Infertility Issues in the Teen Years, Not Just for Girls

As I wrote earlier this year, we're starting to see more awareness of the need for even teens to consider how their current health can impact future fertility. Polycystic ovarian syndrome (PCOS) generally begins in very young women, although most women don't even learn about the hormonal condition until they have problems trying to get pregnant. Now, just as research is showing us that men's lifestyle choices – including diet and exercise – can make a difference in their fertility, we're also learning that teen boys' health might foretell whether they'll have obstacles in becoming fathers later.

A study published in Clinical Endocrinology produced mildly alarming results – a 50 percent reduction in testosterone in teen boys who are obese. According to this related article on the SUNY website, such findings point to an increasing risk of impotency and infertility later in life.

Granted, the sample size is small, so the researchers advise that more studies are needed with greater numbers of subjects to confirm this study's findings. And the research group plans to next look at weight loss and any resulting (hopefully positive) changes in obese teens. But there is already a wealth of strong data pointing a strong connection between obesity and negative reproductive consequences, and now, that data appears to hold up across the lifespan for both genders.

~ Dr. Sonja Kristiansen M.D.

Positive Movement In Veteran's Infertility Legislation

I'm very happy to report that U.S. veterans and their spouses are closer to having much-deserved coverage for fertility treatment. As I mentioned in August, a bill was introduced that would expand fertility coverage by the Veterans Administration. Now I can echo the applause by the American Society for Reproductive Medicine for the Senate's passing of the “Women Veterans and Other Health Care Improvements Act of 2012’’ which

“...would direct the Secretary of the Department of Veterans Affairs to furnish fertility counseling and treatment, including the use of assisted reproductive technology, to severely wounded, ill or injured veterans whose infertility was incurred or aggravated in the line of duty.  Female veterans, the spouses of veterans and surrogates would be eligible.”

The Department of Veteran Affairs has up to 18 months to establish rules of the program, so resulting benefits will not be immediate. But this is a very positive step – next up, to encourage the House of Representatives to pass the bill for Presidential signature – toward facilitating full access to health care services for military personnel who have sacrificed so much for us all.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

Depression Treatment During Infertility

It's common for women with infertility to also experience depression, even if for many the relationship is like “the chicken and the egg” – was the patient going through undiagnosed depression prior to running up against conception obstacles, or has the infertility journey, itself, triggered clinical depression? Which struggle started first is not the biggest question, though.

As a recent review of studies bears out, there are legitimate concerns about the use of certain types of antidepressants by pregnant women. The review, published last October in the journal Human Reproduction, concluded that there is no evidence of improved pregnancy outcomes with antidepressant usage and, in fact, the opposite is true. This related article on ScienceBlog describes “mounting evidence that SSRIs may decrease pregnancy rates” in women who used fertility treatment, and there's a link between antidepressant use and increased miscarriage rates.

Depression must be taken seriously, and not dismissed as “merely” infertility-related sadness. But the choice of depression treatment by women who are also going through fertility treatment should be handled with caution, on a very individualized basis. Just because a particular drug benefits one woman, that doesn't necessarily mean it will benefit all.

If you have ever been diagnosed with depression, or if you have a strong family history of depression, be sure to let your fertility care providers – as well as your primary care physician – know. An informed team approach is the best way to handle a dual diagnosis of infertility and depression.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

Are You In the Infertility Closet?

The infertility journey presents most of us with an uncomfortable opportunity: How open should we be about our problems with others?

There's no right or wrong approach to the question. Every individual's circumstance is filled with variables, from family history to religious views to personality traits. For some, it's important to keep their infertility struggle quiet, perhaps telling only a very select few people about being in treatment. Others may find a load of stress lifts from their shoulders when they come right out and tell the world, “We're going through infertility treatment.”

