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  • The Word on Herbs

    We often have patients who present to us after having tried conventional and alternative treatments for infertility.  Some of the alternative treatments may have included herbs, and patients often want to know our opinion on continuing to use these.

    The docs at TFC recognize the potential benefit of combing ‘Western’ and ‘Eastern’ treatments, and we have multiple patients who undergo acupuncture during the course of their fertility treatments with us.  However, herbal supplements are more controversial.  First of all, there is no FDA regulation of herbal substances – meaning that there’s no proof that the amount and concentration of the substance in the bottle or box is correct.  Second of all, there is very little known about how ‘Western’ and ‘Eastern’ medications interact together.  We have actually had multiple patients with unusual responses to fertility treatment who didn’t realize that the ‘natural’ herbs they were on could potentially decrease the success of their fertility treatment.  Just because something is labeled ‘herbal’ or ‘natural’ does not mean that it is safe in all circumstances.

    As we learn more about how to combine therapies – and when there is more regulation of herbal and alternative supplements – we may be able to optimize fertility treatment by using both.  Until then, however, we would recommend abstaining from any ‘herbal’ or ‘natural’ supplement while undergoing a fertility treatment cycle with us. (Please feel free to talk to your nurse if you have any questions about a particular supplement.)

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    Natalie Burger, M.D.

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  • Peer Support Group

    Texas Fertility Center has initiated a peer support group that was developed to help couples and individuals trying to conceive cope with the struggles fertility treatments can often cause. The goal is to help patients find “friends” going through infertility treatments and give them an outlet to discuss their feelings with others who understand what they are going through. Infertility is a difficult process and one that many people don’t feel comfortable talking about. Many people feel like it is difficult to talk to others about infertility, especially if they haven’t been through it themselves.

    Not talking about infertility treatments can make the experience that much more painful and difficult. A survey conducted by Schering Plough (self) showed that 61% of patients hide the struggle of trying to get pregnant from their family and friends. More than half of the patients, in the survey, reported that it was easier to tell people that they didn’t intend to start their family rather than explain their fertility struggles.

    The purpose of our support group is to encourage people to help break the silence surrounding infertility. A study from Harvard Medical School in Boston shows that women who have difficulty getting pregnant can be as depressed as those with major heart problems and cancers (self). The support group will afford couples and individuals the opportunity to meet others experiencing similar struggles in trying to build their families.

    Speaking with patients, trying to conceive every day, and having dealt with infertility myself, has made me realize that patients need a group of people to talk with that understand what they are going through. I didn’t want to discuss my fertility with my mom or my best girlfriends because they have never experienced infertility and did not truly understand what I was going through. It is nice that we now have a group in place that gives people the chance to talk with others who can relate to them. Patients also don’t feel so isolated and like this is only affecting them and no one else.

    The other great thing about the support group is that there are nurses (myself and Kelli Long) present to help answer any clinical and IVF questions that may arise and also rule out many misconceptions associated with infertility treatments. Eventually we would like to have previous patients who have been successful come to speak at the end of the meetings to give patients legitimate hope for the future.

    Our hope is to give patients an outlet to be able to open up and share their feelings about infertility. We don’t want people to feel isolated in their endeavor to start a family. Our group gives patients an opportunity to meet others who are going through the same processes. We are very passionate about the support group and feel as though it allows patients to really understand that, unlike how they may feel in other offices, they are not just “a number” at our office. We share many of the same emotions with our patients as they are going through the process. We feel their pain and their joys right along with them. This is a way for our patients to see this first hand and to get to know us a little bit better as well.

    The Peer Support Group meets the third Wednesday of each month at the Jewish Community Center (7300 Hart Lane Austin, TX 78731 Room 226 in the Jewish Academy next to the Community Hall on the 2nd floor.) from 6:30-8:00 pm.

