This month, we’ve had some great discussions about hope, happiness and surviving infertility and miscarriage. I shared a bit about how I’ve had to readjust my plans for life and family.

Dr. Lowell Ku shared wonderful information about the definition of infertility and recurrent pregnancy loss, how to choose the fertility clinic that’s right for you and the most common surgical procedures to improve fertility.

Dr. Mary Hinkley from the Reproductive Science Center Bay Area clinic broke down the mysteries of eating fish while trying to conceive. Finally, all of the contradictory advice we’ve heard was broken down!

Sharon, from the Attain Fertility Call Center, told us about Attain Fertility’s IVF programs and shared advice about dealing with questions about your treatment and diagnosis from well meaning family and friends.

Shelly Galvin walked us through some of the great videos from the American Fertility Association’s infertility video series, including my personal favorite on how to give an injection. That video should be required watching for all couples dealing with injections!

On Facebook, we talked about the things you shouldn’t say to someone dealing with infertility or a miscarriage. RSC New England Clinical Psychologist, Adele Kaufman, PhD helped us learn how to deal with marital conflicts over how to proceed with treatment and Dr. Angela Thayer from Seattle Reproductive Medicine shared how we can plan our reproductive futures. Finally, we had some lively discussions about how to remain hopeful in the face of infertility and how to be happy for others.

September is off to a great start and I can’t wait to see what the rest of the month brings us!

September has arrived, the holiday weekend is here and I hope you’re able to catch some much needed R and R.

I’m going to cut to the chase and share with you a great program we are excited to offer here at Attain® IVF; it’s called the Multi-Cycle Plan (available to patients whose doctor recommends IVF using your own eggs). The Program includes four cycles of IVF (2 fresh and 2 frozen), you pay a one time, discounted fee that’s about 30% less than paying on a cycle-by-cycle basis and there is no age criteria for enrollment.

So what does all this mean? It means a greater chance for success due to the multi-cycle approach and the one time fee is paid prior to the start of your treatment leaving you time to focus on having a baby.

We love talking about this Program and more importantly we love talking to you. Give us a call when you’re ready and we’ll get you started.

In observance of the Labor Day Holiday, the Attain IVF Call Center will be closed on Monday, September 6^th. Normal business hours will resume on Tuesday, September 7^th at 9 am ET.

Have a safe Holiday. Until next time, all my best.

Photo by Stephanie Himel-Nelson

Hello again everyone!  I have been MIA for a while due to being super busy over the past few weeks, but I wanted to check in and see what has been happening on the new blog site.

So, I have been talking to quite a few people regarding infertility, its varying forms, and how it is socially “acceptable” for people to respond to them.  The levels run the gamut from unsuccessfully trying to conceive for years, to those who have had multiple miscarriages prior to having a successful and healthy pregnancy.  There are also many who already have been blessed with a child, but would like more, and they are still experiencing difficulties conceiving.  Even though some people may ultimately have children, it doesn’t mean that they were “cured” of their infertility problems.

Sometimes it seems like some of my friends have gotten pregnant merely by looking at their husbands and it still bothers me that, even though I was finally able to conceive, we had to go through all we did just to get to this point.  Plus, my husband and I want to have more children in the future and I am terrified I may have to experience this all over again.  I also know of some people who have 1 or 2 successful pregnancies, but had to endure multiple miscarriages to get to that point.  While they are thrilled to have children, each miscarriage was a devastating experience to endure.

So whether you have been TTC (trying to conceive) for years with no luck or have had a child or two and are trying for more, everyone needs to be sensitive, and, perhaps more importantly, respectful toward all infertility experiences.  Each one of us has had our own unique and stressful experience, but we need to remember that we all are attempting to reach the same goal of a successful and healthy pregnancy.

Jacqui Dunn is an executive assistant for IntegraMed and is expecting her first child after going through IUI.

In order to reduce the possibility of implantation failure, an embryo can be assisted to hatch. According to a Practice Committee of the Society for Reproductive Technologies (SART) and the American Society for Reproductive Medicine (ASRM), “assisted hatching involves the artificial thinning or breaching of the zona pellucida (protective coating of the embryo) and has been proposed as one technique to improve implantation and pregnancy rates following IVF.”

