Fertility and Your Sex Life

What sex life?
For couples who are trying to conceive, sex can become a mechanical process. One of the challenges couples face is the loss of spontaneity and romance when it comes to having sex while they are trying to have a baby. Fertility treatment can also change a couple's sex life.

When trying to have a baby, sex becomes a task necessary for conception. This "conception sex" can involve scheduled sex and specific sexual positions that are believed to improve the chances of getting pregnant. For many couples, these factors can make sex feel like a chore.

A couple who has been trying to conceive for some time may forget that sex can be intimate and that there is a difference between sex for pleasure and sex for conception. Couples need to recognize that the ability to conceive does not define their sexuality.

Feelings of intimacy and privacy can be lost once a couple undergoes fertility treatment. These issues often come up when discussing personal details of their sex life with their doctor, or when undergoing tests such as a semen analysis (to measure sperm counts) or the post-coital test (to assess the interaction between the sperm and the cervical mucus). Keeping a sense of humour can go a long way to help ease the frustrations and challenges you may be going through.

A couple's sex life doesn't have to suffer and become unromantic when they are trying to conceive. Communicate with your partner about your sexual desires and needs. Continue having spontaneous sex during the rest of the month, as if you weren't trying to have sex to conceive a baby. Couples who communicate and stay physically and emotionally connected can continue to have a healthy sex life.

Your doctor or fertility specialist can answer any concerns you may have about fertility and your sex life. Though it may be uncomfortable to talk to your fertility specialist about it, they are trained experts who can help with some of the challenges that couples may face while going through fertility treatment.

New test tells women how long to delay having children

Sarah North has decided to have a newly available fertility test to see if she should start having babies straight away.Miss North, a 31-year-old pharmaceutical company representative who lives with her partner at Laingholm in West Auckland, is certain she wants children - two, three, possibly even four.But she also has a mortgage. So, like many women around her age, she is weighing the benefits of delaying childbearing - such as greater financial security - against the risk that if she waits too long she might need IVF fertility treatment or not be physically able to have them at all.

"Ideally I picture myself at about 35 having children rather than right at this minute."But how long can she wait?The blood test she plans to have next week should give her an idea. A check of her level of an ovarian hormone called anti-Mullerian will show how many eggs she has left, a predictor of her chances of becoming pregnant.The new test - more sensitive than the existing method, which checks the level of follicle stimulating hormone - has been available overseas for several years. Now two chains of private fertility clinics in New Zealand have started offering it: Repromed, at a cost of $85, and Fertility Associates, at $45-$50.A woman's number of eggs is set at birth and declines naturally during her life. Egg quality also starts declining, then this accelerates in the 30s. Both factors affect fertility, which is at its peak around the age of 28.In the mid-20s, it takes on average three months to become pregnant, rising to six months in the mid-30s and a year at 40.

At least 10 per cent of women in their early 30s have an abnormally depleted reserve of eggs, but most do not know.The existing test can reveal this abnormal depletion only once the quality of the eggs has deteriorated significantly.The new test can also help to predict the risk of miscarriage and to tailor the dose of fertility drugs in IVF, but Fertility Associates director Dr Richard Fisher expects its main use will be to help women with a reduced egg count for their age decide when to try to start a family.

Repromed Auckland's medical director, Dr Guy Gudex, said he often saw couples who had been together for many years who, had they known they were going to have difficulty conceiving, would have started trying sooner."Just a couple of years can make all the difference."If a woman's anti-Mullerian hormone level was low, "we might encourage a couple to plan their family earlier."* The testA blood test to measure the level of an ovarian hormone called anti-Mullerian.It helps assess a woman's biological clock - fertility of ovaries' remaining eggs - better than existing tests.

101 Babies Expected After New Infertility Treatment

After suffering the heartbreak of years of infertility, scores of US couples claim their dreams came true due to a newly developed therapy. Over one hundred babies have been born or are expected by women diagnosed infertile after receiving a new physical therapy treatment, similar to a deep massage. The new treatment uses no drugs or surgery, according to its developers, physical therapist Belinda Wurn, and massage therapist Larry Wurn.

It was first used in Florida as an adjunct to medical treatments. Developed to treat infertility and pain, the patent protected Wurn Technique® is becoming available at clinics throughout the US. Cathleen, a Florida nurse, was given a five percent chance of ever becoming pregnant. She underwent four IVF attempts without success, then had a natural pregnancy and childbirth after receiving the new therapy. "It is exactly what my body needed. I was amazed to become pregnant naturally, a few months after the therapy!" Manhattan resident Julie said, "Both of my fallopian tubes were blocked with adhesions before therapy. Two months after therapy, I became pregnant at 42 years of age for the first time in my life!" Julie and Cathleen both delivered healthy baby girls.

Published medical studies "Medscape General Medicine" (6/04) examine the technique's effectiveness. 71% of infertile women in one small study conceived naturally after treatment; a larger controlled study showed that women who received the therapy before in vitro fertilization (IVF) had a 67% pregnancy rate with IVF - much higher than the control group. "Some successes in the natural therapy study were remarkable," said Richard King, MD, gynecologist and Medical Director of Florida Medical and Research Institute. "We had natural pregnancies and births in women diagnosed with adhesions, endometriosis, hormonal problems, and blocked fallopian tubes." Women in both studies averaged 5 years of infertility before the treatment. The therapy has an unusual side effect in some women: increased orgasms.

In a third study published in "Medscape General Medicine," (12/04) the therapy was shown to significantly increase desire, arousal and orgasm, and decrease sexual intercourse pain in study participants. The 20-hour therapy program can be completed in five days at Clear Passage clinics in Florida, Iowa, California or New York. See http://www.clearpassage.com. Free phone consultations are available at 1-866-BABYHERE (866-222-9437).

Acupuncture 'helps women have babies'

Acupuncture could help women undergoing fertility treatment become pregnant, new research has found.
One in three women given the ancient Chinese therapy - which involves the insertion of needles into specific points on the body - alongside their IVF treatment successfully conceived, scientists from the University of Southampton discovered.
The success rate among those who did not combine fertility treatment with acupuncture was one in five.
IVF treatment involves "embryo transfer" - when an egg has been fertilised in a laboratory is put into a woman's womb.
The study, which involved more than 2,000 women, discovered that the chance of the embryo implanting successfully, triggering pregnancy, increased if the patient was treated with acupuncture at about the same time as the transfer.
Its authors, however, found there was no discernible benefit if the acupuncture took place days after the fertility treatment.
They concluded: "Acupuncture around the time of embryo transfer achieves a higher live birth rate of 35 per cent compared with 22 per cent without active acupuncture."
Dr Ying Cheong, from the university's reproductive medicine unit, who led the research, said the findings would offer encouragement for the 33,000 women who embark on IVF treatment each year.
"Our research is good news, because it shows that acupuncture can help with fertility in patients undergoing IVF," Dr Cheong said.
"Whether or not acupuncture helps women achieve a live birth is a controversial issue, and opinion has been divided on it.
"We show that acupuncture, performed at the right stage, can have significant benefit. A woman who does so has a much greater chance of having a live birth than a woman who doesn't have acupuncture."
Acupuncture therapists claim that by inserting very fine needles into points on people's "energy channels", they can stimulate the body's natural healing system. However it is controversial, and many medical experts remain sceptical over its claims. Dr Cheong's research was welcomed by charities that campaign for people suffering from fertility problems.
Susan Seenan, from Infertility Network UK, said: "These results appear to show that acupuncture given with embryo transfers can help improve success rates and we look forward to further research in this area to confirm this.
"Anything that helps improve the success rates for people going through infertility treatment is good news.
"Many of our members report that alternative therapies, such as acupuncture, can help them to cope with the treatment and the general stress."
SOURCE: telegraph.co.uk

