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  1. Tips for Coping with Infertility Over the Holidays

    Couples who are facing infertility may dread the inevitable questions from family and friends about when they will have a baby during the holiday season. There can also be the internal pressure of concealing grief from a failed pregnancy attempt. However, there are ways for coping with infertility and making the holidays enjoyable in spite of the difficulties of the infertility journey.

    Self-Care

    It is easy to become consumed with and overwhelmed by the process of preparing for and undergoing infertility treatment. As with any other stressful situation, it is important to make sure that you take care of you.

    Pursue other interests. Get involved in the hobbies that you enjoy or shift the focus from yourself by volunteering as a way to give back to your community, build confidence and reduce stress within yourself.

    Exercise and Relax.  Getting the body moving provides more than just physical benefits. Exercise relieves stress and boosts overall mood, while meditation and massage calm the mind and provide emotional healing and stress relief.

    Watch what you eat. The holidays offer many opportunities to overindulge. However, when trying to maintain health and keep stress at bay, it is important to limit refined sugars and saturated fats.

    Preparation

    Make social decisions ahead of time. Be choosy about what events you will attend. Allow yourself to say no to baby-focused activities. Speak to family and friends and remind them that you are going through a difficult time that you may or may not want to discuss.

    Be informed. In many instances it is uncertainty that creates stress. Ask questions of your doctor to understand as much of the process as possible about coping with infertility. Research options to help reduce the financial impact on your family. Research statistics to understand that you are not alone, and that other people are also suffering with infertility.

    Share your Feelings

    Infertility affects many aspects of your life and relationships. You may experience emotions of excitement, frustration, fear or all of the above. It can be extremely helpful to have a good support system with whom you can express your feelings. This may include family and friends, professional help or a support group such as Resolve: The National Infertility Association. Keeping a journal is another way to express your feelings even if you do not want to share them with anyone else.

    At Brown Fertility we have support groups and a therapist on staff to help deal with the emotional toll infertility takes not just during the holidays. “It is important to acknowledge your feelings and find support. Connecting with others who are experiencing similar challenges will reduce isolation and help you find genuine support from others who can relate. Also, speaking with a therapist who understands your fertility issues can be beneficial to your emotional health throughout your fertility journey”, states Thais Varzoni, Brown Fertility’s on-site therapist.

    We hope these tips for coping with infertility are helpful during the holiday season. Remember to participate in activities that bring you joy and meaning during the holiday season, as this is what makes the most wonderful time of the year special.

  2. Impact of Age and Ovarian Reserve On Pregnancy

    Women today are healthier and taking better care of themselves than ever before, but improved health later in life does not offset the natural age-related decline in fertility.  As age increases, a women’s ovarian reserve decreases. Resulting in reduced egg quantity, declined egg quality, and higher chances of abnormalities in their chromosomes (genetic material). All these factors together mean that older women have lower pregnancy rates and higher miscarriage rates.

    The Age Factor

    The ability to have a baby decreases in all women as they get older, but the exact age when a woman can no longer conceive varies. About one third of couples will have problems getting pregnant when the female partner is age 35 or older (ASRM). The chart below shows fertility declines significantly for a woman in her mid-30s and accelerates into her late 30s.

    Bloodwork Indicators

    There are several tests that can help show a woman’s fertility potential, also called ovarian reserve (ASRM). Physicians generally start with blood tests to evaluate hormone levels. The goal is to predict the status of a woman’s ovarian reserve, which tells the physician roughly how many eggs are remaining and gives an idea of how the woman’s fertility compares to other similarly aged women.

    Common tests include follicle-stimulating hormone (FSH), estradiol and anti-müllerian hormone (AMH).   FSH and estradiol are checked at the beginning of the menstrual cycle, usually done on cycle day 3, but can be drawn from day 1 to 5. These hormone levels show important information about how the ovaries and pituitary gland are working together. Usually FSH levels are the lowest in the beginning of the cycle and then increase causing follicle growth and allowing the egg to mature. If the FSH is too high, the egg does not mature properly which presents a less likely chance for pregnancy.

