Infertility and women in the military

Fertility issues may be common in women in the US military

A recent survey suggests that infertility may be a common problem among American servicewomen

How common are fertility issues among women in the US military?

According the Service Women’s Action Network, 37% of women from the various branches of the military (army, navy, air force, marines) surveyed experience difficulty in conceiving.

Is it easy to get infertility treatment in the military?

While treatment is available, respondents reported that treatment services were limited and difficult to access. Many basic fertility procedures such as IUI and access to a fertility specialist were unavailable on base, and for those who require advances treatments such as IVF, there are only a few military medical facilities which offer it. Frequently, those centers have long waiting lists, and require significant travel.

What about off base fertility treatment for service women?

Like other practices in different parts of the country, we are close to an active military base. Joint Base McGuire-Dix-Lakehurst is not far and we do participate with Tricare, so we do get to help many couples from the base seeking fertility treatment. The obstetricians and midwives in our practice also see many of the service women and family members for pregnancy care and gynecologic issues.

Does marijuana cause infertility?

Marijuana and fertility: Princeton IVF blog
Marijuana effects on fertility and pregnancy

All across the country, and likely soon in our state of New Jersey, recreational marijuana us is likely to become legal in more and more places. That means that more couples than ever who are trying to conceive will be users. If you are one of them, should you be concerned?

Here is what we know now:

Does marijuana affect a woman’s fertility?

We know that pot can affect a women’s hormones and her menstrual cycle. Ovulation problems which are related to hormone imbalances are a very common cause for female infertility.

Does marijuana affect a man’s fertility?

The main test fertility doctors use to diagnose male infertility is a semen analysis. We have known for some time that marijuana can have an adverse effect on the most important things we check for in a semen analysis, the number of sperm present (the count), how well they are swimming (motility) and the percent of the sperm that are normally shaped (morphology). We also know that exposure to active ingredient in marijuana THC can cause the breakage of chromosomes and abnormalities in a methylation, a natural chemical process which is responsible for how the genetic material is expressed in the body. Again, we do not know if this directly harmful to a man’s ability to father children or may affect the health of those children.

Is marijuana safe for my baby once I am pregnant?

If you believe the studies in animals, marijuana is not safe for pregnant moms to take. Rats whose mothers were exposed to marijuana in utero were more likely to have cognitive and memory problems in multiple studies. We do not know if this is the case in humans though. Keep in mind that a century ago, alcohol was thought to be safe in pregnancy and it was even used by doctors as a treatment for premature labor. We know now that alcohol causes very specific and severe birth defects when taken during pregnancy.

Is marijuana safe to take when I am breastfeeding?

THC can be found in the breast milk for days after use. Whether this poses any risk to a newborn is not known.

What about extracts that are sold at dispensaries?

No one knows for sure if these preparations are more safe or less safe than whole marijuana smoked or eaten.

So, do I need to be concerned?

No one can say definitively that marijuana use is dangerous during pregnancy nor can it be said to be definitively safe. There are however lots of red flags that raise concern. Most prudent doctors will advise that you and your partner consider avoiding pot if a baby is in your near future

Losing weight before conception

Weight loss before baby: Princeton IVF blog
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This time of year is a time when many couples who are having trouble conceiving decide it’s time to start seeking help. That help could come from the OBGYN, a midwife or a fertility specialist. It’s also a time in the year, after indulging during the holidays, when many of us have a few extra pounds to shed.

For those who are overweight, part of that advice will be to lose weight before conception.

While this may not be easy, there are multiple reasons why weight loss before pregnancy is good advice.

  • Being overweight will reduce the chances of you getting pregnant on your own

  • Being overweight will increase the chances that if you do get pregnant, you will miscarry

  • Being overweight will increase the chances of medical complications during pregnancy such as diabetes and high blood pressure.

  • While diet and exercise during pregnancy can help limit weight gain during pregnancy, it is not likely to reduce the likelihood of pregnancy-related complications such as diabetes and hypertension.

Delaying pregnancy and excess weight are both bad for fertility, so delaying pregnancy for weight loss is balancing two risks.

