Archive for September, 2009
I’m not a big fan of Tylenol–it slows down Phae II liver detox (hey, look in the warnings, it’s right there) and is a leading source of liver damage. If you want to offload your shelves (via the AP):
NEW YORK – Johnson & Johnson’s McNeil unit is voluntarily recalling 57 lots of infants’ and children’s liquid Tylenol products because of possible bacterial contamination.
The products being recalled were made between April and June and include nearly two dozen varieties, including Children’s Tylenol Suspension 4 oz. Grape, Infants’ Tylenol Grape Suspension Drops 1/4 oz. and Children’s Tylenol Plus Cold/Allergy 4 oz. Bubble Gum.
Johnson & Johnson said late Thursday it has contacted wholesalers and retailers about the recall. An inactive ingredient didn’t meet internal testing requirements, the company said, and B. cepacia bacteria were detected in a portion of raw material that went unused in the finished product.
Read more here
Posted on September 30, 2009 | Filed under Fertility News | Permalink
CUTLER, Calif. – Over the last decade, the drinking water at thousands of schools across the country has been found to contain unsafe levels of lead, pesticides and dozens of other toxins.
An Associated Press investigation found that contaminants have surfaced at public and private schools in all 50 states — in small towns and inner cities alike.
But the problem has gone largely unmonitored by the federal government, even as the number of water safety violations has multiplied.
“It’s an outrage,” said Marc Edwards, an engineer at Virginia Tech who has been honored for his work on water quality. “If a landlord doesn’t tell a tenant about lead paint in an apartment, he can go to jail. But we have no system to make people follow the rules to keep school children safe?”
read more here.
Posted on September 30, 2009 | Filed under Fertility News | Permalink
What a weird story–this woman conceived ANOTHER kid 2.5 weeks after she became pregnant. It’s called “superfetation,” and I guess it happens… not only can you get pregnant while on your period, etc., I guess you can get pregnant ANYTIME.
http://gmy.news.yahoo.com/
Posted on September 30, 2009 | Filed under Fertility News | Permalink
In vitro fertilization’s risks are back in the spotlight, and some would-be parents are finding a simpler solution.
Posted on September 30, 2009 | Filed under Fertility News | Permalink
For most, the only infertility solutions offered to them are IUI and when that proves unsuccessful , they are pushed into IVF treatment.
Posted on September 30, 2009 | Filed under Fertility News | Permalink
Once you are handed a diagnosis of infertility, you will likely be referred to see an infertility specialist.
Posted on September 30, 2009 | Filed under Fertility News | Permalink
Over the past twenty-one years, HRC Fertility has focused on introducing and perfecting new procedures and techniques that are on the cutting edge of reproductive technology. Together with the American Society for Reproductive Medicine ASRM, the Society for Assisted Reproductive Technology SART, and Gene Security Network GSN, HRC Fertility is pleased to bring Preimplantation Genetic Diagnosis into mainstream diagnostics.
Posted on September 30, 2009 | Filed under Fertility News | Permalink
I was invited to the MSNBC show “Dr. Nancy”. Here’s what I had to say.
http://www.msnbc.msn.com/id/31388323/#33006217
Posted on September 30, 2009 | Filed under Infertility News | Permalink
The time between the hCG and retrieval
For an FSH injection cycle leading to insemination, it’s ok if the ovulation naturally occurs a little early (via a premature LH surge) because we can just do the insemination early. Rarely it’s too early, before the follicle is big enough, and we cancel the cycle. However, for an IVF cycle we have to cancel the cycle if there is an early natural LH surge, even if it’s only a little early, because the timing of the retrieval is very dependent on when the surge starts. The retrieval needs to be about 34-36 hours past the start of the surge (which would also be the time if the hCG shot).
Because we are not taking blood every hour, if the blood test shows a rise in the LH level, we don’t really know when the rise started so we don’t know the right time for retrieval. Lupron, Antagon and Cetrotide prevent the natural rise of the LH, so the premature surge usually cannot occur. However, these drugs do not interfere with the effects of an hCG injection. So there is no natural surge, but there is an artificial surge which starts the moment the hCG goes in.
