Frozen Sperm Last Long, But Age Still a Factor

This past August, twin girls were born to a woman in Minnesota following IVF using donor sperm. The real news here is that the sperm had been donated and cryopreserved in 1971.

This news article on TwinCities.com offers interesting details about the donor and his journey to “carry on his family's bloodline.” The story is also yet another that points to the resiliency of sperm cells and their viability for fertility treatment by patients who need to use frozen donor specimens to conceive.

The article also importantly points out that even our amazing assisted reproductive technology cannot completely defeat the power of passing time's impact on fertility. All that could be revealed in the media about the donor's age was that he was at least 25 years old when his deposit was made. Presumably, since the donor participated in the selection of a couple in this unusual case, he was not too far from age 25 in 1971.

While men have always been thought to be able to father children later in old age than can women, we are now learning that, in reality, there are greater chances of older men passing on inheritable mutations. Reproductive specialists recommend that young men who will face impaired fertility – such as from cancer treatment or even being in harm's way in terms of military deployment or job-related risks – can take steps to preserve their future fertility by banking their sperm.

~ Dr. Sonja Kristiansen M.D.

VA On The Path to IVF Coverage for Vets

The men and women who have served our country in the Armed Forces are on our minds more than ever lately. The numbers who are returning with medical needs of all kinds are staggering. Fortunately, many established service agencies are thinking ahead and new organizations to meet their needs are popping up all over.

What does this have to do with infertility?

Many of these troops are coming home with fertility issues they never thought they'd encounter. And while the Veteran's Administration has long provided coverage for limited fertility treatment, such as diagnostic tests and IUI, patients needing IVF to conceive have been left out of the VA picture.

Now, there's a bill being considered by the Senate that would specifically allow the VA to cover IVF, among other expansions to fertility treatments covered.

From a recent Associated Press article on FoxNews:

More than 1,830 veterans of the wars in Iraq and Afghanistan have suffered pelvic fractures and genitourinary injuries since 2003 that could affect their abilities to reproduce, according to Pentagon figures provided to Sen. Patty Murray, the bill's sponsor and chairwoman of the Senate Veterans Affairs Committee.

Senator Murray, a Democrat from Washington state, says she hopes the committee will act on the bill after returning from August recess.

I've been honored to help build families for men and women who've served the United States. A few years ago, I performed an egg retrieval and ICSI fertilization for a couple at Houston Fertility Center's central location while the husband looked via live video in Iraq. It was an exciting moment for all of us and a perfect example of how the combination of medical and communication technologies can enrich our lives. Houston Fertility Center has served several other veterans, and we regularly offer discounts to the men and women who are serving our country. Now, the Women Veterans and Other Health Care Improvement Act of 2012 seeks to increase the likelihood that all who need fertility care to build their families can access the types of assisted reproductive technology that are necessary for their situation.

You can hear the related personal story of Staff Sgt Matthew Keil's family as they struggled with barriers to fertility treatment access, as told by Tracy Keil (the sergeant's wife, who has become a leading advocate of the proposed bill) at a Senate hearing earlier this summer. 

Mrs. Keil says it best: "War time changes a family. It shouldn't take away the ability to have one."

Speaking of Fertility Preservation: Frozen Eggs Do Well

In Malta, there's a legislative proposal that might decrease the ability of some citizens to resolve their infertility with IVF. While political and social pundits wrestle with the questions of which patients can access which treatment and even specifics on which treatment protocols can be used, one expert shed some positive light on one option in particular.

Image: FreeDigitalPhotos.net

Dr. Eleonora Porcu is possibly the most experienced reproductive specialist in the world when it comes to the use of frozen eggs with IVF. Because of Italy's highly restrictive assisted reproductive technology laws, Dr. Porcu has been very active in the pursuit of technique advancements that make oocyte cryopreservation a viable option when frozen embryos are not available. She was called on by the Maltese government recently to testify about the success she has seen over the past 15 years.

The Times of Malta published this interview with Dr. Porcu, who reports she and her medical team have produced "some 500 births of children conceived using frozen eggs."

