here in the USA...is there something WE can do to help these poor women? Read below to find out more.

 

Sharon LaMothe
Infertility Answers, Inc.

 

Affordable Sanitary Pads for World's Poorest Women

 

By:Anna Portela

A company called Sustainable Health Enterprises (SHE), together with researchers from North Carolina State University, have joined forces to create economical and reliable sanitary pads for millions of women across the globe, who cannot afford the regular feminine products currently available.

Because of their periods, some young women who live in poverty stricken places, are forced to miss up to 50 days of school in a year. This is due to the unavailability of feminine products. Elizabeth Scharpf is founder and CEO of SHE, an organization that is led by women whose goal is to manufacture and distribute affordable, environmentally friendly sanitary pads of good quality, to women in the developing world. What a fantastic idea and mission! Scharph says: “In some …areas of Africa, a month’s supply of imported sanitary pads cost more than a day’s worth of wages. Our goal is to create affordable pads that are…easily manufactured for a low cost at the local level-and the research being conducted at NC State helps us do that.”

The making of these sanitary napkins involves knowledge of areas such as paper and wood science, medical textiles, biomedical engineering and textile engineering chemistry.

The raw materials used in the process are banana stems. The stems undergo a series of chemical treatments that convert the fibers into soft, billowy materials that can absorb liquid.

These sanitary pads can be reproduced at the local level. Dr. Lucian Lucia from the Department of Wood and Paper at the university says that their role in the project was to show that it is possible to turn banana stem fiber into an absorbent material, and that the average person, and one who is not necessarily a scientist, would be able to create the sanitary pads. Local production and distribution means that the sanitary pads can be sold by community health workers for 30 percent less than the available brand.

Dr. Marian McCord, associate professor of textile engineering chemistry, science and biomedical engineering, maintains that the project is just one example of how a university can have an important impact on global health. Very true.

Congratulations to everyone involved in the project, and to SHE for its plans to distribute this sanitary pad to girls and women, so their lives can be made easier when that time of the month rolls around.

Polycystic Ovaries by Dr. Barry Jacobs

Polycystic Ovaries

One of the most common findings when a couple enters a practice with the complaint of difficulty achieving a pregnancy is polycystic ovaries, or PCO.  Sometimes the condition is referred to as PCOS or PCOD, adding either syndrome or diseases after PCO.  I am not sure we can truly classify the problem as a single entity by declaring it a disease or syndrome.  We know of at least 2 causes of the problem.

The majority of women with PCO are insulin resistant.  By that, I mean that their cells do not respond adequately to insulin, so they must make extra insulin to keep blood sugar normal.  No, that does not mean they are diabetic.  However, people who are insulin resistant are at greater risk to become diabetic.  They are also at greater risk for heart attack and stroke.

On of the things insulin does very well, even in people who are insulin resistant is to convert the carbohydrate they eat into fat for storage.  The more fat they have stored, the worse their insulin resistance; the higher their insulin levels rise in response to a carbohydrate load, and the faster they convert carbohydrate to fat.  It’s s vicious circle.  We have to break the circle.  I strongly recommend my insulin resistant patients drastically cut their carbohydrate consumption to 30 grams a day. 

In addition to carbohydrate restriction, I prescribe a medication called Glucophage (metformin).  It will decrease carbohydrate absorption from the intestine and increase the response of her cells to insulin.  We also know that women with PCO have a lesser risk of miscarriage if they are taking Glucophage, and women who are insulin resistant have a lesser risk of developing gestational diabetes, if they are taking Glucophage. 

The side effects of the medication are related to the inhibition of carbohydrate absorption from the intestine.  The carbohydrate remaining in the intestine draws water into the intestine and the bacteria in the intestine make gas, when they eat the carbohydrate.  The result is diarrhea, cramping and gas.  Carbohydrate restriction decreases the symptoms.  The other side effect, if patients really follow the protocol, is weight loss.  Most of my patients like that side effect.

