Infertility Facts to prove you are not alone

Struggling with infertility is usually a surprise for women and couples. Emotions can range from sadness to anger, confusion, frustration and hopelessness. Virginia Center for Reproductive Medicine  (VCRM) team works with women and couples going through these obstacles on an ongoing basis. We do our best to provide comfort, compassion, understanding and HOPE. It’s important and refreshing (for some) to know that while you are facing some difficult times, you are not alone! Consider these statistics:

·      10% of all women in the United States (over 6 million women) have difficulty getting or staying pregnant. Source: http://www.womenshealth.gov/publications/our-publications/fact-sheet/infertility.html

·      Infertility is not exclusively a woman’s problem. In fact, 35% of infertility problems are related to the woman, 35% are related to the man, 20% is a combined problem with a couple and 10% is unexplained. Source: http://www.resolve.org/support/for-family--friends/myths-and-facts.html

·      85%-90% of infertility conditions can be treated with medicine, therapy or fertility treatment. Source: https://www.asrm.org/detail.aspx?id=2322

·      Within 2006-2010, 7.4 million women used an infertility service to try to conceive. Source: http://www.cdc.gov/nchs/fastats/infertility.htm

Deciding to use the assistance of a fertility center to try and conceive can be exciting, overwhelming and maybe even difficult to accept. Again, you are not alone. Even celebrities like Celine Dion, Kim Kardashian, Chrissy Teigen and Jimmy Fallon have struggled with infertility!

Virginia Center for Reproductive Medicine understands the array of emotions and thoughts a woman or couple are going through. The team at VCRM is dedicated to providing a supportive and personal experience for its patients. Our professional and knowledgeable experience will determine the best approach to achieve your dreams of becoming a parent. To learn more about our doctor, staff and fertility center you can visit vcrmed.com.

The Dangers of the Zika Virus when trying to conceive

The headlines about the Zika virus are scary and the stories of the families affected are so sad. Virginia Center for Reproductive Medicine recommends that if you’re pregnant or trying to conceive, be sure to educate yourself about the Zika virus.

Health organizations from around the world are meeting and working together to discuss and respond to this mosquito borne disease. It was first identified in Brazil in May 2015 and has now been detected in over 23 countries. The World Health Organization has declared Latin America a health emergency.  As of May 11, 2016, 503 cases have been reported in the US, and 701 in all US territories (outside the 50 states).

What is the Zika Virus?

 

Zika Virus is a disease that is spread through a mosquito bite. What makes this virus so dangerous is that people don’t usually get sick enough to go to the hospital. Only 20% of those bitten develop symptoms, which are usually mild, lasting several days to a week after being bitten by an infected mosquito. For this reason, many people might not realize they have even been infected until they have already transmitted the disease to another person.

How does it spread?

The Zika Virus can be passed from a pregnant mother to her baby during the pregnancy. It can also be transmitted through blood and sexual intercourse.

What are the symptoms of the Zika Virus?

The most common symptoms of Zika are:

·      Fever

·      Skin Rash

·      Fatigue

·      Joint pain

·      Conjunctivitis (looks like pink eye)

Why is the Zika Virus dangerous to women trying to conceive or pregnant?

The Zika Virus can be passed from a mother to her fetus. The infection during pregnancy can cause a birth defect of the brain called Microcephaly, a serious condition where babies are born with abnormally small heads. Other problems have also been identified in fetuses and babies infected with Zika virus before birth, such as defects of the eye, hearing deficits, and impaired growth.  Women who develop the symptoms should not attempt to get pregnant for 8 weeks, and men should wait 6 months. During that period, couples should use condoms.

How can I protect myself from the Zika Virus?

1) Do not travel to an area with Zika.

You can view countries and territories reporting the spreading of the Zika Virus by visiting: http://wwwnc.cdc.gov/travel/page/zika-travel-information or http://www.cnn.com/2016/01/27/health/map-zika-virus-transmission/

 

2) Prevent mosquito bites.

·      Wear long-sleeved shirts and pants.

·      Use insect repellent

·      Avoid mosquito-breeding areas like bodies of water

3) Avoid sexual interaction with anyone who has lived or traveled to an area with Zika Virus.

Unfortunately, there is no known vaccine or medicine today to prevent someone from getting Zika virus. If you are in the process of trying to get pregnant, be sure to educate yourself about the symptoms and prevention of the Zika Virus. Your healthcare provider would be your best form of contact.

