There's More to Healthy Babies Than Good Eggs

We tend to focus on the very key component of viable egg cells in assisted reproductive technology. There's no doubt that "good eggs" are needed to make conception and pregnancy happen. A piece of the pregnancy puzzle that doesn't usually get as much attention is the impact of uterine health.

It makes sense, of course, that once an egg is fertilized, the resulting embryo needs a healthy place to implant and grow. The lining of the uterus, known as the endometrium, is that place. In cases of women with average to good fertility levels, the endometrium is primed for implantation by a variety of hormones relaying through her body. It's all part of the menstrual cycle. [Here's an explanation of how the endometrium works.] Timing is crucial -- both in natural and assisted conception -- because the lining is re-created and either used or sloughed off through menstruation on a cyclical basis, approximately every 28 days. If a woman's hormones are imbalanced, the result is sometimes an endometrium that's not ready to receive and nourish a conceived embryo. This can be a type of infertility.

We administer endometrium-enhancing medications -- such as progesterone supplementation -- to some patients, regardless of the assisted reproductive technique they're using to conceive. Ultrasound monitoring is used to view and gauge the health of the uterine lining, just as we use ultrasound to see how well a woman's ovaries are ovulating. Still, there's more to solving the pregnancy puzzle, and researchers have recently unveiled a new potential key.

A study of mice has resulted in the newly discovered connection between a protein called Hand2 and the control of the uterine lining's proliferation. The researchers' findings could eventually lead to more ways for fertility experts to help patients who have endometriosis or previously unexplained infertility.

Answering the question, "Why can't we get pregnant?" requires attention to many variables within each patient's situation. The responsive functioning of a woman's uterus is increasingly becoming the focal point of research. After all, there's a lot more to having a baby then simply creating an embryo.

~ Sonja Kristiansen

The Other Side of the Age & Fertility Message

Just on the heels of a study declaring that 30-year-old women have lost most of their 'good' eggs, comes a report out of the UK that women in their 30's and 40's are winding up "accidentally" pregnant because they thought their chances at pregnancy were up.

The claims being made by the British Family Planning Association (FPA) are that messages about women's age and fertility are "overplayed" and leading to something like reverse anxiety. The organization, with a mission of enabling informed sexual health choices, is heading up a new public information campaign to remind women that unless they're willing to get pregnant without trying, contraceptives should be used until after menopause.

One of the messages in the FPA campaign: "Fertility. You'd be surprised how long it takes to disappear."

Menopause is defined as not having a period for at least a year. Perimenopause is what we call the years leading up to that final menstrual period. Perimenopause can last from a couple of years to more than five, and some women are fertile throughout that time.

I'm in agreement that women should remain vigilant about their chances for pregnancy until they are clearly no longer fertile. However, to imply that the messages being sent (about women's age and the natural decrease in fertility) are anything other than appropriate is itself an overstatement.

Trying to Get Pregnant After 30 - Time to Panic?

Good Morning America featured a Scottish study that concluded by the time a woman is 30 years old, she's already lost 90 percent of her eggs.

That's enough to make the typical young woman panic.

We've always known that female fertility is more dependent on age than any other variable. This study points to a sharper decline in fertility than we like to believe.

Before everyone rushes to assisted reproductive treatment, though, let's remember that stress can negatively impact fertility.

Next, it's easy enough to have a consultation and do a quick work-up to determine your baseline level of fertility. That won't provide the definitive answer as to whether or not you will have a baby later, but it can certainly help a woman determine if she has an unexpected, silent infertility condition. Then, a plan of action can be put together to promote her future fertility.

Panic won't help you get pregnant. A little foresight and action can.

Coping With a Ticking Clock When You're Single

As I was exploring the Internet for fertility-related news the other day, I came up with this link to a psychologist's thoughts on single women and their biological clocks.

In "Tick-tock goes your biological clock" on Examiner.com, Dr. Paulette Kouffman Sherman makes some insightful comments on how single women might approach their natural drive to have a baby. I was frankly surprised to see that she included egg freezing as one of the alternatives to quickly tracking down a mate. Apparently, word is really getting out beyond the infertility world that we have turned a bend in family planning.

If you're single and wondering about whether fertility treatments might be your answer to quiet a clanging clock, please feel free to inquire. Don't lose precious time simply by failing to educate yourself.