BBC to pay £½m costs in IVF libel case

IVF libel case:

The BBC yesterday abandoned its claim that a Panoroma investigation into the country’s top fertility doctor constituted “responsible journalism”.
It now faces having to pay out at least £500,000 of taxpayers’ money to Mohamed Taranissi, who is suing the corporation after the flagship current affairs programme accused him of pressuring patients into paying for unnecessary treatment.
BBC lawyers in the High Court ditched a 15-month-old claim that the corporation was protected from the doctor’s libel action by qualified privilege, which shields journalists so long as they carry out “responsible journalism”.
The BBC is still defending the claim on the ground that the Panorama allegations were substantially true.
Richard Rampton, QC, Mr Taranissi’s counsel, said that the corporation had “thrown in the towel” after months of hard work and hundreds of thousands of pounds incurred by both sides. “It follows as a matter of justice, as night follows day, that they should pay,” he said.
Giving judgment, Mr Justice Eady agreed, saying that the BBC must bear the financial burden of that part of the case — estimated by Mr Taranissi’s lawyers to have cost at least half a million pounds.
Adrienne Page, QC, representing the BBC, said that the corporation continued to “stand behind its journalists and its programme and expects both to be vindicated at trial”. Mr Rampton accused the BBC of “grossly exaggerating” the number of medical sources that supported the programme’s allegations that Mr Taranissi offered “unnecessary and unproven” treatment and manipulated the success rates of his two London clinics.
“It’s Alice in Wonderland stuff,” he said. “One of the so-called medical experts was actually an administrative assistant.” He also criticised Panorama for “misleading” viewers, which the BBC denied.
The development came as Mr Taranissi was named as the UK’s most successful fertility doctor in annual figures released yesterday by the Human Fertilisation and Embryology Authority. His Assisted Reproduction and Gynaecology Centre had comfortably the highest success rate of any British clinic in 2006, with 61 per cent of patients aged under 35 having a baby after IVF treatment with their own fresh eggs. The national average for this patient group was 31 per cent.
The doctor’s other centre, the Reproductive Genetics Institute, took second place in the table, with a 50 per cent success rate for women under 35.
The results are embarrassing for the authority, which has been engaged in a long disciplinary action against the doctor over claims that he treated patients at the Reproductive Genetics Institute without the correct licence. Last year the watchdog declared Mr Taranissi unfit to be the “person responsible” for his main clinic, but it annulled the ruling last month after a legal challenge. The High Court also found that the authority used unlawful warrants to search the two clinics last January.
The General Medical Council is currently hearing complaints against Mr Taranissi from two patients, which he contests.
IVF success rates
1 Assisted Reproduction and Gynaecology Centre, London, 61% 2 Reproductive Genetics Institute, London, 50%3= Lister Fertility Clinic, London, 44%3= UCH, London, 44%5 Chelsea & Westminster Hospital, 42%6 Nurture, Nottingham, 41%7= Cromwell IVF and Fertility Centre, London, 39%7= Shropshire and Mid-Wales Fertility Centre, 39%9= Bath Fertility Centre, 38%9= CRM London, 38%9= Guy’s Hospital, London 38%

Source: Human Fertilisation and Embryology Authority (for women under 35 using own fresh embryos)

New master switch found in the brain that regulates appetite and reproduction

LA JOLLA, CA – Body weight and fertility have long known to be related to each other – women who are too thin, for example, can have trouble becoming pregnant. Now, a master switch has been found in the brain of mice that controls both, and researchers at the Salk Institute for Biological Studies say it may work the same way in humans.

Findings from the study, published ahead of print in the Aug. 31 online edition of Nature Medicine, suggest that variations in the gene that produces this master switch, known as TORC1, could contribute a genetic component to obesity and infertility, and might be regulated with a novel drug.
"This gene is crucial to the daisy chain of signals that run between body fat and the brain," says Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, who led the study. "It likely plays a pivotal role in how much we, as humans, eat and whether we have offspring."

It is just as important as leptin, the well-known star regulator of appetite, Montminy says, because leptin turns on TORC1, which in turn activates a number of genes known to help control feeding and fertility.
Judith Altarejos Ph.D., first author on this study, had been trying to understand human energy balance, and what can go awry to promote obesity, diabetes and other metabolic syndromes. In this study, she looked at the signals that travel from body fat to the brain, informing the brain of how well fed the body is. The primary hormone that performs that function is leptin, which travels through the bloodstream to the hypothalamus in the brain (the appetite center), keeping the brain aware of the body's nutritional status.

"Leptin tells the brain that times are good, your body is full, and that it is not necessary to eat more at the moment," Montminy says. The hormone also is known to play a role in reproduction - although, until this study, no one understood what is was. (Very thin women often do not have periods.)
"Controlling appetite and reproduction together provides a big evolutionary advantage," Montminy says. "If there is no food, the brain believes the body should not reproduce because without body fat, a baby's growth in the womb could be stunted, and without food to replenish the body's energy reserves, there will be nothing to feed the offspring."
"Leptin works remarkably well to give the brain a good indication of how much food has been eaten; 99.9 percent of the time it balances food intake with energy use," he says. "The problem is that no machine works 100 percent of the time, and that slight bit of inefficiency can lead to extra body weight."

Obesity results when the brain becomes "deaf" to the leptin signal, so one goal of Montminy's research is to "try to make a way to make sure the brain signals are being heard." But to do that, he and his research team first have to understand all of the signals involved in the satiety pathway.

Through years of research, they have uncovered a family of genes that act as energy switches, turning other genes on or off. One gene, TORC2, acts like a fasting switch that flips on the production of glucose in the liver when blood glucose levels run low, usually during sleep. During the day, the hormone insulin normally shuts down TORC2, ensuring that blood sugar levels don't rise too high. Problems along the pathway, however, can help lead to diabetes.
In this study, Altarejos looked at the function of TORC1, which she knew was produced in the brain – unlike TORC2 and TORC3 – but didn't know what its function was. To do this, she created mice that lacked one or both copies of the TORC1 gene – the first such "knock-out" mice to be developed.

Mice born without TORC1 looked fine at birth, but at about eight weeks, they began to gain weight and became persistently obese in adulthood, with two to three times as much adipose fat as normal mice, and they also became insulin resistant. "Their hormones and blood sugar resembled that seen in humans with these disorders," Montminy says.

They also discovered, to their surprise, that mice of both sexes were infertile; the uteri and ovaries in female mice were anatomically dysfunctional, for example. "We don't study infertility, but we put two and two together," he says. "We knew leptin is the critical hormone for regulating body weight, and that it is also very important for regulating reproduction."
Altarejos discovered that TORC1, which is found within nerve cells, responds to signals from leptin, which binds to receptors on the outside of the same cells. TORC1 then turns on a spate of genes, two of which are well known. One is the CART (Cocaine and Amphetamine Regulated Transcript) gene that is known to stifle appetite. The other, KISS1 (named by its discoverers at the Penn State Hershey Medical Center) is required for reproduction; mutations in the gene produce human infertility.

So when leptin binds with its receptor on brain cells, it turns on TORC1, which, in turns activates CART to suppress appetite, because more food is not needed, and KISS1, signaling reproduction can now commence in this well-fed body. Conversely, when leptin is not activating brain receptors, TORC1 is turned off, as are CART and KISS1.

They also discovered that when mice inherit only one TORC1 gene (instead of the normal two, one from each parent), fertility is restored but the mice gain more weight than normal mice. "This suggests that half of the dose of TORC switch is enough to cause problems in leptin signaling in the brain, and it may be that subtle mutations in TORC1 in humans could be responsible for an inheritable risk factor for gaining weight," Montminy says.
Tweaking mutated and inefficient TORC genes may be possible through drug therapy, he adds. "TORC1 is regulated by phosphate handling enzymes called kinases, and kinases often make for very good drug targets," Montminy says.