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    Jamie Leonard, RN

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  • Can Embryos Get Freezer Burn

    A question I hear rather frequently is “How long can embryos be frozen and still be okay?”  This topic usually arises when a couple is going through IVF and trying to envision a future with a child from a fresh cycle and “siblings” in cold storage.  The answer has always been “Well, we have someone who had a baby after 5 or 6 years being frozen,” because honestly, no one really knows the answer.  Theoretically, it could be indefinite because the embryos are maintained at a temperature where cellular function ceases.  Well, now I am taking care of a woman who moved from another city over 10 years ago.  While there, she had undergone preliminary treatment in preparation for IVF, so when she moved to Austin in 1999, we started a cycle right away.  She was in her 20’s with wonderful ovarian response and had 2 beautiful embryos to transfer fresh and several to cryopreserve.  She surprisingly did not conceive in her fresh cycle, and life got busy for her and her husband.  They recently returned for a frozen embryo cycle.  We repeated some of her evaluation and discovered that she had not had sufficient preparation for IVF all those years ago, so we corrected things in a short outpatient procedure before her frozen embryo transfer.  We thawed and transferred 2 embryos frozen over a decade ago, and the couple is pregnant with twins!  Now when someone asks the question about how long can embryos stay in the freezer, I can proudly say, “At least 10 years!”

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    Lisa Hansard, M.D.

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  • Getting to know us

    At Texas Fertility Center we believe it is very important for our patients to feel as though they are part of the TFC family.  We thought it would be a fun idea to get to know the TFC staff a little bit better. We just don’t want to be a face that you see at the office.   In order to introduce you to our family, we will be featuring different staff members each week and providing fun and interesting facts about them to enable our patients to “get to know” all of us a little bit better.

    This week, we will be featuring the lovely ladies of our Referrals Department, Cori and Diana. They work tirelessly to ensure our patients get as much of their treatment authorized and paid for by their insurance as allowable by their insurance carrier.  They try to stay up to date on current medication prices so that they are able to save our patients without insurance coverage as much money as possible.  They even will split medication orders between 2 or 3 different pharmacies to ensure that our patients get the most cost efficient purchase possible.  They are truly patient advocates and “fight” for each and every patient.

    Diana has been with TFC for almost one year.  She is an LA native and is new to Texas.  She loves to meet new people and is starting to adjust to life here in Texas.  She loves NOT camping and to say the least does not enjoy the outdoors too much.  She feels like she has become the person she used to make fun of, and pet parent is quite the understatement.  She has four ferrets and they are her babies.  She has an undying obsession with European Christmas Decorations and anything German.  Her true passion is cooking, especially while enjoying a glass of wine with her girlfriends and giggling over silly things. 

    Cori has been with TFC for almost three years.  She went to culinary school and loves to cook. Cori enjoys cooking for other people, but most things she will not try.  She does not enjoy condiments, cheese, tomatoes, onions, and the list goes on and on. She does not like it when her food touches.  Each item has to remain separate.  She has major food aversions and actually entered a study about it. She has a love for big dogs.  Currently her family has a Bernese Mountain dog, Hagrid, a Great Pyrenees, Albus, and a Saint Bernard, Guinness.  She enjoys a glass of red wine to relax and eventually wants to travel around the world.

    Stay tuned as we continue to feature different staff members and help you “get to know” us a little bit better.

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    Jamie Leonard, RN

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  • Here a test, there a test, everywhere a test test………

    So, you’ve come in for your first appointment and you walk away with a list of specific tests you are supposed to have done. You are trying to figure out what these tests will tell us and why you have to do them in the first place. The infertility process is not the same for every person who comes into the office. Each treatment plan is custom tailored to the specific needs of the patient and these tests help us determine the best course of treatment that will yield the most successful outcome for your particular set of challenges. Dependent on your specific situation, your physician’s recommendations may vary, but here are some very common tests that are done during the evaluation of infertility.

    The first one that comes to mind is the Hysterosalpingogram or HSG. This is a test that is done in an outpatient radiology center and it examines the inside of the uterus and the fallopian tubes using X Rays and a contrast material. This test enables the radiologist to take pictures of the contrast material (dye) as it passes through the uterus into the fallopian tubes. This test helps to determine if there is a problem with the uterus or tubes such as: tubal blockage, fluid in the tubes, abnormal shape/structure of the uterus, polyp, fibroids, scar tissue, etc. that could contribute to infertility.
     

    Cycle day 3 labs, which help evaluate your ovarian reserve – ie. how many eggs you have left – is another test that may be performed as a part of the initial evaluation. The way I like to explain this to my patients is that this test gives us a bird’s eye view of your ovarian reserve, it helps the physician choose the right course of treatment for you. Ovarian reserve gives us an indication of the quantity and quality of the eggs a woman has. We test both Estradiol and FSH hormones on cycle day 3 of full flow. Our physicians may also measure your ovaries or do a follicle count with an ultrasound, in the beginning of the cycle, to further help evaluate ovarian reserve.