In the United States, we are so fortunate to be free of extreme governmental restrictions mandating which individuals may access ART and which forms of ART they can use to resolve their fertility issues. My Houston Fertility Center staff and I have offered egg freezing to patients for several years now, believing it to be an optimal fertility preservation technique for unmarried women who are about to undergo cancer treatment, as well as others who are without partners and do not want to use donor sperm.

~ Dr. Sonja Kristiansen MD

Common Chemicals Not Just Harmful for Baby – Bad for Baby-Making

A recent study of men and women undergoing IVF found that even low levels of some pervasive environmental chemicals are associated with reduced number of pregnancies. In the small sample of IVF patients, researchers adjusted for confounding factors like age, race, and smoking, and found that small increases in blood levels of both mercury and cadmium are associated with reduced rates of clinical and biochemical pregnancies.

[The term “biochemical pregnancy” refers to two positive hCG tests in very early pregnancy, while the term “clinical pregnancy” refers to detection of a gestational sac on ultrasound.]

In the women, slight increases in blood mercury were associated with pregnancy decreases of up to 35 percent, whereas slight increases in blood cadmium were associated with decreases of up to 94 percent. There were no similar effects detected in the men.

So what does this mean for you, if you're trying to get pregnant? Chemicals are all around us, in products, furnishings, and even foods, and you cannot completely avoid every one of them. But there are a few steps that can be taken to lessen your risk of exposure:

• Don't smoke cigarettes or be around second-hand smoke.
  
  
• Avoid certain types of fish that contain high levels of mercury: bluefin and albacore tuna, swordfish, shark, king mackerel.
  
  
• Don't use phosphate-laden fertilizers.
  
  
• Eat only moderate amounts of organ meats, like liver and kidneys.
  
  
• Have your blood tested for toxins. You might also consider testing your soil and, if you have a well, your water supply.

For more details on the study and on the effects of mercury and cadmium, see this Fertility Authority article.

IVF? Skip That Last Cup & Croissant

Cut back on the caffeine and saturated fats. It's not new advice. But there's a bit more research now that arrives at the conclusion that too much of these dietary no-no's can get in the way of IVF success.

I know my patients at Houston Fertility Center sometimes feel “up to here!” with the restrictions that they already find infertility and its treatment have put on them. So information like this is not always welcome – but remember, the more data we have on which to base our treatment decisions and techniques, the less likely it is that patients will be required to go through numerous treatment cycles to get pregnant.

In two different presentations, researchers at this year's meeting of the European Society for Human Reproduction and Embryology informed us of these findings:

• Drinking more than 5 cups of coffee per day can reduce your chance of pregnancy from IVF by 50 percent, but the reasons are not clear.
  
  
• The type and amount of dietary fats consumed by a woman seems to impact IVF success. Specifically, chances of IVF pregnancy were lessened in women who had higher intakes of saturated fats because they produced fewer mature egg cells.

The dietary fats study is especially small, and the researchers call for more follow-up. The caffeine-related study, too, should be expanded, but for now, authors of this Danish study of nearly 4,000 IVF patients are suggesting that adverse effects of coffee are comparable to the detrimental effects of smoking on IVF.

The researchers in both of these studies clearly state that there's no need to make drastic changes based only on their findings.

Overall, our patients are admirable in how they heed the warnings of research about lifestyle-based effects on fertility treatment. Whether a woman is experiencing infertility or not, going through a little dietary “clean up” during preconception is a great idea with benefits for mom and baby. 

Another Infertility Cause: Fear Of the Unknown

One of the most distressing comments I hear regularly in my office: “Dr. Kristiansen, I cannot believe I waited so long to seek help getting pregnant. Now that so much time has passed, I hope I can still get pregnant!”

Why am I writing about this? Because we know from studies that a big percentage of men and women avoid seeking fertility treatment because they're afraid. If you've already taken that big first step of scheduling a fertility consultation, you know exactly what I mean. People who are starting to worry about why they haven't gotten pregnant scour the Internet for reasons and solutions, and what they see can scare them away from the very thing that could result in pregnancy.