SOURCE: eurekalert.org

FIRST IVF BABY TURNS 30 By Jennifer Rogers

Happy 30th, Louise.

As I approach my 30th birthday, having delayed marriage and children, the social and biological clock of keeping time for childbearing ticks louder. However, thanks to another 30-year-old woman, it's possible for me to feel at ease. That woman is Louise Brown, the first child born via IVF. Last week marked not only her 30th birthday but thirty years of success in giving many women and men a second chance to have a biologically-related (at least, in part) child of their own.

In fact, over 3 million babies worldwide have been born using IVF -- with over 52,000 infants born in the US, accounting for 1 percent of all births in the country.

In conversations with my close friends, it's been comforting to hear that we share the same concerns about starting a family later in life. We joke that after years of being on birth control--from condoms to pills to patches and rings and back to condoms again--diligently trying to avoid an unplanned pregnancy, we're fearful that we may, in fact, experience infertility.

Because of assisted reproduction and the tremendous successes gained in the past three decades, the clock is not ticking as loudly for me as it was for my mother. Instead, my generation has grown accustomed to this $3 billion industry--most of us know at least one friend, family member or colleague who has been through IVF. But this familiarity brings with it a whole new set of concerns. What are the ethical, moral, legal and financial impacts of this field? How do we grapple with these issues as a women's community, before others tell us what's best for our bodies and for our children? We've seen it before, and it will happen again.

It is incumbent upon the women's reproductive health community, particularly those who face these issues daily, to foster this debate. We might begin with the following concerns:

Number 1: Why is my generation of women and men more infertile than our parents? Currently, in the US, 1.2 million (or 2%) of women of reproductive age (defined by the CDC as age 10 to 49) have an infertility-related medical appointment each year; 10% receive infertility services at some point in their lives. As I've alluded, a big factor is age. To simplify things greatly, as more women gained equality in education and in the workplace, we also began to delay childbearing--for many reasons, including lack of maternity leave and inflexible work schedules.

But to highlight only age would be misleading. With so many individuals experiencing infertility (and in cases in which the underlying causes are never found), we cannot ignore the tremendous role that environmental contaminants are playing in this problem. Exposure to ubiquitous dioxins, such as cigarette smoke, lead, mercury and some agricultural pesticides are direct threats to a couple's ability to conceive or have a healthy pregnancy. And, more troubling, new research suggests that a broader range of chemicals--including many that are associated with everyday products such as household cleansers, flame retardants, personal care and beauty aids, and even plastic water bottles--could have a complex and far-reaching impact on fertility.

Number 2: Are these procedures--the hormones, the retrieval of eggs, the implantation of one or multiple embryos--safe for women and their children? The answer, for the most part, is that we don't know. While IVF has generally been accepted as safe by the American public, there are in fact very little published data, let alone quality, standardized data, on the short and long term safety of these procedures on women and children's health. As we see an increase in women going through these procedures for either their own reproduction or to donate their eggs, how can we fully inform them of the potential risks and benefits?

Number 3: The growth of this industry and the growth in the numbers of assisted fertility clinics (now at 475 in total) have increased the demand for women's eggs. While most clinics offer women an average of $3,000 to $8,000, some "baby brokers" have offered as much as $50,000-80,000 for specific egg donors. (The American Society for Reproductive Medicine's (ASRM) guidelines allow for women to be compensated for their time and risk up to $5,000 or $10,000 in some cases, but this is neither mandated nor regulated by either state or federal law.) This issue poses its own ethical and moral dilemmas: should a woman be compensated for donating her eggs? Can payment create a coercive or exploitative situation? What are the race and class implications of who demands and who gets solicited for their eggs?

As with many momentous events in my life, as I approach my 30th birthday, I'm asking myself more questions than I know answers. I have found that asking questions--and listening to a broad range of voices who have their own personal and insightful answers--is the first step in the process in advocating for change.

We must grapple with these issues and then propose solutions that follow our values and morals. So, in that vein, my parting question: what policies will empower all women to make their own decisions about having a child and yet protect her health? The answer to this will be the best 30th birthday present for me and Louise.

PIONEERING TECHNIQUE ENDS BABY WAIT

A couple who tried for a baby for seven years are celebrating the birth of a daughter thanks to a pioneering new technology.

Ian and Rebecca Bloomer attended the IVF clinic at the University Hospital of Wales, Cardiff. In August last year, the hospital began using a new technology to freeze unused embryos through "vitrification".

This method, offered to the Bloomers, gave the embryos a better chance of surviving the freeze so they would be available again as soon as the couple were ready to try again.

Mrs Bloomer fell pregnant almost immediately using one of these embryos and became the proud mother of a healthy baby girl on July 23.
The childhood sweethearts, from Cwmbran, South Wales, had wanted a baby since they married in 2001. But tests revealed that Mrs Bloomer, 28, had endometriosis, a condition which was making it difficult for her to conceive.

Mrs Bloomer said: "We were willing to try anything really, we'd both always wanted children.

"It's overwhelming. I'm still staring at her now thinking 'wow, she's ours - it's actually happened for us'.

"I hope that if anybody going through treatment sees us and sees Evie it gives them one last little bit of hope to go for it.

"It's been a real emotional rollercoaster. There's been ups and downs, but you get through it and, to have Evie now, you forget what you went through. It makes it all worthwhile."

Lyndon Miles, head of embryology and andrology for IVF Wales, said: "The first published study on babies born from vitrification shows no adverse effects of the technique and there are no implications to Evie's health as a result of the vitrification process."

SOURCE: The Press Association

INTERESTING AND INFORMATIVE BLOG ON INFERTILITY

CHECK OUT LOLLIPOP GOLDSTEIN'S INTERESTING BLOG ABOUT INFERTILITY AND PREGNANCY LOSS, AN EXPLORATION OF ADOPTION AND DONOR GAMETES, A BITCH SESSION ABOUT DAILY LIFE AND BOOKS, ETC at:
http://www.stirrup-queens.blogspot.com

HOW DO COUPLES COPE WHEN IVF FAILS?

Broke, babyless and in need of help. John Naish examines the taboo question of how couples cope when it all goes wrong:

Across Britain next Friday, thousands of couples will brace themselves for a welter of “miracle-baby” stories as the world marks the 30th birthday of Louise Brown, the first test-tube child. In the shadow of assisted conception's many successes are the 75 per cent of women patients for whom the gruelling medical process never works. The vast majority are neither monitored nor offered counselling but, it seems, are expected to slink away, marked “failed.”

Caroline Gallup is among the 25,000 women each year whose fertility treatment proves fruitless, often after spending all their available funds and putting their relationships under perilous strain. Rather than quietly grieving, Gallup is campaigning for the NHS and high-earning private clinics to give support after assisted conception has failed and to fund studies into what happens to these people's lives.

Very little research has been done, but in 2000 a small study of 76 women by the Royal Maternity Hospital in Belfast found that five years after their unsuccessful treatment they suffered “significant psychological dysfunction”, particularly stress and depression. The research, published in the journal Human Fertility, concluded: “There is a strong need to prepare women better for treatment failure and to ensure that counselling is available when further treatment is no longer appropriate.” This echoes the findings of a Hull University study three years earlier. Both recommendations have fallen on deaf ears.

The government watchdog, the Human Fertilisation and Embryology Authority, says that it sees issues about follow-up monitoring and counselling as outside its remit, because it regulates only the process of infertility treatment itself.

Hence Gallup's campaigning. “I see the routine provision of post-treatment counselling as a moral duty,” says the 44-year-old Londoner. “When you are treated, you have to believe that a baby will grow. When it doesn't, the crash is awful, but you're buoyed as long as you can go through another cycle. I think it's only morally right for clinics to carry on with ‘after-sales service' when that hope has disappeared.”

