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Entries in fertility (20)

Monday
Sep102012

Rabbis Urge Single, Orthodox Women to Freeze Eggs at 38

Hemera/Thinkstock(NEW YORK) -- Rebecca, an Orthodox Jew from California, was two weeks away from her marriage to the son of a respected rabbi when medication she was taking for migraines triggered a debilitating stroke.

She fell to the floor of the emergency room where she was working as a manager and broke her neck, suffering both spinal cord and brain injuries. When her fiance saw the extent of her disability, he called off the wedding.

"We did everything the Orthodox way," she said of their three-month engagement after being matched by family members. "I was in the hospital on my wedding day and they got out the wheelchair, and he was so frightened he backed off."

Now 38 and walking again, Rebecca is single, but her Orthodox faith implores her to find a husband and build a family. So she sought spiritual guidance from three or four rabbis and has decided -- with their blessing -- to have her eggs frozen for the future, when she hopes she will marry and start a family.

Doctors in the United States who are familiar with "halacha" -- or Jewish religious law -- say they are seeing more Orthodox patients who have been sent by their rabbis to freeze their eggs before their fertility wanes.

Orthodox Jews include a number of different sects worldwide, including the large Hasidic communities in New York City, which all place an importance on raising families.

"I couldn't think of a life without children because of our religion," said Rebecca, who did not want to share her name for privacy reasons. "That's the biggest mitzvah [commandment]. To bear kids and to bring them up the right way and to teach them the Torah is a woman's obligation."

Reproductive technology has perfected freezing techniques so that pregnancy rates are about the same as using fresh eggs when in vitro fertilization methods are used.

Rebecca is prepared to spend $7,000 to $10,000 per cycle to freeze her eggs with fertility specialists who can provide religious supervision.

"Most rabbis are strongly recommending this, and most should," said Dr. Sherman Silber, director of the Infertility Center of St. Louis, whose practice caters to Orthodox Jews. "'Be fruitful and multiply' is considered the first commandment."

The procedure helps make these single women more marriageable in the eyes of their communities, according to Silber.

"In truth, however, most orthodox women marry much earlier than this, often at age 20," he said. "So it is an uncommon event, but an important one for them."

About five percent of Silber's patients are Orthodox and his practice is supervised by top halachic authorities in Judaism from Jerusalem.

He recommends egg freezing "for all women who do not anticipate having a baby soon," he said. "Aging of the eggs is the critical and most important reason for the current infertility epidemic worldwide. And I would suggest well before age 38 to do that."

"We do everything we can to follow Orthodox halacha in all of our IVF practice," said Silber. "The patient can get her shots on Friday night before shabbos, and she can get her shots on Saturday night after shabbos. This is never a scheduling or dosage problem."

Rabbis also give special approval in rare cases when egg pick-up must be over the Sabbath, according to Silber, "as life trumps all other mitzvahs," including getting approval for a non-Jewish doctor.

In Israel the procedure is covered by the government. Some rabbis recommend every single woman over age 32 freeze her eggs as an insurance policy against infertility.

More women delay pregnancy for careers, but by their mid-30s their fertility dramatically drops and miscarriage rates rise. Harvesting a woman's eggs literally freezes them in time.

The first "frozen egg" baby was born in 1986, but success rates were so low that it was considered experimental. Unlike sperm, which had been successfully frozen for years, unfertilized eggs contain a lot of water and slow freezing causes ice crystals to form, destroying cell structure. But a specialized fast-freezing technique called vitrification changed all that.

Dr. Jamie Grifo, program director of the NYU Fertility Center in New York City, has done 1,100 frozen egg cycles since 2005, and recommends the earlier the eggs are harvested the better.

"Ideally, the best results are under 35, optimally in their early 30s," he said.

In his studies of live birth rates from 2003 to 2009, the pregnancy rate among 30-year-olds is 61 percent, but at age 44 it drops to five percent.

Grifo is also able to cater to Orthodox patients and has a rabbinical observer in his labs to oversee labeling and storing of eggs.

In accordance with halacha, eggs must be placed in new Petri dishes, even if they have been sterilized.

Rebecca is now in counseling with Rabbi Gideon Weitzman of Jerusalem, who is director of the Puah Institute, which for 20 years has been a "central authority" on infertility procedures performed in accordance with Jewish law.

