reproductive

Do birth control pills cause infertility?

birth-control-pills-NJThis is one of the most common questions patients ask their fertility doctors and/ or their OBGYNs. Fortunately the short answer is no and this is backed up by large research studies. While their purpose may be to prevent pregnancy, the contraceptive effect of the pill wears off rather quickly. In some women the return to normal cycles and fertility can take a number of months, but usually there is not much of a delay. In other women, such as those with ovulation disorders such as PCOS, coming off the pill may actually increase the chances for conception. If your cycles have not regulated themselves 6 months after stopping the pill or they are becoming less regular over time after then and you're trying to get pregnant, it's probably not the pill, and it's time to discuss this with your GYN or fertility specialist.

Lesley Brown, the unsung heroine of IVF

Being that is National Infertility Awareness Month, this week seemed like an appropriate time to share this story. I recently attended a lecture given by one of pioneers in our field and one my personal mentors, Dr. Eli Adashi. The story he shared with the audience moved me and reminded us of our patients' suffering and why we do what we do. In the history books, when one looks at the breakthroughs in medical infertility treatment, the birth of the first IVF baby does and will stand out as one of the great milestones. The protagonists in the story that everyone knows are, Drs. Steptoe and Edwards, the brilliant gynecologist and scientist team, and of course, baby Louise Brown herself. But the popular narrative leaves out perhaps the most important character in this drama, Lesley Brown, the patient herself.  Lesley was a reserved woman who never wanted attention but her delivery was one of the most famous events of the 20th century. She put up with repetitive surgeries and painful medical procedures knowing there was little chance they would work.  When she did IVF with Drs. Steptoe and Edwards, she was basically (and knowingly) a human guinea pig.  Nobody had any idea as to whether it could work, whether it was safe and if it did whether her child would turn out normal. On top of that she had to put up with moral outrage (and occasionally harassment) of those who opposed the very idea behind IVF. Without her bravery and perseverance, millions of couples would remain childless and millions of babies would never have had a chance at life. Lesley Brown passed away quietly in 2012 but the legacy she left has brought both hope and joy to millions. Image

Aspirin and miscarriages

aspirin-baby-81It is quite common for both OBGYN and Fertility doctors to encourage their patients who have had multiple miscarriages take baby aspirin in order to reduce the risk of future pregnancy losses. The problem with this is that these recommendations were never really backed up by research to see if aspirin is really effective in preventing miscarriages. In order to determine if this common practice was effective, the NIH conducted a large trial to see if taking daily baby aspirin would reduce the risk of subsequent miscarriage in women with 1 or 2 prior miscarriages. Unfortunately, as reported in the journal Lancet,  baby aspirin did not help and these women were no more likely to experience another pregnancy loss than those who took a placebo. The one bright spot in this study: women who took had a single loss early in pregnancy within the last year and took baby aspirin were more likely to actually become pregnant.

Some interesting facts about twins...

pivf-8wk-usIn the world of Reproductive Medicine, and much to the delight of our Obstetrician colleagues, we are always looking for new ways to reduce the risk of twins and other multiple births. Multiple pregnancies significantly increase the risks of all sorts of complications for mother and baby. It was a nice change of pace when I came across this great blog entry from the Renee Jacques at the Huffington Post about some cool and interesting facts about twins. So here they are:

  1. Identical twins do not have identical fingerprints
  2. Massachusetts has the highest number of twin births in US, followed by Connecticut and third our state of New Jersey. Not surprising considering we have lots of couples going through IVF and other infertility treatments and a law mandating coverage.
  3. Mirror image identical twins have reverse asymmetric features.
  4. Identical twins are not completely genetically identical
  5. Moms of twins may live longer
  6. Tall women are more likely to have twins
  7. Women who eat more dairy are more likely to have twins.
  8. It is possible for twins to have two different fathers
  9. Twins interact with each other in utero
  10. Some conjoined (Siamese) twins can experience each others senses.
  11. 40% of twins communicate with their own language.

Be sure to visit her original article here.

 

PCOS: a metabolic disease masquerading a reproductive disorder

PCOSultrasoundPolycystic ovarian syndrome (PCOS) is one of the most common things doctors see in both reproductive medicine and OBGYN practices. Patients often come to us complaining of infertility, miscarriages or irregular cycles, and sometime other issues such as facial hair, acne or weight issues. Because of these are the problems that bring PCOS patients in the office, most patients (and most doctors as well) think of it as a gynecologic disorder.  However, most experts consider most PCOS to be a metabolic disorder, a problem with how the body handles sugar and produces insulin, and that the symptoms of PCOS are the consequences of these metabolic problems. A recent article from the Wall Street Journal, discusses PCOS and interviews some of the leading researchers in the field.