Online Survey Finds Women Wait For Help

By Kathleen

An online survey conducted by Fertility Lifelines and Conceive Magazine was completed by 714 women. The survey found that the majority of women (64%) were waiting longer then recommended before seeking medical help about fertility issues. And even though 86% of women knew someone who experienced infertility most were surprised when they themselves had trouble getting pregnant. A significant number of women reported having emotional problems surrounding infertility including stress, depression, anger, and fear. The survey found women seek information from their medical provider, health magazines (50%), and the internet (78%). These issues along with tips for handling infertility are provided in a new free booklet entitled In The Know: What No One Tells You About Fertility. The booklet can be ordered at http://www.fertilitylifelines.com/ or by calling Fertility LifeLines(TM) at 1-866-LETS-TRY.

Hollywood Moms Highlight Infertility

It is refreshing when Hollywood is open and honest about infertility. The best known example of this is Brooke Shields who has become an advocate for women struggling with infertility. She went through numerous IVF cycles and a miscarriage and became increasingly frustrated. "Everyone around me was getting pregnant. I was starting to feel bitter," Shields said. "Maybe I really wasn't meant to have kids….I didn't want to be happy anymore for the many other people who were having kids. I knew that their blessing had nothing to do with me, but it felt like a slap in the face." She finally went on to conceive her daughter Rowan who was born in 2003. Shields was also very open about her struggle with post partum depression and wrote a well received book about her experience called Down Came the Rain.

Another well known actress, Courtney Cox, used IVF to conceive her daughter CoCo and suffered several miscarriages. Cox says that she will use IVF again in an attempt to conceive a sibling for her daughter. Cox is also considering adoption.

More recently, Desperate Housewives star Marcia Cross was so focused on starting a family that she apparently skipped honeymooning altogether to concentrate on fertility treatments. The 45-year-old actress had already been through infertility treatments and knew how difficult it would be to get pregnant at her age. After undergoing an IVF cycle, Marcia became pregnant with twins, Savanna and Eden, whom she gave birth to in February 2007. The star admits she regrets leaving it so late to become a mother. "It's costly and tough on your body and your relationship. I wish that I'd had my girls in my thirties. Then I could be around longer for them. But they're an incentive for me to stay healthy, take care of myself, and live as long as possible."

Infertility Calling: Do Cell Phones Affect Male Fertility?

By: David Karabinus, Ph.D., HCLD

Cell phones have become an inescapable part of our lives. An estimated 700 million are in use in the US and perhaps 2 billion in use worldwide. They are essentially small radio transmitters and receivers and, as such, expose users to radio frequency (RF) energy or electromagnetic frequency (EMF) radio waves. This is the same energy, at a much, much higher level, that cooks the food in a microwave oven. Every time a call comes in or goes out the cell phone either collects or emits the RF/EMF energy via its antenna.

Whether cell phones can affect male fertility has received much recent attention. Rats whose hind quarters were exposed for 30 minutes to RF energy for 30 minutes at about 25 times the level permitted for cell phones by the FCC exhibited an increase in the number of abnormally shaped sperm that were produced. Another study reported that rats exposed to cell phones for 6 hours daily for 18 weeks produced a higher proportion of dead sperm than unexposed rats. Although the sperm from the exposed rats were normally shaped, most of the sperm formed clumps. In another study, rats exposed to cell phones for one hour a day for 11 weeks exhibited no effects on their sperm. In humans, studies have shown decreased semen quality with increased cell phone use. Sperm exposed to a cell phone show reduced numbers of rapidly swimming sperm and increased numbers of non-swimming sperm. Men who had never used a cell phone produced more normally shaped sperm than those who had used cell phones more than 2 years. Another study showed men who used cell phones more than 4 hours per day produced lower amounts of live sperm, swimming (motile) sperm, and normally shaped sperm compared to those that did not use cell phones. This study also showed that the impact on these sperm traits increased as cell phone use increased from 0- to 2- to 4- to more than 4 hours per day.

The results of studies show that cell phone use can adversely affect the quality of sperm a man produces. The effects appear most pronounced with very high daily use. More study is needed to identify how these effects occur, or even if they are real and not a characteristic of men who spend much of their time on the cell phone. In the mean time, try to stay off the phone.

International Adoption: The Closing Window

After tripling over fifteen years, the number of adoptions by Americans of children from outside the United States has declined sharply. International adoption has never been easy. People who choose to build their families through international adoption have to go through an extensive process that often includes lengthy foreign travel, interactions with social workers and adoption agencies and complex government bureaucracies. The entire process can cost $30,000, or more. Language barriers, cultural differences and jurisdictional issues may compound the difficulties in the process. Waiting times to adopt may extend to years and countries sometimes choose to halt or delay adoptions even when they are in process. Newly tightened laws and regulations have now placed an estimated 5,000 international adoptions at risk of suspension in mid process.

The Hague Conference Convention on the Protection of Children and Co-operation in Respect to Intercountry Adoption is the primary cause of the new restrictions. This Convention, which was promulgated in the worthy effort to protect children and adoptive parents from possible abuses in the largely unregulated field of international adoptions, was signed by the United States in November 2007. The United States now has joined seventy other countries in an effort to regulate and standardize adoption practices across borders. Countries from which adoptions are originated must be part of the international regime. The formal effective date for US accession will be April 1, 2008.

The decline in visas for adoptions granted by the US government is evidence of the effect of the change. In response, China has established strict standards for adoptive parents which set an upward limit on age (50) and standards for education and parental body mass index, as well as eliminating adoptions by singles. Russia, which had suspended adoption agencies, has recently re-opened the field to agencies -- but long waiting lists now exist. Adoptions from Guatemala, which have surged in recent years, will be affected by the suspension of private adoption agencies and higher standards to control the fear of abuses resulting from the very low per capita income in that country.

