The AFA Blog

Rachael Zoe's Next Project

by Merry Armentrout

 Baby rumors have swirled for weeks around celebrity stylist Rachael Zoe, and The American Fertility Association is excited to hear the rumors are in fact, true!

“Hey everyone!” The Rachel Zoe Project star tweeted today, “I want to officially confirm to my loyal friends and followers that I am pregnant!” Zoe continued, “I feel great, Rodger and I are beyond excited and so thankful for all of your love and support.”

The final episode of The Rachael Zoe Project Season 3 showed the Stylist to the Stars visiting a fertility clinic with her husband, Rodger Berman.  After meeting with her physician, Rachel expressed her obviously heartfelt concern that after spending 15 years building her career, and now finally being ready for a family, she's being told it might be too late.

This moment is important for two reasons. The first, no matter who you are or what you do, the biological clock is a real thing and can't be ignored, or washed away by fame. Second, Zoe's forthright honesty  has helped to educate millions of viewers by continuing the conversation about infertility, a subject often associated with shame or embarrassment that is in fact  a reality that won't go away no matter how long you try to ignore it. In fact, the longer you wait, the worse it gets.  

Surprisingly to many, one in 8 couples in the U.S. is infertile.  The American Fertility Association's goal is to have everyone not only know this statistic, but more importantly understand this statistic.  Many couples will be diagnosed with unexplained infertility - a frustrating prognosis for both the doctor and the patient. Something about infertility that is 100 percent certain- age and female fertility are related. The probability of a woman conceiving decreases 3-5 % per year after the age of 30, and at a faster rate after 40. 

One step to overcoming infertility is being aware, and being aware at an early age. That's why The AFA is launching a speaking tour at college campuses in 2011. We'll be talking with young women and men about navigating career, education and family, all with the biological clock ticking in the background. Though there are advancements being made in fertility treatments, there are no treatments for "turning back" the biological clock.

To Rachel: we're thrilled your story ended positively. Congratulations and our sincere best wishes to you and Rodger for a happy, healthy baby. And thank you. Thank you for sharing your story. It's one that we hear far too often, and sadly one that doesn't always end with a baby. We hope that many of your fans - especially the young women who look up to you as a role model - heard the message and will pay attention to it as they seek out what is best for their lives. We would be honored to work with you in the future to bring this message to as many young women as possible.

 

 Photo of Rachel: www.Style.com

Video: www.Bravo.com

A Baby at Last

 

by Carolyn Berger, L.C.S.W.

As those of you who religiously follow the AFA Blog know, Wednesday night’s

Illuminations NYC fundraiser was a remarkable success.

 My favorite part of the evening was giving Dr. Zev Rosenwaks, Dr. Marc Goldstein, and Mark Fuerst our Media Award for their recent book, A Baby at Last.

 If truth be told, I was just a bit anxious before getting up in front of our 170 guests. Would I suffer from “brain freeze,” forget someone’s name, or, even worse, trip on the step up to the stage?  To make matters even more dicey, I decided a minute before I went up that I wouldn’t follow my script, but would speak from my heart instead.  I just didn’t feel that what I had written was enough.

 So I got up there and told people that after I finished reading the first chapter of the book, “You Are Not Alone,” I knew I had to get a second copy.  I counsel fertility patients in two separate offices, and I wanted this book by my side in both places. It would make me a better therapist.

 I’ll tell you why.  The book takes the very complex world of fertility treatment and simplifies it—something that patients and clinicians alike can appreciate.  It intersperses scientific information with vignettes of true-to-life couples struggling to have babies—and it imparts hope.  Each chapter ends with “Take-Home Messages,” which cull the essential ideas and can act as quick reference points for busy patients who don’t have time to re-read chapters looking for one important piece of information.

 Something else I like about the book…. In a world where female fertility issues often take center stage, Dr. Zev Rosenwaks and Dr. Marc Goldstein, both of Weill Cornell Medical Center, have joined together to give male and female fertility equal play, including chapters on both male and female fertility evaluations and treatments. (This is all to the good since while male and female factors each count for 40% of cases of infertility, male-factor infertility has not gotten the attention it deserves.)

 So, my introduction of our Media Honorees went just fine in the end.  Dr. Zev Rosenwaks took out a sheaf of papers when he reached the podium—and then put them aside.  He spoke from his heart instead.  Dr. Marc Goldstein did the same. And Mark Fuerst followed suit.

 It was just that kind of evening, hopeful and celebratory all at once, and when I went home I was smiling.

 Carolyn Berger, LCSW, is Founding Board Chair of The AFA.  She has a practice devoted to Fertility, All Forms of Family Building and Adoption in Westchester and Manhattan.

 

The Mysteries of Funny Looking Sperm

by Craig Niederberger, M.D., F.A.C.S.

I was at a meeting recently, and one of the hottest topics of discussion was sperm shape. We call it “morphology”, and it’s how sperm look under the microscope. A technician counts up the number of normal looking sperm, and reports the percentage of the total. Here’s the odd part: with fairly generous criteria, (like normal means one oval head with one tail,) only about a third of a man’s sperm look normal. That means, for most men, most of their sperm are funny looking.

Is that a bad thing? Well, we all managed to get here with fathers that had for the most part funny looking sperm. Was it the best looking sperm that found its way into the egg and made you? That’s the million dollar question, and one for which we don’t yet entirely know the answer.

