Before Infertility Strikes, PCOS Is Common, Treatable, Even for Teens & Young Women

A little bit of facial hair in “the wrong places” can be normal, even if aggravating, for women near and after menopause. But for younger women, hirsutism (hair growth in abnormal patterns) can signal something to be worried about – polycystic ovarian syndrome.

image: freedigitalphotos.net

PCOS is one of the most commonly-presented female disorders in a fertility clinic. Not every woman with polycystic ovarian syndrome has infertility, but many do. In fact, not all PCOS sufferers have the same symptoms, which in addition to hirsutism might include:

• small cysts on the ovaries

• irregular menstrual periods

• weight gain for no apparent reason

• acne beyond the teen years

This article in UK's Daily Mail says that one in 10 British women are affected by PCOS. A fact sheet from the U.S. Department of Health and Human Services Office on Women's Health says similar numbers of affected women are found in the U.S., as many as 5 million of them, and that it can occur in girls as young as 11 years old.

This is a point I want to impress: PCOS is a hormonal condition, not merely a nuisance of facial hair and weight gain, and it begins in most cases during puberty. Unfortunately, most woman don't become knowledgeable about PCOS until it's created a problem for them – most of the time, that problem is infertility.

Most important to know is that infertility is not the only problem to which PCOS can lead. It's also been linked to a number of very serious metabolic disease-related health conditions like diabetes, high blood pressure, high cholesterol, and cardiovascular disease. So treating PCOS is something that should be initiated as soon as it's discovered, and not just for fertility-related reasons.

How can teens and young women know if PCOS is a worry for them?

• Develop an ongoing relationship with either a family practitioner or OB/Gyn.

• Keep close track of your menstrual periods and report on them to your physician annually. If you notice something different (for your body) happening – such as longer or shorter times between periods, more pain than usual, or periods that are heavier or lighter than usual – let your doctor know that you are concerned.

• If you have “male-pattern hair growth,” let your doctor know.

• If you notice extreme weight loss or gain within a brief period of time that cannot be explained by changes in your activity level or eating habits, tell your doctor.

There's more good information about PCOS specifically for young women on this website by the Center for Young Women's Health.

Finally, as a reproductive endocrinologist, I have a great deal of expertise and experience in treating hormonal conditions related to the reproductive system -- and PCOS-related infertility is indeed successfully treatable. If PCOS is your issue, the Houston Fertility Center can help.

~ Dr. Sonja Kristiansen M.D.

Surrogacy Is Special In Many Ways, Including Legally

Some of the hardest choices to make when infertility gets in the way of your family-building is whether or not to involve other people in making your dreams of a baby come true. For many who must turn to third-party reproductive services, the use of a gestational surrogate feels like a final step in the journey. Fortunately, surrogacy is a very successful means of arriving at the destination of a healthy baby! The laws surrounding the use of surrogacy can be tricky to manage, though.

image: freedigitalphotos.net

This article in the Milwaukee-Wisconsin Journal Sentinal describes the confusion that can occur because of the varying laws from state to state. This matters a great deal to patients using a gestational surrogate, because surrogates can live in states different from the intended parents.

In addition to the variances in state laws, it's also good to keep in mind that these laws are changing in many places. While the medical treatment side of infertility has been fine-tuned to result in tremendous success, the legalities involved haven't quite kept up pace. This is especially true regarding third-party ART.

So we naturally insist that patients wishing to use a surrogate do the best thing: Get experienced, qualified legal advice. Texas is actually one of the best (some say THE best) state in terms of laws that pertain to surrogacy. There are many attorneys who specialize in reproductive laws right here in the state, and Houston Fertility Center is happy to connect patients with those experts.

Surrogacy is an incredible way to build a family, for so many reasons. Making sure your arrangements and agreements are bound by law protects everyone involved, including your new child.

~ Dr. Sonja Kristiansen M.D.

VA On The Path to IVF Coverage for Vets

The men and women who have served our country in the Armed Forces are on our minds more than ever lately. The numbers who are returning with medical needs of all kinds are staggering. Fortunately, many established service agencies are thinking ahead and new organizations to meet their needs are popping up all over.

What does this have to do with infertility?

Many of these troops are coming home with fertility issues they never thought they'd encounter. And while the Veteran's Administration has long provided coverage for limited fertility treatment, such as diagnostic tests and IUI, patients needing IVF to conceive have been left out of the VA picture.

Now, there's a bill being considered by the Senate that would specifically allow the VA to cover IVF, among other expansions to fertility treatments covered.

From a recent Associated Press article on FoxNews:

More than 1,830 veterans of the wars in Iraq and Afghanistan have suffered pelvic fractures and genitourinary injuries since 2003 that could affect their abilities to reproduce, according to Pentagon figures provided to Sen. Patty Murray, the bill's sponsor and chairwoman of the Senate Veterans Affairs Committee.

Senator Murray, a Democrat from Washington state, says she hopes the committee will act on the bill after returning from August recess.