Image(s): FreeDigitalPhotos.net

Here's what I want them to know: An initial consultation with a fertility specialist does not equate to treatment, but it can often add up to more informed women and men who go on to “get it right,” with or without treatment.

What are they afraid of?

Intimacy issues – Who wants an audience to be in on your private dreams of building a family? It's hard enough to discuss with loved ones, but talking to a professional can make you feel even more uncomfortable. Fortunately, I can tell you that my staff at Houston Fertility Center are all long-timers in this medical arena. We understand, in some cases from personal experience, the emotional discomfort that you're going through. Your concerns are treated with utmost dignity and discretion.

Medical procedures – Most fertility patients are of average health and have never gone through any kind of treatment process beyond an occasional round of antibiotics for infection. It's understandable that virtually any medical tests or treatments might seem scary. Many are under the mistaken impression that IVF is the only kind of treatment. Again, simply talking with a fertility specialist does not necessarily include any tests or procedures. That said, a lot of first-time patients do agree that scheduling their initial consultation on Day 3 of the woman's cycle, and undergoing a simple blood draw to determine levels of reproductive hormones, can save time and money in the getting-pregnant process. It's your choice.

Financial costs – It's true that once you decide to become a fertility patient, there will be some costs involved. The financial expenses will vary from patient to patient, depending on health care coverage (or not) and on the causes that are determined to be your own fertility obstacle. Treatment costs vary widely and, actually, most patients do not need IVF to get pregnant. The majority of patients can become pregnant with less costly forms of treatment, like IUI (intrauterine insemination). (I'll address the differences in an upcoming blogpost.) But no one can tell you what your costs will be until thorough diagnostics have been implemented, and you have had a chance to discuss the options.

The important point: There's no way that your research alone or even any online-only consultations can adequately review and assess your fertility status and sum up whatever issues might need to be addressed for you to get pregnant.

Don't let fear of the unknown be your own major obstacle to getting pregnant.

Speaking of Infertility Awareness: The Question of Age + Pregnancy = Never-Ending Confusion?

Advanced maternal age and how it gets in the way of pregnancy is in the news again. This time, the focus is on how so many women have the misunderstanding that assisted reproductive technology can defeat age as a barrier to conception.

How many times have I heard, "Dr. Kristiansen -- I hate that term! Can't we use something different to refer to my age?" Sorry -- it's a rather tacky-sounding medical terminology shortcut that means "chronologically older than average for optimal fertility".

Here's a message that needs to be heard during this National Infertility Awareness Week:

The fact: Without intervention, most women in their 40's (and many in their 30's) would not get pregnant.

Another fact: Yes, IVF is incredible technology worth marveling at, and one of the reasons is its ability to facilitate conception in women who otherwise would not get pregnant.

The Big Myth: IVF is so effective, you can wait until you're of "advanced maternal age" to try and get pregnant -- and have a high likelihood of succeeding by way of fertility treatment.

That myth IS a fact for some women. But only for some women. Are you one of them? There's a good chance that a thorough diagnostic workup by a reproductive endocrinologist can provide clues to answer that question. Can we guarantee it? No.

I don't think either the media or fertility experts intend to confuse women about the question of age and pregnancy. But the confusion among women is apparently prevalent and ongoing.

Just as it would be overkill to suggest that all women in their teens or early 20's run out and get fertility testing to prepare for the future, it is unreasonable to recommend women put all their eggs into that future basket by expecting ART to be their surefire answer to pregnancy. (There is the option of freezing your eggs, a different but related story...)

So, the simple truth: If you're delaying conception until your late 30's or older with the intention of simply walking into any fertility center and getting pregnant easily on the first try, you're automatically decreasing your odds.

If you're like many of my patients and have delayed pregnancy for lifestyle reasons like not finding Mr. Right, wanting to give your all to your career before parenthood, or because your finances aren't in order yet, you can take heart in knowing that virtually any safe and effective technique will be made available to you here at Houston Fertility Center. Not only that, but the treatment will be delivered by a team of experienced, compassionate women.