At what point do the risks of delaying pregnancy offset the benefits of weight loss?

  • According to a recent study presented at the American Society for Reproductive Medicine, women in their late 30’s or those have poor ovarian reserve may be best off not delaying childbearing despite the obvious benefits.

Your diet and menopause

Diet, vitamins and menopause: Princeton IVF blog
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Can what you eat affect when you go into menopause?

New research from the UK suggests that it might.

They followed 914 women through menopause and sent them questionnaires about their diets, and what they found was interesting:

  • Fatty and oily fish delayed the age of menopause by 3.3 years for each daily portion

  • Fresh legumes delayed onset of menopause by 0.9 years for each daily portion

  • Refined pastas and rice was accelerated the age of menopause 1.5 years for each daily portion

They also asked these women about daily vitamin intake:

  • Vitamin B6 delayed menopause by 0.6 years

  • Zinc delayed menopause by 0.3 years per daily portion

Does this mean that making the right dietary choices can affect when one will go through menopause?

Perhaps, but not necessarily. Women who eat healthier may also live healthier lifestyles which could contribute to this as well.

Does this mean that these dietary choices can effect how long a woman will remain fertile?

While it certainly makes sense that dietary changes which delay when a woman runs out eggs should affect the quality of the ones that are left, this research does not address that issue.

AMH blood test- everything you wanted to know about this common blood test but were afraid to ask

AMH testing, a Q&A: Princeton IVF blog
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Common questions and answers about AMH testing

What is AMH?

Antimullerian hormone, commonly known at AMH, is hormone that is secreted by follicles in the ovary. It was initially studied for its role in reproductive development but is now widely used as a test of ovarian reserve.

What is ovarian reserve?

Ovarian reserve is a measure of the aging of the ovaries, and how many eggs the ovaries are likely to produce when given fertility medications. AMH, day 3 FSH and estradiol levels and antral follicle counts on ultrasound are commonly used measures of ovarian reserve.

What does a low AMH level mean?

A low AMH level, which most doctors consider a level of less than one, indicates that the ovary has fewer eggs available to stimulate. Women with low AMH levels, will usually make fewer eggs when given fertility drugs for IVF or insemination cycles.

Does a low AMH level mean that I am less likely to get pregnant?

AMH is a great test to determine how a woman will respond to medications, but it not as good at predicting pregnancy rates. It is true that women who produce more eggs are more likely to get pregnant, but particularly in young women, who do not need a large number of eggs, there does not seem to be reason to be concerned.

What does a high AMH level mean?

A high AMH level suggests that you are likely to respond very well to fertility injections and may be more likely to become hyperstimulated when taking them. It is also is considered a sign of polycystic ovaries (PCO) although AMH levels are not currently used to make the diagnosis.

Can the AMH level be used to predict if I will have trouble getting pregnant in the future?

Not really. Despite the early hope that AMH could help women know in advance if they might have infertility in the future, it turns out there is no evidence that AMH can predict future fertility.

Pain medicine and miscarriage

NSAIDS and miscarriage risk: Princeton IVF blog

Opioid pain medications are making all the headlines, but are over the counter pain medications really safe?


New research suggests that taking over the counter pain meds could increase the risk of miscarriage.

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California researchers tried to determine whether using over the counter pain medications such as acetominophen (Tylenol) and non steroidal anti-inflammatories ( such as ibuprofen, Motrin or Advil) might affect the risk of miscarriage. They studied almost 1100 pregnant women, comparing those women who took no pain medications to those who took acetaminophen, those who took non-steroidal and those who took both.

What they found was interesting…

  • Women who took tylenol or NSAIDs such as ibuprofen were more likely to miscarry that those who did not

  • Taking this medications around ovulation appeared to be the riskiest

  • Women who used these drugs for longer periods of time were at the greatest risk

  • Thin women were more at risk than overweight women

So, what does this all mean…

  • It does not mean that over the counter pain medications actually cause miscarriages, just that women who take them for whatever reason are more likely to miscarry.

