Infertility A Blessing in Disguise?

Here's a way to re-frame things: Michele Olson of thinkmarriage.org suggests that infertility could actually be helpful to couples.

In this article from the Wausau Daily Herald, she offers tips on how to think about fertility challenges so that your relationship not only doesn't crumble, but improves.

Economy Makes Saving Embryos Tougher Decision

A recent study found that there is indeed an expected correlation between the United States economic downturn and people's choices regarding their frozen embryos.

In other words, presumably the cost of maintaining frozen embryos has pushed patients to think harder about whether or not to keep them on ice in perpetuity.

Last December, I referred to The Embryo Dilemma which was front-and-center in the media at the time. Single embryo transfer is absolutely the answer for some patients, whereas for others, it simply won't provide their desired outcome.

ART research has focused on the fine-tuning of techniques that will allow fewer IVF-created embryos to be transferred and still create a healthy pregnancy. Still, many patients will end up with extras.

The options -- aside from cryopreservation storage or discarding -- for unused embryos at Houston Fertility Center:

*If couples let us know before their eggs and sperm are combined for fertilization via IVF, we can perform the FDA-required testing for embryo 'adoption' to be an option.

*We will assist couples in making their embryos available for research at approved institutions.

It's imperative that patients using IVF to create embryos discuss -- in advance -- all of the options with their partners and any others they typically consult for life's big decisions.

Safer Fertility Treatment Must Be Made Available

The New York Times' recent series on "21st Century Babies" provides a distressing glimpse into an unpleasant side of reproductive medicine.

Besides being the Medical Director of Houston Fertility Center, I am a mother -- and one who is especially sensitive to NICU issues. My first-born spent the first week of his life in the NICU.

It was several days before we knew if he would live. Although he was not a twin, I cannot imagine how awful it would be to wonder if two or three of your children would die before coming home, or have long-term sequela.

Because of this heightened sensitivity, and because assisted reproductive techniques have become so finely tuned, I encourage single embryo transfer in indicated situations.

The NYT series, by Stephanie Saul:

The Gift of Life, and Its Price

Grievous Choice on Risky Path to Parenthood

Experts weigh in on the subject on the blog
The Trouble with Twin Births

Surrogacy The Final Stop In the Journey For Some

The Wall Street Journal has published a detailed article on the growing prevalence of international surrogacy as a way to build American families. The piece describes the incredible lengths that some couples will go through to have a child, heart-rending stories in some cases. It also brings up some of the concerns about connecting cross-culturally to resolve infertility.

To be sure, using a "third party" -- whether through donated sperm or egg, or gestational surrogacy -- requires more contemplation than other forms of fertility treatment. In situations where the donors are from relatively impoverished circumstances, hopeful parents-to-be must wrestle with the realities and potential consequences of their choices. With international medical care of any kind, some of the gravest issues can become mired in the differences between laws and health care technology and provision.

International medical care may be less expensive, but there are other costs. All parents must choose between rocks and hard places in "the parenthood."

How Do My Patients Want Their Loved Ones To Think About Infertility?

Every now and then I run across unusually good advice to friends and loved ones of infertility patients. This Q&A by Dr. Miriam Stoppard on UK's Daily Mirror is one such piece.

Titled How can I help my daughter cope with not having children?, Dr. Stoppard's response explains both succinctly and thoughtfully some of the emotions that infertile people experience. She also describes in understandable terms a healthy frame of mind that family and friends can adopt toward loved ones to lend respect to the individual's experience and journey.

This is a nice one to clip and pass around.

When Fertility Really Is About Your Diet

No woman wants to be told she needs to lose weight, least of all my patients who have struggled (sometimes for years) with trying to get pregnant. Whether we decide their fertility treatment will include fertility medications, IVF, IUI, or some other assisted reproductive technology, the best starting point is a healthy body -- and for many, that means coming to a more optimal weight.

This article in the Belfast Telegraph describes a rather novel approach to meeting the challenge of weight versus fertility, specifically as it relates to polycystic ovarian syndrome (PCOS), one of the most common causes of female infertility.

Are there similar programs in the United States?

Another Step Forward Toward Fertility Preservation

A drug used to treat ovarian cancer (cisplatin) promotes egg cell death by way of a particular enzyme. The good news: a drug used to treat a different (but related) disease, chronic myeloid leukemia (CML), protects egg cells from cisplatin's killing effects.

Researchers in Italy have published their interesting conclusions in the online edition of Nature Medicine (see a HealthDay News report on the Medline website.)

So far, these are initial studies performed with mice, but the call by cancer patient advocates for such research is loud enough that follow-ups shouldn't be far behind.