"There is a very, very huge interface through the millennia between Judaism and medicine and technology," he said. "We've learned to go hand in hand with science."

Weitzman said freezing the eggs of single women is a real "boon" for Orthodox women who are taught at a young age that marriage and children are important.

"We get calls on this question every single week, if not every single day," he said.

Most of the time, women who freeze their eggs do not end up using them after they have found a husband and conceive the usual way.

Jewish law is "permissive" on destruction of unused eggs or embryos.

"Everybody agrees life in a Petri dish isn't life," said Weitzman.

Rebecca, who is of Moroccan Jewish descent, did not grow up in a religious family, but became modern orthodox when she was 27. She observes Shabbat (the Sabbath), prays each morning and dresses modestly in skirts below the knee -- except at the hospital, where she wore scrubs to work.

After his initial hesitation, her fiance later asked her to marry once again, but she refused.

"That wasn't an option for me after the way he behaved in my recovery," she said. "I wanted someone to be there for me the Orthodox way -- to be there for you regardless, someone who is more nurturing."

She wears a neck collar and has multiple therapies for her brain injury, which makes her processing slower.

"As an OR manager and director, I was, all the time, very active," she said. "But now, it's sometimes hard to read a book. I get fatigued easily."

She has been told she can never do nursing again. But with a helping husband, she said being a mother one day is possible.

"I know that I have a long road to recovery and my self-esteem went down," she said of her broken engagement.

Still, she eventually wants to go back to dating and find a husband.

"I feel hopeful," she said. "I am a very positive person. Thank God, I never got depressed and my religion has helped me a lot."

Copyright 2012 ABC News Radio

Thursday
May172012

Egg Yolk, Soybean Oil Drip to Treat Infertility?

iStockphoto/Thinkstock(LONDON) -- Four rounds of in-vitro fertilization couldn’t help Sara Conyers conceive, according to the U.K.’s  Daily Mail.

But the fifth time was the charm for Conyers, 33, who now has twins. Conyers says the only way she could get pregnant was with the help of an experimental fertility method called intralipid infusion, Conyers, who lives in the U.K., told the Daily Mail.

The procedure, more commonly used in the U.K. than in the U.S., is used to supplement another fertility treatment, such as in-vitro fertilization.  The woman is intravenously given a fat solution consisting partly of soybean oil and egg yolk.

Some experts who tout its success say it can prevent miscarriage by limiting activity of overactive so-called natural killer immune cells found in the body that would otherwise destroy the embryo.

But many fertility experts in the U.S. are not so sure about its effectiveness, since there are no definitive studies to suggest that the method works or is even safe.

“Before I can endorse this theoretical therapy for my patients, I need at least some evidence,” said Dr. Michael Murray, director of reproductive endocrinology and infertility at Northern California Fertility Medical Center.

This procedure is one of many that some of Murray’s patients ask him about, who are “grasping at straws for a solution to their recurrent miscarriages,” he says.

And some experts agreed, comparing the fertility-boosting procedure to others that are seemingly inexpensive with unknown risks for side effects, such as herbal supplements.

Previous studies done on animals or in lab dishes have found conflicting results about whether intralipid infusion works. Studies are also conflicted about the role that natural killer cells play in fertility.

“Most of the time when IVF fails, it is due to the quality of the embryos that were transferred and not the immune environment in the uterus,” said Dr. Tamer Yalcinkaya, section head of reproductive endocrinology and infertility at Wake Forest Baptist Medical Center.

If the scientific evidence supported the claims, intralipid infusion may benefit women with good quality embryos who have undergone previous IVF cycles but haven’t yet been able to conceive, said Yalcinkaya.

As for Conyers’ multiple unsuccessful IVF tries followed by one supplemented by intralipid infusion that worked, some experts say it’s hard to tell what part of that equation turned out to be the tipping point for Conyers.

“Success of a repeat IVF cycle may be a chance event and does not necessarily indicate that the need of an intervention was the cause of that improvement,” said Yalcinkaya.

Copyright 2012 ABC News Radio

Monday
Mar262012

Study: Few Women with Cancer Freeze Eggs to Preserve Fertility

Siri Stafford/Photodisc/Thinkstock(SAN FRANCISCO) -- Few women in their childbearing years with cancer opt to preserve their eggs before going through chemotherapy and radiation treatment, according to the findings of a new study.

