Our high pregnancy rates result from applying advanced fertility treatments in a caring and empathetic environment.

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09/21

2017

Dr. Mickey Coffler and the Importance of PCOS Advocacy

September is PCOS Awareness Month, a wonderful opportunity to educate the public about polycystic ovary syndrome (PCOS), the most common hormonal disorder impacting women.

According to the PCOS Awareness Association, PCOS affects seven million women in the U.S., more than the number of people diagnosed with breast cancer, rheumatoid arthritis, multiple sclerosis and lupis combined. Though millions of women have this syndrome, public awareness about it is not high and support organizations receive very little funding. As a result, close to 50 percent of women are not diagnosed properly or may not learn they have PCOS until they try to get get pregnant.

This year, one of the leading PCOS advocacy organizations, PCOS Challenge, is taking awareness a step further. PCOS Challenge wants Congress to pass legislation (H. Res. 495) to officially designate September as PCOS Awareness Month. This law recognizes the seriousness of PCOS and the need for further research and treatment options and, potentially, a cure. This is a historic, bipartisan effort.

Contact your Member of Congress
PCOS Challenge is encouraging PCOS patients and medical professionals to contact their Congressional representatives to let them know the importance of the bill’s passage. If your Congressional representative is not already a sponsor, you can identify him or her at this link: http://bit.ly/2ePFWy0. Sponsors are listed here: http://www.pcoschallenge.org/prioritize-pcos.

PCOS advocacy organizations
In addition to advocating for positive legislation, PCOS organizations play important roles in moving the conversation forward about how to help women with PCOS control their symptoms, prevent future disease complications like heart disease and diabetes, and combat fertility if pregnancy is their goal. Two of the leading ones are PCOS Challenge and the PCOS Awareness Association.

PCOS Challenge (http://www.pcoschallenge.org), the group behind the passage of H. Res. 495, is one of the leading nonprofit support organizations advancing PCOS awareness and serves nearly 45,000 members. Its focus is education and raising public consciousness; it also provides “confidence” grants to women for laser hair removal and other treatments to deal with body hair growth.

The PCOS Awareness Association (http://www.pcosaa.org) is another not-for-profit providing resources and information to women with PCOS.

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09/05

2017

Finding the Right Answers with Dr. Michael Feinman

Today Amanda is enjoying her life as a busy mother of newborn twin boys. But for more than four years she was frustrated both by her inability to get pregnant as well as by not being able to find a doctor who could provide her with a diagnosis.

Amanda recalled, “I Just wanted to know why I wasn’t conceiving. I’m the type of person who needs to have answers about my problems, but no one could tell me why I couldn’t get pregnant. It was frustrating.”

Amanda and her husband underwent one unsuccessful cycle of IUI with their OBGYN in Florida. After the couple moved to California, they decided to take a short break from fertility treatment. But Amanda was in her mid 30s and soon realized it was “do or die” time for her fertility. After researching clinics, she met with a few doctors and quickly learned how important it is to be compatible with the physician who treats you.

Amanda found her perfect match with Dr. Michael Feinman. “More than with other doctors I met, Dr. Feinman seems to push the envelope of fertility treatment and thinks out of the box,” she said. “Dr. Feinman suggested we have an Endometrial Receptivity Analysis (ERA) before the egg retrieval for our first IVF. This was a game-changer. He wanted to know why I couldn’t get pregnant almost as much as I did. Plus, I liked his dry sense of humor and how he didn’t sugarcoat my situation.”

The ERA assesses the optimal time when the endometrium will be ready for the embryo transfer. Based on the ERA results, Dr. Feinman froze Amanda’s eggs and prescribed progesterone and Estrace for a month. The two embryos Dr. Feinman transferred a month later became Amanda’s twins, Hunter and Cooper.

Amanda advises other couples to be realistic, but hopeful: “With fertility treatment, you may not always get the answers you want. But with a doctor like Dr. Feinman, you can be assured he will go the extra mile to get you answers so you can make the final decision about what is best for you.”

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08/30

2017

Dr. Diana Chavkin Explains Primary Ovarian Insufficiency

A woman in her early 20s or 30s who may have trouble getting pregnant, or a woman who is concerned about irregular periods, hot flashes, night sweats and vaginal dryness may find that she has primary ovarian insufficiency.

This can be one of the hardest diagnoses for a woman to face.

What is Primary Ovarian Insufficiency?
Primary Ovarian Insufficiency (POI), previously called “premature ovarian failure (POF) is when menopause occurs before the age of 40. POI occurs in 1 in 1,000 women between the ages of 15-29 and 1 in 100 women between the ages of 30-39. Twenty seven is the average age of onset.

Women with POI have complete or near complete ovarian follicular depletion with resulting low estrogen and high Follicle Stimulating Hormone (FSH) levels. They often will experience menopausal symptoms such as hot flashes, night sweats and vaginal dryness and will rarely ovulate.

Some women with POI can still ovulate and menstruate and may be able to conceive. However, the odds are low. According to the National Institute of Health, between five to ten percent of woman with POI have conceived and have carried normal pregnancies without medical assistance.

Who is at risk?
In about half the cases, a reason for POI is not found. However, we know that women with a family history of POI are at greater risk. The condition is also associated with autoimmune disorders affecting the thyroid and adrenal glands. And it is also linked to genetic causes such as Turner and Fragile X syndrome. Additionally, women exposed to chemotherapy and radiation are at greater risk for POI.

