"Big News" About New Eggs Is a Big Maybe

This week, a study published in the journal Nature Medicine is promising to scramble a long-held belief about women's eggs.

Scientists at Massachusetts General Hospital have isolated egg-producing stem cells from human ovary tissue. Then, in laboratory conditions, the cells eventually resulted in new egg cells.

Image: Carlos Porto / FreeDigitalPhotos.net

It's the big health news du jour. (So I'm sure my inbox will fill with hopeful "Dr. Kristiansen, did you see the news?!")

For years now, we've all believed that females are born with the most eggs they'll ever have and that when the number dwindles down, natural infertility is the result. This new finding is exciting in terms of possibilities for related infertility treatments.

But good research takes time. Often, a very long time.

Do you recall when we started learning more than a decade ago that, contrary to long-held beliefs, human brains can generate new cells? It's very exciting to consider people with brain injury may be able to recover more fully! But now, many years of research later, experts in neuroscience are skeptical again.

There are still far more questions that must be addressed before this knowledge about "new" egg cells is usable by fertility specialists in helping women with age-related infertility or premature ovarian aging. In fact, I'd bet that the necessary details will come too late to institute a related plan for any woman who is currently considering fertility treatment. For those who want to delay conception but take advantage of their youthful fertility, the best options remain egg or embryo freezing via IVF. And my team at Houston Fertility Center will be happy to serve you with those tried-and-true techniques, today.

Dear Valentine: Would You Take An At-Home Sperm Test?

Okay, it's not really the most romantic idea, so you may want to wait until a day or two later to ask, but getting your guy in on the diagnostic testing is a crucial piece of the infertility puzzle.

And now, he'll be able to test his sperm count at home. It's not the first product of its kind, but starting in April, it could be the only one on shelves of big drugstores like Walgreens and CVS, and it appears to be simpler to use. According to this article on Bloomberg.com, the makers are counting on "women dropping an extra $40 for the test when they buy ovulation and pregnancy kits for themselves."

Great idea, since it's true that most men aren't eager to jump with both feet into the fertility diagnostic effort. It's hard to blame them. But proceeding with fertility treatment having only searched for causes in the woman is like, well, getting a half-filled box of chocolates.

Still, $40 seems like a lot to drop on something that only gives you part of the picture anyway. Like its predecessors, SpermCheck Fertility tells you whether or not the sperm count is 20 million or more per millileter of semen, which is considered normal. That's all.

The test doesn't give users any information on the extremely important factors of morphology (sperm cell shape) or motility (movement), both of which can make or break a guy's capacity to play Cupid to your Valentine.

For just a slightly higher fee, you can get the whole big picture -- count, shape, and movement of the sperm cells -- and have a laboratory professional do the reading. (Do I get patient calls like this: "Dr. Kristiansen, I can't tell if I see a line on this OPK..."? Yes, I do.)

So, I can't advise you on whether or not to spend your money on this product, but if you do and find out that he's "normal" -- but you still don't get pregnant -- I *can* tell you that your continuing infertility is not necessarily, therefore, all on your shoulders. It's not uncommon to have a great sperm count but with a high percentage of cells that don't function well.

Fortunately, reproductive endocrinologists (like me) have plenty of ways around those issues. Please note: you won't find the most advanced treatments, like ICSI or TESE, available through OB/Gyns who aren't Board Certified in REI. In fact, just like shelling out the bucks for at-home tests that don't give you a full diagnostic result, trying to achieve pregnancy with male factor infertility through your OB/Gyn can be a money drain.

Besides, if the at-home sperm count test comes back "abnormal" your next step is heading to a physician anyway. I bet your sweetheart would far rather lob all of those arrows in one appointment. If he's sweet enough to participate in helping you have a baby, maybe you should bundle all of his related tasks into one romantic, hopeful day. The Houston Fertility Center staff is happy to help make your dreams real.

~ Dr. Sonja Kristiansen MD

Yes, Of Course, I'm On Facebook

Please come and say hello!

And Twitter, too. Here's where to find Dr. Sonja Kristiansen of Houston Fertility Center on the Internet.

If you're trying to find Houston Fertility Center's Facebook page, here it is:
https://www.facebook.com/HoustonFertilityCenter

And our Twitter account?

It's at http://twitter.com/drsonjak (That's for Sonja Kristiansen MD)


And Houston Fertility Center's had a website for years -- http://calldrk.com

Dragon Babies In the Making!

Surely, you've seen this recently? The Chinese New Year has arrived, and this year, deemed The Year of The Dragon by Chinese astrologers, is supposed to be especially auspicious for having babies.

The Wall Street Journal says that "dragon babies" -- those born from now until February 9, 2013 -- are supposed to be strong, smart, and lucky. Quite a combination! What parent wouldn't want those things for their child? Even if you think astrology is nothing more than silly fun...

But here's the modern twist on an ancient tale: Couples are actually taking advantage of assisted reproductive technology to boost their chances of getting pregnant with a Dragon Baby. In the article, one egg donation agency reports they've increased the number of donors with Chinese ancestry to prepare for an expected rise in intended parents.