  • It is a good idea to avoid Tylenol, Motrin, Alleve and other over the counter pain medications around the time of ovulation is you are trying to have a baby

Adenomyosis and your fertility

Adenomyosis and fertility: Princeton IVF blog

Adeno what?

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Most women have never heard of adenomyosis, but most gynecologists have, and it is a condition that may affect your chances of having a baby.


What is adenomyosis?

Adenomyosis is a disease where the glands that line the uterine cavity (the endometrium) are growing into the muscle of the uterus (the myometrium). In the past adenomyosis was considered a form of endometriosis, a disease in which the glands that normal grow in the endometrium grow outside of the uterus.

What are the symptoms of adenomyosis?

The symptoms of adenomyosis are similar to those of fibroids, painful and heavy periods. Not everyone with adenomyosis had symptoms though.

How is adenomyosis diagnosed?

In the past and sometimes still, adenomyosis was diagnosed when the tissue from a hysterectomy (removal of the uterus), usually done on someone who is thought to have fibroids, is examined in the laboratory. Sometimes, adenomyosis can be seen on ultrasound and can be seen even better on MRI.

Does adenomyosis affect fertility?

In the past, the answer was unclear. Recent research suggests that it may harmful to your fertility. Women undergoing with adenomyosis undergoing IVF had lower implantation rates, lower pregnancy rates, lower live birth rates and higher miscarriage rates.

How is adenomyosis treated?

Most adenomyosis is treated by hysterectomy, but this is not an option for fertility patients. There are newer experimental procedures such as ultrasound ablation, but it is not clear how safe and effective they are.

Melatonin and fertility

Melatonin and fertility: Princeton IVF blog
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What is melatonin?

Melatonin is a hormone that is produced in the pineal gland, at the base of the brain. It is involved in the regulating your natural circadian rhythms of sleep and wakefulness. It is considered a “dietary supplement” by the FDA and is available over the counter at pharmacies and vitamin stores.

What is melatonin used for?

Many people find melatonin useful to help them sleep and take a pill (typically 3 mg) at bedtime. It is often helpful for insomnia, for those with unusual  work schedules, overcoming jet lag and to help blind people who do not experience the light and dark cycles. It has also been tried for a number of other medical and psychiatric disorders.

Why would melatonin affect fertility?

Melatonin has been known for sometime to the influence reproduction in some animals so it is not a long shot to think it might affect humans. In one study, they found that the follicular fluid, the liquid that surrounds the eggs and is extracted during an IVF procedure, contains high levels of melatonin.

Is there any evidence the melatonin may help?

There is some research that show eggs retrieved from IVF are more likely to fertilize, produce higher quality better looking embryos, and are more likely to implant. The problem with these studies is that oftentimes they are given along with other supplements (folic acid, inositol and antioxidants) that have been shown to help fertility. Also, just taking a pill or supplement that you think will help you, will help even if it does not contain any active ingredients. That is called the placebo effect. The bottom line is that we do not know.

What about melatonin for men?

There is some evidence that melatonin may lower sperm counts and motility (the percent of sperm that are swimming). For that reason, it is a good idea for men trying to father children to avoid taking melatonin.


The holidays- developing a coping strategy

Infertility during the holidays: Princeton IVF blog
Christmas, Chanukah, Thanksgiving and Kwanzaa can be a difficult time when you have infertility. Here are some suggestions to get through it.

The holiday season can very difficult for couples suffering from infertility.

Whether you celebrate Christmas, Hanukah, Kwanzaa, some combination, or none, the holiday season may not always be as joyous for those who have been trying to get pregnant without success. With some planning, it is still possible to de-stress yourself at this time of year. Here are some suggestions from counselors who work with couples suffering from infertility.

  • Decide on a plan for opening your holiday cards.

    Opening cards with pictures of your friends or family’s children can be painful. Discuss with your partner how you want to handle this

  • Think about your holiday parties and how to avoid awkward situations.

    Hosting the party yourself can help you to control the situation. Think about how you might exit a gathering at someone else’s how if the situation becomes uncomfortable.

  • Decide what you what to share about your fertility.

    The two of you should decide how much or how little you wish to share about what is going on, and a strategy for handling the questions. It is very likely you will get questions or comments, so be prepared.

