The AFA Blog

Can You be a Poor Responder and Get Pregnant on Your Own?

by Fred Licciardi, M.D.

So a little story about a couple I saw recently. She was a poor responder with borderline FSH levels, normal tubes and a favorable age. He had low sperm counts. They had been through IVF. I suggested that he see a urologist because maybe there was something that could be done to improve his counts. She still ovulates every month, so by upping the odds on the sperm side, maybe they could get lucky and get pregnant on their own.

My statements were very surprising to them. They had been told that because of her “fertility status”, meaning her FSH was a little high, pregnancy could not occur naturally, so why bother with the sperm.

This may be close to accurate but it is not completely true. Unfortunately, many couples with significant fertility problems never get pregnant, but for some, the pregnancy rate per month is not zero. Even if it is ½ percent per month, after a year, a few women with normal tubes, borderline FSH levels and good sperm will get pregnant (age helps).

Can you count on it?  No, but if there is something fixable, you might as well explore the options.

This is also the reason that some doctors suggest a laparoscopy after many failed IVF cycles. Even if the odds of tubal disease are low, correcting a small problem may improve the odds of a spontaneous pregnancy down the road.

Inspired by Embryo Donors

 by Craig R. Sweet, M.D.

Pay It Forward Day is April 28, 2011. The concept is pretty simple. According to the Pay It Forward Day Website, “Pay it Forward Day is all about people, from all walks of life giving to someone else and making a positive difference.” Is there a better example of paying it forward than donating embryos?

 Deciding what to do with frozen embryos is a tremendously difficult decision. Certainly, using the embryos to expand one’s own family is ideal, but some patients need to look for other options. Our goal is to decrease the number of frozen embryos that are cryopreserved indefinitely, abandoned or discarded. Donating embryos to science or to patients in need are decisions that pay it forward. While human embryonic stem cell research holds promise, its potential outcome is uncertain and may not be known for many years. Therefore, donating embryos to patients in need may be the best immediate option. Embryo donation has the potential to build families that would otherwise not exist.

 Infertility patients, when they come to the conclusion that they will not be able to have children of their own with other types of treatment, are also faced with difficult options. Adoption may be cost prohibitive, so embryo donation may be the last, best choice for them. Not only are the embryo donors paying it forward, but so are the recipients. The embryo recipients are giving a lifelong commitment to the offspring of these donated embryos.

 The reproductive facilities that have dedicated their efforts to build families through embryo donation are also paying it forward. The time, effort and complexities regarding embryo donation are daunting and reproductive facilities can certainly spend their time more profitably on other options. The practices dedicated to embryo donation feel that embryos deserve a heightened level of respect and are committed to their patients by offering an option for family building that few are able to provide.

 In a world that is increasingly complex and overwhelmingly busy, it is wonderful to know that the basic human experience is still really about caring for each other. Pay it Forward Day is the antithesis of this endeavor and who cannot be inspired by our courageous embryo donors and our committed embryo recipients?

 Pay it forward yourself on April 28 and please encourage patients with cryopreserved embryos to consider doing the same. Families are just waiting to begin.

Dr. Craig Sweet is the medical director and founder of Embryo Donation International, a private non-faith based, non-discriminatory reproductive endocrinology and infertility practice located in Fort Myers, Florida.

In a small way, Embryo Donation International has decided to make a positive difference. For every set of embryos donated, they will pay it forward by donating to one of ten international, national and regional charities selected by the donor(s), including The American Fertility Association. For more information and a full list of the designated charities, please visit www.embryodonation.com/donating-to-charity.php

 

 

 

Immature eggs and infertility treatment

by Fred Licciardi, M.D.

Say you are undergoing IUI or IVF and your doctor has told you that you have a high percentage of immature eggs.

Remember, having a rate of 10-20% of immature eggs is normal.

However, having a high percentage of immature eggs can be a function of a few things. Firstly, maybe you received the hCG too early, and waiting 1-2 more days may have increased the percentage of mature eggs. Most people on average do not have an excess of immature eggs when receiving their hCG shot, once their biggest follicles reach about 18 mm. Some women however, need their biggest follicles to be 20 or 22 mm before most of their eggs are mature.

