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February 2007 Blog Archive

Wednesday, February 21, 2007
Rare Disease, Cause of Infertility, Often Misdiagnosed
Here's an example of how truly intertwined a person's fertility is with seemingly uninvolved other body functions: a rare genetic disease that shows up mostly in respiratory symptoms also results in infertility.

The disease, primary ciliary dyskinesia or PCD, is often misdiagnosed as asthma, allergies, or cystic fibrosis.

Many people already know that the gene that causes cystic fibrosis also indicates male infertility. But PCD is different. In addition to the culprit known as immotile cilia or ciliary aplasia, people with PCD have reversed internal organs.

Cilia are tiny hairlike structures that exist throughout the human body. Their job is to whisk away mucus, bacteria, and other things that our body needs to be rid of, and when the cilia are immotile, or stuck, inflammation and infection result.

Researchers have just published a study in which they found that 80 percent of people diagnosed with PCD had respiratory distress as newborns. So while the genetic disease itself happens only rarely, the study authors are encouraging a curious eye be turned toward babies who are born at term (that is, at or around 40 weeks gestation) and have respiratory distress or persistent hypoxemia (low blood oxygen). Similarly, patients who are known to have reversed organs along with chronic sinus and ear infections that don't respond to treatment and/or persistent wheezing and cough should be considered for possible PCD diagnosis.

While a PCD diagnosis could be disheartening, the fertility-related bonus would be learning early that infertility treatment should be considered when pregnancy is desired.
Saturday, February 17, 2007
Hypnosis for Infertility: Another Way to Say Just Relax?
A recent piece on the website of Seattle's King 5 News talks with a hypnotherapist and her satisfied patient about the use of hypnosis for infertility. The therapist has just authored a related book titled It's Conceivable. According to the reported comments, the mechanism for how hypnotherapy can resolve infertility is via reducing the stress that goes along with trying to conceive unsuccessfully. The patient, who used the therapist's assistance to eventually conceive, refers to her own previous "three and a half years of infertility..."

While there's a growing body of research that indeed points to a connection between reducing stress and enhanced reproductive function, people who are struggling to conceive should bear in mind the importance of word usage here. Quite simply, there's a difference between reduced or sub fertility and infertility.

There are numerous non-medical things that can be done to boost an individual's or couple's fertile potential. That's not always the case with physical conditions that result in infertility.

Word needs to be spread that fertility is not a lightswitch. It's not an either-or condition of human physicality. Fertility occurs over a spectrum of incidence and variables.

A man and woman of "average" fertility take an average of nearly two years to conceive, if all goes optimally. Yet in our hurried, fix-it-now, want-it-all world, we've taken to viewing that length of time as too long. While, yes, women who begin trying to get pregnant in their mid-30's or later need not tarry too long in old-fashioned TTC mode, the truth for women who are younger and of relative good health is that time is still on their side.

Hypnosis and other stress-reduction techniques can certainly enhance the quality of life for virtually anyone, regardless of whether they're trying to get pregnant or not. Before more well-done studies indicate otherwise, however, it is risky to link the many conditions that cause infertility to stress. The thing that could be risked is valuable time to the truly infertile patients.

Tuesday, February 13, 2007
High-Risk Preg Not Always Due to Fertility Treatment
Multiple babies. Twins, triplets, and more. They may be cute and even very desired, but the hard truth is that multiple pregnancies can be dangerous for both mom and babies. Such pregnancies are also on the rise. One of the reasons: fertility treatment.

Fertility specialists have been leading the charge in the past decade to decrease the incidence of multiple pregnancies resulting from various treatments for infertility. With in vitro fertilization (IVF), for example, a great deal of research has been and is still being conducted to whittle the best odds down to the transfer of one single, well-chosen embryo. Elective single embryo transfer (sometimes called eSET) is becoming more available across the country as practitioners become more skilled at related techniques and labs begin using the most advanced facilities.

In an article by the Associated Press' Marilyn Marchione on the website of the Monterey County Herald, specialists comment on both the growing number of high-risk pregnancies and on how the definition of high-risk itself is changing, in part due to the incredible technology that saves neonatal lives today.

While fertility treatment has become unfortunately known for producing a large percentage of "super twins" (the term used to refer to any multiples group of triplets or more), according to the maternal-fetal medicine specialists quoted in the article, there are also many more women who are choosing to conceive and go through pregnancies in the face of what used to be thought of as insurmountable health odds. More women who are older are choosing to attempt pregnancy, and their odds of naturally-occurring multiples have been known for decades before the widespread use of fertility drugs and techniques. In addition to older moms, women with medical conditions -- organ transplant recipients, cancer survivors, women with AIDS and heart disease and more -- are feeling encouraged by the scientific breakthroughs that allow far more babies to survive high-risk pregnancy.

As such pregnancies become more commonplace, judgements about "the perfect pregnancy" begin to change.

