Most American women know that age is an important factor in the success of fertility treatments, finds a new survey of 763 women, aged 18 and older, including 125 women who’ve had fertility treatment.

The HealthyWomen poll found that 88 percent of respondents were under age 35 when they first sought medical advice about their fertility.

The survey asked women about their views and priorities when it comes to having children, and their experiences when seeking medical help to treat fertility problems.

Fifty percent believed fertility problems are equally likely to be a female or male issue, while just 5 percent believed men are more likely to be infertile. In fact, infertility is a female problem in 40 percent of cases, a male problem in 40 percent of cases, and a combined or unexplained problem in 20 percent of cases, according to HealthyWomen.

The majority of women knew that risk factors… Read the rest of this article US News.

Originally Published on Friday, December 11th, 2009 by HealthDay News.

Are you a female athlete — or just someone who likes challenging workouts — who also wants to get pregnant? It may make sense to ease off a bit as you try to get pregnant. New research from the Norwegian University of Science and Technology (NTNU) shows that the body may not have enough energy to support both hard workouts and getting pregnant.

Roughly seven per cent of all Norwegian women are believed to have infertility problems, which means that they are unable to become pregnant during the first year of trying — even if they might later become pregnant.

Infertility can have many causes, both medical and lifestyle-related. Known risk factors include smoking, stress, and alcohol. Being extremely under- or overweight can also play a role.

It is known, however, that elite sports women have more fertility problems than other women. But does extreme physical activity play a role in fertility among other women as well? NTNU researchers examined precisely this question in a study involving nearly 3,000 women. They found that overly frequent and hard physical exercise appears to reduce a young woman’s fertility. But the decrease in fertility probably lasts only as long as the hard training.

Two vulnerable groups

The study was based on material from the Health Survey of Nord-Trøndelag from 1984-1986 and from a follow-up survey in 1995-1997. All of the women who participated were healthy and of childbearing age, and none had a history of fertility problems.

In the first survey, women responded to questions about the frequency, duration and intensity of their physical activity — and ten years later were asked questions about pregnancy and childbirth.

The NTNU researchers also recorded other information that could have significance for the study.

“Among all these women, we found two groups who experienced an increased risk of infertility,” says Sigridur Lara Gudmundsdottir, a PhD candidate in NTNU’s Human Movement Science Programme. “There were those who trained almost every day. And there were those who trained until they were completely exhausted. Those who did both had the highest risk of infertility.”

Age an important factor

If the women also were under 30 years old in the first study, the relationship became even more evident in both groups. Among those who reported training to exhaustion (regardless of frequency and duration), 24 per cent had fertility problems. In the group that had trained almost every day (regardless of the intensity and duration), 11 per cent reported the same.

Even when the data were adjusted for other possible contributing factors (such as body mass index, smoking, age, marital status and previous pregnancies), the researchers found that women who trained every day had a 3.5 times greater risk of impaired fertility as women who did not train at all.

“And when we compared those who trained to exhaustion to those who trained more moderately, we found that the first group had a three-fold greater risk of impaired fertility,” says Gudmundsdottir.

In women who reported moderate or low activity levels, researchers found no evidence of impaired fertility.

A transient effect

But the negative effects of hard training do not appear to be permanent, the researcher says.

“The vast majority of women in the study had children in the end. And those who trained the hardest in the middle of the 1980s were actually among those who had the most children in the 1990s,” she adds.

There may be various explanations for why the women who first were least fertile ended up with the most children. “We do not know if they changed their activity level during the period between the two surveys. Or if they just had trouble getting pregnant the first time, but afterwards had a hormonal profile that made it easier to get pregnant again,” Gudmundsdottir said.

Too demanding?

Scientists have a theory that high levels of physical activity are so energy intensive that the body actually experiences short periods of energy deficiency, where there simply is not enough energy to maintain all the necessary hormonal mechanisms that enable fertilization.

Read the rest of the original article here

She also recommends that physically active women be particularly aware of their menstrual cycles. “A long cycle or no menstruation at all are danger signals,” she says.

http://www.sciencedaily.com/releases/2009/11/091111120257.htm

Dr. Lavy: There are 5 main categories in which we find women and men needing egg donation.

1. Women who have age related decrease in ovarian function. Most of these women are in their early 40’s whose ovarian function does not allow successful pregnancy.

2. Premature ovulation failure which is the cessation of ovarian function at an early age as a result of genetics, disease conditions, surgery or environmental factors. Eggs lost cannot be replenished. However in the absence of ovarian function the uterus under certain hormonal control retains its’ ability to carry a pregnancy.

3. Repeated IVF Failure due to poor egg quality.

4. Genetic Conditions which include genetic abnormalities that are carried by the female partner may preclude a normal pregnancy and require egg donation.