There is no way to know this in advance of the first cycle. But, if this is the case, changes should be made for subsequent cycles and you should discuss this with your doctor.

There are some women who, no matter how long we wait to give the hCG shot, will still have a large number of immature eggs. We can’t explain why this is so.  It is simply a case of dealing with what you have.

In general, we don’t want to wait too long before giving the hCG shot because eggs can become over-mature and this could show up later as poor quality embryos.

Finding Faith this Easter

by Merry Armentrout, The AFA's Director of Communications

For Christians, Easter is a time of celebration.  I always look forward to the church service on Easter Sunday because I know the pulpit will be filled with beautiful flowers, the hymns will have a festive tone and a huge brunch will follow the service where I will try desperately not to spill anything on my  new Easter dress.  We're celebrating the Resurrection of Jesus, and a time where Christians can't help but remember the love Jesus has for his children. 

What happens when Easter rolls around and you don't feel much like celebrating?  Maybe you're dealing with infertility, undergoing IVF or in the thick of the adoption process, and you're just not in the mood to be festive.  Maybe your problem has nothing to do with starting a family, but life's other challenges have you trying to keep your head above water.  This Easter, my family is struggling to find joy, to find faith.

My father has struggled with glaucoma for years, and lost most of the vision in his right eye a few years ago.  Last Thursday, he had a minor eye surgery on his left eye, and developed a staph infection in his eye.  Less than 10 hours later he had lost all vision in his left eye.  The doctors told him this week his retina might regenerate in a year, but there are no guarantees.  Hopefully he'll be able to see well enough to read, but he will never drive again. He is legally blind. This would be hard news for anyone to receive, but one of my dad's passions is collecting antique cars, and the thought of never driving again really hit him hard.

It has been a hard week for my family. I flew home and spent hours in doctor's offices and hospitals, getting a glimpse of the hell my dad has endured.  I watched the proudest man I know, ask me to walk him to the bathroom in an unfamiliar restaurant.  I helped my mom learn how to use the computer so she can help my dad check him emails.  I heard the bravest man I know say he needs a break from the hourly antibiotic drops he has to put into his eyes- could he just skip one time?  I heard both my parents crying as we sat in church yesterday, thinking I didn't notice their tears, as I wiped my own eyes.  We're trying to adjust to a new life, but are left questioning why we were put in this situation.  My prayers are intertwined with pleas for dad's sight to return, and angry accusations as to why God would have this happen.  It's very difficult to watch someone you love so much go through something so terrible.  What I need right now is faith, and it's the one thing I'm having a hard time finding.

For me, faith is not blaming God, but trusting Him.  Trusting everything will be okay, trusting my father will find the determination to get through this and trusting the same man that raised me with such temerity, will be the same man who emerges from this battle.   I just spent the last week looking at my father's face- it was not full of faith, but fear and dejection, and my father is the ringleader of our group, the one who drags us to church every Sunday since we were children.  If he can't find faith, how possibly can I?

I don't know.  I'm sure you're looking for something more inspirational, but it's the truth.  I don't know how I'm going to find it, but I have faith I will.  I might not be in a celebratory mood this Sunday, but I will put on my new Easter dress, go to church and appreciate the beautiful flowers and uplifting hymns.  I will then turn to one of my dad's favorite bible verses.

Philippians 4:6-7

⁶ Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. ⁷ And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.

 

If I have to read it a hundred times, a thousand times, I will. I'll read it until I find the faith, until I find the peace.  And so will my dad.

I don't know what battle you're fighting, or if you're even fighting a battle at all.  But I do know it helps to realize you're not alone in battle.  My cousin always told me she smiles at everyone because you never know what that person might be going through.  Life is tough.  Life is unexpected. But as one of my favorite poets, Robert Frost said, "In three words I can sum up everything I've learned about life.  It goes on."

Might as well go with it.  And find time to celebrate.

