Surrogacy 101

Society for Assisted Reproductive Technology Releases Latest Clinical Outcomes Data: 58,727 Children Born from 2010 ART Procedures

Washington, DC - The latest data on assisted reproductive technologies in the United States has been released by the Society for Assisted Reproductive Technology. SART’s 2010 IVF Success Rate National Summary builds on many of the previous year's positive trends: transferring fewer embryos per cycle and increased use of single embryo transfer leading to further reductions in percentage of twins and high-order multiple births in critical lower-age categories.

 

For 2010, 370 clinics reported data to SART on 146,693 treatment cycles leading to the birth of 58,727 babies.

 

Glenn Schattman MD, President of SART, noted, “We are continuing our focus on ART best practices, performance, and safety.  Using our comprehensive ART treatment registry, new features that provide the earliest access to current data, greater transparency and clarity, SART now presents users with guidance on the definitions and recommended interpretations of fields that appear on the Clinic Summary Reports at www.sart.org.  As users mouse over various elements on the new report, pop-up text bubbles inform the user on how each calculation was derived and provide additional information to help patients better interpret success rates.  This is an important step but one of many SART is taking to improve access and understanding of ART treatment metrics."

 

At sart.org, data from all reporting clinics are aggregated in the National Summary Report. Individual clinic reports, as well as the National Summary Report, include a convenient drop down box allowing viewers to see previous years' reports; data from 2003 through 2010 are posted. Additionally, the clinic reports note procedures each clinic offers with corresponding success rates, and allows prospective patients to request information from clinics with a single click. Go to www.sart.org and click on "IVF Success Rate Reports" to view the National Report or search for SART member clinics in your area.

 

Last Acts of Kindness; Lessons for the Living from the Bedsides of the Dying by Judith Redwing Keyssar: A LaMothe Book Review

Reviewing the book Last Acts of Kindness; Lessons for the Living from the Bedsides of the Dying by Judith Redwing Keyssar surprised and inspired me as I read it almost in one sitting…holding a tissue in one hand. Redwing (as she referred to herself throughout the book) is an amazing woman teaching us all about life through her experiences with the dying. I noticed that because of her work with hospice and oncology most of her stories took place either in the hospital, at home, or in a hospice setting. And to truly experience these deaths she spent quite a bit of time with her patients, caring for them, learning about their beliefs and helping family members and friends accept death as a part of life. We all know that we will all die but do we talk about it? No…we avoid the subject at all costs.

She asks the question Death: Medical Event of Spiritual Experience in Part One of Last Acts of Kindness. All of part one is dedicated to those who died in a hospital setting. From ‘Pulling the Plug’ to ‘A Champagne Toast in the ICU’ the reader is touched by what we mortal beings go through as we take those last few breaths.

I especially liked Part Two: Ingredients for Easing Suffering: Wisdom, Humor and Love.  Parts Three and Four are also very valuable to anyone interested in seeking inner peace for themselves or a loved one. I love the fact that there are several pages of resources in the back for those who want to plan for the end of their own life or to assist older parents or patients who are suffering with cancer and other such diseases to prepare for what is surely to come.

Throughout Last Acts of Kindness you will find poetry, quotes and Redwing’s own thoughts and opinions which are very poignant in some cases and in others strait to the point. I am so glad that I read this book now, in my own mid-life. I feel I have a much better understanding of what’s to come not only for myself but for those I love and cherish.

 

Judith Redwing Keyssar, RN, BA,

is the Director of the Palliative and End-of-Life Care Program at Seniors at Home, a division of Jewish Family and Children's Services (JFCS) of the San FranciscoBay Area. Previously, she was the Director of Patient Care Services for Zen Hospice Project (ZHP). Ms. Keyssar also spent  fifteen years working in intensive care, oncology and hospice. She was "called" to be a “midwife to the dying” while she was attending her closest friend, who was dying at age 30 after sustaining severe head trauma from a motorcycle accident.  The story of her initiation into the field of death and dying is presented in the prologue of the book.

When Infertility Becomes a “Guy Thing”

How Men Can Combat Declining Fertility Trends

When infertility strikes, it can be a massive source of stress for couples, and many are too quick to assume it’s a female issue.

Alarmingly, the average sperm count for adult males has decreased by 50 percent since 1938 and is currently declining at a rate of 2 percent each year, according to a study in the British Medical Journal. Stress, exposure to environmental toxins and diets deficient in key vitamins and minerals are likely to blame.