Assisted hatching is generally performed on day 3 embryos. However, there are risks to the embryo that can occur when performing assisted hatching. According to the Practice Committee, “the assisted hatching procedure may be associated with specific complications independent of the IVF procedure itself, including lethal damage to the embryo and damage to individual blastomeres (cells that make up a day 3 embryo) with reduction of embryo viability.” In other words, the embryo can be damaged or destroyed during the process of assisted hatching. The skill level of the embryologist performing assisted hatching can determine the rate of embryo damage. The more experienced the embryologist, the less chance there will be damage to the embryo during the procedure.

The available data studying assisted hatching showed higher clinical pregnancy and implantation rates. However, the delivery rates did not improve significantly enough to justify the use of assisted hatching in every patient.

After reviewing the available studies on assisted hatching, the Practice Committee concluded that “the available published evidence does not support the routine or universal application of assisted hatching in all IVF cycles at this time.” The Committee further stated that “assisted hatching may be clinically useful in patients with a poor prognosis, including those with ≥ 2 failed IVF cycles, poor embryo quality, and older women (≥ 38 years of age).”

Assisted hatching is not the cure all for infertility, but it could help if you fall into one of the above categories. However, you must be mindful of the risks of assisted hatching. Ask your infertility doctor if assisted hatching may be helpful in your particular infertility situation.

Source: Fertility and Sterility, Volume 90, Issue 5, Page S196-7, November 2008, Authors: Practice Committee of the Society of Assited Reproductive Technologies and American Society for Reproductive Medicine.

Dr. Lowell T. Ku, M.D. is a leading Reproductive Endocrinology and Infertility specialist at Dallas IVF, one the nation’s premiere infertility centers.  Dr. Ku clarifies the many confusing terms used in the world of Infertility using straightforward explanations.

Photo by Stephanie Himel-Nelson

When you’re suffering from infertility or you’ve had multiple miscarriages, it can be hard to watch your friends and family celebrate pregnancy and birth after pregnancy and birth. I know.

You’ve all heard about my history of miscarriage and infertility, but I haven’t yet shared how I deal with pregnancy around me.  In the last 6 months or so, two of my best friends, my dear cousin and my sister-in-law have all announced pregnancies. Yes, it was hard, but I was thrilled for each of them. I know what a blessing a child is and how can I possibly begrudge someone else’s longed-for child? I want the people I love to be happy.

I was so excited when my brother (B) told me he and his wife (F) were expecting several months ago. I remember the day well because I was traveling and in meetings and my brother couldn’t reach me on the phone. B finally resorted to texting me and I read his news while in my very first face-to-face meeting with the people behind the Attain Fertility community. I squealed, interrupting the meeting, and shared the news. B and F had been trying for some time and everyone in the meeting understood exactly why I was so excited. They all dedicate their professional lives to informing us about treatment options for infertility and rejoice when one of us succeeds. My brother’s news was greeted with congratulations all around!

On my way home that evening, I thought about my little nephew or niece-to-be and how happy I was for B and F. Then I thought about how great it would be if we could give the baby-to-be a little cousin about the same age. And I felt that pang of sadness and regret. You all know what I mean. It’s the feeling you can’t avoid, no matter how happy you are for someone else. It’s the regret that you can’t have that happiness too.

As I watched B and F’s announcement on Facebook and all of the congratulations from our families and their friends, I felt that pang again. But I reminded myself that their pregnancy isn’t about me. It’s about their new family. I got over myself and then I debated how long I should wait before buying something for B and F’s new little one. In the past I’ve had a hard time feeling hopeful when I discovered that I was newly pregnant, but I didn’t want to transfer my anxieties to B and F. I wanted them, and everyone else, to rejoice over the new pregnancy.

Then, on Friday I got the call from my brother. B and F had gone in for an ultrasound and there was no heartbeat. She miscarried.