5. Gay couples and single men that are would like to have children who are genetically related to both partners.

Question: Egg Donation is a relatively a new program in Reproductive Medicine. Can you give us an overview of the process and the technology involved?

Dr. Lavy: Egg Donation has been practiced in the United States for over 20 years. The process is becoming common place as the rates of success improve and the availability of donors increases. Rigorous screening has brought standardization to this area and ensures “high quality” donors. The FDA provides an additional measure of security by regulating screening of donors.

The process includes the following steps:
1. Consultation with your doctor and the egg donor team.

2. A mock cycle or trial cycle may be prescribed. This allows the physician to evaluate the hormones estrogen and progesterone on the uterine lining. The mock cycle is to make the necessary adjustments to the drugs thus maximizing the chances of success.

3. The Recipient Couple will meet the psychological coordinator. Usually the same counselor also meets with the donor. The psychological counselor will answer questions regarding the emotional impact of egg donation and assist you in making the decision that is right for you.

4. The recipient couple will be screened. Both partners require blood tests to rule out infectious disease. In addition the female partner will have hormonal tests.

5. The recipient couple will start the process of choosing a donor. Usually the couple is required to list the important characteristics they are seeking in a donor. Couples can either choose to work with our own egg donor registry or use an outside egg donor agency.

6. Before you are ready to start, a review of your treatment plan , consent signings and injection teaching will be presented so that your familiar with the details of your treatment plan and are ready to administer your medications.

7. Next your cycle will be synchronized with the donor’s. The donor will begin her stimulation medications and the recipient the hormonal preparation of her uterus.

8. Retrieval of the egg will be scheduled as soon as the donor’s eggs are mature and ready. The male partner is asked to submit a fresh semen sample on the day of the retrieval.

9. On the day of the retrieval eggs are usually fertilized. The embryos are observed for 3-5 days prior to transfer. The transfer procedure is simple, takes about 10 minutes and does not require anesthesia.

10. Two weeks following the transfer a pregnancy test will determine if the cycle was successful. Once pregnant you will continue the hormone therapy or 6-8 weeks.

Question: What is your criteria for selecting egg donors?

Dr. Lavy: Approved donors must be between the ages of 21 and 30, have a healthy family history, must be a non-smoker with a normal body mass index. A full review of the information gathered from the donor’s screening will be reviewed by myself and the third party team for final acceptance.

Question: What screening is completed on the donors?

Dr. Lavy: Screening of egg donors include a medical review, evaluation of egg reserve, a medical examination, a psychological assessment , genetic screening and final assessment where the team reviews the information and comes to a decision on the eligibility of the donor into our program,

Question: Are egg donors and recipients anonymous to each other?

Dr. Lavy: In the case of anonymous donation, yes. If a couple is using a directed donor, then the identity is known. Donors will undergo the same screening as anonymous donors.

Question: How are egg donors chosen to match a couple?

Dr. Lavy: A partial profile of each of the donors is available on our website as well as photos of the donor.

Our anonymous donors provide us with a detailed history of themselves and their family. This information is summarized in the donor profile. A 15 page document is available to the recipient couple to review. The donor file also included photographs ( current as well as childhood pictures) . A final collaborative review of the selected donor is conducted with the third party team , recipients and myself.

Most of are donors are recruited and tested by us. By doing so we are able to control donor selection, improve quality and improve success. Our anonymous egg donor pool is the largest in the region.

Question: How many cycles can a donor participate in?

Dr. Lavy: American Society of Reproductive Medicine advises IVF clinics to only allow 6 retrievals per egg donor.

Question: How is the intended carrier prepared for the transfer of the embryo?

Dr. Lavy: The recipient is prepared with estrogen and progesterone to prepare her uterus for embryo implantation.

Question: What are the success rates for egg donation?

Dr. Lavy: At our clinic approximately 7O% success rates using our donors.

For more information on New England Fertility Egg Donation Program please contact Marion Welch at mwelch@nefertility.com

