Is Putting Off Pregnancy The Best Idea?

An article in the Los Angeles Times recently touted the benefits of the economic recession in terms of women delaying pregnancy.

While I believe that there are certainly advantages (as described by the author) to later-aged motherhood, I think we need to tread carefully when discussing the impact of age on fertility in general.

The majority of women (and men) have no idea what their body's fertility status is until they try to conceive. Unfortunately for some, the news is not only alarming but comes too late for them to take advantage of treatment in an optimal way.

Of the many causes for infertility, many (perhaps most) are not age-related, it's true. But that rosy perspective can work in reverse -- if a woman's not ovulating or if her tubes are blocked, it doesn't matter how old she is: she won't get pregnant without assistance.

While we're looking for silver linings to the recession's dark cloud, let's not throw the baby out with the bathwater.

Your Environment & Your Fertility

A small-scale study, recently published in Fertility & Sterility, adds to what we know about a woman's environment and the quality of her eggs.

In "Serum unconjugated bisphenol A concentrations in women may adversely influence oocyte quality during in vitro fertilization," the study authors conclude that, during IVF cycles, as levels of bisphenol A (BPA) rose, the number of fertilized eggs fell.

There is no simple test for BPA that can be administered in clinics. So, as with many things that may impact fertility, the best advice I can give patients is to try and reduce your exposure to BPA.

This Mayo Clinic article - What is BPA, and what are the concerns about BPA? - offers a quick list of things anyone can do to avoid BPA.


For more on this study:
BPA can affect egg quality, study claims

Male Infertility Research & Recommendations Long Overdue

Last month, I wrote about more enlightening research on male fertility and dietary factors. A lot of women may not admit it, but some are perfectly comfortable stepping up and saying, "It's about time!" So far, most research has focused on female fertility and obstacles to conceiving. A recent article -- "The Bad Daddy Factor" -- points to some possible societal reasons why this may be the case.

Article author Emily Anthes goes all the way back to the 1960's to mention the few researchers who were looking at the impact of men's contribution on both fertility and infant well-being. She describes how most of their scientific colleagues weren't equally concerned, so the burden of cause continued to fall mostly in women's laps for decades. The writer goes on to connect this historical lack of aggressive research with society's viewpoints on gender and even politics. The good news: those viewpoints seem to be evolving.

Like my own colleagues, I am thrilled every time I hear about new interest in reproductive research. The more we learn about the causes of infertility, the better able we are to both educate young men about prevention and to treat the later results of lifestyle choices that are not fertility-focused.

On behalf of Houston Fertility Center's staff, my wish this season is that you and yours reap the benefits from advancing research, technology, and compassionate fertility care -- and grow your family with love.

Getting Through the Holidays with Infertility However You Can

Seasonal holidays are tough on the spirit when you're trying to get pregnant and can't. The Web is full of places you can go to and read or chat with others about ways to cope. Here are a few that I recommend:

Thanksgiving: To Attend or Not To Attend: That Is the Question
The title says "Thanksgiving," but this piece by Lori Shandle-Fox on Fertility Blogs covers all family gatherings with a light heart.

Infertility and Holidays: Don't Just Survive - Thrive!
Tracy Morris on FertilityCommunity covers a lot of different emotional tactics that can help you view holidays from a different perspective.

The Season of Giving
An interview with Kathy Stern of Southwest Surrogacy Associates, LLC about the role of giving in third-party reproductive treatment, during the holidays and beyond.

The Perfect Storm of Holidays: Infertility and Christmas
Melissa Ford taps into a perfect analogy with "The Great Peanut Day". Use it to explain your emotions to those who just don't seem to 'get it.'

Tips for Facing Infertility During the Holidays
On ParentDish, Mary Beth Sammons interviews a woman who's been going through fertility treatment for six years. Her personal advice - "what helps most is 'to know that I'm not alone.'"

There are plenty more out there -- just search for "holidays and infertility" and you'll see that, indeed, you're not the only one.

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.

Weight Issues & Fertility Not Just a Woman's Concern

Here we are again -- the end of year holidays. This time can have a real double whammy effect on people trying to conceive. First, there are the joyous gatherings... with babies everywhere. Then, there's the abundance of food, much of it rich and not-so-nutritious. You know, the kind that's so much fun to enjoy too much of...

Why is food a problem for people trying to get pregnant?

By now you've probably heard about the impact that weight has on a woman's fertility -- both too little and too much weight can result in ovulation disorders. Also, overweight women increase their surgical risks even for procedures as commonplace as egg retrieval. But there's more research now that says men need to keep an eye on their fatty food intake, too.

At this year's meeting of the American Society for Reproductive Medicine, researchers presented evidence that men with the highest intake of saturated fat had 41% fewer sperm than those who ate less. Also, men who ate more omega-6 and omega-3 polyunsaturated fats, specifically, had better sperm motility and morphology.

There is some good news on the research front for men who are overweight. The low testosterone levels that apparently go along with high BMI (body mass index) do respond positively to clomiphene citrate (Clomid).

But on this eve of one of our country's biggest binge-eating holidays, I'd recommend having a double helping of the carrots and lay off the gravy a little bit.

Also see:

When Fertility Really Is About Your Diet

Weight & Fertility (from my April 2007 newsletter)

Fertility Treatment for Cancer Patients Is Reality. Even If They Don't Know It Yet.

Houston is a major destination for people battling cancer. The city's medical center is renowned for providing the most advanced cancer care available, and patients come from around the world to access life-saving science and techniques. Besides the facilities in the centrally-located Texas Medical Center, there are also cancer treatment centers in outlying areas around Harris County where patients are receiving the benefits of cutting edge research put into clinical practice.

More cancer patients are surviving and going on to live healthy, happy lives. But many forms of cancer treatment result in infertility. Fortunately, the technology exists now to take steps to preserving a person's fertility for the future. Freezing embryos and freezing eggs top the list of techniques proving successful. And for patients who have types of cancer that are transmitted genetically, the technology is available to screen embryos for the related genes.

I've networked for several years now with organizations that assist cancer patients, groups like Livestrong's Fertile Hope program, the Young Survivors Coalition, and the Susan G. Koman Foundation. Speaking to groups about fertility preservation is always eye-opening for them and for me. I continue to hear the same sense of surprise and sometimes regret from participants who wish they had known before undergoing cancer treatment. I wish they had known, too.

If you know someone who's struggling with cancer, let them know that infertility doesn't have to be part of the result. Help me and other reproductive endocrinologists make fertility treatment available to cancer patients, by spreading the word about the hopeful possibilities.

Also see:

Women Want Working Options for Motherhood
On Lindsay Nohr Beck's presentation at ASRM 2009.


Fertility Preservation and Oncology
My thoughts about Jane Brody's column on how oncology is still behind the curve in addressing their patients' future fertility needs.