Trying to Conceive After 35? Advanced Maternal Age, #Infertility and Getting Pregnant

Posted on by

Natural pregnancy rates are affected by age and the average woman’s chance of conceiving on her own during a 12 month period of time decreases as she gets older. Advanced Maternal age is one cause of infertility.

  • 20-24 year old women have a 86% chance of conceiving in 12 months
  • 25-29 year old women trying to conceive have a 78% chance of getting pregnant within a year
  • 63% of women between the ages of 30-34 attain pregnancy naturally with 1 year
  • At 35-39 years old, most women have a 54% chance when trying to get pregnant over the course of one year.
  • After 40, a woman who is trying to conceive over 1 year has a 36% chance of pregnancy
  • By 45, only 5% of women conceive a child naturally after one year of trying for a pregnancy

In addition, after 1 year of not conceiving, there is only a 5% chance of getting pregnant by waiting an additional 6 months to 1 year. Another way to view this information is by a woman’s chance of getting pregnant per month. During the first year of trying, a woman at age 23 would have an approximately 25% chance of pregnancy each month, whereas a woman at age 40 would have a 13% chance of pregnancy each month.

The decline in a woman’s chances of getting pregnant is not related to a woman’s health or how young she feels. The main cause for this decrease in the chances of getting pregnant lies within the genetics of the egg.

As a woman ages, the quality of the eggs deteriorates. The decline in quality causes an increased risk of chromosomal problems within the eggs, which leads to fewer normal eggs and an increased risk of miscarriages due to chromosomally abnormal embryos such as Down syndrome. Preimplantation genetic testing (PGD)of embryos is one way to detect chromosomally abnormal embryos.

There are not any known medications or treatments that can change the effects of age on the eggs, since the problem lies within the genetics of the eggs. When a woman’s ovary is being formed, the body sets aside cells that will make up the eggs within the ovary. A woman is born with all of the eggs she will ever have in life. The eggs have not finished their cell division and still contain 2 complete sets of chromosomes. Before an embryo can be formed, the egg must finish separating the chromosomes so that the egg will only contribute one set of chromosomes that add to the set of chromosomes provided by the sperm. Over time, the ability of the egg to separate the chromosomes normally starts to decline, and there will be an increase in the number of chromosomally abnormal eggs. Many eggs will stop living because of the abnormalities, though a woman may still ovulate normally. Some embryos will be formed from an abnormal egg, but most of these pregnancies will end in a miscarriage.

In addition to the increase in chromosome abnormalities, the number of eggs available for fertility treatments will also decline. In a normal menstrual cycle, only one egg survives and goes through ovulation. During fertility treatments, medications are used to increase the number of eggs produced. As a woman ages, the number of eggs available, or “ovarian reserve,” decreases. Having fewer eggs available can result in lower pregnancy rates with fertility treatments. There are tests available to try to evaluate “ovarian reserve,” but these tests are often inaccurate. A normal ovarian reserve test does not imply that a woman has a better chance of getting pregnant and will not undo the effects of age on her chances of getting pregnant.

There are tests that can be used to detect abnormal eggs and embryos with genetic problems.  These tests are referred to as pre-implantation genetic diagnosis, PGD, and pre-implantation genetic screening, PGS.  There are various techniques for looking at genetic material from embryos before pregnancy.  California IVF continues to push forward with new clinical infertility treatments to help with recurrent pregnancy loss, testing eggs before pregnancy, and gender selection.

When an egg from a donor is used, pregnancy rates are generally not affected by age. Women who are interested in becoming an egg donor are younger, screened for infectious diseases and generally provide excellent chances for another woman to become pregnant. Additionally, women using donor eggs would be more likely to have extra embryos which could be used in a frozen embryo transfer so the overall pregnancy rate is even higher than depicted. Donor eggs are often used as an option for women who are unsuccessful using their own eggs or who have reached an age where their chances using their own eggs become too low.

Article source: http://feedproxy.google.com/~r/CaliforniaIvfDavisFertilityCenterInc/~3/nkgATc8xyXE/trying-to-conceive-after-35-advanced.html

Pregnancy Success Rates May Improve With Genetic Testing of Day 5 Embryos

Posted on by

The “buzz” at the ASRM Annual Meeting in Denver, October 2010, was biopsy of Day 5 (blastocyst) embryos with subsequent genetic analysis. Current embryo biopsy techniques focus on Day 3 embryos for pre-implantation genetic testing (PGD) of embryos.