  • Think about an exit plan if the social situation becomes uncomfortable.

    Many couples find attending a party with young children or with prying relatives to be too much to bear. Think about how you might handle the situation and what you might want to reveal when extracating yourself from the situation.

The holidays can and should be a time for joy and love. Some advanced planning can help it stay that way.

Fishing for a baby

Fish and fertility: Princeton IVF blog
Eating more fish may help your chances of having a baby.

Can eating more fish make you more fertile?

It might actually help your chances of of having a baby, according to researchers at Harvard

What is the connection between fish intake and fertility?

The group at Harvard looked at women who were trying to get pregnant, how much fish they consumed and how long it took them to get pregnant. They found that women with regular fish intake were more likely to get pregnant and more likely to be sexually intimate with their partners.

How much fish intake is necessary to get this benefit?

The fertility benefit was seen with as little as 2 servings of fish a week.

Does a fish-rich diet make your more fertile.

This study shows the women who eat more fish are more likely to achieve pregnancy sooner, but one should not necessarily assume that their dietary choices directly caused their higher fertility. Causation is certainly likely, but this study was not designed to prove it.

Why would fish intake improve a couples fertility?

There are good reasons to believe that eating fish might make it easier to get pregnant. Fish are very high in omega 3 oils which have been shown in multiple studies to be beneficial in both promoting better pregnancy outcomes and better outcomes with in vitro fertilization (IVF). Other nutrients found in fish and other seafood such as Zinc may also explain the fertility benefits of fish.

What about the mercury?

That is the big unknown. Many large ocean fish such as swordfish, shark, tuna and tilefish have been shown to contain accumulate large amounts of environmental toxins such as mercury. The FDA recommends limiting these kinds of fish when pregnant over these concerns. It is unknown whether that benefits of regular fish intake offsets the risks of exposure to potentially dangerous chemicals. So, it is recommended for women who are pregnant or attempting pregnancy to minimize large ocean fish in their diet.

The Golden Arches and your Fertility

Fast food and time to conceive: Princeton IVF blog
Eating too much fast food may cause infertility

Can eating too much fast food be making it harder to get pregnant?

New research suggest that eating too much fast processed food may actually lower your chances of getting pregnant, or at least delay the time to conception.

Researchers in Australia decided look at how long it took women to conceive and compared that to how many times a week they consumed fast food and how many times a week they ate fruit. They found that women who had fast food more than 4 times a week took longer to get pregnant than those who had it 2-4 times a week, who in turn took longer than those who did not consume fast food. The exact opposite was true with eating fruit. Those women who ate fruit regularly got pregnant faster than those who did not. Interestingly, green leafy vegetables and fish conception did not speed up the time to conception.

So, what does this mean if I am trying to get pregnant.

Lay off the fast food.

Despite, the title of this post, in all fairness to McDonald’s, this is not unique to to the golden arches or any other hamburger joints. This also applies to fried chicken from the Colonel, the forth meal at Taco Bell, the greasy Chinese food place at the mall and any number of fast food restaurants. Processed, high calorie, high salt, high carbohydrate food may taste good and be quick and convenient, but it may make it harder to get pregnant. They are also not great for your health or the baby’s.

Eat whole foods.

That does not mean go to one of Amazon Inc.’s high priced supermarkets. It means avoiding processed foods, like those that are served at fast food places.

Eat fruit.

Your grandmother was right. Most fruits are good for your fertility and health.

Green leafy vegetables are still good for your pregnancy.

Even if this study did not show a benefit to speeding up the time to conception, the folic acid in these veggies can help reduce your baby’s risk of birth defects such as spina bifida.

The oils in fish is also good for your pregnancy and it may reduce the rates of some complications.

Many prenatal vitamins contain fish oils. Just be wary of getting too much mercury from large ocean fish.

Eight million IVF babies

World welcomes the 8 millionth IVF baby: Princeton IVF blog

2018 sees the number of IVF babies top 8 million

IVF is a now a common treatment for infertility

It’s been 40 years since Louise Brown, the first IVF baby, was born in the United Kingdom. At the time, it was both a miracle and controversial. Now in 2018, it has become a common medical procedure, not just in Britain and the US, but around the world. Now we have reached a new milestone.

