A close look at diet and IVF

What you eat has a great impact on all areas of your health, including reproduction. Reputedly one of the healthiest diets around is the Mediterranean diet, and fertility experts in England want to find out if such an eating plan can improve outcomes in in vitro fertilization (IVF).

This pioneering study will follow 110 couples planning to undergo IVF. The couples will adhere to one of two different diets, started six weeks prior to treatment (the preconception period), one of which will include supplements of omega-3 fish oil and vitamin D, nutrients associated with the Mediterranean diet.

The researchers will then use a cutting-edge incubator called an embryoscope, a time-lapse video monitoring device that makes possible close analysis of the quality of sperm and egg cells, the resulting embryo, the environment of the uterus and the chances that the embryo will develop successfully.

Previous studies have found that dietary manipulations around the time of implantation had profound effects on early development in rodents. If the same is found to be true in humans, it could have significant implications for fertility treatment.

We’ll be following this closely.

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Help us recognize National Infertility Awareness Week

Reproductive Science Center of New Jersey and RESOLVE:  The National Infertility Association will recognize the 25th Anniversary of National Infertility Awareness Week, April 20 through April 26, joining millions of women and men who are fighting the disease of infertility, healthcare professionals, psychologists and others to promote greater awareness about infertility.

One in eight U.S. couples of childbearing age is diagnosed with infertility. RESOLVE addresses this public health issue by providing community to these women and men, connecting them with others who can help, empowering them to find resolution and giving voice to their demands for access to all family building options.

During National Infertility Awareness Week, our center is utilizing social media to raise awareness and understanding about infertility. For more information, visit our website at www.fertilitynj.com or follow us on Facebook at www.Facebook.com/FertilityNJ. You can also visit the RESOLVE website.

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Cracking the genetic code for infertility

A landmark study, published in The New England Journal of Medicine and Human and Molecular Genetics, shows for the first time that a mutation in a particular gene is the major cause of two human fertility disorders: premature ovarian failure (POF) and lack of sperm.

The gene, known as STAG3, provokes a loss of function of a protein that is crucial in the production of gametes—the cells that become eggs and sperm. Alberto M. Pendás, a researcher at the Cancer Research Center, states, “Our work … demonstrates that POF and azoospermia, a disorder that impedes normal sperm production, are probably the two faces of the same genetic disease.”

It’s too early to be certain, but this breakthrough may lead to treatment for these two conditions someday.

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What to tell the children?: Digging deeper, part 3

By Kristen Mulheren Levitt, MS, LCSW, Infertility Counselor

Below are some excellent resources for both parents and children that offer advice and guidance about the issue of disclosing to children the facts about a donor’s role in their conception.

Websites:

• The American Society for Reproductive Medicine (ASRM)

Resolve: The National Infertility Network

• The American Fertility Association

Here are several books for parents and children addressing conception by donation.

For parents:

• Building a Family with the Assistance of Donor Insemination. Daniels, Ken. Dunmore Press, 2004. For those who are considering donor conception or who have built their families through donor conception. Includes the experiences of families formed this way, their journey and their issues associated with talking to children about the family’s donor origins.

Everything Conceivable: How Assisted Reproduction Is Changing Men, Women, and the World. Mundy, Liza. Alfred A. Knopf, 2007. An insightful and fascinating account of the world of assisted reproduction, including interviews with mothers, fathers, infertility doctors, surrogate mothers, egg donors, sperm donors and adult children conceived through surrogacy and IVF.

For children:

• Hope and Will Have a Baby: The Gift of Sperm Donation. Celcer, Irene. Illustrated by Horacio Gatto. Graphite Press, 2007. The story of how Mom and Dad met, fell in love, and built a family with the help of donor sperm. (ages 3–6)

• Let Me Explain: A Story About Donor Insemination. Schnitter, Jane T. Perspectives Press, 1995. This lovely and warm book explains donor insemination from the perspective of a young girl with heterosexual parents; she is matter-of-fact about her conception by DI and her close connection to her dad. (ages 6–10)

• Mommy, Did I Grow in Your Tummy? Where Some Babies Come From. Gordon, Elaine R. Greenburg Press, 1992. Explains infertility, IVF and alternate ways to become a family, including donor gametes and surrogacy. Nicely illustrated. Heterosexual focus. (ages 4 and up)

• Before You Were Born: Our Wish for a Baby. Grimes, Janice Webster, Iowa : X, Y, and Me Books, 2004. A bear boy asks his father about his wish for a baby and learns about the use of a donor for “special cells” that Daddy did not have. (ages 3–5)

• “Telling & Talking” books and videos. Produced by the UK Donor Conception Network. A set of unique resources for current or prospective parents of donor-conceived children, their families and friends, as well as for the professionals who support them.

Finally, click here for a pdf of an annotated bibliography on assisted reproduction for parents and children.

If you have any questions, please don’t hesitate to call me at 732-977-3547 or email me at ktmm15@verizon.net.

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What to tell the children?: Digging deeper, part 2

By Kristen Mulheren Levitt, MS, LCSW, Infertility Counselor

An organization called Resolve: The National Infertility Network, is the only established nationwide network mandated to promote reproductive health and to ensure equal access to family building options for men and women. Resolve believes it is in the best interests of both children and families to be open about the use of a donor in conception. In support of disclosure, says Resolve, are the facts that secrets can be damaging and that they do not always stay secrets; children often sense secrets, and those who do may infer that something is wrong and assume it is about them. In regard to not disclosing, issues identified include your child’s questioning his or her attachment to you or respect for your parenting abilities and the fear that your fertility issues could be disclosed on a broader level.