The research, carried out at the University of California at San Francisco, surveyed more than 1,000 women ages 18 to 40 who were diagnosed with five different cancers: leukemia, Hodgkin's disease, Non-Hodgkin Lymphoma, breast cancer and gastrointestinal cancer.  The data showed that only 61 percent of the women had received counseling on infertility and only 4 percent of women overall pursued fertility preservation.

White women who were younger and college-educated were among the most likely to receive counsel on fertility options from their doctors.

"There remains a large unmet need for fertility preservation," said Dr. Mitchell Rosen, lead author of the study and director of the UCSF Reproductive Labs and Fertility Preservation Program.  "Chemotherapy and radiation save lives, but they potentially compromise the ability to carry on a legacy, something that we all may take for granted."

Just as it is automatic for patients to consult with a plastic surgeon to discuss reconstruction after a mastectomy, Rosen said fertility consultation should be a part of the process, as well.  But, while reconstructive surgery is covered by health insurance, fertility preservation is not, and it can cost as high as $20,000.

It is difficult for an oncologist to predict whether a woman will be infertile after her cancer treatments, but age and the type and dose of chemotherapy given factor into risk.  Because of this, a good working relationship is needed between the oncologist and the fertility specialist to provide options to women, said Dr. Jennifer Litton, assistant professor of breast medical oncology at MD Anderson Cancer Center in Houston.

"This conversation needs to happen early during treatment decisions in order to have enough time to stimulate and retrieve the eggs before chemotherapy needs to start," said Litton.  "There are certainly…some cases where it may not be appropriate as the treatment cannot wait the potential two- to six-week delay."

Copyright 2012 ABC News Radio

Friday
Mar162012

Vigorous Exercise May Delay Pregnancy; But Not for Overweight, Obese

Hemera/Thinkstock(BOSTON) -- Fertility experts say exercise is important, buy maybe not how you'd expect. Women trying to get pregnant should ease up on working out, new study findings published in the journal Fertility and Sterility say.
 
The study, authored by Lauren Wise, an associate professor of epidemiology at Boston University School of Public Health, was based on a sampling of more than 3,600 Danish women age 18 to 40 who were trying to conceive. Researchers found that healthy women who do such high-intensity exercise as running, cycling, swimming and aerobics may be cutting down the odds of conception by overworking the body and preventing ovulation.
 
One exception, however, was found among overweight and obese women. High-intensity exercise was associated with a shorter time to pregnancy for this group.      
 
Such moderate exercise as walking and golfing was associated with shorter time-to-pregnancy, suggesting that all women seeking pregnancy may benefit from some exercise.

Though reseachers found no direct causal relationship between longer conception periods and intense exercise, they controlled factors which could justify the long delay to getting pregnant, such as caffeine or alcohol consumption, smoking habits, frequency of intercourse or other childbirths.
 
The message, Wise says, is if you're having trouble conceiving, you might try to lighten up on the heavy workouts and switch to lighter activity.
 
Copyright 2012 ABC News Radio

Thursday
Jan122012

In IVF, Is Three Embryos Too Many?

iStockphoto/Thinkstock(GLASGOW) -- A new study suggests women undergoing in-vitro fertilization (IVF) should receive no more than two embryos, regardless of their age or the quality of the embryos. But some fertility doctors say the benefits and risks of transferring extra embryos still depend on the woman.

In IVF, a woman’s eggs are fertilized outside of her body and the resulting embryos are transferred into her uterus. Because not all embryos will successfully implant and result in pregnancy, doctors often transfer more than one -- a practice that increases the odds of multiples and, consequently, the risk of complications.

The British study, which was based on a review of more than 120,000 IVF cycles yielding 33,514 live births in the UK, found a higher live birth rate and lower complication rate among women who received two embryos compared with women who received three, regardless of their age. Transferring two embryos was associated with a higher live birth rate than transferring one, and the live birth rate was lower among women over 40, irrespective of the number of embryos transferred.

“In older and younger women, the transfer of two embryos was associated with greatest live birth rates,” the study authors wrote in their report, published Wednesday in The Lancet. “A clear implication of our study is that transfer of three embryos should no longer be supported in women of any age.”

