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Many infertile patients have a decreased chance of becoming pregnant when using in vitro fertilization (IVF). For these patients, many different treatments are available, but none of them have been shown to be better than the others. We are testing which of three different treatments are better than the others. Patients who are expected to have a decreased response to ovarian stimulation will be randomized to either a microflare protocol, an antagonist protocol, or a demi-halt protocol.

Detailed Description:

Infertile patients with an anticipated poor response to ovarian stimulation will be randomized to one of three different protocols in their upcoming IVF cycle. Each of the protocols will be performed as is the standard of care with the addition of serum evaluation during the course of the stimulation as well as follicular fluid analysis which is obtained as a byproduct of the oocyte retrieval. Chart review will be performed to collect background characteristics (including age, ethnicity, previous fertility treatment), treatment response (such as oocyte number, embryo grade, embryo quality), and pregnancy outcome (such as miscarriage, singleton pregnancy, or higher-order multiple pregnancy). Statistical analysis will be performed to determine if one protocol leads to higher pregnancy rates and multivariate analysis will be performed to determine potential etiologic variables.

Ages Eligible for Study: 18 Years to 45 Years

This study is currently recruiting participants.

Full article:
New technique clears way for parents' second child

After more than five years trying to conceive, Paul and Martina Weyde started to think their dreams of having another child were hopeless.

"I was willing to try anything," Martina Weyde said. "It was very devastating. It was always a blow to my husband and I to go month after month and find out you're still not pregnant."

Endometriosis — a condition that causes scar tissue around the uterus making it difficult to conceive — had hindered the Denmark couple's chances, said Dr. Herb Coussons, a surgeon who specializes in infertility for Bellin Health.

Coussons suggested the couple try laparoscopic surgery in order to correct the endometriosis — a procedure he would perform with the help of a surgical robot.

"I was all for it," Martina Weyde said. "I was sick of waiting. I would've done it that day if I could have."

Although she had undergone the surgery twice before without robotic assistance, Coussons said the robot, formally called the da Vinci Surgical System, would be able to remove the blockage with greater precision.

Three months to the date of her robotic-assisted surgery, Martina Weyde was finally pregnant.

"It was complete disbelief," she said. "It was very surreal. It was joy and tears. I was speechless."

Paul Weyde also experienced a full gamut of emotions when that day finally came.

"I was so happy for my wife," he said. "She had to deal with the physical signs so it was such a relief. We wanted this so much."

The couple welcomed baby Gabriella, now nearly 6 months old, to their family in June — something that would not have been possible without the robotic surgery, Martina Weyde said.

"Technology is so awesome right now," she said. "I am just so thankful for Dr. Coussons and what a blessing he is to our family."

Bellin started using the machine nearly three years ago, making it the first hospital in Wisconsin to do so, Coussons said.

The robot's arms act as a surgeon's, holding medical instruments and making incisions but with more precision and dexterity, he said.

A surgeon controls the robotic arms from a console a few feet away, peering in a viewer displaying a 3-D, real-time image relayed from cameras located on the arms, Coussons said.

"When I move my hands and do whatever I do, the robot understands," he said. "The ability to give the control is phenomenal."

Patients who undergo robotic-assisted surgeries will experience less blood loss, reduced risk of complications and a shortened hospital stay, he said.

"I went home that day," Martina Weyde said of her surgery. "I was back to work in about a week."

The $1.5 million piece of equipment has already performed more than 400 procedures, Coussons said, adding that they are one of five or six in the state to be using the technology.

St. Vincent Hospital has been using a da Vinci Surgical System since February and has since performed 90 procedures, said Paula Haseman, chief nurse executive.

"It really is amazing," she said. "It allows for a very small incision and less pain for patients."

For 9-year-old Abi Weyde, it was the solution that brought her a new baby sister — the 29th of 31 grandchildren in the family.

Being a big sister is "very fun," she said. "She sleeps in a room right next to mine."

The Weydes said although they never planned to have their second child eight years later, they are thankful to have been given the chance.

"It's a blessing Dr. Coussons was able to fulfill our wants and dreams," Paul Weyde said, "and complete our family."

There's often no definitive answer to why a couple is unable to conceive a child.

Even after charting ovulation days, undergoing drug therapies to stimulate ovulation, taking injections or having surgeries to improve fertility, the painful fact is some couples won't become pregnant.

In this special Wausau Daily Herald report, we have examined the emotional journey through infertility for women who wish to bear children.

Ann Young, 34, of Tomahawk is at peace with her decision not to have children with Roy, her husband of nearly seven years. It's the end of a long journey that involved six rounds of intra-uterine insemination and volleys of unwanted questions about when they would be having kids of their own.

"It felt very business-like to us," she said.

And then, the Youngs made the difficult decision not to have children, which prompted Ann to begin local support groups to help other couples going through infertility.

It was painful to accept the joys of others, including her brother, who were having children.

"I wanted to take this negative situation and turn it into something positive to help others," Young said.

The meetings have started small, with about five participants. Young said people are encouraged to open up, though they don't have to give their full names if they'd rather keep their experiences private.

Recent topics of discussions have included coping strategies for getting through the medical disappointments and sharing positive experiences with doctors and clinics.

On the other side of the pain, Young realized that not raising children gives them the freedom to pick up and go and to focus on doing things to enrich their marriage, she said.

"We're very lucky with all other aspects of our lives," she said. "I have an attitude of gratitude."

The National Infertility Association "Resolve" recently began online advertising of Ann's groups meeting in Weston, Stevens Point and Tomahawk at Ministry Health Care sites.

Young said she hopes the group will grow, because so many couples -- at least one in six -- are having the same experience she had.

"You can feel very alone in infertility," she said.

Adding another layer of competition to the mating game, scientists are reporting possible biochemical proof that the reproductive system of female mammals can "sense" the presence of sperm and react to it by changing the uterine environment. This may be the molecular mechanism behind post-copulatory sexual selection, in which females that have mated with several partners play a role in determining which sperm fertilizes their egg.

Lead author Alireza Fazeli says that the deep new molecular insights into this post-coital "ladies' choice" has profound implications for in-vitro fertilization (IVF), cloning, and animal breeding. It is also a windfall for evolutionary biology, providing a possible explanation for female promiscuity in the animal kingdom, he adds.

In a first-of-its-kind study scheduled for ACS' Journal of Proteome Research, Fazeli's international scientific team reports the first chemical evidence of a sperm recognition system in the oviducts of pigs -- standard animals for such research because their reproductive systems are similar to humans.

In the traditional view, competition for the egg is male-oriented, with sperm themselves deciding which fertilizes the egg by being the faster swimmer. With post-copulatory sexual selection, the female is in control, her oviducts selecting the "winner" -- the best quality sperm from the healthiest male -- and rejecting the rest.

"This study clearly shows that the sperm's arrival in the female reproductive tract triggers a cascade of changes that leads to alteration of protein production in the oviduct and a change in the oviductal environment. We speculate that this is mainly done to prepare oviduct environment for storing sperm, fertilization and early embryonic development," Fazeli said. However this can also be used as a detection and selection system that alerts females to the presence of different kinds of sperm and then triggers mechanisms in the oviducts that control sperm transport, binding and activation for fertilization.

