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Archive for the ‘Biological Clock’ tag

Age and Fertility

By David Kreiner MD

February 2nd, 2015 at 4:23 pm

 

credit: photostock/free digital photos.net


You’ve heard the “Reproductive Bell” toll and may question “Is it real?”…

You see celebrities getting pregnant well into their 40’s and think “Then why can’t I?” So, is your reproductive clock as critical as modern doctors say?

I have come across fertility advice from non-physician practitioners, such as acupuncturists and Chinese herbalists, who encourage their patients to “question the Western dogma” when it comes to age and fertility. They claim the effect of aging and fertility is “exaggerated by the Medical profession and can be overcome with a shift in an individual’s health and lifestyle”.

Unfortunately, this advice comes without any cited research or statistics in support of it.  According to the Society of Assisted Reproductive Technology, as published on SART.org, a review of the 2012 national statistics, those most recently published of IVF cycles started, the age breakdown for IVF live birth rates are the following:

 

Age <35= 40.2%

 

Age 35-37=31.3%

 

Age 38-40=22.2%

 

Age 41-42=11.8%

 

Age >42=3.2%

 

It is true that a woman’s health and physiology gets worse as she gets older.  Some of these non- physician practitioners argue that perhaps if this can be improved then the diminishing fertility commonly seen with aging can be reversed. But though improving a woman’s general health may help it is not sufficient in most cases.  Fertility rates decrease with increasing age in large part because there is an increase in genetic abnormalities found in gametes (eggs and sperm) as patients (women in particular) age.  This is the result of long-term environmental exposure to toxins, in addition to the increased likelihood of genetic damage over time.  Miscarriage rates increase with age for the same reason in large part due to the greater likelihood of embryos having chromosomal abnormalities.

Many women as they age also will experience a significant drop in their ovarian activity, referred to as diminished ovarian reserve.  This activity can be assessed by your physician with a blood level of Anti Mullerian Hormone (AMH) and day 3 FSH and estradiol levels.  Women with lower AMH levels and elevated FSH in the presence of a normal low estradiol have fewer ovarian follicles, and hence eggs, that will respond to ovarian stimulation.  Since the likelihood of these eggs being genetically normal is less, then fertility is reduced and the probability of IVF and other fertility treatments resulting in a live birth becomes significantly lower.

The challenge to any practitioner dealing with an aging patient attempting to conceive is to optimize their patient’s chance to have a healthy baby which optimally would include an integration of multiple modalities.  Therefore, ideally a physician specially trained in the fertility process (a Reproductive Endocrinologist), should implement state-of-the-art Western therapies with a complementary holistic approach that aims to shift their patient’s health and fertility.  These holistic approaches include diet and lifestyle changes as well as fertility-directed acupuncture and herbal therapy treatments.

Lifestyle changes that may improve fertility primarily include those that reduce stress and improve diet and activity.  Stress at work, at home, and with family and friends can create pathology from both Eastern and Western perspectives.  Diets that do not support adequate blood production or create Eastern patterns of cold or heat can affect fertility.  Excesses or deficiencies of particular foods…such as dairy, fat, or grains… can create imbalances or pathology that may affect fertility or result in obesity or malnutrition which also impact reproduction.

Inactivity may impair fertility. Therefore some level of exercise, combined with an improved diet directed at improving fertility, stress reduction techniques, acupuncture, and supplements (which may include Chinese Herbs as well as Western supplements) will optimize your chances of successfully building your family.

The first step is to seek help from a reproductive endocrinologist skilled in state-of-the-art fertility therapies who can coordinate a program which is ideal for you. But if you are hearing the “Reproductive Bell” tolling, it is important to take that first step soon, because, while these many complementary approaches can optimize your fertility, they may not be enough to overcome the reality of the negative effect of advanced age in fertility.

Long Island IVF offers complementary holistic approaches to achieving pregnancy (See our Mind-Body Program http://www.longislandivf.com/mind_body.cfm ) as well as a well-respected Donor Egg Program http://www.longislandivf.com/donor_programs.cfm  with no wait for pre-screened, multi-ethnic donor eggs, or Donor Embryos.

