Inheriting infertility via ICSI

I read this article in Times Online today. It states that there is now evidence that fathers of test-tube babies may be passing their infertility on to their sons. Anyone who was trying to conceive back in the mid-90's heard speculation then that ICSI can help couples conceive, but it can't guarantee that if there's a genetic defect causing the man's infertility that it won't be passed on to the child. And why wouldn't it?

So this study goes on to linking ICSI to shorter fingers in boys - a trait they say is known to be associated with infertility. The study compared 211 six-year-olds conceived through ICSI with 195 naturally conceived children of the same age. The boys in the ICSI group had shorter fingers. OK, now let's think about it. ICSI was most frequently used to overcome male infertility. There are other reasons for using ICSI, but that is the reason it was developed and, at least in the past, was its main use - if there were plenty of swimmers, it wasn't really necessary... Then there's this lovely quote from John Manning (and a nearly identical one by Allan Pacey), "This is telling us that we sould only use ICSI when it is absolutely necessary." Um. Maybe what it's really telling us is what we knew all along - genetics are inherited... It isn't the ICSI that's causing the infertility in the next generation, it's the genes the child inherited...

A question to anyone who would contemplate using ICSI on this basis - why, if ICSI can produce a healthy (yet, possibly infertile) child today would you think that in another 25 years or so, when this child wants to become a father, that medical science would not have improved this process and made it even easier to become a father?

Yes, I really do wonder

I do. I wonder why I have a blog if I don't have time to update it.

There were two things I wanted to share from recent news in Israel.

Today, it was announced that from now on it will be illegal to fire any person undergoing fertility treatments both during the treatment and within 150 days of the time they began. I couldn't find the article in English, but the google translation does an almost tolerable job...

The other was that Hadassah Ein Kerem hospital announced that they are now able to provide fertility treatments to HIV positive men, removing the virus from the sperm and using ICSI to create healthy embryos. Apparently this treatment is already available in the US.

I'm busy doing a huge user interface project and completing a course in survey methodology - and going to sleep way too late every night (and waking up way too early every morning).

Free IVF Cycle & Book Giveaway

It turns out that there are clinics that give away free IVF cycles. Apparently HRC Fertility offered 20 such cycles - each couple had to write an essay of up to 500 words, stating their reasons for wanting to have a child.

Here's one of the stories of a couple who won a free cycle - http://www.dailybulletin.com/ci_13794655.

Want to read more stories? Sign up below for a chance to win a copy of Making Babies: Personal IVF Stories by Theresa Miller. Ms. Miller interviewed people involved in 14 stories of IVF on their way to try to become parents (some were successful, some not). One of the stories discussed "sensing" an unborn baby's thoughts and wishes, which I couldn't get in touch with. Another discussed the decision to stop treatment - an important topic I believe far too few people have written about. Overall, the book was interesting and provided plenty of opportunities to shed tears (mostly joyous ones). Leave a comment below by November 26 for your chance to win it! Tweet this post for another chance (and let me know in the comment that you have).

Coming up soon on FertilityStories Blog:

• A giveaway for a shopping cart cover from CNS
• An excerpt from The Stewart Institute's book, "Do You Love Someone Who is Infertile?" - a guide for a spouse, sibling, parent or friend. (They actually sent me a copy it looks fabulous!)

Womb transplants - getting closer?

I just read this article on the BBC News site. They report that British Doctors claim to be closer than ever to being able to transplant a womb, so that a woman could conceive (with the help of IVF), carry one or more pregnancies, deliver by c-section and then have the womb removed. The article raises a number of questions that I found both interesting and relevant.

What are your thoughts?

In the news...

I really enjoyed this article by Pamela Tsigdinos -Fertility Industry: Boon and Curse. She wrote it as a response to the article the New York Times ran on Sunday - "The Gift of Life, and Its Price" that I didn't find particularly interesting, but I have heard it drew a lot of comments that people going through infertility found offensive (I do my best to avoid reading them - I have enough stress in my life.)

Monday's New York Times ran an article about multiples & selective reduction that, once again, caused me to think that unmonitored IUI should be a crime (although one of the cases they talk about was monitored and still ended up with high order multiples).

If things are going to change, it should be based on the research that's been done on e-SET - elective single embryo transfer. Having read many journal articles about it and its advantages (I was planning to write a seminar paper about it, but came up with some ethical issues that got in the way), it's clear that guidelines could be written to avoid unnecessary premature births and pregnancies with high-order-multiples that endanger the mother.

The New York Times also has an online presentation about e-SET.

Laptops & reduced spermatogenesis

An article that came up in my news page today quoted Dr. Suzanne Kavic, director of the division of reproductive endocrinology at Loyola University Health System as saying that "...the heat generated from laptops can impact sperm production and development making it difficult to conceive down the road."

Since they didn't quote any research that backed that, I went to check it out. I found this abstract from Human Reproduction where Yefim Sheynkin, Michael Jung, Peter Yoo, David Schulsinger and Eugene Komaroff tested men for scrotal hyperthermia when working on laptops.

They tested 29 volunteers and found that indeed the use of laptops raised the temperature between 2.6-2.8 degrees celsius. Based on the abstract, "scrotal hyperthermia has been identified as a risk factor for male infertility" - so they've shown that laptop computers cause scrotal hyperthermia and since that's a known risk factor for male infertility, it definitely sounds like something even young boys should be made aware of.

