March 2007 Blog Archive
Tuesday, March 20, 2007
Study Says Do It At Home!
There are few aspects of fertility diagnosis and treatment that strike more panic into the hearts of even the manliest men than the semen analysis or providing a sample for intrauterine insemination (IUI). Let's be frank -- specifically, guys get the willies about the collection
of the semen to be analyzed.
Nothing like a closet-sized bathroom and a bunch of printed pornography in a public place to get your engines revved...
So, many people opt to "collect" the sample at home. But because of worries about the quality of the resulting sample -- think driving through morning rush hour traffic with a specially provided container tucked into your shirt for continuing warmth -- home collection isn't always allowed for patients who live too far from the lab.
Enter the thoughtful researchers from University of Rochester Medical Center in New York. They wanted to know just how much difference, if any, it makes to the final outcome of fertility treatment whether or not the guy, ahem, obtains his sample in the privacy of his own home or down the hall from the appropriately disinterested lab personnel. They thought there would be a difference in favor of clinic collection.
Lucky for lots of guys out there (and the women who often have to talk them into this task), they were wrong.
Following strict World Health Organization (WHO) guidelines, they allowed patients to bring a sample from home if they expected their travel time to be less than 45 minutes. Controlling for variables like cause of infertility and treatment drugs used, the study compares pregnancy rates between home-collectors and lab-collectors. No significant difference was found.
Next time you and yours are asked to provide a semen sample, here's a link to the study that you want to print out and present to the fertility treatment team... Location of semen collection and time interval from collection to use for intrauterine insemination
, published online in Fertility & Sterility
, March 2007.
Gyun Jee Song, Ph.D., Rita Herko, B.S., Vivian Lewis, M.D
Tuesday, March 20, 2007
A Kiss for Ovulation
When the KiSS-1 gene was first discovered in Hershey, Pennsylvania, the clever researchers decided to name it for the locale's famous goodie, Hershey's chocolate kiss candies. Now, endocrinology researchers have learned that a related hormone, kisspeptin, can nudge some women closer to ovulating.
The trick happens after injections of the hormone. Volunteers in an experiment soon began demonstrating an observable rise in luteinising hormone (LH) -- that's the hormone your ovulation predictor kits measure. LH is necessary to stimulate ovulation.
The researchers are looking forward to more data to confirm that Kisspeptin could be yet another way to help women with ovulatory function conceive with their own eggs.
Tuesday, March 20, 2007
Combing Out the Cellular Fertility Details
At the most recent (2006) meeting of the American Society for Reproductive Medicine, frequent references could be heard about cellular advances being the latest high road to success in fertility treatment. A recent finding by researchers in Canada and the U.S. is further proving that may be the case.
Dr. Richard Oko of Queen's University in Ontario is now working on further development of possible uses for Postacrosomal sheath WW domain binding protein, or more simply put, PAWP. Specifically, Oko and Drs. Warren Foster of McMaster University and Peter Sutovsky of University of Missouri-Columbia are aiming at making intracytoplasmic sperm injection (ICSI) work better with the help of PAWP.
The dance that egg and sperm do in the baby-making show is all about the right signals being transmitted at the right time, in the right places. It's far more complicated than a couple of sex cells bumping into each other. For a long time, science has tried to locate something that seems to activate the egg cell and prepare it for fertilization by sperm. Now, they think they've found it in the form of PAWP.
While ICSI is a technological marvel in and of itself, rendering cellular level fertility to countless men who would otherwise remain infertile, it still has a relative low success rate -- less than half of ICSI attempts, in which a single sperm cell is injected directly into an egg cell, achieve fertilization. The upcoming research will investigate whether or not PAWP can increase those success rates.
With any luck, just as many of us were awed years ago by the incredible science of ICSI, perhaps a few years down the road we'll be seeing the fruition of this latest ground-breaking research.
Tuesday, March 20, 2007
The Beckham's Want a Daughter
Because three sons and a rich, hunky husband aren't quite enough, a source tells the Sunday Mirror
that Victoria Beckham is going the extra mile or two to assure conception of a baby girl.
Well, that is, she's getting a special intimately-placed tattoo and has asked her husband, David, to go on a diet of foods that are supposed to help in the project.