The other known cause of PCO is a deficiency of an enzyme in the adrenal gland.  The enzyme involved is called 21-hydroxylase.  It is part of the pathway to create cortisone.  There are 2 known molecular variants of the enzyme abnormality.  One is relatively mild, and the other more severe.  It requires 2 copies of the gene to make the enzyme – one from each parent.  If a woman has 2 abnormal copies of the gene, and one is a mild version, she will have a condition which will be clinically described as PCO.  Adding a low dose of steroid at bed time will help.  If one gene is a severe variant, and her pregnancy inherits that one and a severe abnormal copy from her husband, the child will have a condition called adrenogenetal syndrome.  If it is a girl, she will have ambiguous genetalia.  Both boys and girls are at risk to be salt wasters and have severe disorders of blood chemistry.  Diagnosis is critical.  These gene abnormalities are among the most common known, and are present, in at least a carrier state, in at least 5% of some ethnic groups.

Ovulation induction to help achieve a pregnancy for women with PCO can be assisted using treatments such as Glucophage or steroids, if indicated, but alone, neither is usually adequate.  There are specific medications available for ovulation induction.  The oldest, and to my thinking the worst, is Clomid.  Far better is the group of products that are pituitary hormones which cause development of the ovarian follicles which contain eggs.  The use of these medications is safest if done by a Reproductive Endocrinologist.

    

 

Dr. Jacobs is a Reproductive Endocrinologist, practicing in Carrollton, Texas, a northern suburb of Dallas.  He completed his residency training in obstetrics and gynecology at Baylor College of Medicine in Houston, and remained at that institution to become its first fellow once Baylor achieved accreditation for an advanced training program in Reproductive Endocrinology and Infertility.  Dr. Jacobs has served on the faculty of several medical schools and was director of Reproductive Endocrinology at Texas Tech Health Science Center in Amarillo.  Currently, in addition to his clinical activities caring for infertile patients and those with recurrent pregnancy loss, he is Chairman of the IVF committee at Baylor Medical Center in Carrollton.  

Barry Jacobs, M.D., 4323 M. Josey Lane, Suite #201, Carrollton, TX 75010 www.texasfertility.com
Phone: 972-394-9590 Fax: 972-394-9597

In Vitro Fertilization (IVF) and Acupuncture, By: Teri Calandra, L.Ac & Kristine Ward, L.Ac

In Vitro Fertilization (IVF) and Acupuncture, By: Teri Calandra, L.Ac & Kristine Ward, L.Ac

I love the fact that there are so many options for us to explore in regards to complimenting IVF treatments. Please read below and article from my guest bloggers Teri Calandra and Kristine Ward. Your comments are always welcomed!

In Vitro Fertilization (IVF) and Acupuncture
By: Teri Calandra, L.Ac & Kristine Ward, L.Ac
South Loop Acupuncture: Chicago, IL

Acupuncture has been the primary medical system in China for thousands of years. Many people are aware of the benefits of acupuncture for stress reduction, addictions, and pain management. However, most people are still in the dark about Traditional Chinese Medicine (TCM) as an adjunct to woman’s health and infertility.

Traditional Chinese Medicine includes acupuncture, Chinese herbs, and Tui Na (a type of Chinese medical massage). For the purposes of IVF and TCM the most beneficial combination is acupuncture and Chinese herbs. In addition, diet and lifestyle changes may also be recommended by the TCM practitioner.

Infertility and Traditional Chinese Medicine

It is important to mention that the diagnoses of conventional pathologies (such as infertility and polycystic ovarian syndrome) are not within the scope of practice for a licensed acupuncturist. Chinese Medicine views the inability to become pregnant and sustain pregnancy as a symptom of a number of different patterns that can be treated.

The accepted statistic of infertility according to the World Health Organization is that one in seven couples has difficulty in getting pregnant. Acupuncture and Chinese herbs can be conducive for increasing your IVF success rates, sustaining pregnancy, decreasing aches and pains, decreasing stress, and easing labor and delivery.