* * * * ** * ** * ** * *** ******** ***

Has the increased visibility of older celebrity moms getting pregnant made you think you have more time? Have you considered combining Western and Eastern medicine in your family-building treatment?

 

 

http://www.freedigitalphotos.net/images/Younger_Women_g57-Young_Woman_Holding_Clock_p49428.html

 

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An Infertile Woman’s Advice to the New Grad

By Tracey A. Minella

June 21st, 2014 at 6:19 am

 

credit: david castillo dominici/freedigitalphotos.net

How innocent you look there in your cap and gown, your broad smile gleaming in the sun. Another educational milestone met. Another diploma for the wall.

You’ve got grand plans for your bright future. Another advanced degree, or maybe your first big job, waits. Visions of the good life fill your mind. Having it all. The career with its promotions, the marriage with romantic vacations. The first house. And then…eventually… the baby. The one you’ve decided will arrive in May of some yet undetermined year. Right on schedule. Exactly as planned.

Today, your foot is poised on the ladder to success.

And as I see you, my mind screams “Put it in the stirrups!”

I was you, long ago. Innocent, with no reason to suspect my life’s lofty goals would not turn out exactly as planned. And as it turns out, I’d trade all my degrees, romantic vacations and big empty house in a heartbeat just to have some of that time back. Just to have thought to start trying to conceive sooner. Or to have budgeted money better. And sadly, I’m in good company feeling this way.

I never thought I’d be married 13 years before I finally conceived. Or that my journey to the crib would take 6 years and 6 IVF cycles and then another IVF four years later. Or that the costs…financial and emotional… would be so great and still have an impact on my life for so many years.

There’s something about graduations that brings out the cynic in me.  It’s that innocent optimism of the grad and the sense that they have all the time in the world before having a family that makes me want warn them that a rude awakening may await them. But who am I to shatter their dreams?

So the best advice I can give new grads is to look ahead optimistically, but keep one eye on the mirror and keep your ear on the biological clock because time moves faster than you think. Whether you have a partner or not, see an RE periodically for a complete fertility evaluation as your eggs may be older than you think. Rule out or treat any issues found early…before you’re ready to conceive.  Consider egg freezing, if indicated. A simple semen analysis is an inexpensive test that yields a lot of information. These exams will let you know if you should consider changing your original family-building timing.

Being book smart is great, but there’s more. Be smart about your body and your fertility. Know your options because knowledge is power.

Now, go out and conquer the world.

* * * * * * * * * * * * * * * ***

What, if anything, would you do differently in terms of timing your education, career, and family planning?

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Is Your Biological Clock Running Out?

By David Kreiner, MD

January 10th, 2014 at 10:35 pm

 

image courtesy of photo stock/freedigital photos.net

Tears start to course down the cheeks of my patient, her immediate response to the message I just conveyed to her. Minutes before, with great angst anticipating the depressing effect my words will have on her, I proceeded to explain how her FSH was slightly elevated and her antral follicle count was a disappointing 3-6 follicles. I was careful to say that though this is a screen that correlates with a woman’s fertility, sometimes a woman may be more fertile than suspected based on the hormone tests and ovarian ultrasound. I also said that even when the tests accurately show diminishing ovarian reserve (follicle number), we are often successful in achieving a pregnancy and obtaining a baby through in vitro fertilization especially when age is not a significant factor.

These encounters I have with patients are more frequent than they should be. Unfortunately, many women delay seeking help in their efforts to conceive until their age has become significant both because they have fewer healthy genetically normal eggs and because their ability to respond to fertility drugs with numerous mature eggs is depressed. Women often do not realize that fertility drops as they age starting in their 20s but at an increasing rate in their 30s and to a point that may often be barely treatable in their 40s.

A common reason women delay seeking help is the trend in society to have children at an older age. In the 1960’s it was much less common that women would go to college and seek a career as is typical of women today. The delayed childbearing increases the exposure of women to more sexual partners and a consequent increased risk of developing pelvic inflammatory disease with resulting fallopian tube adhesions.