    Semen Analysis is the principal test that evaluates male fertility. This test is vital, because it helps to evaluate the sperm count, motility, and morphology which can all help to identify if male factor is playing a role in the infertility the couple is experiencing. If the semen analysis results are abnormal, we may refer the male partner to a urologist for further evaluation.

    After your initial evaluation, your physician will discuss the results with you as well as their recommendations for next steps. There may be other tests needed, but these are the typical tests that most patients have done. These tests provide us with a wealth of information and allow us to get a better indication of your specific situation.

    I think that the initial infertility evaluation is critical in determining the best treatment course for you. At TFC you are not just a number who walks through the door; each patient has their own treatment plan that is custom tailored to their specific needs. You may feel like you have to do many tests, but remember each test helps us to get a clearer picture of what may be causing YOUR infertility to occur.

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    Jamie Leonard, RN

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  • New Tests Improve Hope for Healthy Babies

    Recently, I saw a new patient who wanted to be evaluated for difficulty in becoming pregnant. She told me that a close friend of hers had recently delivered a baby with a genetic disorder. The patient seeking our assistance was very worried about having a similar experience.

    It turns out that the patient’s friends (both the man and the woman) were carriers of a recessive gene that combined during fertilization. The combination of these two recessive genes resulted in the child developing the disease. Diseases that result from the combination of a recessive gene from each parent is referred to as an autosomal recessive disorder. Although neither the mother nor the father of the child had an abnormality, both were carriers of the recessive gene. In this situation, the baby from this couple had a 25% chance of developing the disease. If the child did not develop the disease, then the child had a 50% chance of being a carrier and a 25% chance of not being affected at all.

    It is estimated that every person may be a carrier of several recessive genes. If there has not been a child born in her family with an abnormality, the couple may have no knowledge of being a carrier of a recessive gene. Unfortunately, this may not be discovered until he couple has a child with a genetic disorder. It is preferable to test the man and the woman prior to conception to determine if they are carriers and avoid a genetic disorder, rather than test them after an affected child has been conceived.

    Today, there is available testing for the man and the woman for a DNA analysis with the ability to indentify over 100 recessive genes. Some of these have been recommended by the American College of Obstetricians and Gynecologists at their visit for preconception counseling. If it is discovered that the man and woman are carriers for the same disease, the couple can elect to undergo a cycle of in vitro fertilization (IVF) with pre-implantation genetic screening (PGS) and transfer unaffected embryos to avoid having a child with the genetic abnormality. Although a couple could elect to undergo insemination with donor sperm or to undergo a donor oocyte cycle, IVF with PGS is usually more desirable. All of these procedures allow the couple to avoid having a child with the genetic disorder that could have resulted from the combination of their recessive genes.

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    Thomas Vaughn, M.D.

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  • Demystifying the myths of infertility

    How many times have you heard, “Just relax and you’ll get pregnant, it’ll happen when you least expect it”? For many couples, these comments that are not meant to be hurtful can be the ones that hurt the most. Many people who have not struggled with infertility don’t truly understand the magnitude of the process which leads to common myths being passed on as truths. While relaxing can help everyone, stress is not a cause of infertility but it can definitely be a side effect. Reducing your stress may not increase your chances of conceiving, but it may make the situation seem a lot better.

     A big misconception is that people can get pregnant very easily.

    For me it seemed like everyone else around me was pregnant and yet I was unable to have a baby. Infertility affects 7.3 million people in the U.S. and 1 in every 8 couples have difficulty conceiving, so it is definitely not as easy as it seems.

    Talking to many patients, a common thing I hear is I’ve had a baby before, so I shouldn’t have a problem getting pregnant this time. Secondary infertility is a very common and over one million couples have difficulty conceiving a second child. There are many factors that can contribute to secondary infertility such as age (even if it has been only 1-2 years), scarring of uterus after birth, hormonal changes, irregular ovulation, or tubal disease.

    There is a common misconception that you can wait until you are in your 40’s to start trying to conceive.

    I think a lot of this stems from celebrities’ success stories of how their fertility treatments were successful. While it is not impossible to get pregnant later in life, it is well known that at age 35, fertility begins to decline more rapidly. Women are born with the maximum number of eggs they will ever have. As women age the quantity/quality of eggs decrease, yielding a higher chance of abnormal eggs which causes lower pregnancy rates and a higher risk of miscarriage.