    AMH is the best test available for ovarian reserve and can be drawn at any time during the menstrual cycle. It is produced in the follicle and is related to the number of eggs remaining. The higher the number of eggs in the ovaries, the higher level of AMH in the bloodstream. A typical AMH level for a fertile woman is 1.0–4.0 ng/ml and AMH level under 1.0 ng/ml is considered low.

    It’s important to remember that no single test is conclusive of a woman’s ovarian reserve, but rather a comprehensive picture obtained by factoring in the woman’s age and appropriate testing.

    When to see a Reproductive Endocrinologist

    Infertility is usually diagnosed if no conception after one year of unprotected intercourse.  If you are 35 or older however, you should initiate your evaluation after 6 months of unprotected intercourse.  If you are concerned about fertility or have an obvious medical problem affecting your ability to conceive, such as irregular menstrual cycles (suggesting that you are not ovulating), diagnosed polycystic ovarian syndrome, sexual dysfunction, a history of pelvic disease, prior surgery, or, if your partner has a known fertility problem, you should begin the infertility evaluation immediately. At Brown Fertility, we welcome the opportunity to help grow your family.

  3. Oocyte Vitrification

    Oocyte Vitrification is one of the techniques used in preserving a woman’s fertility therefore allowing reproductive capacity to be postponed until the time is right. With the vitrification process, preserved oocytes have the same viability as they did at the time of freezing.

    The Procedure: 

    Vitrification of oocytes is a solidification process in which the oocytes are treated with cryoprotective substances and submerged in liquid nitrogen. (ASRM) The steps to prepare the patient’s body for retrieval are the same as a fresh cycle retrieval. First, we stimulate the female’s ovaries with hormones to aid in follicle production. Then, instead of fertilizing these eggs, they are vitrified and subsequently stored in liquid nitrogen.

    Vitrification V. Slow-Freezing:

    Recent studies suggest that vitrification is superior to and presents less risk to the embryo than the older “slow-freeze” method.

    Slow Freezing is the preservation process in which an egg is cooled very slowly, until it reaches the final storing temperature of -320º Fahrenheit. At this temperature all biological processes cease inside the cell, therefor allowing the egg to be safely preserved. In total, the entire process takes approximately two to three hours.

    In contrast, vitrification is a “flash freezing” method that cools cells so rapidly to -320 ºF that they become “glass-like” or “vitrified.” While the slow freezing technique takes hours, vitrification is finished in just minutes.

    This is important to the success of egg freezing because the longer the freezing process takes, the higher the chances that ice crystals will form inside the cell. The speed of vitrification allows for a higher concentration of cryoprotectants that decreases the risk of destructive ice crystals. Typically 97% of vitrified oocytes survive the process.

    Oocyte Vitrification Is Recommended For: 

    • Patients about to undergo treatment for cancer or another illness that may affect future fertility potential.Certain medical treatments such as radiation or chemotherapy can harm fertility. Vitrification allows these patients to conceive a biological child post-treatment.
    • Frozen Embryo Transfer with IVF.Frozen transfers are utilized for several reasons. For instance, some patients are unable to complete a fresh cycle due to an increased risk of hyper stimulation.
    • Preserving younger eggs now for future use. Since pregnancy rates are largely effected by the age of the female’s eggs, freezing them at a younger age may help preserve a woman’s ability to reproduce at a more desirable time

    Oocyte vitrification is recommended in numerous and very wide-ranging situations, but the common denominator is postponing fertilization of the oocytes and/or pregnancy. Our team at Brown Fertility is dedicated to educating our patients on all aspects of the fertility preservation process and will guide them in deciding which option fits their specific needs.

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“Throughout our journey to conceive, Dr. Brown became so much more than our reproductive endocrinologist. He became our therapist, problem-solver, cheerleader, and—most importantly—our friend.”Greg & Dana