 

 

 

This is Your Brain. This is Your Brain on Clomid

by Fred Licciardi, M.D.

Thanks for reading yesterday's post.  Here is a little more about Clomid.  Clomid, also known as Serophene, is a very valuable medication, but it can be associated with some nasty side effects.

Believe it or not, Clomid was originally devised to be used as a birth control pill. You see, it’s an anti estrogen, meaning it blocks estrogen in your body. People thought that if estrogen was blocked, pregnancy could not occur. However, the body fights back. So when you take it, it goes to your brain and your brain says “Wow, there’s no estrogen, we need to make some.” So the upper brain sends strong signals to the part of the brain called the hypothalamus, which in turn sends signals to the pituitary gland, and a larger than normal amount of FSH is produced. The FSH travels to the ovaries, and ovulation occurs.
In women who don’t ovulate frequently, this is a miracle drug. About 80% will ovulate and about 80% of those get pregnant easily.
We also use Clomid in women who ovulate like clockwork. Why? Because it does help a little. We don’t know if it helps because it creates a better ovulation, or it’s because more eggs are released. With Clomid, 50% of the time 1 egg is released, but in the other half, 2, or less frequently 3 or more, are released.
So what about those side effects? Some are physical and some are mental. Because Clomid is an anti-estrogen, it can disrupt some pretty important estrogen-dependent tissues. One tissue is the glands of the cervix that make the cervical mucus. Sometimes Clomid will thicken the mucus and this causes problems for swimming sperm. Another is the glands that line the inner uterus, the endometrium. If the lining is too thin (a subject for another day) pregnancy will not occur. An ultrasound can measure the lining, and if it looks too thin, we move away from Clomid and go to the next step.
The mental side effects include blurry vision, seeing small spots, moodiness, jitteriness and depression. Women with significant depression should not be placed on Clomid. This is a little known but important fact. An anyonomuos blogger reminded me that headaches are another side effect.
All this being said, Clomid is a drug that helps many women have babies. About 15% of women have side effects, most mild.

My Sung Hero

by Corey Whelan

 

So I want to talk about my friend Mark.  I met Mark in a cold country, which works for him because a) he skis and b) he has the clothes for it.  Me, not so much.  However, after many conversations and many years I’ve gotten to know this man very well, and wanted to share some of what I know with you.

Mark is a warrior and served his country proudly in the Army.  But that “Used to be a soldier warrior fierceness” has since metabolized into a fierce warrior like caring for his patients.  Do or die.  That is the level of his commitment to those he serves.

Mark is kind.  I am honor bound to not tell you about most of the good stuff he does behind the scenes in our world.  If I broke rank and told, Mark would be the feature lead story on 60 Minutes and in People Magazine.  Suffice it to say, for Mark, no man gets left behind.  No patient gets left behind either.  Sorry I can’t say more but I do want you to know that this man is guided by faith, and conscience.  .

Mark is honorable.  He says what he means and he means what he says.  End of story.

Mark is my friend.

The AFA is honoring Mark Bush, M.D., at Illuminations Denver this year.  I am writing this blog post on my plane on the way to Denver, but opted not  to WIIFI on this trip (glorious freedom) so I will publish this post as soon as I can.  (The glorious not connected freedom never lasts for too long).

Oh, and one more thing.  The folks at The AFA and the folks at Mark’s practice, Conceptions Reproductive Associates of Colorado, really dig each other.  In many ways, we are all renegades in this field, and we recognize that in each other.  We all do what needs to be done, we all go where it is needed that we go.  BPA and repro health?  Let’s talk about it.  Toxic nail salons and infertility?  Done. Infertility Prevention and Women Not Ever Needing an RE?  Yup, we go there too.  And towards that end, Mark Bush, M.D. is one of the only docs that I know that would use his time to talk to college women about infertility prevention.   Our gig tomorrow is at the University of Colorado at Boulder and Mark, Brenda, Ken Mosesian and myself will be speaking to young men and women about not ever needing to become patients.  Some RE’s I know if asked to do that, just wouldn’t feel it a good use of their time.  Not a good marketing opp.  Oh hush, of course not all, there are tons of unsung heroes in our field but let me tell you, Mark jumped on this opportunity, again, on behalf of young women everywhere and for The AFA.   He jumped on this non ROI, educational opportunity, for which I want to publicly say, thank you.  For all the unsung heroes out there, you are my sung one.