I see there are already patent applications and products to help solve this problem.

Cervical Cancer Vaccine Scare

As I was checking the links on my links page, to make sure there weren't any dead ones, I came across this story...

It started like this: Last week, on Sept 28, 2009 , Natalie Morton, a British 14-year-old girl died suddenly, just over an hour after having been given Cervarix, a vaccine against HPV (human papilloma virus) produced by GlaxoSmithKline (see video). 9 other girls reported feeling mildly ill. So GSK quickly recalled all the unused doses in the batch, while an autopsy and investigation began.

Obviously some chose to make the immediate link between the vaccine and her death. But then the autopsy showed that Natalie Morton, in fact, had a large malignant tumor in her heart and lungs. (Though this article claims the autopsy is just a cover-up.)

And then there's the question asked by Deborah Kotz (follow-up post) as to whether if a vaccine did indeed cause a single injury or death - does that deem it unsafe (DK's original post)? (Read the comments too, if you want to be really confused.) It makes sense to me that a vaccine would have to do more good than harm - if we consider 1.4 million girls who were vaccinated, how many of them were likely to die or suffer due to cervical cancer (if they had not been vaccinated)? I'm glad that it seems that Natalie's death was not caused by the vaccine - and I hope that somehow people will get the information needed to make the best decision for their daughters - and not be swayed by a single, terrible coincidence that linked the vaccine with death.

Mistakes that should never happen

It should never have happened that doctors transferred the wrong embryos to Carolyn Savage. I feel terrible for her and for her family and some people may think that Paul and Shannon Morell got a good deal - no pregnancy, healthy baby - but I feel terrible for them too. They missed out on experiencing a pregnancy, on being there and able to feel his first kicks and I bet they've also got some guilt about taking the baby (who is biologically theirs) from Sean and Carolyn Savage - even though the mistake wasn't theirs. I have a lot of respect for Sean & Carolyn who decided to continue the pregnancy - I can think of all the reasons why they "had" to, but I can think of a lot of reasons why they might not want to too. I hope the two families will be able to form some kind of relationship that will give both a sense of peace about what happened.

Dr. Grumbles posted an article about Ochsner Hospital (in New Orleans) that was shut down due to "mishandling of frozen embryos". Some of the embryos are mislabeled or missing. Missing I've heard of before - inexcusable and horrible, but not nearly as scary as mislabeled. I can't imagine the 100 families (or so) who are dealing with this news. When I was going through IVF it occurred to me that there could be a mix up, but then I thought, "I'm putting crazy ideas into my head. That's exactly what these people do - keep the embryos labeled correctly so there are no mistakes - and they know how important it is." One would hope...

These recent events make it even more understandable why some people would choose to have the entire process supervised. For many years, orthodox Jews (particularly ultra-orthodox) have had specially-trained supervisors who watch the process from start to finish, making sure there are no mix-ups. This article discusses the cooperation formed between The Jewish Community Council of Montreal (Vaad Ha’ir) and the McGill Reproductive Centre, located at the Royal Victoria Hospital - they've launched a program that strictly adheres to halachah (Jewish Law) while offering the latest technology, including in vitro fertilization (IVF). I bet more and more people, not only Jews, are going to be interested in this type of supervised IVF in the near future.

Life after infertility treatments

There's a great article in Thursday's New York Times - Shelagh Little writes about making the decision to stop fertility treatments and live without children.

PCOS, Acupuncture, Surrogacy & Donor Gamete Babies

In this article published by NewsMax (which my dad sent me), they discuss a recent study performed by Elisabet Stener Victorin at the Sahlgrenska Academy, University of Gothenburg, Sweden. In it, they studied women diagnosed as having polycystic ovarian syndrome (PCOS).

During the study, one group of women with polycystic ovary syndrome received acupuncture regularly for four months. They received a type of acupuncture known as “electro acupuncture”, in which the needles are stimulated with a weak low frequency electric current, similar to that developed during muscular work. A second group of women were provided with heart rate monitors and instructed to exercise at least three times a week. A control group was informed about the importance of exercise and a healthy diet, but was given no other specific instructions.

The results showed more normal menstruation and significantly lower testosterone levels in the group who received acupuncture.

My mom sent me this article (yeah, sounds like I no longer have to do any of my own research) about children born via surrogacy, egg donation and sperm donation. Polly Casey from the Centre for Family Research at Britain's Cambridge University studied nearly 200 families – 128 with children born using assisted reproduction of one of the types mentioned above and 70 conceived without ART. She found that “the family types did not differ in the overall quality of the relationship between mothers and their children and fathers and their children”.

The article also discusses parents’ intentions as to revealing donor and surrogacy issues to their children and what they actually chose to do by the time the children were seven years old.

Infertility & Lack of Sleep

What's the connection, if any, you ask? I just read this article by Michael J. Breus about a possible link between lack of sleep and impaired fertility. He mentions these points:

• Sleep's effect on the body's hormonal system - implying that a lack of sleep could hinder regular ovulation.
• Sleep deprivation's effect on leptin levels, which can also have an impact on ovulation.
• Insomniacs' higher levels of cortisol and adrenocorticotropic, both of which can suppress healthy cycles.

