Basic Fertility Treatment (Ovulation Induction with Insemination): latest information and recommendations reviewed

One aspect of fertility treatment that exacerbates the frustration of many couples is the uncertainty. They often don’t have a specific reason for their problem—even after their testing is completed. They also don’t understand the typical challenges that everyone faces on a monthly basis. Without this information, it can be difficult to create realistic expectations. I believe it also makes the most logical and simple recommendations seem very appealing.

Basic Fertility care is often introduced as ovulation induction (OI)—using medication to regulate the menstrual cycle and optimize the timing of the “fertile window.” This procedure is often combined with “sperm wash” where the partner’s specimen is processed to optimize its potential and then placing that into the woman’s uterus—known as intrauterine insemination (IUI). This treatment has been available for decades. There have been few changes in how this is done over the last 10 years.

I reviewed the subject of OI/IUI back in 2015 and those studies are still very relevant. So please check that out as well. More recently, we have had a couple of publications that provide even more data for us to guide patients through these important decisions. Please consider the watching the following video blog for a quick (less than 10 minute) summary ( https://youtu.be/GwmbkIpw3ek ) .  In case you can’t access the link, here is a brief summary of findings;

  • Ovulation Induction with intercourse wasn’t much better than trying to conceive naturally
  • Insemination without ovulation induction had success rates comparable to natural conception
  • In considering OI/IUI
    • Success rates drop dramatically after three or four attempts
    • Having more than two follicles is not recommended due to increased risk of multiple pregnancy
    • The timing of the insemination is more flexible than most anticipate
    • There is no greater benefit in having more than one insemination per cycle
    • For women over 40, success rates were modest and associated with a lower risk of multiple pregnancy—even when three or more follicles were available            

I hope that you find this information helpful and empowering as you consider your treatment options and plan your family.

With kindness and optimism

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

References:

Fertility Treatment and Social Distancing are Codependent During the COVID19 Outbreak

As we continue to adjust to life during the SARS-CoV-2 outbreak it is important that we adjust our activities. Fertility treatment is ESSENTIAL care for those that need it. Our goal is to continue continue to provide this care for all of those seeking treatment–but it will require their assistance as well. Here in Colorado our use of social distancing has clearly reduced the severity of the outbreak. I’ve summarized in a videoblog the recommendations to keep our patients, our staff  and our community safe: https://youtu.be/7sBN7WgC35I .

Safer at home videoblog

So please continue to stay safer-at-home when possible and follow established social distancing when out in public place.

With kindness and support,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

 

Fertility and Clean Air: some encouraging news for those pursuing pregnancy

As fertility treatment resumes following the pause created by the COVID19 Outbreak, we have experienced marked improvement in air quality. Many are unaware the of the unfortunate effects that pollution has upon fertility. Here on the 50th Anniversary of Earth Day is a great time to update you on how our improved environment can boost your chances of achieving and maintaining a healthy pregnancy: https://youtu.be/Iq93CXlrp4Q .

Happy Earth Day

I hope that you found that information to be encouraging. Let’s see if we can take it a step further and make some better choices as we move forward in to the future.

REFERENCES from this video: 

COVID19 and Fertility Treatment: an update for patients in Colorado

Treatment for fertility patients has been challenging during the COVID19 Outbreak. There is agreement that fertility treatment is essential and not elective. But whether or not it was urgent created some confusion as whether or not treatment should be continued or halted during the early days of the outbreak in the United States.

CORONA VIRUS

At this point, it is becoming more apparent that various regions are experiencing this pandemic very differently. Here’s the latest update for patients seeking care at our center in Colorado: https://youtu.be/Ky5lcP-Rzus.

Stay safe, stay well and if you can please stay home.

With kindness,

~Robert Greene, MD, FACOG

COVID19 and other infectious disease concerns—here’s what fertility patients should consider

There is increasing concern over Corona Virus or COVID19 as this infection spreads. In perspective there are other infectious diseases that people seeking pregnancy should also consider. Here is a link to a videoblog we recently created to try to answer some of these questions and provide some practical advice: https://youtu.be/a6p4uUC8hgk  COVID19

 

 

 

Starting a new video blog: Clinical Conversation

In our effort to remain relevant and provide you with current and relevant content–we’re starting a new YouTube Channel called Clinical Conversations. My partner in this project–Lisa White–is a licensed counselor that has actually gone through fertility treatment herself.

Introducing Fertility Chat

Our goal is to help support you by providing you with some short dialogues about topics that you find to be most relevant. Consider signing up or emailing us some suggestions for topics.

If you can’t find us at the link above just search “clinical conversations–fertility chats” on YouTube.

We hope to see you there!

Tea and Plastics: the most recent example of healthy food packaged/prepared badly

As fertility specialists we try to point out how diet/lifestyle can optimize your fertility efforts. Recently, I shared the latest information that coffee and tea can actually have some benefits—despite popular, but misguided beliefs. But it is always important to realize that it’s not just what we consume—but also how we prepare it that matters!