 And he’s done this kind of thing, behind the scenes, with The AFA for years. 

 So hat’s off to you, Mark.  You deserve to be honored.  We are honored to know you. Hat’s off to you, Dr. Bush, and to your team of amazing renegade thinkers and doers..  Ski hat’s, of course.

 See you tomorrow.

BPA & IVF

by Karin Russ MS, RN We hear a lot about bisphenol A (BPA) in the news lately.  While the federal government calls for further study of BPA, state legislatures are taking action to ban the substance in children’s products.  Even in the absence of laws limiting the use of BPA, manufacturers are responding to consumer demand for BPA-free baby and children’s products. What’s all the fuss about? BPA is a synthetic chemical added to plastics to improve their performance. Unfortunately, it also mimics estrogen in the body, and so is known in the medical world as an endocrine disrupting compound.  Currently, consumer advocacy groups are focusing their efforts on eliminating BPA from children’s products, such as baby bottles, sippy cups and toys.  This is a good start, aimed at protecting some of the most vulnerable members of our society. But because BPA disrupts the endocrine system, it may also have an effect on fertility.  Over the last decade, animal studies have found that BPA has a negative effect on the quality of eggs produced.  Now, two studies published in 2010 found negative effects on human fertility associated with BPA.  Researchers at the University of California, San Francisco looked at the level of BPA in blood samples taken from women undergoing in vitro fertilization (IVF) and compared the amount of the chemical in their blood with their chances of successful fertilization.  They found that as the amount of BPA in a patient’s blood doubled, the chance of successful fertilization was cut in half.  Another research team at the Massachusetts General Hospital Fertility Center, in conjunction with the Harvard School of Public Health, measured the amount of BPA in patients’ urine, and compared it to the number of oocytes retrieved during IVF. They found that as the amount of BPA in a woman’s urine increased, there was a proportional decrease in the amount of eggs retrieved.  The way in which BPA interferes with oocyte development is not clear.  Scientists speculate that the estrogenic compound may interfere with DNA formation or with the cytoplasm within the oocyte as it is maturing.  Regardless, it’s a good precaution for couples experiencing infertility to avoid exposure to BPA.  BPA is found in certain types of plastic and in the plasticized epoxy lining of metal food cans.  The Environmental Working Group has tested substances taken from containers made with BPA, and found that the chemical leaches into food and drinks during storage.  While occasional use of canned food or drinking from containers made with BPA may expose us to a small amount of the chemical, continued use causes BPA to accumulate in the body.  To reduce exposure to BPA, incorporate as many of these strategies as possible into your life: §   Avoid canned foods- the highest levels of BPA are found in canned coconut milk, soups, meats, beans, juices, fish and meals-in-a-can. §   Focus on fresh or frozen fruits and vegetables. §   Avoid beverages in epoxy-lined metal cans: beer, soda, juice. §   Carry liquids in stainless steel bottles.  Look for bottles that do not have a plastic liner. §   Microwave in glass or ceramic dishes- never microwave plastic! §   Avoid plastic wrap coming in contact with food. §   Storing food in glass or steel containers is ideal. §   If using plastic containers, choose items with recycling labels #1, #2 and #4 on the bottom- these do not contain BPA. §   Avoid #7 plastics.  These are polycarbonate (sometimes labeled “PC”) and contain BPA. 8,9 Karin Gunther Russ MS, RN is the National Coordinator for Fertility & Reproductive Health Working Group Collaborative on Health and the Environment.  Karin is dedicated to minimizing environmental risks to women and children and will be blogging on environmental concerns and reproductive health for The AFA throughout the next several months. She lives with her husband, three children and three cats in Ellicott City, Maryland, near Washington DC. References

