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  1. 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.

  2. 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.

  3. (VIDEO) – Q&A with Jacksonville Moms Blog

    Dr. Brown sat down with the Jacksonville Moms Blog to discuss our services, when to see a specialist, lifestyle habits that affect fertility,  your first appointment, testing and more. You can watch the informational session below:

     

    Join us for a FB Live with Dr. Samuel E. Brown of Brown Fertility for a Q&A on infertility and to learn more about the services they provide. Brown Fertility is a fully comprehensive fertility clinic offering patients exceptional results through personalized care and world-class treatment plans. With over 30 years’ experience, and the management of more than 5,000 IVF cycles, the providers at Brown Fertility consistently achieve success rates above the national average. From basic evaluation and testing to the most advanced procedures and treatments available, Brown Fertility is dedicated to Conceiving Miracles™.For more about Brown Fertility visit: https://www.brownfertility.com/about-us/our-providers/meet-dr-brown/

    Posted by Jacksonville Moms Blog on Monday, July 23, 2018

    To learn more information about our fertility services, register for a free upcoming New Patient IVF Seminar in Jacksonville or Orlando or contact our offices to schedule an appointment at (904) 260-0352.

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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