COUPLES HAVE THE UTMOST OPTIMISM
“The clinics do tell you at their open days that there is a 76 per cent failure rate across the board, but couples aren't in a position to take that in,” says Gallup. “The only way you can enter into something so grim is with the utmost optimism.” Indeed, a study in The Obstetrician & Gynaecologist journal found that although clear information on success rates is given to couples, “the majority believe that they will be the minority who achieve pregnancy”.

Gallup and her husband decided to stop trying after they had paid £8,000 for private treatment. “It was partly down to money - we'd run out - and partly the fact that it was wrecking our relationship. My husband said he didn't want to go through it any more. It was turning me into a total obsessive,” she says, adding: “Blame can play a really big part in relationships after treatment failure. It's one of the big reasons why counselling is needed.”

Four years after the treatment ended, she says: “My husband and I are still dealing with it. I have had to reinvent myself. I didn't know what my identity was after we had finished. That's a huge psychological thing.” Now she has taken a less demanding job in her career in events management to spend time lobbying interest groups and politicians. She is also trying to develop a career as a writer, having published a book on her fertility treatment experiences, Making Babies the Hard Way.

Emerging from fertility treatment babyless, broke and in need of professional support to get back on the rails is a common experience, according to the British Infertility Counselling Association. “A lot of people come out of the process highly stressed and they think they can go for free counselling, but there is no such thing,” says a spokeswoman. “Funding is a big problem for most people. They may well not be able to pay for private counselling because they have spent all their money on treatment.”

One of the few organisations to provide social support is More To Life, which helps involuntarily childless people to develop networks and swap advice. Membership costs £20 annually and has grown rapidly in the two years since it was established, says Susan Seenan, one of the organisers. “Social life can be difficult for infertile couples, especially women,” she says. “Wherever you go - barbecues, parties, christenings - everyone has children.
“It's difficult to talk about infertility and childlessness. It's seen as a stigma. But with more people leaving it until later in life to try for children, there is bound to be more infertility, more treatment, and more disappointed couples.”

It is not only infertile women who face bereavement and loss of purpose. David Downage regularly attends More To Life social events. He and his wife went through treatment in the NHS and privately, but ultimately decided that their hopes were beyond slim. “It was a traumatic decision, but the danger is that you go on trying too long and damage your relationship,” he says. “So we decided to move on.”

The Downages joined More To Life to extend their social network beyond old friends with their new families. “We had to find it by searching the web,” he says. “It's strange that clinics can't point you to organisations like this after the treatment has failed,” says David, 47, a property developer. “For a man, discovering that you're going to be childless raises questions about what you are doing with your life. Once you can pay the bills, what is there after that? My wife and I came to view it as an opportunity to do other things. She is keen to get involved in charity work with children. We plan to retire early and, hopefully, be able to put some of our money into building children's schools. Certainly we will be able to do that as a legacy.”

Finding renewed purpose is one of the best survival strategies, says Jacky Boivin, a researcher at Cardiff University's School of Psychology. She has followed more than 100 women undertaking IVF over seven years, and is running a five-year study of 818 couples in Denmark.
“There is not much research into what happens to people in the long term after unsuccessful treatment, but our data indicates that about 40 per cent of couples are highly distressed at having to stop. After they have made the decision, around 5 to 10 per cent remain stuck in that state. People who come to the end of the IVF treatment and feel they could have had more are often seized with resentment.

“You have to reinvent a life that is not about having a family,” she stresses. “You have to look for the positive while acknowledging the negative. People have to regain a sense of control over their lives, after having it taken over by regimens that tell them exactly when they should be having sex. And they need to look at the experience as an opportunity to renew life interests. Sadly, the lack of post-treatment counselling means people don't have support in this.”

AND NOW THE GOOD NEWS
There is one surprise. Boivin says: “Oddly, the divorce rate is much lower among couples whose fertility treatment failed than for the general population: 10 per cent versus 50 per cent. We don't know why. There is life after infertility treatment. Not always an easy one, but most people will go on to find contentment, though the experience will always carry a sting.”
SOURCE: THE TIMES ONLINE

Science thinks big for better IVF

A new IVF technique involves selecting sperm with a shape and size that indicate good genetic quality. The best are injected into eggs to fertilise them. Results show improved pregnancy rates.
Infertile men can more than double their chances of fatherhood with a new IVF technique, according to the most comprehensive study of the procedure yet conducted.

The results of a major trial of the approach, which builds upon the technique of injecting sperm directly into an egg, suggest dramatic benefits for the one in 12 couples affected by male factor infertility. A far more powerful microscope is used to identify the sperm most likely to succeed.

The results, from a team in Italy, are encouraging for men with an especially poor fertility prognosis and who have tried and failed to have children by IVF at least twice in the past. Their prospect of becoming fathers using the therapy was double that with standard methods, the study found.

The method, which was first developed in 2004 by a team led by Benjamin Bartoov, of BarIlan University in Israel, is called intra-cytoplasmic morphologically-selected sperm injection (IMSI). It involves examining sperm under a high-magnification microscope, about five times more powerful than standard laboratory equipment, to select those with a shape and size that indicates good genetic quality. The best-looking sperm are then injected into eggs.

British scientists hailed the results as the strongest demonstration yet of the new therapy’s benefits. “I don’t think a lot of people in the UK have woken up to this yet, but they are going to have to,” said Allan Pacey, Lecturer in Andrology at the University of Sheffield. “This is strong evidence from a well-designed study. If it can be repeated in two or three studies, people would seriously have to think about changing their approach.”

The treatment builds on the success of intra-cytoplasmic sperm injection (ICSI), a therapy for male infertility that has enabled thousands to become fathers since it was developed in the early Nineties. ICSI involves fertilising an egg in a laboratory by injecting it with a single sperm. As the sperm does not have to swim up to the egg and penetrate it, the method can help men whose sperm would otherwise be too weak. Even when men produce no sperm, doctors can sometimes recover them surgically from the testes.

ICSI is now used in about 40 per cent of the 41,000 IVF cycles performed annually in the UK, and accounts for about 4,500 children born each year. This suggests that upwards of 10,000 men a year could be appropriate patients for the new technique.

The Italian team, led by Monica Antinori, of the Raprui clinic in Rome, has conducted the largest randomised controlled trial to compare outcomes for IMSI and ICSI. It involved 446 couples in which the man was infertile and the woman was not known to have any problems.

The results, which are published in the journal Reproductive Biomedicine Online, show that the IMSI method can deliver considerable improvements in pregnancy rate. The overall pregnancy rate for the IMSI group was 39.2 per cent, compared with 26.5 per cent for the ICSI patients.

Among men with the worst prognosis, who had had at least two failed attempts at ICSI before, the improvement was better still. The pregnancy rate for IMSI was 29.8 per cent, compared with 12.9 per cent for standard ICSI. The miscarriage rate also fell considerably.

Dr Antinori said the findings demonstrate that the technique has potential, particularly for men with a history of IVF failure. “By treating this kind of patient with this technique, we offer them an opportunity to solve their fertility problems. As you can see from the results, the group that has had two or more IVF failures can get more than twice the opportunity to have a pregnancy with this new technique.”

She cautioned, however, that IMSI is about twice as expensive as ICSI, which typically costs between £3,000 and £5,000 per cycle in Britain. It also requires special training for embryologists, and the purchase of expensive high-magnification microscopes.

IMSI is not yet offered in the UK, though it is performed by clinics in Italy, Israel, Switzerland and Spain.

Dr Pacey said: “People have been seduced into thinking that, as long as you’ve got a sperm that’s half decent, it’s got as good a chance as any. But it looks like we can do better than that.”

