Spanky asks Dr Geoffrey Sher on Let’s Talk Infertility !

I’m very excited..I posted many of your questions to Dr Geoffrey Sher, Here are his Bio

Awards & Accomplishments

– 30+ years experience with In Vitro Fertilization
– Founder of the first private IVF Clinic in the US
– Influential in the births of more than 18,000 babies
– Trained under Patrick Steptoe and Robert Edwards, the “Fathers of IVF”
– Internationally renowned authority on immunologic causes of infertility
– Pioneer of many “firsts” in the field of IVF
He is located in Las Vegas NV…

So Fridays will be ” Answers from Dr Sher” I want to do this for a long time , so I need questions from all of you……

So Let’s Talk Infertility:     1st question?

Spanky Glasses

Spanky asks:
Dr Sher
Why after a loss- Does it take so long to get cycle back and why is it so different than before. AF (Aunt Flo)longer and O (Ovulation) is much later?

Dr. Geoffrey Sher – August 4, 2016 reply

After a pregnancy the central control over hormonal cyclicity can take a while (usually up to 2 months to reinstate.)
Geoff Sher

Sperm Tales made it to the Huffington Post

#AGEMATTERS35 : Why Don’t Doctors Tell Patients That Age Matters ?

07/12/2016 07:33 am 07:33:26

The clock is ticking away….When Do I Have My Baby, Now or Later?
 After listening to a news story from Australia about how fertility specialists are not telling over 40-year-old patients the real chances of having a child, I was disturbed to find out that added-on procedures to an IVF are being performed with absolutely no studies being tested to show that they work. For example embryo glue, which is a product that can be used to help the embryo stick to the uterus, is being used. Does it work? Are patients being charged for false hope?

There are some Medicare rebates for IVF procedures in Australia but there is still cost to the patients. So many couples are having over six IVF procedures and still not pregnant. One specialist mentioned a patient went through over 37 IVFs before having a child. Fertility treatments not only cause stress with the cost of IVF but also there’s emotional stress to couples ― depression, guilt, blame ― the list goes on and on. The show, “The Baby Business,” said that a woman at the age of 43 has less than 3% chance of having a live birth. True this was from Australia but the statistics are not far off in other countries. It’s standard knowledge that a women trying to conceive in her 40’s has an extremely low chance of having a live birth with her own eggs. When specialists are asked the main cause of infertility, the answer is “AGE.” Fertility for women starts dropping very quickly at the age of 35. (#AGEMATTERS35)

Society and lifestyles have changed for women but the number of eggs they are born with haven’t changed and as time goes on the quality and number drop.Women go off to college, find work in their careers, travel, etc., but often times delay the time for having children. Unfortunately, many women don’t stop to think about the real meaning of “the clock is ticking,” which is that the perfect time to conceive is between the ages of 18 – 29. Remember: the older the eggs, the harder it is to get pregnant.

The desire to have one’s own biological children can be strong and compelling, the effects of infertility for individuals and couples who are unable to conceive can be devastating. Treatments of infertility can be medically invasive and may cause discomfort or be associated with health problems for women, men and the resulting children.

The CDC has developed the National Public Health Action Plan for the Detection, Prevention and Management of Infertility. Given the goal of public health to reduce disease, premature death, injury and disability through prevention and health promotion, preventing infertility and results associated with its treatment are important concerns.

The plan is to promote healthier behaviors that can maintain fertility. It is also to help educate, promote prevention and early detection and treatment of medical conditions that threaten fertility, reduce exposure to environmental, occupational, and infectious agents that can threaten fertility.(1)

 

Women need to think of the big picture…….

 

A large part is to educate our young women when to have their family. I am not saying to run out, find Mr. Right and get pregnant, but keep this all in your mind. In my book, Sperm Tales: An Informative Guide Through the Challenges of Infertility. In chapter one, When Do I Have My Baby, Now or Later? it reviews an article in Newsweek 2001, about different women who pondered when they wanted to start their families, most of which chose to put it off for several years.

Some were at the height of their careers, others were traveling or going to graduate school. They had no social life and felt that this wasn’t the right time to have children. One woman who was in medical school knew she was pushing the biological time clock. Even so, she felt that the advancement in technology would help her conceive by the time she was ready.