1. Bishphenol A (BPA) Information for Parents.  US Dept. of Health and Human Services.  http://www.hhs.gov/safety/bpa 2. Massachusetts Becomes Latest State to Ban BPA in Baby Bottles (2011). http://www.hktdc.com/info/mi/a/baus/en/1X07BSTV/1/Business-Alert-%E2%80%93-US/Massachusetts-Becomes-Latest-State-to-Ban-BPA-in-Baby-Bottles-.htm 3.  Distinctions in Meiotic Spindle Structure and Assembly During In Vitro and In Vivo Maturation of Mouse Oocytes. (2003).  Alexandra Sanfins, Gloria Y. Lee, Carlos E. Plancha, Eric W. Overstrom, and David F. Albertini. http://www.kumc.edu/physiology/documents/DistinctionsinMeiotic.pdf 4.  Bisphenol A exposure causes meiotic aneuploidy in the female mouse. Current Biology 2003; 13:546–53. Hunt PA, Koehler KE, Susiarjo M, Hodges CA, Ilagan A, Voigt RC, et al. 5.  Continuous exposure to bisphenol A during in vitro follicular development induces meiotic abnormalities. Mutation Research 2008: 651:71–81. Lenie S, Cortvrindt R, Eichenlaub-Ritter U, Smitz J. 6. Serum unconjugated bisphenol A concentrations in women may adversely influence oocyte quality during in vitro fertilization   Fertility and Sterility, In Press, Corrected Proof, Available online 3 December 2010 Victor Y. Fujimoto, Dongsul Kim, Frederick S. vom Saal, Julie D. Lamb, Julia A. Taylor, Michael S. Bloom 7.  Urinary bisphenol A concentrations and ovarian response among women undergoing IVF. International Journal of Andrology 2010;33:385–93.  Mok-Lin E, Ehrlich S, Williams PL, Petrozza J, Wright DL, Calafat AM, et al. 8. Consumer Tips to Avoid BPA.  Environmental Working Group. http://www.ewg.org/bisphenol-a-info  9. Mission Local: How to Eliminate BPA Exposure http://missionlocal.org/2011/01/as-ucsf-study-and-others-continue-to-show-bpa-problems-whats-a-consumer-to-do/

 

A London Fertility Charity, Chana, Provides a Lifeline to the Orthodox Jewish Community

by Lisa Marsh, The AFA's London Correspondent

I recently attended the 1^st International Medical Conference in London, hosted by Chana, a not-for-profit organization serving the Jewish community.  In this ground-breaking event, Chana brought together specialists in fertility medicine, Rabbis from the UK and Europe, local GPs, midwives and counsellors, Kallah teachers (Jewish pre-marital instruction) and members of the community.

I attended the conference, titled "Facing the Fertility Challenge Together," to learn about the part that Jewish (Halachic) law and culture play in a couple's decision-making process about fertility treatment.  While Jews represent only about 2% of the population in London, and only .5 % of the total UK population, the greatest concentration of Jewish people are in the areas of Hertsmere and Barnet in North London, comprising 11% and 14% of those communities, respectively.  The majority belong to one of the Orthodox Jewish sects, ranging from the Modern Orthodox to the Ultra-Orthodox.  I think it’s fair to say that within those communities, both religious and cultural traditions govern the way that individuals conduct their personal lives.  Their Judaism is inseparable from the rest of their personal identity.  The Orthodox community favours early marriage, some still arranged by parents to ensure appropriate matches, and large families.  On the one hand, I wondered how individuals within that community cope when faced with infertility and pregnancy loss.  On the other hand, I wondered how religious leaders within the Orthodox community respond to some of the ethical dilemmas posed by ever-changing technology in fertility medicine.