We know how much you want a baby. We applaud your courage and tenacity in the pursuit of parenthood. We'll educate you about every treatment option. We'll be your cheerleaders in the journey. And we'll be honest with you, too.

~ Dr. Sonja Kristiansen M.D.




[Image: photostock | FreeDigitalPhotos.net]

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

Why I'm Grateful For My Own Lab: Twins from Stolen Sperm

In the United States, we're relieved to be free of a strong government hand in private affairs like choosing to use reproductive medicine. Occasionally, though, my inbox is filled with rather frantic "Did you see this, Dr. Kristiansen?!" emails bearing news stories that remind us of why some regulations are necessary.

One such story -- about accusations of stolen sperm and unwanted fatherhood -- is coming out of Houston right now.

A young man is taking a Houston area fertility center to court, saying they never actually had his consent to use his semen for IVF that eventually impregnated a former girlfriend. This news video on Click2Houston.com has interviews of both the man -- now the father of twins -- and a representative of the fertility center.

Stories like this are fortunately rare, but they still play on the fears of fertility patients. It's understandable -- not all fertility specialists use their own labs. In fact, Houston Fertility Center's own in-house, state-of-the-art laboratory has provided embryology and related services for physicians from other clinics for years. Being able to rely on my own lab provides me and my staff with an extra layer of confidence in the fertility services we provide to patients.

While things in general are far more easy-going in the U.S. than in other countries, reputable fertility centers honor both the requirements and recommendations of existing regulatory bodies. This young man's experience clearly demonstrates one reason -- no one should be cornered into parenthood.

Rules about patient consent and the use of tissue (which includes sperm and eggs) can add a layer of cumbersome bureacracy to the IVF process. Now and then, a patient will complain, "But Dr. Kristiansen, some of these requirements seem over the top and unnecessary!" My response? I am grateful to have my own laboratory serving Houston Fertility Center, and for staff who are vigilant in maintaining compliance with regulations for the benefit and well-being of everyone involved.

Building a Family In Tough Times

The country's economy is struggling so much that women are quite possibly having fewer children as a result. A report published last month by the Centers for Disease Control likens the trend to the Great Depression's fertility rates.

My patients feel the pain. If getting pregnant the old fashioned way is harder now, imagine what it's like to need special fertility treatment in order to have a baby.

In that light, I'm currently offering a big discount on IVF: $7995 through November 30th.

Because Houston Fertility Center has its own state-of-the-art laboratory, I'm able to provide the highest quality reproductive medicine services at more affordable prices. And since this is the time of year when people living in the Houston area are caught between high electric bills (for air conditioning!) and impending holiday season expenses -- it seems like the best time of year to make family-building a reality for so many.

Hang in there!

~Dr. Sonja Kristiansen MD

IVF Works for Hispanic Women, Too

Many of my patients may be relieved to hear this piece of research news from a colleague in San Antonio: Hispanic women are just as successful with IVF as are non-Hispanic anglo women.

There's no particular reason to believe otherwise, but a previous nationwide study that compared IVF success rates among women of multiple ethnicities showed that Hispanics were 13 percent less likely to have a baby following the procedure. They were, however, just as likely to get pregnant via IVF as anglo women.

The newer study is smaller and included only patients at one clinic. Also, nearly all the Hispanic study subjects were Mexican-American, unlike the larger, national study. It also showed that while getting pregnant is comparable in terms of percentages, Hispanic women were more likely to miscarry, although the researcher, Dr. Robert Brzyski, says that's likely a chance occurrence.

Of particular interest is the clear difference in cause of infertility between whites and Hispanics. White women had more endometriosis and Hispanic women were more often diagnosed with tubal factor infertility.

Tubal blockages and resulting infertility were the original reason for IVF being invented. As long as other factors aren't impacting a woman's chances for pregnancy success, using IVF to work around tubal factor infertility is very effective.

Like Dr. Brzyski's practice, Houston Fertility Center is in the middle of a richly diverse metropolitan area. With Spanish-speaking staff and educational efforts within the Hispanic community, we provide every opportunity possible to bring home the message to women that infertility is treatable. I'm happy to be able to add this piece of good news to our message.