I've been honored to help build families for men and women who've served the United States. A few years ago, I performed an egg retrieval and ICSI fertilization for a couple at Houston Fertility Center's central location while the husband looked via live video in Iraq. It was an exciting moment for all of us and a perfect example of how the combination of medical and communication technologies can enrich our lives. Houston Fertility Center has served several other veterans, and we regularly offer discounts to the men and women who are serving our country. Now, the Women Veterans and Other Health Care Improvement Act of 2012 seeks to increase the likelihood that all who need fertility care to build their families can access the types of assisted reproductive technology that are necessary for their situation.

You can hear the related personal story of Staff Sgt Matthew Keil's family as they struggled with barriers to fertility treatment access, as told by Tracy Keil (the sergeant's wife, who has become a leading advocate of the proposed bill) at a Senate hearing earlier this summer. 

Mrs. Keil says it best: "War time changes a family. It shouldn't take away the ability to have one."

How Treating Infertility Can Help A Nation

If you've ever had a nagging feeling that your struggles to have a baby are selfish, now there's news that might make you feel otherwise. The United States' fertility rate has arrived at its lowest point in 25 years.

So you could say that efforts to get pregnant are a way to give back to the community!

Image: FreeDigitalPhotos.net

With all of the news about over-population and its impact on the earth, talk about low fertility rates might sound off-track. But this essay on FoxBusiness explains how, for a nation, the short-term benefits of a fertility rate that's lower than the normal 2.1 replacement rate "are outweighed by the more serious long-term consequences."

In brief, having 2.1 children is a way to replace a population and promote a balanced economy. When a population's overall rate is lower than that, eventually there is a proponderance of older people (who naturally have less earning power and tend to be more dependent on government assistance) and not enough younger ones to balance out the burden.

The good news, as the writer points out, is that this marked decline could likely prompt introduction of very family-friendly policies, like those seen in some other countries. Nations like France and Sweden, among others, offer new parents economic and childcare incentives to make family-building not only less of a burden personally, but also supportive of the community.

So if you hear misinformed comments by individuals demonstrating their lack of understanding or compassion for people who go to great lengths to get pregnant, you might rest assured knowing that, in fact, trying to have a baby is good for the economy!

~ Dr. Sonja Kristiansen MD

Speaking of Fertility Preservation: Frozen Eggs Do Well

In Malta, there's a legislative proposal that might decrease the ability of some citizens to resolve their infertility with IVF. While political and social pundits wrestle with the questions of which patients can access which treatment and even specifics on which treatment protocols can be used, one expert shed some positive light on one option in particular.

Image: FreeDigitalPhotos.net

Dr. Eleonora Porcu is possibly the most experienced reproductive specialist in the world when it comes to the use of frozen eggs with IVF. Because of Italy's highly restrictive assisted reproductive technology laws, Dr. Porcu has been very active in the pursuit of technique advancements that make oocyte cryopreservation a viable option when frozen embryos are not available. She was called on by the Maltese government recently to testify about the success she has seen over the past 15 years.

The Times of Malta published this interview with Dr. Porcu, who reports she and her medical team have produced "some 500 births of children conceived using frozen eggs."

In the United States, we are so fortunate to be free of extreme governmental restrictions mandating which individuals may access ART and which forms of ART they can use to resolve their fertility issues. My Houston Fertility Center staff and I have offered egg freezing to patients for several years now, believing it to be an optimal fertility preservation technique for unmarried women who are about to undergo cancer treatment, as well as others who are without partners and do not want to use donor sperm.

~ Dr. Sonja Kristiansen MD

Not All Infertility News Is Bad News!

I realized the other day that my most recent blogposts were presenting nothing but the "bad news" about trying to get pregnant. Lots of "don't do this" and "here's something else to avoid" can add up in a fertility patient's mind to "Well, what's the use in trying?!"

I was browsing the Internet for topics of interest to my blog readers when I stumbled on this: "Women ditched me because I was infertile" (It sounds like an ad, but it's an article on the Daily Mirror.)
 The young man's story perfectly illustrates so many aspects of why we do what we do at Houston Fertility Center.

Image: FreeDigitalPhotos.net

Not many men feel secure enough to reveal their deepest emotions about their infertility, and particularly in the way that this semi-pro football player in Great Britain did. His loss of a testicle to cancer -- without fertility preservation efforts prior to cancer treatment -- resulted in a distressing mix of relief from being a survivor and embarassment at "losing his manhood". He even felt that his diagnosed inability to father a child kept women from wanting to be his partner.

I won't reveal the whole story to you -- it really is a sweetly romantic tale worthy of a screenplay, and I encourage you to read it on the Daily Mirror's website.

It's important to stay on top of new research findings, as well as all of the fertility basics that are already known to optimize your chances at pregnancy. But now and then, it's also good to just bask in the hope of others' true stories.

~ Dr. Sonja Kristiansen MD