Chana sprung from the need for mutual support of a few infertile, Orthodox Jewish women fifteen years ago.  It has developed into a large, charitable organization dedicated to informing and supporting infertile people across the entire Jewish community.  According to Carolyn Cohen, Principal Social Worker at Chana, they hold many fertility-related, educational programmes in the London area and have provided support through its Helpline to callers from as far away as South Africa.  Callers are not asked any questions about their religious affiliation or beliefs.  However, it must be emphasized that Chana takes a sensitive and respectful stance on the place that rabbinical guidance plays in family matters within the Orthodox community.  In the Conference guide, it is noted that “Rabbonim (Rabbis) advise members of the public to seek professional Rabbinical guidance before embarking on fertility treatment.”  

As you may expect, in practice, even among Orthodox Jewish fertility patients, some will involve their rabbis in the enquiry, discussion and decision-making process, and many others will not; afraid perhaps of what their judgment will be.  One might suspect that Orthodox Rabbis are restrictive, operating under very old-fashioned values and uninformed about matters of fertility, medically-assisted conception, the use of third party donors and new technologies.  I discovered that, far from shying away from the very progressive area of reproductive medicine, the Orthodox community is using its strong links within the medical field to educate itself about the causes of infertility and miscarriage, the emotional impact they cause upon the couple involved, the availability of treatment and its accessibility. There were 90 Orthodox Rabbis present among the 400 people attending the Conference.  Dr Simon Fishel, Managing Director of Care Fertility Group and a member of Chana’s Medical Advisory Panel, told me that Orthodox fertility patients sometimes bring their Rabbi with them to consultations in an effort to reconcile their family-building goal, their diagnosis and the medical treatment available with their religious beliefs.  According to both Dr Fishel and Carolyn Cohen, there is no one rule which governs a Rabbi’s judgment about any aspect of fertility treatment; they take each couple’s situation on a case-by-case basis. The overriding intention is to help the couple achieve parenthood if at all possible.

As in other cultures that promote large families, there is enormous pressure on Orthodox Jewish couples to conceive early and often.  An infertile couple in that situation may feel particularly embarrassed, ashamed, judged, isolated and/or excluded.  Added to that, the extreme privacy with which matters of intimacy are regarded, it can be difficult for them to seek advice and support.  Chana successfully negotiated the interests and needs of the various members of the community by providing separate, single-sex meetings for men and women, and entirely separate seminars for
Rabbis, Groom and Bride Teachers attending.  This enabled members of the packed seminars to listen to matters of marital intimacy, such as the consummation of marriage, and ask questions after each presentation without the potential embarrassment of a mixed audience.   

Some of the lectures were all about the current status in a given area of fertility medicine, such as the one on recurrent miscarriage by Prof Lesley Regan, of St Mary’s Hospital, Paddington (London).  Prof Regan carefully explained the research in which her team is involved, why miscarriage occurs and the restrictions upon investigation and treatment under the National Health System. None of the facts or figures was specific to the Jewish community.  What made this lecture and the others unique was the context in which they were made.  Care was taken by speakers to respect the particular sensitivities of the largely Orthodox Jewish, female audience, how they communicate and the level of privacy they cherish. Their cultural norms also present characteristics that form a part of the patient's history to be taken by a fertility specialist. For example:

1.       Sexual history - Patients may be very reticent about matters of sexual function and intimacy, which are generally not discussed in mixed company.  Without a full and frank discussion of their sexual relationship, her menstrual cycle and fertility health issues such as sperm production, it could be very easy to mistake very early miscarriages for a failure to conceive or vice-versa, complicating potential treatment. Understanding of the sensitivities involved, as well as religious proscriptions against consummation of the sexual relationship prior to marriage, would be essential for a good doctor-patient relationship;

2.       Genetic History - there are certain genetic mutations which affect Jewish people, which would be exacerbated by inter-marriage within the relatively small Orthodox community. One in 27 Ashkenazi Jews are carriers of the gene mutation that causes Tay - Sachs disease, while only 1 in 250 Sephardi Jews are carriers. Therefore, genetic testing may be an earlier focal point in couples who are both Ashkenazi Jews. Additionally, the usage and source of donor eggs and sperm is of particular interest, so that any potential incestuous relationships among  future generations are absolutely avoided;

3.       Emotional aspects of the patient's infertility -  Because having children is such an integral part of an Orthodox Jewish's woman's life purpose and her marriage, those who fail to conceive could feel particularly pressured, leading to feelings of anxiety, failure and low self-worth.

