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

08/30

2017

Dr. Diana Chavkin Explains Primary Ovarian Insufficiency

Posted by admin | Filed under Age Factors, All About Eggs

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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08/04

2017

Dr. Bradford Kolb and HRC End Couple’s Cycle of Heartbreak

Posted by admin | Filed under Age Factors, Getting Pregnant

Mary and James had been trying to conceive for eight years before being referred by their OBGYN to HRC and Dr. Bradford Kolb. The couple had seen other infertility specialists, including one overseas, and had undergone unsuccessful IUI and IVF cycles plus a heartbreaking ectopic pregnancy.

By the time they first saw Dr. Kolb in fall 2015, they were considering surrogacy. “We thought our age was a factor, “recalled 42-year-old Mary. “But Dr. Kolb reviewed our records and ran some tests. He convinced us that everything looked good and was confident we could get pregnant with IVF.”

The couple really liked how Dr. Kolb took the time to listen and was hands on, which was a pleasant departure from their previous physicians. One doctor would only see them a few minutes before handing them off to the staff. They also liked that Dr. Kolb was receptive to Chinese acupuncture, which made them feel less stressful and more relaxed.

At HRC Fertility, Mary and James underwent two cycles of IVF and had their embryos genetically tested. The remaining viable one became their son, who was born in June. They thank their lucky stars for this gift.

Mary advises other couples to do their homework to see if prospective clinics are a good fit for their needs and personality. They also encourage others to have a game plan, as they did. Mary explained, “We felt stressed during our previous IVF cycles. During our last one at HRC, we felt comforted knowing we had a backup plan if it didn’t work. That really helped to reduce our stress levels.

Even though they weathered much disappointment with other fertility providers, Mary and James are grateful for having found Dr. Kolb, knowing he was the difference in helping them create their family.

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05/05

2017

A Millennial Woman’s Guide to Egg Freezing

Posted by admin | Filed under Age Factors, All About Eggs, IVF

To freeze or not to freeze?

That is a question many millennial women are asking themselves. Should they freeze time and their biological clock by undergoing oocyte cryopreservation, the medical term for egg freezing, or will Mr. Right come along before their fertility is reduced?

At HRC Fertility, we are seeing an increased interest in “social” egg freezing as the technique becomes more popular and effective. Some employers, such as Google and Facebook, have even begun offering this benefit, realizing their female employees want more reproductive choices.

Though there is no “one size” fits all answer, the women who come to our clinic to inquire about their options generally look at these factors to make a decision: current age; finances; professional and education goals; relationship status; desire to become a mom and have children.

What do women really need to know about egg freezing?
Before they embark on their egg freezing journey, the typical twenty or thirtysomething woman should know the answers to these questions about preserving their fertility.

What is the best age to freeze my eggs?
Ideally, women should freeze their eggs in their late 20s or early 30s when their fertility potential is highest. The older a woman is, the more eggs she will need to have retrieved to maximize her chances of a pregnancy when she uses them. This might mean several egg retrieval cycles.

How are eggs frozen?
The largest cell in the human body, the egg, is mainly comprised of water that can form ice crystals when frozen, which damages the cell. At our laboratory, we freeze eggs using a flash freeze process known as vitrification. First, however, we add an “anti-freeze” to prevent crystallization. Vitrification was a major advancement over the slow freeze method previously used.

What is the egg retrieval process like?
Similar to IVF, egg freezing requires a series of hormone injections and monitoring of your hormone levels and ovaries. When th eggs have matured, they are retrieved using transvaginal guided ultrasound while the patient is under anesthesia.

What happens when I want to use my eggs?
We will thaw your eggs and combine them with the sperm of your choosing. Current estimates indicate that up to 75 percent of eggs survive thawing with 75 percent of those fertilizing and growing into embryos.

About 2,000 babies have been born from egg freezing, and there have been no reports of higher birth defects or abnormalities with these babies. Experts currently believe eggs can remain frozen indefinitely, although there have been no studies of eggs frozen more than 10 years.

What if I don’t use my eggs?
Many women have found that frozen eggs gave them peace of mind to pursue their professional goals and/or to move with their lives without worrying about losing their chance to have a baby. Many find partners and get pregnant the “old fashioned” way but are glad they took out this fertility insurance plan.

Who else should freeze their eggs?
For women facing a cancer diagnosis, freezing their eggs can be a game changer for life after their cancer is cured or in remission. We highly recommend they undergo an egg retrieval before starting life-saving, but fertility-damaging treatment.

