Infertility

More Thoughts on PGD

2010-11-07T16:17:23-05:00

I had an interesting conversation with a friend over brunch today where we touched upon pre-implantation genetic diagnosis.

I have written very briefly about PDG before, but I’d like to comment on it about it again here.

Why are physicians and hopeful parents practicing PGD? It can be used along with in-vitro fertilization to test embryos for certain medical conditions like cystic fibrosis, down syndrome, and I believe some certain cancers.

Different Types of Fertility Treatments

2010-08-17T02:37:19-04:00

There are many different types of fertility treatments. Here are just a few:

In-Vitro Fertilization (IVF)
Intrauterine Insemination (IUI)
Hormone Treatments (Clomiphene or Estrogen, among others)
Acupuncture

Each fertility strategy has its own benefits and drawbacks, and each infertility case is different, so its probably best to speak with your physician about which treatment is right for you. It might even make sense to get a second opinion!

I know one couple who tried IVF several times before giving up and trying acupuncture successfully.

Ideas for a Research Network

2010-01-10T09:16:34-05:00

These were the original ideas for a fertility related research network:

Plan

Divide up ideas into components

Build concept scaffolding / framework - identify existing code, and customize to resemble the goal of the research network

At this point, a project management package would be the closest package. We should try to set one up and see how it performs.

Install active collab, mediawiki, and wordpress for a domain.

Initial Concept Components

BASIC: Member administration, profiles, discussion groups, etc.
COMPLEX: Project Management - what is a research project? Hypothesis, data collection, data analysis.
COMPLEX: Social networking, web of trust, etc.

Opening Page

Member Sign-In / Sign-Up
Discussion Groups
Open Projects
Member Directory
Researchers Actively Seeking Projects
Search

Industry Projects

Latest Publications
In the news

Discussion Groups

IVF

Single
Embryo Grading
PGD

Menopause

POF (Premature Ovarian Failure)

Project Page

“Title”
Project Founder

Participants and Criteria for Participation

Data - spreadsheet / database
IRB Forms - legal

New Project

Hypothesis
Create Spreadsheet
Choose Participants
Submit IRB Approval

Member sign-up

Submit CV
Personal Info
Interests

Join A Project

Apply to project - submit CV, explain intent, agreement
View Application

Select Participants

Only viewable by founder

Announce project (public / private)
View applicants

Notes

Social network - people currently / previously worked together
Degrees of separation
Web of trust
Approval
Sponsors for the network in general or for specific projects

Octomom

2009-06-10T15:48:38-04:00

Nadya Suleman aka. Octomom has become somewhat of a punchline and rightly so. Apparently she’s off her rocker to say the least.

Prior to giving birth to the octuplets she already had 6 children who she was unable to support financially. It’s infuriating that although unemployed with 6 children, she still decided to go through with the in-vitro fertilization. The fact that this woman is responsible for 14 children is disturbing.

The government should be able to step in in situations like this. If she was unemployed I don’t know how she could afford the fertilization. I’m not even sure how much that costs, but I imagine its not cheap.

Additional Thoughts:

Some states require health insurance to pay for in vitro fertility treatments, which I think is appropriate for people who need it. Otherwise its around $20,000 per session.

In the case of Nadya, I wonder about the ethics involved on the part of the doctor who performed the fertilization. Should they be allowed to practice?

Medical ethics is one of the most complex and challenging topics.

Oocytes at Birth?

2009-04-12T15:28:46-04:00

Here’s an interesting story at the Washington Post about whether female mammals are born with all the oocytes they will ever produce:

Long-Held Tenet on Women’s Fertility in Question

Publicly Funded Research

2009-03-18T00:03:21-04:00

Should publicly funded research be freely accessible by the public? Here’s an interesting blog post about this topic, relating specifically to the NIH:

Publicly-funded knowledge should be public

Ovary Transplants

2008-11-15T23:03:49-05:00

A new procedure called ovary transplantation has proven successful with the birth of “Maja”:

Ovary transplant mother speaks of her “indescribable” joy after giving birth

Congratulations to their family!

Acupuncture vs. IVF Article

2008-02-08T16:48:04-05:00

A new study suggests Acupuncture can be used to augment the efficacy of IVF. See the this link for more details.

Acupuncture as an Infertility Treatment

2008-01-25T14:31:21-05:00

When western medicinal tactics fail to assist with fertility, it can be emotionally taxing for a couple trying to conceive. May people view this as their last resort, and when it doesn’t work, they may end up feeling helpless. Thankfully, there are additional measures which can be taken, including acupuncture. Acupuncture has been successful in helping fertility-challenged couples conceive.

Each patient presents with a different “pattern” or “disharmony” and the acupuncturist creates a treatment strategy specific for that individual. Couples may be treated side by side, or separately. Treatment strategies are not confined strictly to women, either. If a man is found to have a low sperm count or lowered sperm motility, acupuncture may help him too.Different practitioners will have different approaches. The best way to decide on who to see is to get a referral. That is not always possible though, so calling a practitioner and asking the right questions can lead you to someone who can help.

Good questions to ask:

Have you any experience with infertility?
What is your success rate?
How many treatments do you think it will require? - You probably won’t get an answer to this question until after they do a full intake.

