Not being able to conceive a baby can be one of the most difficult and stressful things a couple may ever have to face. However, science continues to make great advances in treating infertility. Older women who had a very slim chance of getting pregnant before now have scientific advancements on their side.

For example, one of the latest celebrities to announce her pregnancy with the help of infertility treatments is Celine Dion. She announced that she is pregnant with twins after years of trying to expand her family. Her pregnancy is the result of her sixth in vitro fertilization (IVF) attempt. At 42, she should be a model of hope for those who have come to rely on infertility treatments as they become older.

Also, it is interesting to note that Celine Dion used acupuncture techniques to bolster her pregnancy chances. Combining different treatment options can be successful, which is why RHS encourages a holistic approach to infertility treatment.

Learning as much as possible about different treatment options can bring a sense of hope and empowerment to people struggling with infertility:

Ovulation Induction (OI) – where fertility drugs are given to a woman in order to regulate, stimulate or increase ovulation. They typically work to stimulate or mimic two hormones responsible for ovulation: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). 

Artificial Insemination – is a process in which the sperm is placed inside the uterus through medical intervention instead of sexual intercourse. Doctors can treat the sperm in a laboratory setting before placing it inside the uterus, increasing the chances of the sperm successfully fertilizing the egg.

In Vitro Fertilization (IVF) – is a method that fertilizes an egg in a laboratory setting and then places it inside a woman’s uterus. This can be done with either donor sperm or eggs or with sperm and eggs from the infertile couple, depending upon the specific cause or causes of infertility. IVF is typically suggested when a woman’s fallopian tubes are blocked, but is also recommended in cases like unexplained infertility, cervical problems, male infertility and certain ovulation disorders.

Lifestyle changes – if medical intervention is not desired, simple lifestyle changes may also be done to treat infertility. Increasing the frequency of intercourse, eating a healthier diet and getting regular exercise are all things that may increase the chances of conception. In addition, appropriately timing sexual intercourse by tracking ovulation can increase the odds of pregnancy.

Other helpful changes for stress reduction include acupuncture and yoga.

Sleep might be a fairly important factor to consider when trying to conceive. Not getting enough of it can throw your body out of whack enough to make conception more difficult.

The physicians here at RHS encourage their patients to try to get plenty of rest. They understand that procedures like in vitro fertilization (IVF) can cause a considerate amount of stress that might have an effect on a woman’s ability to conceive. When you are trying to conceive, the excitement about getting pregnant – or the worry that you won’t – can certainly keep you tossing and turning all night!

Getting a good night’s sleep helps to keep your circadian rhythm running smooth. Your circadian rhythm is your internal clock, the one that helps to control every system in your body. The rhythm also helps to determine when you ovulate. If your body lacks sleep, it wants to protect itself, so it boosts the immune system and performs other activities that take its attention away from conceiving.

While it’s not clear exactly how much sleep deprivation might compromise fertility, it is apparent that chronic stress and obesity can lower a woman’s chances of getting pregnant. These conditions can all be made worse by sleep loss. 

What can you do to improve your sleep and your odds of conceiving?

·        Put yourself on a regular sleep schedule – go to bed and get up at the same time every day. Also, establishing a nightly routine before bed will help you relax and clear your mind.

·        Get moving – moderate exercise will reduce stress.  Working out makes falling and staying asleep easier. If you have trouble sleeping, avoid evening workouts.

·        Lose weight if your BMI (Body Mass Index) is >35 – being overweight can have a direct effect on your quality of sleep. It can lower your chances of pregnancy; not to mention other serious health problems, including heart disease, stroke and diabetes. 

In regards to sleep and conception, one thing is for certain: a good night’s sleep will not hurt your odds, it just might help. 

How will the New Health Care Bill affect coverage for Infertility treatments?

In terms of covering infertility treatments or in-vitro fertilization, none of that is made mandatory under the new bill for insurance companies.  In other words, there is no change.  However, one benefit is that insurance companies cannot deny coverage to couples who suffer from infertility because it was deemed a pre-existing condition. 

The Right Amount of Exercise

Too little exercise isn’t good for your health, but women have long been told that too much isn’t good for their fertility. Just how much exercise is the right amount in order to conceive?