"We know sperm selection exists in nature, especially in promiscuous species, when females mate with several males," Fazeli said. "Baboons are a good example. During one reproductive cycle, if the female mates with several males, most of the time the offspring belong to one of the males -- not a spread between all of them… We are now seeing what can be the molecular basis for this effect."

While sperm interaction with oviduct cells has been studied in laboratory cultures, the new research is the first to provide evidence for this poorly-understood process in living animals, Fazeli said. Using minimally invasive techniques, the researchers compared protein changes in the oviductal fluids before and after sperm introduction to the reproductive tract.

The data shows that the mammalian female reproductive tract is a far more tightly regulated environment than once thought -- a fact that Fazeli says is "nearly completely ignored by modern IVF." He believes the new findings have profound implications for the massive IVF industry, which has grown exponentially in the past 25 years, as well as cloning. Both techniques rely on egg fertilization outside of their finely-tuned reproductive environment.

"The female reproductive tract is a very highly organized and regulated system," Fazeli explained. "With IVF, the embryo can develop into an adult, but the question remains: 'Are we doing the fine-tuning right'? We are not sure if what we are doing, based on differences between in-vitro and in-vivo fertilization, is creating health problems for these babies."

Applications for this research extend into agricultural animal breeding, since it has the potential to improve fertilization rates and reproductive techniques in livestock.

Fazeli suggests that the work his team is doing is also applicable to the artificial insemination industry. Some of the products that a female's oviducts produce in response to sperm are meant to store and keep the sperm alive. This may be an aspect of post-coital sexual selection since sperm may remain viable in the human female's reproductive tract for nearly five days. Other female animals sustain sperm for even longer periods -- bats can do so for up to six months.

Fazeli said that another aspect of this work relates to understanding the mechanisms involved in determination of self and non-self by the immune system. Since sperm are a foreign entity in the female reproductive tract, the immune system should attack and destroy them. In reality, however, sperm are protected and stored.

The traditional explanation is that sperm somehow evade the immune response. Fazeli says his data shows that this is not true. He found that the female immune system instead recognizes sperm as a friend, not a foe. Fazeli suggests that the female reproductive tract is equipped with sensory systems that recognize sperm and alert the ancient, non-specific "innate" immune system to dampen its reaction towards them.

"The main message from this work is that the female reproductive tract has a lot more control than previously thought," says Fazeli. "This discovery profoundly influences our understanding of the physiology of events leading to conception and the bearing of offspring."

Article adapted by Medical News Today from original press release.
Maximize your pregnancy odds with this diet and exercise plan

Trying to get pregnant?

There are many factors involved, but a very common issue with many women are problems with ovulation.

According to a study led by researchers at the Harvard School of Public Health, women who followed a combination of five or more of the following healthy lifestyle factors, experienced more than 80 percent less relative risk of infertility due to ovulatory disorders compared to women who engaged in none of these factors.

This new report was published in the November 1, 2007, issue of Obstetrics & Gynecology.

(It’s important to mention that the relationship between a healthier diet and lesser risk for infertility was similar for different subgroups of women regardless of age and whether or not they had been pregnant in the past. This study did not examine risk associated with other kinds of infertility, such as low sperm count in men.)

8 steps to increase fertility

1. Maintain a healthy weight (and lose weight, if you’re overweight)

2. Avoid trans fat. Trans fat is typically found in stick margarine, fried food and hydrogenated oil.

3. Stop eating excessive sugar and refined carbohydrates.

4. Consume more protein from vegetables rather than from animals. Good sources of vegetable protein include beans (all types) and lentils.

5. Eat fiber-rich foods. Best sources of fiber include vegetables, fruit, and whole grains.

6. Consider taking a standard multivitamin.

7. Exercise every day for at least 30 minutes.

8. Consume one daily serving of full-fat dairy (i.e., 1 cup whole milk, full fat yogurt, or 1-2 ounces cheese). That’s because a recent report showed full fat dairy may help increase fertility in women more so than low-fat/non-fat dairy. That said, full fat dairy is loaded with calories and saturated fat, thus, I recommend you make only ONE of your daily servings full fat.

Bottom line: Lose weight if you’re overweight, make smart food choices and exercise regularly – these lifestyle factors may help you become more fertile if you’re experiencing problems with ovulation.

QUESTION: I'm shocked because I went to the doctor and he did a blood test called FSH which showed I'm menopausal even though I'm having regular periods. How can this be?

ANSWER: Hormonal blood tests are notoriously unreliable as hormone levels vary widely from day to day and even during the day. The FSH test is basically useless for determining what stage of the perimenopausal transition anybody is in. Here are statements from the abstracts of three studies you can find on Medline. You might like to print out the whole abstracts and show them to your doctor if you want to convince him. Of course he *could* simply mean "perimenopausal" - the two words are often used interchangeably (and confusingly!) - Pat
Clin Endocrinol (Oxf) 1981 Mar;14(3):245-255
Pituitary-ovarian function in normal women during the menopausal transition.

It is concluded that the appearance of high levels of FSH and LH is characteristic of the perimenopause and often precedes the sustained loss of sex hormone secretion by the ageing ovary. Postmenopausal biochemical parameters are no guarantee of the postmenopausal state.
Maturitas 1993 Dec;18(1):9-20
Perimenopausal patterns of gonadotrophins, immunoreactive inhibin, oestradiol and progesterone.

It was concluded that typical postmenopausal hormone patterns may occur at the time of entry into the normal menopausal transition, and in some women with anovulatory infertility, but may be completely and relatively abruptly reversible. Elevation of serum FSH into the postmenopausal range, with undetectable INH concentrations, does not provide reliable evidence that the menopause (or permanent ovarian failure) has occurred. INH contributes to elevations of serum FSH during the menopausal transition.
Eur J Endocrinol 1994 Jan;130(1):38-42
Diagnostic role of follicle-stimulating hormone (FSH) measurements during the menopausal transition -- an analysis of FSH, oestradiol and inhibin.

It is concluded that FSH measurement is of little value, if any in the assessment of women during the menopausal transition because it cannot be interpreted reliably and because, apparently, ovulatory (and, presumably, potentially fertile) cycles may occur subsequent to the observation of postmenopausal FSH levels. Both oestradiol and inhibin are important negative feedback regulators of circulating FSH.

extract from Menopause 1999;6:29­35. © 1999, The North American Menopause Society

Among U.S. women aged 35­60 years, median FSH and LH levels began to increase for women in their late 40's and reached a plateau for women in their early 50's.This study supports the previously reported association between serum FSH and age (i.e., serum FSH and LH levels increase with age) and smoking (i.e., current smoking was associated with an increased level of serum FSH). At FSH levels of = or >15 IU/L or = or >20 IU/L, 70 and 73% of women, respectively, were postmenopausal. Our study also found an interaction between age and oophorectomy. In addition, the present data suggest that women with only one ovary may have higher FSH levels than women with both of their ovaries.

Full article:
The purpose of this clinical trial on possible effects of nocturnal MEL administration in perimenopausal women was to find if MEL by itself modifies levels of hormones and produces changes of any kind, independently of age (42-62 years of age) and the stage of the menstrual cycle.

It is accepted that a close link exists between the pineal gland, MEL, and human reproduction and that a relationship exists between adenohypophyseal and steroid hormones and MEL during the ovarian cycle, perimenopause, and menopause.