When patients have endometriosis, delaying pregnancy allows the endometriosis to develop further and cause damage to a woman’s ovaries and fallopian tubes. They are more likely to develop diminished ovarian reserve at a younger age due to the destruction of normal ovarian tissue by the endometriosis.

Even more important is that aging results in natural depletion of the number of follicles and eggs with an increase in the percentage of these residual eggs that are unhealthy and/or genetically abnormal.

Diminished ovarian reserve is associated with decreased inhibin levels which decreases the negative feedback on the pituitary gland. FSH produced by the pituitary is elevated in response to the diminished ovarian reserve and inhibin levels unless a woman has a cyst producing high estradiol levels which also lowers FSH. This is why we assess estradiol levels at the same time as FSH. Anti-Mullerian Hormone (AMH) can be tested throughout a woman’s menstrual cycle and levels correlate with ovarian reserve. Early follicular ultrasound can be performed to evaluate a woman’s antral follicle count. The antral follicle count also correlates with ovarian reserve.

By screening women annually with hormone tests and ultrasounds a physician may assess whether a woman is at high risk of developing diminished ovarian reserve in the subsequent year. Alerting a woman to her individual fertility status would allow women to adjust their family planning to fit their individual needs.

Aggressive fertility therapy may be the best option when it appears that one is running out of time. Ovulation induction with intrauterine insemination, MicroIVF and IVF are all considerations that speed up the process and allow a patient to take advantage of her residual fertility.

With fertility screening of day 3 estradiol and FSH, AMH and early follicular ultrasound antral follicle counts, the biological clock may still be ticking but at least one may keep an eye on it and know what time it is and act accordingly.

* * * * * * * * * * * * * * * * *

Did you realize that aging is not the only factor in the biological clock race? Did you know that certain conditions, like endometriosis, can play a part, too?

 

Photo credit: http://www.freedigitalphotos.net/images/agree-terms.php?id=10049499

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(Another) New Year’s…and Tips to Survive It

By Tracey Minella

December 29th, 2013 at 11:47 pm

 

image courtesy of danillo rizutti/free digital photos.net


And so we move on toward yet another new year. Another supposed-to-be Happy New Year.

But holidays aren’t happy when you’re trying to conceive. They just aren’t. And sticking the word “happy” on them only adds to the stress. Isn’t it enough to have to face another year without a baby? Now you have to be “happy” too?

Father Time’s clock on New Year’s Eve is not welcome to many infertiles. How many of us have morphed into hermit couples over time? There is actually a pattern to it.

One year, you’re typical party-goers hoisting champagne at some big, loud gathering and confidently proclaiming to all within earshot “This year is the year we’re having a baby!”

Time passes. It’s New Year’s again. The crowd you’re celebrating with dwindles to a few close friends or family and the scene is more low-key. You trade in the bubbly for an alcohol-free toast because you’re doing everything you can to make that baby wish come true. You no longer say out loud that “This is the year”. You are still hopeful, but uneasiness dampens your party spirit.

More time passes. It’s just the two of you now. You don’t want to be out with others. Maybe you’ve suffered losses or are frustrated by financial roadblocks to necessary fertility treatment. You’re depressed and are simply too exhausted to pretend you’re happy…especially when surrounded by people who don’t understand your totally understandable depression. You’re tired of saying “This will be the year” only to find another year goes by and you’re making the same wish over and over. You’re hope is dangerously depleted and you officially loathe New Year’s with all its shallow celebratory nonsense. Prolonged infertility has stolen your happiness.

It’s okay. It really is okay not to be happy on New Year’s.

But it is not okay to lose hope. You need to keep hope alive. Nourish whatever bit is left. Breathe life back into it. Even if there is only a glimmer remaining.  Find a way. Because your dream needs hope…and more…in order to come true. Depending on your circumstances, it may also need some combination of action, money and/or a miracle to come true.

So, from someone who ushered in about a decade of consecutive frustrating infertile New Year’s here’s some advice on how to make the best of a tough night.