Research suggests that moderate exercise can boost some women’s chances of getting and staying pregnant. Exercise can lessen the likelihood of high blood pressure and glucose metabolism problems that often interfere with fertility. Exercise can also make it less likely that complications such as preeclampsia and musculoskeletal aches and pains will occur during pregnancy.

How Exercise Can Help

Diabetes rates are rising at an alarming pace and women who have diabetes can experience problems getting or staying pregnant. Gestational diabetes mellitus (GDM) is the single most common medical complication of pregnancy. Moderate aerobic exercise, such as brisk walking, could be one of the most effective means of prevention. There is scientific evidence that exercise’s positive effect on body weight, body chemistry, and insulin resistance lowers diabetes risk. 

Exercise is now part of more and more physicians’ prescriptions for those suffering from high blood pressure. It has also been proven that moderate exercise can help women suffering from endometriosis. Being physically active can be a powerful antidote to physical and emotional pain. There is no question that exercise benefits a woman’s overall health.

The time to start working out, wherever you are in your baby-planning agenda, is now. The desire to conceive and have a healthy child should be the perfect motivation to start a healthier lifestyle!

Diet and Fertility

Maintaining a proper diet is essential when trying to conceive. Meals should be healthy and balanced, containing foods from every food group.

Organic foods, whole wheat, fruits and vegetables all help increase a woman’s chance of becoming pregnant. Protein sources, such as meat and poultry, help maintain healthy levels of iron. Low iron levels at the onset of pregnancy increase the risk of developing postpartum anemia. 

Calcium is another positive factor in boosting fertility. Dairy foods, such as milk, yogurt and cheese are good sources of calcium.  Fat-free dairy products contain the same amount of calcium as whole milk products, but have significantly fewer calories and lower levels of saturated fat. Broccoli, kale and oranges are all high in calcium. 

When choosing fruits and veggies, the brighter the color, the more nutrients the food contains. Peas, broccoli and pumpkin are excellent sources of fiber and vitamins.  Blueberries and red peppers are a good source of antioxidants. Eating foods with folic acid is also very important during pregnancy.  Oranges and lemons are excellent food sources of folic acid.

For more information and tips, please refer to our Healthy Lifestyle section on the website.

Donor Egg

Sometimes fertility issues make it impossible to achieve pregnancy without the help of an egg donor. As a result of a variety of medical conditions, a woman/couple may seek an egg donor to allow the birth of a child through in vitro fertilization (IVF).  

An egg donor can either be anonymous or a directed/known donor to the recipient patient. If a directed or known donor is selected, a legal agreement between the recipient and egg donor is required. If an anonymous egg donor is being used, no legal contract is required. The anonymous donor is required to sign a consent which includes a waiver and release, forever relinquishing any rights to any child or children born.

Our donors at RHS are between the ages of 21 and 32 and are recruited from the Western PA and Pittsburgh areas. All donors are screened for substance abuse and communicable diseases such as HIV and hepatitis. A complete medical/genetic history is obtained to gather information about the donor’s personal and family health history. Also, a written psychological evaluation, along with multiple counseling sessions, helps us to determine if an individual is an appropriate egg donor. Egg donors are screened according to FDA requirements for eligibility.

RHS strives to meet the varied needs and desires of our intended parents. The coordinators put a significant amount of time and effort into finding what we feel makes a close match. Once egg donors become available, the recipient will be notified and profiles will be sent for review. The recipient patient will have approximately two weeks to confirm.

Once the egg donor had been chosen, the intended parent(s) will begin planning the IVF cycle with a nurse coordinator.

Donor Sperm

Many couples experiencing male factor infertility may choose to undergo donor insemination (DI) in order to achieve pregnancy. During DI, the physician or nurse places donor sperm into the female’s reproductive tract near the time of ovulation. Donor insemination has become one of the most effective methods for couples with severe male factor infertility to experience pregnancy and childbirth. Patients may also choose this treatment in the absence of a male partner.

In order to decide whether to undergo donor insemination, couples need to know the cause(s) of infertility. At RHS, patients who are interested in DI undergo a thorough evaluation prior to initiating treatment. Donor insemination may be indicated if there are significantly abnormal semen characteristics and if the female appears to be fertile after a series of tests.