Chana does not limit its support to the Orthodox community; however that is largely where its users are from. Perhaps it is because Jews from other sects do not feel as strong a connection between their Judaism and the medical decisions they need to make.  However observant they may be, it may simply never occur to members of the Reform or Liberal Jewish movements to consult their Rabbi about an inability to conceive, a need for assisted conception or a decision to stop trying when IVF fails.  It is likely that they believe their needs for emotional support are adequately met by other people who are trained in talking therapies and/or infertility. While I didn’t glean any definitive information about how fertility treatment is viewed in relation to Halachic Law, I did come away with the feeling that Rabbis seek, where possible, to permit medical assistance for infertility rather than preclude a couple from having a family of their own. 

If there was one element missing from the conference, it was the absence of any personal examples of how infertility affected members of the community and how they have resolved or might be able to resolve them. I didn’t hear anyone speak publicly of their personal experience with infertility, or with their need for medical assistance and emotional support.  Questions for the speakers were carefully phrased very generally or technically, changing the nature of the intended “workshops” to more of a lecture or presentation.  It was not until I had a chance to read the very personal, albeit anonymous, stories, poetry and letters in the remarkable Chana Magazine, that I understood the unique social repercussions of infertility in the Orthodox Jewish community and how Chana’s services are a lifeline for those affected. The message was clear: no one in the community needs to bear the pain of infertility or pregnancy loss on their own. Isolation is unhelpful; reaching out is worthwhile; help is available.

Infertility, Information, and the Internet

by Iris Waichler, M.S.W., L.C.S.W.

             I recently won some prizes in an author contest.  One of the prizes was a consultation with a media expert who has been in the business a long time. I wanted to find out about keywords relating to infertility.   When we spoke he remarked how shocked he was by the number of word searches and sites relating to infertility that he discovered.  For example, people search for ovulation related topics one million times a month.  There are over 9 million places they could find information on ovulation during that word search.

            I remember when I first started my infertility treatment 12 years ago and went on line to get information.  I recall there being 169,000 places to go when I put in the word infertility.  Today it can be a mixed blessing simultaneously having access to a wealth of information and being overwhelmed by the quantity and quality of what you find. 

            It got me thinking about, how do we know where to get credible information? In my work researching infertility related topics I have seen websites ranging from getting an egg donor with a Stanford degree for $100,000 to rubbing a crystal to help with your fertility. There are literally thousands of blogs offering information and advice regarding infertility. When you are engaged in infertility treatment you are in a vulnerable position. You want accurate, easily accessible information you can trust. 

            What I suggest you do is this.  Think about your goal and the purpose of the website as you review it.  If they are trying to sell you something keep that in mind as you explore the site.  If the goal of the site is to inform or educate you, review the material carefully to ensure the information is balanced.  The people offering you information should have the appropriate credentials and expertise.  Do you find them referenced on other sites?  You can consult your doctor or trusted friends about where to look.  Established programs like RESOLVE and The American Fertility Association have a host of expert contributors.  Compare the claims of these contributors to other expert sources to feel confident that their information is accurate.

            Some people want the chance to connect with others who are in a similar position. Blogs can offer the opportunity to share personal experiences, resources and opinions.  It can be a place to find comfort, information, support, and reduce feelings of isolation.  Remember that the information found in blogs can be based on opinion or non expert advice. Spend time critically evaluating what is presented, determine the source, and think about what feels right based on your individual situation.

People go to the internet for a variety of reasons.  Trust your instincts, use your common sense, and take time to carefully evaluate the information you obtain.  Advocate for yourself as you make choices about what doctor, agency, support, and type of treatment you will have.  Remember you wouldn’t necessarily consult a stranger about how and where to get a heart transplant. Using an unknown egg donor website is comparable.   The decisions you make regarding how you approach your infertility can have far reaching consequences.  The stakes are high! If you obtain the right information you can make these decisions with more confidence.  Remember, the object is to help your family building goal achieve positive results.  I wish you good luck on your journey.