·         Don’t think of yourselves as alone.  Remind yourself of why you chose and love this person and reconnect. Realize the power couple you are. You’ve been blessed with each other to get through this journey and, hard as it is, it’s making you stronger. When you finally do have a child, you will be ready for anything life throws your way. Take the night to make a written plan for 2014. What is the next step going to be? What do you need to get there? And how will you get it? Real steps. In writing. Make the plan.

 

·         Acknowledge the elephant in the room…the baby that is not here yet. Instead of focusing on what’s missing, why not play a game? Similar to the movie “The Odd Life of Timothy Green”, you and your partner can brainstorm on the character traits you imagine your future baby will have. Boy or girl? Good at soccer or music? Quiet or loud? And so on. Positive visualization can do wonders.

 

·         Offer to babysit. For those up to it emotionally (and it’s okay not to be), consider offering to babysit for a friend’s baby overnight. You get a real taste of parenting and you get to help out a friend who may want to go out. When you have your own baby, maybe they’ll return the favor!

 

·         Have a Plan. If you are venturing out into the fertile, celebratory world you need a plan. If you’re with people who know you are trying, tell them up front that the topic is off limits tonight. If not, try to have a planned response ready for any possible nosy comments so you are not caught off guard. Have a secret “signal” with your partner that means “It’s time to leave…NOW!” Preparation is the best defense.

Wherever you are, kiss at the stroke of midnight. It’s the best way to enter the New Year. And it’s bound to fill your heart with hope.

* * * * ** ** * ***

What are your plans and tips for New Year’s Eve?

 

 

Photo credit: Danilo Rizzuti

 

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Infertility Podcast Series: Journey to the Crib: Chapter 12 What Do You Know About Your Fertility?

By David Kreiner MD

May 13th, 2013 at 8:16 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twelve: What Do You Know About Your Fertility? You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=74

What do you know about your fertility?

Women have a biological clock.  Everyone knows that.  However, life seems to get in the way sometimes; whether it be school, career or failure to find Mr. Right.  Most people assume that if they are healthy then there should not be a problem conceiving.  Unfortunately, general health and fertility are not always related.

Women are born with their reproductive lifetime supply of eggs.  That means the body doesn’t produce new ones.  With each menstrual cycle one egg is released and an additional thousand eggs simply are lost in the body’s natural process of selecting one for ovulation.  As a woman approaches 50, she typically runs out of her store of eggs.

Additionally, there is the issue of the effect of aging on the eggs.  Older eggs are more likely to have chromosomal abnormalities making them unlikely to become viable embryos.  Fertilized eggs with abnormal chromosomes are the most common cause of miscarriages, running about 40% by age 40.

Furthermore, not everyone’s ovaries/eggs age at the same rate and again it is not necessarily reflective of how old you look either.  Often very young looking women have very old acting ovaries and eggs.  You can be screened to evaluate your fertility status with an ultrasound examination of your ovaries performed by an experienced reproductive endocrinologist as well as by blood hormone screening looking at your FSH, estradiol and AntiMullerian Hormone levels.

I urge every woman of reproductive age who has not completed her childbearing to be evaluated and make plans based on knowledge about her own fertility.  Aggressive fertility treatment might be needed depending on your age, how long you have been trying to conceive, and your fertility screening.  Women who do not have a partner should explore the possibility of freezing their eggs while the likelihood of them still being healthy is high.  Remember, fertility treatment has a high success rate that decreases significantly as time passes on the biological clock.

* * * * * * **  * * * *

Was this helpful in answering your questions about your fertility?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them personally.

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Is Your Biological Clock Running Out?

By Tracey Minella and David Kreiner MD

January 6th, 2012 at 12:00 am


So, we just counted down the minutes on the regular clock, ringing in a brand new year. Did that remind you of anything? Maybe some other clock that is ticking down and causing you to fidget a bit?

You know which clock I mean: THE BLASTED BIOLOGICAL CLOCK!

I’ve always hated this term. Probably because I used to hit its SNOOZE button for years. It used to nag at me in the back of my mind as I pursued my education and got settled in my career…especially since I married young. And when it wasn’t in the back of my mind, it was being shoved smack in my face by the rude comments of nosy jerks, collectively known as “the masses of asses”. We’ve all got ‘em.