Subjects took a daily dose of 3 mg synthetic melatonin or a placebo for 6 months. Levels of melatonin were determined from five daily saliva samples taken at fixed times. Hormone levels were determined from blood samples three times over the 6-month period. Our results indicate that a cause-effect relationship between the decline of nocturnal levels of MEL and onset of menopause may exist.

The follow up controls show that MEL abrogates hormonal, menopause-related neurovegetative disturbances and restores menstrual cyclicity and fertility in perimenopausal or menopausal women.

At present we assert that the six-month treatment with MEL produced a remarkable and highly significant improvement of thyroid function, positive changes of gonadotropins towards more juvenile levels, and abrogation of menopause-related depression.

Smoking while pregnant could reduce the fertility of baby boys, it emerged today. The new study comes in the wake of today's controversial news that there is little evidence that binge drinking harms unborn babies.

The wealth of new advice about what mothers-to-be can and cannot do is likely to add to the confusion among women during pregnancy

The research led by the University of Aberdeen found evidence that smoking while pregnant affects a key testis gene.

Researchers said there is evidence that there is a greater chance of boys developing abnormal penises and poorly descended or smaller testicles if their mothers smoked during pregnancy.

Total Urinary Follicle Stimulating Hormone as a Biomarker for Detection of Early Pregnancy and Periimplantation Spontaneous Abortion

Total concentrations of follicle stimulating hormone (FSH) were evaluated in daily urine samples from conceptive and nonconceptive menstrual cycles by measurement of the FSH beta subunit following treatment of the samples to dissociate the FSH heterodimer.

Samples were self-collected by normal subjects during cycles in which daily blood samples also were obtained. Daily blood and urine specimens were collected prospectively from 10 subjects in conceptive cycles, which led to normal pregnancies, and from 10 subjects with bilateral tubal ligations to provide control samples from nonconceptive cycles.

Mean serum and urinary FSH concentration profiles were parallel in both groups following ovulation and during the first 9 days of the luteal phase. Mean values for both serum and urinary FSH rose significantly above the postovulatory baseline by 10-12 days following the midcycle luteinizing hormone (LH) peak in nonconceptive cycles, but did not rise at any time following ovulation during conceptive cycles.

Following regression analysis of the changing FSH concentrations between days 9-14 post-LH surge in conceptive cycles, a slope of 0.02 ng FSH/mg creatinine/day was selected as a cutoff point to identify conceptive cycles. There was a high concordance between the day of LH peak in serum and the day of FSH peak in urine.

Therefore, in applying the algorithm, the day of FSH peak in urine was used to determine the days for which the FSH slope would be calculated, i.e., days 9-14 post-FSH peak in urine. The sensitivity and specificity of the change in urinary FSH concentrations to detect pregnancy in a different set of 55 cycles were found to be 88.9% and 89.3%, respectively.

All six cases of early fetal loss in the sample set were correctly identified. These results suggest that urinary FSH can be used as an additional biomarker for the verification of early pregnancy in prospective epidemiologic studies in which early fetal loss is a suspected outcome.

Full Article:
Women with a BMI over 35 should be deferred for fertility treatment until they lose weight, claims the British Fertility Society (BFS).

Women need to have a BMI below 35 to be referred for fertility treatment.

In women under 37 years with normal levels of folic-stimulating hormone, a BMI below 30 should be the aim.

A healthy weight is needed to ensure women have a good chance of success and to mimimise the risk of complications, states the BFS in its latest guideline.

GPs need to tell obese women wanting to be referred for fertility treatment that carrying excess weight reduces the likelihood of successful conception both naturally and with assistance.

Additionally, being obese increases the risk of complications in pregnancy, including miscarriage and congenital abnormalities.

The safety of fertility treatments is also compromised by obesity, which makes anaesthesia difficult and can mean the ovaries are unable to be seen on ultrasound scans.

Psychological support, dietary advice, exercise classes and even pharmacological and surgical procedures should be offered to these women.
Losing just 5-10 per cent of their body weight could restore fertility, according to the BFS.

CHICAGO - A single gene may be crucial for the final stages of sperm cell formation and could help explain why some men are infertile, U.S. researchers said on Wednesday.

Laboratory mice who lacked the gene had a significantly lower sperm count and were infertile, researchers at the University of North Carolina at Chapel Hill discovered.

And the few sperm the mice did produce had significant defects, they said.

“Because this gene has a very specific effect on the development of functional sperm, it holds great potential as a target for new infertility treatments,” Yi Zhang, a professor of biochemistry and biophysics at the university’s school of medicine, said in a statement.

About 1 in 6 couples in the United States has difficulty conceiving a child, according to the National Institutes of Health. In 30 to 40 percent of these 2.6 million couples, the men are infertile.

Zhang’s study, which appears in the journal Nature, focused on the last stage of sperm cell formation known as spermiogenesis. During this phase, DNA is crammed into a tight ball at the head of the sperm, ensuring that it can successfully penetrate an egg.

Mice bred to lack a gene responsible for this process produced few mature sperm, and the few that were produced had abnormally shaped heads and immobile tails.

“This gene is very important in controlling key genes that are involved in compacting the DNA,” Zhang said in a telephone interview.

In the mutant mice, Zhang and colleagues detected a defect in sperm DNA packaging. The mice also had smaller testes, but Zhang said this was because the testes were not filled with sperm as they should be.

He said more work needed to be done to discover whether this same defect causes infertility in men.

“The first thing we need to know is whether people have mutations of this gene,” said Zhang, who plans to team up with researchers studying this infertility syndrome in humans.

Ultimately, he said this discovery could lead to the development of a drug that compensates for mutations in the gene.

“That possibility is there, but it is not going to happen tomorrow,” Zhang said.

The research was funded by the Howard Hughes Medical Institute and the National Institutes of Health.

BEIJING - Chinese doctors have developed a new technique in birth control surgery for men that could be made available to the public next year, the China Daily said on Thursday.

The method involves making a small incision along the testicle into which doctors place a tiny tube.

"The tube functions as a filter that blocks sperm," Wu Weixiong, the director of Guangzhou Family Planning Technology Center, said was quoted as saying.

The technique, which is reversible by simply taking out the tube, had been patented and the health department would promote it as soon as it is approved by the National Food and Drug Administration, Zhu Jiaming, the vice-president of the Guangzhou Sexology Association, said.

"The success rate for this form of birth control is 97 percent," he said.

Wu said the operation took just 10 minutes.

"However, it is very difficult and requires highly skilled doctors," the newspaper said.

DuoFertility is a patent-pending, non-hormonal and minimally invasive passive medical device that allows women to accurately identify ovulation cycles, without daily observation.

Picture of our prototype devices and coins - click for a larger picture Our current prototype devices are about the size of a US dime, 1 Euro cent, or a UK 5 pence piece.

Unlike other ovulation prediction kits, with the DuoFertility system there is no need to:

* Maintain consistent sleeping and waking patterns
(i.e. for example, shift work)
* Wake early each morning (e.g. 4am) to take your temperature, or
* Collect your first urine sample of each morning to measure it, and
* Have your measuring and recording equipment with you every morning
(which can be a problem if you travel)

We believe that by eliminating these constraints placed on women by existing methods, the reliability of ovulation detection will be greatly improved.

How it works...