 Iris Waichler, MSW, LCSW, has a Master’s Degree in Social Work and has been a licensed clinical social worker for over 30 years.  She has done workshops, individual, and group counseling with people experiencing infertility.  Ms. Waichler is the author of the award winning Riding the Infertility Roller Coaster: A Guide to Educate and Inspire.  She currently writes freelance infertility and health related articles.

 

Leading experts bring infertility prevention awareness to University of Colorado

DENVER, Feb. 21, 2011 /PRNewswire/ -- The American Fertility Association (The AFA), a national family-building non-profit organization, is heading to college campuses around the country to educate young men and women about infertility - a disease affecting one out of 6 couples in the U.S. The 2011 College Tour Series kicks off on March 4th at the University of Colorado in Boulder with a presentation entitled "Why Mother Nature Wants You To Get Laid Right Now". Students will learn about preventing infertility by avoiding certain environmental toxins, STI (Sexually Transmitted Infection) prevention, and about the realities of the biological clock. Brenda Strong, The AFA's national spokesperson, board member, and Desperate Housewives actress, will be on hand to talk about the benefits of yoga to help alleviate stress, which can affect fertility. She will also lead a yoga demonstration for the students. Though The AFA's goal is to prevent infertility whenever possible, sometimes infertility can't be avoided. Dr. Mark Bush, a reproductive endocrinologist with Conceptions Reproductive Associates in Denver, will speak at the event so students are aware of savvy treatment options.  Executive Director Ken Mosesian and Program Director Corey Whelan will discuss infertility prevention for men and women, environmental toxin avoidance, and STI (sexually transmitted infection) avoidance.

Later that night, The AFA will honor Dr. Mark Bush with the Joyce M. Vargyas, MD, Visionary Award at the Illuminations Denver cocktail party. Dr. Bush has extensive experience in all aspects of reproductive endocrinology, infertility, and assisted reproductive technologies. He has published numerous scientific and clinical papers in the field of women's health. Recently, Dr. Bush has taken a serious interest in elective single embryo transfer in order to avoid multiple births. The AFA strongly supports the use of single embryo transfer when possible for the safety of the patient and the child.

This year's Illuminations Denver will focus on The AFA's work, empowering young men and women to take control of their fertility. Illuminations Denver will be held at Palazzo Verdi at Fiddler's Green, and special guests will include Brenda Strong, Dr. Kevin Fitzgerald from Comedy Central and Animal Planet and pianist Joseph Eisele with the prestigious Young Musicians Foundation of Colorado. The event is designed to raise much-needed funds to support the educational outreach work of The American Fertility Association.

The media is welcome, and encouraged, to attend both events. The AFA would like to thank all of our sponsors who are helping to make both of these events a huge success, including our Platinum Event Sponsors, Ferring Pharmaceuticals and Conceptions Reproductive Associates, and our Gold Event Sponsor EMD Serono. Special thanks to Disney / ABC Television Group for their support as the Charter Sponsor of our 2011 College Tour. If you're interested in sponsoring Illuminations Denver or purchasing tickets, please contact Corey Whelan at 718-853-1411.

Press Contact: Merry Armentrout Director of Communications, The AFA 205-470-9406 [email protected]

The American Fertility Association, a 501(c)(3) national non-profit organization, is a resource for infertility prevention, reproductive health and family-building. AFA services and materials are provided free of charge and without reservation. These services include an extensive online library, resource directory, hosted message boards, daily fertility news and a toll-free support line. http://www.theafa.org or 888.917.3777

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SOURCE American Fertility Association

Read more: Preventing Infertility and the Future of Fertility Treatments - The Denver Post http://www.denverpost.com/coloradocorporatestatements/ci_17442679#ixzz1EdBw9Rec
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