David has to limit red meat and dairy intake.
Just how much impact does diet have on gender selection?
We'll wait and see.
Monday, March 12, 2007
Asian Women Not Benefiting As Much From IVF
In a unique study, published in February's Fertility & Sterility
, examining possible impact of ethnicity on successful outcomes of in vitro fertilization (IVF), researchers have concluded that IVF simply isn't working as well for women of Asian descent.
They're not sure as to the reasons yet, but one theory posited is that it's more cultural and environmental than biological or genetic.
Lead author Karen Purcell MD of Fertility Physicians of Northern California in San Jose and her team reviewed both national and local data that compared over 25,000 white women and more than 1,400 Asian women, all of whom went through IVF in the United States. Making sure to control for variables like the type of treatment and medications used, number of eggs retrieved, the women's ages, hormone levels, and male infertility causes, the study found that the Asian women were 31 percent less likely to get pregnant than the Caucasians.
One theory on the cause: because of traditional Asian diets that are rich in seafood, the women could have higher blood levels of methyl mercury, known to be toxic to embryos.
An important factor that was not considered in the data mining for this study: the male partner's ethnicity and whether it impacted IVF success.
Until more studies explore the relationships between ethnicity and IVF success, this report's authors advise fertility experts to at least let their patients of Asian descent know that their outcome statistics may vary from the numbers they frequently read on websites and in advertisements.
Monday, March 12, 2007
"Wives Tale" About Hot Tubs Proves Correct
For years, men have been told to stay out of the hot tub if they're trying to get pregnant. Now, a researcher at the University of California, San Francisco has started to document the reality of the common sense tale.
The bad news: hanging out in "wet heat" situations -- hot tubs and long baths for 30 minutes or more a week for at least 3 months -- really can impair sperm production and motility.
The good news: the effects on sperm of wet heat appear to be reversible without treatment.
A pilot study with 11 subjects, all of whom were regularly immersing their bodies in hot water, showed a mean increase in total motile (moving) sperm count of 491 percent after three to six months of refraining from dunking.
The researchers believe that six of the subjects who saw no increase in sperm count or motility were probably left out of the benefits of no-hot-tubbing because they were heavy cigarette smokers, a known factor in sperm production and quality.
The study was published in the January-February issue
of International Brazilian Journal of Urology. You can also read a quick summary of the findings in the PR from UCSF
Friday, March 09, 2007
Obesity Equals SubFertility (or Maybe Just Not Enough Sex)
Yet another study links weight and fertility; specifically in this instance, nearly 48,000 Danish couples who were clinically obese. Obesity is marked at body-mass index (BMI) -- weight in kilograms divided by the square of height in meters -- of 30 or higher.
But the study authors slipped up in one especially important area: they didn't inquire as to how much sexual intercourse was occurring in the subject group.
Much has already been written on the relationships between weight and how too much or too little can negatively impact both male and female fertility levels. This study, just published in the journal Human Reproduction
, is the first to examine the weight of a couple as a unit.
In this review of the study on MedPage Today
, the resulting action points indicated are to explain to patients:
A. that if both partners are obese, it could take longer than a year to conceive, and
B. the length of time to conception could be shortened when the woman (if she is obese,) in particular, loses weight.
Good advice, no doubt. The study review renders plenty of supporting details. However, it's very hard to feel quite confident in the results when the researchers plainly state that no reliable information "on the frequency and timing of sexual intercourse" was collected from the subjects, so they "cannot know whether infrequent intercourse delayed conception in overweight and obese couples."
The gap in data led another article
to surmise that the fertility problem for obese couples could be more related to their sex life than to some hormonal or other biophysical connection.
Friday, March 02, 2007
Got a Miracle Baby? Enter Contest for Educational Fund
One of the world's manufacturers of fertility drugs, Ferring Pharmaceuticals, is offering up to $10,000 in an educational fund for children who came to be with the help of their medications.
You have until the deadline of July 31, 2007 to submit an original piece of writing for Ferring's My Little Miracle Essay Contest.
If you used Bravelle(R) or Menopur(R), you're eligible to enter your essay of up to 1,000 words, in English. In addition to the big prize, Ferring is also awarding several lesser prizes to runners up and honorable mentions.