All sperm must be frozen and stored until adequately screened. The American Society for Reproductive Medicine (ASRM) recommends that all sperm be frozen for at least six months prior to insemination. Here are some donor sperm cryobanks that have been approved by RHS:

            California Cryobank, Inc.

            11915 La Grange Avenue

            Los Angeles, CA  90025

            (800) 977-3761

            Fairfax Cryobank

            3015 Williams Drive,    Suite 110

            Fairfax, VA  22031

            (800) 338-8407          

            Cryobiology, Inc. Sperm Bank

            4830-D Knightsbridge Blvd.

            Columbus, OH  43214

            (800) 359-4375

Don’t panic! The financial counselors at RHS are always here to provide you with information and options for financing your infertility journey. 

Yes, treating infertility can be costly. RHS does participate with several insurance plans, but infertility is often excluded from health insurance coverage. Because we know that your finances should be the least of your worries, and since we require pre-payment for all services, we meet with each couple individually to determine their best financial route right from the start. We determine what level of insurance coverage exists, and if no coverage exists, these couples are considered “self-payers.”     

For self-payers, two popular options are available at RHS beyond the traditional out-of-pocket payment (cash, check, credit card): 

1. Discounted Loan

RHS has streamlined the loan process to make IVF an affordable option. We partner with Dollar Bank to offer our patients a significant discount on loans.

1. Cost Sharing

IVF Cost Sharing is an innovative program offered by RHS which allows eligible patients to reduce out-of-pocket costs by purchasing a series of three IVF sessions in advance.

By purchasing three cycles at one time, patients pay less than they would for three individual cycles at the traditional fee-for-service rate. Please contact any RHS financial counselor to obtain the current costs for the IVF Cost Sharing Program.

RHS is always open to discussing payment options with concerned IVF candidates. If you would like any additional information on the payment options mentioned or would like to request an appointment with one of our financial counselors, please call us at 412-731-8000 or 800-318-3144.

As we all know we had an incredible snowstorm this past week. We got hit with about 18 inches in less than 12 hours.  Because RHS sees patients 7 days a week (every day but Christmas day and New Years Day) patients were scheduled for Saturday morning.  What a nightmare!  Dr. Kubik, who was on call over the weekend, got a call at 5:30 from Bernadette our embryologist, the one person who is in fact more critical than the physician, because she is the one that has to prepare the embryos for transfer.  Trees were down, roads were blocked and there was no way for her to get to RHS.  Electricity was out for the other embryologist so there was no way to get in contact with her.  Back up plans were immediately made.  Our weekend receptionist is none other than Dr. Kubik’s soon to be 80-year-old mom, Norma.  Dr. Kubik called her at 6 am (no answer) - because she was on her way to the office!! Her roads were snowy but plowed.  Everything was plowed EXCEPT the road leading to our office and our parking lot.  Undaunted, Norma drives her car (a Jeep) up the unplowed road, parks about 50 feet from the door, uses (according to her) a handbag on either side for balance, trudges through the 18 inches of snow, hauls the back door open, makes a pot of coffee and gets to work.   Of the 8 people scheduled to work, 5 people made it so a big thanks to each of them.

By the time everyone was ready to leave (and after some calls to our landlord about plowing the parking lot), the snowplows had arrived.  Thank goodness, because in the meantime, we got 3 more inches of snow and the plows had to dig each of the staff out one by one.

We had one patient that actually made it into the office, what a trooper! The embryologist did end up making it in to tend to the embryos and RHS was back to a normal routine by Sunday morning.

Everyone made it home safe and sound.

Ahhh, Valentine’s Day.  It’s considered the most romantic day of the year, but if you and your significant other are dealing with infertility, it may be harder to get in the mood.  Let cupid’s arrow strike and turn this Valentine’s Day into a day of hope, health and happiness.

Here are a few suggestions for you and your loved one on Valentine’s Day (or any other day for that matter) on ways to keep your relationship healthy:

1.      Schedule a non-fertility date.  On this date, neither of you are allowed to talk about children, infertility, medical treatments or anything to do with what you’re going through.  Consider going to dinner and a movie; or, cook a dinner for two and decorate the room with heart-shaped candles.

