Things You May Not Want to Hear When You're Trying to Get Pregnant: Stop Drinking Alcohol

"Anything but THAT, Dr. Kristiansen!" I've heard those very words uttered by patients in my office at Houston Fertility Center a few times. There a number of recommendations I might make for optimizing attempts at getting pregnant -- some of those requests are not welcomed by patients!

Here's one: Stop drinking alcohol.

Now, that's a pretty stringent version of what I actually recommend. That blogpost, "TTC with IVF? Skip the Alcohol Tonight" was published on New Year's Eve 2009. Nothing about the information in the links therein has changed: subsequent research bears out the conclusion that alcohol doesn't do you a bit of good if you're using IVF to conceive. In fact -- and there are plenty of theories but no certain, understandable reason yet -- drinking alcohol might be the thing that tips the conception scales against you.

Most recently, clinical researchers published in Obstetrics & Gynecology, the American College of Obstetricians and Gynecologists' journal, that enjoying as few as 4 drinks per week reduces your chances of IVF success. Interestingly, that holds true for couples as well as women who were surveyed prior to going through their first IVF cycle.

As I said, some Houston Fertility Center patients bristle when I suggest they stop drinking alcohol while trying to conceive. I'm sure the same is true in other fertility specialists' offices. But taking charge of your reproductive health means holding yourself accountable -- a little firm but positive self-talk might be in order. If it feels easier to ponder cutting back instead of quitting altogether, try that instead and use the less-than-four-drinks per week as a gauge. Or tell yourself that you're training for parenthood, a time when the idea of drinking more might seem appealing but is really at cross purposes with your goals -- just like during an IVF cycle.

In the end, you'll want to look back on your trying times and be able to say you did everything you could to have that baby.

~ Dr. Sonja Kristiansen M.D.

Putting the Risks of IVF in Patients' Hands

Australia is home to some renowned fertility specialists. They've also developed a reputation for research on the offspring of IVF, and the most recent information is now being provided in brochure form to patients in Victoria. The brochure is produced by the Victorian Assisted Reproductive Treatment Authority, an Australian institute that helps regulate the use of A.R.T. in that country.

The news about how "The Children of ART" are doing is important to the patients I see at Houston Fertility Center (Here's a link to a related newsletter, now archived on CallDrK.com.) IVF has been helping people conceive babies for more than 30 years now, so current patients can benefit from long-term studies on their development.

So far, the news is overwhelmingly positive, as this brief, related news piece from the Herald Sun explains. One of the biggest hurdles to health for both baby and mom is multiple pregnancy (often a precursor to preterm and premature births), and the fine-tuning of IVF techniques has resulted in far fewer of those. The article also mentions parenting anxiety as being more prevalent in IVF mothers, but I'd wager there are some cultural differences there. Seems to me that in this day and age, most savvy moms have a lot on their plate to worry about, so some anxiety comes with the territory -- no matter how your baby came to be.

The data on a topic as broad as "development of children born from IVF" will always be changing and sometimes debatable. The important thing is that it's out there, that researchers are continuing to explore with long-term studies, and the information is in the patients' hands.

~Dr. Sonja Kristiansen

Is Your OB On Board With Baby-Making?

When questions about getting pregnant arise, most women first turn to their OB/Gyn. You probably even rely on your OB/Gyn as your primary care physician, especially if you have health insurance. Patients typically count on their OB/Gyns to alert them when it's time to see a fertility specialist.

Unfortunately, though, a lot of woman also find that their OB's may not act very quickly when the patient expresses more than just fleeting thoughts but worries about getting pregnant.

That's why I and many of my colleagues spend at least some of our time educating other physicians about the differences in fertility levels and about how those differences may show up in their otherwise healthy patients.

If you're not yet a fertility patient (and you may never have to be!), here are a few related basic points to look into and discuss with your OB/Gyn if your goal is conception:

How long have you been trying to conceive?

Do you know when your most fertile times are each month, based on your cycle?

Do you have any family members who had trouble getting pregnant?

And if you're in your mid-30's or older and are still thinking "maybe someday"... it's time to discuss plans now with your physician, even if you don't plan on putting it into action immediately.

Knowing when to seek care from a fertility specialist can really make the difference between having a baby or not. If your OB/Gyn doesn't know what to look for or doesn't ask you the above questions, start the ball rolling yourself.

How Do Fertility Patients Feel About Donor Anonymity?

I work in a medical field that is ripe with controversy at times. There's nothing casual about helping people try to create life. But I try to avoid bringing a sense of alarm to my patients, even when the news headlines are worrisome. I do think there's a place for staying updated, though, when the news is about laws that may find their way into how I practice reproductive endocrinology and how my patients' treatments will be impacted.

The most recent such item is a state law that's about to bump up against the way things are often done for patients who need third-party reproductive treatment. Later this month, the state of Washington will enact a law that chips away at the anonymity of egg and sperm donors.

Now, most fertility specialists and their patients have been sharing medical history from their egg and sperm donors. It makes good common sense in light of what we know about genetic transmission of many things. If you have a baby using an anonymous donor's sperm or eggs, you likely at least want to know if there are potential medical conditions that may show up in your child. But the sharing of identifying information about donors has long been handled case-by-case, depending on the needs and comfort level of the donors and the fertility patients.

The Washington state law requires that anyone who donates eggs or sperm must provide both medical history and identifying information. Also, children born from third-party reproductive techniques will now be allowed to obtain the donor's information from the fertility clinic once the child becomes 18 years old. However, donors can file a disclosure veto with the clinic that prevents the identifying info from being revealed to the offspring; only the medical history is mandated to be disclosed on request.

This is a first in the United States, but it's not a surprise. Adult donor offspring over the past few years have been gathering to make their needs known. In some countries, donor anonymity is already a thing of the past. America has been slow to legislate these unique and intimate relationships. Those of us impacted by such laws -- fertility specialists, patients, and their families -- will be watching with interest to see if Washington state encounters some of the challenges that have resulted in other nations, most notably a serious decline in the number of available sperm and egg donors. In the meantime, I will continue serving my patients' best interests by providing access to the highest quality fertility care available, including third-party reproductive technology.

~ Dr. Sonja Kristiansen MD

Here's what Huffington Post blogger Naomi Cahn had to say about the new law and its potential repercussions: The Biological Clock -- for Donor-Conceived Offspring?