2018 marks the birth of the 8 millionth IVF baby

So what is IVF all about?

IVF means in vitro fertilization. In vitro literally means in glass. The eggs and sperm are removed from the body, fertilized in a dish (it’s plastic, not glass though) and returned to the womb.

Why has IVF become so common?

Because it works. While IVF is not always successful, it is the only fertility treatment that has higher pregnancy rates than those of normal fertile couples. The technology has improved, and as the developing world has become more prosperous, these technologies have spread outside the US and Western Europe. IVF is now largely accessible to infertile couples worldwide.

Why do IVF instead of other medical procedures?

IVF is not necessarily the first treatment we try. Many patients will conceive with other lower tech ways such as intrauterine insemination or fertility pills and don’t need IVF. Some couples, such as those with damaged fallopian tubes or with very poor quality sperm, cannot conceive without IVF.

10 questions about using donor sperm

Donor sperm: 10 questions from the Princeton IVF blog
We offere donor insemination in our Lawrenceville NJ office

Thinking about using a sperm donor? Here are ten questions you may be asking yourself if you are considering doing donor insemination:

What are my chances for success using donor sperm?

The success rates for therapeutic donor insemination (TDI) treatment range from 8% up to about 25% per month, depending on your age other factors. Keep in mind that 20-25% are the normal pregnancy rates in couples who do not have fertility issues, so the success rates are actually quite good. Cumulatively up to 80% of women will conceive with IVF

How is donor insemination performed?

In our center, we use only washed sperm and perform intrauterine insemination (IUI) since this type of insemination has the highest chances for success. The sperm sample which we have received from the sperm bank is thawed out and injected into the uterus. We use ultrasound monitoring and an injection of hCG (pregnancy hormone) to assure the best timing. IUI is only slightly more uncomfortable than a pap smear.

Why choose donor insemination over other options? 

Donor insemination (TDI) is both cheaper and easier that the alternatives such as IVF and egg freezing.

Should I chose an anonymous or known donor?

 Any anonymous donor is the best choice. The FDA has very strict requirements for using donor sperm (and donor eggs). The process required to use sperm from a known donor can more difficult and more expensive than to order sperm samples from a bank where the semen has already been cleared.

How do I move forward with donor iui?

If you live in or near central New Jersey and would like to see us for your treatment, set up a consultation with the doctor. You can call us at 609-896-4984 or click here to start the process. At the time of the consultation, we will discuss how to get the process started and answer all of your questions about the process.

How do I choose a sperm bank?

All sperm banks in the US are accredited and inspected by the Food and Drug Administrations, and follow similar guidelines. We usually recommend California Cryobank and Fairfax Cryobank as they have the widest selection of donors due to their size.


What if I want a full biologic siblings for my child?

Successful donors are often retired to reduce the chances that a man and woman who find each other randomly will not turn out to be biological siblings. Once you are pregnant with a donor, we advise purchasing a number of vials for the next pregnancy in case the donor is retired. On occasion, a sperm donor will come out of retirement to help a couple have a biologic sibling.


Are there limits the number births for each donor?

Yes, for the reasons above.


Should I tell my child about how I got pregnant?

While of course the ultimate decision is yours, most psychologists and counselors who work in Reproductive Medicine recommend that you do tell your children. A counselor can help give you advice on the best way to do this.


Are there medical problems in children from donor sperm?

Children from donor inseminations are no less healthy than other children.

Dr Derman a top doctor again

Seth G Derman,MD, top doctor: Princeton IVF blog

Dr. Seth Derman listed as top doctor in Reproductive Medicine again for 2018

A top fertility doctor in New Jersey 2018 from Inside Jersey magazine

Our medical director at Princeton IVF and a Reproductive Endocrinologist at Delaware Valley OBGYN and Infertility, Lifeline Medical Associates, Dr. Seth Derman has been named one of Inside Jersey Magazine's Top 2219 Doctors for 2018.