In this piece on Crosscut.com, Seattle writer Cathy Merchant reveals how she and her husband have come to terms with infertility, moving down that all-too-familiar path that starts with “We're going to get pregnant!” to adding “totems and rituals and snake oil” and finally, to the choice of medically-assisted fertility treatment. As of this writing, they're still trying to have a baby, but have arrived at a somewhat resigned resolution that this isn't going the way she'd hoped – but she still has hope.

I'm honored to be in a position at Houston Fertility Center to assist people in their quest to become parents, no matter how private or public the experience.

~ Dr. Sonja Kristiansen M.D.

Image: Free DigitalPhotos.net

Takes a Village to Have a Child

It's remarkable, the things that people will do in order to afford fertility treatment. While it is disheartening that so few people have insurance coverage for the medical techniques that could make them parents, the creativity and resourcefulness of some patients is inspiring. Raising funds through social media is becoming more mainstream, as discussed in this ABC News piece.

Using the Internet to rally your supporters is a new take on the old concept that “it takes a village to raise a child” – now, because of social media's ability to expedite getting in touch with others, fertility patients who need assistance to afford treatment are thinking it takes a village to have a child.

And their Twittering, Facebooking, and website-building are apparently paying off. If you find yourself in the majority who have little to no insurance coverage to help you pay for fertility treatment, the holidays may be the best time of year to put the word out and see what your loved ones think about helping out. And to help out further, nearly every year Houston Fertility Center offers IVF discounts – our current low price is good until the last day of 2012. Take a look at CallDrK.com for more details. We're happy to be part of your family-building village!

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

What Loved Ones Would Tell You, If They Knew What Infertility Feels Like

If you've been through the holidays while struggling with infertility before, you know the drill. As you travel toward gatherings of friends and family, your mind searches for the next best response to the inevitable question: “Are you pregnant yet?”

Fortunately, the Internet is now full of helpful tips for the people around you, advice on what not to say. But this article by Larami Williams on Divine Caroline offers more than that – she lists 7 things that infertile people want to hear from loved ones.

This could one of those links that gets passed around frequently this time of year. And instead of dreading the holiday gatherings, try considering that most loved ones really will say the right thing, once they've been enlightened about how it feels to long for parenthood. I and my staff at Houston Fertility Center wish you the warmest Thanksgiving ever.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

Stop Smoking, Increase Your Fertility, Live Longer

November 15, 2012 is the date of the37th annual Great American Smokeout. It's a great time to quit smoking, especially if you're a woman who wants to get pregnant. The effects of smoking aren't only bad for babies in utero – it's bad for your fertility.

The ASRM Patient's Fact Sheet on Smoking and Infertility gives you some of the details on how smoking can get in the way of your getting pregnant. And now, there's a study that highlights another angle of why moms-to-be should kick the habit: Women who smoke lose a decade of life.

Many of my patients arrive at Houston Fertility Center having struggled for years to get pregnant before finally deciding to use assisted reproductive techniques. So, as with many fertility practices, I counsel a lot of older moms-to-be, who have a few things to worry about that women in their 20's don't when it comes to infertility. Women in their 30's and 40's often express different concerns about how their bodies will fare through pregnancy, labor and delivery, and they often have more questions about higher risks for their babies. I doubt if a single one of my older patients hasn't done some quick math – with a little trepidation – to figure out how old she'll be when her child is a teenager or heads to college. Longevity is a natural, normal concern.

In this UK study published recently in the medical journal The Lancet, more than 1 million women were surveyed and followed for up to 15 years and asked about their cigarette smoking habits. The impact on their mortality was significant. From the study:

“... smokers lose at least 10 years of lifespan. Although the hazards of smoking until age 40 years and then stopping are substantial, the hazards of continuing are ten times greater. Stopping before age 40 years (and preferably well before age 40 years) avoids more than 90% of the excess mortality caused by continuing smoking; stopping before age 30 years avoids more than 97% of it.”

So, older moms, you have even more reason to stop smoking now – you might want to enjoy being a grandmother longer.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net