Two other types of patients might also want to consider egg freezing: those who have moral or religious objections to excess embryos and women with a family history of premature menopause.

At HRC Fertility, we firmly believe that young women who think they someday want kids should take charge of their fertility. Knowledge is power, and we encourage them to educate themselves about fertility in general and egg freezing in particular.

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07/07

2016

Important Points About Unexplained Infertility

Posted by admin | Filed under Age Factors, Infertility

unexplainedFor couples who have been trying to get pregnant for months or even years, hearing they have a ‘diagnosis’ of unexplained infertility can seem like a double blow, both physically and psychologically. Please keep this in mind:

You’re not alone
Unexplained infertility affects approximately 15% of couples. It is defined as the lack of an identified cause for a couple’s inability to conceive after 12 months (or six months for women 35 and older), despite evaluation of: tubal potency and a normal uterus; adequate ovulation; and, a normal semen analysis.

There are many treatment options
Though you may not receive an official diagnosis with unexplained infertility, it does not mean that unexplained infertility is untreatable. The prognosis for unexplained infertility is directly dependent on the female partner’s age.

Treatment options include Clomid combined with IUI. If that is not successful after three for four cycles, IVF is generally recommended. In fact, results from FASTT*, the fast track and standard treatment randomized clinical trial, showed that it made more sense financially and emotionally to refer patients with unexplained infertility to IVF after failed IUIs versus advising more IUIs with injectable hormone medications.

In addition, laparoscopy will be offered to patients with symptoms suggestive of endometriosis or pelvic adhesions.

IVF can be a diagnostic tool
Once a patient undergoes IVF, we might discover factors we did not know about previously, such as poor egg quality, embryo development or implantation. Having the ability to look at these variables under laboratory conditions can help us assess a reason for your infertility.

Having no diagnosis can be frustrating
Having no diagnosis is often stressful and very frustrating. People generally do better knowing that there is an identifiable reason for their difficulties, and that there is a solution for it. Unexplained infertility is associated with a lot of uncertainty and creates typically high stress and frustration, more so, of course, when treatment fails.

You can optimize your fertility
In addition to standard courses of treatment, many patients feel better emotionally and physically when they take steps to live a healthier and more mindful lifestyle, which also may benefit their fertility. Eating healthy, exercising, and incorporating mind/body techniques can help you feel more in control.

As always, please feel free to contact us if you have any questions about this or another fertility topic.

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06/08

2015

The Highs–and Lows–of Fertility Treatment

Posted by admin | Filed under Age Factors, All About Eggs, Getting Pregnant, Infertility, IVF

Fertility treatment is a challenging time for couples–physically, financially and emotionally. There are many ups and downs for those struggling to get pregnant.

L. and A. had their ups and downs as well, beginning with a clinic that made them suspicious that they were being taken advantage of by their endless testing and lack of communication about what was happening.

After doing their research on other clinics, the couple moved to Dr. Robert Boostanfar at HRC. While they were happy with HRC and the way that Dr. Boostanfar guided them through the process, they still had to deal with a disappointing egg retrieval with their first IVF cycle and anxiety about embryo transfer with the second cycle.

“I’m an optimist and try to look at things in a good light, but going through all of this is difficult and draining,” L. explained. “You can’t let yourself get too sucked into it.” Because of her age (38) and medical history (her mother went through early menopause), L. was happy and relieved when she produced seven eggs during the second cycle. But not all of them developed into viable embryos.

“That was pretty disappointing because we knew we didn’t have any back-ups if those embryos didn’t take,” she said.

The two-week wait after embryo transfer was equally nerve-wracking, and L. remembers she and her husband trying to hide their anxiety while visiting with friends and family. They were out to dinner when they got their POSITIVE news!

“We hadn’t told anyone about the implantation because we didn’t want their sympathy if it didn’t work out,” she said. “We didn’t want their feelings of disappointment to rub off on us because we knew we if it didn’t work, we would do it again.”

Finding out they were pregnant was one of the best moments of their lives.  In fact, after finding out they were pregnant with twin girls, L. said, “We couldn’t even eat. Such a shame, too! It was a huge, good-looking buffet.”

If the couple could offer any advice, L. said it would be this: “You know that saying ‘the world has a way of making sure you really want what you say you want’–or something like that–I kept thinking of that throughout everything. The process isn’t easy and has its ups and downs. You need support, a sense of humor, a firm grasp of yourself and why you’re doing this because it truly does make sure you really want what you say you want!”

 

 

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