Another woman found her “Mr. Right” at the age of 42 and decided then she wanted to start her family, thinking if movie stars can get pregnant at 40, why can’t I? (Movie stars don’t tell you, there is a good chance they are using donor eggs.) Over the next few years this woman and her husband tried to conceive naturally with no success. They went to a fertility specialist and in time, were able to conceive, but then miscarried. She was devastated. She could not have imagined she would have such a problem conceiving. She asked herself, “What did I do? Did I wait too long to start trying?” To make matters worse, she had spent over $3,000 for the first month of injectable medications.(2)

 

The general misunderstandings and misguided assumptions about the process are often made worse by the hesitancy of some doctors to mention the topic of age to their younger patients. The above-mentioned Newsweek article highlights that many physicians choose not bring up fertility plans to women under 35 unless the patient herself initiates it. The reasons for this include the idea that some doctors assume that women are aware of the issues related to their fertility or they fear that if it’s brought up might cause them distress or encourage them to make a premature decision to have a child before they are ready. As it is, when a woman visits her OBGYN for the first time the physician usually will ask if the patient is sexually active and if she is using birth control.

In a recent poll, 52% of women over the age of 35 would have made different decisions with better fertility education in their younger years. The new norm is 20% of women having their first baby at 35-45 years of age which has no guarantees and that also includes infertility treatments and higher risks.

Women are very proactive in situations once they have all the major elements to see the big picture, and education is key. My book Sperm Tales: An Informative Guide Through the Challenges of Infertility  is an attempt to help patients start an Infertility program on time and to heighten the chance for success, and also to educate young people to keep a clear head about this harsh reality as they plan their lives, families and careers.

 

 

In closing, I think it is so important for OBGYN’s to bring up the conversation of fertility or like Resolve said at National Infertility Awareness Week (NIAW) this past April 2016 ― “#Start Asking!”

 

1 National Public Health Action Plan for the Detection, Prevention and Management of infertility, CDC, June 2014

2 Claudia Kalb, “The Truth about Fertility,” Newsweek August 13, 2001.

 

Lynn M. Collins was trained in the Infertility field at Brigham and Women’s Hospital in Boston, MA and later set up and worked for more than 10 years at an Infertility Lab and Sperm Bank in Massachusetts. Collins draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. She is the author of Sperm Tales: An Informative Guide Through the Challenges of Infertility, website:  http://www.infertility-tales.com/   Lynn lives in New Hampshire with her husband Kevin,black lab Shamus and cat Trapper John.

Edited by Skye Wentworth, Book Publicist, website: http://skyewentworth.org/wordpress/

 

 

Author Event: Infertility and Yoga !

spermtales6final copy   Infertility and Yoga !

Merrimac Public Library , Merrimac Ma.

Thursday , June 23, 2016 7 pm- 8 pm

86 W. Main St. , Merrimac, MA

Lynn Collins will be teaming up with Paula Wilson, Registered Yoga Instructor

Lynn will read from her book Sperm tales – An Informative guide through the challenges of Infertility. The CDC says 1 in 8 couples are infertile. Lynn will read selections from her book and be on hand to answer questions and sign copies of the book.

Paula Wilson has been a Registered Yoga Teacher since 2004 and has taught Yoga to people of all ages and abilities, including adults, seniors, children, pregnant women and even special needs students

Paula struggled with infertility for 5 years before having 2 beautiful children.  She feels Yoga helped her on her long journey to having children.  She taught and practiced throughout both of her pregnancies,  which helped with stress, anxiety,  and even labor and delivery. Yoga also kept her flexible and in great shape as well.
For free classes:
Anyone who attends the event can take 1st Yoga class free at the Merrimac library with Paula Wilson, Registered Yoga Teacher from May – August and the can enter a raffle to win 3 additional FREE Yoga classes with her (to be used by 12/31/16). Please visit her website at www.Harmonyyoga.info for details on her classes.