He quotes this article by Toni Parker that discusses research performed in Boston on women athletes who were given leptin to help resume their menstrual cycles and restore ovarian function. (There's a movie clip and several tips on how to sleep better there too.)

And while I find all of these studies interesting - and their advice good to follow, just for general good health - I think it's still important to say that a lot of cases of infertility can't be solved simply by getting a better night's sleep - on the other hand, you really have nothing to lose...

Infertility in China

CNN ran an article yesterday about infertility in China. When I think about China and babies, my first thought is how awful it must be to be limited to just one baby and how sad it is that some parents feel that having a daughter is some sort of failure… Even with my being so aware of infertility, China wasn’t one of the places I thought about. (Although I have thought about China for a lot of other reasons, including my parents’ multiple trips there – see http://drsavta.com/travelkosher/ for amazing pictures and fascinating information, especially if you keep kosher and are interested in having the best tour guide ever… BTW, they’re going to Vietnam & Cambodia too.) Anyway, I found the article both interesting and surprising… and I’m happy for the couple featured in the article that they ended up having not one but two healthy babies :-)

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I updated my post about tooth gemination and added new pictures.

Egg & Sperm - Lock & Key?

I finally opened a twitter account for Fertility Stories (feel free to follow me - http://twitter.com/fertilitystorie) and someone sent me a message asking me if I'd seen this article.

The article mentions Dr. Martin Brinkworth, Dr. David Miller at the University of Leeds and Dr. David Iles (but doesn't mention where -if anywhere- results of the study are being published). It summarizes their findings:

The study researchers have found out a mechanism called lock-and-key mechanism by which reproduction takes place.
In living organisms, sperm and egg cells unite in a distinct way. The sperm cells have keys (genetic signals or codes) and the eggs have locks (genetic signals or codes) and only the most suitable key signal can fit into the lock of an egg.

OK. Sounds interesting, but how does this help, I asked myself... Later in the article comes their explanation:

The scientists could use the newer understanding to develop some test to screen infertile man. This would cut down the failure rate of IVF by 75 percent as filtering out male candidates who can never produce children would become possible.

To this, all I can say is, "Yeah, right". Who's going to take a sperm sample that looks fairly normal and then run it by a lab that stamps a big "FAIL" on the results and decide, "oh, OK, so I'll just never have a biological child"? And what happens if the woman, even just once, got pregnant naturally and, even if it ended in miscarriage, are they really going to accept that his sperm isn't able to fertilize her ova? I just don't believe that a lab test, without ever actually going through the process of IVF is going to convince the average couple...

Now, if these guys could find a way to fix the 'key' mechanism, I'd be the first to say they were on to something...

I did hate those IUIs

Forbes published a story a few days ago about a study that tested results of couples who went through either three or six IUI cycles before moving on to IVF. I looked for the original article, which they said was published by Fertility and Sterility, but I wasn't able to find it in their list of articles.

According to the Forbes article, the couples were divided into two groups of 256 (3-cycle program) and 247 (6-cycle program). Couples from both groups who had not yet achieved pregnancy went on to up to six cycles of IVF.

The results were surprising - the average time to pregnancy in the 3-cycle group was eight months whereas it was eleven months in the 6-cycle group. In addition, the couples in the 3-cycle group saved on average over $2600. They explained part of this savings by the fact that more women from the 3-cycle group had singleton births (and births of multiples are more expensive). Overall, 67% of the couples in the 3-cycle group and 61% of the couples in the 6-cycle group ended the study with a baby.

I would be interested to hear why the researchers think that the success rate in the 3-cycle group was higher (if it is statistically significant) - does it have to do with being run down? Do the IUI cycles have a long-term negative effect on the uterine lining?

Male Infertility - Gat Goren

As I scanned this morning's paper, I came across a mention of the Gat Goren method for treating varicocele - it was listed as one of Israel's recent important achievements.

Among the differences between the Gat Goren method and traditional treatment of varicocele are the short recovery time and the less painful medical procedure. This article writes:

DURING THE procedure, which is performed under local anesthesia, Goren inserts a catheter through a vein in the upper thigh. The catheter is used to inject a fluid that selectively closes off all the malfunctioning veins, thereby enabling the testicular tissues to recover and begin to produce normal sperm in normal amounts. It takes one to two hours (plus half an hour of rest before going home), and causes virtually no discomfort. Within 48 hours, the patient resumes his normal routine.

"In the conventional procedure, in which men undergo general anesthesia in an operating room, a urological surgeon performs a left high ligation and blockage of the central vein. It takes 20 minutes, but urologists didn't do the right side, or weren't aware of the whole network of bypasses in the system, so in a significant number of cases, it didn't solve the problem," Gat says. But the Gat-Goren catheterization method locates and treats defective blood vessels on both sides and improves oxygen supply necessary for the production of sperm cells.

Apparently, men are coming to Israel from all over the world to have this procedure performed.

Ovary transplant & Surrogacy

Although babies have already been born as a result of the transplant of ovarian tissue, this is the first to be born after transplanting an entire ovary. So far, the procedure is only performed on identical twins.

Thank you to Lelo for sending me to this article about surrogacy. It's actually a combination of a photo essay and video essay - I haven't had time to watch it all, but it looks fascinating.