Long-term effects
The low estrogen levels associated with POI may make women particularly prone to develop osteoporosis and early heart disease. Women may also be at a greater risk for depression. If POI in a particular case is linked to a genetic condition, then there might be a risk to future children.

Emotional impact
This can be an emotionally devastating diagnosis for many young women. Dreams of motherhood and ideas about self worth may be challenged. At the same time, they may have to deal with the physical symptoms of menopause years before their peers. This can take an emotional toll on one’s psyche and relationships. Counseling and support are available.

Treatments
There is no cure for POI, just as there is no cure for aging eggs. Many women don’t find out about this condition until their FSH level is measured when they see a doctor because their periods are irregular or nonexistent.

To achieve pregnancy, a woman with POI may opt to undergo IVF with her own or with a donor’s eggs. Additionally, a woman with POI will likely be advised to take supplemental estrogen in order to avoid some of the detrimental effects that low estrogen can have on her bones and heart.

References
http://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/fact-sheets and-info-booklets/what-is-premature-ovarian-insufficiency-also-called-premature-ovarian-failure/

http://www.mayoclinic.org/diseases-conditions/premature-ovarian-failure/symptoms-causes/dxc-20255567

http://medlineplus.gov/prematureovarianfailure.html

http://www.hormone.org/diseases-and-conditions/womens-health/primary-ovarian-insufficiency

https://www.nichd.nih.gov/health/topics/poi/conditioninfo/Pages/treatments.aspx

http://www.resolve.org/about-infertility/medical-conditions/premature-ovarian-failure-1.html?referer=https://www.google.com/

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08/29

2017

When is it Time to Consider Donor Eggs?

We are often asked this question by patients who are at a crossroads in their treatment. Deciding to use the genetic material of another woman to have a baby is typically made with a lot of thought, deliberation and soul-searching.

Here are some questions to consider as you move forward in our family building journey.

Do you have a pre-existing condition?
Some women arrive at our office knowing they will need an egg donor. They may have lost their fertility because of cancer treatment or a medical condition that caused their ovaries to be removed or stop functioning. Other women may carry an incurable genetic disease they don’t wish to pass to their future children and don’t want to genetically screen their embryos.

Are you older than the age limit for your clinic?
Many fertility clinics have upper age limits for females past which they will not perform IVF with a woman’s own eggs. From their experience, they feel the IVF success rates are too low to justify the time and expense of this procedure versus the results. This can be a frustrating policy for patients, but one developed from the experience of the particular clinic.

Do you have weak ovarian reserve?
Every female fertility patient undergoes several fertility assessment tests. These tests provide an overview of the approximate number of eggs remaining in her ovarian reserve as well as her potential response to fertility medications. None of the tests can evaluate egg quality, though we know this declines with age.

Your doctor will discuss the test results with you so you can make a joint determination about whether to proceed with further treatment using your own eggs. Often women need to see if they can beat the odds with their own eggs before moving on to another family building procedure. Usually an IVF cycle, especially one combined with genetic screening, can provide patients with valuable information about the odds of conceiving with their own eggs.

Have you experienced multiple IVF and pregnancy losses?
Women who decide to use donated eggs frequently have experienced multiple losses with their own eggs, including failed IVF cycles and miscarriages. When you are producing abnormal eggs and embryos, it’s probably time to make other choices.

Is experiencing pregnancy and childbirth important to you?
The loss of passing your genetic characteristics to your child can be perceived as a profound loss. However, using donor eggs also gives you many benefits. Donor egg with IVF enables women to experience pregnancy and childbirth, take care of their baby prenatally, and nurse their child.

Using donated eggs also allows the female’s partner to be genetically related to their child, which is an important consideration for many couples.

Learn more about HRC Fertility’s egg donation program, one of the most experienced and successful in the United States. Visit http://www.havingbabies.com/infertility-treatment/egg-donation-program/.

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08/11

2017

All in the Family with Dr. John Wilcox

Courtney Glickman is the second member of her family to be treated by Dr. John Wilcox. Her aunt, who has pre-teen twins from fertility treatment with Dr. Wilcox, referred her to HRC’s Pasadena office when Courtney was having trouble conceiving.

At the time, Courtney couldn’t have imagined she would have her own set of twins a little over a year later in 2012, and another baby, born in 2017.

Courtney’s fertility journey began several years earlier. After she stopped using birth control pills, her periods became very unpredictable and then stopped altogether. She started treatment with an OBGYN, who kept diagnosing her with different conditions but nothing definitive.

“My aunt told me I needed a one-stop shop for infertility care. So I transitioned to Dr. Wilcox, who diagnosed me with unexplained infertility,” recalled Courtney. “He also told me my periods would probably return after childbirth.”

Initially, Dr. Wilcox took a conservative approach, prescribing medication and intrauterine insemination. When this didn’t work, she underwent her first round of IVF, which resulted in her boy/girl twins.

Courtney was not yet finished building her family, however. After again having trouble conceiving with her new husband, Dr. Wilcox performed surgery to reduce the scar tissue in her uterus and then two rounds of IVF. This go-around, the couple was able to utilize newer genetic testing and gender selection technologies.

Looking back, Courtney added, “Going through infertility treatment is very emotional. Even though you try to be hopeful, it’s still very hard. But Dr. Wilcox and his team made us feel like we weren’t alone. He and his nurses always communicated with me, no matter how many questions or concerns I had, including a scary trip to the emergency room.”

Courtney advises others to find someone like Dr. Wilcox: a physicians they can trust, who communicates well and who provides the full array of fertility services in one location.

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