Chinese Medicine is also able to help with male infertility. It is recommended to combine acupuncture and Chinese herbs to increase sex drive, and increase the quantity and viability of seminal fluid.

What is Traditional Chinese Medicine and Acupuncture?

Traditional Chinese Medicine is a complete medical system for diagnosis and treatment. The individual is seen as an integrated whole. Every part, process, thought, and emotion within the individual is considered in terms of its contribution to the healthy functioning of the whole person. Each disease and disorder is not seen as an isolated event but as an outward manifestation of the whole person being out of balance.

Acupuncture is able to influence health and sickness by stimulating certain meridians or, “energy pathways” along the body. These “energy pathways” are stimulated using single use needles that are as thin as a hair. The goal of acupuncture is to put your body into a state that allows it to heal itself.

TCM (acupuncture & Chinese herbs) can also utilize stress reduction techniques that can have an effect on subtle and non-mechanical reasons for infertility. Irregular ovulation, low sperm counts, or undiagnosed causes respond the best to a combination of TCM and IVF treatments. IVF is the best means to obtain pregnancy in cases of tube blockage. However, acupuncture is able to keep the body in a homeostatic state to maintain the body as nurturing environment for the embryo. (Lyttleton 379)

The following are just a few of the many articles and books that support acupuncture and IVF.
- W. Paulus, M.D., M. Zhang, M.D., I. El-Danasouri, Ph.D., E. Strehler , M.D., and K. Sterzik,M.D, “Influence of acupuncture on pregnancy rate in patients who undergo assisted reproduction therapy”, Fertility and Sterility, Vol. 77, No. 4, Apr. 2002
o “The analysis shows that the pregnancy rate for acupuncture group is considerably higher than for the control group (42.5% versus 26.3%”
- Johnson, D “Acupuncture prior to and at the embryo transfer in an assisted conception unit-a case series”, Acupuncture in Medicine: Journal of the British Medical Acupuncture Society, Vol. 24, No. 1, pp 23-8, Mar. 2006
o “This was a success rate of 57.7% compared with 45.3% for patients in the IVF unit not treated with acupuncture”
- Liang L. O.M.D., Ph.D, L.Ac. 2003 “Acupuncture and IVF” Blue Poppy Press, Boulder , CO
- Lyttleton J. 2004 “Treatment of Infertility with Chinese Medicine” Churchill Livingstone, Edinburgh, UK
- Zhi-Qiang C, Li-Yun L. 2008 “Male and Female Infertility” People’s Medical Publishing House, Beijing, China

Teri Calandra and Kristine Ward both have a background in massage therapy, and graduated from Pacific College of Oriental Medicine with their Masters of Science in Traditional Chinese Medicine. They are both NCCAOM board certified and are licensed through the state of Illinois. Teri and Kristine have been working together since 2005, and they co-own South Loop Acupuncture in Chicago. South Loop Acupuncture offers acupuncture, Chinese herbology, and Nambudripad's Allergy Elimination (NAET). Together they have combined specialties in woman's health, digestive, and respiratory disorders, musculoskeletal dysfunctions, and allergies. Both practitioners have a strong belief that where one medicine leaves off the other picks up. They believe that it is important to work with all medical modalities in order to offer the greatest care to the patient.

Tubal Problems

Thank you once again, Dr Jacobs, for providing such valuable information on Tubal Issues. If any of my readers would like to contact Dr. Jacobs directly, his information is at the bottom of this post!

Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/

 

 

 

Tubal Problems

 

 

 

 

 

Fallopian tubes are necessary for the retrieval of the egg at the time of ovulation and for the ability of a living embryo to reach the uterus, where a pregnancy is carried until labor and delivery. 

 

 

The fallopian tubes, long structures which resemble straight brass horns, play a critical role in reproduction.  They have a very complex and delicate structure designed to retrieve an egg at the time of ovulation, conduct sperm to the end of the tube near the ovary, where fertilization is to occur, nourish the new embryo and conduct it to the uterus.  That is a huge responsibility. 