Day 3 embryos are usually composed of 6-8 cells, and one cell is removed, fixed to a slide, and analyzed in the lab. Having only one cell to work with, though, can be a negative in several ways. Firstly, there’s always the chance that the material from one cell will not be enough to provide a sample for analysis. Secondly, there is the somewhat complicated issue of mosaicism.
As cells grow and divide, genetic mistakes can happen. Since the embryo is made up of several different dividing cells, it’s possible that some of the cells divide normally, while some of them create genetic mistakes during their division.

The result can be a mosaic embryo—one that has some normal cells and some genetically abnormal ones. The concern with embryo biopsy on Day 3 is that with removing only one cell, how do you know that all the other cells have the same genetic makeup?

Studies show that embryos that make genetic mistakes have a high tendency to correct themselves by the time they reach the blastocyst (Day 5) stage. In other words, the normal cells continue to grow and divide, forming a healthy embryo, and the genetically abnormal cells disperse. This phenomenon is called self-correction. So a significant concern with Day 3 embryo biopsy is that a single cell can be analyzed and identified as abnormal, leading to discarding of that embryo, while in fact, it could undergo the process of self-correction, leading to the discard of a perfectly fine embryo.

Day 5 embryo biopsy has definite advantages over Day 3 biopsy. Day 5 embryos generally have 100-150 cells, so usually 10-15 cells can be removed without harm. This allows a larger sample to test. The test is also run at the later, Day 5, stage, which allows for self-correction to happen. Also, by the time the embryo reaches the Day 5 stage, it has formed two separate structures: the inner cell mass, which can become a baby; and the trophectoderm, the outer cells which will form the placenta. The cells removed in the biopsy come from the trophectoderm, leaving the inner cell mass intact.

The major disadvantage of Day 5 biopsy is in the time it takes to run the genetic tests. The blastocyst stage is when the embryo would begin to burrow in and implant in a woman’s uterus. So by the team an embryo reaches blastocyst stage in the lab, it can only be transferred into a uterus or frozen for storage. Genetic testing may take several days, so an embryo that is biopsied on Day 5 must be frozen until the results are available. This would involve a scheduled future transfer of the normal embryo in another cycle, after preparing the uterus with hormones. Fortunately, improvement in embryo freezing techniques, primarily the use of vitrification, has made this option a successful alternative. It was revealed at the 2010 ASRM Annual Meeting that some centers are also working to shorten the time the diagnostic testing takes, so that the biopsy could be done early on Day 5 and allow transfer early in the morning the following day, with excellent pregnancy rates.

About Dr. Laurie Lovely:

Sacramento Infertility Specialist Dr. Laurie Lovely is board certified by the American Board of Obstetrics and Gynecology (ABOG) in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility. She has received a research grant from the American College of Obstetricians and Gynecologists for her work on the effects of hormones and the endometrial lining. She presented a prize-winning paper on the effects of stress and infertility at an annual meeting of the American Society for Reproductive Medicine. Additional professional interests include pubertal problems and reconstructive tubal surgery including tubal ligation reversals.

— © California IVF: Davis Fertility Center, Inc. Northern California Male and female infertility specialists near Sacramento and Roseville.

Article source: http://feedproxy.google.com/~r/CaliforniaIvfDavisFertilityCenterInc/~3/xWEFsDYTZUI/pregnancy-success-rates-may-improve.html

Infertility Supplements and Dietary Aids

Posted on by

Infertility problems affect millions of couples in America. As the stress of infertility increases, it is common for people to search for answers on the Internet and printed sources such as magazines. Much of the information and advice available to women trying to conceive has not been written or reviewed by an infertility specialist. Even worse, much of the information is simply not true, and can lead to couples to take medications or treatments that may actually decrease their chances of getting pregnant.It is important to understand that any medication or dietary aid that is labeled with the words “nutritional supplement” or “dietary aid” are classified as food items by the Food and Drug Administration (FDA). This means that these supplements are not regulated by the same laws that regulate medications. Laws pertaining to medications require that new medications are equivalent or better to existing medications, and these medications can not be misrepresented in terms of their effects and side effects. Nutritional supplements do not even have to contain any medications, and there is not government oversight to protect against harmful contamination in these medications.