~Sonja Kristiansen, M.D.

How Many IVF's Is Enough?

Yesterday I wrote about the importance of perseverance in fertility treatment. And in light of research that says "more IVF attempts equals greater chances of success" plus my concurring with Dr. Rosen's comment that likelihood of success per cycle decreases... here's my explanation of what sounds like conflicting stances:

There are so many facets that add up to IVF success or failure, we potentially learn something each time we use this technique for a patient. I use every tool I have -- the latest research findings, my years of experience in treating infertility, state-of-the-art equipment, highly skilled staff -- and still must approach each patient as a unique situation. Every body is different.

So any treatment cycle is an opportunity for us to find out more about how this body responds to various components of the IVF journey. When subsequent treatments are required, I take what we've learned, adjust the plan accordingly, and continue to observe the results carefully. Try again.

Decreasing success per cycle may not be related to the failure of the IVF technique itself, but to an organic sort of patient-screening dynamic.

For example, a patient chooses to undergo IVF. Her diagnostic workup reveals a potential reason for her infertility thus far, and we believe IVF can help resolve this issue. Her first IVF attempt does not result in a pregnancy, yet through that experience we learn something else about this patient's fertility factors. We decide on parts of the IVF process to change -- we may tweak the medication protocol, or use some additional technique or tool -- and we all try again. If we continue in this manner, the IVF process may wind up revealing even more causes of this patient's infertility with each treatment cycle. In most cases, after paying careful attention to a patient's IVF responses and adjusting the next cycle accordingly, success -- a healthy pregnancy -- is the outcome. For some, the result is coming to terms with the need to move forward, either with a different treatment technique or to adoption or to living child-free.

So in some situations, each procedure adjustment we make whittles away at the possible infertility causes until finally, we determine that IVF either is or is indeed not the answer for this patient. But there may have been no way to determine that fact if IVF had not been tried.

Of course, passing time is one of the biggest factors for decreasing success rates per cycle. Especially for women who are already in their 30's when they start fertility treatment, the natural biology of the female results in fewer chances for pregnancy as her body ages.

To some extent, medical treatment -- not just for infertility, but other conditions as well -- involves taking risks. My fellow practitioners and I always first balance the risk of harm to a patient versus the potential success of treatment. Each patient is different, not only in their body's responses to treatment, but in attitude and ability to move forward. Some are naturally more at ease taking risks, while others are more comfortable risking little. Helping patients make those choices is part of my job.

~ Sonja Kristiansen M.D.

Try, Try Again

"If at first you don't succeed, try, try again."
I can nearly hear your sighs. One of the hardest parts about infertility and its treatment is the need for perseverance. Many of my patients who are now parents will tell you that even more than peaceful patience, going through infertility treatment and keeping your sanity requires maintaining a heavy dose of "hang in there".

Recently, Australian researchers concluded that the likelihood of IVF success increases with each cycle. This is especially true for mothers-to-be who are older than 35, but even for younger women, going through an average of three IVF cycles boosts success rates up to 58 percent.

Granted, this makes common sense in a way -- the more you try something, the greater the odds you'll succeed eventually. But this isn't the first bit of research that hints at something more: the treatment learning curve and the artful practice of medicine.

of course, as Dr. Rosen points out at the end of the article in BioNews, the likelihood of success per cycle decreases, and eventually an end to treatment attempts may need to be considered for some patients. I'll discuss that seemingly paradoxical point in a future blogpost.

For now, I'll leave you to consider the reality that, yes, for many fertility patients who choose IVF, it takes more than one treatment cycle to get pregnant. As I mentioned in my last blogpost, coming to grips with treatment realities is a kind of loss. Perseverance is a good trait to muster. And when you run out of your own, borrow some from a loved one or friend. Keep trying.

More to come...
~ Sonja Kristiansen

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!

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

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.

How Old Is Too Old?

Recently, a local colleague of mine was quoted in the media about having an "an age cutoff" for fertility treatment, specifically IVF. I thought I'd enter the field to air my own thoughts on the question of "how old is too old" for becoming a mom.

