male fertility

Ready to give up after IVF? It's not time to give up.

Many couples with unsuccessful IVFs get pregnant on their own
Upto a third of couples who failed to get pregnant with IVF may get pregnant on their own.

IVF treatment can be incredibly stressful, even when it is successful. Imagine how difficult IVF can be when it is not? That is likely why so many couples give up after an unsuccessful IVF cycle.

According to reasearchers in the UK, almost a third of couples who are not successful at IVF and stop treatment will conceive on their own, although that might take up to 2 years.

Surprisingly, many of the couples who did conceive this way were not as thrilled as one might expect. Some couples have moved on in their life situations, and others were felt that maybe they never needed IVF in the first place.

Trying IUI before IVF

IUI-vs-IVF-treatment.jpg

A new study suggests a few months of IUI might work just as well.

No surprises here. We have been advising our patients to consider intrauterine insemination (IUI) as an alternative to IVF for years.

A recent study again confirms the that IUI is a reasonable approach to treating infertility. Researchers in New Zealand found that women who did IUI along with oral medications (clomiphene was used in this study) for 3 months has similar pregnancy rates to those who went straight to IVF on their first treatment cycle.

So, why would one to go straight to IVF? IVF offers several advantages over inseminations:

  • higher pregnancy rates
  • shorter time to conception
  • ability to genetically test the embryos before putting them back
  • elimination of most multiple births when only one embryo transferred
  • the ability to freeze left over embryos for future use 

IUI also has some significant  advantages:

  • much less expensive (about 1/5 of the cost)
  • much less invasive
  • fewer drugs, fewer injections
  • no need for anesthesia
  • less stressful
  • lower multiple birth rates when oral fertility drugs are used and multiple embryos are transferred with IVF

All couples have a different comfort level when it comes to fertility treatment. Like most medical treatments, fertility treatments involve balancing the effectiveness and risks of the various options. This is an important discussion to have with your doctor.

Your weight and your fertility

Your weight can affect your fertility: Princeton IVF blog
Being overweight can make it take longer to get pregnant in both men and women.

If either partner is overweight, it can harm your fertility

It has been know for for years that women who are overweight have a lower chance for success for IVF, and most fertility specialists encourage their patients who are overweight, to lose weight if possible, before treatment. So, the next logical questions is this: Does being overweight affect your chances of getting pregnant on your own even if you do not have infertility?

A study by National Institutes of Health (NIH) addressed that particular issue. The study was called the Longitudinal Investigation of Fertility and the Environment (LIFE) Study and they looked at couples who were both normal and with various degrees of being overweight to see how long it took them to conceive, commonly referred to as TTC. They looked about 500 couples from Texas and Michigan  and broke them down into 4 groups, normal weight (BMI 18-25), overweight (BMI 25-25), class I (BMI 30-34.9) and class II (BMI 35 and higher).  

The researchers found that in couples with class II obesity ( BMI > 35), it took 55% more time to conceive, than in normal weight couples.

It means that being significantly overweight not only affects your chances for pregnancy with fertility treatments such as IVF, it also makes it more difficult to conceive on your own.

Veterans and Fertility Care

veterans-VA-IVF-fertility.jpg

US Congress considers improving veterans access to reproductive health care

After faithfully serving our country in Iraq and Afghanistan, many of the brave men and women of our armed forces return home with injuries. While the more devastating injuries such as head injuries, missing limbs and PTSD, make all the headlines, there are other battle scars that remain unspoken. One of those is infertility.

Serving our nation can have an adverse effect on couple's ability to start or grow a family, whether it be from the direct trauma of battle or the inevitable delays that come from prolonged deployments. Appropriately, the Defense Department recognizes the importance of this for our fighting men and women and provides at least some fertility coverage for active service personnel.

The same is not true for our veterans. In fact, federal law prohibits covering these treatments through the VA system. On several occasions, Senator Patty Murray (D-Washington) has introduced bills to address this issue without success. Now, there is also movement on the other side of the aisle. Just this past week, Representative Jeff Miller (R-Florida), Chairman of the House Committe on Veterans Affairs has introduced a bill to correct this inequity. His bill HR 2257, if passed and signed into law, will allow veterans to treat fertility issues that arose during their service even after they leave the armed forces. Hopefully, this legislation will make it through the congress and on to the President's desk.

 

Abnormal sperm and healthy babies

The advent of ICSI (intracytoplasmic sperm injection) two decades ago has enabled men with very low sperm counts to father children through IVF.  Prior to this, as fertility specialists, we could offer these couples only donor sperm. Despite this "miracle" of modern medicine, one of the lingering concerns was as to whether using sperm from men with very low counts might lead to a more birth defects. Adding to this concern, were some studies suggesting that ICSI or even regular IVF might result in a higher than normal rate of abnormalities. Some good news, however.  A recent study from the NIH suggests that this is not a concern. The researchers found that  couples who conceived with very low sperm counts did not have children with more birth defects.