Now, more than ever, I wish I could tell my little brother just how to fix this; that I had some magic words to make them feel better. I warned B that he may get over this, or at least be able to push it from his mind, a little more easily than F, but to understand that F may not. Aside from that, all I can do is tell them how sorry I am and that I’ll always be there to listen. I don’t want to offer empty platitudes that I know from experience will only make B and F feel more alone right now. But, of course, I can’t stop thinking about them and hoping that they know how much they are loved.

What do you wish your friends and family would say to you about your infertility or losses? What helps you feel a bit better?

I’ve always been a book worm. Now I’m a video-aholic. I love watching videos… on Hulu, Netflix, YouTube, HBO on Demand (it would be a sad world without True Blood). And now my latest passion is The American Fertility Association’s Video Fact Sheet series.

Granted I’m prejudiced because Attain Fertility is funding 20 of their videos, which are in various stages of production.

Apparently I’m not the only one who thinks highly of The AFA’s fine work. To date, their video on how to give an injection has been viewed nearly 1,900 times on our YouTube channel.

Other topics include endometriosis, in vitro fertilization, questions to ask at your initial consultation, PCOS.

Now why am I feeling the love so much today in particular? We’re in the midst of planning the next set of videos they will tape at our fertility centers and:

1. They are timely, relevant and cover popular topics with a unique perspective that sets them apart from other videos. (Spoiler alert: topics in discussion include IVF success rates and donor sperm for the lesbian community.)
2. We’re also adding topics to the queue that you’ve requested in our Facebook community. Most notably, you’ve asked for additional information on PCOS, which is now in the planning stages.

So if you’re ready for some educational viewing between episodes of Top Chef, check out the AFA videos.

And please, please keep the suggestions coming!

Photo by Stephanie Himel-Nelson

Today, I am going to go back to the basics and discuss the definitions of infertility and recurrent pregnancy loss.  Now, you may think you know how to define infertility and/or recurrent pregnancy loss. After all, if someone cannot get pregnant, they have infertility, right?  If someone loses four or five pregnancies, that’s considered recurrent pregnancy loss, right?  Well, you might be surprised to learn about the actual definitions of infertility and recurrent pregnancy loss.

In 2008, the American Society of Reproductive Medicine (ASRM) revised its definitions of infertility and recurrent pregnancy loss.  In a Practice Committee Report published in 2008 in the journal of Fertility Sterility, the ASRM states:

“Infertility is a disease, defined by failure to achieve successful pregnancy (clinical pregnancy) after 12 months or more of regular unprotected intercourse.”  So, infertility isn’t just the inability to get pregnant but the inability to conceive after actively trying for at least 1 year.

“Recurrent pregnancy loss is a disease distinct from infertility, defined by two or more failed pregnancies (clinical pregnancies).” Thus, the tragic loss of just 2 pregnancies can be considered recurrent pregnancy loss.

Did you realize that infertility and recurrent pregnancy loss are considered diseases?  The 31^st edition of Dorland’s Illustrated Medical Dictionary published in 2007 states that a disease is:

“Any deviation from or interruption of the normal structure of any part, organ, or system of the body as manifested by characteristic symptoms or signs; the etiology, pathology, or prognosis may be known or unknown.”

Source: Fertility and Sterility, Volume 90, Issue 5, Page S60, November 2008, Authors: Practice Committee of the American Society for Reproductive Medicine.

Dr. Lowell T. Ku, M.D. is a leading Reproductive Endocrinology and Infertility specialist at Dallas IVF, on the nation’s premiere infertility centers.  Dr. Ku clarifies the many confusing terms used in the world of Infertility using straightforward explanations.

I just returned from a trip to the coast. The sounds of the waves and cool breezes off the ocean make everything, including food, better. Each night we’d enjoy fish, shrimp, and other gifts from the sea.

I am often asked by patients about eating fish before and during pregnancy. How much is too much? How much is enough?

We know from studying cultures who eat a large amount of seafood that their level of omega 3 fatty acids is higher than a classic American-based diet. This can have far-reaching consequences to your health and the health of your children in a positive way. However, this very same fish can have contaminants that can accumulate in your body and affect neuro-developmental function.