In my practice at Houston Fertility Center, I don't use any particular age to determine whether a woman is "too old" to use IVF. Mother Nature will determine when a patient's body is unable to conceive. So we explore the same related variables -- egg reserve, uterine health, hormone levels -- with every patient.

Our primary emphasis is on the health of the hopeful mother-to-be.

As for IVF using donor eggs, which allows women with low ovarian reserve to become pregnant, I find that women in the age range of 48 to 50 are starting to think again about the impact (of carrying a pregnancy) on both their health and the outcome for the baby. We presently don't have enough data to clearly determine all health issues for women over 50 years old who become pregnant. Research has clarified, however, that children born to mothers in their later years have a higher risk of a number of health conditions.

As with virtually every other facet of the conception picture, a woman's age must be taken into consideration, but primarily in the context of her present health condition.

For more of my thoughts on a woman's age and her fertility, see these blogposts, too:

The Other Side of the Age & Fertility Message


Trying to Get Pregnant After 30 - Time to Panic?


ASRM Embryo Guidelines Should Improve Overall Picture for Fertility Patients

Safe Versus Affordable: Are Couples Forced to Choose?

This article on Australia-based News-Medical.Net reports that increasing numbers of twins and triplets are being born as a result of the global economic crisis.

The increase (in Australia) is due to more infertility patients requesting the transfer of more than one embryo in each IVF cycle. Essentially, in an effort to save money, couples are trying to boost their odds of pregnancy per cycle.

This is an unfortunate state of affairs, since studies have for a long time pointed to several related facts, including the bottom line that multiples and their mothers are at greater risk for numerous precarious health conditions.

Because of the many complex variables at play in each IVF cycle and in each woman's own reproductive condition and functioning, some patients must undergo more than one IVF cycle before successfully achieving a healthy pregnancy. In some cases, one treatment cycle is all that's required.

Now that the combined work of embryologists and reproductive endocrinologists has arrived at a point of making single embryo transfer a viable option for many, and certainly transferring only one or two more embryos to counteract some infertility-causing conditions, my recommendation for struggling couples is to take advantage of seasonal discounts when available.

Rather than boosting your odds per pregnancy, which in turn may boost health risks for you and your hoped-for baby, I encourage patients to time their treatment around clinics' occasional specials. For example, Houston Fertility Center is currently offering IVF for $7,950 per cycle, until June 30, 2010. We've long offered summer price cuts so that patients who typically vacation during summer months can fill their off-time with baby-making. (It's especially popular with teachers, we've learned.) At the discounted rates, if getting pregnant requires more than one cycle of IVF, you'll still be receiving affordable treatment and at a much safer embryo transfer rate.

I know the anxiety that many patients feel, about time passing, about affording treatment, and about possibly never having a baby. But I also know that all of my patients, to a person, want a healthy baby over everything else. Boosting the odds of pregnancy by narrowing down to one IVF cycle with too many embryos is not the safest way to fulfill their dreams.

Summer in Texas Means Heat -- & Babies

I've noticed in my years of practicing reproductive medicine that given every other factor, there does seem to be a calendar-based trend to conception. So I'm happy to find out about studies that point to what we've seen in our practice here in sub-tropical Houston. It appears that summer is a great time to try and conceive with IVF.

In this study, published in Human Fertility (Vol 9, No 4, 2006), the researchers looking at more than 2,700 IVF/ICSI cycles saw "significant improvement in assisted conception outcomes performed" in summer months.

They're not exactly sure of what causes the boost but they propose it may be related to production of melatonin, a light-inhibited hormone that regulates sleeping and waking cycles.

This bit of information turns out to be in many patients' favor, since summer is the traditional season to take time off from work for vacation.

We've always encouraged our patients with seasonal jobs, like teaching, to take advantage of those stretches on the calendar when they're likely to be less stressed and busy on a daily basis. IVF treatment is carefully timed, so fitting it into a more relaxed schedule is beneficial -- lessened stress has also been linked to better fertility treatment outcomes.

Not only do I consult with patients to determine best times to schedule fertility treatment, I've started offering discounts timed specifically so they can take advantage of summer months.

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!