Proteins for embryo implantation & a link

Research performed by British researchers including Professor Helen Mardon and Professor Anne Ridley published in the Proceedings of the National Academy of Sciences, found two proteins that appear to be responsible for enabling embryos to implant in the uterus. It doesn't seem as if there are practical implications of this research right now, but clearly the more that is understood about the process of implantation the more likely it is that advances will be made toward improving embryo implantation in IVF.

Myoncofertility.org is a new, patient-friendly website for both women and men who are dealing with cancer and interested in preserving their fertility. The site also has sections for parents and for partners. Although it would be nicer if no one really needed this information, it's great that they've put all the information together in one place, in a visually-pleasing and useful way.

Male Infertility Q&A

Lately msnbc has been posting interesting articles about infertility.

The one I saw today is questions & answers (answers by Dr. Edmund Sabanegh) about male factor infertility. Most of the answers are brief and at least semi-informative, but his answer to the second question as to whether there is a way to test for infertility in her 14-year-old son conceived with the help of ICSI didn't really answer the question that was asked... Was he recommending that she take her son in to test his y-chromosome for deletions? Or perhaps her husband? And if the problem causing his infertility was a y-chromosome deletion (not that I know what that means) wouldn't it cause the defective sperm not to fertilize the egg?

Another article (also published yesterday) discusses this very issue (fertility of sons of infertile men).

Discrimination includes infertility treatments

In the recent court decision reported in the Wall Street Journal, infertility treatments are regarded the same as pregnancy in terms of protecting women under the Pregnancy Discrimination Act. Although this is only true in 3 states so far, (Indiana, Illinois and Wisconsin) it's definitely a step in the right direction.

When I came back to work after having my first daughter by IVF, my boss took me aside and said, "If you're planning on having any kids in the next 2 years, we don't want you back." It was a punch in the stomach, but I did get full compensation (it's automatic, if it's within a year after giving birth, here in Israel) and I was able to quickly find another job, but still...

Mother - Daughter - Grandchild - Surrogacy

This article in Times Online talks about a mother who was a surrogate for her daughter and gave birth to her own grandchild. It's interesting that the strongest part of the article is the debate about surrogacy that the whole story has sparked in Japan.

There is, however, something wrong with the story - check out this paragraph, "Yesterday’s successful treatment involved the woman having her daughter’s already fertilized egg implanted in her womb. The entire family is understood to have agreed to undergo the process, despite its difficulties, because the woman’s daughter was born without ovaries..." OK, so I want to understand how, if she was born without ovaries, she had ova... (it also sounds as if the treatment took place yesterday, whereas the report was about a birth...)

Updated: I did manage to find this article that says the daughter has no uterus. That makes more sense...

Update from the post about a preemie miracle - sadly, the little girl died the next morning.

I grew up in a more conventional world

Men having babies? Thomas Beatie is a new father... (or mother? or both?)

Women this age in Oklahoma* are (very) often great-grandmothers...

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*I only mention Oklahoma because it's the last place I lived in the US. In my senior year, I sat next to Janet every day in journalism class... Sometime around April, she came in one morning very clearly pregnant. She'd waited until her 18th birthday to tell her parents. (She misunderstood the law about statutory rape.) She had her baby in June or July - that baby would now be almost 23 years old... My guess is that Janet's already a grandmother.

Articles...

Juanne Fuller discusses her feelings after discovering she has fibroids.

Interesting article about infertility in Nigeria.

Lastly - an article about hospitals in Great Britain who are denying IVF treatment to smokers.

Socialized medicine in some countries has led to extensive research regarding single embryo transfer - as a way of reducing the incidence of twins and higher-order multiples and along with that, the long-term medical costs that often follow premature birth. It makes sense to me that socialized medicine has different boundaries. What do you think?

Unbelievable Ectopic

If you haven't read this story about an ectopic pregnancy that went to term, do.

The baby went to 38 weeks and was born weighing 6lbs 3oz, despite implanting in her mother's ovary.

Unbelievable!

Yeah, that oughta help...

Here's one of those articles that I really hate... Although they do say some of the right things, like, "The worst thing you can tell a woman who's trying to get pregnant is that she just needs to relax," the overall message is that probably relaxation is a huge step in the right direction.

Can you see the steam coming out of my ears???

Klinefelter's Syndrome & Hope

I just found this article about Kristin and Jeremy Flannery who became parents to twins, despite Jeremy's diagnosis as having Klinefelter's Syndrome. Using microdissection of the testicle, urologist Jay Sandlow was able to find just 11 sperm cells - enough to fertilize 5 eggs, 2 of which were transferred to Kristin's uterus.

Pretty amazing.

Happenings...

I read a few interesting articles lately:

Fertility experts will meet in Arusha, Tanzania, this weekend under the auspices of the European Society of Human Reproduction and Embryology to discuss the challenges of infertility in Africa at the first conference on infertility in developing countries. Their goal is to develop a low-cost version of IVF, making in vitro fertilization available to couples worldwide - including those in developing countries, where infertility is often so strong a stigma that it often results in social isolation & sometimes even in suicide. Perhaps this research will help make IVF more affordable and safer everywhere.