[mwelch] If anyone has a question on IUI, you may also email mwelch@nefertility.com.
[Patty O'Neill, APRN] Yes Marion. An IUI or intrauterine insemination is a procedure in which semen (either fresh or frozen) is prepared to separate the motile sperm cells from the semen.
[Patty O'Neill, APRN] Then this sample is injected into the uterus with a thin plastic catheter
[Patty O'Neill, APRN] It is typically a short painless procedure
[mwelch] Patty when is this procedure recommended?
[Patty O'Neill, APRN] This procedure is recommended with mild male factor infertility or to improve the success rate with fertility treatments like ovulation induction
[mwelch] Patty can you give us any success rates ?
[Patty O'Neill, APRN] Typically a couple can expect to try IUI 3 or 4 times. Although many couples are successful on the first try
[mwelch] Patty what are the actual steps in performing the IUI and what steps are taken to verify samples.
[Patty O'Neill, APRN] Well of course as you know Marion success rates depend on many factors like the diagnosis of the coupe and the age of the woman. Typically you can expect an insemination cycle to have a 15 to 25 % success rate depending On…
[Patty O'Neill, APRN] The type of treatment and the age
[Patty O'Neill, APRN] Excellent question! There are many safeguards in place to verify samples. At New England Fertility there are 2 people verifying the sample during each phase of the process.
[Patty O'Neill, APRN] Additionally, when the woman arrives for her procedure she is given a name band much like they use at the hospitaly
[mwelch] Thank you for your time.
[Patty O'Neill, APRN] Please feel free to email any of the clinicians or Marion Welch if you have questions.
[mwelch] Patty before we end is there anything you would like patients to know about this common procedure?
[Patty O'Neill, APRN] You are correct marion
[Patty O'Neill, APRN] that this is one of the most common procedures
[mwelch] Patients should contact NEFI for a consult to discuss this procedure and some of the new assisted technology available to couples who have been trying to conceive.
[Patty O'Neill, APRN] There is great care taken with the specimen once it is brought to the clinic until the IUI procedure.
[mwelch] Please be advised that the Connecticut Insurance Mandate for Fertility covers this procedure if you are under the age of 40 and work for a company based in Connecticut. Coverage is for 3 IUI’s.
[Patty O'Neill, APRN] That typically means that you would have 3 months of trying to conceive with IUI
[mwelch] If we have no other questions we will end it here. This transcript will be posted on our website for anyone who would like to access this interview.
Thank you so much for coming to our chat about IUI. I hope you found all this very helpful.

How Extensive Is Your Experience In Dealing With The Orthodox Jewish Population?

Our practice offers the state of the art in reproductive medicine. The New England Fertility Institute has been in the forefront of innovation since its inception. Dr. Gad Lavy’s background makes him knowledgeable and sensitive to the special needs of the Jewish population. Born and raised in Israel, he obtained his medical degree from Hebrew University Hadassah Medical School in Jerusalem. Dr. Lavy completed his specialty training in New Haven at Yale University and is board certified in Obstetrics and Gynecology as well as Reproductive Endocrinology. He speaks Hebrew and Yiddish as well as Romanian. Dr. Lavy’s current practice includes Orthodox Jews from New York City and New Jersey. He is knowledgeable in Jewish law and its application to reproductive medicine. He often consults with prominent Rabbis for their opinion in difficult cases.

Are the latest fertility treatments available through your practice?

In my 25 year career of treating infertile couples I have seen a vast improvement in our ability to diagnose and treat infertile couples. Many innovations have been introduced to this field making the treatments more successful. Most of the couples who walk into our offices complaining of infertility can be properly diagnosed and helped. My personal goal is to make fertility treatments more effective, more affordable and less taxing on the couple’s physical and emotional resources. We also provide cord blood banking through our own company, Lifeline Cryogenics, which is the only private cord blood bank in the state of Connecticut.

Is your practice equipped to deal with the unique needs of the Orthodox Jewish couple experiencing infertility?

Approximately 20% of Jewish couples experience infertility and we have extensive experience working with Jewish couples who are experiencing infertility. Certain genetic conditions affect Jews more than other ethnic groups and have to be considered when treating these couples. To determine the couple’s best course of action and help them choose the best treatment option for their specific condition, we encourage the couples to work with their own Rabbi to decide on their best course of action and to seek advice.

Where does the state of CT stand in terms of insurance coverage for patients seeking treatment?

Connecticut is one of a handful of states that addressed the issue of insurance coverage for fertility therapy. The Connecticut mandate forces insurance companies to cover fertility diagnosis and therapy under certain conditions. Our office will be happy to review the details of the plan with you and make sure that you qualify.

Dr. Lavy, can you address the emotional needs of a couple going through infertility and what support systems are available through your practice.

We are acutely aware of the emotional impact of infertility and the burden of fertility therapy. We assess the couple’s emotional needs on their first visit and throughout their fertility journey. Our administrative and clinical staff is trained to cater to the emotional needs of our patients. In addition, we have two psychological counselors on staff that have over 20 years of experience counseling couples who suffer from infertility. NEFI also encourages couples to seek alternative medicine such as acupuncture or massage therapy when appropriate. We work with various groups in the area who can provide these services.

Is your office easily accessible to the Waterbury community?

New England Fertility Institute has offices in Stamford, Shelton and Hamden. This provides us with wide coverage of Southern and central Connecticut. Our Shelton office is located off Route 8 in Shelton and is easily accessible from Waterbury.