“It’s a fact that one in six couples will have difficulty conceiving, but many aren’t aware that almost half the time, it’s the male who is the cause of the problem,” said fertility expert, Dr. Amos Grunebaum. “When couples address this issue, it’s been my experience that the woman is the first to see a specialist to determine her fertility status. It’s a little more difficult to get the man on board with doing the same thing. Some men just don’t want to acknowledge that they may have a fertility problem. As such, they are more reluctant to get tested and I have seen a lot of men delay seeing a specialist or even avoid it completely.”

Unfortunately, Dr. Grunebaum can confirm these disturbing statistics as he has seen sperm counts decline in his 25+ years of practice.  

“From my experience, low sperm count is one of the primary reasons that couples have a difficult time conceiving,” said Dr. Grunebaum, also a medical health advisor for Fairhaven Health (www.fairhavenhealth.com). “Quite simply, the fewer sperm a man produces, the lower the likelihood that one will successfully fertilize the egg.”

However, according to Dr. Grunebaum, there are a variety of ways men can help improve their reproductive health.  

“A diet rich in antioxidants such as Vitamins C, E and Zinc can go a long way in improving sperm health. Exercising regularly plus limiting caffeine, alcohol, and tobacco intake can also help a great deal,” he added.

While low sperm count is known to be a major cause of infertility, for many men, visiting a doctor or clinic to have a sperm analysis done can be a daunting task.

“The testing process itself can be a little embarrassing and even more so when faced with the prospect of exposing their condition to the doctor, nurse or office staff,” he added.

Fortunately, there is now a way to test for low sperm count in the privacy of one’s own home. A new product from Fairhaven Health, the SpermCheck Fertility Test, accurately confirms if a man has a normal count (20 million per milliliter). The test can be completed in a matter of minutes and retails for around $35. Should the SpermCheck at-home test confirm a low count, it’s generally a good indicator that he should see a specialist to help further diagnose the problem.

“There are many benefits from determining early on if sperm count is a problem for you,” Dr. Grunebaum said. “The sooner an issue is pinpointed, the sooner proper treatment can be started. Treatments for male infertility typically include lifestyle changes, vitamin, mineral or herbal supplementation, prescription medication, or even surgical procedures. But before any of that can begin, the couple has to be able to communicate and agree to take action.” 

About Dr. Amos Grunebaum

Dr. Grunebaum is a New York based physician who is double-board certified in obstetrics/gynecology and maternal-fetal medicine (high-risk pregnancy). He is recognized as one of New York's foremost Ob/Gyns as evidenced by his regular inclusion in Castle Connolly's "Top Doctors: New York." Dr. Grunebaum has helped formulate a number of products for Fairhaven Health, a leading manufacturer of products to help couples conceive.

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

STD Awareness and Our Youth Obsession by Guest Blogger By Michelle Sobel of STD Test Express

STDs are an important topic that can sometimes get brushed aside when thinking about surrogacy and third party births.

Yet, according to the CDC, Chlamydia and gonorrhea are the most important, preventable causes of infertility. These infections, if left untreated can cause pelvic inflammatory disease (PID) for up to 40 percent of women. PID can not only lead to infertility, but also to potentially fatal ectopic pregnancy.

An unnoticed STD can cause serious problems during pregnancy.

That’s why it’s important to pay special attention during National STD Awareness Month. However, if you look at the way efforts are being made to drive awareness, you might think STDs only afflict young people – or that they’re the only ones vulnerable to the inflictions of an STD. This year, the CDC, Planned Parenthood, the Kaiser Family Foundation, and others are sponsoring a great awareness campaign by MTV to encourage young people to get tested for sexually transmitted diseases.  It’s called Get Yourself Tested or GYT and it’s a terrific campaign.

But what about the rest of us? Women in their 30s, 40s, 50s, 60s and beyond are an important demographic too! While it is critical to teach young people how to protect themselves, it is important to focus on the remainder of the population as well. Especially because the highest number of newly acquired cases of HIV/AIDS have been found in middle-aged adults, ages 35 to 44. According to the CDC, the next highest age group is people ages 45 to 54 with the least affected group being the youngest, ages 25 to 34.

The new faces of STDs are not just sexually overactive teens or drug users, it’s the women approaching 40 who aren’t using condoms or the divorced 42-year-old dad who’s dating again after many years and doesn’t know how to bring up the subject of using protection of STD testing.

While there are certainly plenty of causes for this, it might just be that grownups are not so good at using proper protection. In a University of Chicago survey of single women ages 58 to 93, nearly 60% said they didn’t use a condom the last time they had sex. A May 2008 study conducted by the New York Department of Health and Mental Hygiene showed that among single people with at least two sexual partners, 56% of people over age 45 reported using condoms the last time they had sex, compared with 61% of 25-to-44-year-olds and 80% of 18-to-24-year-olds.