If you’re wondering whether your biological clock is really running out, this post by Dr. David Kreiner may be enlightening:

Tears start to course down the cheeks of my patient, her immediate response to the message I just conveyed to her. Minutes before, with great angst anticipating the depressing effect my words will have on her, I proceeded to explain how her FSH was slightly elevated and her antral follicle count was a disappointing 3-6 follicles. I was careful to say that though this is a screen that correlates with a woman’s fertility, sometimes a woman may be more fertile than suspected based on the hormone tests and ovarian ultrasound. I also said that even when the tests accurately show diminishing ovarian reserve (follicle number), we are often successful in achieving a pregnancy and obtaining a baby through in vitro fertilization especially when age is not a significant factor.

These encounters I have with patients are more frequent than they should be. Unfortunately, many women delay seeking help in their efforts to conceive until their age has become significant both because they have fewer healthy genetically normal eggs and because their ability to respond to fertility drugs with numerous mature eggs is depressed. Women often do not realize that fertility drops as they age starting in their 20s but at an increasing rate in their 30s and to a point that may often be barely treatable in their 40s.

A common reason women delay seeking help is the trend in society to have children at an older age. In the 1960’s it was much less common that women would go to college and seek a career as is typical of women today. The delayed childbearing increases the exposure of women to more sexual partners and a consequent increased risk of developing pelvic inflammatory disease with resulting fallopian tube adhesions.

When patients have endometriosis, delaying pregnancy allows the endometriosis to develop further and cause damage to a woman’s ovaries and fallopian tubes. They are more likely to develop diminished ovarian reserve at a younger age due to the destruction of normal ovarian tissue by the endometriosis.

Even more important is that aging results in natural depletion of the number of follicles and eggs with an increase in the percentage of these residual eggs that are unhealthy and/or genetically abnormal.

Diminished ovarian reserve is associated with decreased inhibin levels which decreases the negative feedback on the pituitary gland. FSH produced by the pituitary is elevated in response to the diminished ovarian reserve and inhibin levels unless a woman has a cyst producing high estradiol levels which also lowers FSH. This is why we assess estradiol levels at the same time as FSH. Anti-Mullerian Hormone (AMH) can be tested throughout a woman’s menstrual cycle and levels correlate with ovarian reserve. Early follicular ultrasound can be performed to evaluate a woman’s antral follicle count. The antral follicle count also correlates with ovarian reserve.

By screening women annually with hormone tests and ultrasounds a physician may assess whether a woman is at high risk of developing diminished ovarian reserve in the subsequent year. Alerting a woman to her individual fertility status would allow women to adjust their family planning to fit their individual needs.

Aggressive fertility therapy may be the best option when it appears that one is running out of time. Ovulation induction with intrauterine insemination, MicroIVF and IVF are all considerations that speed up the process and allow a patient to take advantage of her residual fertility.

With fertility screening of day 3 estradiol and FSH, AMH and early follicular ultrasound antral follicle counts, the biological clock may still be ticking but at least one may keep an eye on it and know what time it is and act accordingly.

* * * * * * * * * * * * * * * * *

Did you realize that aging is not the only factor in the biological clock race? Did you know that certain conditions, like endometriosis, can play a part, too?

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TTC and the “Generational” Clock

By Tracey Minella

August 19th, 2011 at 12:00 am

Nearly everyone TTC or doing IVF has heard of their biological clock running out. That phrase refers to the woman’s advancing age, diminished supply and questionable quality of eggs, the rapid approach of menopause, the potential increase in miscarriage and fetal abnormality rates, and the eventual cliff-dive in IVF success stats.

But this week I was reminded of the “other” clock. The more silent clock. Sometimes, the ticking is almost a whisper.

I’m going to call this other clock the “Generational” clock.

The Generational clock is the one that makes you worry that your parents are not going to live long enough to see you have your children. Or maybe not live long enough to become grandparents at all… if you having a baby is their only hope. Or they may have fewer years with your kids because of the infertility delays.