The DuoFertility system consists of a stick-on patch, about 3cm in diameter, which is worn discreetly under the arm. This patch contains a coin-sized circuit that automatically measures and records your body temperature every 10 minutes. When you want to know if you are fertile, you use the hand-held reader, which is about the size of a make-up compact, to read out the temperature data and analyse it, in about 30 seconds. It then tells you whether or not you have ovulated. You consult the reader at your convenience - there is no need to have it with you all the time, and you don't need to do it at any particular time of the day or week.

We have developed and tested our first prototype patches on ourselves with positive results. We are now building test units, which we aim to place with women already trying to conceive. We are always very pleased to hear from women who are interested in what we are trying to do, and if you are interested in being a
trialist please fill in our pre-trial questionnaire.

Full article:

“Perimenopausal endogenous ovarian hyper-stimulation” is the exact opposite of “The Myth of the Shriveling Ovary”: High estrogen levels during perimenopause, coupled with characteristically intermittent ovulation, can explain much of the misery of perimenopause.

My hypothesis is based on the assumption that inhibin production decreases while there are still viable follicles (capable of producing both estrogen and eggs) in the ovaries and that this in turn stimulates FSH to increase the production of estrogen in the follicles. I offer five pieces of evidence for this hypothesis:

Perimenopausal changes are similar to changes caused by some infertility treatments.

In vitro fertilization (IVF) requires laparoscopic surgery (through a small tube in the abdomen) to suck up ovarian egg cells that are nearly ready to ovulate so they can be grown and fertilized in a laboratory and then injected into the woman’s uterus. In order to collect the maximum number of eggs, gynecologists override inhibin using a technique called “ovarian hyper-stimulation.” The woman is given daily injections of FSH until many follicles have been stimulated and estrogen levels are very high. She is then injected with another hormone (much like luteinizing hormone [LH], another pituitary hormone that stimulates the ovary) to mimic the normal mid-cycle HL surge and this triggers ovulation.

A rare pituitary tumor causes higher-than-normal FSH levels, resulting in hormone levels and symptoms similar to those experienced in menopause.

In an “experiment of nature,” a 36-year-old woman with a tumor on her pituitary gland complained of very heavy menstrual flow. An ultrasound of her pelvis showed seven ovarian cysts and an unusually thick endometrium (lining of the uterus). Her bleeding was successfully treated with medroxyprogesterone (Provera) for ten days each month. This woman’s FSH levels were increased, but only to a level commonly found in perimenopausal woman during the five or more years before the last menstrual period. Her inhibin level was in the normal range, but her estrogen levels during days four to eight of her cycle, were about 12 times higher than normal for the early follicular phase.

More ovarian follicles are used up each year during a woman’s late 30s and early 40s, as compared to earlier in her life.

Pathologists have observed that there is a steady decrease in the numbers of ovarian follicles as women age. (The highest number of follicles is present before birth). This gradual loss takes place during adolescence and young adulthood without any perceptible influence of FSH. The marked increase in the rate of decline in midlife is an indication that more follicles are being stimulated.

Women in their forties are more likely than younger women to be pregnant with non-identical twins (i.e. from two different eggs).

Many women try unsuccessfully to get pregnant for years and then are suddenly successful: compared to younger mothers, these women in their 40s are more likely to bear non-identical twins. In these cases, two ovarian follicles are stimulated, both ovulate and both are fertilized. This could well be due to lower levels of inhibin and higher FSH levels.

Average estrogen levels in perimenopausal women are higher than in younger women.

Although perimenopausal women often believe their estrogen levels to be high, scientists have been slow to acknowledge this possibility. However, two recent studies may change this. One study (subtitled “hyperestrogenism in the perimenopause”) compared the amounts of estrogen (estrone in urine, during one cycle) in two groups of regularly cycling women — one group aged 47 or over and another aged 19 to 38. Ovulation occurred in some cycles and not in others. The older women not only had higher levels of estrogen but also had lower levels of progesterone.

Another study involved a large, randomly selected group of women aged 45 to 55 in Melbourne, Australia. During the early follicular phase, these women showed unexpectedly high estrogen levels (averaging 226 pmol/L) as compared to the expected average of 175 pmol/L. Forty-two per cent of women in a subgroup who had skipped periods for three to 11 months, had levels higher than normal for that phase of their cycle and eight per cent had levels higher than the usual mid-cycle estrogen peak.

[I was gratified to find that high estrogen levels during the perimenopause had been found in a large, well-designed study. However, when I read the authors conclusion that the menopausal transition was characterized by “an increase in serum FSH and decrease in estrogen,” I felt I had to write. The authors subsequently acknowledged that I was probably right about high estrogen levels in the perimenopause.]

Women’s experience and “perimenopausal ovarian hyper-stimulation”In the book Women of the 14th Moon, nurse practitioner Maura Kelsea says, “At [peri]menopause* life can turn into one long premenstrual experience. Hormones slap you up against the doors of your unfinished business.” Her description of “one long premenstrual experience” aptly describes the physical and emotional upset related to abnormally high estrogen levels. If a woman is to differentiate between moods caused by the social stress of the menopausal transition, and moods caused by high estrogen levels, it helps to be able to recognize the effects of abnormally high estrogen.

For women who menstruate, there are two accurate signs of high estrogen levels that normally occur for a day or two at the middle of a menstrual cycle: front-of the-breast tenderness and stretchy cervical mucus. If estrogen remains high for several days, then the breasts also swell, become firmer and may develop the kind of tenderness often characteristic of early pregnancy. Stretchy mucus is caused by estrogen stimulation of the glands of the cervix (the mouth of the uterus). This mucus is clear and slippery (like raw egg white), can be stretched in a long thread 5-7 cm (2-3" long) and acts to assist sperm traveling into the uterus to fertilize an egg. This type of mucus disappears after mid-cycle when progesterone comes on the scene. Therefore, not only is mucus a sign of high estrogen levels, its disappearance is good evidence of ovulation.

Many perimenopausal women have a high estrogen mid-cycle peak without ovulation. FSH then stimulates another follicle to make high estrogen levels that peak a week or so later. At that point the endometrium has become thickened, is over stimulated and begins to bleed. Thus a common menstrual pattern in the perimenopause is for front-of-the-breast tenderness and stretchy mucus to begin in the middle of the cycle, but then to continue and be at their maximum at the start of a period. Menstrual blood mixed with this mucus may resemble currant jelly. When these signs are present, it is clear evidence that ovulation did not occur. It may also be associated with heavy flow, increased premenstrual moodiness, fluid retention, bloating, and sometimes with menstrual cramps.

What is the significance of these high estrogen levels – aside from breast tenderness and stretchy mucus? According to one recent study, estrogen serves to amplify our body’s hormonal responses to any kind of stress. This was demonstrated by randomizing young men to wear either a high-dose estrogen or a placebo patch and then subjecting all of them to a standard stress test (speaking and doing math problems in front of an audience). Those who were receiving estrogen were found to produce higher levels of the kinds of hormones manufactured in response to stress (i.e. ACTH, cortisol and norepinephrine).
Daytime hot flashes and night sweats are usually interpreted as indicators of low estrogen, despite the fact that they occur in response to rapidly decreasing estrogen levels. Many women who experience flashes find that they start while they are still menstruating regularly – before estrogen could be low. There is now good evidence that hot flashes are related to at least two conditions:

The brain must have been exposed to high estrogen levels at some time, and
The level of estrogen has to be decreasing. The brains of women who have regular periods and mid-cycle estrogen surges will become used to high estrogen levels.