Yet, it is this age group who’s sexual health is possibly most important. Throughout the years where we are trying to have children and start a family, are the same years we are taking the most risks – even if we don’t realize it.

Grownups — here’s our message during STD Awareness Month,  please hear it.  STDs and HIV are preventable.  Please be sure to make STD screening an important part of your surrogacy. You may be struggling with your own fertility problems and having an STD impact your third party birth would be devastating.

 

Michelle Sobel is the co-founder of STD Test Express, the leader in Online Care for private STD testing and is the only service to provide free phone consultation with physicians for results counseling and follow-up care. Michelle has been a leader in promoting health through Online Care for nearly a decade and continues to break the barriers of health services with regular contributions to new innovations.www.stdtestexpress.com

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.

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 "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."

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/

All About Frozen Embryos

Although Infertility Answers has some of the information below located on our site...Miracles Waiting has much more to offer. Click on any of the links below to visit their website. 

How are embryos created during an In Vitro Fertilization cycle? At what stage are embryos frozen? What is an oocyte?  Is it the same as a gamete? What is the difference between an embryo and a pre-embryo? What is a 2PN embryo? What is a Zygote?  What are Blastomeres? What is a Morula? What is a Blastocyst? How does implantation occur? What is assisted hatching? Is it better to transfer 8-cell embryos or blastocysts? How are embryos frozen and stored after an IVF cycle? How long does it take for embryos to thaw? How does the thawing process work? Will all the embryos survive the thaw? How long after they are thawed are embryos transferred? How long can embryos be frozen and still be viable? Will frozen embryos be as likely to produce a pregnancy as fresh embryos after they are thawed? Can embryos be frozen more than once? What are the factors thought to affect embryo quality? How are embryos graded? What is “normal development” for an embryo at the time of transfer? What is PGD? Is it possible to have genetic tests performed on embryos that have been frozen? Is it possible to tell the gender of an embryo? What is the typical success rate with frozen embryo transfer? When do embryos implant in the uterus? What are the symptoms of implantation? How soon can I take a pregnancy test? What factors can be used to assess the likelihood that an FET will be successful? Are children born from frozen embryos normal?

 

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.

Tips: Working with your clinic

 

Below is a short list of documents and tips that you and your clinic will need to facilitate your ART case.

 

 

1. Your clinic will need to have the contract signature page at the very least (they may require the entire contract) on file or an affidavit from the contractual attorney, indicating that the contract is complete and has been signed by all parties.

 

2. The medical information forms need to have been signed by all parties and given to your clinic for their files.

 

3. The Surrogate Mother/Carrier is the patient. Information on medication, transfer, and follow up must be conveyed to her through the clinic and not the Intended Parents although they should be informed as well.

 

4. The Intended Parents need to make sure that they have a credit card on file with the clinic for all medication and procedures that involve the Surrogate Mother/Carrier and/or Egg Donor.

 

5. The Surrogate Mother/Carrier or Egg Donor should receive NO BILLS. She is not responsible for any payment of bills and this is usually stated in the contract between the Intended Parents and Surrogate/Egg Donor.

 

6. IVF costs should not be attempted to be billed through the Surrogate Mother/Carrier's insurance. (Blood tests, pap smears, OB appointments etc. are usually ok.) Remember the Surrogate Mother/Carrier is not the infertile woman and billing her for IVF costs can cost her the insurance policy and possibly pose insurance fraud accusations. Medicaid should not be used under any circumstance.

What is an Endometrial Biopsy?

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.

What is a Hystersonongram?

Saline Infusion Sonogram (SIS),
( sonohysterogram )
or
Hystersonongram

A saline infusion sonogram (saline sonography) is routinely performed to make sure that the endometrial cavity (inside of the uterus) appears normal.  Benign uterine growths, such as endometrial polyps or uterine fibroids, may develop in the cavity and create an environment that is hostile for implantation.  Scar tissue may also be identified with the saline infusion sonogram.  This procedure may be done as part of an evaluation for recurrent pregnancy loss or done prior to an IVF cycle.  It may also be done to evaluate causes of irregular or very heavy menstrual cycles and some types of chronic pelvic pain.  The saline infusion sonogram is scheduled early in a menstrual cycle, just after your period stops but before ovulation – usually between days 5-12 of the cycle.

The procedure is simple and usually takes 10 to 15 minutes to complete.

A speculum is inserted into the vagina and the cervix is cleansed with an antiseptic solution.

A special catheter approximately 1mm in diameter (about the size of a single strand of spaghetti) is inserted and slides through the cervical canal.

The ultrasound probe is placed in the vagina.