To learn more about the Zika Virus, Virginia Center for Reproductive Medicine recommends visiting the Centers for Disease Control and Prevention: http://www.cdc.gov/zika/

Helpful & Supportive Infertility Forums

12 BLOGS AND PODCASTS

Suggested and created by the #infertility community

You are not alone in your journey. Thousands of people from around the world share their experience in some form, online. You may find value in these different sites with content created by those experiencing infertility.

1. Triumphs and Trials. www.triumphsandtrials.com Written and curated by Melissa, married with one child, struggling with infertility for nine years.
2. Happiness Glass. www.happinessglass.com Infertility and fitness blog by Mallory, infertility warrior and enthusiast for solving problems.
3. Life Abundant. www.lifeabundant-blog.com Active blog by Jessi, with posts about her treatment and experience.
4. Smart Fertility Choices. www.smartfertilitychoices.com Resources and podcast by Kym, who both interviews guests and shares her own experience.
5. The Delinquent Stork. www.thedelinquentstork.blogspot.com By Karen, RESOLVE’s 2015 award for blog of the year.
6. Then Comes Family. http://www.thencomesfamily.com/community/#category-2 Online forum for couples and individuals coping with infertility.
7. Hope and Hopscotch. http://www.hopeandhopscotch.com/personal/ First person journal.
8. Beat Infertility Podcast. https://beatinfertility.co/ Heather interviews both people dealing with infertility and experts in the field.
9. RESOLVE Podcasts. http://www.resolve.org/resources/resolve-s-podcasts.html Archive of all of the podcasts from the National Infertility Association, with topics ranging from adoption to third party reproduction.
10. Don’t Count Your Eggs. http://dontcountyoureggs.typepad.com//blog/ About the journey on “Infertility Island”.
11. Waiting for Baby Bird. www.waitingforbabybird.com Faith-based infertility support blog by Elisha.
12. Sincerely Emma. www.sincerelyskin.ca/emma Blog that includes discussion on loss and secondary infertility.

The Virginia Center for Reproduction does not contribute to, regularly check, or in any way endorse the viewpoints of these sites. This is simply a list of infertility blogs that others have found valuable.

How to Improve your Fertility

So you’ve decided to travel the journey of trying to conceive? Congratulations! Here are the top 5 things the Virginia Center for Reproduction recommends you do to boost your fertility and get pregnant sooner!

1) Eat a Balanced Diet

Your diet is very important when you are trying to get pregnant. Choose whole grain foods, fruits, vegetables, omega-3 fatty acids (like salmon). Also, avoid foods consisting of trans fats. For more information about a healthy fertility diet, click HERE 

2) Avoid Pesticides

Pesticides are chemicals used to kill bugs and weeds that threaten crops. However, studies are revealing that the men who ate the most pesticide-treated foods had both lower sperm count and lower sperm quality. It is believed there is a decrease in male fertility but pesticides could also impact female fertility by hindering ovarian function and causing inconsistent menstrual cycles.  When you are trying to conceive, it is best to eat organic fruits and vegetables 

3) Watch your drinks

Drinking too much caffeine or alcohol can impact a woman’s fertility. Relax, moderate amounts of caffeine is ok! Experts believe that if you keep your caffeine intake to less than 250 milligrams a day (one to two eight ounce cups of coffee) your fertility will not be affected. As for alcohol, studies find mixed results. Alcohol is known to alter estrogen and progesterone levels. Excessive alcohol consumption can restrict a woman’s ovulation and cause abnormalities with the endometrial lining. We recommend stopping ANY alcohol intake before you start planning to conceive.

4) Stay Calm

Trying to conceive can be stressful and even cause conflict with your partner. Cortisol (the stress hormone) can negatively impact your reproductive system. Be sure your life is balanced; you have a stress relief activity, monitor your emotions and have FUN trying to get pregnant

5) Know your cycle

Track your ovulation by the calendar method-assuming ovulation occurs 14 days before your menstrual cycle is due or using an ovulation predictor kit. Pregnancy is most likely to occur with intercourse within three days before ovulation

If you find difficulty in the process of trying to conceive we welcome you to partner with the Virginia Center for Reproduction Medicine. We would be honored to help you achieve your dream! 