Final Maturation
There is a second very important job of the LH Surge/hCG injection:
it causes the egg to mature. As the days of stimulation progress the eggs are slowly maturing, but more is needed for the final maturation. Necessary last minute changes occur inside the egg from the LH/ hCG.
Why is this important? An immature egg will not fertilize. If the retrieval is before about 33 hours after the hCG, the result will be immature eggs. Sometimes they are all immature, or just some.
If the retrieval is 38-39 hours after the hCG, the eggs will be mature but they will already have ovulated. We would retrieve none; they would be floating in the pelvis around the ovaries waiting to get picked up by the tubes. So we need to grab the eggs just after they mature but just before they ovulate, which is at about 34-37 hours after the hCG injection.
What day should you get your hCG?
hCG can only mature eggs that have been growing for enough time for the follicle to become large. The sizes of all of the follicles need to be taken into consideration before giving hCG in IVF cycle.
Not all of the follicles grow at the same rate. For example, if there are 10 follicles, and the biggest is 18mm, they will not all be 18 mm. Some will be mid-sized and some will be much smaller. Each follicle does not need to be 18 mm to produce an egg that is mature. As long as the biggest (the lead follicle) is 17-18mm, the mid-sized (13-16) should also have mature eggs. The small follicles (10-12) may or not be mature. But if the lead follicle is 14 mm, none of the eggs have yet reached maturity. Giving hCG would not be enough to achieve maturity.
How Important are Estrogen Levels?
Not very. When you are monitored for your IVF cycle, the follicle size is much more important that the estrogen (estradiol) levels. We need the estrogen to rise, but if midway through your cycle we see 10 follicles, with the biggest being 13 mm, we don’t really care if the estrogen level is 500 or 900. Estrogen is more important when we are monitoring someone who may be on track for hyperstimulation.
Therefore, we use mostly the size of the follicles, with not much emphasis on the estradiol levels, to determine when to give the hCG. At NYU we feel the best time to get the hCG is when the lead follicle reaches 18 mm. Now because there are many variations from cycle to cycle and from patient to patient, it’s not easy to say that 18 mm is the rule.
For example, let’s say there is one follicle 18 mm, three that are 15 mm and others that are smaller. Here we may worry that some of the small ones may be too immature, so we may wait another day before giving the hCG. Let’s say there are 20 follicles, with the biggest 17mm and an estrogen level of 2900. Here we are aware that the smaller follicles may be immature, but we also are concerned about the estradiol getting much higher because the woman would be increasing her risk of hyperstimulation. So we give the hCG at 17 mm, which may yield some immature eggs, but should give us enough mature eggs to work with.
And there are many more variations. Some women have gotten their hCG a little on the early side and have all mature eggs. Some women in their first cycle get the hCG at 18 mm with lots of good size follicles, and have ½ their eggs be immature. So next cycle we wait till the follicles are 20-22 mm before giving hCG. This sometimes gets more mature eggs but sometimes no matter what we do, that woman’s ovaries make more immature eggs than expected.
So why not wait and give hCG later? Because eggs can get over-mature. This over-maturity can lead to lower embryo quality and lower pregnancy rates.
When we see the records of women who have failed IVF elsewhere, many times we see that he hCG was given with large sized follicles. The first and easiest “fix” we can do is to give the hCG earlier in her next cycle, more inline with our standard procedures.
Why do some doctors wait longer to give the hCG?
Some may feel that the higher the estradiol level the better, so by waiting estrogen levels will go up. This is probably not important. Others may feel that it is necessary to wait so there will be no immature eggs. Well this sounds good, but it may not be worth sacrificing the quality of the eggs form larger follicles, which are probably the best eggs anyway.
And back to the original question.
What if instead of the average 11-12 days it takes to grow the follicles, they are of the right size after only 6 days or 8 days?
