Fertility and Age - A Broader View

Fertility doctors are, in my view, utterly ignorant of what can and does occur in the natural world.

So concludes a guest writer over at the blog Infertility - Fertility Over 40, a history buff who has a bone to pick with all the folks spreading negative hype concerning women's age and fertility. She brings to light a slew of historical examples of women not only getting pregnant after 40, but doing it without even breaking a sweat, so to speak!  She gives some pretty compelling evidence to her cause, through anecdotal examples throughout history and also provides some good statistical back up:

Here in the UK, there were 26,419 births to women over 40 in 2008, hailed as a "record high" having nearly doubled since 1998. But let's take a step back! In 1938 there were 27,200 births to mothers over 40, at a time when our population was significantly less so that the birth rate to mothers over 40 was even higher. In fact, births to "older" mothers only really dropped with the introduction of the pill and access to abortion. 

Are our fertility doctors really that out of touch with the way our bodies work? Given our culture's tendency to over prescribe and medicate, I wouldn't find that too surprising. But there's something else at work here...

While she makes a good point, it is a medical fact that women over 35 are more likely to be affected by reproductive problems such as endometriosis and fibroids. And while this may not prevent most older women from having children, the sad truth of the matter is that older women are much more likely to conceive a child with birth defects than their younger counterparts. March of Dimes gives us the following statistic:

A woman’s risk of having a baby with Down syndrome is:

• At age 25, 1 in 1,250
  
• At age 30, 1 in 1,000
  
• At age 35, 1 in 400
  
• At age 40, 1 in 100
  
• At 45, 1 in 30
  
• At 49, a 1 in 10

Perhaps so many older women are using IVF, not only as a method of overcoming declining fertility with age, but also as a way to screen for genetic defects in the embryo.  Perhaps the media and fertility doctors are misrepresenting or misinterpreting the reasons behind the use of artificial methods of conception.  Still...she does make a good point, and takes a healthy, broader view of fertility and age.

Read the full article on Fertility Over 40

Do Infertility Drugs Raise the Risk of Autism?

image from tangle_eye on morguefile.com

Researchers at Harvard School of Public Health have found a disturbing link between Clomid-type drugs and a raised incidence of children born with autism.  An article on Time's website reviewed the data which revealed this:

A study presented Wednesday at the International Meeting for Autism Research in Philadelphia provides some of strongest evidence to date that Landes might be onto something. The study, conducted by a team at the Harvard School of Public Health, found that autism was nearly twice as common among the children of women who were treated with the ovulation-inducing drug Clomid and other similar drugs than women who did not suffer from infertility, and the link persisted even after researchers accounted for the women's age.

Moreover, the association between fertility drugs and autism appeared to strengthen with exposure: the longer women reported being treated for infertility, the higher the chances their child had an autism spectrum disorder (ASD).

The study was conducted via questionnaire, nearly 4000 nurses who had used Clomid-type drugs themselves filled it out.  Of those women, 111 reported bearing a child with autism.

While the research had some holes in it, it still presents a very compelling link between autism and Clomid.  What worries me most is why has it taken this long for these kinds of correlational studies to be done?!  Clomiphene was approved in 1967, and no one has asked if the children conceived during its use are suffering from abnormal effects?  What is wrong with our pharmaceutical companies!!!

IVF is also known to cause a high risk of birth defects, especially since most IVF procedures involve attempting to implant multiple embryos, and twins and triplets are always at greater risk. (I've already posted about alternative methods that use just one embryo, Single Embryo Transfer IVF, and Soft IVF, which also uses lower doses of Clomid-type drugs.)

 I worry that most doctors immediately resort to hormone treatments for infertility: fear of wasting time and money on phony products makes doctors and patients alike more biased towards pharmaceutical solutions.  But the truth is, these drugs are some serious shit! Take a look at  Clomiphene's Wikipedia page and one of the sections is "Use in bodybuilding", as in a follow up to a steriod cycle (!), and we all know that bodybuilders get pretty messed up.... Anyways, for a lot of people, natural methods work! Ovulation tracking, prenatal vitamins, a healthy amount of exercise... shouldn't our doctors be prescribing us these things first?

I'm all in a huff.   Read the full article here and let me know how you feel. 