Most of the dietary supplements advertised to help with infertility have no evidence supporting the proposed benefits. Unfortunately, the nutritional supplement market for infertility is a multibillion dollar industry. As long as there are individuals that will believe the marketing hype surrounding infertility diet aids, these products will continue to be sold. These products are frequently packaged like medications and the advertisements frequently report that the effects are clinically proven. Other than a potential false advertising claim, there are no restrictions on how these supplements are marketed, and no requirement to test the quality or effects of these supplements.Scientific studies on some of these compounds showed very harmful contamination and broad ranges of chemicals and hormones that can have harmful effects. Infertility specialists are frequently asked for their opinion about these supplements and often encounter resistance when patients are advised to stop using these supplements. Most of this faith placed in these nutritional supplements comes from the marketing and hype placed on these nutritional aids and vitamins. This marketing does not take into account the well-being of infertility patients, but instead seeks only to make a profit. Infertility doctors are committed to the health and well being of their patients and keep up to date with all of the evidence-based treatments designed to improve an infertile couple’s chances of having a baby.

Vitamins may play a role in overall health, however, patients do not need to take anything more than a multivitamin or prenatal vitamin. It is recommended that women trying to conceive take at least 400 micrograms of folic acid (folate). In certain circumstances, women may be advised to take additional vitamins or other nutritional supplements, but should do so only under the advice of a physician or other health care provider.

California IVF: Davis Fertility Center, Inc. does not support the use of dietary supplements or nutritional aids, and remain concerned that many of these nutritional aids may have harmful effects in addition to being very expensive. There is no evidence that nutritional supplements for male and female infertility will have any benefits on the chances of having a baby. Please inform your physician of any and all nutritional aids, dietary supplements and vitamins that you are taking.Our infertility doctors fully support and educate our patients about healthy eating and diet changes that can help women get pregnant.  Diet can have a big effect on PCOS and having a baby.  A balanced diet and healthy lifestyle including exercise and avoiding smoking and smokers can help improve a woman’s fertility health and chances of conceiving.

Article source: http://feedproxy.google.com/~r/CaliforniaIvfDavisFertilityCenterInc/~3/R2II3CGlTbw/infertility-supplements-and-dietary.html

Sacramento Fertility Center Specialists Explore Advances In Infertility Treatment at ASRM

Posted on by

Sacramento infertility specialists Dr. Laurie Lovely and Dr. Ernest Zeringue attended the annual meeting for the American Society for Reproductive Medicine, or ASRM in Denver Colorado.  This meeting is a gathering point for scientists and clinical practitioners from fertility practices worldwide.  Clinics and researchers share their techniques and scientific discoveries for the purpose of advancing the field of reproductive medicine.  This sharing of ideas usually serves as valuable means of evaluating developing techniques and technology, and often leads to the introduction of new treatment options for infertility patients.

 

There have been many exciting advancements in the infertility treatment arena.  The two most notable topics are oocyte preservation, or egg freezing for the purpose of saving a woman’s fertility for the future, and pre-implantation genetic diagnosis and screening (PGD/PGS).  Both egg freezing and  PGD/PGS advancements will offer immediate changes in the way infertility treatments are rendered.  California IVF: Davis Fertility Center, Inc. is at the forefront of these new technologic developments as we continue to bring our patents the latest and most advanced options for overcoming infertility.

 

Pre-implantation genetic screening PGS is used when embryos are tested for the presence of a genetic abnormality such as an abnormal number of chromosomes.  Pre-implantation genetic diagnosis, PGD, is used when there is a known risk of a specific genetic disease when there is a family history of a specific genetic disease.  PGD is often used to refer to both PGD and PGD services collectively, although this is technically inaccurate.  PGD/PGS has been used for several years, but the limitations of the technology and the types of genetic tests available for infertility treatments has been a limiting factor in the success of the testing.  High costs of the tests have also limited the use of the testing in addition to in vitro fertilization, IVF. 

 pregnant_ca_infertility_age_2

Recent advancements in PGD/PGS has allowed fertility clinics to move away from FISH and embrace SNP and aCHG for genetic screening of embryos.  These newer tests have the advantage over existing FISH technologies in that SNP and aCGH can look at all chromosome pairs.  There are 23 pairs of chromosomes with one pair used for sex determination.  A test will look for 24 chromosomes, 22 normal pairs of chromosomes plus the X and Y chromosomes which determine if the baby will be a boy or a girl.  Testing for X and Y chromosomes has also been useful for gender selection – determining a boy or girl with IVF before the embryo is used to make a pregnancy.

 

Refinements to the PGD/PGS process were presented at ASRM.  These latest changes will likely lead to an increase in the number of PGD/PGS cases performed in the United States.  By performing the embryo biopsy on day 5 using a laser and a precision microscope, the genetic test results have a higher prediction rate of a normal pregnancy than a biopsy performed on day 3.  Several researchers and infertility clinics reported pregnancy rates as high as 85 to 90% when PGD/PGS was used on a day 5 embryo.  While these are early studies and need additional verification, it seems very clear that the future of embryo biopsy and genetic testing is about to make a significant change to the field of in vitro fertilization.