If the size is good, but it seems early, we usually go at least one more day that we normally would, maybe 2. If it’s day 9 and the follicles are 19-20 mm, it really sounds ok to give hCG. If it’s day 7 (so 5-6 days of FSH injections), and the follicles are 17-18 mm, more time would probably be a good idea.
Thanks for reading and don’t forget the disclaimer 5/17/06.
Dr. Licciardi
Posted on September 30, 2009 | Filed under Infertility News | Permalink
Watch as Dr. Alex Kim, Yale-trained, board certified, fertility specialist at Fertility Physicians of Northern California FPNC, discusses treatments for male infertility. Click here to watch.
Posted on September 29, 2009 | Filed under Fertility News | Permalink
Watch as Dr. Alex Kim, Yale-trained, board certified, fertility specialist at Fertility Physicians of Northern California (FPNC), discusses treatments for male infertility. Click here to watch.
Posted on September 29, 2009 | Filed under Fertility News | Permalink
By now you’ve probably heard of bisphenol Abetter known as BPAa chemical used to make the plastic often used in food containers, water bottles, baby bottles, and plastic toys. And you’ve probably also heard that the chemical is considered a hormone disruptor, potentially leading to fertility problems when ingested. Indeed, new findings from the National Research Centre for the Working Environment NRCWE in Denmark show that women who work in factories that manufacture plastics containing BPA are 20 percent more likely than other working women to receive fertility treatment. Many countries are trying to ban the chemicalif not from all products, at least for products made specifically for children. And BPA is currently banned in baby bottles in Canada, Minnesota, and Connecticut. But last week one of these efforts in the U.S.–California’s Toxics-Free Babies and Toddlers Act, designed to ban BPA from food and beverage containers designed for children under age 3failed to get enough votes to pass.As a result of the failed legislation, wife and husband Shelley Aronoff and Michael Ritterbrown, co-founders of L.A.-based Green to Grow a BPA-free infant and childrens feeding manufacturer are donating more than 5,000 worth of BPA-free baby bottles on September 29 to San Franciscos Compass Community Services. Green to Grow products are free of BPA, phthalates, lead and PVC, and include plastic baby bottles, glass baby bottles, silicone nipples, organic cotton baby cloths, totes, and accessories.
Posted on September 29, 2009 | Filed under Fertility News | Permalink
In a natural conception, the egg is surrounded by all these sperm…but only one (sometimes two at the same time) gets in. If you watch the real time movies of the process, it’s not a race to see which sperm gets there first. The egg sits there like this for a while, almost as if deciding which sperm to let in.
The successful sperm has to have many factors: it can’t be weirdly shaped so it can’t swim, it has to be fast enough to stay with the crowd, it has to secrete a special enzyme that dissolves the outer layer of the egg.
Nature builds in its own protection, and thus lame-o sperm, which is also likely to have DNA damage, get left by the wayside. But there is a way that doctors can FORCE the egg to accept a sperm, by ICSP, intracytoplasmic sperm injection, where they pierce the egg with a needle and push the sperm in. Nor surprisingly, they are finding kids born of this procedure often have genetic or other anomalies.
So one other IVF procedure they often add to this is PGD, pre implantation genetic diagnosis, where they “steal” a call from from a new multicelled fertilized egg and examine the DNA. As you can imagine, when the blastocyst is only made up of a few cells, it kinda needs them. Amazingly, the long term effects on children born to PGD haven’t been studied, until now:
From Natural News:
(NaturalNews) Preimplantation genetic diagnosis (PGD) has become an important part of the booming infertility and baby-making medical industry. This example of unnatural selection allows for the chromosomes of an embryo created through in vitro fertilization (IVF)to be analyzed. If there’s a problem, the embryo can be discarded or, at the very least, frozen away. PGD has helped many couples conceive children believed to be totally healthy and the procedure is promoted as a widely used and safe medical test — at least, until now. A new long-term analysis of PGD suggests that this procedure may hold serious long-term risks for humans subjected to this test while they were embryos. Animal tests have come up with worrisome evidence PGD could increase risks of obesity and dementia in adulthood.
read more.
