Podcast: Fertility treatments in the context of Roe vs. Wade

Recently, the U.S. Supreme Court overturned Roe v. Wade, which some worry may have unintended consequences for couples looking to use IVF to grow their families. In our latest podcast, Dr. Alan Martinez discusses this topic that has so many people concerned and unsure what to make of it.

Listen to it here.

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Male factor testing: What to expect, when to begin

Men can be impacted by infertility too, but what causes male infertility challenges? What contributes to our general lack of education about male factor infertility, and what tests are performed to help doctors identify a cause? What can men expect at their first appointment? What can men do after a diagnosis?

Resolve: The National Infertility Association, has posted a video addressing these and other questions about male factor infertility. Watch this video to learn more about male factor testing. If you have questions or wish to make an appointment to talk about male factor testing, contact one of our offices.

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Study: Psychological toll of fertility lasts for years

Researchers from the University of Newcastle (Australia) and the Hunter Medical Research Institute (HMRI) found that half of the women with fertility issues experienced psychological distress compared to women without fertility issues. For women whose fertility issues were resolved, 45 percent still reported psychological distress.

Lead researcher Dr. Tanmay Bagade said infertility affected millions of people globally. “Unfortunately, the societal burden of a couple’s struggle to have a biological child falls disproportionately on women. Women are pressured to have children due to societal and cultural norms, and if they are unable to conceive, I have seen them carry this burden and stigma for a long time,” said Dr. Bagade.

“Infertility is emerging to be a significant but ignored public health and equity issue. Couples with fertility issues might spend several years on an incredibly stressful and expensive journey to conceive using Assisted Reproductive Technology. Importantly, our research shows that even when women’s fertility journey is successful, and they have a baby, they continue to experience higher levels of psychological distress than women who didn’t have fertility issues,” Dr Bagade said.

This is the first Australian study to take a longitudinal approach by investigating the changes to women’s mental health over time. The researchers analyzed changes to the mental health and fertility status of more than 6,500 women over a period of 18 years.
The researchers also found that having a partner, being underweight or overweight, addiction to tobacco smoking, and high-risk alcohol drinking increased the odds of psychological distress in women suffering fertility issues.

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Where you live can affect your ability to conceive, study finds

People who live in socioeconomically deprived neighborhoods are about 20% less likely to conceive in any given menstrual cycle compared with people living in neighborhoods with more resources, a recent Oregon State University study found.

The study measured “fecundability,” which is the monthly probability of getting pregnant, among couples attempting conception without the use of fertility treatments. Researchers compared neighborhoods based on their “area deprivation index” score, a measure of the socioeconomic resources in a neighborhood. They found that even among a relatively affluent, highly educated study population, people living in more deprived neighborhoods had lower fecundability rates than people living in higher-opportunity neighborhoods.

“The world of fertility research is beginning to examine factors associated with the built environment. There are dozens of studies looking at how your neighborhood environment is associated with adverse birth outcomes, but the pre-conception period is heavily under-studied from a structural standpoint,” said lead author Mary Willis, a postdoctoral scholar at OSU. “Turns out, before you’re even conceived, there may be things affecting your health.”

Public health research in the last decade has highlighted the importance of social determinants of health and the idea that ZIP code is the greatest predictor for overall life expectancy, based on factors like income, health care access, employment rates, education level and access to safe water. “But the concept that your neighborhood affects your fertility hasn’t been studied in depth,” Willis said. “In addition, the world of infertility research is largely focused on individual factors, so when I came into this study as an environmental epidemiologist, I was thinking we should look at it as a structural problem.”

The study concludes that investments in deprived neighborhoods to address socioeconomic disparities may yield positive benefits for fertility.

 

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Study debunks concerns about fertility treatment, children’s development

Differences in the growth weight, and body fat levels of children conceived through fertility treatment are small and no longer apparent by late adolescence, finds new research. The University of Bristol (UK)-led study, published in JAMA Network Open, sought to address concerns around whether fertility treatment is associated with growth, weight and body fat from infancy to early adulthood.

The study, led by an international research group from the Assisted Reproductive Technology and Future Health (ART-Health) Cohort Collaboration, assessed whether conception by ART, which mostly involves IVF, was associated with growth, weight and body fat from infancy to early adulthood.

Using data on 158,000 European, Asian-Pacific, and Canadian children conceived by ART, the data show those conceived using ART were on average shorter, lighter and thinner from infancy up to early adolescence compared with their naturally conceived peers. However, the differences were small across all ages and reduced with older age.

Dr Ahmed Elhakeem, Senior Research Associate in Epidemiology in Bristol Medical School: Population Health Sciences (PHS) at the University of Bristol, and lead study author, said, “This is important work. Over the last three decades conception by ART has increased. In the UK just over one in 30 children have been conceived by ART, so we would expect on average one child in each primary school class to have been conceived this way. Parents and their children conceived by ART can be reassured that this might mean they are a little bit smaller and lighter from infancy to adolescence, but these differences are unlikely to have any health implications.”

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Human eggs remain healthy for decades by putting ‘batteries on standby mode’

Immature human egg cells skip a fundamental metabolic reaction thought to be essential for generating energy, according to the findings of a study by researchers at the Centre for Genomic Regulation (CRG) published in the journal Nature.

