cancer

Could your fertility be a gauge of your health?

Infertility may mean health risks in the future

Research suggests that women with infertility may be at higher risk for health problems in the future

As a fertility specialist, I hear this all the time. I am healthy and take good care of myself, so there should be no reason I am not be getting pregnant. Naturally, we go on to discuss how one's fertility can be quite separate from your general health, as is quite often the case. Perhaps, though, that is not completely true.

A study out of the University of Pennsylvania and the National Cancer Institute followed women long term for health issues. 

They were mostly followed for cancer related issues, but were also asked about a history of infertility as a part of the study.

What they found though was interesting, including:

  • overall, women with a history of infertility had a 10% risk of dying over the 13 year study time
  • women with a history of infertility had a 20% increased risk of dying from cancer
  • women with a history of infertility had a 44% increased risk of dying from breast cancer
  • women with a history of infertility had a 70% increased risk of dying from diabetes, even though they were no more likely to have diabetes
  • uterine and ovarian cancer were no more common in women with a history of infertility

Does these mean the infertility causes poor health? Probably not, but it does mean that infertility could be sign of underlying health issues.

It means that women with a history of infertility, whether they were treated or not, whether they were successful or not, need to pay attention to their general health. 

 

 

Egg freezing- the controversy continues

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Egg freezing- Is it effective and is it a "fertility insurance?"

Several years back the American Society for Reproductive Medicine declared that the freezing and storage of unfertilized eggs (oocyte cryopreservation) was no longer experimental. Reproductive science specialists have worked out the kinks and figured how to freeze, thaw, fertilize and grow these eggs, and from them get healthy live born children. The initial focus was to help women who wanted to have children, but were facing cancer treatment (surgery, chemotherapy or radiation) that might render them sterile. The data on pregnancy rates was very sparse but it in comparison to the alternative in these women, moving forward was a no brainer.

Now researchers in in Canada, have published on the outcomes in couples based on US data. The pregnancy rates range from 4-12 %, and that is in young women under 30.  The rates are likely much lower in women in their 30s and 40s. While not great, it does offer some hope where there was none before. The problems is that now egg freezing is being used to delay childbearing in women for social reasons. With the announcement by google that they will pay for the procedure in their employees and the advent of "egg freezing parties," this is becoming more widespread.

As reproductive medicine specialists, we all want to offer our patients reproductive freedom, the ability to have children at a time that works out in their lives. Undoubtably, freezing and storing eggs for future use will enable some women to have children well into their 40's and early 50's. However, those who are unsuccessful with frozen eggs, and there will be many of them, will be left little choice other than using eggs from a donor, knowing that their biologic clock ran out while they had other priorities in life.

The problem is this: Is egg freezing an answer to a real problem? or is it giving women false hope? It may be a little of both. Only time will tell as the technology moves forward.