Sterile salt-water solution (saline) flows through the catheter into the uterine cavity.  This distends the endometrial cavity and allows the physician to see the entire cavity on the ultrasound monitor.  You may experience mild cramping at this point.

Several images of your uterus will be taken during the procedure, pictures of your ovaries may also be taken.

You will need to schedule an appointment with your physician to discuss any abnormalities that are seen during the procedure.

After the procedure you may continue to have mild cramping for a few hours.   You may also experience light spotting or watery discharge for as long as 24 hours after the procedure.  You should refrain from intercourse for approximately 48 hours.  If any symptoms other than those listed above are noticed, please call the office at which you are seen.

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

How to Protect Yourself From Bankruptcy and Medical-Bill Disaster

By Meryl Davids Landau
From Health magazine

It’s a fact of life: Everyone gets sick at times. The scary thing is that illness or medical bills cause nearly two-thirds of all bankruptcies, according to a study from Harvard Medical School. And in 78 percent of cases, the person goes bankrupt despite having health insurance. “Typically, it was a relatively brief illness that led to bankruptcy,” says study co-author David U. Himmelstein, MD, associate professor of medicine at Harvard Medical School. Here’s how to protect yourself.

Never let your policy lapse.
It’s tempting to forgo insurance premium payments if you’re jobless. But “not having insurance is as risky as not wearing your seat belt,” warns Atlanta financial planner Mary Claire Allvine, co-author of The 7 Most Important Money Decisions You’ll Ever Make. “It takes only one accident or illness to financially ruin you.” Thankfully, the federal government will, in most cases, pay 65 percent of your COBRA bill for nine months if you’re laid off this year.

Budget for health care like you do for gas.
Factor your annual deductible, doctor-visit fees, and drug co-pays into your budget, Allvine says. Divide what you pay in a typical year by 12 to see what to save monthly. And use your employer’s flexible-spending benefit, so you can pay for uncovered medical expenses with pretax dollars.

Get to know your policy.
You’re more likely to get claims covered when you strictly follow your insurer’s requirements, says Erin Moaratty, chief special-projects officer at the nonprofit Patient Advocate Foundation in Newport News, Virginia. Read your policy thoroughly to see what the rules are for seeing out-of-network doctors, getting preapproval for procedures, etc.

Check your disability coverage.
Find out if you have this important insurance from your employer (most offer it). Even if you do, many companies pay only 60 percent of your salary should you become unable to go back to work, so consider getting a supplemental policy that makes up the other 40 percent. Compare quotes from different companies at eInsurance.com.

View healthy living as a money matter.
See a doctor even for small issues to avoid bigger, costly problems down the line. Eating right, exercising, and quitting smoking are also smart ways to save.

Don’t take “no” from your insurer.
“Appeal every claim that is denied,” Moaratty advises. “In our experience, a majority of denials are eventually overturned.” In some cases, fixing a simple coding error (via a quick call from your doctor) will do it. If that doesn’t work, craft a written appeal with care, working with your MD and following the timetable spelled out in your policy. This is important not only because it can help you win, but also because, if you don’t appeal and later want to sue in court, you’ll be limited to arguments you raised in your appeals.

Enlist an ally.
Consider hiring a medical advocate who knows the ropes, so you don’t have to battle your insurance company’s or hospital’s billing office alone. Fees vary, but start your research at the Medical Billings Advocate of America’s Web site. For free guidance, go to the Patient Advocate Foundation’s site.

Negotiate with your doctor and hospital.
If you get a huge bill, ask for the billing or finance department (not your doc) and tell them what you can afford. Most will slash fees for the promise of a speedy payment or set up a payment plan. “The best time to do this is early in the process, “ Moaratty explains. “Once it goes to a collection agency, you’ll have fewer options.”

Get cash to pay your medical expenses.
Many charities and organizations offer financial aid to those who can’t pay their health-related bills. Click here for a sampling of companies, hospitals, and non-profits that can help you cut your costs.

Sharon LaMothe Will Be Attending the ASRM Meeting in Atlanta, GA Oct 17-21st

 

I will be attending the annual American Society for Reproductive Medicine meeting in Atlanta GA! If you are in the area and would like to meet please contact me at the cell number below. I will be arriving late Saturday evening October 17th and leaving the afternoon on October 21st. I am looking forward to all of the great educational opportunities offered and meeting other professionals within the Infertility field. I will blog about what I observe and learn when I return.

 

I look forward to seeing you there!

 

Sharon LaMothe
Infertility Answers, Inc.
http://infertilityanswers.org/
LaMothe Services, LLC
http://lamotheservices.com/
727-458-8333