These days, in light of the BP oil spill, we are bombarded with information about how it’s impacted fish in the Gulf of Mexico. While contaminates may not be as much of an issue on the Pacific Coast, we do have to worry about mercury levels in fish. A recent article in the June edition of OB GYN News reviewed the FDA and Environmental Protection Agency’s recommendations regarding fish and shellfish. They recommend that pregnant women limit their intake to no more than 12 oz a week (2 average meals). They also recommend avoiding swordfish, shark. king mackerel, and tilefish. Tuna can also contain large amounts of mercury.

By following the FDA recommendations, most women will have low levels of mercury, but if you are interested, some university centers can check the mercury level in hair. If you do not like fish (salmon, trout, halibut), or find that you eat it less than once a week (especially with morning sickness hits in early pregnancy), then consider DHA/EPA supplements—especially if plant-based (algae). 200 mg of DHA a day should be a good starting point but it can also be found in combination with prenatal vitamins.

There are also a few other reasons to consider DHA other than “the FDA told me to”:

• Children whose mothers took a DHA supplement during pregnancy scored higher on intelligence tests at four years of age than children of mothers not taking DHA supplements, as published in a 2003 study in the journal Pediatrics.
• Children whose mothers had high blood levels of DHA at delivery had advanced attention spans into their second year of life. During the first six months of life these infants were two months ahead of babies whose mothers had lower DHA levels. (2004 Child Development.)
• In a trial of women receiving DHA supplementation during the third trimester, the average length of gestation increased six days (Obstetrics & Gynecology, 2003).
• In the Journal of Affective Disorders, 2002, scientists believe increasing levels of maternal DHA may reduce the risk of postpartum depression.

Dr. Mary Hinkley, MD is an infertility specialist in our Reproductive Science Center Bay Area clinic.

Simply said, the Customer Care team at the Attain® IVF Call Center is devoted to providing information about our Programs because we are as committed to building your family as you are.

The Attain Programs include IVF, IVF/Donor Egg and the Multi-Cycle plan. The common thread with all our Programs is multiple cycles. Let the statistics speak for themselves. http://attainfertility.com/article/ivf-statistics When you commit to multiple cycles, you increase your chances for success.

What about the cost?

This is probably the single most asked question we get, and rightfully so. Unfortunately, many who pay for IVF on a cycle-to-cycle basis drop out of treatment too early because of uncertainty over how long to try, how much to spend and the stress of it all. With the Attain Programs, you pay a one time fee upfront for multiple cycles; leaving your focus on the treatment and having a baby.

We’d love to speak with you, so give us a call @ 1-866-968-7483. Rose, Tammy and I are available to provide the details of the Attain Programs and financing options; but, most importantly, an ear to listen to you, wherever you may be in your journey. We are in this together so let’s get started and schedule that first appointment for you. If you’re already at an affiliated Practice, we’ll start the application process to get you enrolled in the Attain Program.

We look forward to your call!

Until next time, all my best.

I recommend that you choose an IVF center that is not only medically successful but also successful in supporting you emotionally through the process of infertility treatments. From the time you first step foot into the IVF center to the time that you are pregnant, the center’s staff, nurses, technicians, and physicians should be helpful, understanding, and supportive. I also recommend that you choose a physician that you trust and is willing to answer all of your questions in an honest manner.

I encourage patients to ask questions when assessing whether or not a fertility clinic is right for them. So, choosing an IVF center that is right for you is not just a matter of bottom line numbers, but whether or not an infertility center can support you during the difficult journey from infertility to parenthood.

Dr. Ku is an infertility specialist at Dallas IVF, one of the nations’ leading infertility centers that consistently has among the highest success rates in the United States.  (www.DallasIVF.com) Dr. Ku and his wife have suffered with infertility and Dr. Ku states that his experience with infertility has made him a better infertility doctor and makes him work harder for his patients. “I know how it feels to struggle with infertility. I am there for my patients every step of the way to parenthood!”