Research suggests that those who disclose the fact of a donor’s role in conception to their offspring early experience less stress, are more at ease with the process and are able to introduce the topic gradually. These children are able to receive and process the information in a factual, nonemotional way. Those who learned later in life sometimes experienced resentment, mistrust, confusion about identity and more negative feelings about their conception.

In deciding whether to disclose, it is important to discuss your values, morals and any religious beliefs you and your partner have. It is in the best interests of both you and your child(ren) to read as much as you can about disclosure, utilizing resources both for you and for your child(ren). There are many books written for adults and children that can help guide and advise you in the best way to speak to your individual child(ren). I’ll share those with you in my next post.

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What to tell the children?: Digging deeper, part 1

By Kristen Mulheren Levitt, MS, LCSW, Infertility Counselor

Our recent blog post titled “What to tell the children” drew a lot of comments, including this one: “My concern would be a male factor—telling your child that they were conceived via donor sperm. Do you tell them or not? It’s not like adoption, but could be more of an issue.” This is an important topic, and in this post and two more to follow I will tell you my thoughts and offer some helpful resources.

The biggest concern among those pursuing donor conception is that of disclosure to their offspring. When a child is conceived using a donor sperm or egg, there is always the question of “to tell or not to tell,” and there is never a clear cut, easy, go-to answer.

The American Society for Reproductive Medicine (ASRM) is the internationally recognized leader for education, information, advocacy and standards in the field of reproductive medicine. The ethics committee of ASRM put together an ethics paper discussing disclosure to offspring of conception through the use of a donor. The committee states that the choice to disclose to one’s child is an individual and highly personal choice, but that disclosure is ultimately encouraged by the society. The society believes benefits of disclosure include the encouragement of open and honest communication with the child(ren) and help in avoiding secrets that could ultimately strain relationships and create resentment.

When to disclose to the child(ren) is debated, as it could be beneficial to tell the child when younger so he or she can absorb the information over time, but it is generally based on the psychological readiness of the child. Also, unplanned disclosure is considered more problematic than planned, intentional disclosure. If people other than the parents and doctor (family and friends, for example) are aware of the use of donor sperm (or egg), it can create a very difficult situation because you cannot control what others talk about.

Also, those who support disclosure reflect upon the trend of disclosure in adoption. Studies of adopted children demonstrate that the need to know one’s origins is integral in the development of identity and suggest that hiding the information could cause confusion and low self-esteem. Disclosing in a loving and supportive environment is always best. On the side of nondisclosure, it might potentially prevent social and psychological turmoil and could keep the outside world from knowing about the fertility issues the parents experienced.

In my next post, I will continue this discussion.

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A better way to treat fibroids

Uterine fibroids, which affect up to 40 percent of all women 35 and older, can cause heavy menstrual bleeding and, sometimes, infertility. Typically, interventional radiologists have treated fibroids by threading a catheter through a woman’s femoral artery, located in her thigh, to the uterus. But researchers recently announced a new approach that is less painful, reduces bleeding complications and allows patients to sit up and move immediately after uterine fibroid embolization (UFE). Plus there’s no hospital overnight stay required.

In this new treatment, the interventional radiologist threads the catheter through one of two arteries in a woman’s left wrist. The doctor guides the catheter to uterine arteries that supply blood to the fibroid tumor, and then releases tiny particles, no bigger than a grain of sand, which block blood flow and cause the tumor to shrink.

The research, published in the March 2014 issue of the Journal of Vascular and Interventional Radiology, collected data on 29 women ages 23-56, from March through October 2013. Wrist (transradial) UFE was deemed a safe and effective alternative to groin (transfemoral) UFE. More and larger studies are needed to confirm the findings, but this offers a promising alternative for the millions of women suffering from fibroids.

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Yet another warning on plastics

Chemicals called phthalates are used to make the plastics employed in manufacturing the containers of many consumer products, including foods, beverages and cosmetics. Research over the past few years has linked these chemicals to a number of health problems, including infertility. Now comes another warning to avoid these products.

Women whose male partners have high concentrations of three common forms of these chemicals take longer to become pregnant than do other women, according to researchers at the National Institutes of Health and other institutions. The study was published online in the journal Fertility and Sterility.

“Our study shows that exposure to certain phthalates can reduce the chances of conception for otherwise healthy couples,” said the study’s first author, Germaine M. Buck Louis, Ph.D., Director of the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. “Many people have been exposed to these compounds, so it’s important to continue to investigate whether they have any health effects.”

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The latest on uterine transplants

Researchers in Europe are conducting a remarkable study investigating the possibility of transplanting a uterus. They performed the last of nine planned uterus transplants in the spring of 2013, and the six-month follow-up found that live-donor uterus transplantation has a low risk.

The article, “The First Clinical Uterus Transplantation Trial: a Six-Month Report,” was published in Fertility and Sterility. In the next phase of the unique research project, researchers will help seven of the women become pregnant through IVF treatment.

What do you think of this development?

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Marijuana linked to stillbirth

Marijuana has been legalized or decriminalized in many areas of the nation, and the overall attitude to the drug is becoming more relaxed. But that doesn’t mean it’s safe for everyone. Women who are pregnant, or hope to become pregnant, should take note of this startling new finding: Expectant mothers who smoke marijuana may triple their risk of a stillbirth.

The report, which appeared in the January issue of Obstetrics & Gynecology, found that the risk of stillbirth—defined as fetal death after 20 weeks of pregnancy—increased whether moms were exposed to pot alone or in combination with other substances.

The researchers analyzed 663 stillbirths that occurred between March 2006 and September 2008, and compared these with about 1,900 live births. They tested umbilical cord blood and blood from mothers for a variety of illegal drugs and found that, among all the drugs, signs of marijuana use were most often found in umbilical cord blood from stillborn infants.

Please avoid all drugs, except those prescribed by your doctor, during pregnancy. Including marijuana.

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