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This Week in Fertility

Should You Just Keep Trying if You're Not Getting Pregnant?

Try, try again. Does that apply when you're having trouble getting pregnant? Maybe.

You've heard it quite a bit. If you're under 35 and haven't been successful getting pregnant after trying for one year, go see a fertility doctor. The same goes for if you're over 35 and haven't been successful after trying for six months.

But now an Australian study has raised questions around that conventional wisdom. The study, published in Fertility and Sterility, found that one in four women with a history of infertility can still end up having a baby without fertility treatment.

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Gay Parenting Information Sources Growing

By Leigh Ann Woodruff, February 19, 2012

Gay prospective parents face a host of questions — logistical, legal, practical and emotional — when exploring the options of in vitro fertilization (IVF), egg donation, sperm donation and surrogacy. As European interest in American fertility clinic options grows, new and different questions arise.

The Practical Concerns of Americans

In America, gay prospective parents' questions and concerns run to more practical considerations, according to Michael Doyle, M.D., medical director of Connecticut Fertility Associates. Rarely do they have have concerns about international law, going through customs or a baby being taken away at the airport. In addition, many of the emotional considerations have been dealt with.

"The LGBT community that accesses these services are living very out and proudly and are usually in communities that are supportive," Dr. Doyle says. "They've usually processed 'what is it going to be like to be a gay parent,' 'how is my kid going to be accepted'? I think the issues are much different. They're more focused on cost and efficiency and effectiveness. They're not grappling with being a pioneer. They usually have much more practical concerns: 'Can we use a shared cycle?' Their questions tend to be those kind of medical things."

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Fertility Clinic Testing for Sperm DNA Fragmentation

By Leigh Ann Woodruff, February 15, 2012

If you and your partner are having trouble conceiving, and his conventional sperm parameters — sperm count, motility (speed) and morphology (shape) — are normal, the problem could still be because of sperm. Talk to your fertility doctor about screening the sperm for sperm DNA fragmentation, and this may give you more insight into why you are not getting pregnant. A high level of DNA fragmentation may compromise the possibility of a successful pregnancy no matter what fertility treatment is used.

"It is likely that sperm DNA fragmentation levels are on the rise due to increased reproductive toxicants in our environment," says Donald P. Evenson, Ph.D., HCLD, president and director of SCSA Diagnostics. "Dramatic cases are those working with pesticides and heavy metals like lead; however, in cities with high levels of air pollution and a documentation of infertility and miscarriages, the levels of sperm DNA fragmentation have been very high."

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IVF, Infertility and Valentine's Day

Five ways to put the spotlight back on you and your partner

Does Valentine's Day seem like another painful holiday to you this year? The pressure to make Valentine’s Day all about sex and romance can feel daunting, especially if you have your baby-making sex scheduled down to the minute, and all you can think about are basal body temperature charts, ovulation and the possibility of in vitro fertilization (IVF).And, of course, if you're taking fertility drugs, you could be dealing with bloating, hot flashes or mood swings, making sex seem remarkably unsexy.

The good news is there are ways to enjoy Valentine’s Day even if you are in the middle of your fertility treatments.

“The nice thing about Valentine’s Day is its focus on the couple,” says Leslee Murphy, an infertility therapist at Houston Fertility Counseling who also works on-site at Houston IVF. “A lot of the other holidays — Christmas, Easter, Mother’s Day — are more about the family and children, but Valentine’s Day is about you and your partner.”

So snuggle up with your sweetie and read through our list of Five Ways to Cope with Infertility This Valentine’s Day.

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Endometriosis: Developments in Gene Research

By Leigh Ann Woodruff, February 9, 2012

Endometriosis is a condition in which uterine tissue grows in other parts of the body, such as the abdominal cavity, ovaries, vagina, and cervix. The condition affects millions of women — 5 percent to 15 percent of women of reproductive age — causing chronic pain and infertility.

Endometriosis is often hereditary, and now researchers at the Yale School of Medicine have found an inherited mutation located in part of the KRAS gene, which leads to abnormal endometrial growth and endometrial risk. The KRAS gene makes the KRAS protein, which is involved in cell signaling pathways, cell growth and cell death. It is believed that this gene may cause cancer when it is mutated.

"This tells us that a single gene mutation leads to endometriosis in some women," says Hugh S. Taylor, M.D., professor and chief of the Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale. "Not all endometriosis is caused by this variation, but in those who have this type of endometriosis, we can track it and its inheritance. We can start to personalize treatment and perhaps target therapies that work towards this new pathway.”

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SART Releases IVF Success Rate Data for 2010

By Leigh Ann Woodruff, February 7, 2012

The Society for Assisted Reproductive Technology has released the 2010 IVF Success Rate National Summary, the latest clinical outcomes data on assisted reproductive technologies for the year 2010.