 

The addition of day 5 embryo biopsy and genetic testing advances our capabilities and improves upon our 5 year experience with genetic testing and embryo biopsy.  Having egg freezing capabilities opens the doors for new avenues in donor egg banking, making the process of egg donation and infertility treatments with donor eggs less complicated.  Freezing eggs also offers a women the opportunity to save her fertility in the face of cancer treatments such as chemotherapy or radiation therapy.  Oocyte cryopreservation will soon offer women the opportunity to preserve their fertility for a later time in life when her own chances of conceiving may be reduced due to the effect of age on egg quality.

 

Thanks to the scientific community and professional sharing of knowledge and scientific study, ASRM members can remain up to date with the latest changes.  California IVF: Davis Fertility Center, Inc. continues to change our practice as new developments become available.  To this end, many fertility centers and patients and indebted to the efforts of ASRM.  According to the ASRM website, the Vision of the American Society for Reproductive Medicine (ASRM) is to be the nationally and internationally recognized leader for multidisciplinary information, education, advocacy and standards in the field of reproductive medicine. The ASRM is a non-profit organization whose members must demonstrate the high ethical principles of the medical profession, evidence an interest in infertility, reproductive medicine and biology, and adhere to the objectives of the Society. 

 

Dr. Laurie Lovely and Dr. Ernest Zeringue are proud members of ASRM and will continue to leverage the knowledge and research benefits of ASRM to realize the goals and dreams of our patients – having a baby.

Why is IVF so expensive? IVF Pricing explained.

Posted on by

California IVF: Davis Fertility Center, Inc. strives to make in vitro fertilization (IVF) a cost effective approach to maximizing the chances of pregnancy. We understand the additional stress finances place on patients wishing to get pregnant and that for many, the cost of starting or continuing treatment is a barrier to pregnancy.

Cost, Overhead and the Modern Embryology Lab

The combination of physician, embryologist and staff experience along with our modern embryology laboratory, which creates an environment that mimics the human body, is why we can help women get pregnant with in vitro fertilization (IVF). However, in addition to high staffing costs, maintaining a high tech lab contributes significant overhead and affects the cost of treatment. Major lab systems include the:

Air System – Designed by a specialized engineer, this system creates a positive airflow that pushes air out of the lab, limits temperature fluctuations within 1-2 degrees and constantly removes contaminants with four Hepa filtration units. It is inspected annually for clean air compliance and maintains a 96% seal from the outside world.

Gas System – The oxygen concentration of normal air is toxic to embryos. Specialized incubators, microscopes and handling techniques protect the embryos and maintain a gas mixer that optimizes growth.

Microscope System – Given the tiny size of embryos, high powered microscopes fitted with mechanical manipulation devices are required to perform treatments such as intracytoplasmic sperm injection (ICSI) or embryo biopsy for pre-implantation genetic diagnosis (PGD).

Safety System – This system continuously monitors the lab for proper air and incubator temperatures and gas levels as well as the liquid nitrogen level of frozen embryos and semen samples. If there is a power outage, our diesel generator automatically starts and can run for several days without refueling.

California IVF: Davis Fertility Center, Inc. uses its modern embryology lab to increase the effectiveness of fertility treatment and patient pregnancy rates. If you have any questions regarding the embryology lab and its affect on the cost of treatment, please ask. We remain committed to helping patients realize the joy and miracle pregnancy can bring.

Dietary Modification and Exercise

Posted on by

The “EZ Diet” is a dietary modification plan that has been gaining momentum over the last few years. Many people are completely unaware that dietary modification can lead to weight loss and improved fertility. Weight loss has many other benefits including prevention of cardiac diseases, reducing the risk of diabetes, and improving a person’s mood and energy levels. Dr. Zeringue has been working with infertility patients struggling to lose weight for many years. After gaining a detailed understanding of how the body regulates weight and other diseases, the diet modification plan has evolved into its current form. Nicknamed the “EZ diet”, many people have very successfully lost weight and maintained this weight loss.

There is no magical formula for weight loss, but there is real science. By gaining a better understanding of what foods do to a person’s body, Dr. Zeringue has found that most people are more committed to sticking to the diet. Doctors already know that most any diet plan will work if people stick to the diet. Most people want to lose weight or eat better, but finding reliable information can be difficult. Dr. Zeringue has performed community service lectures to help educate the public about a healthy diet plan and long term compliance. These seminars are free to the public and there are no products to purchase and no sales gimmicks.