 

Let’s begin with packing up the egg.   The end of the fallopian tube next to the ovary consists of a large array of delicate finger like projections called fimbriae.  The fimbriae are anchored to the bell shaped end of the tube called the ampulla.  It is the ampulla where fertilization takes place.  The remainder of the fallopian tube, called the isthmus, has a very narrow channel or lumen.  The lining of the tubal lumen consist of 2 cell types.  The secretory cells provide the nutrients for the embryo resulting from fertilization of the egg.  The other cells have microscopic hair-like projections called cilia.  The cilia beat in rhythmic fashion and propel the embryo to the uterus.  A number of agents can damage the cells and structures and impair tubal function. 

 

There are 2 infections, which are epidemic that can damage fallopian tubes.  Both Chlamydia and gonorrhea infect the lining of fallopian tubes causing scarring.  The fimbriae scar together, so that they will not function to pick up an egg.  As the infection progresses, scarring of the fimbriae can totally block the end of the tube near the ovary.  When the tube is blocked at the fimbriated end, the nutrient secretions from cells of the tubal lining collect.  If the infection is not adequately treated in a timely manner, the infection in the closed space of the blocked tube becomes an abscess.  Even if no abscess forms, the cilia of the tubal lining are damaged and cannot propel an embryo to the uterus.  In the circumstance that cilia are damaged a pregnancy will attach to the tube and produce a tubal pregnancy.  Tubal pregnancy can require emergency treatment, or can become fatal. 

 

There are other forms of tubal blockage.  One form of tubal blockage can usually be easily remedied.  Cells which cover surfaces are continually produced and the replaced cells are shed.  The portion of the fallopian tube which traverses the uterine wall, the intramural portion, has a lumen about the size of the tear duct you can see at the inner corner of your eye, near your nose.  It seems as though shed cells sometimes block the channel in the intramural segment of the tube.  That is easy to fix.  The other tubal blockage can be difficult to identify.  It is called salpingitis isthmica nodosa (S.I.N.).   The best way to describe it is like a sieve partially blocking the lumen of the isthmic portion of the fallopian tube.  During studies to determine if the tube is open, the dye can go through to give the appearance that the tube is OK.  Sperm can get through to the egg, but the embryo cannot traverse the tube to the uterus.  The result is a tubal pregnancy.  Instead of having a baby, a woman with a tubal pregnancy must have treatment to destroy the pregnancy in the fallopian tube.  A tubal pregnancy is life threatening.  If an examiner knows what to look for, salpingitis isthmica nodosa can usually be identified, and disaster averted. 

 

OK, there is a self inflicted tubal problem.  It is tubal sterilization.  At one time it was only accomplished by cutting out a section of each fallopian tube and tying the stumps.  Although a few programs, mostly OB-GYN generalists, try to reopen tubes after “tubal ligation”, today, it is probably better to by-pass the tubes with in vitro fertilization (IVF). 

 

Tubal problems are a fairly common finding when evaluating an infertile couple.  Today, in stead of surgery, we have much better and more effective tools to deal with tubal infertility.  If fallopian tubes are badly damaged, we can bypass them.  Today, we do not even need fallopian tubes.  We have in vitro fertilization (IVF).              

 

 

Dr. Jacobs is a Reproductive Endocrinologist, practicing in Carrollton, Texas, a northern suburb of Dallas. He completed his residency training in obstetrics and gynecology at Baylor College of Medicine in Houston, and remained at that institution to become its first fellow once Baylor achieved accreditation for an advanced training program in Reproductive Endocrinology and Infertility. Dr. Jacobs has served on the faculty of several medical schools and was director of Reproductive Endocrinology at Texas Tech Health Science Center in Amarillo. Currently, in addition to his clinical activities caring for infertile patients and those with recurrent pregnancy loss, he is Chairman of the IVF committee at Baylor Medical Center in Carrollton.
Barry Jacobs, M.D., 4323 M. Josey Lane, Suite #201, Carrollton, TX 75010 www.texasfertility.comPhone: 972-394-9590 Fax: 972-394-9597

 

For more articals please visit Infertility Answers, Inc.

http://infertilityanswers.org/

STUDY DEMONSTRATES EFFICACY OF NEW SUPPLEMENT IN HELPING PREVIOUSLY UNSUCCESSFUL IVF

I wanted to pass this bit of information along to my readers....if you have any questions about this product, please contact the phone number offered below!