Advocates for the convention believe that in the long run, these rules will benefit both children and prospective parents by ensuring higher standards for international adoption. In the meantime, those considering international adoption are faced with a more arduous and uncertain route and much to think about.

Surrogacy Fears Largely Unfounded

By Kathleen

Despite concerns regarding the impact surrogacy has on the well being of the family and resulting offspring, research has shown there is little to worry about. This small study involved 43 families who used surrogates and was conducted by the Family and Child Psychology Research Center at City University, London. The findings showed that parents of children born of surrogacy tended to have better parenting skills when compared to non-surrogate children. The babies also showed no difference in temperament or behavior from non-surrogate babies. A popular misconception is that the surrogates may have trouble turning the baby over to the mother who commissioned the surrogacy. The study found the vast majority of surrogates reported no problems. Ninety percent of the mothers reported to have a good relationship with the surrogate, and seventy percent kept in touch with her after the birth. This research should dismiss some of the misconceptions regarding surrogacy and be very reassuring to couples pursuing this reproductive option.

Personal Genomics Revolution: To Know, or Not to Know?

By Brian Mariani, Ph.D.

How much do you want to know about yourself? We think we know a lot already, the good and those things we need improvement on, but do you really want to know what you’re made of? I’m talking about our genetic “selves”, the information that we are born with (and have no say in choosing)- an almost equal component from each parent- combining to make us both similar to our family members, but unique at the same time.

The era of being able to take a “look” at our unique genetic selves is upon us. Today, nascent as the field is, you can place an order with one of a dozen genomic companies to have your genetic quilt-work stitched together and made available for your perusal using a secure website. Although not laid out as nicely as a quilt, you get a listing of “markers” from across your chromosomes that display the constellation of markers you have inherited.

These markers are in the neighborhood of your genes- the conveyers of your traits, looks, abilities, metabolism, and health & disease, among many other aspects of self. The databases used by these companies make what are called associations between the versions of your genes (usually 2 copies per gene: mom’s and dad’s) and those that have been studied and characterized in genetic association studies performed in the research realm.

What you get therefore is a prediction, however large or small, of how your genes might stack up to the rest of the population; some versions might be good, some might be not so good, and many will be neutral- meaning they’re just like everyone else’s. Do you want to know that you have good genes with respect to heart function or sugar metabolisms, if that means you also find out about your ApoE4 gene, linked to Alzheimer’s ? Your call.

This is where this blog entry could lurch on for pages, but I will leave you with only some basic facts. The price for these test’s can range from ~$600 to $1,250 depending on method and degree of analysis. No blood need be drawn; you can submit a self-collected cheek swab using a kit supplied by each company. Some medical history may be asked for, but probably not required. After several weeks, you will be given a secret pass code to view your results. The data files can be extensive, but most websites are designed for easy navigation and searchability, either by gene, trait, or disease. Data on your ancestry may be part of the package as well. Importantly, make sure before hand that a session with a genetic counselor is available and included in the price. Then, as with anything new in the rapidly evolving world of “information” technology, keep an open mind (or check your data to see if you have inherited this trait!).

In closing, please note that the concept of personalized genomics has raised heated debate inside and outside the medical genetics community. Many say that knowledge is power; that a sophisticated, self aware cliental is ready for this knowledge- these being individuals wanting to maximize their genetic potential, or take preemptive measures if necessary, or they’re just curious. Opponents argue that for many users, their personal genetic knowledge will only shade things toward the gray, or darker colors of the data, where appropriate perspective may not be kept or counseling sought. As with all new, breakthrough technology, this debate will only rage on as the field moves forward. And as with all pioneers, those in personal genomics field will claim that the drive for moving the science forward is in their genes.

For more information, take a look at the following companies that I’m familiar with; 23andMe, DeCODE, DNA Direct, GATC Biotech, Knome, Navigenes, and SeqWright, among others.

Caffeine Consumption and Risks of Miscarriage

By Stephen R. Lincoln, M.D.

Lately, the news media has highlighted a recent study suggesting caffeine consumption may increase a woman’s chance for miscarriage (American Journal of Obstetrics and Gynecology. Jan 2008). The study reviewed over 1000 women at about 10 weeks gestation about their exposure and amount of caffeine consumed. The study found a 42% increase in miscarriage in women drinking small to moderate amounts (200 mg or less) and a 123% increase for consumption over 200mg compared to women with no caffeine intake. Should patients immediately stop caffeine intake if planning to conceive?

When the article is reviewed carefully, it is found the group with greatest caffeine consumption was also significantly older than those who did not drink caffeine. Clearly advanced reproductive age is a risk factor for miscarriage and this factor may have complicated the findings.

It is always important to consider other recent studies carefully as well as looking back at what previous studies have shown. Another study recently published this year (Epidemiology. 2008;19:55 – 62) reviewed over 2000 women and failed to show any increase risk of miscarriage with up to 500 mg of caffeine a day, and this study received virtually no press. Older studies taken together have not shown a definitive conclusion and most likely moderate caffeine intake (less than 500 mg/day) poses no increased risk. However, high doses (over 500 mg/day) may indeed pose some risks.

Practical advise would be to limit intake to no more than 1 to 2 cups of coffee a day for a total of about 250 mg of caffeine or if possible stop altogether.

How much caffeine is in my drink? Generally speaking:
8 ounces brewed coffee – 130 mg
8 ounces brewed tea – 75 mg
8 ounces of cola – 40 mg

Check the label of products for precise information.