15 Is Magic Number?

Last February, I wrote that there's no magic to getting pregnant. That post was specific to "miraculous" fertility supplements. Well, now the news is full of "magic" again. This time, it's a Magic Number.

It's 15.

What kind of magic does the number 15 do for infertile couples?

A study that looked at 17 years worth of data concluded that 15 eggs retrieved in one IVF cycle renders the best chance of a live birth. Retrieving more eggs than that was linked to higher incidence of ovarian hyperstimulation syndrome.

The study authors failed to clarify that they were looking at conventional IVF cycles, not at cycles using very minimal or no ovulation stimulation medication. They did, however, tease out and present their findings related to the different ages within the study subjects. Specifically, the number 15 (eggs) did not make the live birth chances for women over 40 much better than otherwise. But as this article in the Globe and Mail suggests, a chance of live birth boosted by 4 percent might be inspiring to fertility patients older than 40.

I would remind patients that this is statistics, although well done. I worry about patients hearing these sorts of numbers and feeling stressed because theirs haven't "hit". As with so many aspects to treating infertility, your mileage may vary. We do everything possible to make each cycle safe *and* effective, and always, the outcome -- a healthy baby -- is our focus.

Tis the Season For Donor Eggs: Fresh or Frozen Work

In our minds, the concepts of fertility and eggs go hand-in-hand -- especially this time of year. Now, there's some very good news for those who want to either preserve their fertility for the future or otherwise have a Plan B in the freezer for subsequent treatment cycles.

Research performed in the nation of Cyprus has concluded that frozen donor eggs are just as likely as fresh to have a pregnant outcome.

Freezing sperm for later use is almost fool-proof, it's been done for so many years. Likewise, freezing embryos has become a far smoother process that ends in success more often than not. Freezing eggs, on the other hand, has been a challenge.

I've spoken often about the use of egg cryopreservation technology -- the tricky nature of the egg cell that makes the freeze-thaw processes so tenuous, and the hope that comes with improvements on the technique. In 2008, I was interviewed by Houston Business Journal about the intersection of related advanced reproductive technology and society. The ASRM has long been pleased to hear of frozen eggs being used for women prior to cancer treatment, but they've been slow to agree on the technique's use for women who aren't preserving fertility in the face of life-threatening illness.

Now, a new subset of patients are given hope by frozen eggs -- women who must use a donor's eggs to conceive a child.

Arriving at "Honey, I think we need to use donor egg to get pregnant" comes only after some serious thought about very tough topics. Women who've gone through menopause prematurely in life -- a huge psychological burden itself -- and older women who've deferred pregnancy find themselves giving thought to what most people don't have to: "I can either have a child who isn't genetically related to me, or not at all."

Using donor egg to get pregnant also adds to the financial burden of these patients, since they are required to meet the donor's compensation needs.

Among other benefits, documentation of frozen donor egg success increases the possibility of egg banks, similar to long-standing sperm banks, which might then make the entire process cost less. More directly for patients, knowing that subsequent cycles using their donor's frozen eggs can be just as likely to help them get pregnant as that first fresh cycle -- that's a huge load of stress taken from the patients' shoulders.


Any bit of hope we can offer to donor egg recipients is a good thing in my book. The news that frozen donor eggs can be just as successful in rendering a pregnancy is very good.

Another Reason to Be Glad You're in America: Donor Supplies

Getting pregnant with the help of a third party, either an egg or sperm donor, is a tough decision to make. And how much to share with the resulting offspring about their beginnings is best left to the parents. At least, that's the American stance.

This piece in the Scottish paper, the Daily Record, illustrates how bad things have gotten in the UK since anonymity of donor records was made illegal. So few men step forward to donate sperm there now that the health system is helping out by importing semen from London. Many hopeful parents-to-be are spending time and money to go abroad, to countries where third-party supplies are more plentiful.

For patients at Houston Fertility Center, we collaborate with highly reputable agencies that have both sperm and egg donors available and waiting. The level of interaction between fertility patient and donor can vary with the agency and, most importantly, with the needs of all parties involved.

The U.S. may still have quite a few unsettled issues in the healthcare arena, but we can at least rest assured that supplies for third-party reproductive care are just fine.

How Old Is Too Old?

Recently, a local colleague of mine was quoted in the media about having an "an age cutoff" for fertility treatment, specifically IVF. I thought I'd enter the field to air my own thoughts on the question of "how old is too old" for becoming a mom.

In my practice at Houston Fertility Center, I don't use any particular age to determine whether a woman is "too old" to use IVF. Mother Nature will determine when a patient's body is unable to conceive. So we explore the same related variables -- egg reserve, uterine health, hormone levels -- with every patient.

Our primary emphasis is on the health of the hopeful mother-to-be.

As for IVF using donor eggs, which allows women with low ovarian reserve to become pregnant, I find that women in the age range of 48 to 50 are starting to think again about the impact (of carrying a pregnancy) on both their health and the outcome for the baby. We presently don't have enough data to clearly determine all health issues for women over 50 years old who become pregnant. Research has clarified, however, that children born to mothers in their later years have a higher risk of a number of health conditions.

As with virtually every other facet of the conception picture, a woman's age must be taken into consideration, but primarily in the context of her present health condition.

For more of my thoughts on a woman's age and her fertility, see these blogposts, too:

The Other Side of the Age & Fertility Message


Trying to Get Pregnant After 30 - Time to Panic?


ASRM Embryo Guidelines Should Improve Overall Picture for Fertility Patients