The American Society of Reproductive Medicine and the Society for Assisted Reproductive Technology currently recommend transferring no more than two embryos in women younger than 38, no more than four embryos in women aged 38 to 40, and no more than five embryos in women 41 to 42.

Copyright 2012 ABC News Radio

Wednesday
Jan042012

Spike in Twins Tied to Fertility Treatments

Michel Tcherevkoff/Getty Images(WASHINGTON) -- The twin birth rate among women age 35 to 39 has jumped by nearly 100 percent since 1980, and among women over age 40, the rate has increased more than 200 percent, a new government study finds.

Epidemiologist Joyce Martin is the lead author on the study, by the National Center for Health Statistics, part of the Centers for Disease Control and Prevention.

"Mothers of all ages and all races and from all parts of the country are having more twins," said Martin.

The study finds that from 1915 through the 1970's, the twin birth rate was stable, at about 2 percent of all births. By the early 1980's though, multiple births began to increase.

"The number of twins more than doubled between 1980 and 2009 and the twin birth rate rose by three-quarters or 76 percent," Martin said.

If the birth rate had not changed, 865,000 fewer twins would have been born in the U.S. in the last three decades.

Much of the increase can be linked to the success of infertility treatments, but not all. Authors say that women overall are waiting until they are older to have babies, and studies have found that hormonal changes in women over age 35 increase the chance of multiple births.

A 2006 study from the Netherlands found that older women had a higher level of a hormone which stimulates egg production in the ovaries. So older women were more likely to release more than one egg during their monthly cycle.

Still, the study found that, not surprisingly, two-thirds of the increase in twin births in the past few decades is linked to infertility treatment.

"The good news," said infertility expert Dr. Robert Stillman, is that there are a lot more kids out there from successful fertility therapies, and a lot of them are doing great. But he added, "The bad news is that twins are still complicated."

Twins are more likely to be born early and at a lower birth weight. Stillman, who is the medical director of Maryland's Shady Grove Fertility Reproductive Science Center, said 14 percent of twins are born very prematurely, compared with fewer than 2 percent of single births.

Stillman says as infertility treatment improves, the "goal is to eliminate twins." He added, "The triplet rate and the quadruplet rate has plummeted, and the twin rate is the next thing we have to attack."

There's evidence from the new government study that that's starting to happen. Researchers found that the rate of twin births is still increasing every year, but the annual increase has slowed since 2005.

Stillman says he's seen evidence of that at Shady Grove, the nation's busiest infertility center. In 2009, 21 percent of patients trying to get pregnant had a single embryo implanted. In 2010 that jumped to 37 percent, and he expects the 2011 percentage to be even higher.

So while the twin birth rate remains higher than ever, it's likely to level out in the years ahead.

Copyright 2012 ABC News Radio

Tuesday
Nov292011

Can Wi-Fi Kill Your Sperm?

iStockphoto/Thinkstock(NEW YORK) -- Attention all men: You might want to keep your laptops, smartphones and other Internet-browsing tools away from the family jewels.

A new study, albeit a small one, suggests that using Wi-Fi may damage sperm and decrease a man’s fertility. The cause is electromagnetic radiation generated by wireless communication.

In the study, published in the journal Fertility and Sterility, researchers took semen samples from 29 healthy volunteers and placed them under a Wi-Fi-enabled laptop connected to the Internet. After four hours, the semen suffered -- 25 percent of the sperm were no longer swimming and nine percent of them showed DNA damage. Semen samples kept near a laptop that was turned on but not connected to the Internet showed minimal damage, as did samples that were stored separately.

“Our data suggest that the use of a laptop computer wirelessly connected to the Internet and positioned near the male reproductive organs may decrease human sperm quality,” the authors wrote in the study, noting that they were unsure if their findings extended to all wireless devices or if there were other conditions affecting sperm quality.

The findings fuel anxiety for the millions of men who keep a number of Wi-Fi-enabled devices on their laps, in their pockets and in close proximity to their nether regions.

According the American Urological Association, nearly one in six U.S. couples have difficulty conceiving, and about half of the time, the man’s fertility is the problem. For optimal fertility, a man should have 70 million sperm per millimeter. Some research has found that environmental factors can lower sperm counts below this level.

A study published in early November indicated that the heat generated by holding a laptop on the knees was enough to raise testicle temperatures to dangerous, sperm-damaging levels, even after 10 to 15 minutes.