The national SART data shows that for 2010:

  • 370 clinics reported data to SART
  • Data was reported on 146,693 in vitro fertilization (IVF) treatment cycles.
  • There were 58,727 babies born from IVF treatment cycles.
  • For fresh embryos from non-donor eggs, the percentage of IVF cycles resulting in live births for women 42 (4.1 percent )
  • For fresh embryos from non-donor eggs, the average number of embryos transferred for women 42 (3.1 )

The 2010 data reflects many positive trends, including transferring fewer embryos per cycle and increased use of single embryo transfer. “We are continuing our focus on ART best practices, performance and safety," says Glenn Schattman M.D., President of SART. "There's clearly a decrease in the number of embryos transferred, which is a steady progression every year based on SART embryo transfer guidelines.

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Thyroid Function and Your Fertility

By Leigh Ann Woodruff, February 6, 2012

If you are experiencing menstrual irregularities and trying to get pregnant, it is a good idea to have your thyroid tested. An underactive or overactive thyroid could be at the root of your fertility issues.

It is somewhat difficult to determine whether the thyroid is exclusively the cause of infertility, because infertility is often caused by a combination of factors, according to Susan L. Treiser, M.D., a reproductive endocrinologist with IVF New Jersey, part of the Attain Fertility Center Network. "But I would say probably as frequently as 20 percent of the time, you'll see some sort of abnormality with thyroid function in patients who are trying to conceive," she says.

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Alcohol Absolutely Not Safe During Pregnancy

By Leigh Ann Woodruff, February 1, 2012

Even though "safe" amounts of alcohol have been debated, in light of two new studies, there's just no question when it comes to drinking alcohol during pregnancy. There is NO safe level of alcohol, and women should just not do it — and that goes for alcohol during fertility treatment as well.

Alcohol and Miscarriage

A recent study from Denmark found that women who drank just two drinks a week had 1.5 times the risk of miscarriage compared with those who didn't drink at all. The researchers surveyed mothers on the amount of alcohol they drank weekly during the first four months of pregnancy.

"The study examined the risk of miscarriage and alcohol consumption in the first trimester," says Brad Miller, M.D., a fertility doctor and founder of Reproductive Medicine Associates of Michigan. "Interestingly they found even one or two drinks per week increased risk for miscarriage by 5 percent. If they consumed two to three drinks per week, there was a 66 percent increased risk for miscarriage, and those consuming four or more drinks per week, the risk of miscarriage doubled."

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IVF, Frozen Embryos, Talked about on Campaign Trail

In the days leading up to the Florida primary, Republican Presidential candidate and former Speaker of the House Newt Gingrich called for a ban on embryonic stem cell research and the creation of a commission to study the ethics of in vitro fertilization.

According to the Washington Post, Gingrich was expressing concern about the excess embryos created in the IVF process and said, “I believe life begins at conception, and the question I was raising was what happens to embryos in fertility clinics, and I would favor a commission to look seriously at the ethics of how we manage fertility clinics. If you have in vitro fertilization, you are creating life; therefore, we should look seriously at what the rules should be for clinics that are doing that, because they are creating life.”

Barb Collura, executive director of RESOLVE, says the statements demonstrate a lack of understanding about the science and medicine behind IVF, as well as a lack of understanding about infertility. "He is not understanding this is a medical condition, this is a medical treatment, and now you're going to take one option that we have and say we're going to put this under the microscope and we may decide that there needs to be government intervention and government rules and government managing it," she says. "And that is really sad when we're looking at a private medical condition, a medical decision that people want to make, and now we're going to have government telling you what kind of care you should have, what the medical procedure should be.

"When we look at transferring embryos and freezing embryos, that's the standard of care," Collura continues. "How many embryos are you going to transfer, what are you going to freeze, what's the drug protocol you're gong to use to stimulate? Those are the standard of care questions."

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Needle Free! Boston Fertility Doctors Develop Saliva Test

Patient-friendly monitoring replaces daily blood tests for IVF

A typical in vitro fertilization (IVF) cycle requires hormone therapy to stimulate production of eggs, and daily blood tests to monitor hormone levels and a patient's response to therapy. These daily blood draws for up to seven days can be one of the most unpleasant parts of fertility treatment — leaving a woman feeling stressed and even a little bit like a voodoo doll.

But a Boston fertility clinic is eliminating that stress. Following two years of research, Boston IVF fertility doctors have developed the first needle-free saliva test that will replace the daily blood tests to monitor infertility treatment. They have proven that the hormone estradiol, traditionally measured in the blood, can also be accurately measured in saliva, which virtually eliminates the need for daily blood testing during a patient's treatment cycle.

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