The Other Side of the Age & Fertility Message

Just on the heels of a study declaring that 30-year-old women have lost most of their 'good' eggs, comes a report out of the UK that women in their 30's and 40's are winding up "accidentally" pregnant because they thought their chances at pregnancy were up.

The claims being made by the British Family Planning Association (FPA) are that messages about women's age and fertility are "overplayed" and leading to something like reverse anxiety. The organization, with a mission of enabling informed sexual health choices, is heading up a new public information campaign to remind women that unless they're willing to get pregnant without trying, contraceptives should be used until after menopause.

One of the messages in the FPA campaign: "Fertility. You'd be surprised how long it takes to disappear."

Menopause is defined as not having a period for at least a year. Perimenopause is what we call the years leading up to that final menstrual period. Perimenopause can last from a couple of years to more than five, and some women are fertile throughout that time.

I'm in agreement that women should remain vigilant about their chances for pregnancy until they are clearly no longer fertile. However, to imply that the messages being sent (about women's age and the natural decrease in fertility) are anything other than appropriate is itself an overstatement.

Translating Molecular Science: Marijuana Use Slows Down Sperm

This article in Scientific American is rather complex reading but reveals some important findings. One of the items in the piece, about study results just published in the journal Cell, is tucked in at the very end -- which is too bad, because it's a tidbit of data that even the least technical reader can grasp.

According to researcher Yurij Kirichok of the University of California at San Francisco, "Marijuana likely activates sperm prematurely, leaving them burnt out in a matter of hours."

Importantly, this study was not about marijuana's effects on male fertility. Rather, the researchers were investigating molecular components that impact how and when a sperm cell gets moving. Besides pinpointing a molecule (Hv1) that activates a resting sperm cell, they also found a few more pieces to the puzzle linking marijuana and male infertility, via endocabbinoids.

Too much medical geek talk? Just simplify it to what we typically recommend: avoiding toxins of all kinds can enhance fertility.

Trying to Get Pregnant After 30 - Time to Panic?

Good Morning America featured a Scottish study that concluded by the time a woman is 30 years old, she's already lost 90 percent of her eggs.

That's enough to make the typical young woman panic.

We've always known that female fertility is more dependent on age than any other variable. This study points to a sharper decline in fertility than we like to believe.

Before everyone rushes to assisted reproductive treatment, though, let's remember that stress can negatively impact fertility.

Next, it's easy enough to have a consultation and do a quick work-up to determine your baseline level of fertility. That won't provide the definitive answer as to whether or not you will have a baby later, but it can certainly help a woman determine if she has an unexpected, silent infertility condition. Then, a plan of action can be put together to promote her future fertility.

Panic won't help you get pregnant. A little foresight and action can.

"iPhone Baby" Not So New; More Fertility 101 Needed

Here's an eye-catching piece: an article about a young woman who finally conceived after years of infertility -- all because of an iPhone app.

Essentially all that happened here was good (and successful -- congratulations!) use of an old TTC standard done up in new technology. The app she downloaded was one of apparently several that counts a woman's cycle days and flags her when she should be at her most fertile.

Keyword here is "should"...

One of the most common reasons that some women don't get pregnant easily is ovulatory disorder. There are plenty of ways that a woman's ovulation can become disrupted, out of sync, or cease altogether. The important thing to know is that very often, the woman has no symptoms to clue her in to her body's fertility problem. Simply having a period, even regularly, doesn't necessary mean ovulation is occurring on target.

So, yes, timing is crucial in trying to get pregnant. But for a 30-year-old to have tried unsuccessfully for *four years* and still only then resort to counting the days in her cycle... that tells me our fertility educational efforts aren't getting out there like we hope, whether or not the technology is a calendar on the wall or an iPhone app.

TTC with IVF? Skip the Alcohol Tonight

As 2009 comes to a close, we at Houston Fertility Center would like to wish everyone a healthy and fertile 2010!

And as a physician, please allow me a little nagging space before the celebrating begins: alcoholic beverages can negatively impact both your overall health and fertility.

It's true.

Now, complete teetotaling may not be necessary for everyone, but if you're about to invest in IVF treatment, you might consider a sober New Year's Eve.

This article on ConceivingConcepts.com refers to a study that even pointed to specific types of alcohol that seem to stand in the way of success for patients going the IVF route to pregnancy.

Taking advantage of Internet searches this week for "all things Party", The Harvard Gazette points to a full related article on London's Guardian that was written earlier this year when the research results were first publicized.

The study was large (over 2,500 couples interviewed before IVF treatment) and the results were striking.

Besides, if you're just about to undergo fertility treatment, now may be a good time to get used to the little sacrifices that parents make. Keep looking to the future!

ASRM Embryo Guidelines Should Improve Overall Picture for Fertility Patients

This year, the American Society for Reproductive Medicine took an expected step forward to increase the safety and health of prospective IVF moms and their future babies. They issued guidelines stating specifically that women under age 35 should have no more than two embryos transferred per IVF treatment cycle.

The goal is to prevent multiple pregnancy, which is full of risks to both mother and babies.

The patient's prognosis, not just her age, should also be taken into account. In cases of a woman younger than 35 having optimal chances at pregnancy, the ASRM further recommends that single embryo transfer be considered.

Other ASRM embryo transfer recommendations, by which Houston Fertility Center adheres, are:

Patients 35 to 37 years old with good prognosis -- 2 embryos
Same age group with less optimal prognosis -- up to 3 embryos (or up to 2 resulting from extended culture)

Patients 38 to 40 years old with good prognosis -- up to 3 cleavage-stage or 2 blastocysts
Same age group with less optimal prognosis -- up to 4 cleavage-staged or 3 blastocysts

Even in cases of patients who typically have the least optimal chances of pregnancy -- women 41 to 42 years old -- no more than 5 cleavage-stage or 3 blastocysts should be transferred.

Balanced Media Reporting Highlights Balanced Infertility Treatment Approach

It's hard enough for infertility patients to find well-founded facts on the Internet, but confusion can really swirl when the marketing of books or products by physicians becomes involved.

This piece by Tennessee Valley's NBC affiliate, WRCBtv, does the right thing with a strong attempt at clearing the air over one fertility expert's book.

I wouldn't go so far as to refer to Dr. Sami David's book as "controversial" (as the title of the WRCB piece implies) but his stance -- that possibly "as high as 50 percent" of IVF procedures are unnecessary -- can be quite misleading taken out of context.

The WRCB team accordingly interviewed another local IVF specialist who introduces the idea of "a balanced approach" to fertility treatment.