When estrogen decreases – even from high to normal — hot flushes are triggered. Two studies have now shown that severe hot flushes can occur concurrently with either very high or normal estrogen levels.

Treating “perimenopausal endogenous ovarian hyperstimulation”This picture of erratic (and explosive) estrogen levels in perimenopause not only can help us to make sense of our experiences. It can also guide us toward appropriate treatment choices, including the avoidance of supplementary estrogen until flow has been gone for a year and the possible use of cyclic progesterone.

In the normal course of events a 47-year-old woman seeing her doctor about night sweats, heavy flow and PMS would likely be given combined hormone (estrogen/progestin) therapy or the oral contraceptive pill. (She might even be told that she is too young to be menopausal and scheduled for a D & C). She is not likely to be told that there are many things she could do to help herself.

She could find and talk to other women who have come through the perimenopause; she could get more information about perimenopause at community seminars and read about perimenopause. She could also help herself by exercising regularly. Walking (or more strenuous exercise) for 30 minutes a day may not alleviate all premenstrual symptoms but will help reduce stress, control weight, allow more sound sleep, possibly relieve hot flushes and be good for both bones and heart. The hot flushes can also be helped by a daily dose of vitamin E (400-800 IU) and even more so, by relaxation training. Finally, she could use vitamin B6, oil of evening primrose and herbal remedies like black cohosh to see if they help.

If perimenopause is a time of high estrogen and low progesterone, a logical treatment is supplementary natural oral micronized progesterone or medroxyprogesterone, provided that the progesterone and/or progestin produce adequate physiological blood levels to be effective. At the outset, progestin/progesterone may briefly (for one cycle) exacerbate estrogen-related mood symptoms, migraines or breast tenderness. But if you persist, progesterone will block these unpleasant symptoms.

Progestin/progesterone therapy is certainly indicated when estrogen excess (relative to progesterone) causes spotting, heavy flow (defined as more than 16 soaked pads/tampons a period), periods too close together (e.g. two periods within the same month) or endometrial hyperplasia (over-stimulation of the cells lining the uterus). These situations are so common in the perimenopause that physicians or nurse practitioners should feel comfortable prescribing this therapy; gynecological consultation is rarely necessary and endometrial biopsies or ultrasounds are usually not needed.

The treatment involves either oral micronized progesterone (Prometrium®) in a dose of 300 mg at bedtime because of its drowsy side-effect, or medroxyprogesterone acetate (MPA) in a dose of 10 mg per day for 16 days – on days 12 to 27, counting from the first day of the menstrual period. This will usually bring flow back to normal.

To ensure an adequate counterbalance to the high estrogen, each 16-day course of progestin/progesterone must be completed, even if bleeding starts. In other words, the woman should finish the 16 days but – at the same time – start counting towards day 12 and the next dose from the beginning of flow. This means that during some cycles, she may be off progesterone for only a few days. Cyclic progesterone therapy should be continued for at least six months.

In some situations, if excess estrogen symptoms are severe, if flow starts before the ninth day of the progestin/progesterone therapy, or if breakthrough bleeding occurs, higher doses of progesterone may be needed. For instance, I have used cyclic natural progesterone (300 mg per day for days 12 to 27 of the cycle) and added daily progestin (Provera®) at 5 or 10 mg per day every day. The daily dose of progestin can be stopped when flow becomes scant or some periods are skipped, but the progestin/progesterone taken on days 12 to 27 should be continued for another six months.

We know that several old controlled studies showed that hot flushes were relieved by progestin treatments. So the cyclic progestin/progesterone treatment I recommend will not only control heavy bleeding, but also alleviate night sweats that often begin before flow. We also know that in premenopausal women experiencing abnormal cycles, ten days a month of Provera can increase spinal bone density by a high significant 2 per cent. Best of all is the knowledge that cyclic progestin/ progesterone therapy can bring estrogen and progesterone back into a healthy balance. You can monitor your feelings and bodily changes, as well as therapy, using a Daily Perimenopause Diary®.

By dispensing with “The Myth of the Shriveling Ovary” and learning the secrets of “perimenopausal endogenous ovarian hyperstimulation,” we can make sense of the chaotic physical and emotional changes of perimenopause.

by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research

Image: It Starts with the Egg: How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF, by Rebecca Fett. Publisher: Franklin Fox Publishing LLC (March 25, 2014)-It Starts with the Egg:
How the Science of Egg Quality Can Help You Get Pregnant Naturally, Prevent Miscarriage, and Improve Your Odds in IVF
by Rebecca Fett

-- Whether you are trying to conceive naturally or through IVF, the quality of your eggs will have a powerful impact on how long it takes you to get pregnant and whether you face an increased risk of miscarriage.

Poor egg quality is emerging as the single most important cause of age-related infertility, recurrent miscarriage, and failed IVF cycles. It is also a major contributor to infertility in PCOS.

Based on a comprehensive investigation of a vast array of scientific research, It Starts with the Egg reveals a groundbreaking new approach for improving egg quality and fertility.

With a concrete strategy that includes minimizing exposure to toxins such as BPA and phthalates, choosing the right vitamins and supplements to safeguard developing eggs, and harnessing nutritional advice shown to boost IVF success rates, this book offers practical solutions that will help you get pregnant faster and deliver a healthy baby.

Image: Buy Now on Amazon.comPaperback: 304 pages
Click to order/for more info: It Starts with the Egg - US | CDN | UK

Image: Buy Now on Amazon.comStart reading It Starts with the Egg on your Kindle in under a minute!

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Two years ago, when Catherine was in sixth grade, she was given a school assignment that would have been unremarkable for most kids: make a timeline for history class in which half the events occurred before she was born and half after. For a while, she worked quietly at the dining-room table of her family’s rambling Northern California home. Then she looked up.

“Mom?” she asked. “What was the year that you and Dad met our donor?”
Sitting with me in May, Catherine’s mother, Marie, a 59-year-old therapist, smiled wryly, remembering the incident. The crinkling of Marie’s eyes gave her a passing resemblance to the actress Anne Bancroft — but not to her own daughter. Marie, who asked me to use only her middle name and a family name for her daughter to protect their privacy, is dark where Catherine is blond, olive-skinned where Catherine is fair, brown-eyed where the girl’s are hazel. There is no similarity to their jaw lines, their cheekbones, the shapes of their faces. Of course, lots of kids don’t look like their mothers; few people would consider that odd, though they might — often incessantly — comment on it in conversation.

“So, what’s going to happen with this project?” Marie recalled responding to Catherine at the time, being careful to keep her voice neutral. “Is it going to be put up in the hallway? In the classroom?”
Catherine shrugged. “I don’t know,” she said. And later, “Mom, this is my timeline.”
“I got the message,” Marie told me. “But in essence, I was outed on the wall of the middle school. It was there in black and white for everyone to see. They’d all know we used an egg donor. We’d been committed to openness from the beginning, but my first reaction was, ‘No!’ ”

If Marie and Catherine are unusual, it is only because of Catherine’s age. In 1992, the year she was conceived, there were just 1,802 attempts by women to become pregnant using someone else’s eggs, according to the Centers for Disease Control. Three years later, there were more than 4,738 such cycles; by 2004, the most recent year for which data has been published, there were 15,175 cycles, resulting in 5,449 babies. By comparison, some 22,911 children were adopted from abroad that year, and although there are no official figures, one survey estimated that at least the same number are conceived annually via donor insemination. Donor eggs are now used in 12 percent of all in vitro fertilization (I.V.F.) attempts, making it among the fastest-growing infertility treatments.