Source: The Times July 7 2008

COFFEE CUTS CHANCE OF HAVING BABY

Drinking too much coffee or tea can cut the chances of a woman getting pregnant by a quarter if she already has fertility problems. The effect is the same as drinking excessive alcohol, according to researchers in the Netherlands. They looked at 8,669 women who had undergone IVF treatment and found the likelihood of pregnancy was significantly reduced for those who smoked, drank too much coffee and alcohol, and were overweight. Fertility expert Prof Bill Ledger, of the University of Sheffield, said: ‘A lot of women can have 20 cups of coffee a day and get pregnant while falling off a log, but if you’re already sub fertile it could push you over the edge.’

Source: Metro newspaper Tue, July 8, 2008

IMAGINE THIS: ELDERLY BRITISH INDIAN COUPLE ACCUSED OF ABANDONING IVF TWINS BECAUSE THEY WERE GIRLS!

Reports that a British couple abandoned twin girls after IVF treatment in India because they were the wrong gender have been disputed by an NHS trust.

The Sun reported that the mother, 59, and father, 72, who are Indian-born British citizens, travelled to India for fertility treatment that would not have been allowed in the UK because of their age.

The babies were born by Caesarean section in Wolverhampton’s New Cross Hospital a fortnight ago after which - the newspaper reported - the parents, who have not been named, told medical staff that they were of "the wrong sex".

The Sun said that the husband then asked medics how long it would be before his wife was fit enough to fly back to India for more IVF treatment in the hope of getting a boy to continue the family name.

MORE DETAILS AT:
http://www.timesonline.co.uk/tol/news/uk/article4025532.ece

NATURAL IVF

For an ivf cycle, a woman’s body is practically bombarded by powerful drugs; first to shut down her ovaries (down regulation), and then other drugs to stimulate them to produce more eggs(FSH), and yet another drug to trigger ovulation (HCG). Women react to these drugs in different ways and one (costs aside), may understandably be wary of subjecting the body to them. The effects of long term use of these drugs (necessary when one has to repeat treatment cycles) can be worrisome and is still being studied.

NATURAL CYCLE IVF is definitely worth considering. In effect, you get the best of both worlds. For this procedure, it is the single egg produced in a woman’s normal cycle that is inseminated. Also known as no or low stimulation IVF, it is an invitro fertilisation procedure which uses no artificial fertility drugs, or very low dose ones.

Why Would I Want To Have IVF Without Fertility Drugs?
For some couples, the choice is financial. It is done at a fraction of the cost of standard IVF, so it may be their only chance at treatment. Some people prefer to try this method before moving on to traditional IVF.

For others, the choice may be medical. They may be contraindicated to fertility drugs (for instance, with a previous history of ovarian cancer or depression) or they may have reacted badly to a course of fertility drugs before. Women who have suffered with ovarian hyper stimulation syndrome may be offered this type of treatment as the syndrome is very serious and can be life-threatening so it may not be safe for them to continue with standard IVF.

Some couples just don't like drugs and prefer a more natural approach to infertility.

A point to note is that because of the improvement in the embryo culture technology, we are now at a point where even one egg gives a reasonable chance of success – about 15% per cycle. Therefore, in women who do not wish to use fertility medications, cannot afford fertility medications, or who do not produce many eggs even when they use fertility medications – Natural Cycle IVF is a logical and often successful alternative. Given that the success is 15% per attempt, it has been the experience of many centers that with several cycles of Natural IVF, one can achieve the same success rate of one cycle of stimulated IVF (45%).

Please see http://www.invitrofertilisation.blogspot.com for conclusion of this topic.

EGG WHITE AS A NATURAL FERTILITY AID

Yes indeed, egg white! If you’ve tried everything and nothing has worked, it is indeed worth a try and it does seem to work from the many testimonials on its use. However it appears that there is a slight risk of infection involved. These are the stories of ladies who swear by it:

Husband and I had been trying to conceive for 5 months with no luck. This month we decided to use real egg whites. I used a syringe without the needle to insert the egg whites. I also used the pillow to prop myself up during intercourse. And then I stayed in bed until the next morning without getting up. We used them the day before ovulation and the day after.

14 days later we found out we are pregnant. I also know two other women who got pregnant recently and the only thing they did differently that month was the egg whites. I would recommend it to anyone!
James Jelly Bean


I’m nine weeks pregnant and here’s my story: husband and I have been trying to conceive for one year after a miscarriage. I’m 43 and was aware that I was producing much less cervical mucus that I used to. Most months I am not aware of any egg white cervical mucus.

I read about the egg white in February and tried it only once a few days before ovulation. I took an egg from the fridge, broke it open and sucked up some egg white with a medicine dropper. Took it into the bathroom and inserted it into my vagina and squeezed tight as I walked to the bed. We had intercourse and I got pregnant!

My doctor says it’s an absolute miracle. I believe he is right; however I didn’t tell him about the egg whites. I’m keeping that my little secret until I find out the genetic testing comes out okay. Then I will tell him about it.
Dorian

For more info & testimonials on EGG WHITE AS A CONCEPTION AID, please visit: http://www.tryingtoconceive.com/eggwhites

IUI DOES WORK: ENCOURAGING SUCCESS STORIES

Ten weeks ago, I gave birth to my beautiful baby. He was conceived on my second IUI attempt in June of 2004. We were dealing with tubal issues and male factor, so we were overjoyed that the second IUI took. To give a brief history, I had one tube removed in March of 2002 due to a hydosalpinx and husband was diagnosed with low counts, morphology, and motility in 2001. After an HSG and laparoscopy to remove the bad tube, I conceived naturally in June of 2002. This was after we were told by several fertility doctors that due to our combined fertility issues, IVF was our best option. Our baby was born in February of 2003. Best of luck to everyone here and believe that miracles do happen.

*Carrie proud mommy to Alexa and Zachary


Never Give Up
This is a testament to never giving up. My husband and I tried to get pregnant for over 5 years . He was okay with no problems. But for me the story was very different.I struggled with hormone inbalances, thyroid problems and a poor reaction to the Clomid ( even though we tried it for a whole year --- mistake).In the end of the struggle - when I thought I could not bear any more tests, any more procedures ... I had my 6th IUI with Follistim for the 3rd time ... and to my surprise and pleasure. I was pregnant! I got another surprise on 02/28/2005 - when TWO HEARTBEATS were seen on the ultrasound screen. I am almost 16 weeks with these two angels!Never stop trying!

*Brooke

TIPS FOR IMPROVING IUI SUCCESS

Q: Do I have to lay down after an IUI?

A: You don't have to lay down because the cervix doesn't remain open, but most doctors let patients lay down on the table for 15-30 minutes after the procedure.

Q: Do I need to take it easy after an IUI?

A: Most people don't need to, but if you had cramping or don't feel well afterward it makes sense to take it easy for awhile. Some people reduce their aerobic activity and heavy lifting during the luteal phase in hopes it will increase the chance of implantation. It is more important to take it easy for a bit after IVF, as that is a more invasive process.

ACHIEVING PREGNANCY THROUGH IUI

Intrauterine insemination (IUI): A procedure in which a fine catheter (tube) is inserted through the cervix (the natural opening of the uterus) into the uterus (the womb) to deposit a sperm sample directly into the uterus. The purpose of IUI is to achieve fertilization and pregnancy. IUI is a relatively simple procedure. "Intrauterine" is within the uterus. "Insemination" is from "in-" + "semen," seed = seed in. So, "intrauterine insemination" = seed in the uterus.