There will also be a free drawing for a copy of Sperm Tales. With each signed book you will receive a tip sheet “10 Fertility Tips: How to make pregnancy possible ”

There will be light refreshments served……Hope to see you there

Avocado Diet “triples chance of success” with IVF

Avocado diet ‘triples chance of success’ for couples undergoing IVF

 

The study says Mediterranean foods like avocado can enhance fertility

The study says Mediterranean foods like avocado can enhance fertility

Eating avocados and dressing salads with olive oil could help women trying to have a baby through IVF, researchers claim.

Foods typically eaten as part of the Mediterranean diet may triple the chances of success for women having the fertility treatment.

A study found monounsaturated fat – found in olive oil, sunflower oil, nuts and seeds – was better than any other kind of dietary fat for would-be mothers. Those who ate the highest amounts were 3.4 times more likely to have a child after IVF than those who ate the lowest amounts.

In contrast, women who ate mostly saturated fat, found in butter and red meat, produced fewer good eggs for use in fertility treatment.

US experts behind the study believe monounsaturated fats – which are already known to protect the heart – could improve fertility by lowering inflammation in the body.

The study was presented at the European Society of Human Reproduction and Embryology in Istanbul.

It was carried out at Harvard School of Public Health, funded by the US National Institutes of Health.

The study took place among 147 women having IVF at the Massachusetts General Hospital Fertility Center.

Their intake of different dietary fats was recorded and the outcome of fertility treatment compared between the highest and lowest third of intake in each category.

Women eating the highest levels of all types of fat had fewer good eggs available for use in treatment.

Prof Chavarro said the link was driven by saturated fat intake, while high levels of polyunsaturated fat consumption produced poorer quality embryos.

Higher intakes of monounsaturated fat were linked to a 3.4 times higher live birth rate than those with the lowest intake.

For those eating least, monounsaturated fat made up nine per cent of calories in their diet while it comprised a quarter for those eating the most.

Prof Chavarro said ‘Different types of fat are known to have different effects on biological processes which may influence the outcome of assisted reproduction – such as underlying levels of inflammation or insulin sensitivity.

‘However, it is not clear at this moment which biological mechanisms underlie the associations we found.’

He said fish remained a source of ‘good’ omega 3 fatty acids, although the study was not able to pin down its contribution.

 

 

Resolve New England Sperm Tales

 

By Lynn M. Collins

Infertility has its own vernacular, or terminology, and I will help you understand some of the “infertility lingo”.

Some fertility programs are located in a large hospital setting and some in a more intimate clinic setting. The staff can consist of four to five Reproductive Endocrinologists (RE), Urologists, Nurses, Embryologists and professional counselors. Larger programs could have a larger staff. The clinic will have a laboratory, which may be called an Andrology Lab (Andrology is the study of the male reproductive organs). The lab consists of three to five medical technologists, depending upon the size of the clinic and whether or not it specializes in Andrology. The Andrology lab performs the blood tests and measures hormones; performs semen analysis and sperm washing for Intrauterine Insemination (IUI), and may possibly have a sperm bank. The clinic may have an In-Vitro Fertilization (IVF) lab or be affiliated with a hospital that has the lab. An IVF lab consists of many embryologists, which perform the intricate testing that goes along with IVF.