 

Sharon LaMothe
Infertility Answers, Inc.

 

STUDY DEMONSTRATES EFFICACY OF NEW SUPPLEMENT IN HELPING PREVIOUSLY UNSUCCESSFUL IVF

PATIENTS ACHIEVE PREGNANCY

In an August 2009 publication at the Society of Reproductive Biology, the authors reported on a study in which 17 of 18 women who had prior failed IVF, achieved a successful IVF outcome (defined as a positive chemical pregnancy and clinical pregnancy) through integrating

Total Fertility with a subsequent IVF treatment. Patients selected for participation in the study had, on average, two prior failed IVF attempts in which Total Fertility was not a part of their treatment plan. Further study is underway to provide more support for the product’s efficacy.

The specific supplement, Total Fertility™, Coast Science, San Diego, California, has been designed to encourage blood flow and improve egg and embryo quality. The patients who were selected to participate in the study had on average, two prior failed IVF attempts and a mean age of 36.4 years.

“With this ground breaking news, it is our hope that fertility specialists will use Total Fertility as a standard of preparing patients for fertility treatment. With the challenging economy, it is extremely important that every measure of preparation is taken to insure the best possible outcome in the first cycle of fertility treatment. Total Fertility can be taken by all patients trying to conceive a healthy baby,” said Bruce J. Thomsen, Chief Executive Officer, Coast Science.

Coast Science is a leader in nutritional science and has designed Total Fertility as an easy to swallow capsule for IVF patients and women preparing for fertility treatment. It can also be taken as a prenatal vitamin following IVF. Coast Science has several other products, including the Male Fertility Supplement, Coast MFS, scientifically formulated and established to improve overall sperm quality. Coast Science also has a family of nutritional supplements for men, women, and children intended for optimum health.

Contact:

sales@coastscience.com

877‐237‐3748

Evaluation of the Infertile Couple Part Three: By Dr. Barry Jacobs

This is the last of the 3 part series entitled Evaluation of the Infertile Couple. To read more articles by Dr. Jacobs please visit Infertility Answers, Inc. where he writes about pregnancy loss and endometriosis.

Sharon LaMothe

Evaluation of the Infertile Couple Part Three: By Dr. Barry Jacobs

We need for sperm to meet eggs. In nature, that takes place in the female reproductive tract. At intercourse, sperm are deposited in cervical mucus. Remember, estrogens stimulate cervical mucus production and secretion. Cervical mucus has a rather characteristic molecular structure, in that the molecules are long chains that line up to create “highways” for sperm to travel through the cervix into the uterine cavity. Although cervical mucus may look like egg white, it is quite different. I have seen recommendations from non-professionals that women with poor cervical mucus should put egg white in their vaginas as a substitute. Don’t do that!

The uterine cavity, in the non-pregnant state, is not really a cavity. It is a potential space, leading to the fallopian tubes where fertilization takes place. Assuming everything is normal. Sperm are in the fallopian tubes to greet an egg shortly after intercourse. Since we are evaluating an infertile couple, we cannot assume all is normal.