A 48-year-old Minnesota woman is pregnant after using an egg that was frozen, thawed and fertilized before being transferred to her uterus. Dr. Jacques Stassart of Reproductive Medicine and Infertility Associates in Woodbury, Minnesota said that the technique is still experimental but that his clinic will offer it on a case-to-case basis. There have been other cases like this, but not too many. I think egg freezing is an amazing option, but that care needs to be used in choosing the women to be treated. Someone needs to be looking out for the future children as well - those who may be born to women at practically any age.

A change in Victorian law will now allow access to IVF treatment for single moms and lesbian couples. It seems to make more sense to allow them access to insemination - why go straight to IVF if there are no fertility issues?

And last, but definitely not least, I really enjoyed Bea's posts about the value we place on being parents (she actually asked how many years of our lives we would be willing to give up to successfully become parents). I chose the odd-woman-out answer (as I often do) but I really enjoyed reading all of the other answers as well. In many ways, this reminds me of how frustrated I felt reading Stumbling on Happiness (by Daniel Gilbert) in which he presents research showing that we're actually less happy once we have children, but doesn't compare it to the alternative of not being able to have children.


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P.S. Tomorrow's our growth scan. This will be the first in over 10 weeks(!) I 'get' to do it a week early because despite having done two 100-gram-GTT's this pregnancy, I am still at risk for gestational diabetes.

Swapped Babies - Update

In October, I posted a scary story about babies in the Czech Republic who had been swapped at birth. Since discovering the mistake, both sets of parents have been trying to find a solution that everyone involved would feel comfortable with. A few days ago, both girls went to live with their biological families.



On another topic, Malky wrote yesterday about my being open with my kids about having gone through fertility treatments to have them. I never thought not to share it with them... and they probably do know more about IVF than the average adult. Easier to talk about than sex, no? :-)
What will you tell your child(ren)?

Wacky surrogacy laws

I read this article about Senator Stephen Conroy and his wife Paula Benson (Victoria, Australia) who finally got legal recognition of their status as parents to their child who was born by surrogacy. What surprised me most was the following paragraph:

Victorian law says that a woman can be a surrogate only if she is medically
infertile, a ruling that has been widely described as bizarre.

Even after reading that it was 'described as bizarre', I still thought there must be some mistake in the sentence. Perhaps only couples who were medically infertile were eligible to choose surrogacy? The surrogate mother??? So I went to look it up...

A slew of articles (like this one from The Age or this one also about Senator Stephen Conroy & his wife in The Brisbane Times) confirm that this is indeed the case...

Surrogacy laws in Israel are complicated too - for religious reasons. As far as I know, only gestational surrogacy is allowed. Then, a surrogate must be an unmarried woman (if a married woman were to carry a child created with the sperm of a man who is not her husband, the child would be considered a mamzer - not a good thing...) In addition, she must be the mother of at least one child of her own (though I have heard that this is standard in other countries too). I don't know how many babies are born by surrogacy each year in Israel, but the numbers are still very small.

Apparently, as it says in the articles - "the law has not kept up with science". I hope legislation will help those couples whose best chance to have a child is via surrogacy, while protecting all sides - the surrogate, the intended parents and especially the baby.

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interesting search of the day: early symptoms of pregnancy in the father.

None that I know of. Perhaps finding multiple pee-stick wrappers lying around? Hearing barfing noises? Got any other ideas?

Today's news & search

Two articles caught my eye today. First, in the UK, the Human Fertilisation and Embryology Authority (HFEA) is working toward having clinics reduce the number of twin & triplet births (resulting from IVF) from 1 in 4 to 1 in 10. I have been reading the literature about this (particularly that coming out of Scandinavia) and I believe this is the correct thing to do. Difficult, particularly emotionally, for the couples going through IVF, but correct.

Second, Family Court Judge Ellen Greenberg (New York) ruled that a man who acted as a sperm donor many years ago is responsible for child support. It's not clear to me why the mother waited until the child was almost 18 to claim this... Mostly, this supports my feeling that whenever a third party is involved, you're better off having a legal agreement.

Last - a search query: missed IUI but got pregnant. I hope this is what happened to the person who searched :-) If so, congratulations!

I lost a client!

I just got a call from someone who's been buying pregnancy strips from me for nearly 2 years, in packages of 10 (just once every few months). He called to tell me that his wife had gotten an early positive, waited another day & went to take a blood test. It was positive :-) He said that at first they were sure the test must be off (been there myself :-))... I'm so happy for them.

In other news, I read an interesting article about the use of IVF in HIV-discordant couples - particularly where the husband is HIV positive and the wife is HIV negative. Apparently, with the use of ICSI, they can guaranteed that the baby will not have AIDS.

Blogosphere Quickie

First, a cute article about IF bloggers.

And I also wanted to wish good, great, amazing, fantastic luck to:

• Kirby - starting what will hopefully be her first REAL cycle tomorrow!!!
• Watson - tomorrow's the c-section. She made it past 38 weeks with twins :-)
• Julie - whose HPTs are showing two lines!
• NakedOvary - there are no words... :-) (Thanks, mom, for pointing this out!)

I love happy news...

Miracle Baby & Multiple Births

Some items I came across in the news...