For more information visit: http://californiaivf.com/Diet-weight-loss-insulin-IGF.htm

Hyperinsulinemia & Insulin Resistance

Posted on by

Diagnosis: The diagnosis of insulin resistance implies you have a disorder in tissues such as muscle are impaired in its ability to respond to the action of insulin. This leads to a situation where the pancreas produces extra insulin in an effort to overcome the resistance to insulin. This elevation in insulin is known as hyperinsulinemia, or high blood insulin. Insulin resistance is not the same as diabetes although it is considered an early form of diabetes. The main difference in the two disorders is that the person with insulin resistance is capable of producing excessive amounts of insulin to maintain blood glucose whereas the diabetic patient can no longer produce adequate levels of insulin. Insulin resistance can come about through more than one mechanism. Receptor defects and obesity appear to be independent risk factors that may appear alone or in combination. There appears to be a genetic link so a family history of adult onset diabetes is a risk factor. Hyperinsulinemia can also occur in situations where the the body is overproducing insulin but the tissues aren’t technically resistant to the effects of insulin. This occurs most commonly in the setting of excessive sugar intake. Insulin is a hormone which causes changes in different cells throughout the body. Excessive hormones can cause changes in the appearance of individuals. Polycystic Ovary Syndrome and Syndrome X are labels to describe a common appearance among patients with high insulin levels. Insulin resistance is the most likely the underlying metabolic abnormality when the appropriate testing is performed. Many tests focus on tissue resistance to insulin rather than the absolute level of circulating hormone. We have specialized tests designed to find these elevations in hormones. Treatment results can be quite impressive and can lead to pregnancy without fertility medications in many cases.

For more information visit: http://californiaivf.com/insulin-resistance.htm

Male Infertility

Posted on by

Male infertility accounts for 30-40% of infertility. Male infertility is usually related to abnormal sperm production or function. Problems can occur anywhere in the production of sperm including hormonal regulation, storage, and transport of sperm. Genetic abnormalities can also contribute to decreased sperm or abnormal function. Fortunately, there are treatments that can help improve a couple’s chances of becoming pregnant. Intracytoplasmic Sperm Injection (ICSI) is one of the most commonly performed procedures for male infertility. Other procedures including aspirations, biopsies, and varicocele repair can also be useful. Once you have a diagnosis of male factor infertility, let California IVF help you in selecting the best options available.

For more information visit: http://californiaivf.com/male-infertility.htm

Intrauterine Insemination (IUI)

Posted on by

The introduction of the sperm sample into the uterine cavity may be done to increase the number of sperm in the upper genital tract. In certain individuals this may increase the likelihood of conception. IUI may avoid cervical and vaginal factors preventing sperm entry or compensate for low sperm counts. Intrauterine insemination is sometimes called artificial insemination or therapeutic sperm insemination.

In order to introduce the sperm into the uterine cavity the semen has to be treated to remove chemicals in the liquid portion of the semen which may cause irritation of the uterus. The washing procedure takes about 1 hour. Sperm samples are most often collected in the clinic to assure a prompt delivery to the lab. Once in the lab, the specimen will be allowed to liquefy. Different types of special liquids called sperm media are used to rinse the debris and chemicals from the semen. The concentrated mixture that remains is made mostly of sperm. Gradient washes are often done to improve the concentration and selection of motile sperm. The washed sperm is now safe and ready for insertion into the uterus.

The insemination is a relatively simple procedure similar to obtaining a Pap smear, which can be accomplished in the clinic without anesthesia.

For more information visit: http://californiaivf.com/insemination.htm

Treatment Options

Posted on by

Once your initial evaluation has been completed, Dr. Zeringue will meet with you to discuss the findings and make individual recommendations. Since there is tremendous variability in the exact treatment that individuals receive, this section will be divided into generalized treatment categories. Below is a brief description of the different types of treatment. Click on the title to go to the page of interest where you will find more specific information.

Some couples complete their testing without any abnormalities identified. While this may be frustrating to be diagnosed as unexplained infertility, all hope is not lost. This simply means you have reached a point in your evaluation that the more common causes of infertility have been ruled out and the best course of action is to begin a coordinated attempt at pregnancy rather than continue to look for reasons why you are not pregnant. Without identified abnormalities during your evaluation you will likely have a very good chance of becoming pregnant.

For more information visit: http://californiaivf.com/treatment.htm