Despite the portentous hype around women like Frieda Birnbaum, a 60-year-old New Jersey resident who in May used donor eggs to become the oldest American to give birth to twins, the bulk of intended mothers are in their 40s. The birthrate among women ages 40-44 has risen 62 percent since 1990, while the rate among those in their late 40s has more than doubled. Among those who used I.V.F. in 2004, about a third of the 43-year-olds used someone else’s eggs; by 47 years old, 91 percent did.

With egg donation, science has succeeded in, if not extending women’s fertility, at least making an end run around it, allowing older women who, for a variety of reasons (lack of money, lack of partner, lack of interest, lack of partner’s interest) didn’t have children in their biological prime — as well as younger women with dysfunctional ovaries — to carry and bear babies themselves. It has given rise to the mind-bending phrase “biogenetic child,” meaning a child who is both biologically and genetically related to each of its parents, by, for the first time in history, separating those components.

In that way, it is fundamentally different from sperm donation, though it also levels a certain playing field: mothers can now do what fathers always could — conceal the truth about their blood relationship to their children. And as with any new reproductive technology, it has provoked a torrent of social, legal and ethical questions about the entitlement to reproduce, what constitutes parenthood, children’s rights to know their origins and the very nature of family.

I first became interested in the implications of egg donation because I tried it. After five years of repeated miscarriages and invasive, futile infertility treatments, a 21-year-old friend offered to spot me her gametes, the cells containing half the chromosomes necessary for reproduction. It wasn’t something I ever imagined I’d consider — it seemed so “Handmaid’s Tale.”

Then again, with a donor egg, I could feel a baby grow inside me, experience its kicks and flutters. I could control — that sweetest of words — the prenatal environment, guard against the evils of drug and drink. I could give birth to my own child, breast-feed it. After a year of discussion, my husband and I decided to go ahead, only to find that, when placed in a petri dish, his sperm and my friend’s eggs refused to tango.

Full article:

Grade A Baby Eggs: An Infertility Memoir
by Victoria Hopewell

-- Victoria Hopewell was a forty-something divorced clinical psychologist when she met and married a longtime bachelor whose ninety-year-old parents were anxiously waiting for a grandchild.

Problem was, even though Victoria had two young daughters from a previous marriage, her intense desire to create a baby with her new husband was thwarted by her own body.

Her eggs were aging faster than her healthy hormones and youthful appearance would suppose.

Desperate to bear a child, willing to undergo every procedure from Lupron shots through egg harvesting and in vitro fertilization (IVF), she is blocked at every corner of medical protocol from achieving her dream of a successful pregnancy.

Finally she journeys toward acceptance of using a donor egg, much to the dismay of her growing daughters.

But no eggs are available, and she is placed on a lengthy hospital wait-list. Victoria and her husband then embark on a surrealistic egg hunt to find their own donor.

Follow her insider's account of the hidden world of egg donation-where women's eggs are bought and sold over the internet and a beautiful model with high SATs and a prior successful donation commands the highest prices.

Image: Buy Now on Amazon.comPaperback: 214 pages
Click to order/for more info: Grade A Baby Eggs

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Don't have a Kindle? Get your Kindle here, or download a FREE Kindle Reading App.

A mother has given birth to twins using a revolutionary new fertility treatment for the first time in the UK.

The fertility technique, called in vitro maturation (IVM), could be a good alternative to conventional IVF for some high-risk women, say experts.

Under the process, women do not first need to take potentially risky fertility drugs as they do with IVF.

The technique is also cheaper and faster - but its success rate is lower and it is not available on the NHS.

Doing well

The twins were delivered a minute apart on Thursday 18 October.

The boy was born first, weighing 6lb 11oz, while his sister weighed 5lb 14oz. Both were said to be doing well.

Their names have not been released by their parents, who wish to protect their privacy.

Under IVM, the mother gave birth to the twins using her own eggs matured in a laboratory

In January, the Oxford Fertility Centre was awarded the only licence in the UK to offer IVM.

The technique is still relatively new - about 400 IVM babies have been born globally, compared to 2 million IVF babies.

For standard IVF treatment, a woman needs to take drugs to shut down her ovaries and then undergo two weeks of daily hormone injections so that mature eggs can be retrieved from her ovaries.

With IVM the woman needs only one injection. The immature eggs are retrieved from a woman's unstimulated ovaries under ultrasound guidance and then matured in the laboratory for 1-2 days.

Some women develop a potentially fatal reaction to the powerful drugs needed for normal cycles of IVF.

With both treatments, once the eggs are fertilised in the lab the resulting embryos are transferred to the woman's womb.

Tim Child, consultant gynaecologist at the Oxford Fertility Clinic says IVM has clear benefits over IVF for some women, particularly those with polycystic ovarian syndrome.

Not only does it reduce inconvenience and discomfort, it also removes the risk of a condition called ovarian hyperstimulation syndrome (OHSS).

In mild and moderate cases, affecting up to 20% of women undergoing ovary stimulation, this leads to symptoms such as swelling and breathlessness that resolves.

However, in about 1% the symptoms can become so severe that they are deadly. Among women with PCOS, the rate is nearer 5-10%.


IVM treatment is also shorter and less expensive than IVF.

On the flip-side, the success rates are lower, however.

Mr Child said: "IVF, overall, has a better success rate, but the side effects are higher.

"Patients should have the choice of an alternative. IVM is safer, simpler, cheaper and more acceptable."

Some have expressed theoretical concerns that the maturation process could somehow damage the eggs and lead to abnormalities in any resulting babies.

This has not been borne out by the IVM births to date, although experts say they will continue to scrutinise the safety of this new treatment.

Mr Child said the twins, who were born 18 October, were both doing well.

Dr Richard Fleming, of the Glasgow Centre for Reproductive Medicine and the British Fertility Society, said: "This is good news. There is always a need for alternative ways of doing things."

He said women should be counselled about the pros and cons of both treatments.

A spokeswoman for the Human Fertilisation and Embryology Authority said the organisation would be closely tracking the use and outcomes of IVM.

Found on the High FSH Support Forum board, posted by Chrissy:

I just came across this thread on the Life Extention forum. I think you have to register to read it, so I just copied and pasted the whole thread below which includes links to the studies they are talking about. I didn't read the links or the studies, I just read the thread but it sounded interesting to me because Dr. Check once mentioned to me that he thought the link to stopping menopause or getting someone over 45 pregnant had to do with a certain protein (he didn't get specific) but said he hasn't had the time to do the research necessary because he is busy with his Cooper practice and also cancer research. So a little bell went off on my head and I thought you all might want to read about it.

Here's the thread :

If you read LEF daily news New menopause research reported from Harvard University ( see link), it would appear that by supressing the bax protein women could delay menopausal ovarian failure and reap the many anti-aging benefits of staying pre-menopausal.