Like the biological clock, the generational clock is tied to your life and your infertility journey, but the generational clock is also tied to your parents’ and in-laws’ lives. That makes it twice as worrisome…twice as likely to blow up in your face.

Mine blew up in 1994 and again in 1996. My parents never became grandparents as I was an only child. My IVF babies were born in 1998 and 2002. Fortunately, my kids have had my wonderful in-laws. They easily give enough love and attention to cover for two sets of grandparents.

 

This week, my husband’s generational clock exploded with the passing of his dad. I am sad and angry over many aspects of this loss, but mostly that my young children have been deprived of the love of the world’s best grandfather.

He lived long enough to see his other grandchildren graduate college, saw some marry and have children. My oldest would have been 20, not 13, if not for infertility. It’s just not right.

Only one precious grandmother left.

I should stop typing now, so I can plug my ears and drown out the deafening whisper of that ticking…

* * * * * * ** *  * *

Have you feared the loss… or actually experienced the loss… of a parent during the infertility journey? How do you cope?

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Is Your Biological Clock Running Out?

By Tracey Minella and David Kreiner MD

May 19th, 2011 at 9:02 am

I’ve always hated this term.

It used to nag at me in the back of my mind as I pursued my education and got settled in my career…especially since I married young. And when it wasn’t in the back of my mind, it was being shoved smack in my face by the rude comments of nosy jerks, collectively known as the "masses of asses".

If you’re wondering whether your biological clock is really running out, this post by Dr. David Kreiner of East Coast Fertility may be enlightening:

Tears start to course down the cheeks of my patient, her immediate response to the message I just conveyed to her. Minutes before, with great angst anticipating the depressing effect my words will have on her, I proceeded to explain how her FSH was slightly elevated and her antral follicle count was a disappointing 3-6 follicles. I was careful to say that though this is a screen that correlates with a woman’s fertility, sometimes a woman may be more fertile than suspected based on the hormone tests and ovarian ultrasound. I also said that even when the tests accurately show diminishing ovarian reserve (follicle number), we are often successful in achieving a pregnancy and obtaining a baby through in vitro fertilization especially when age is not a significant factor.

These encounters I have with patients are more frequent than they should be. Unfortunately, many women delay seeking help in their efforts to conceive until their age has become significant both because they have fewer healthy genetically normal eggs and because their ability to respond to fertility drugs with numerous mature eggs is depressed. Women often do not realize that fertility drops as they age starting in their 20s but at an increasing rate in their 30s and to a point that may often be barely treatable in their 40s.

A common reason women delay seeking help is the trend in society to have children at an older age. In the 1960’s it was much less common that women would go to college and seek a career as is typical of women today. The delayed childbearing increases the exposure of women to more sexual partners and a consequent increased risk of developing pelvic inflammatory disease with resulting fallopian tube adhesions. When patients have endometriosis, delaying pregnancy allows the endometriosis to develop further and cause damage to a woman’s ovaries and fallopian tubes. They are more likely to develop diminished ovarian reserve at a younger age due to the destruction of normal ovarian tissue by the endometriosis. Even more important is that aging results in natural depletion of the number of follicles and eggs with an increase in the percentage of these residual eggs that are unhealthy and/or genetically abnormal.

Diminished ovarian reserve is associated with decreased inhibin levels which decreases the negative feedback on the pituitary gland. FSH produced by the pituitary is elevated in response to the diminished ovarian reserve and inhibin levels unless a woman has a cyst producing high estradiol levels which also lowers FSH. This is why we assess estradiol levels at the same time as FSH. Anti-Mullerian Hormone (AMH) can be tested throughout a woman’s menstrual cycle and levels correlate with ovarian reserve. Early follicular ultrasound can be performed to evaluate a woman’s antral follicle count. The antral follicle count also correlates with ovarian reserve.

By screening women annually with hormone tests and ultrasounds a physician may assess whether a woman is at high risk of developing diminished ovarian reserve in the subsequent year. Alerting a woman to her individual fertility status would allow women to adjust their family planning to fit their individual needs.

Aggressive fertility therapy may be the best option when it appears that one is running out of time. Ovulation induction with intrauterine insemination, MicroIVF and IVF are all considerations that speed up the process and allow a patient to take advantage of her residual fertility.