The Pivotal Role of Your Nurse

Depending on the program, a nurse is assigned to one or two specialists. The RE works together with you as a couple, and will order blood work and other diagnostic tests. But when it comes to physical exams the RE examines only the female partner. If the male has an abnormal semen analysis or any conditions that relate to the male reproductive system, he’ll be sent to an Urologist for an examination. The nurse that is assigned to a couple in a fertility program remains involved with the patients at every step, building communication and trusting relationships with the patients. Sandy Vance, nurse manager at Women’s Health Center has said, “Infertility has been compared to a terminal illness and when a woman has tried everything and cannot get pregnant, she begins to experience grief, shock, denial, isolation, depression and guilt. We work to get the woman to a place where she can understand what her status is.” (This is perhaps the only field in which nurses work more with the patients than the physicians.) Once you have the first consult with the specialist, the nurse then becomes the person with whom you will communicate the most on a monthly, weekly or even daily basis. Your nurse will give you a packet containing information on testing. It may also contain orders for your testing, instructions on giving injections, operational hours of the center, and who to call in an emergency. Please read this information and keep it in a safe spot at home. These nurses are on their phones most of the day, answering questions, encouraging, or giving instructions to their patients. One of the hardest calls they make to a patient is that her pregnancy test came out negative and it doesn’t get any easier. The best call is the one that delivers the news to the patient that her pregnancy is positive. Nurses are so excited and make that call first. In either case, as one of our nurses at our Women’s Health Center, Paula Ayers, has said, “The most gratifying compliment I can receive is when a woman does not achieve success in conceiving, despite all of our efforts, and she thanks us for the respect and supportive approach to her care.” One patient, who went through the program at the age of 40 and was diagnosed with old eggs, was able to get pregnant after her first IVF cycle. She said, “It may sound easy but until you are the one going through it you can’t appreciate the kindness of the nurses. Even on my lowest day, thinking this wasn’t going to happen, Sandy found something positive we could hold on to.” As you can see, nurses in a fertility program grow very attached to their patients and work very hard, with great compassion, to help patients navigate the ongoing ups-and-downs of an infertility program. I posed this question on Facebook to some fertility nurses: In a perfect world, what would make your day-today job easier when it comes to caring for your patients? Sandy Vance responded: “We all like it when patients ask questions, because it shows that they really want to understand their treatment. But it would be helpful if they would read all of the materials we send home with them. They really are helpful in explaining the process.”

How the Process Begins

The first phase will start you with one of the following Assisted Reproductive Technologies (ART) procedures and may progress to others depending on your success. These procedures include and not limited IUI and IVF. Beyond that, IVF can break down to include other techniques, such as, for example Intracytoplasmic Sperm Injection (ICSI). Below are a few brief descriptions of both IUI and IVF.

The IUI procedure is a simple procedure that takes little time and involves minimum discomfort. At the time of ovulation the sperm is collected and processed. The sperm is then placed in a catheter and is placed in the female’s uterus. It is very important that this procedure, also known as artificial insemination, occurs with ovulation. Using the over-the-counter ovulation kits can easily monitor the time of ovulation. The hormone Luteinizing Hormone (LH) is measured, noting when it spikes. This indicates ovulation has occurred and the female is at her most fertile time. The IUIs are performed seven days a week and take only about one hour. The males collect the specimens in the morning and drop it off at the lab. (Some centers prefer the males to collect the specimen at the center.) The lab performs a sperm wash to the specimen, wherein the non-motile sperm is separated from the motile sperm and other debris from the semen. The female partner returns to the center around 11:30 a.m. to 12:00 noon for IUI procedure. The washed specimen is placed in a catheter and is inserted through the cervix into the uterus where the specimen is released. The procedure is very similar to getting a pap smear. The patient relaxes in the exam room for about 10 to 15 minutes after the procedure and then she can resume her daily routine. The nurse instructs her to notify the nurse in two weeks if she has not gotten her menstrual cycle. At that time her blood will be drawn for a pregnancy test.

IVF is more involved than an IUI. An IUI is less invasive and the cost is much less. This procedure differs from an IUI because the eggs are removed from the female’s body. The female will take the gonadotropins follicle-stimulating hormone injections that will stimulate the ovaries to produce as many eggs as possible. The eggs will be removed surgically, which is called the retrieval, and then placed in a petri dish where your partner’s sperm will be washed and placed with your eggs. The dish is incubated and evaluated a few days later to see how many eggs fertilized. The female returns for an embryo transfer, which is where a certain number of embryos will be placed back or transferred into the uterus. The embryos will be placed in a catheter like the sperm for the IUI and placed in the uterus. You’ll return to the center in approximately 14 days after the procedure for a pregnancy blood test. The success rate for IVF is higher than IUI. Which procedure you start with depends on the results of your initial testing (for both of you), insurance coverage, and how aggressive you want to be, depending upon your success, or lack of success at other clinics. This will all be discussed with your medical team.

Lynn M. Collins is the author of Sperm Tales: An Informative Guide Through the Challenges of Infertility. Lynn draws on her experience as a laboratory supervisor for a leading national sperm bank and manager for a multi-million dollar infertility laboratory. In Sperm Tales, she offers compassion, humor, and clear step-by-step information about the numerous challenges–medical and otherwise–that attend the process of infertility treatment