Reasonably you can expect that you will need at least 3 months of weekly treatments depending on the condition.Feel out the person too. Do you get a good feeling from them? Are you comfortable around them? It’s important to find someone you sync up with not in a social capacity, but rapport and trust with your practitioner is vital.

Acupuncture can be expensive, not when compared to the cost of in-vitro fertilization (IVF), but nonetheless it usually runs about $75 a treatment, so be prepared this is a financial undertaking, just like anything else.

Successful acupuncture requires a commitment from the patient beyond just arriving for treatments. Your practitioner may suggest changes in diet, and without those changes your treatments may be rendered unsuccessful. For example, you may be asked to give up dairy for a little while.

Most importantly, emotional stress can have a negative impact on the body. From a Chinese perspective, deep frustration may actually cause a blockage and inhibit the ability to conceive. It is important not to get frustrated (I know - easier said than done), and listen to your doctor’s and practitioner’s advice when they tell you to take it easy.

Infertility Treatments

2008-01-11T10:34:30-05:00

I’ve asked someone (an OB/GYN, specializing in REI) about the different infertility treatments available. The first thing she said is that there are quite a lot of them! So we’ll just cover some common basic ones for now.

Clomid

This drug enhances release of a hormone called FSH, resulting in minor hyper-stimulation of the ovaries. This typically can kick start ovaries into releasing eggs. However, occasionally this works too well and more than one egg is released. This is why the chances of conceiving twins in increased.

Gonadotropins

If Clomid doesn’t work, physicians commonly prescribe injections of FSH. Like Clomid, this causes increased stimulation of the ovaries in an attempt to increase egg release.

Intra-Uterine Insemination

This is a technique that can be used with either Clomid or Gonadotropins. A small catheter is used to inject semen into the uterine cavity. I always call this the “turkey baster” method. This circumvents the need for the sperm to cross the formidable barrier of the cervical mucus. This often increases the concentration of sperm which comes into contact with the egg.There are many more techniques available, but these three are a couple of basics. Also, these methods are only used in patients with anatomically normal tubes (no tubal blockage).

PGD

2007-11-06T22:03:43-05:00

PGD, or pre-implantation genetic diagnosis, is the process of testing embryos for genetic diseases prior to in-vitro fertilization. Pretty cool, huh?

Open-Clinica

2007-07-01T14:03:05-04:00

Open-clinica is a great open-source software application that can be used to organize individual studies being conducted in many centers by multiple clinicians.

After reviewing their website, I have the following comments:

I like their “study management” section. In this section, study directors delineate what information they want to collect and the inclusion/exclusion criteria for study subjects. Here, directors also select/eliminate individual researchers and study sites. It also allows study directors to view data collected by specific researchers.
On the other hand, I am not a big fan of the “data submission” section. This portion of the software is very confusing and over-done. I like the idea of having separate pages for each patient/subject entered. However, there should not be separate pages for each event that occurs to each patient. It would be much easier if every subject had one page with various blanks to fill in. It might be nice to also have a “comments” section on each subject site where researchers could add in a comment on a specific patient if they wanted to.
I like the “extract data” section. This section allows a director to identify which data points she wants to compare at any given time, thus allowing her to analyze diffrent parameters of the study separately.
I like the login and user profile pages. This is a good way to ensure the integrity of the site. By viewing each others’ CVs on the site, researchers can feel more comfortable about sharing ideas with people they have only met online.
When I tried to download the demonstration, it wouldn’t work and it filled my computer screen with strange symbols. I had to shut the computer down to get rid of it. They are using Windows Media Videos (wmv), which won’t work on a Macintosh. MPEG would have been a better choice, as that will display on any platform. In general, I think that open clinica is a great piece of software with the potential to bridge geographical obstacles to conducting research. Once it is recognized, I think it will be well-received in the medical community.

REI Fellowship

2007-06-30T21:46:14-04:00

It’s hard to become a fertility doctor these days… In order to treat women with infertility, a doctor must graduate from medical school, complete a 4-year residency in Ob-Gyn, and then go on to a 3-year fellowship in infertility.

These fellowships are highly sought-after and only accept bright, motivated physicians with lots of research experience. So, women can rest assured that reproductive endocrinologists are a unique bunch of highly-trained doctors.

Informed Infertility

2007-05-25T23:27:42-04:00

This blog has been started due to many conversations with someone who is currently an obstetrics and gynecology resident and is applying to fertility fellowships after graduation. She is very passionate about the field and to encourage her I’ve setup this blog where she can share her passion with the internet. Just today she told me about how Extend Fertility announced that a baby was born from a frozen egg (aka egg cryopreservation). Pretty amazing!

About

2007-05-25T23:27:42-04:00

This blog has been started due to many conversations with my wife, who is currently an obstetrics and gynecology resident and is applying to fertility fellowships after graduation. She is very passionate about the field and to encourage her Iâ€™ve setup this blog where she can share her passion with the internet. Just today she told me about how Extend Fertility announced that a baby was born from a frozen embryo (aka Embryo Cryopreservation). Pretty amazing!NOTE: The content on this site is copyright, all rights reserved. It is for novelty use only, if you need medical advice seek the help of a professional.