With fertility screening of day 3 estradiol and FSH, AMH and early follicular ultrasound antral follicle counts, the biological clock may still be ticking but at least one may keep an eye on it and know what time it is and act accordingly.

no comments

Getting Information To Women About Their Bodies: Easier Said Then Done

By Pamela Madsen

November 8th, 2010 at 10:36 am

I have spent a great deal of my life working to prevent infertility – and in cases where we can’t prevent infertility – get those affected by infertility into treatment early when treatments are more likely to be successful.

When I was the Executive Director of The American Fertility Association – I did the work through the organization – and now I continue to do this work through my blogging, the media, and through my job at East Coast Fertility where I help to develop patient and professional education and support. One of the things that I do is visit ob/gyns with our doctors to bring education to their door step.

Going directly into the GYN office has been quite a learning experience for me.  About half of the doctors that I have visited in the last two years are women.  Women have not only achieved the right to equal status under the law – woman have become leaders in every field.  Many women are now being born into this expectation of no glass ceilings. These young women own their personal power and their birth right to accomplish anything. They often do not view gender as an obstacle to anything that they want to accomplish in their lives.  I love and support that!

Yet, when it comes to fertility education, I still encounter a kind of odd paternalism towards women and their ability to handle the facts around reproductive health when it comes the very particular subject area of reproductive aging and fertility preservation.   I used to be surprised when I bumped up against this during a presentation – but no longer.

This is how it usually goes. I schedule a presentation with a gynecologist’s office and I usually bring in lunch or breakfast - then I wait for the doctors and nurses to come in and grab something to eat. I often go with one of the reproductive endocrinologists that I work with at East Coast Fertility. We usually dish about life – and then talk about the various programs that we believe in at ECF such as Micro IVF or Single Embryo Transfer.

At some point the conversation usually turns to fertility preservation and fertility education. Now, this is not something that we are "selling". This is a series of simple tests that the gynecologist can do in their office to let women know where they stand in regards to their own personal biological clock. It is our hope that gynecologists will do Fertility Evaluations for women every year – just like they do a pap smear. It is our hope that women are given the information that they need about their own bodies so that they can plan their reproductive futures – and make the best decisions for themselves.

But what sometimes happens is that there will be a gynecologist who will say that while they see many women who have no idea about their  biological clocks – that they do not want to worry women about their fertility. They don’t want to make women "anxious" about their biological clocks. In other words, they don’t want to worry our pretty little heads!! What ever happened to "Knowledge is Power?" Why is it politically correct to talk to women about STD’s, birth control, abortion, but not our reproductive potential? Isn’t this a form of gender bias – believing that women cannot handle information about their own bodies? That some how if we learn the truth about our own fertility – that this particular knowledge will make us go running out into the streets and grab the first man we see to make a baby! Or perhaps learning about our biological clocks will put us into such an emotional state of distress that we will need to be put on anti anxiety medication or worse! Do doctors really think that women can handle all of the information that is needed to go to medical school – but not fertility information?

Where is this coming from?

Doctors never have an issue "worrying" me or creating "anxiety" in me when it comes to my weight! Or when I am late to get a mammogram or pap smear! What is it about fertility that gets some of them all twitched? Is it that talking about a women’s possible  plans to be a mother, or talking about the possibility of becoming pregnant is some how considered anti feminist – where talking about "the pill" is considered pro feminist and politically correct? And who drew these lines?

I think that society has some interesting views about feminism. Sometimes, I feel like I am a permission giver. I walk around giving the facts to gynecologists about what women know and don’t know  – something that they really already know – and then I give them permission to talk about it with their patients. We are introducing a new idea – the idea that women are really entitled to complete information about their bodies. We are introducing this idea of a Fertility Evaluation – so women truly know where they stand.  I trust women. I trust women to be able to handle the truth about their own personal reproductive health and not jump off the Brooklyn Bridge because they learn that fertility begins to decline in the late twenties. I trust that when women are given information that they will make their own decisions. But I do believe that women need to be given this information – right in their gynecologist or general practitioners offices on a regular basis.  I am sorry if giving women this information can make some doctors uncomfortable. Perhaps I should start a support group!!!