Congratulations to Kristy Atkins & Francis Tettey who became parents to Michael last month! Kristy was diagnosed with Turner's Syndrome when she was 8 and was led to believe she would never be a mom. I can't imagine how surprised she was when she saw those 2 pink lines!

Yesterday, I added a page on FertilityStories with an index of the infertility success stories posted on the site. Miracle babies is one of the categories :-)

I enjoyed reading this article by Samira Ahmed on the dangers of multiple births. I think her closing paragraph was the most significant part:

The question isn't whether the NHS should help such families but whether, when we get pictures of five little babies and their delighted, grateful parents, we are in danger of ignoring the man-made dangers and pain that, all too often, go with pushing the frontiers of fertility.

How can we avoid saying how cute the little quintuplets are? But then again, gosh... all the risks & all the care that goes into them. Is that really what we want?

And for anyone who's interested in the results of the poll from a few days ago (for some reason I can't get it to work) - here they are:

First UK IVM Babies Born

On October 18th, the first babies created using the IVM procedure (which I blogged about in February 2006) in the UK were born - a set of boy/girl twins!

See some articles here and here.

I find this so exciting, as it's a real opportunity for women whose risk of OHSS is too high for them to go through standard IVF cycles.

Congratulations to the new parents & babies!

Every other day? Maybe not...

In Israel, I sell discount ovulation kits, along with telephone support - so the question as to whether to have sex every day or every-other-day during the fertile time comes up a lot. Being unable to take any sort of responsibility, I quote a doctor (who gave me permission to quote him) and say that if they don't suspect a problem with the quality of the sperm, then every day is fine too. Now it seems that even if there is a problem with the quality of the sperm, sex every day might be better than sex every-other-day.

A pilot study (see article) led by David Greening, of Sydney IVF tested 42 men whose sperm showed significant DNA damage and found that daily ejaculation reduced this damage by 12%. These results were presented at the American Society for Reproductive Medicine conference in Washington yesterday.

Abstaining from sex increases the number of sperm cells that are ejaculated - leading to the recommendation for couples who are trying to conceive to only have sex every two to three days - but the article says that beyond this time period, although the quantity may rise, its quality declines; a trade-off.

I wonder if such DNA damage is tested in a normal sperm analysis, if so, what parameters show it and how common is such damage? If it makes an important difference (knowing whether there is or isn't DNA damage), it seems like information couples should have - and may even make it sensible to have two sperm analyses day-after-day to check if the sperm quality improves.

Scary Story - Swapped Babies

In Trebic, a town in the Czech Republic two babies were switched in the hospital, after the nurses wrote only the mothers' first names (both Jaroslava) on the baby ID bracelets...

Here (in Israel), and I'm sure in most places, they show you the baby and the bracelets on him or her before ever leaving your sight. They also use stickers that include additional identifying information - and the mom, dad & baby stickers are all a part of the same numbered set, so that mix-ups like this can't happen.

The amusing part of the article, in my opinion, was the husband going for DNA testing because he suspected he wasn't the father (he wasn't) and the mother doing the same (she wasn't the mother either...)

Currently (as I read in another article) both moms are refusing to give up the babies they raised.

Ugh

Warning... you may detect a bit of anger in this post...

Tomorrow I get to meet with a social worker (a new one, from another city) and my ex, to try to find a way to communicate. Now, in theory, that might be a nice plan. In practice, the #$(!@#* I was once married to (for 13-way-too-long-years) is an extremely irrational, terrifying creature who lacks self-control & doesn't hold himself accountable for things that he says or does. Most of our phone conversations end with me deciding I'm not going to listen to any more of his maniacal shouting and hanging up. The truth is, not communicating with him ever again about anything sounds pretty good to me.

Why is it automatically assumed that every divorced couple CAN achieve civil communication? I got divorced because I was way past the point of even trying to communicate with him... I mean, for the last 6 years of my marriage I wasn't allowed to ask questions like, "How was your day?" because it infuriated him. (Yes, I'm totally serious.)

The bottom line, though, is that I have to give it some sort of shot, because it will be completely obvious if I don't & that will knock points off my scorecard (the judge gets a report about these meetings).

At least the settings on my GPSare better than last time, so it should take me on faster roads. Hey, that's something to look forward to, right?

In other news, I posted a new page about early pregnancy. It still needs to be expanded (a lot), but I think it's a good direction, especially seeing that so many of the blogs I follow have gotten two pink lines in the past few months (and I hope many more will in the coming months!). Comments, as always, are welcome :-)

Donor Insemination Movie - And Then Came Love

Eric over at di-dad sparked my curiousity about the movie And Then Came Love in this post. He raised some very interesting questions and I wondered if there was any way to get an answer to some of them.

I sent a letter to Caytha Jentis, the writer and producer of the film, asking her to share any information she could regarding the donor insemination aspect of the movie (specifically mentioning that I would share her responses with the readers of my website).

Here's her response:

Dear Rachel,

Thank you so much for contacting me to learn more about our film. As you know our film is about a donor inseminated single mother, and I would describe it more as a romantic dramedy than comedy. While it certainly has a romantic fantasy element with humor and is a "feel good" film, it was very important to us to deal with the subject matter in a sensitive, thoughtful way and introduce issues that are not only relevant to DI single mothers, but the broader post feminist issues today's women face pertaining to balancing career and family - as well as even broader topic of "what is a family?"