What we're talking about here is a new kind of family planning, people taking full advantage of the availability and increasing reliability of fertility treatment success, even if there are no fertility problems. "But Dr. Kristiansen," you're wondering, "isn't IVF for fertile people going to extremes?" IVF is the most direct means of assisted conception for many people, but artificial insemination can work as well for some.

So if you want to have a Dragon Baby, you need to institute a plan and aim for conceiving by mid-May of this year. My staff at Houston Fertility Center will be happy to assist -- even if you think astrology is just for fun.

~ Dr. Sonja Kristiansen M.D.

Image: Naypong / FreeDigitalPhotos.net

Infertility E-Books - More Snake Oil?

The other day I opened an email from a website making helpful claims for women with PCOS. Polycystic ovarian syndrome is very common, not just among infertile women. Untreated PCOS is linked to infertility and to more serious, chronic conditions involving cardiovascular health. There are many well-established websites about PCOS, some that are backed by medical institutions, to which I refer my Houston Fertility Center patients. So I took a quick look at this relative newcomer site to judge its reliability as a patient education resource.

Quick red flag: If the words "cure" or "miracle" appear on a treatment website, be very wary. (I won't credit the site by linking to it in this post.)

Fortunately, there are many other reputable websites that educate and support patients with PCOS. But what I found especially disturbing about this one (and there are others out there) is their tactic of making money from the dissemination of medical information that's already available to consumers for free. That's the miracle of the Internet.

Before you're tempted to spend your money on e-books, email "programs" or newsletters, or even virtual face-to-face counselors who claim to have cures for PCOS -- or any other cause of infertility -- stop and do your research first. Investigate the authors, as well as the company marketing the products and services. Even more importantly, connect with the many available patient groups (like PCOSChallenge) who can tell you what you need to know and offer you support and tested resources, too.

DIY Artificial Insemination Just Adds to Infertility Stress

Gone are the days of uninformed consumers and all-knowing experts. Now with just a flip of the webpage, you can find step-by-step instructions on everything from remodeling a bathroom to getting pregnant with artificial insemination. DIY conception used to be the only means available for people who couldn't get pregnant "the old fashioned way." It's a real good thing we've come a long way from those days.

But have we? It turns out there's an underground, online market for sperm, where women can access prospective biological fathers for their children without the intervention (and guidance, and screening, and medical and legal protections) of reproductive professionals.

Newsweek's Tony Dokoupil called one related website "a weird blend of Facebook, Match.com and a traditional sperm bank" in this article for ABC News.

"What's wrong with the DIY approach to getting pregnant, Dr. Kristiansen?"

Here's a quick list of why I think you and, more importantly, your potential children are far better off going the more conventional routes to accessing sperm for getting pregnant:

Without standard controls by the Food & Drug Administration and the policies and procedures of reputable clinics like the Houston Fertility Center, you risk transmission of infectious diseases and genetic conditions, to both the mother and child.

Engaging in activity within this level of intimacy, even if sexual intercourse isn't on the agenda, with people whom you've only "met" online is simply not as safe as using professional services.

Agreements made between individuals about level of parental responsibility and involvement in the child's life may not be binding without proper legal representation and execution.

If you've found the whole process of getting pregnant stressful, just imagine the additional burden that comes with using what amounts to be an unknown substance to conceive. Worry about the cost of artificial insemination? It just doesn't compare to worrying about your personal safety and your child's health and future.

Happy Holidays to The Non-Exclusive Club of Kindred Spirits

Virtually all of my patients at the Houston Fertility Center come in feeling alone, at least at the start of their fertility journey. Occasionally I receive "Dear Dr. Kristiansen" emails, mostly from women who live in fear that their situation, their particular cause of infertility, is rare and untreatable. And the holidays is by far the hardest time of year to have an overwhelming feeling of being left out in the cold. But things are a lot better now than in past years, when infertility truly wasn't something anyone talked about beyond clinic hallways.

In this blogpost for Huffington Post, author Leslie Goldman sums up the thoughts that run through so many patients' minds: "Why not me?!" Just as Leslie found out when she dared reveal her struggles with getting pregnant, there is in fact a huge number of people who are going through the same or similar. She finishes up her post with experienced advice for those who are still trying to conceive: "Drink wine. Lots and lots of wine. And enjoy it while you can."

For this holiday season, I encourage you to let things go a bit. If you're in the middle of an IVF cycle or other treatment, follow doctors' orders, of course, but also take advantage of every single opportunity allowed to enjoy yourself. Any questions about whether it's okay to do this or that in mid-cycle? Just ask. If you're not in the middle of treatment, then try your best to shelve the sense of urgency. Breathe as much as you can, both literally and figuratively. After the holidays, you can get right back on the path (if you want) or start thinking about new roads to travel.

But for now, I wish you all peace.

~ Dr. Sonja Kristiansen M.D.