    Many people believe that infertility is only a woman’s problem. Infertility is non selective and it affects men and women equally. A lot of times it can be a combination of both male and female factors that contribute to a couple having difficulty conceiving.

    It is very important to know that there are many myths associated with infertility. Infertility is a disease, but is one of the few curable diseases. Don’t believe everything that you hear and make sure to follow up with your fertility specialist with any questions you may have. You have the ability to preserve your fertility and be successful in creating the family you always dreamed of.

     

    For more information, please visit www.txfertility.com

     

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    Jamie Leonard, RN

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  • Is your biological clock ticking?

    You’ve been trying to get pregnant but have not been successful. Your mind is racing trying to figure out what to do and how to fix this. You remember as a young woman being on the birth control pill and you now realize how hard it is to get pregnant and wonder why that was necessary. 7.3 million Women in the U.S have experienced infertility and there is something you can do about it.
    Women have a hard time deciding who they should see when they are having difficulty conceiving. Many women will first go to their Obstetrician/Gynecologist (OB/GYN). This is usually the first point of contact, when dealing with women’s health issues. An OB/GYN cares for and treats the general population as well as a woman when she is pregnant. A Reproductive Endocrinologist, or Fertility Specialist, focuses exclusively on infertility. They work on evaluation, diagnosis, and treatment of all types of infertility. These specialists are best able to fully manage any fertility issues. For millions of women, the road to pregnancy can sometimes be difficult. This is why it is imperative to know when to see a Fertility Specialist and how they can help you.

    When should you make an appointment with your Fertility Specialist?

    If you are under 35 and have been unable to get pregnant after one year of unprotected intercourse or over 35 and have been unable to get pregnant after 6 months of unprotected intercourse.

    If you are told you need surgery and are trying to get pregnant. Fertility Specialists have been trained to preserve reproductive organs so it is very important to consult with them before having a surgery that could affect your potential future fertility.

    If you have a history of three or more miscarriages, because there are many tests that can be performed to try to figure out what is causing the miscarriages to occur.

    If you or your partner has a know risk factor such as a history of infectious disease, genital infections, pelvic inflammatory disease, or an anatomical factor such as undescended testicles for example.

    A semen analysis that is abnormal (for example low concentration, motility or morphology).

    If you and your partner have had basic testing done, but have still been unable to conceive.

    Most importantly is to follow your instincts. You know your body the best, and if you are continuously trying to get pregnant and month after month you have no success, that’s when you should see a Fertility specialist.

    Fertility Specialists can help piece the puzzle together to try to figure out why you are not conceiving and hopefully get you a successful outcome in the end.

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    Jamie Leonard, RN

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  • Are all Your Eggs in One Basket?

    We’ve gotten a few questions about egg development this week.

    Here are the questions, followed by the answers:

    1. How many eggs do I have?

    Women are born with all of the eggs (oocytes) that they will ever have. In fact, approximately 20 weeks before a female child is delivered, she has about 15-20 million eggs in her ovaries. Under normal conditions, this number falls to around 6-7 million by the time of birth and 300,000-500,000 around the onset of puberty. By age 40, the typical adult woman will only have approximately 10,000 eggs remaining in her ovaries.

    2. How many eggs normally develop each month?

    Contrary to popular belief, more than one egg develops during each menstrual cycle. The younger the woman, the more eggs develop, such that teenagers may well have over one hundred eggs start developing each cycle. Through a very complex process, most of these eggs die off before they mature, and only one egg actually achieves maturity and ovulates. It appears that the same number of eggs develop over time – regardless of whether a woman takes birth control pills, fertility medications, or nothing at all. In other words, just like birth control pills will not prolong a woman’s reproductive life and cause menopause to be delayed, there is no solid evidence that fertility medications will cause her to use up her eggs any faster and enter menopause any sooner.

    For more information on this subject, please check out the female fertility evaluation section of our website at http://www.txfertility.com/03female-infertility.php

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    Kaylen Silverberg, M.D.

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  • Texas Fertility Center Launches Blog

    Texas Fertility Center has Officially Launched their Blog. Visit www.texasfertilitycenter.com for all the latest news and information.

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    Texas Fertility Center

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