Smoking and excessive alcohol are obvious culprits in depleting sperm, said Shanna Swan, director of the Center for Reproductive Epidemiology at the University of Rochester School of Medicine. She also told ABC News that men who are worried about their fertility might think about eating organic foods to avoid pesticides that might lead to less viable sperm. Eating a healthy diet and getting regular exercise doesn’t hurt either.

Some scientists say they don’t believe using a laptop will make men infertile. But just in case, maybe consider using our computer on your desk.

Copyright 2011 ABC News Radio

Friday
Nov252011

Man, 36, Claims Ex-Girlfriend Stole Sperm to Impregnate Herself

Getty Images(LONG ISLAND, N.Y.) -- A father of 4-year-old twins is claiming his ex-girlfriend stole his sperm and impregnated herself at a fertility clinic and is now suing for full custody of his sons.

Joseph Pressil, who currently lives in Long Island, N.Y., had moved to Houston, Texas to be with his ex, and even bought a house there. Now, he says, he has no plans to go back.

"This was so shocking to me," Joseph Pressil told ABC News. "I met her in Miami, Fla., in May 2006. I remember that day," said Pressil, 36. "That was the beginning of the end."

The couple broke up at the end of November that same year and just three months later she told him she was pregnant. They eventually proved paternity with a DNA test, and Pressil, a telecommunications manager, began paying more than $800 a month in child support.

Then, this February, he discovered a receipt in his mailbox for sperm cryopreservation.

Confused, he called the company that had sent him the paperwork, Omni-Med Laboratory. They referred him to the Advanced Fertility Center of Texas where a manager asked him to sign a medical release form.

He told ABC News that he never heard back, so he decided to pay a visit in person. According to the lawsuit, the manager said the clinic assumed he and his ex were married when they performed the successful in vitro fertilization procedure that resulted in the birth of his twins. The clinic refused to share anything more because of the HIPPA privacy rule.

Pressil confronted his ex, who according to him said, 'Oh you're not stupid. I thought you knew.'

Now, he says, her behavior during sex makes more sense.

"At the time she was giving me these condoms, and she said because of her fibroid these condoms were not lubricated, and would not affect the fibroid enlargement," he explained. "Every time she would give me these condoms after the sex she would leave the room. She'd come back, give me something to drink. We always had sex in the morning and she'd say she had to go do something. She would leave about 10 or 15 minutes afterward."

According to the Mayo Clinic website, sperm ejaculated outside of the body can survive, at most, for a few hours.

Pressil says he never discussed IVF with his former girlfriend and they had never intended to have children.

Under Texas' Uniform Parentage Act, an unmarried man must consent to the use of sperm for assisted reproduction, and that consent "must be in record signed by the man and the unmarried woman and kept by a licensed physician."

The clinic claims to have that document, but Pressil told ABC News his signature was forged and "doesn't match."

That's why Pressil's lawyer, Jason Gibson, says this is a case of theft.

He currently has joint custody of the children, and plans to seek full custody "because of all her scandalous ways."

In the lawsuit he's asking for a jury to determine how he ought to be compensated for child support and mental anguish.

The entire incident is simply "embarrassing" he said. "How do you let someone do that without knowing?"

Copyright 2011 ABC News Radio

Wednesday
Nov092011

Fertility After Cancer Treatment Aim of New Free Program

Getty Images(NEW YORK) -- Many woman who battle cancer, also face the loss of their fertility.

Age is a large factor in fertility in general, and how that fertility is affected by cancer treatment is no exception.  The types of drugs used to treat the cancer are also factors, but overall, the older the woman is, the less likely it is that her fertility will not return.

But what about younger women facing cancer treatment? According to Dr. Drew Tortoriello, medical director for the Sher Institutes for Reproductive Medicine, nearly 70,000 women under the age of 20 are diagnosed with cancer every year and Tortoriello hopes to offer them a chance to rescue their fertility.

Tortoriello estimates that nearly 50 percent of women lose their ability to have children a few months after chemotherapy and radiation.

For many women, the only possibility of holding on to their fertility lies in a cycle of harvesting their eggs, scheduled in between the cancer diagnosis and the on-set of chemo and radiation treatment.  And this safety net comes at a price.