Winners will be announced at this year's meeting of the American Society for Reproductive Medicine.
For more details and a contest application visit www.ferringfertility.com or www.ferringusa.com or call (203) 762-8833 and ask for the My Little Miracle Essay Contest representative.
Friday, March 02, 2007
Researcher Calls for End to Common Empirical Treatment
From a meta-analysis of 13 studies, researchers are concluding that a commonly prescribed therapy should not continue to be used in the current manner. The treatment, prescribing glucocorticoids such as prednisone in hopes of assuring embryo implantation, is empirical as opposed to evidence-based.
Therein lies both the reason and the quandary.
After reviewing all of the studies, which involved a total of 1,759 couples in randomized controlled trials that compared success rates of IVF and IVF with ICSI, the review authors concluded that there simply is not enough evidence of benefit to using prednisone. Plus, there are possible ill effects for developing embryos that could be unwittingly exposed to the steroid hormones.
However, much of fertility treatment has evolved from the empirical use of different therapies. There's nearly always a cost-benefit ratio analysis involved.
"Empirical treatment" refers to therapies that are attempted before a diagnosis is confirmed. Doctors are often in a position to prescribe empirically when there are acceptable reasons -- such as the ethics-based inability to experiment on a population, like embryos, or in cases where the patient will be harmed strictly because of any delay in administering treatment.
On the other hand, evidence-based medicine uses a scientifically-proven framework within which to determine appropriate treatment. The reviewers of the glucocorticoid studies are simply saying that the common prescribing of this class of steroid hormones, like prednisone, has not been well-proven to be beneficial enough, even though the potential adverse effects also have not been well documented.
Patients and their doctors are still in charge of their treatment plan of choice. For many women who either miscarry frequently in the first trimester or who have unexplained failed IVF cycles, the use of prednisone will likely continue until more solid evidence of contraindication is made available.
For more details on the review, read this Health Behavior News Service article
Thursday, March 01, 2007
To Heck with Low-Fat, Eat Ice Cream
There's not a lot of good research out there yet on connections between nutrition and fertility, but the body of literature is growing. Nutrition impacts are huge in virtually any realm of health, physical and mental, so there's always been a bunch of folks out there who are just waiting on the edge of their seats for the Magic Fertility Food to be found.
Now, we're seeing headlines that scream about ice cream and how eating it might help you get pregnant.
Dr Jorge Chavarro, research fellow in the Department of Nutrition at Harvard School of Public Health in Boston, is going to be the hero of many women.
For this study, he and his team combed 18,555 women research subjects out of 116,000 who had participated in The Nurses' Health Study II. These 18k were ages 24 to 42, had no infertility history, and either tried to or became pregnant somewhere between 1991 and 1999. The women answered periodic surveys about, among other things, what they ate and drank. Of the lot, 438 turned up infertile because of ovulation problems, specifically.
The data led researchers to conclude there's an 85% increased of anovulatory (meaning lack of ovulation) infertility for women who ate two or more servings of low-fat dairy food every day, when compared to women who ate one or fewer servings per week.
Here's the happiest part, why we love this study: They found a 27% decreased risk of infertility for those who ate high-fat dairy food one or more times a day
, as compared to women eating one serving only once or less often in a week.
Incredibly, it gets even better:
They say that more
is optimal. The more ice cream the subjects ate, the lower their risk of anovulatory infertility. Ice cream twice or more a week equalled (for the study subjects) a 38% lower risk of such fertility problems, compared to someone eating ice cream less than once a week.
Before you grab your pints and spoons, know the rest. While the lead Doc says go ahead and trade out your low-fat dairy for the good stuff, he warns that you should be prepared to switch back to low-fat once you're preggo. And while you're still trying to conceive and digging that sweet cream, Chavarro says to maintain your normal caloric intake and limit staturated fats overall.
It's not that ice cream is the Magic Fertility Food. It's more about a still mysterious fat-soluble substance that probably makes your ovaries work better.
Okay. Works for me!
Read about A prospective study of dairy foods intake and anovulatory fertility. Human Reproduction. doi:10.1093/humrep/dem019