In fact, it could be that in time, ART will be used to avoid multiple pregnancies and their inherent complications. While IVF often erroneously gets the blame for ART-related ills, the truth is that the most well-known and dangerous super twin pregnancies resulting from fertility therapy actually came from a much simpler and less costly form of treatment -- artificial insemination (AI) -- with the use of superovulatory medication. With AI and medication, far less control is available to the patient and physician regarding number of eggs produced and fertilized, therefore regarding the number of embryos produced.

Education on the risks of pregnancy in general is lacking, far behind education made available on contraception. One source of good, fact-based information is the Society for Maternal-Fetal Medicine. Another, the March of Dimes.
Tuesday, February 13, 2007
Midwest Doc Makes Big Splash Again with Ovary Transplant
A woman from San Francisco, on one of the U.S. coasts where cutting-edge fertility treatment is de rigueur, recently traveled to the Midwest for an experimental procedure that could bring back desired feminine qualities. Joy Lagos received a whole ovary from her sister, Meapple Chaney, through transplant surgery by Sherman Silber MD in St. Louis, Missouri.

Sticking his professional neck out is nothing new for Silber. From his post at Infertility Center of St Louis, he's already well known as a pioneer of microsurgical techniques to reverse both tubal ligation and vasectomy, intracytoplasmic sperm injection (ICSI), and just a few years ago, the transplant of ovarian tissue pieces that resulted in successful pregnancies.

In an Associated Press article, Joy Lagos talked about her distress from being thrown into early menopause as a result of cancer treatment before the age of 30. Cured from cancer, she then had to deal with osteoporosis, decreased libido, and hormone-related emotional changes, in addition to infertility. She hopes that the ovarian transplant will renew her life and result in children.

Once again, the world will be watching one of Dr. Sherman Silber's patients for future signs of success.

Monday, February 05, 2007
RESOLVE Grows Its Board of Directors
The following individuals were recently named to the national Board of Directors for RESOLVE: The National Infertility Association. They will serve two-year terms in assisting to direct the organization:

Susan Caughman, President, New Hope Media

Marcelle I. Cedars, MD, Director, Division of Reproductive Endocrinology, University of California, San Francisco

Alice D. Domar, PhD, Executive Director, Domar Center for Complementary Healthcare at Boston IVF

Frank R. Dunau, retired financial executive

David L. Keefe, MD, Chair, James M. Ingram, M.D. Professor and Chairman of the Department of Obstetrics and Gynecology, University of South Florida College of Medicine

Deborah Rice, RN, Assistant Nursing Supervisor, Shady Grove Fertility Reproductive Science Center

Richard T. Scott, Jr., MD, Medical Director, Reproductive Medicine Associates of New Jersey and Clinical Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Robert Wood Johnson Medical School

(Press Release, Gina Cella, Cella Communications)

Monday, February 05, 2007
Good Idea: Preconception Health Advice
Two nurses in Great Britain aim to squeeze their consultation services in between the innocence of rather blindly trying to get pregnant and the trials and tribulations of infertility treatment.

They say that it's often a matter of telling couples to have sex more often.

Their business, Fertility Essentials, offers just that: knowledge that really is essential for procreation. Isn't it funny how few of us get to adulthood with this knowledge already intact?

But there you have it. Even in a country where fertility treatment is virtually free (yes, within rules and boundaries, but as compared to the United States' system or lack thereof, the NHS does pretty well by its countrypeople), classes are still needed in the subject of How To Get Pregnant.

"Preconception health" is a term that needs to be used more often in the United States, too. We often hear of prenatal health, referring to things an already-pregnant woman can do to enhance her developing baby's chances of a good outcome. But for the average adult, the notion of there even being a time period referred to as "preconception" doesn't often arise until it's an issue, most often then because the issue is one of TTC (trying to conceive.) That's when we finally learn about all the things we could've been doing before all that time passed without a pregnancy...

Unfortunately, Family Practitioners and OB/Gyns are either not that good at getting the word out about this idea of preconception health (save for some educational posters and brochures in their exam rooms) or they don't see it as an issue warranting attention. After all, when you consider the amount of money spent on avoiding pregnancy and the fact that most patients of FP's and OB's simply "fall pregnant" as the British say, it would be easy for a doctor to conclude that teaching young people about how they might more finely tune their reproductive systems just isn't worth the time.

Talk to fertility specialists, though, and you'll hear the contrary.
Monday, February 05, 2007
More Opinion On The Question of Age
In a piece for Salon, writer Carol Lloyd brings up the 67 year old mom's prior living arrangements, bioethicist Arthur Caplan, and the late actor Tony Randall as she wonders aloud about conception-related double standards.
Friday, February 02, 2007
How old is too old to give birth?
Should Age Matter when it comes to seeking Infertility? If you want to have a baby and can't have it the natural way, should you be penalized for that? This is in reference to the recent "news" story about the woman from Spain who lied about her age to her Infertility Specialist to get treatment. She eventually had twins. I am not sure what the fertility laws are but isn't this about a woman's right to choose? Ok, I get it she is old. But I thought fifties was the new forty and wouldn't that make sixties the new fifties. Let me know what you think? When do we stop pidgeonholing ourselves. We can be anything that we want to be shouldn't that extend to - having anything all our hearts desires too?

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