“A cycle of IVF for the most part costs in the range of about $10,000 to $15,000. So it can be very cost prohibitive for people. Unfortunately, insurance is very, very hit or miss in terms of its coverage,” Tortoriello explains.

But Tortoriello and his colleagues at the Sher Institutes for Reproductive Medicine came up with a way to try to help. “Fertility Rescue is something that the physicians at the Sher Institute got together about maybe six months ago, and decided it was going to be our way of dealing with the infertility issue facing cancer patients…those who can never afford it, are actually going to be able to afford it because we are offering it essentially completely free.”

Vianney Ferdinand was the first patient to participate in the Fertility Rescue Program at the Sher Institutes for Reproductive Medicine.

After her bi-lateral mastectomy, but before beginning chemo and radiation, Ferdinand underwent a 10-day process to harvest her eggs and fertilize some of those eggs with her husband’s sperm.

Most oncologists recommend that women wait two to five years before trying to conceive, either naturally or otherwise. Ferdinand is aware that there are no guarantees with fertility, but she is optimistic and plans to add to her family in a few years.

Because this program is so new, Tortoriello does not have any statistics on the Fertility Rescue Program producing children to cancer survivors, but he remains confident that he will be helping many women in the months and years to come.

Copyright 2011 ABC News Radio

Tuesday
Oct182011

Guiliana Rancic: Fertility Treatments and Breast Cancer

Dan MacMedan/WireImage(NEW YORK) -- Guiliana Rancic has attributed her breast cancer diagnosis with her efforts to get pregnant. But could her fertility treatments have contributed to her diagnosis?

Specialists in breast cancer and fertility say no. Studies so far have shown no increased risk in women undergoing fertility treatments and the occurrence of breast cancer.

"Right now there is no convincing evidence that IVF causes breast cancers," Dr. Jennifer Litton at MD Anderson Cancer Center in Houston told ABC News.

"We need further follow-up and long-term studies," she said, adding, "We are actively evaluating the effect of IVF on breast tissue."

Rancic, the 37-year-old E! and Style Network host, has long documented her struggle to have a baby on her Style Network reality TV show Giuliana and Bill, with husband Bill Rancic, the first Apprentice winner. Her first round of in-vitro fertilization ended in a miscarriage and the second failed to work.

It was during her third round of IVF that her doctor insisted she undergo a mammogram first, since pregnancy could accelerate the spread of any potential cancer. That's when a tumor was detected.

Rancic said her prognosis is good, having caught the cancer at an early stage. "I will be OK, because I found it early," she said.

She will undergo a lumpectomy later this week, followed by six weeks of radiation therapy.

"We are grateful that thanks to early detection, Giuliana is expected to have a swift and complete recovery," E! said in a statement to ABC News, while it applauded her decision to go public with her diagnosis, "in the hope that it will encourage women everywhere to take necessary and preventive measures."

Rancic, who already had embryos retrieved in her latest round of IVF, still plans to pursue pregnancy after her breast cancer treatment.

"I still want this baby," she told NBC's Today. "What's amazing is that baby will have saved my life. If I had gotten pregnant later down the line, I could have been a lot sicker."

Litton doesn't see a problem with Rancic trying to get pregnant.

"Finding cancers early with appropriate detection there are very high cure rates," Litton said. "And it does not take future motherhood off the table."

Dr. Jennifer Mersereau, director of the fertility preservation program at University of North Carolina at Chapel Hill, said that for those who have had breast cancer and wish to become pregnant, studies are "very reassuring that there is not an increased risk of [cancer] recurrence."

As for their chances of conceiving afterward, Mersereau said there is not a whole lot of data. Age at the time of diagnosis, type of treatment and previous fertility history are all factors that can play a role.

Rancic said she was dragged "kicking and screaming" into her mammogram, something she had planned to do at 40. Like 85 percent of all women with breast cancer, she did not have a family history of it.

Rancic shared the following message with women: "A lot of us think we're invincible...but we have to start putting ourselves on the to-do list. I had a friend call me yesterday, and she said, 'I'm so sorry, can I do anything for you?' And I said, 'Just call your doctor tomorrow and make an appointment. That's what you could do for me.'"

Mersereau said women under 40 shouldn't rush out to get mammograms. Age 40 is still considered the baseline age. But women should tailor their screening depending on many factors, including their family history, Litton said.

Copyright 2011 ABC News Radio







ABC News Radio