I am the writer and producer of the film, and this is my first film. I hope that you and members of your group can see the film, as we always hoped that our film would invoke discussion. In fact one of our Behind the Scenes featurettes is about the "issues" and includes interviews with Jane Mattes, the founder of "Single Women by Choice" and Amy Harmon of the NYTimes who wrote extensively on DI.

While I am not donor inseminated nor a single mom, I did a tremendous amount of research on the subject matter, and do feel a strong connection to our protagonist as the film is really about the "search for love" as much as "search for the father." By the way, it was important to the director and I that the film should not have all the answers, and in the end was a film about people that any audience would care about.

All the best,
Caytha Jentis

I was glad to read that the topic hadn't been taken lightly and it will be interesting to see the movie.

Infertility Control

I started reading this article by Deborah Kotz with a "prepare to be mad" attitude (if I can't help it, at least I admit it). I think the article is well-researched and has basically good things to say. Though the title is, "Couples fighting infertility might have more control than they think" it doesn't claim that making changes will help everyone, rather that in some cases, improving nutrition, stopping smoking, gaining or losing weight and doing moderate exercise (more for those who don't do it at all, less for those who are overdoing it) can have an effect, particularly when the infertility is unexplained. She provides simple biological explanations to support these claims, in addition to quoting research from several respected sources.

It was only when I got to the middle of the 3rd page that my blood started to boil a bit. I particularly didn't like this sentence, "For some infertile couples, a phone call to a travel agent seems to do the job." ARGHHHHHH... after that, it looked like she threw in all of the rest of the information she collected while researching the article and I could have lived without that data as well...

Overall, an interesting read, especially for women just starting their TTC journey or couples with unexplained infertility. The article also touches upon methods currently in use to alleviate stress while going through fertility treatments.

When going through my fertility treatments, I didn't use any additional techniques. If you did, what were they and did you feel they helped?

Infertility Revisited

I wanted to share an article by Wendy Neilson about becoming a grandmother after infertility (her stepdaughter gave birth to a baby boy). I found it touching and I think the points she makes are important.

Shacking up & other news

I told my sister that I moved in with Ohad. She corrected me and said I'd 'shacked up' with him... She has the advantage of having lived in an English-speaking environment for far longer than I did. I, unfortunately, am stuck with the English of someone who left the US at 16 and decided to immerse herself in the new culture... language included. Anyway, back to the point... I finally decided that in order to get work done I needed to hire someone to care for Nomi some of the time. The allergist said it's too risky for her to be with other kids (she's allergic to milk, eggs, sesame seeds and almonds... so far), so it meant someone at home. My office, until yesterday, had been in the middle of the house - literally, a desk in between the kitchen and living room, with a view of most of the first floor of the house. Perfect for watching her crawl around while I check my spam email. I took over a corner of Ohad's (already scrunchy) office & now I can hide out here during those few hours a week when a babysitter comes to watch Nomi. Ohad and I have worked in the same office before & I'm actually finding it very nice. I would post a picture, but I don't think anyone would believe that my desk is the neat one (it is).

In other news, Mia sent in an update about her twins (born at 24 weeks) that will be posted later today (it's mostly good news, as she put it).

A good friend of mine who was misdiagnosed with PCOS and called me up one day to ask what a beta of 38 means (to which I answered - COME OVER & proceeded to give her peestick that showed a faint pink line) just started her 3rd trimester. In honor of that, I made her this shirt:

I'm going to have a designer draw a better version and put in on a t-shirt that people can buy (maybe at cafepress, if their site revives itself).

Congratulations to Adrienne Domasin, who is the first woman in the United States to have a baby born from IVF using both frozen egg and frozen sperm.

Last, but certainly not least, Bea has posted information about the next IIFF - International Infertility Film Festival.

Normal must be overrated...

These are the results of my 'normal' test:

You Are 50% Normal

While some of your behavior is quite normal... Other things you do are downright strange You've got a little of your freak going on But you mostly keep your weirdness to yourself

How Normal Are You?

I didn't notice anything strange, but then I guess that just proves how accurate this test is, right? Um. OK, maybe not.

There are still several free OPKs available. I'm also doing a trial sale on eBAY.

Here's a link to a new blog I've started reading: My Perky Ovaries. Karen's currently pregnant with triplets & has a lot on her mind. I'm sure she'll appreciate the support.

Watson posted 3 clips on how to prepare injections for IVF. She and her husband are great! Go take a look!

Multiple Births & Surprise Babies

My mom sent me this article by Susanne Sanchez who tells her story, from the discovery of triplets, through the impossible decision as to whether to reduce from triplets and the results of her decision. I think she has presented the dilemma well.

I couldn't miss this story about April Barnum of Orange, California who went into the hospital with stomach pains (not knowing she was pregnant) and ended up with a healthy 7lb 7oz baby. It seems that in the past she and her partner had wanted to have a child and had given up on the dream because they'd been unsuccessful. With April being as overweight as she is (420 lbs) it's easy to understand how doctors might not have been very optimistic about her chances.

Lastly, a small request: Please keep your fingers and toes crossed for Bea, now in the rotten two week wait.

Go get some ice cream

Check out this research being published today...