Posted on September 29, 2009 | Filed under Fertility News | Permalink
There is a “baby hope for women on toxic cancer drugs”, according to the Daily Express.
Posted on September 29, 2009 | Filed under Fertility News | Permalink
Please join Dr. Rinku Mehta for her Infertility Orientation at our Frisco location. She will review the causes of infertility, diagnostic testing and treatment. Space is limited. Reserve a seat by calling 817-540-7094 or email dusteem@embryo.net.
Following are the scheduled dates and times:
Saturday, October 31st at 10am
Saturday, November 14th at 10am
Saturday, December 19th at 10am
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
My HCG level dropped considerably and the nurse informed me my pregnancy is biochemical. My husband and I are disappointed, but knew this was a possibility when the repeat test didn’t rise appropriately. Luckily, we have frozen embryos to try again. We have a consultation with Dr. Nackley this week to talk about an FET. Despite the disappointment, we are looking forward to the next step because it will be one step closer to our goal.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
My repeat pregnancy test did not rise the way it was supposed to. Dr. Nackley wants me to repeat the test tomorrow. She says at this point that it could go either way. My husband and I have all our fingers crossed and we are both anxious and nervous to see what happens.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
I cheated. The anxiousness was overwhelming and I decided to take a home pregnancy test yesterday. It was negative. I was very upset and frustrated. My husband has been very supportive during this entire journey and he continued during my meltdown. He kept reminding me that the whole process had probably been a shock to my body and we had frozen embryos to try again. I went to CAR this morning for my real pregnancy test. Imagine my shock and surprise when the nurse informed me it was positive. We are both so excited. My advice to anyone: save yourself the heartache and don’t cheat. It does no good.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
We had good embryo development and were able to transfer two and freeze a few for future treatment. Despite the mock transfer, I was extremely nervous when we arrived for the embryo transfer. I took the valium and within 20 minutes my nervousness dissipated. The transfer went very smoothly and felt just like the mock transfer. We returned home and I spent the day reclining like I was instructed. I felt a little bloated the day after the transfer, but since then I’ve felt normal. Now we are anxiously awaiting the pregnancy test.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
My retrieval was everything and nothing I thought it would be. I was very nervous about the IV which ended up being the easiest part of the day. I had the best nurse start my IV and I didn’t feel a thing after the mild sting of the lidocaine. When they were ready for the retrieval, they walked me back to the OR. The next thing I knew, Dr. Kathy woke me up telling me they had retrieved 22 eggs. I had moderate abdominal pain and felt very nauseated. The recovery nurse gave me crackers and Tylenol and let me up to get dressed. I vomited a few times and slept for the rest of the day. I cannot say enough about the care and compassion I received.
The day following my retrieval, I woke with mild abdominal pain. I took two Tylenol that did the trick. I started my Endometrin and Estrace with no real side effects to speak of. Despite maintaining a high sodium diet, I became so bloated by lunch that I was having difficulty breathing and had gained 5 lbs. The nurse asked me to have a sonogram and I-stat. They recommended that I keep up the high sodium diet. Day by day the bloating has gotten better. I feel a little bloated, particularly in the afternoon, and a little nausea that comes and goes. I am anxious to see how our embryos develop.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
By the end of the day yesterday, I was so bloated that I felt miserable and was having difficulty breathing. I decided to take the nurse’s advice and increase my sodium intake. My husband and I reviewed online menus for nutritional information and found something to fit the bill. We were on a sodium quest. I cannot say enough about how much better I felt after eating so much sodium. It has made all the difference and I have continued a high sodium diet today with much success.