The candidates for the top doctor list are vetted  by Castle Connolly, and nominated and selected by their peers for inclusion in this list.

Fertility treatment in Delaware

Delaware mandates fertility treatment: Princeton IVF blog
Delaware joins New Jersey and other states with IVF mandates

Delaware joins New Jersey in mandating IVF treatment

What does the Delaware law mandate?


How does this differ from the New Jersey IVF law?

The New Jersey Family Building Act was originally passed in 2001 and was recently amended. The NJ law differs in several ways:

  • The NJ law only covers 4 cycles

  • The Delaware mandate limits how long an insurance carrier to require patients to do IUI before their IVF coverage kicks in.

  • Only the Delaware law requires coverage for fertility preservation for cancer patients.

Want to find out if your insurance plan will cover fertility treatment?

Surrogacy is now legal in New Jersey

NJ surrogacy law passes: Princeton IVF blog

Gestational carrier agreements are now allowed in the state of New Jersey

What is gestational carrier IVF?

IVF, also know as the test tube baby procedure, is a treatment for infertility in which an egg is fertilized with the sperm outside of the body, and the embryo that results is implanted into the womb. With standard IVF, the embryo is implanted into the woman whose eggs were used, that is the intended mother. With a gestational carrier IVF, the embryos is implanted into another women who will carry the baby for her.

How does gestational carrier differ from surrogacy?

To most folks, gestational carrier and IVF are the same thing, but they are not. With traditional surrogacy, the surrogate is both both the biologic mother (since the eggs come from her) and the birth mother (since she will give birth to the baby). It was possible to this even before the invention of IVF. This is rarely done nowadays. With gestational carrier IVF, the intended mother is still the biologic mother, since her eggs are used, and the gestational carrier is the birth mother only.

Was using a gestational carrier illegal before?

Technically no, but in reality it was in New Jersey. There was a case called the Baby M many years ago in which a surrogate mother refused to hand the child over to the intended mother, even though she had a written agreement to do, and the baby’s biologic father was married to the intended mother. The NJ supreme court gave custody to the birth mother. Since that time, attorneys have advised their clients seeking to use a carrier to utilize a carrier who will give birth in another state, one in which the rights of intended parents to recognize these contracts are protected by law.

Why is the New Jersey Gestational Carrier Agreement Act such a big deal for fertility treatment in New Jersey?

The act allows binding legal contracts to be drawn up between intended parents and their gestational carrier. For the first time, couples in New Jersey can use a gestational carrier and do treatment near home knowing that they will actually be able to keep their own child.

What kind of stipulations are required for surrogacy contracts under the new law?

This is a not a substitute for the advise of an attorney who is knowledgeable in Reproductive Law, but here are a few the more important points:

  • Both parties must have legal representation

  • The carrier must be at least 21

  • Appropriate psychological counseling is required

  • If the intended mother is married or in a civil union, whether heterosexual or lesbian, their partner must be a party to the agreement

  • The gestational carrier is required to hand the baby over immediately upon birth, and the intended parents must accept the child as their own regardless of the baby’s medical condition.

  • The intended parents cover the gestational carrier’s medical costs associated with the pregnancy.

How do we get started?

If you need IVF and think you need to use a gestational carrier, the first thing to do is see a reproductive medicine physician. Many couples who think they need a carrier actually do not, so it is best speaking to a specialist at the outset. If you would like to come to our practice, click here to help set up an appointment.

Should we try Femara first?

letrozole-femara-fertility

For years clomiphene has been the main medication that fertility doctors and obgyns use to help women with polycystic ovarian syndrome and irregular cycles to get pregnant

That may be starting to change. In fertility practices such as ours, we have switched to a different drug, letrozole, also known by the brand name, Femara.

What is Letrozole?

Letrozole is a medication that blocks an enzyme in the body that converts testosterone into estrogen. It causes the estrogen levels to drop which lead to the pituitary gland to produce more of a hormone called FSH. FSH (follicle stimulating hormone) is the hormone the causes the eggs to start growing. By doing this, letrozole stimulates ovulation The most common use for letrozole is to help women with breast cancer reduce their risk of recurrence.