What is an intrauterine insemination?
If you're having trouble getting pregnant, your doctor may recommend an intrauterine insemination (IUI) -- a relatively noninvasive and inexpensive way to boost your chances of conceiving.
With an IUI, your partner provides a sperm sample at home or in the doctor's office on the same day of the insemination. Then, his sperm are "washed" -- that is, the sperm are separated from the semen and concentrated; the washing also cleanses the sperm of potentially hazardous chemicals that could harm the uterus. The resulting liquid is placed in a thin soft tube and injected high into your uterus. This positions the sperm much closer to the fallopian tubes, where it will have to be for one of them to fertilize an egg.
If you don't have a male partner, or if your partner is unable to produce viable sperm, you can undergo the same procedure using frozen sperm purchased from a sperm bank.
The procedure takes only a few minutes. You may experience mild cramping, but it's usually brief and you can resume your activities immediately afterward.

Am I a good candidate for IUI?
The procedure works well for many women under 45 with certain fertility problems (whose partners have viable sperm), and for those in the same age group without male partners who are trying to get pregnant using donated sperm. Some infertility groups say it is less likely to work if women are over 42 or even 40. It's a common treatment for women who have ovulation problems or unexplained infertility, or whose partners have low sperm counts, poorly shaped sperm, or problems with sperm motility (ability to travel).
IUI is particularly appropriate when the woman has been prescribed clomiphene citrate (Clomid or Serophene) to stimulate ovulation, since this medication can result in cervical mucous that is thick and difficult for the sperm to swim through.
Fertility specialists don't usually advise women who have blocked fallopian tubes, severe tubal damage, or very poor egg quality to try IUI. They are also unlikely to suggest this treatment if a man has more than a mild problem with his sperm quality. It's standard to have a thorough fertility workup, including an evaluation for hormonal imbalances, infections, or blockages, before trying IUI.
Single women, couples where the man has no viable sperm, and lesbian couples using donor sperm are also good candidates for intrauterine insemination. Because donor sperm is often frozen and a woman's chances of getting pregnant are reduced using frozen -- as opposed to fresh -- sperm, IUI is a relatively easy way to boost the odds. It's more effective, say doctors, than using a plastic syringe to position the sperm on the cervix, a procedure known as intracervical insemination (ICI) that women generally do at home.

Will I need to take fertility drugs?
IUI is timed to occur in the most fertile period of your cycle, or ovulation. In some cases, women receive intrauterine inseminations without having to take drugs. Although there's no universal agreement, many fertility specialists feel women have a better chance of getting pregnant if they combine IUI with a drug that stimulates the ovaries to produce mature eggs. If you are having ovulation problems, your doctor may have you take an ovulation-stimulating drug, such as clomiphene, for several weeks before doing the IUI. The procedure can also be tried in conjunction with injections of FSH, or follicle-stimulating hormone.
If you are injected with ovarian stimulation drugs, your doctor will need to monitor you carefully with blood tests and ultrasounds beginning on the sixth day of your cycle. Women taking these drugs are at risk of ovarian hyperstimulation syndrome (OHSS), a rare but potentially life-threatening condition marked by abnormal swelling of the ovaries and fluid collection in the abdomen.

What are the other risks of IUI?
Complications of IUI are infrequent, according to fertility experts. Besides the risks of combined IUI and fertility drug treatment, they include infection and the possibility of venereal disease. To lessen the risk of disease, fertility clinics should quarantine all frozen specimens of sperm for 180 days and retest the donor for HIV before releasing the sperm, according to the American Society of Reproductive Medicine. Although some fertility clinics offer fresh donor sperm, the society recommends against its use.

How long will it take to get pregnant?
Specialists recommend from three to six cycles of IUI before you consider moving to a more invasive or expensive treatment, such as in vitro fertilization (IVF). If your doctor thinks you could benefit from IUI, at $200 to $500 per insemination, as opposed to $7,000 to $15,000 for IVF, it's well worth a try.
-- Elaine Herscher is a senior editor at Consumer Health Interactive. She formerly covered health policy for the San Francisco Chronicle.
What is an intrauterine insemination?
If you're having trouble getting pregnant, your doctor may recommend an intrauterine insemination (IUI) -- a relatively noninvasive and inexpensive way to boost your chances of conceiving.
With an IUI, your partner provides a sperm sample at home or in the doctor's office on the same day of the insemination. Then, his sperm are "washed" -- that is, the sperm are separated from the semen and concentrated; the washing also cleanses the sperm of potentially hazardous chemicals that could harm the uterus. The resulting liquid is placed in a thin soft tube and injected high into your uterus. This positions the sperm much closer to the fallopian tubes, where it will have to be for one of them to fertilize an egg.
If you don't have a male partner, or if your partner is unable to produce viable sperm, you can undergo the same procedure using frozen sperm purchased from a sperm bank.
The procedure takes only a few minutes. You may experience mild cramping, but it's usually brief and you can resume your activities immediately afterward.

Am I a good candidate for IUI?
The procedure works well for many women under 45 with certain fertility problems (whose partners have viable sperm), and for those in the same age group without male partners who are trying to get pregnant using donated sperm. Some infertility groups say it is less likely to work if women are over 42 or even 40. It's a common treatment for women who have ovulation problems or unexplained infertility, or whose partners have low sperm counts, poorly shaped sperm, or problems with sperm motility (ability to travel).
IUI is particularly appropriate when the woman has been prescribed clomiphene citrate (Clomid or Serophene) to stimulate ovulation, since this medication can result in cervical mucous that is thick and difficult for the sperm to swim through.
Fertility specialists don't usually advise women who have blocked fallopian tubes, severe tubal damage, or very poor egg quality to try IUI. They are also unlikely to suggest this treatment if a man has more than a mild problem with his sperm quality. It's standard to have a thorough fertility workup, including an evaluation for hormonal imbalances, infections, or blockages, before trying IUI.
Single women, couples where the man has no viable sperm, and lesbian couples using donor sperm are also good candidates for intrauterine insemination. Because donor sperm is often frozen and a woman's chances of getting pregnant are reduced using frozen -- as opposed to fresh -- sperm, IUI is a relatively easy way to boost the odds. It's more effective, say doctors, than using a plastic syringe to position the sperm on the cervix, a procedure known as intracervical insemination (ICI) that women generally do at home.

Will I need to take fertility drugs?
IUI is timed to occur in the most fertile period of your cycle, or ovulation. In some cases, women receive intrauterine inseminations without having to take drugs. Although there's no universal agreement, many fertility specialists feel women have a better chance of getting pregnant if they combine IUI with a drug that stimulates the ovaries to produce mature eggs. If you are having ovulation problems, your doctor may have you take an ovulation-stimulating drug, such as clomiphene, for several weeks before doing the IUI. The procedure can also be tried in conjunction with injections of FSH, or follicle-stimulating hormone.
If you are injected with ovarian stimulation drugs, your doctor will need to monitor you carefully with blood tests and ultrasounds beginning on the sixth day of your cycle. Women taking these drugs are at risk of ovarian hyperstimulation syndrome (OHSS), a rare but potentially life-threatening condition marked by abnormal swelling of the ovaries and fluid collection in the abdomen.

What are the other risks of IUI?
Complications of IUI are infrequent, according to fertility experts. Besides the risks of combined IUI and fertility drug treatment, they include infection and the possibility of venereal disease. To lessen the risk of disease, fertility clinics should quarantine all frozen specimens of sperm for 180 days and retest the donor for HIV before releasing the sperm, according to the American Society of Reproductive Medicine. Although some fertility clinics offer fresh donor sperm, the society recommends against its use.

How long will it take to get pregnant?
Specialists recommend from three to six cycles of IUI before you consider moving to a more invasive or expensive treatment, such as in vitro fertilization (IVF). If your doctor thinks you could benefit from IUI, at $200 to $500 per insemination, as opposed to $7,000 to $15,000 for IVF, it's well worth a try.
-- Elaine Herscher is a senior editor at Consumer Health Interactive. She formerly covered health policy for the San Francisco Chronicle.(from a healthyme.com)

WHEN A WOMAN IS MOST LIKELY TO BECOME PREGNANT

WHEN A WOMAN IS MOST LIKELY TO BECOME PREGNANT


Failing to conceive may be a result of careless timing of intercourse by couples apart from diseases that contribute to infertility.