Their study showed that if women ate two or more servings of low-fat dairy foods a day, they increased their risk of ovulation-related infertility by more than four fifths (85%) compared to women who ate less than one serving of low-fat dairy food a week. On the other hand, if women ate at least one serving of high-fat dairy food a day, they reduced their risk of anovulatory infertility by more than a quarter (27%) compared to women who consumed one or fewer high-fat dairy serving a week.

I wonder if they recommend a particular flavor...

Some really good news

Beth, after the most horrible pregnancy ever, welcomed her daughter on Thursday! Congratulations!!!

Amillia Taylor an IVF baby born at just 21 weeks and 6 days, was released from the hospital and her prognosis is good!

Faith's second beta looks good - this is her first IVF/ICSI cycle.

Other's I've missed?

Comparative Genomic Hybridization - huh?

In a press release by the Sher Institute, they discuss comparative genomic hybridization (CGH) - a method in which DNA derived from a small egg chromosomal structure known as the first Polar body (PB-1), located immediately below the egg surface is tested. This testing aims to identify and then selectively fertilize only those eggs that are chromosomally normal and were thus deemed highly likely to be capable of developing into chromosomally normal embryos.

The results they report are good - a 74% live birth rate from a single cycle. In addition, they only transferred a maximum of two embryos, significantly reducing the risk of higher order multiples.

The same press release also mentions egg freezing using CGH and vitrification (a new method of rapid freezing of the ova, without causing damage to them) to freeze top-quality eggs for future use. 95% of the eggs frozen in the study thawed successfuly and 60% developed into viable embryos.

Endometriosis & Uterine Transplants

Kudos to Julia Bradbury, a presenter on BBC1's Watchdog who told her story of endometriosis just to help raise awareness. I admire her willingness to share something so personal.
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Uterine transplants are in the headlines again. Dr. Sherman Silber doesn't see it as being realistic due to all the 'normal' problems associated with organ donation. Personally, it seems so science-fiction to me that I can't even think clearly about it... He brings up some interesting points, so if you're interested in the issues, read the article.
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Special thanks to Nomi, my 9-1/2-month-old baby, who has now slept for more than 7 hours straight two nights in a row. Her sleep makes this blogging possible...

Ovarian Transplants

Stacy sent in the most incredible story - at 25 she was diagnosed with premature ovarian failure & her FSH was over 100. She was told she would never be able to have children of her own. Fortunately, Stacy had a trick up her sleeve. She is an identical twin, so she asked her sister to donate eggs & went through IVF with the eggs that would hopefully give her and her husband children that, genetically, would be identical to those she should have been able to have naturally. But the IVF failed & Stacy and her sister were devastated, until they heard about ovarian tissue transplants.

Ovarian transplant is currently only available to identical twins and as far as I can tell, it's only being done at St. Luke's Hospital in St. Louis, Missouri. The most famous case is of Stephanie Yarber, who is the first woman to have delivered a baby after ovarian transplant (includes a video of the doctor who delivered the baby), but since then, at least 4 others have delivered healthy babies.

Wow.

IVF babies become parents

I was shocked to see this article (2 articles about the same birth) today. Not because it is shocking that the world's first IVF baby, Louise Brown, has become a mom, but because earlier today I was thinking that there must already be a second generation after IVF... Louise's sister, Natalie was the first IVF baby to become a mom. Pretty cool.

After dealing with all the "is she normal?" questions about my daughter, it feels like another reassurance that there isn't anything different about being a test-tube baby. (And believe me, I get the weirdest letters about the effect of light on the embryos in the lab.)

Congratulations, Louise :-) and a special congratulations to her parents who worked so long & made such an effort to have her & by doing so proved that it was possible.

I'll need a double room

Womb, actually, that is... A woman with a double womb gave birth to triplets - a pair of identical twins in one womb and another baby in the other. Hannah Kersey, who's just 23 is now a mom to 3 girls born in September, 7 weeks early by c-section. This is the first reported case of triplets born from two uteruses in the same woman. Apparently, separate or partially joined wombs are more common than I thought - about 1/1000. As for City Girl, (with a unicornate uterus) she and Bat Girl are hanging in there, nearing 35 weeks now :-)

I've written about uterine transplant before and I find the continued research very interesting. They write that "The researchers point out that the transplant of organs that are not needed to preserve life raises ethical issues." I'm guessing that they are referring to the danger of major surgery and of rejection by the recipient, because there are organs that are donated to improve the quality of life (e.g., cornea transplants).

This article, last week about the first baby born after the Katrina embryo rescue brought tears to my eyes. I can only imagine what the couples with frozen embryos were going through - not only were their houses and their city being destroyed, but possibly their future children too. Some stories do have happy endings :-) Thank you, Eema, for sending me the link!

There was an interesting article recently about infertility in Orthodox Jews (from the Jewish Press). I may have heard it before, but still found it surprising that IUI is sometimes permitted even at times when the couple is not allowed to be intimate. Considering the large number of phone calls I've had from short-cycled women who are having trouble trying to conceive (let me know if you'd like an explanation as to why), this may not be a fun solution, but it at least is another option to taking drugs to postpone ovulation.

If you're interested in what's happening in the infertility field and would either like to post a guest post or join this blog, feel free to write me.