What is PGD (Pre Implantation Genetic Diagnosis) or Preimplantation Genetic Testing?

PGD (Preimplantation Genetic Diagnosis), is a process that allows genetic testing of an embryo prior to implantation and before pregnancy occurs. The procedure coincides with In-Vitro Fertilization (IVF) and uses only embryos analyzed as being free of a specific genetic disorder to be transferred for pregnancy.

PGD is broadly used to refer to any testing performed on an embryo prior to it being transferred to the uterus. However, there is a difference in the terms PGD and PGS.

PGD, Preimplantation Genetic Diagnosis, is a test looking for a specific genetic condition (like cystic fibrosis, sickle cell disease, muscular dystrophy) prior to transfer

PGS, Preimplantation Genetic Screening, is testing for overall chromosomal normalcy in embryos. PGS is not looking for a specific disease diagnosis - it is screening the embryo for normal chromosome numbers.

By testing the chromosomes of the embryos available for transfer, fertility clinics can discard embryos with abnormal chromosomal arrangements and pick the embryo(s) for transfer from those with normal chromosomes.

If you answer Yes to any of these questions, PGD could be helpful for you:

•            Are you a woman over the age of 35?

•            Have you suffered from several miscarriages?

•            Have you had a previous pregnancy with a chromosome abnormality?

•            Has a past IVF cycle been unsuccessful for you?

•            Does low sperm count play a role in your difficulty to conceive?

•            Are you aware of any family history of genetic diseases? For example: cystic fibrosis, muscular dystrophy or Huntington disease

•            Do you want to choose the gender of your child?

Visit our website to read our clients most FAQs about PGS & PGS: http://www.vcrmed.com/other-services/genetic-screening/pgd-and-pgs/

What is Infertility?

Approximately 85% of women will become pregnant within one year of trying. Only an additional 7% of couples will conceive in the second year. Based on these results, infertility is defined as the inability to conceive within 12 months.

The most common causes of Infertility are:

● Advancing Maternal Age: As women age, the number of eggs they produce and the egg quality decreases at a rapid rate.

● Ovulation disorders: Normal and regular ovulation (the release of a mature egg) is essential for women to conceive naturally. There are many disorders that may impact the ability for a woman to ovulate normally. The most common disorders impacting ovulation include PCOS (link to past written PCOS article). Ovulation can be detected by keeping a menstrual calendar or using an ovulation predictor kit.

● Uterine Fibroids: There are three types of fibroids and 40% of women have them. However, only submucosal fibroids reduce a woman's pregnancy rate. Submucosal fibroids can cause heavy periods, or bleeding between periods LINK TO PAST FIBROID ARTICLE

● Endometriosis: It causes infertility by producing inflammation and scarring in the uterine cavity. This can result in pelvic pain and affect eggs, sperm or developing embryos.

● Unknown: About 15% of couples can never pinpoint the cause of their infertility.

Luckily there are fertility treatments to help overcome Infertility:

1) Clomid, Tamoxifen, Letrozole (pill form) or Gonadotropins (Injectable): These medications help induce egg development and ovulation

2) Insemination: Intrauterine Insemination (IUI) is the process where sperm is washed and prepared for placement into the uterine cavity, bypassing the cervix and bringing the sperm closer to the tubes and ovulated egg

3) In Vitro Fertilization (IVF): IVF is the process where the woman's eggs are collected and then fertilized by sperm outside the body in a laboratory

When a couple decides to seek the help of a fertility specialist they will have a fertility evaluation. 

During this process the following will be conducted:

● Medical and Fertility History

● Transvaginal Ultrasound: An ultrasound is an important tool in evaluating the structure of the uterus, tubes, and ovaries. It can also detect any abnormalities like fibroids or ovarian cysts. Additionally, transvaginal ultrasound offers the opportunity for your doctor to assess the estimated number of available eggs (i.e your ovarian reserve).

● Laboratory testing: Blood work is conducted to measure blood levels of hormones like Estradiol, FSH and AMH (anti-Mullerian hormone), (related to ovarian function and overall egg numbers), TSH (assesses thyroid function) and Prolactin (hormone that can affect menstrual function if elevated), and Vitamin D.