There are numerous articles online supporting this like:

Does anyone know of a compund or supplement that will supress the bax protein?

Some research indicates that indole-3-carbinol up-regulates bax.

Here is a whole list of compounds that react with BAX, do any look like reasonable suppresors? It says that indole-3-carbinol results in increased expression of BAX and that resveratrol results in decreased expression of BAX protein.;jsessionid=BDDEB3777B71D015FC0B2EB06314258A?view=ixn&type=gene&acc=BAX
According to the chart linked above, melatonin also inhibits bax and may therefor help delay menopause?

Also, ethanol promotes the reaction (BAX protein binds to BCL2L1 protein).
Stop drinking to delay menopause? And... aspirin results in increased expression of BAX protein.

Also - inhibin loss seems to cause menopause - can it be replaced like other hormones?

I would love to see LEF do a protocol for slowing down ovarian aging.

Scientists develop pill to delay the menopause

Many articles this week - wonder if, like many drugs that they develop over many years to be patented, there is a natural source for this??

Lowering levels of FSH hormone seems to be a main key towards delaying menopause. Many studies out of Japan and Thailand are showing that Pueraria mirifica can do just that. It also seems that, with many times the pytoestrogen content of soy, Pueraria mirifica can be used for estrogen replacement. If you are within 5 years of menpause either way, you will want to research Pueraria mirifica . Here is a link regarding the FSH.

How much do you know about what's going on down below? Take this quiz and get the facts. For more information, read their Infertility fact file and feature: Shooting blanks: it's a man thing.

In the Old Testament, Abraham's wife, Sarah, foremother of a people, was initially unable to conceive a child. Despite harmonious marital relations, she bled every month and her belly failed to swell. Longing for a son, she did what any resourceful wife of her day would have done: she dispatched her husband to her maidservant, Hagar. The plan worked, but Hagar, having succeeded where Sarah had failed, lost respect for her barren mistress. Sarah, in turn, began to treat her harshly, making her fetch extra water and denying her seconds of stew. It was an unpleasant situation for everyone--with the possible exception of Abraham.

Hagar bore a son, Ishmael, on Sarah's behalf. Fourteen years later, though, God stepped in. He blessed Sarah -- by then wizened and post-postmenopausal -- with a child by blood, Isaac. "Who would have said to Abraham that Sarah would suckle children!" marveled the triumphal nonagenarian. "Yet I have borne a son in his old age." Eventually she instructed Abraham to cast Hagar and Ishmael out into the desert.

Had Sarah lived in the twenty-first century, she would have had a menu of options to consider before resorting to concubine recruitment. She could have tried fertility drugs, a few rounds of in vitro fertilization (IVF) or a trick called intracytoplasmic sperm injection (ICSI) to escort Abraham's seed to its destination. If all that failed, she could have had eggs extracted from Hagar or taken her pick among strangers with higher SAT scores. There likely would have been no need to wait until her 90s to bear a child -- although if she were to give birth at that age, she would have had no shortage of company in the never-ending tabloid contest for World's Oldest Mother.

Full article:
CHICAGO -- (BUSINESS WIRE) -- In recognition of RESOLVE: The National Infertility Association’s 18th Annual National Infertility Awareness Week® taking place November 4th-10th, Fertility Centers of Illinois, SC (FCI) is offering a free In-Vitro Fertilization cycle valued at $10,000, to two deserving infertile couples in need of IVF but unable to afford it. In order to help all aspiring parents, FCI also offers every day tips for women and men to enhance their chances of conception.

Issues of infertility currently affect 7.3 million people in the United States, representing 15 percent of couples in their prime reproductive years. FCI supports the ongoing efforts by RESOLVE and the American Fertility Association (AFA) to build awareness of the seriousness of infertility and also understands the struggles that both men and women endure as they pursue infertility treatment, both emotionally and financially.

Angeline Beltsos M.D., reproductive endocrinologist and medical director of the FCI River North IVF Laboratory explains that offering these free IVF cycles are a way for FCI to give back to the community of infertile couples that they have been evaluating and treating for over 30 years. “We want to take the opportunity to make a difference for couples that might not otherwise be able to pursue treatment due to the financial burden, as well as bring awareness to this often misunderstood condition,” she says.

In addition to medical fertility treatments, FCI offers suggestions as to every day things couples can do in order to enhance their reproductive health:

Diet: Eat organic, fresh, nutrient-filled whole foods such as fruits, vegetables and whole grains as much as possible. Drink plenty of water everyday and avoid smoking, caffeine, alcohol, fried foods and saturated fats.

Exercise: Regular exercise is a must, but stick to low impact options such as walking, swimming and yoga if in the middle of fertility treatment or ovulation time. High intensity activities place excessive metabolic stress on the body.

Mind-Body Techniques: Various holistic techniques such as acupuncture, massage and meditation are a great way to decrease stress and cope with feelings of depression, anger or anxiety.

Communicate: The fertility journey can be challenging, so share your feelings and emotions with friends or family. Alternatively, seek out support groups such as RESOLVE or the American Fertility Association (AFA) in your local area.

Age: Today, more women are having babies at an older age; however be aware that fertility declines with increasing age and the risk of complications also increases. These problems accelerate for women past the age of 35. It’s better to seek help early so that causes of infertility can be evaluated and treated properly.

Consult with an Expert: If you have been trying to conceive for six months to one year without success, a consultation with a fertility expert is important to further evaluate possible things that may need to be addressed.

The free IVF cycles offered through FCI will be available to couples whose insurance does not provide a benefit for IVF. The IVF cycles will include all medications, monitoring, oocyte retrieval, embryo transfer, intracytoplasmic sperm injection (ICSI) and assisted hatching. It will not cover embryo freezing, embryo storage, donor oocytes, donor sperm or preimplantation genetic diagnosis (PGD). To qualify, women must be between the ages of 18 and 39, have a Body Mass Index (BMI) between 18 and 29, with no more than one previous failed IVF cycle. Potential patients should have no history of polycystic ovarian syndrome (PCOS), substance abuse, recurrent miscarriage, or endocrine disorders other than ovulatory dysfunction that are not well-controlled.

RESOLVE applauds FCI for getting involved in National Infertility Awareness Week and offering these free IVF cycles. “This is a remarkable way to not only help two couples achieve their dreams of parenthood, but to also raise greater awareness of infertility and its widespread effects,” said Barbara Collura, executive director of RESOLVE.

To read more about qualifying for this program, go to and view the What’s New @ FCI section. Applications will be accepted until November 30, 2007. The qualifying couples will be notified the week of December 3, 2007 and publicly announced December 10, 2007.


Fertility Centers of Illinois, S.C., is one of the nation’s leading infertility treatment practices, providing advanced reproductive endocrinology services in the Chicago area for over 25 years. FCI has more babies born than the next ten centers combined with high success rates that are recognized throughout the nation. In addition to a team of nationally recognized reproductive physicians who stay current on the latest technology and procedures, FCI patients have access to many other unique support services, such as professional counseling from a licensed, Ph.D. clinical psychologist, patient advocates and innovative financial options. FCI is part of IntegraMed, the nation's largest and most reputable network of fertility centers and has multiple offices conveniently located throughout the Chicago area. For more information visit .