By altering their metabolic activity, the cells avoid creating reactive oxygen species, harmful molecules that can accumulate, damage DNA and cause cell death. The findings explain how human egg cells remain dormant in ovaries for up to 50 years without losing their reproductive capacity.

“Humans are born with all the supply of egg cells they have in life. As humans are also the longest-lived terrestrial mammal, egg cells have to maintain pristine conditions while avoiding decades of wear-and-tear. We show this problem is solved by skipping a fundamental metabolic reaction that is also the main source of damage for the cell. As a long-term maintenance strategy, it’s like putting batteries on standby mode,” says Dr. Aida Rodriguez, postdoctoral researcher at the CRG and first author of the study.

Human eggs are first formed in the ovaries during fetal development, undergoing different stages of maturation. During the early stages of this process, immature egg cells known as oocytes are put into cellular arrest, remaining dormant for up to 50 years in the ovaries. Oocytes have mitochondria — the batteries of the cell — which they use to generate energy for their needs during this period of dormancy.

The findings could lead to new strategies that help preserve the ovarian reserves of patients undergoing cancer treatment.

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Study may help improve IVF success

In humans, a fertilized egg is no guarantee of reproductive success. Most embryos stop developing and perish within days of fertilization, usually because they have an abnormal number of chromosomes. Now, researchers at Columbia University Vagelos College of Physicians and Surgeons have found that most of these mistakes are due to spontaneous errors in DNA replication in the earliest phase of cell division.

The findings provide new insights into the basic biology of human reproduction and in the long term could lead to improvements in the success rate of in vitro fertilization (IVF). The study was published in the journal Cell.

Approximately 24 hours after a human egg is fertilized, the process of cell division begins. During cell division, the entire genome — 46 chromosomes containing more than 3 billion base pairs of DNA — must be faithfully duplicated. The duplicate sets of chromosomes must then be separated so that each daughter cell receives a complete set.

“Duplicating the genome is a challenging task for the early embryo,” says study leader Dieter Egli, PhD, the Maimonides Assistant Professor of Developmental Cell Biology (in pediatrics) at Columbia University Vagelos College of Physicians and Surgeons.

The researchers are planning additional studies looking at DNA damage during replication in the hope of understanding normal and disease-causing variations in the human germ line. In the long term, these studies may lead to methods to reduce the risk of genetic abnormalities and embryo attrition for patients undergoing IVF.

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“Infertility patients fear abortion bans could affect access to IVF treatment,” NPR reports

NPR recently reported on the fears raised among those struggling with infertility when the U.S. Supreme Court overturned Roe v. Wade.

“I’m sitting here desperate for babies — desperate,” a woman in Michigan named Melissa told NPR. “And this can seriously impact whether I can grow my family, whether I can afford to, whether I want to risk it.”

NPR reports that this concern could be very real, according to a law professor at Northern Kentucky University with expertise in reproductive health.

You can read the NPR report here.

 WE ARE HERE FOR YOU

In light of the recent Supreme Court’s decision to overturn Roe v. Wade, we want to reassure patients this will not affect their care in our office. Our state supports reproductive rights, which includes treatment for infertility.

The staff at the Reproductive Science Center of New Jersey understands the significance of this decision and we are here to assist those in need of reproductive services.

If you have any questions or concerns please contact one of our offices.

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Sperm are masters of DNA packing

During sperm production, an enormous amount of DNA has to be packed into a very small space without breaking anything. A central role is played by certain proteins around which the DNA thread is wrapped, called the protamines. A recent study by the University of Bonn provides new insights into this important mechanism. The results have been published in the journal PLoS Genetics.

During their production, sperm are faced with an almost insoluble task. They have to pack 23 DNA threads with a total length of one meter into a head with a diameter of just three thousandths of a millimeter. And in the process, the delicate threads must not become entangled in an inextricable knot, nor must they tear.

We often sit on an overpacked suitcase to close it. The body resorts to a similar trick during spermatogenesis. Normally, DNA forms a comparatively loose tangle. In sperm cells, however, it is enormously compressed. Biologists call this process hypercondensation. During hypercondensation, chemicals called protamines exert a very strong attraction on DNA. The thread therefore wraps itself in very firm and tightly loops around the protamine

Most mammals seem to produce only one type of protamine, PRM1. Humans, and also rodents like mice, produce a second type, PRM2. Exactly what this second protamine is needed for was not known until now. However, it was known that some parts of it are successively cut off during sperm development. These cut-off parts that appear to be immensely important, according to the new study. When mice produce only a truncated PRM2 molecule that lacks the cut-off snippets, they are infertile.

It is possible that a defective protamine 2 can also lead to infertility in human males. The team now plans to investigate this hypothesis further. This could also lead to new therapies against male infertility, the researchers hope.

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July 25 is World Embryologist Day

On July 25, 1978, Louise Brown, the world’s first IVF baby, was born. In honor of that event, July 25 is now recognized as World Embryologist Day.

Embryologists are the scientists who help bring babies to life. They combine complex laboratory work with direct, compassionate care for patients struggling with infertility.

On this special day, we would like to thank our embryology team for their dedication and for all their hard work in “Helping Small Miracles Happen.”

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