2.      Bring spontaneity back into sex.  What about making reservations at a hotel for this Valentine’s Day? But remember not to discuss fertility before, during or after!  The key to this is to make it so spontaneous and fun that you banish the work that sex has become.  A simple “I Love You” with a kiss can set the mood.

3.      Communicate the positive.  Try putting limits on the time you talk about infertility so that it does not overtake all of your communication.  Reassure your partner that you are both in it together.  Tell your loved one how you feel about them and why you want to have a child together.

4.      Keep a sense of humor.  No matter how tough things get, being able to find something humorous about the situation helps to relieve tension.  Laughing together is good for the health of your relationship. 

5.      Consider getting professional insight.  Even if you think your relationship will weather the infertility storm, it’s still a good idea to consider talking to a couples therapist or joining a support group for people going through infertility treatments. 

For more information:

·         RESOLVE – www.resolve.org

·         American Society for Reproductive Medicine - www.asrm.org

During your twenties:

From a strictly biological perspective, your twenties are the best ten years for conceiving and carrying a baby. The chances of having a miscarriage or your child having birth defects like Down’s syndrome are low. Twenty-somethings also have a lower risk of health complications, high blood pressure and diabetes. RHS Medical Director Dr. Judith Albert has found that the difference between early and late twenties is negligible.  

During your thirties:

The happy medium for motherhood: parents are apt to be more financially secure and have plenty of stamina and resilience - qualities that come in handy for parenting young children. In your early thirties, the chances of getting pregnant are only slightly lower than in your twenties.  After 35, miscarriage rates and pregnancy complications rise slowly. At 35, a woman needs to think critically about whether or not she wants to have children, especially more than one.

Forty or older:

Now you are presumably more financially secure and able to provide a solid foundation for raising a family.  However, it is harder to get pregnant because your number of eggs has declined and pregnancy complications are twice as high. But on the positive side, there’s no better time in history to try to get pregnant as an older women, given the range of new assisted reproductive technologies and the recent success of using donor eggs. 

No matter what your age, here are a few things a woman should do before trying to get pregnant:

• Stop smoking
• Limit your caffeine and alcohol consumption
• Eat healthy and exercise (your Body Mass Index, or BMI, should be in the 20-30% range)
• Make efforts to reduce stress in your life

 This Seedlings blog post is written by Reproductive Health Specialists’ newest employee, Jane Plasman. Look for more from Jane in future blog posts!

 As a new employee at RHS, I am excited about making New Year’s resolutions - and actually keeping them this year. What better time than now to reflect back on the positive achievements of 2009 and to set new goals for 2010 at a new job! I’m excited to achieve a sense of accomplishment by setting, reaching and maintaining my goals - hopefully I can get you excited too.  

After working at RHS for just a short amount of time, realizing the importance of a healthy lifestyle has really energized me to get healthy myself. That includes not only being physically fit, but also having a positive outlook on life. So, I have made three resolutions for this year: to eat healthy, exercise and reduce stress - things that every woman wants to accomplish. For proper nutrition, I plan to keep a food journal to be aware of what I am putting into my body. For exercise, I plan to exercise in the morning instead of making a hundred excuses at night about why I’m too tired. (My ironing has been removed from my treadmill!) And for stress reduction, I plan to give myself “me time” each day (even if it is only five minutes) to do something I enjoy.

As I set my own goals, I see patients struggle with the daily stress of infertility and hear the physicians at RHS speak of nutrition, weight loss and the negative impact of stress. The women at RHS understand the daily stresses of a woman and are always reaching out to patients with information on ways to get healthy: mentally, physically and emotionally.

Learning the ropes at RHS, I’ve noticed that our website is also an excellent resource for any woman’s New Year’s resolutions. Here are a few helpful links:

• Nutrition Basics
• Nutrition/Exercise Resources
• Healthy Lifestyle Tips
• Relaxation Tips
• RHS’ “Balance Within” Philosophy

In years past, two weeks into January my resolutions have been buried deep in the snow, but I vow to make a conscious effort this year. So come on - list your resolutions in the Comments box and let’s set, reach and maintain our goals together…WE can do it.