Obviously we need for this entire passageway to be intact. There are a number of ways to evaluate the uterine cavity and fallopian tubes. The least invasive way is to perform a hysterosalpingogram or HSG. An HSG is an X-ray study performed by injecting an X-ray contrast solution into the uterine cavity while watching on a fluoroscope. The contrast material outlines the uterine cavity and should pass through the fallopian tubes and spill freely into the pelvic cavity. Radiologists pass a small catheter with a balloon on the end into the uterus and inflate the balloon. I do not like that technique. Inflating a balloon in the uterus hurts, and the balloon can hide things I may need to see. Instead, I use an older technique of applying a canula, sort of a glorified soda straw, to the opening of the cervix. Through the canula I slowly inject the X-ray contrast and take pictures of the uterine cavity and fallopian tubes. If the cavity is not formed normally, it may increase the risk of miscarriage. Polyps, benign fleshy growths, in the cavity may impair the ability of an embryo to implant. Fibroids, benign fibrous tumors of the uterine wall can interfere with pregnancy if they are right under the endometrium (uterine lining). If tubes are blocked, well, I think it is fairly obvious that will prevent a pregnancy. There are some other more subtle findings that the radiologists commonly do not identify. Sometimes we see kinking of the fallopian tubes. That implies there is some scarring around the tubes, frequently related to endometriosis. After injecting the X-ray contrast and taking pictures, I remove all the instruments, and take 1 more picture of my patient’s pelvis while she is standing. I want to see the distribution of X-ray contrast material in the pelvis. If my patient has scarring in the pelvic cavity, the contrast material will not all form a layer over the pelvic floor. It will become trapped in pockets which can be identified while she is upright.

I have now covered the basic testing of the infertile couple. There is one other test I discuss with my patients. I recommend this test for my IVF patients because I think it is cheap insurance. If my patient does not need IVF, I think this test provides useful information, but I am less certain as to the economic value. I offer it to those who do not need IVF, but do not feel justified in pushing them to do it.

Let me provide some background about this final test. There are 4 families of adhesion molecules which allow our cells to stick together, so we do not end up as puddles on the floor. One of these families of adhesion molecules is called integrins. There are 3 integrins in the endometrium regulated by progesterone, the hormone made after ovulation. These 3 integrins come and go at different points in time during the 2 week interval between ovulation and subsequent menstrual period. All 3 are present at the time an embryo should implant in the endometrium – about a week after ovulation. One of them is present only at that time, so we use it as a marker for the receptivity of the endometrium – how likely is an embryo to stick there and grow.

There are 3 things we know of that can impair production of our marker integrin. One of them is low progesterone levels. Well, that’s s no-brainer. If you need progesterone to make the integrin, and progesterone is low, you will probably not have the integrin. The second thing that impairs production of the integrin is fluid collection in fallopian tubes which have been severely damaged by an infection like Chlamydia or gonorrhea. The fluid in those tubes contains inflammatory proteins which do impair production of the integrin. The third thing that can interfere with production of this integrin is endometriosis. So far, all of my patients who have not made this integrin when they should have had endometriosis. Since I started treating endometriosis in this sub set of patients who did not make our integrin, my IVF pregnancy rates went up 10 percentage points. That is significant increase.

Once an evaluation of the infertile couple is complete, we can start developing a treatment plan. Sometimes, it may be necessary to deal with one or more intermediate issues, such as trying to improve semen parameters, or treating endometriosis. The only times I treat endometriosis, today, is if my patient does not make the integrin we discussed, or in an effort to relieve menstrual main, which may be associated with endometriosis. Again, I do not think it appropriate to start treating a patient without knowing what I am treating. The entire evaluation can be performed in the span of a single menstrual cycle, and, if performed diligently, can actually save time and money.


Dr. Jacobs is a Reproductive Endocrinologist, practicing in Carrollton, Texas, a northern suburb of Dallas. He completed his residency training in obstetrics and gynecology at Baylor College of Medicine in Houston, and remained at that institution to become its first fellow once Baylor achieved accreditation for an advanced training program in Reproductive Endocrinology and Infertility. Dr. Jacobs has served on the faculty of several medical schools and was director of Reproductive Endocrinology at Texas Tech Health Science Center in Amarillo. Currently, in addition to his clinical activities caring for infertile patients and those with recurrent pregnancy loss, he is Chairman of the IVF committee at Baylor Medical Center in Carrollton.
Barry Jacobs, M.D., 4323 M. Josey Lane, Suite #201, Carrollton, TX 75010 www.texasfertility.comPhone: 972-394-9590 Fax: 972-394-9597

Evaluation of the Infertile Couple Part Two: By Dr. Barry Jacobs

This is a continuation of Dr. Barry Jacobs article on how he evaluates infertile couples who come to him for help. Your comments are welcomed!