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Why Can’t We Trust Women With Real Information About Their Bodies?

By Pamela Madsen

September 10th, 2010 at 12:00 am

I have spent a great deal of my life working to prevent infertility – and in cases where we can’t prevent infertility – get those affected by infertility into treatment early when treatments are more likely to be successful.

When I was the Executive Director of The American Fertility Association – I did the work through the organization – and now I continue to do this work through my blogging, the media, and through my job at East Coast Fertility where I help to develop patient and professional education and support. One of the things that I do is visit ob/gyns with our doctors to bring education to their door step.

Going directly into the GYN office has been quite a learning experience for me.  About half of the doctors that I have visited in the last two years are women.  Women have not only achieved the right to equal status under the law – woman have become leaders in every field.  Many women are now being born into this expectation of no glass ceilings. These young women own their personal power and their birth right to accomplish anything. They often do not view gender as an obstacle to anything that they want to accomplish in their lives.  I love and support that!

Yet, when it comes to fertility education, I still encounter a kind of odd paternalism towards women and their ability to handle the facts around reproductive health when it comes the very particular subject area of reproductive aging and fertility preservation.   I used to be surprised when I bumped up against this during a presentation – but no longer.

This is how it usually goes. I schedule a presentation with a gynecologist’s office and I usually bring in lunch or breakfast - then I wait for the doctors and nurses to come in and grab something to eat. I often go with one of the reproductive endocrinologists that I work with at East Coast Fertility. We usually dish about life – and then talk about the various programs that we believe in at ECF such as Micro IVF or Single Embryo Transfer.

At some point the conversation usually turns to fertility preservation and fertility education. Now, this is not something that we are "selling". This is a series of simple tests that the gynecologist can do in their office to let women know where they stand in regards to their own personal biological clock. It is our hope that gynecologists will do Fertility Evaluations for women every year – just like they do a pap smear. It is our hope that women are given the information that they need about their own bodies so that they can plan their reproductive futures – and make the best decisions for themselves.

But what sometimes happens is that there will be a gynecologist who will say that while they see many women who have no idea about their  biological clocks – that they do not want to worry women about their fertility. They don’t want to make women "anxious" about their biological clocks. In other words, they don’t want to worry our pretty little heads!! What ever happened to "Knowledge is Power?" Why is it politically correct to talk to women about STD’s, birth control, abortion, but not our reproductive potential? Isn’t this a form of gender bias – believing that women cannot handle information about their own bodies? That some how if we learn the truth about our own fertility – that this particular knowledge will make us go running out into the streets and grab the first man we see to make a baby! Or perhaps learning about our biological clocks will put us into such an emotional state of distress that we will need to be put on anti anxiety medication or worse! Do doctors really think that women can handle all of the information that is needed to go to medical school – but not fertility information?

Where is this coming from?

Doctors never have an issue "worrying" me or creating "anxiety" in me when it comes to my weight! Or when I am late to get a mammogram or pap smear! What is it about fertility that gets some of them all twitched? Is it that talking about a women’s possible  plans to be a mother, or talking about the possibility of becoming pregnant is some how considered anti feminist – where talking about "the pill" is considered pro feminist and politically correct? And who drew these lines?

I think that society has some interesting views about feminism. Sometimes, I feel like I am a permission giver. I walk around giving the facts to gynecologists about what women know and don’t know  – something that they really already know – and then I give them permission to talk about it with their patients. We are introducing a new idea – the idea that women are really entitled to complete information about their bodies. We are introducing this idea of a Fertility Evaluation – so women truly know where they stand.  I trust women. I trust women to be able to handle the truth about their own personal reproductive health and not jump off the Brooklyn Bridge because they learn that fertility begins to decline in the late twenties. I trust that when women are given information that they will make their own decisions. But I do believe that women need to be given this information – right in their gynecologist or general practitioners offices on a regular basis.  I am sorry if giving women this information can make some doctors uncomfortable. Perhaps I should start a support group!!!

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