I took my trigger last night, elated that it was my last injection. I mixed it the way the nurse instructed, but I had a difficult time drawing all of the medication out of the vial. I worked the needle around and shook the vial several times and finally got all of it except a small drop. By the time I was finished the needle was bent, so I got a new one for the injection. The injection felt the same as it has with the other medications. However, I have had more of a reaction to it. The injection site feels bruised and I have some mild breast tenderness. It seems hard to believe that time has gone by so quickly. If anyone had told me a year ago that I would be capable of giving myself injections in the stomach I would not have believed them. It is so much easier than I thought it would be. I am fully convinced that if I can do this, anyone can! I am very nervous about my retrieval tomorrow. I have never had any type of surgery or even an IV. It’s a big day for me.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
I have now had 3 sonograms and it has been amazing to watch all the follicles develop. I have felt good, but the past few days I’ve felt bloated. It has been mildly uncomfortable. I talked to the nurse about it today and she said I needed to increase my sodium intake. The nurse also gave me trigger instructions, pending my E2 result. Sure enough, Dr. Kevin decided to trigger me today for a Wednesday retrieval. I’ve gotten really comfortable with the FSH injections. Now those are all gone and I have a new set of instructions to follow. I feel like I’m starting over and am all confused again.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
I have gotten much better at the FSH injections and the process has become very streamlined. It no longer seems intimidating, which is very exciting. My first Estradiol level was yesterday and Dr. Nackley said it was exactly where it should be. My first sonogram is scheduled for tomorrow. I don’t feel any different since starting FSH and I am anxious to see what is happening.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
Last night was my first FSH injection. I had decided that I was going to inject the Lupron last since I’ve done it before and the Menopur first since the nurse told me it may sting. I got out everything I would need and my kitchen table was covered in syringes, needles, vials, and instruction sheets. Just by looking at the table, the injections seemed overwhelming. I was also very nervous about making a mistake. I mixed the 2 vials of Menopur and injected them. It did sting a little, but not near as much as I thought it would. Next I primed then injected the Gonal-f. The needle is so small and the medication didn’t sting at all. Then the Lupron and I was done! I’m sure I’ll get more confident in a few days as I get used to the new routine.
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
If you have decided that the time is right for you and your partner to have a child, then you need to make sure that you are both healthy. If you find that you are struggling to conceive, and have been unable to get pregnant despite a year of trying, they might be having infertility problems. Research suggests that around 10% of people in America suffer from infertility. The same research shows that in around a third of cases are due to male infertility factors.
There are a number of factors that can cause infertility in men including a low sperm count, problems with ejaculation, and even sperm that is “abnormal”. These are sperm that are malformed and have a short life span.
Your general health has a lot to do with fertility. A healthy lifestyle makes your sperm healthier, and by avoiding drugs such as nicotine, cocaine, and as well as alcohol, you can avoid reducing your sperm count, and also boost your overall fertility.
Having a poor diet inevitably contributes to male infertility. Particular attention should be paid to getting enough vitamin C and zinc in your diet to boost fertility. If you contract certain diseases such as tuberculosis, and mumps in adulthood you can increase certain infertility risks through reproductive system infections such as epididymitis, Prostatis and orchitis.
Sexually transmitted diseases like chlamydia or gonorrhea can cause a great deal of damage to the spermatic ducts. These diseases can also affect women, and by passing on such diseases to your partner, particularly in the early stages, when the symptoms are minimal, can cause infertility.
There are a number of medications that can cause male infertility. Cancer-treating agents such as chemotherapy, and anabolic steroids can both cause testicular shrinkage and infertility, while sulphur based treatments for diarrhoea and ulcerative colitis can all cause male infertility.
Injury to the testicles and infections or even varicose veins in the testicle called varicoceles can increase the heat of the scrotum, and this will harm sperm, and reduce the production of more sperm, thereby reducing fertility levels.
Lifestyle issues such as stress, or too much exercise, even wearing tight trousers and spending time in a hot environment can all reduce the production of sperm. If you work in an industrial environment, where there are chemicals such as benzene, lead, and certain pesticides, you can suffer from infertility, but thankfully many of these causes are short term, and will be reduced as soon as you change your ways.
Comments
Posted on September 28, 2009 | Filed under Male Reproduction | Permalink
Next »
Copyright @ 2001 and Beyond Fertility Portal: Fertility and Infertility Research News
Web Design By Dynamic Creator | Web Hosting by Trade Web Hosting
