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

One Woman's Egg Freezing Story & Hope for Brighter Futures

As discussed in October, the American Society for Reproductive Medicine no longer considers egg freezing experimental. The topic was big news, covered by everything from national to local media affiliates.

This interview show on NPR offered an opportunity to hear the patient's perspective of oocyte cryopreservation, as told by well-known New York Times blogger, Suleika Jaoaud. She's the young woman who shares her experience with leukemia in “Life, Interrupted”, including her need to confront the possibility of infertility after life-saving chemotherapy. In this interview, Suleika describes how she learned about the option of oocyte cryopreservation on her own, not from her oncology physicians, and what it was like to go through the egg freezing process just prior to her initial treatments.

Also speaking is Dr. Samantha Pfeifer, one of the physicians on the ASRM committee that made the decision which should result in more expedient coordination of treatment for such patients. I and my Houston Fertility Center staff look forward to continuing teamwork with physicians who are helping save lives, so that our patients can have the brightest futures possible.

~ Dr. Sonja Kristiansen M.D.

Image: FreeDigitalPhotos.net

Some Folks Will Do Anything to Get Pregnant

You've probably caught yourself saying things like "I'd stand on my head if it would help me have a baby!" A recently published study from Israel of 219 women going through IVF found that bringing in the clowns can help.

It sounds pretty funny, but this was bona fide research published in Fertility & Sterility, the journal of my esteemed colleagues, the American Society for Reproductive Medicine.

The clinic employed the services of a "medical clown" who performed a standardized routine for each patient on some days. Women who attended clinic on a "non-clown" day were less likely to get pregnant, even taking into consideration factors like age, infertility cause, and the number of embryos transferred.

Like the lead researcher, Dr. Shevach Friedler, says, it's "one of the least hazardous interventions" for IVF patients.

While I'm sorry to say that we don't have a clown on staff here at Houston Fertility Center (yet), we do take pretty seriously the growing body of research that points to connections between stress and treatment success. Besides offering a soothing environment at our clinics with staff members who are sensitive to your worries, we refer patients to massage, acupuncture, and counseling professionals, all of whom specialize in the needs of fertility patients. I'm a believer in the value of learning personal stress management and the positive impact on infertility and treatment.

You never know what people will try next. So the next time you're at our place for an appointment, don't be surprised if you hear laughter. After all, helping people make their dreams come true can be pretty fun!

Why I Attend the Meetings of American Society for Reproductive Medicine

One of the reasons I felt compelled to move from straight OB/Gyn work to reproductive endocrinology-infertility (REI) is because of the constant advances in science. I find it exciting to apply techniques that have developed along a continuum from creative brainstorming on how to meet patients' fertility challenges all the way through validation in labs and clinics.

I'm heading to Denver this week with some of my Houston Fertility Center staff to attend the 66th Annual Meeting of the American Society for Reproductive Medicine. ASRM is always a great place to catch up with colleagues from around the world and hear about the latest ways to treat our patients. This year promises to be even more enjoyable as we'll be honoring two pioneers of IVF, Dr. Howard Jones, who performed America's first IVF procedure, and Professor Robert Edwards, who recently was awarded the 2010 Nobel Prize in medicine for his development of IVF.

Bestowing accolades on esteemed professionals is just part of the reason for gathering. More importantly, I look forward to returning to Houston Fertility Center with new ideas to share with patients on clearing their family-building hurdles. Sometimes, even a simple treatment can be years in the making. Once new technology is available, a whole new group of once-infertile men and women can find themselves parents, and that's why I do what I do.

European Women Happy to Freeze Eggs for Future

According to two studies presented at the annual meeting of the European Society of Human Reproduction & Embryology (ESHRE), European women are embracing the idea of egg freezing as a means of having more reproductive control over their lives.

A small Belgian study of women average age 38 years found that half of them planned to freeze their eggs to lessen the pressure they feel to find the best parenting partner. Most foresaw using their eggs for conception after age 40.

A larger study in the UK saw eight in 10 medical students would be willing to freeze their eggs so that career growth could continue to take a front seat.

Women in the U.S. are also warming up to the idea of using assisted reproductive technology even when infertility isn't an issue in their life. Advances in the technology have made egg freezing with IVF more affordable and even covered by some women's insurance plans.

http://www.bioedge.org/index.php/bioethics/bioethics_article/9085/

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.