Fancy tea bags

Tea can easily become an example of a healthy drink gone bad if not prepared properly. A recent study from McGill University demonstrated that just one of the new fancy plastic tea bags can release 11 billion microplastic and 3 billion nanoplastic particles into your drink in as little as five minutes when prepared at standard temperatures. These tiny particles cannot be seen without a microscope. But because of their size they can enter your body much easier than they can ever leave. In fact, a study from the World Wild Life Fund found that it is not unusual for people to consume about 5 grams of plastic per week by eating sea food or drinking beer from cans lined with plastic. That’s equivalent to eating the amount of plastic in a credit card each week!

Although we don’t (yet) know of all of the potential health effects of micro-particles—we do know that plastics can have a negative impact upon fertility due to the chemicals that they contain. In fact, a direct link has been found between the ingredients used in plastics upon egg quality and maturation (their ability to be fertilized). More importantly, these plastic tea bags are not needed and have only recently been introduced.

Here are a few tips to consider:

  • Say “NO” to unnecessary plastics—as consumers you speak volumes with your purchases. Let companies know if you’re choosing to not use their products due to their packaging choices
  • Get a re-usable device to steep your tea
  • Support organizations like the Environmental Working Group that offer tips to minimize your exposure to plastics

 

As I said in my previous blog post, “these low calorie, plant based beverages may have some health and fertility boosting benefits.” But now I’ll modify my statement with a reminder that this is only true if packaged and prepared in a health way.

Stay informed and motivated,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

Modern Family Building strategies for the LGBTQ Community

Many of us take for granted that having children will become a natural outcome of our current relationship. For members of the LGBTQ community—this is not the case. A recent survey conducted by the Family Building Council found that 33% of the LGBTQ respondents over age 55 either had children or were planning to have children. This was a sharp contrast to LGBTQ Millennials—age 18 to 35—for whom 77% are either already parents or planning to have children. Even more encouraging among Millennials, is that there are nearly as many members of the LGBTQ community planning to have children as their non-LGBTQ peers—48% vs 55%. However, the LGBTQ Millennials know that they are going to need some assistance to achieve their family.

Booth at Pride Fest

The Family Building Survey also revealed among LGBTQ Baby Boomers—those 55 and older—nearly 75% became parents through intercourse. Many of those were children conceived in former relationships and therefore were “blended families.” This was in sharp contrast to Millennials. Among the 18 to 35 year olds, more than half planned to use Assisted Reproductive Technologies, adoption or fostering to meet their family building goals. That amounts to an estimated 3.8 million LGBTQ Millennials considering expanding their families and 2.9 million that are actively doing so.

 

If you’re among those seeking to become parents, consider the following:

  • Learn what options are available rather than simply thinking about the simplest way to initiate a pregnancy
  • Consider what your ideal completed family would like before finalizing your plan—it can be very difficult to find the same donor years later if you want a sibling
  • Seek out providers in the healthcare community that will serve as your allies and advocates
  • As more insurance companies are covering reproductive technologies as a covered benefit—investigate how those options apply to you

 

Stay informed,

~Robert

 

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado

Vitamin B3: an emerging tool in reducing the risk of miscarriage

About one in four pregnant women will experience a miscarriage. At least two thirds of miscarriages are believed to be due to a genetic abnormality in the embryo. It can make it even more emotionally devastating if the pregnancy was initiated following an IVF procedure with an embryo that had already been genetically tested prior to transfer. That’s why it is so very important that we investigate other—possibly preventable—causes of early pregnancy loss. One emerging strategy is to optimize vitamin B3 intake.

Vitamin-B3

Vitamin B3—also called niacin—serves as critical component of energy within cells to support growth and development. It also serves as a key signal for a group of chemicals that are necessary to repair DNA as well as regulate your body’s stress response. These are all critical functions to initiating and maintaining a successful pregnancy. Unfortunately not all pregnant women are getting enough vitamin B3.

 

Surprisingly, not all prenatal vitamins contain niacin / B3. One study that was following over 500 pregnant women found that despite following a healthy diet and taking daily supplements—a high percentage of women were vitamin B3 deficient. More recently, a study published in the New England Journal of Medicine demonstrated that giving a group of high risk pregnant women a high dose vitamin B3 supplement seemed to reduce the risk of both miscarriage and birth defects. Additional studies are on-going to see how this may translate into women with average risk.

 

While we await the results of future studies in this area, there are some safe and simple steps you can consider to help minimize your risk of miscarriage:

  • Eat fortified cereals and grains
  • Include blueberries and grapes as part of your healthy diet—they contain a chemical pterostilbene which can enhance Vitamin B3 activity
  • Check your prenatal vitamin to confirm that it has at least 20 mg of Vitamin B3
  • Talk to your provider about whether or not you should consider a Vitamin B3 supplement

 

Stay informed,

~Robert

Robert Greene, MD, FACOG

Conceptions Reproductive Associates of Colorado