Why would you want to use letrozole instead of clomid?

Stimulation with letrozole results in fewer eggs than clomiphene, resulting in fewer multiple births. It is also less likely to cause the side effects of hot flashes and mood swings that are common with clomid.

So, what do the experts say about Femara?

The American College of Obstetrics and Gynecologists has endorsed letrozole as first line treatment for women with PCOS and infertility.

 

The mediterranean diet and fertility

Mediterranean diet and fertility: Princeton IVF blog
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As a fertility specialist, one of the most common questions I get is about diet, what can changes can I make in my diet to help me get pregnant?

For some patients, particularly those with PCOS that answer is relatively simple. It well know that a diet high in protein and low in carbohydrates helps women with polycystic ovaries to conceive. 

For other women with infertility, the answer is less clear.

A recent study from Greece, looked at women who self-reported at following a "mediterranean diet." Women on a Mediterranean diet had a higher pregnancy rate that those who did not.

Does this prove that a diet in low in animal fats and high in vegetables and fruit can help you get pregnant? No, but it does suggest a health diet low in carbs and red meats may help your chances of having a baby.

Acupuncture and Infertility

Acupuncture and IVF pregnancy rates: Princeton IVF blog
New study sheds doubt on whether acupuncture really helps IVF pregnancy rates

Lots of women seek out acupuncture to help them get pregnant, but does it really help?

Complementary and alternative medical treatments have become very popular for treating and preventing diseases, including the treatment of infertility. This may including vitamins and herbs and treatments such as acupuncture.

A number of researchers have found that acupuncture does improve fertility, at least in women who are undergoing IVF treatment, but some have not.

In order to figure out what it really going on, a group of doctors in Australia studies 824 women undergoing in vitro fertilization at their clinic. Half got real acupuncture (meaning the needles were placed in the right place according to acupuncture practice guidelines) and in the other half of patients, the needles were placed in locations that were not expected to have any effect. We call this last treatment "sham" acupuncture. They compared outcomes between the two groups.

They found out that women who had sham acupuncture were no more likely to get pregnant than those who had acupuncture done correctly. The pregnancy rates in these two groups were almost identical.

So what does this mean?

It is likely that acupuncture does not improve the chances for success with IVF, and if it does, the benefit is likely very small.

Were there any benefits to acupuncture in these women?

Yes. Women who received acupuncture were more relaxed and had a better sense of well being that those who had only sham acupuncture. This is not a small issue since IVF treatment is very stressful to the couples who are going through it.

Knowing this, should I still get acupuncture done?

Acupuncture is safe and comforting even if it may not be effective in IVF treatment. Other than the cost if it is not covered, there is really no risk to trying it.

Fewer complications in IVF pregnancies?

New research suggests IVF pregnancies could have lower rates of some complications

Surprisingly, some complications might actually be less common in pregnancies that result from assisted reproductive technology such as IVF

This seems to go against what fertility doctors, obgyns and midwives have been telling their patients for years, namely that women with IVF pregnancies are more likely than "regular" pregnancies to experience pregnancy complications.

What complications were actually less common in IVF pregnancies?

A group looking at IVF outcome data submitted through the Society for Assisted Reproductive Technology (SART) to the Centers for Disease Control (CDC) found that risk of perinatal mortality (the risk of stillbirth or newborn death) in very premature births was lower in women who conceived with IVF than those who did not. They found this to be true with both single births and multiple births (twins triplets, etc.) This informations was recently presented at the American College of Obstetricians and Gynecologists.

Does this mean getting pregnant with IVF is actually safer than getting pregnant on your own?

Probably not. Women who conceived with IVF were less likely to lose a premature baby than those who got pregnant on their own. We have no idea why this is the case. It could be due to more careful prenatal care with IVF pregnancies, or a higher socioeconomic level in couples doing IVF, rather that a results of what is actually going on with the pregnancy. 

Why is this surprising?

There are many studies show a higher rate of complications in pregnancies that result from assisted reproduction such as IVF, and some others that show no effect. It was surprising to find out from such as large database, that at least one serious complication was less common.