A woman is most likely to conceive just after the time she ovulates. An egg lives for about twenty four hours after it is released from the ovary. If a woman is going to conceive, the egg has to be fertilized within these twenty four hours.

If you want to become pregnant then the time to make love is around the time of ovulation. The best time of all is the day before ovulation. This gives the sperm time to travel up into the Fallopian tubes and so to be waiting when the egg is released.

You can find out when you ovulate and so when you are likely to conceive.

HOW TO FIND OUT WHEN YOU OVULATE

There are several ways of finding out when you ovulate. If you use all the methods together, you will get the most accurate idea of your time of ovulation.

The Calender Method
1. If your monthly cycle is fairly regular, you are probably used to working out when your next period is due. You can work out when you ovulate in the same way. First you have to get to know the pattern of your monthly cycle. Keep a record of your periods. Each month, record the first day of bleeding, in your diary or on a calendar. Do this for a number of months.

2. you can now work out the length of your monthly cycle. For each month that you have recorded, count the days from the first day of the next. If you have a regular cycle, the number of days between your periods will be about the same each month. But if the numbers vary a lot, you obviously have an irregular cycle and you will need to use the temperature or mucus methods to find out when you ovulate.

3. The length of a woman’s cycle varies. But most women ovulate about fourteen days before their next period. So using what you know to be the usual length of your monthly cycle, work out the first day of your period. Now count back fourteen days and you have the time when you are likely to ovulate. If you have intercourse around this time, you have a better chance of conceiving than at any other time in the month.

10 INFERTILITY QUESTIONS TO ASK YOUR DOCTOR

Ten Infertility Questions to Ask Your Doctor

Medical Author: Melissa Stoppler, M.D.Medical Editor: William C. Shiel, Jr, MD, FACP, FACR

Be sure to take along the records of any diagnostic studies and/or fertility treatments you may have had in the past if you are visiting a new fertility specialist. If you have been keeping records of the dates of your menstrual cycles and/or basal body temperature charts, take these along too. Also, print this and take it with you to your doctor visit.

1. What is my diagnosis, and how does this condition specifically interfere with fertility? Does my partner have a condition that interferes with fertility? Will these conditions worsen over time, improve, or remain constant?

2. If the reason for my infertility is unclear, what diagnostic tests do you recommend? What is the likelihood that each of these tests will establish a diagnosis? Are there any risks associated with the testing? Does my partner need additional testing?

3. What type of treatment would you recommend trying first? Does this treatment involve surgery, medications, or both? What are the risks of treatment?

4. In your practice, how often does this treatment result in pregnancy? (Be sure to determine whether your doctor is talking about pregnancy rates or live-birth rates when discussing specific treatments so you can make adequate comparisons. For example, a treatment may have a 30% pregnancy rate per cycle but only a 25% live-birth rate due to early miscarriages.)

5. Are less-invasive or more conservative treatments available? How do these compare with your recommended treatment in terms of risks and success rates?

6. How many cycles of treatment would you recommend before trying another option? Do you recommend skipping a menstrual cycle between treatment cycles?

7. Are there any lifestyle modifications that might help my condition and increase my chances of getting pregnant?

8. (If this is an acceptable option for you) Would you recommend treatments using donor eggs and/or sperm? Does your clinic or practice offer these options?

9. What is my prognosis? In your opinion, how likely is fertility treatment to be successful for me? (While no doctor can give you an exact answer to this question, taking into account your personal medical information and age, your doctor's past experiences may allow him or her to roughly estimate whether you will have an average, below-average, or above-average chance of success).

10. What does treatment cost? Does my insurance cover any of the medications, hospital charges, or doctor's visits? If I must pay out-of-pocket, do you offer any special payment plans?

WHAT IS ASSISTED REPRODUCTIVE TECHNOLOGY (ART)?

What is assisted reproductive technology (ART)?

Assisted reproductive technology (ART) is a term that describes several different methods used to help infertile couples. ART involves removing eggs from a woman's body, mixing them with sperm in the laboratory and putting the embryos back into a woman's body.

How often is assisted reproductive technology (ART) successful?

Success rates vary and depend on many factors. Some things that affect the success rate of ART include:
age of the partners
reason for infertility
clinic
type of ART
if the egg is fresh or frozen
if the embryo is fresh or frozen

The U.S. Centers for Disease Prevention (CDC) collects success rates on ART for some fertility clinics. According to the 2003 CDC report on ART, the average percentage of ART cycles that led to a healthy baby were as follows:
37.3% in women under the age of 35
30.2% in women aged 35-37
20.2% in women aged 37-40
11.0% in women aged 41-42

ART can be expensive and time-consuming. But it has allowed many couples to have children that otherwise would not have been conceived. The most common complication of ART is multiple fetuses. But this is a problem that can be prevented or minimized in several different ways.

What are the different types of assisted reproductive technology (ART)?

Common methods of ART include:

In vitro fertilization (IVF) means fertilization outside of the body. IVF is the most effective ART. It is often used when a woman's fallopian tubes are blocked or when a man produces too few sperm. Doctors treat the woman with a drug that causes the ovaries to produce multiple eggs. Once mature, the eggs are removed from the woman. They are put in a dish in the lab along with the man's sperm for fertilization. After 3 to 5 days, healthy embryos are implanted in the woman's uterus.

CLICK HERE TO READ MORE ABOUT IVF : www.invitrofertilisation.blogspot.com

Zygote intrafallopian transfer (ZIFT) or Tubal Embryo Transfer is similar to IVF. Fertilization occurs in the laboratory. Then the very young embryo is transferred to the fallopian tube instead of the uterus.

Gamete intrafallopian transfer (GIFT) involves transferring eggs and sperm into the woman's fallopian tube. So fertilization occurs in the woman's body. Few practices offer GIFT as an option.

Intracytoplasmic sperm injection (ICSI) is often used for couples in which there are serious problems with the sperm. Sometimes it is also used for older couples or for those with failed IVF attempts. In ICSI, a single sperm is injected into a mature egg. Then the embryo is transferred to the uterus or fallopian tube.

ART procedures sometimes involve the use of donor eggs (eggs from another woman), donor sperm, or previously frozen embryos. Donor eggs are sometimes used for women who can not produce eggs. Also, donor eggs or donor sperm is sometimes used when the woman or man has a genetic disease that can be passed on to the baby.

WHAT MEDICINES ARE USED TO TREAT INFERTILITY IN WOMEN?

What medicines are used to treat infertility in women?

Some common medicines used to treat infertility in women include:

Clomiphene citrate (Clomid): This medicine causes ovulation by acting on the pituitary gland. It is often used in women who have Polycystic Ovarian Syndrome (PCOS) or other problems with ovulation. This medicine is taken by mouth.
Human menopausal gonadotropin or hMG (Repronex, Pergonal): This medicine is often used for women who don't ovulate due to problems with their pituitary gland. hMG acts directly on the ovaries to stimulate ovulation. It is an injected medicine.
Follicle-stimulating hormone or FSH (Gonal-F, Follistim): FSH works much like hMG. It causes the ovaries to begin the process of ovulation. These medicines are usually injected.
Gonadotropin-releasing hormone (Gn-RH) analog: These medicines are often used for women who don't ovulate regularly each month. Women who ovulate before the egg is ready can also use these medicines. Gn-RH analogs act on the pituitary gland to change when the body ovulates. These medicines are usually injected or given with a nasal spray.
Metformin (Glucophage): Doctors use this medicine for women who have insulin resistance and/or Polycystic Ovarian Syndrome (PCOS). This drug helps lower the high levels of male hormones in women with these conditions. This helps the body to ovulate. Sometimes clomiphene citrate or FSH is combined with metformin. This medicine is usually taken by mouth.
Bromocriptine (Parlodel): This medicine is used for women with ovulation problems due to high levels of prolactin. Prolactin is a hormone that causes milk production. Many fertility drugs increase a woman's chance of having twins, triplets or other multiples. Women who are pregnant with multiple fetuses have more problems during pregnancy. Multiple fetuses have a high risk of being born too early (prematurely). Premature babies are at a higher risk of health and developmental problems.