Soft IVF: A safer, cheaper way to artificially conceive

I just read an article about IVF methods I've never heard of before: soft IVF and natural-cycle IVF.  Not only do they cost less than normal IVF, but unlike standard IVF, they don't force the body into menopause and have no health risks.  Read the full article:
 The Telegraph

Here are some excerpts from the article:

"I was told I had fewer eggs than expected for a woman of my age and warned the quality could be poor," says Marina. "My fertility was more like that of a woman of 40, and my chances of conceiving naturally were around 10 per cent.

The couple were told that IVF offered the best chances of a successful pregnancy, and Marina joined the ranks of more than 36,000 women who undertake IVF each year in Britain. Like many of these women, Marina had to undertake the treatment privately. For while the NHS offers infertile couples aged between 23 and 39 three cycles of IVF, standards of service vary across the country, with many primary care trusts offering fewer cycles.

Marina had concerns. "As a chemist, I didn't want to throw myself into IVF. I was concerned about the drugs involved." She decided to explore her options and contacted dozens of fertility clinics before coming across one that offered alternatives to conventional IVF.

Create Health Clinics in London offered two procedures that sounded promising: "soft" IVF, which uses minimal doses of drugs and "natural-cycle" IVF, in which no drugs at all are used. Compared to the average £5,000 cost of a cycle of standard IVF, soft IVF (£2,500 per cycle) and natural-cycle IVF (£1,500) were also considerably cheaper.

"Soft IVF is far less disruptive to a woman's body than the standard approach,"says Dr Geeta Nargund, consultant gynaecologist and director of Create Health Clinics. "With soft IVF, ovary-stimulating hormones are given to a woman during her natural cycle, whereas the practice with conventional IVF is to induce an artificial menopause and then kick-start an artificial cycle,"

"The drug doses are also far lower – just 30-40 per cent of those used in standard IVF. The aim is to collect around six or seven mature eggs rather than 12 to 14. As a result, there is a greatly reduced risk of ovarian hyperstimulation syndrome, a condition in which the ovaries and abdomen can swell and fill with fluid. It can lead to discomfort and nausea and, in severe cases, may prove fatal. It affects up to 2 per cent of women undergoing IVF." explains Dr Nargund.

Marina began her first soft IVF treatment in June 2006. "I was given a 10 per cent chance of success and the first two attempts failed," she says. "Each time, the fertilised egg grew into an embryo but when it was placed back in my uterus, it didn't implant in the womb lining."

Dr Nargund recommended that for her third attempt Marina try natural-cycle IVF. This procedure uses sophisticated scanning techniques to monitor blood flow and the growth of an egg within a woman's natural cycle. Just before ovulation, the egg is collected and fertilised in the laboratory. If it grows into a healthy embryo, it is placed in uterus three to five days later.

Marina's procedure was a success. "To our absolute delight, I became pregnant," she says. "My son Radha is now two-and-a-half."

...

"The ovaries of women who are nearing the end of their fertility do not respond well to fertility drugs," explains Dr Nargund. "We also know that stimulating the ovaries with higher drug doses is linked to a negative effect on egg quality. That is not what you want when your egg quality and quantity may already be low."

Indeed, scientists at the University Medical Centre in Utrecht found that using lower drug doses and collecting fewer eggs was equally, if not more, effective in producing healthy embryos. Soft IVF produced 39 per cent of healthy embryos compared to just 28 per cent in women given conventional IVF.

"It is generally thought that the more eggs the better, but what you really want is better quality eggs and embryos," says Dr Esther Baart, embryologist at the University Medical Centre in Utrecht, who carried out the study.

Bill Ledger, Professor of Obstetrics and Gynaecology at the University of Sheffield and head of the Assisted Conception Unit at the Royal Hallamshire Hospital, says that the benefits of soft IVF are so clear, he hopes it will one day replace high-dose approaches.

"At Sheffield, we've been offering soft IVF for a long time," he says. "It's more attractive to patients who are wary of higher dose drugs and we get comparable results. With the standard protocol, the woman suffers at least a two-week menopause with hot flushes, night sweats and no libido. With mild IVF, that just doesn't happen."

...

"These approaches are safer for the woman, cheaper, less disruptive and vastly reduce the risk of multiple pregnancy," she says. "It really makes sense to consider them instead of blindly using high doses of fertility drugs."