Sharon LaMothe
http://infertilityanswers.org/

Evaluation of the Infertile Couple Part Two

By Dr. Barry Jacobs

Now we can talk about spending a little money. Ovulation predictor kits test for the presence of LH in urine. LH is a hormone from the pituitary gland which is supposed to trigger ovulation. If ovulation actually does occur, it takes place about 36 hours after the surge in the level of LH, and about 24 hours after it is detected in the urine. At least now you have some predictive value to a test – if you actually ovulate. Again, among the infertile population of women, we see evidence of an LH surge, without rupture of the follicle to release the egg. There is still progesterone production, so the level of progesterone may be appropriately elevated, but you have still not ovulated. For that reason, testing your blood for progesterone level is not entirely reliable, either.

There are only 2 reliable ways to know if you ovulate. One of them is ridiculously obvious. You become pregnant. OK, if you do, you don’t need this article. The other reliable way to know if you ovulate is to perform ultrasound evaluations of the pelvis starting on the 12th day after the start of the menstrual cycle. If you are going to ovulate, you should see a follicle about 17 mm in average diameter on one of your ovaries. Two days later it should be gone. You ruptured the follicle to release the egg – ovulated. Some times we see that the pre-ovulatory follicle has become significantly larger, and there is progesterone in the blood. The follicle has gone through the hormonal changes of ovulation without releasing the egg. The resulting un-ruptured follicle is called a luteal cyst. If this happens, do not be alarmed. In young women, 98% of all ovarian cysts go away without any treatment, at all. You do not need any treatment, especially surgery if it is gone within 2 menstrual cycles.

Women who do ovulate regularly have clock-work regular menstrual flows, every 28 days. Ovulation should occur on cycle day 13 to 14 and, if no pregnancy occurs, there is menstrual flow 2 weeks later. There are a number of subtle ovulation dysfunctions which impair fertility. A variance from a 28 day cycle may signal a problem. Late ovulation and a short interval from ovulation to subsequent menstrual flow will probably prevent a pregnancy form becoming established.

We need an adequate number of good quality sperm. Performance of a thorough semen analysis is an essential part of the evaluation. Too often, semen analysis is delayed until after treatment efforts have been initiated, only to discover that there is a male factor problem contributing to the couple’s impaired fertility. We have now wasted both time and money. In the interest of cost effectiveness, semen analysis should be part of the initial evaluation. Often I have heard, as an excuse not to provide a specimen that he has a child from a previous relationship, or simply, “I know it is not him.” Things can, and often do change in the male, and until appropriate evaluation is performed, you do not know. Remember, also, that a male factor problem does not always prevent pregnancy, but merely decreases the chance one can be achieved. A previous mild male factor problem may not have prevented pregnancy in the past, but may contribute to the current problem. The mild problem may have become worse. Do your part, guys. Your wife has a lot more to deal with, even if the primary problem is a male factor issue.

 

~Part three will be posted next week


Dr. Jacobs is a Reproductive Endocrinologist, practicing in Carrollton, Texas, a northern suburb of Dallas. He completed his residency training in obstetrics and gynecology at Baylor College of Medicine in Houston, and remained at that institution to become its first fellow once Baylor achieved accreditation for an advanced training program in Reproductive Endocrinology and Infertility. Dr. Jacobs has served on the faculty of several medical schools and was director of Reproductive Endocrinology at Texas Tech Health Science Center in Amarillo. Currently, in addition to his clinical activities caring for infertile patients and those with recurrent pregnancy loss, he is Chairman of the IVF committee at Baylor Medical Center in Carrollton.
Barry Jacobs, M.D., 4323 M. Josey Lane, Suite #201, Carrollton, TX 75010 www.texasfertility.comPhone: 972-394-9590 Fax: 972-394-9597

September is Ovarian Cancer Awareness month.