HOW DO DOCTORS TREAT INFERTILITY?

How do doctors treat infertility?

Infertility can be treated with medicine, surgery, artificial insemination or assisted reproductive technology (CLICK HERE TO VISIT: www.invitrofertilisation.blogspot.com)
. Many times these treatments are combined. About two-thirds of couples who are treated for infertility are able to have a baby. In most cases infertility is treated with drugs or surgery.

Doctors recommend specific treatments for infertility based on:

* test results
* how long the couple has been trying to get pregnant the
* age of both the man and woman
* the overall health of the partners
* preference of the partners

Doctors often treat infertility in men in the following ways:

Sexual problems: If the man is impotent or has problems with premature ejaculation, doctors can help him address these issues. Behavioral therapy and/or medicines can be used in these cases.

Too few sperm: If the man produces too few sperm, sometimes surgery can correct this problem. In other cases, doctors can surgically remove sperm from the male reproductive tract. Antibiotics can also be used to clear up infections affecting sperm count.

Various fertility medicines are often used to treat women with ovulation problems. It is important to talk with your doctor about the pros and cons of these medicines. You should understand the risks, benefits, and side effects.

Doctors also use surgery to treat some causes of infertility. Problems with a woman's ovaries, fallopian tubes, or uterus can sometimes be corrected with surgery.

Intrauterine insemination (IUI) is another type of treatment for infertility. IUI is known by most people as artificial insemination. In this procedure, the woman is injected with specially prepared sperm. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI.

IUI is often used to treat:
* mild male factor infertility
* women who have problems with their cervical mucus
* couples with unexplained infertility

HOW LONG SHOULD WOMEN TRY TO GET PREGNANT BEFORE CALLING THEIR DOCTORS?

How long should women try to get pregnant before calling their doctors?

Most healthy women under the age of 30 shouldn't worry about infertility unless they've been trying to get pregnant for at least a year. At this point, women should talk to their doctors about a fertility evaluation. Men should also talk to their doctors if this much time has passed.

In some cases, women should talk to their doctors sooner. Women in their 30s who've been trying to get pregnant for six months should speak to their doctors as soon as possible. A woman's chances of having a baby decrease rapidly every year after the age of 30. So getting a complete and timely fertility evaluation is especially important.

Some health issues also increase the risk of fertility problems. So women with the following issues should speak to their doctors as soon as possible:

irregular periods or no menstrual periods
very painful periods
endometriosis
pelvic inflammatory disease
more than one miscarriage

No matter how old you are, it's always a good idea to talk to a doctor before you start trying to get pregnant. Doctors can help you prepare your body for a healthy baby. They can also answer questions on fertility and give tips on conceiving.

How will doctors find out if a woman and her partner have fertility problems?

Sometimes doctors can find the cause of a couple's infertility by doing a complete fertility evaluation. This process usually begins with physical exams and health and sexual histories. If there are no obvious problems, like poorly timed intercourse or absence of ovulation, tests will be needed.

Finding the cause of infertility is often a long, complex and emotional process. It can take months for you and your doctor to complete all the needed exams and tests. So don't be alarmed if the problem is not found right away.

For a man, doctors usually begin by testing his semen. They look at the number, shape, and movement of the sperm. Sometimes doctors also suggest testing the level of a man's hormones.
For a woman, the first step in testing is to find out if she is ovulating each month. There are several ways to do this. A woman can track her ovulation at home by:
recording changes in her morning body temperature (basal body temperature) for several months
recording the texture of her cervical mucus for several months
using a home ovulation test kit (available at drug or grocery stores)

Doctors can also check if a woman is ovulating by doing blood tests and an ultrasound of the ovaries. If the woman is ovulating normally, more tests are needed.

Some common tests of fertility in women include:

Hysterosalpingography: In this test, doctors use x-rays to check for physical problems of the uterus and fallopian tubes. They start by injecting a special dye through the vagina into the uterus. This dye shows up on the x-ray. This allows the doctor to see if the dye moves normally through the uterus into the fallopian tubes. With these x-rays doctors can find blockages that may be causing infertility. Blockages can prevent the egg from moving from the fallopian tube to the uterus. Blockages can also keep the sperm from reaching the egg.

Laparoscopy: During this surgery doctors use a tool called a laparoscope to see inside the abdomen. The doctor makes a small cut in the lower abdomen and inserts the laparoscope. Using the laparoscope, doctors check the ovaries, fallopian tubes, and uterus for disease and physical problems. Doctors can usually find scarring and endometriosis by laparoscopy.

IS INFERTILITY JUST A WOMAN'S PROBLEM?

Is infertility just a woman's problem?

No, infertility is not always a woman's problem. In only about one-third of cases is infertility due to the woman (female factors). In another one third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.

What causes infertility in men?

Infertility in men is most often caused by:
problems making sperm -- producing too few sperm or none at all
problems with the sperm's ability to reach the egg and fertilize it -- abnormal sperm shape or structure prevent it from moving correctly

Sometimes a man is born with the problems that affect his sperm. Other times problems start later in life due to illness or injury. For example, cystic fibrosis often causes infertility in men.

What increases a man's risk of infertility?

The number and quality of a man's sperm can be affected by his overall health and lifestyle. Some things that may reduce sperm number and/or quality include:
alcohol
drugs
environmental toxins, including pesticides and lead
smoking cigarettes
health problems
medicines
radiation treatment and chemotherapy for cancer
age

What causes infertility in women?

Problems with ovulation account for most cases of infertility in women. Without ovulation, there are no eggs to be fertilized. Some signs that a woman is not ovulating normally include irregular or absent menstrual periods.

Less common causes of fertility problems in women include:

blocked fallopian tubes due to pelvic inflammatory disease, endometriosis, or surgery for an ectopic pregnancy
physical problems with the uterus
uterine fibroids

What things increase a woman's risk of infertility?

Many things can affect a woman's ability to have a baby. These include:
age
stress
poor diet
athletic training
being overweight or underweight
tobacco smoking
alcohol
sexually transmitted diseases (STDs)
health problems that cause hormonal changes

How does age affect a woman's ability to have children?

More and more women are waiting until their 30s and 40s to have children. Actually, about 20 percent of women in the United States now have their first child after age 35. So age is an increasingly common cause of fertility problems. About one third of couples in which the woman is over 35 have fertility problems.
Aging decreases a woman's chances of having a baby in the following ways:
The ability of a woman's ovaries to release eggs ready for fertilization declines with age.
The health of a woman's eggs declines with age.
As a woman ages she is more likely to have health problems that can interfere with fertility.
As a women ages, her risk of having a miscarriage increases.

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WHAT IS INFERTILITY?

What is infertility?
Most experts define infertility as not being able to get pregnant after at least one year of trying. Women who are able to get pregnant but then have repeat miscarriages are also said to be infertile.

Pregnancy is the result of a complex chain of events. In order to get pregnant:
A woman must release an egg from one of her ovaries (ovulation).
The egg must go through a fallopian tube toward the uterus (womb).
A man's sperm must join with (fertilize) the egg along the way.
The fertilized egg must attach to the inside of the uterus (implantation).
Infertility can result from problems that interfere with any of these steps.
Is infertility a common problem?