Stress and Infertility

When you were growing up, did you mother ever tell you not to stress out about those school projects too much, or else you'll catch a cold? ...I know mine did, and it turns out she was right.  Stress has a known negative effect on overall well being.  Unfortunately, this means stress also negatively affects reproductive health, and can inhibit fertility.  Bad news for all the TTC people who can't spend a waking moment not worrying about their next ovulation or pregnancy test result!

Feeling "stress" triggers the release of "stress hormones", like adrenaline and epinephrine, which boost your heart rate and suppress reproductive, digestive, and growth systems. While essential for survival on a short term basis, long term chronic stress, which many infertile couples feel full force, interrupts ovulation and sperm production, and decreases the desire to reproduce in both men an women.  If your "baby dancing" has become a bit of a chore, stress might even be the culprit!

What's the solution to stress?  One of my favorite stress relievers is the tried and true long hot baths in scented bath salts, or maybe lighting a few soothing candles while drinking a cup of tea, but the most popular method right now is yoga.  There are many yoga routines out there, even many home yoga for fertility plans, but I'm going to talk about my favorite, Bend Breathe and Conceive with Dr. Anna Davis.

Dr. Davis is a fantastic teacher. She holds a doctorate in Biophysics and Physiology and has been practicing yoga for more than 25 years.  Her voice is soothing and the poses she guides you through are easy enough for beginners and interesting enough for seasoned yoga pros.

 This fertility yoga DVD consists of a series of poses, hand positions, and meditative breathing techniques designed to relieve stress - while simultaneously toning muscle groups that play vital roles in conception and pregnancy.

Bend, Breathe, and Conceive is a fertility yoga routine specifically designed for trying to conceive women, but I've heard of many couples happily and successfully going through the DVD together.



To view a clip from the DVD, visit Bend, Breathe and Conceive's website, http://www.bendbreatheandconceive.com/bbc_trailer/yoga-trailer-n1.html

You can buy Bend, Breathe, and Conceive from Fairhaven Health, where it has a perfect 5 star review!!

Is the Pill Masking a Common Cause of Infertility?

Premature Ovarian Failure, or POF, affects 1 in 100 women but many women may not even know they're affected. What can keep women and doctors alike from noticing this disease? The Pill!

Premature Ovarian Failure (POF), also known as Premature Menopause, occurs when the ovaries aren't making enough of certain hormones for the body to ovulate properly.  It can cause irregular menstrual cycles, bone loss, and if left untreated, infertility.  Irregular periods can be a sign of POF - and a simple hormone test can diagnose the disease.  But many times, doctors can write off missed or irregular periods as a result of poor diet or stressful life style, and put women on the pill without testing for POF. The pill then masks the symptoms - forces the body to menstruate regularly - without addressing the source of the disease.

So what happens if you've been taking the pill for years, stop taking it, and months later are still not ovulating regularly or pregnant?  While its normal to not have a period for up to a few months after stopping the pill (your body has to start making its own hormones again, after all) after about 3 months or more, you might want to speak to your Ob-Gyn.  They can easily test for hormone levels and let you know if you're affected by Premature Ovarian Failure. It is important to get treatment for POF - untreated it heightens your risk for osteoporosis.

So, if you're coming off the pill and don't start ovulating again, talk to your doctor and stay healthy!

TTC TV on TLC - What a mouthful!

If you haven't heard of it yet, theres an interesting show (or mini-series, I suppose) that might help you feel like you're not the only one out there with infertility problems.  TLC.com's new web-only series called "The Conception Story" follows six women through their trying-to-conceive journeys.  So far, there are only introduction clips for each of the women, along with profile stories in their blogs, but it promises to grow into a pretty amazing thing.  The stories are all rather touching, and its wonderful to hear women talk about their infertility issues while letting other infertile women know that they're not alone.

Each of the women is keeping a TTC blog and the series will unfold in real time as these couples send video footage to TLC, the network edits it, and posts it a few days later. The women are of varying ages, and have had different fertility experiences thus far across the board, from the 25 year old doctor, Angel, trying for her first to the stay-at-home mom, Amber, whose first child came as a surprise and whose second child hasn't come at all, after almost 3 years of trying.

Its a pretty interesting series, but I was disappointed to read in the New York Times that the whole thing was a an idea for an advertising stunt from First Response Pregnancy Tests. My hope, however, is that this series about such an intimate and personal subject will become something larger than what it starts out as.  I mean really, how could it not?

If you've seen any TTC related tv lately, let me know! I'd love to here what else is out there!