Founded in 1974, RESOLVE: The National Infertility Association, headquartered in McLean, VA, is the oldest and largest consumer-based, nonprofit group that provides education, advocacy and compassionate support for those struggling with infertility in the United States. Each year, RESOLVE and its nationwide network of affiliates and chapters handle more than 1.5 million contacts from people seeking information and help. For more information, visit the RESOLVE website at .


Infertility affects one couple in six, but simple lifestyle measures can help many couples conceive, say US researchers.

In our parents' day most women were married and had at least one kid by the age of 25. That seems like a lifetime ago.

These days in Australia most women give birth in their 30s. While they may be in a better position financially and perhaps mentally – in a more stable relationship, with a higher income – they're much less likely at that age to actually fall pregnant.

Women are most fertile between 17 and 25. Over the age of 35, one woman in three will have trouble getting pregnant.

It's not always the woman's fault – in 40 per cent of cases the finger can be pointed at the male. (In 40 per cent of cases the problem lies with the woman; in 10 per cent there is a problem with both partners and in another 10 per cent, the cause is unknown.)

There are various reason why a woman finds it harder to conceive in these later years – there may be a structural problem with the reproductive organs, like blocked fallopian tubes, or a disease of the uterus like fibroids or endometriosis.

Most cases, though, are due to a failure of ovulation – eggs just don't ripen and release when they're supposed to. This is usually because of a hormonal imbalance – at an older age, the body isn't producing enough sex hormones at the right time and in the right amounts to ovulate successfully.

For these women, IVF (In Vitro Fertilisation) is an option, but it's not the preferred one: apart from anything else, it's time consuming, expensive and has a high failure rate.

But there's some good news this month from the US. Researchers from the Harvard School of Public Health and Harvard Medical School say that adopting a few lifestyle measures can drastically improve the chances of getting pregnant, at any age.

They followed a group of 17,544 married women who were infertile due to ovulation failure but who were trying to get pregnant. The women were part of a larger study of women's health called the Nurses' Health Study II, based at the Brigham and Women's Hospital at Harvard. The researchers followed them over an eight-year period, looking in particular whether or not they followed a range of dietary and lifestyle measures. They looked at:

the ratio of mono-unsaturated to trans fats in their diet
protein consumption (and whether it came from animals or vegetables)
carbohydrate consumption (including the amount of fibre they ate, and whether high or low glycaemic index)
consumption of dairy products (and whether low or high-fat)
iron consumption
use of vitamin supplements
body mass index (BMI, i.e. weight in kilograms divided by the square of the height in metres)
degree of physical activity.

The researchers took into account whether a woman smoked, drank alcohol or coffee, and/or had used oral contraceptives in the past.

Those women with the lowest rate of infertility (and most likely to fall pregnant) were those who ate less trans fat, less sugar, ate food with a low glycaemic index such as pasta and whole grains, ate more protein from vegetables than from animals, had a good iron intake, took multivitamins, exercised daily, kept their BMI between 20 and 25, and (surprisingly) consumed more high-fat dairy products and less low-fat dairy products.

The more of these measures they adopted, the lower the infertility rate and the higher the pregnancy rate. This was regardless of the woman's age, or whether she'd had children before.

For example, those who adopted just five of these measures had a 69 per cent reduced risk of infertility compared to those who adopted none of the measures.

Even following just one of these lifestyle measures reduced the risk of infertility by 30 per cent compared to those women who followed none. Of all the lifestyle measures, weight and diet, rather than exercise, were the most important.

Blood sugar and insulin
Why should these measures improve fertility? It's believed they improve insulin resistance – that is, they help regulate insulin and blood sugar levels and this in turn may help the sex hormones to regulate ovulation successfully.
Why high fat dairy products help remains a mystery though.

Now adopting these measures won't necessarily work for other types of infertility, such as blocked fallopian tubes. But what it does mean is fertility due to ovulation problems – which account for most infertility cases – can be partly prevented through modifications of diet and lifestyle, the authors say.

As an added bonus, these measures are also good for the pregnancy if a woman does conceive, they say. Taking multivitamins containing folic acid helps prevent neural tube defects in the foetus. And keeping weight down reduces the chances of pregnancy complications like gestational diabetes or pre-eclampsia.

Not to mention avoiding having to explain, when the boy or girl gets a bit older, how some babies come from test tubes.

Pregnancy after 40 is quite normal nowadays due to the desire for career advancement and many other factors. Pregnancy over 40 need not be dangerous and there is nothing to be afraid of, if you follow a healthy lifestyle and avoid tension throughout the pregnancy wheel and take proper precautions in all the pregnancy stages. However, getting pregnant over 40 is best avoided.

Pregnancy after 40 might appear to be a difficult and dangerous proposition, as there are so many misconceptions about it. However, there are many successful instances to prove that getting pregnant over 40 will not necessarily be unsuccessful and that a perfectly normal delivery is likely, most of the time. All that you need to do is to heed a few good advices that are, in any case, applicable to all pregnancies. The essential requirements are that you should have a healthy diet, keep your weight under control, take plenty of rest, consume a lot of water, and be relaxed. In order to be able to cope with the problems during and after the pregnancy wheel, you should read plenty of good books and articles regarding pregnancy and try to gain as much knowledge as possible. You should also develop a positive attitude towards your pregnancy after 40 and be fully prepared for any eventuality.

Fear Is Your Worst Enemy

Fear arises out of lack of knowledge and it can prove to be your worst enemy during all your pregnancy stages. Moreover, there is so much negative information going around that having apprehensions regarding premature delivery, gestational diabetes, miscarriage or a c-section is quite normal. You might even be imagining that your baby will be born with birth defects or abnormalities. The best way to tackle these apprehensions is to read a lot and get the right information, so that all your fears regarding pregnancy after 40 are dispelled.

Another way of getting rid of your apprehensions, is to go in for additional tests apart from the normal urine, blood and other prenatal tests. If you have pregnancy after 40, you can get your doctor to check for birth defects. Chorionic Villus Sampling and Amniocentsis are two such tests and if you get normal results, you can rest assured that your pregnancy after 40 is quite normal.

Adverse Reactions from Friends and Family Members

It is quite possible that the news regarding your pregnancy after 40 will elicit adverse reactions in the form of a curt remark or a disapproving gesture from your friends or family members. You should be prepared for these reactions and, in fact, you can make it clear to them that it is your life and you can take any decision that you like. You would do well to avoid meeting such people, as you might be having emotional highs and lows due to the hormonal changes during the pregnancy wheel and you can certainly do without additional stress. On the other hand, if you have pregnancy after 40, you should take plenty of rest and celebrate the impending arrival of your baby.

There are many reasons for pregnancy over 40 – the primary one being career considerations. However, it is advisable to balance out your career aspirations and your family life and let nature take its own course at the right time. You should avoid stress, eat healthy food, and have the strength to admit that you are what you are and that you do not need to prove anything. You need not be afraid of pregnancy after 40 but it is best avoided.

There are many misconceptions doing round about the feasibility of pregnancy after 40. Pregnancy over 40 is a tough decision and there are possibilities of pregnancy complications. When you decide in favor of getting pregnant over 40, seek the advice of doctor beforehand and follow that in all pregnancy stages to enjoy a happy and healthy pregnancy. Log on to pregnancy for more information and reading on late pregnancy and other pregnancy information.


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