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.

"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!

Infertility A Blessing in Disguise?

Here's a way to re-frame things: Michele Olson of thinkmarriage.org suggests that infertility could actually be helpful to couples.

In this article from the Wausau Daily Herald, she offers tips on how to think about fertility challenges so that your relationship not only doesn't crumble, but improves.

Surrogacy The Final Stop In the Journey For Some

The Wall Street Journal has published a detailed article on the growing prevalence of international surrogacy as a way to build American families. The piece describes the incredible lengths that some couples will go through to have a child, heart-rending stories in some cases. It also brings up some of the concerns about connecting cross-culturally to resolve infertility.

To be sure, using a "third party" -- whether through donated sperm or egg, or gestational surrogacy -- requires more contemplation than other forms of fertility treatment. In situations where the donors are from relatively impoverished circumstances, hopeful parents-to-be must wrestle with the realities and potential consequences of their choices. With international medical care of any kind, some of the gravest issues can become mired in the differences between laws and health care technology and provision.

International medical care may be less expensive, but there are other costs. All parents must choose between rocks and hard places in "the parenthood."

When Fertility Really Is About Your Diet

No woman wants to be told she needs to lose weight, least of all my patients who have struggled (sometimes for years) with trying to get pregnant. Whether we decide their fertility treatment will include fertility medications, IVF, IUI, or some other assisted reproductive technology, the best starting point is a healthy body -- and for many, that means coming to a more optimal weight.

This article in the Belfast Telegraph describes a rather novel approach to meeting the challenge of weight versus fertility, specifically as it relates to polycystic ovarian syndrome (PCOS), one of the most common causes of female infertility.

Are there similar programs in the United States?

The Embryo Dilemma

Recent news reports brought up again the ongoing questions surrounding embryo creation via IVF. Actually, the questions aren't so much about the creation side of things as they are about disposition of extra embryos.

As reproductive medicine specialists, we have focused mostly on the best ways to help individuals and couples conceive biological children. Success is very often a matter of numbers: the more eggs a woman ovulates, the more sperm a man has available, the more embryos created... the greater their chances at getting pregnant.

For years now, we specialists have been boiling down the science and finely tuning the techniques toward the ultimate goal: how best to unite only as many eggs and sperm necessary to create only as many embryos needed to make one healthy baby.

Single embryo transfer is a true possibility for some patients, but almost a pointless, expensive protocol for others.

At this point, it remains common for IVF patients to wind up with at least some "extra" embryos -- that is, too many embryos to transfer within the same treatment cycle -- so the question of what to do with the surplus continues to be answered.

In the study recently published in Fertility & Sterility, more than 1,000 infertility patients were surveyed about the choices they've pondered and made to address their own embryo surpluses.

Among other things, the survey results reveal a broad consensus of disappointment -- with the options offered at various clinics and with the level of pre-IVF information made available to them.

Fertility treatment centers are like any medical practice: filled with professionals who are people first. Different practices have varying policies based on many factors, including the personal beliefs of the professionals. Another component that steers clinic policies is the availability of resources.

Patients and professionals need not have all their beliefs in common, but there are sometimes "bottom lines" that patients use to make their choices about which fertility practice to turn to for assistance with getting pregnant and about which treatments to use. In the past, some practices were so results-driven, so focused on success rates, that even crucial issues like the disposition of surplus embryos were side-stepped or, at least, addressed with as much brevity as possible. The dilemma of extra embryos is very real and can no longer be seen as ancillary.

I'll discuss specific related options for patients of Houston Infertility Clinic in a follow-up blogpost.