There are two ways to measure the look of sperm. One is using the World Health Organization (WHO) criteria, which for the most part say that if a third of sperm look fairly normal, the whole lot are O.K. These criteria have been around for a while, about a half century. The new kid on the block is about twenty years old, and uses a much stricter definition to call a sperm ‘normal’. Thinus Kruger invented this stricter system, and so it’s often called ‘Kruger morphology’ or ‘strict morphology’. To calculate strict morphology, the technician takes measurements of the sperm, and if any are outside the normal range, the sperm is counted as abnormal. The usual cutoff for strict morphology is 4%, which means that 95% of your sperm can be funny looking, and you’d still be considered to have normal morphology. That should give you an idea of how oddly shaped most sperm are in the typical male.

One big challenge in assessing morphology is that even though it appears to be an objective way to describe sperm shape, it still includes a great deal of subjectivity on the part of the technician. The technician is like a referee. Sometimes he or she will let a sperm pass the shape test, sometimes not. From some labs, almost no sperm are called normal in shape. So the first thing you’ll want to do if you’re told that your sperm are especially strangely shaped is to have the test repeated, preferably at a lab that does a lot of semen analyses.

For as many scientific studies that say morphology predicts how sperm do, there are those that say it doesn’t. You might think, as I did, that if a man has especially odd looking sperm, it would affect the chances of sperm getting into the egg and be a good reason to have the sperm injected into the egg using intracytoplasmic sperm injection (ICSI). ICSI is a technique used in in-vitro fertilization (IVF) where the sperm is injected directly into the egg. But in 2007, Keegan and colleagues published a study which reported that there was no advantage to using ICSI for semen with an abundance of funny looking sperm, meaning they did just as well getting inside the egg by themselves as men with “normal” looking sperm.

What does this all mean? Well, it could mean that sperm shape counts, but we don’t yet know how to measure it correctly. Or it could mean that the sperm shape doesn’t have much to do with its function–in other words, the shape of the boat doesn’t say much about how good the captain is that’s piloting it. I don’t know which is right, and I don’t think anyone does yet. So if someone tells you that your sperm is funny looking, don’t despair. It might not be the thing keeping you from becoming a father.

Craig Niederberger, M.D., F.A.C.S. is a highly published author and editor, and head of the Department of Urology, University of Illinois at Chicago. His blog, Male Health, and other writings will be syndicated on this page for The American Fertility Association's readership 

The assumptions we can make of those with fertility challenges

by Maria Portella

One life lesson that I always seem to never quite learn is that you should never make assumptions about others, because you can realise how wrong you are if you do so without asking any questions or getting the facts.  I was very recently reminded of this all over again.

We were talking about someone that we actually don't know, who we had heard was having fertility challenges, and who we were told had said did not want to do IVF.  The assumption made was that the person had investigated this with fertility specialists before coming to that conclusion. But it then transpired we may be wrong and I felt very bad.

Here's the thing - even those of us that battle with fertility issues can forget that everyone's experience is different.  We shouldn't assume anything.  We cannot assume to have an idea of what that person's feelings and thoughts are, and we shouldn't even for a nanosecond pretend to try and second guess.  This whole situation certainly made me think a little more about the issue of fertility challenges.

• It can cause a great deal of anxiety and we all react to it in a different way.  In someone like me who is such a 'do-er', it translates into wanting to do all the investigation and steps I can to work out what I can do to increase the chances of a successful pregnancy.  In others that anxiety can have a paralyzing effect.  And there are others who are very relaxed about their chances of success and feel that there is nothing which they need to do.  Some of us may need help however, to relax, some of us may need someone to lend us a hand to help us out of our 'mind fog' and some of us may need nothing more than a friend or someone to be there.  The biggest challenge is for the person themselves to work out which type they are and for others to help them in this process - this sounds easy but it can be very hard.
• There is an assumption that the cure to all fertility issues is IVF.  Because it is so popular nowadays, we take for granted that this is the only way to go in order to deal with fertility issues but actually that is not the case.  There are some fertility specialists who are of the view that people move on too quickly to IVF before trying other things first.  And if someone feels that IVF is not for them, for whatever reason, they really shouldn't feel there is nothing they can do.  There are certainly lots of things people can try besides IVF which can be helpful and many promote natural fertility remedies.  My personal view is that the two can be complementary - you can pursue traditional medicine and also do natural things like reduce toxins, for example eat organically and do acupuncture to maximize your chances; but you should be open with your practitioners as to what you are doing to be sure the two do not clash with each other.  And we should never criticize someone if they don't want to do IVF - it is a personal choice, we should remember to be supportive to alternative things they may wish to try.  In my opinion, people can sometimes be too quick to dismiss natural and alternative remedies.
• We should never forget to stretch out a hand to others - you can never make someone come to you for help, but you can extend a hand and say you are there if they need to speak or point them in the direction of someone who can help.  Even if you don't know the person, be there for them, particularly if you know what it is like to be there yourself.   
• I realized how lucky folks in the US actually are.  There are many wonderful organizations such as The AFA that are there to help support folks through their family building experience.   These organizations are truly active, enthusiastic and progressive.  Speaking with counterparts back in the UK,  I realize how much more the help and support in that country is ad hoc and just not on the same level - it is changing and getting there, but not quite yet.  (If any UK person is reading this and doesn't agree I apologize - this is just my personal view.)

 So where does this all take me?  Well probably not very far.  But if nothing else it underlines to me how difficult and challenging dealing with fertility issues is.  Nobody should ever underestimate this and assume that everyone reacts the same way.  Stretch out a hand and seek to understand the person.  This isn't about you - it is about them.       

Maria Portella is originally from the U.K. and now resides in the West Indies.  Her special interest is promoting better education about fertility amongst working women.  She reached out to The American Fertility Association because she wished to share her story.

Photo: Courtesy M. Portella