September is Ovarian Cancer Awareness month. Ovarian Cancer is one of the most deadly of women's cancers. Each year, approximately 21,500 women will be diagnosed with ovarian cancer. In 2008, approximately 15,500 women will die in the United States from ovarian cancer. Many women don't seek help until the disease has begun to spread, but if detected at its earliest stage, the five-year survival rate is more than 93%. Recent research suggests that together the four _symptoms_ (http://www.ovariancancerawareness.org/about.aspx) of: bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly and urinary urgency or frequency may be associated with ovarian cancer.

Live Webcast On Friday, September 18, 2009 at 12:30 PM, we will be holding our Third Annual Live Webcast on Ovarian Cancer. The webcast will be held at the Omni Parker House Hotel (60 School Street) in Boston in the Press Room. To view our live webcast, log on to our web site at 12:30 PM. Coalition members, survivors and doctors will be answering your questions. If you would like to attend the webcast in person, please contact Kari Johnston at 617-912-3817 or at _mailto:kjohnston@therendongroup.com_ (mailto:) to reserve your spot.

Sharon LaMothe

 Infertility Answers, Inc.

 http://infertilityanswers.org/

Indian girl beheaded by neighbor to 'help conception'

 

"A five-year-old girl was beheaded by a neighbor who believed her 'sacrifice' would help him and his wife conceive a son." My reason for posting this is that it highlights how far someone will go to "cure" their infertility. We, as professionals, need to be aware of what type of advice we give, know what options are available and be aware that each patient/client comes with a set of beliefs that could very well change the "intended advice" into an action that is irreversible.

 

I am not in any way implying that this "witch doctor" is a professional and this maybe an overly dramatic way of pointing out the impact of a trusted advisor but my point is made....read on...your comments are welcomed!

 

By Dean Nelson, South Asia Editor
Published: 8:30PM BST 30 Jul 2009

Ram Niwas, 25, consulted his uncle a 'tantrik' or black magic priest, who told him he and his wife would only give birth to a boy if he killed a young girl in a ritual sacrifice.

The body of Vandana was discovered in a field close to her home in a village in Lakhimpur Kheri district around 100 miles south of Lucknow, Uttar Pradesh. Her body was surrounded by incense sticks which had been used in the tantrik ritual.

Ram Niwas, his uncle, tantrik priest Mewa Lal, 55, and friend Yousef Ansari, 22, were arrested shortly after the discovery.

A man beheaded his neighbour's five-year-old daughter after being told by his uncle, a self-proclaimed tantrik (witch doctor), that only a human sacrifice would enable his wife to give birth to a healthy male child.

The gruesome ritual took place in a village in Lakhimpur Kheri district, 150km south of Lucknow on Tuesday. Ram Niwas, 25, who beheaded the child, his uncle, Mewa Lal, 55, and an associate, Yousuf Ansari, 22, have been arrested, the police said.

The three men confessed to their crime shortly after the body was discovered on Tuesday evening, said local police station officer Ravi Srivastava. Niwas told detectives he had turned to his Tantrik uncle because he and his wife had suffered fertility problems.

The case highlights India's chronic levels of female infanticide. An article in The Lancet revealed that 10 million female foetuses had been aborted in the last 20 years by women who wanted a son, while campaigners say many newborn girls are murdered at birth and recorded as stillborn.

Girls are widely regarded as a financial burden by Indian families because of high dowry demands from the families of prospective grooms.

Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/

Infertility Answers~ Research Your Options Here

If you are considering Egg or Sperm Donation, Surrogacy or Embryo Donation, research is KEY! There are so many facets to the Third Party Family Building journey that it's imperative that those seeking to be donors or surrogates do their research as well as Intended Parents looking for the services offered from women advertising themselves as "good candidates". You can find information regarding these issues and more, including medical and legal concerns world wide, on Infertility Answers, Inc. http://infertilityanswers.org/ This easy to navigate site is perfect for those just starting to understand the complexities of Third Party Family Building.

 

Wishing you all the best!

Sharon LaMothe