● Hysterosalpingogram (HSG): This test is important in evaluating fallopian tubal patency, uterine filling defects such as fibroids and polyps, and scarring of the uterine cavity (Asherman syndrome). Many uterine and tubal abnormalities detected by the HSG can be surgically corrected. We have been performing HSG at our facility since 2009, and Dr Sharara has performed over 1000 HSGs.

● Semen analysis: The semen analysis is the main test to evaluate the male partner fertility concerns. There are many factors analyzed including:

1) semen volume

2) sperm concentration

3) sperm motility (movement)

4) morphology (shape)

5) WBC count

6) viscosity

If you are having trouble conceiving or have already been diagnosed with infertility and are in the process of selecting a fertility clinic, we invite you to visit read this article for an overview of options and factors to consider. Visit: http://vcrmed.blogspot.com/2015/04/how-to-choose-fertility-center.html

Improve your Fertility with a proper Diet

According to the National Survey of Family Growth, Infertility affects over 7.3 million individuals or 1 in 8 couples in the United States. While there are numerous conditions that may cause or contribute to a diagnosis of infertility, a poor diet is a growing and significant factor that couples can address.

Factors like age and genetics cannot be controlled, but controlling the foods you consume is something you can do yourself, without medical procedures, to help improve your fertility. Dr Sharara created The Infertility Diet (TID) to educate couples about this very important topic

 

As a woman contemplates conception, it is recommended that she starts consuming foods high in certain vitamins:

·      Vitamin B supports the release of an egg and promotes implantation Zinc can help with cell division and progesterone production

·      Vitamin C is found in high quantities in the follicle after the egg is release and could play a role in progesterone production

·      Essential Fatty Acids (EFA’s) promote blood flow to the uterus and support the opening of the follicle to release the egg

 It is also recommended to eat the following types of food:

1.    Leafy greens

2.    Whole Grains

3.    Eggs

4.    Meat

5.    Fish (or fish oil supplements)

6.    Drink LOTS of water. Water can transport hormones and develop follicles. It also thins out cervical mucus, allowing sperm to reach the egg

7.    Stop all processed food and avoid foods high in sugar

Dr. Sharara, the Founder & Medical Director at the Virginia Center for Reproductive Medicine understands the road to parenthood can be emotional and costly. To support and guide couples on their journey of trying to conceive, he created an app called “The Infertility Diet.” 

The App shows users how a proper diet can improve their chances of naturally conceiving a healthy baby.

We invite you to learn more about the app http://theinfertilitydiet.com/

An Overview on Egg Freezing

Egg Freezing has become quite popular over the past few years. Women find it appealing to be able to preserve their fertility for medical, lifestyle or career reasons. A variety of companies including Apple and Facebook even assist their employees with the financial costs of Egg Freezing. According to WebMD, there have now been more than 2,000 live births from frozen eggs, about 1,000 within the past 5 years.

The Egg Freezing process is done for a variety of reasons:

•            Cancer or other radiation treated diseases

•            Delay motherhood to pursue educational, career or personal life goals (fertility preservation)

In order to retrieve eggs for freezing, a woman undergoes the same hormone-injection process as in-vitro fertilization. The only difference is that, following egg retrieval, the eggs are frozen.

It takes approximately 4-6 weeks to complete the egg freezing cycle and the steps are the same as the initial stages of the IVF process including:

•2-4 weeks of birth control pills to temporarily turn off natural hormones

•10-14 days of hormone injections to stimulate the ovaries and mature multiple eggs.

Once the eggs have adequately matured, they are removed with a needle placed through the vagina under ultrasound guidance. This procedure is done under intravenous sedation and is not painful. The eggs are then frozen within few hours.

The Virginia Center for Reproductive Medicine recommends and practices a newer freezing technique called Vitrification. This process is ultra-rapid cooling (not true freezing) and reduces potential egg freezing risks. Frozen embryos remain viable for an infinite amount of time after the initial freeze.

When a woman is ready to try to conceive, the eggs are thawed, fertilized using OCSI with partner’s sperm, and transferred to the uterus 5 days later as embryos. This process is called Frozen Embryo Transfer (FET). The eggs will be the exact age and quality of the time period she froze them, regardless how many years have gone by. The pregnancy success rates related to a Frozen Embryo Transfer depend on the women’s age at the time she froze her eggs.

The Virginia Center for Reproductive Medicine invite you to learn more about the Egg Freezing process by visiting: http://www.vcrmed.com/other-services/egg-freezing-program/