ASRM Video Understanding Fertility

Posted on March 19, 2014 by admin

The American Society for Reproductive Medicine has an introduction video about understanding fertility in various aspects. This is a great place to start for anyone who is considering using donor sperm or having trouble conceiving.

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Donor Sperm for Couples experiencing Male Infertility

Posted on March 10, 2014 by admin

Blog written by CLI Laboratory Director, Michelle Ottey, PhD.

The CDC website lists data from a 2002 National Survey of Family Growth. They found that 7.5% of sexually experienced men under the age of 45 have visited a fertility doctor. These men visited a fertility doctor, presumably, due to an inability to conceive. Eighteen percent were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%). A varicocele is a condition that causes a man’s testicular veins to be enlarged, which leads to the testes overheating. When this occurs sperm morphology (shape) and motility can be affected.

Male infertility is not often discussed, and can be a challenging emotional hurdle to a couple who is trying to start or add to their family. Male infertility is caused by numerous factors such as medical conditions, medications, lifestyle choices involving alcohol, drug use, smoking, and environment. All of these factors can lead to low sperm counts, poor motility, and below average morphology scores.

If a couple is having trouble conceiving, a semen analysis is the easiest method used to test fertility. The male partner will produce a semen specimen via self-masturbation and that specimen will be analyzed for count, motility, grade, morphology, and overall appearance. It is recommended that a minimum of two semen analyses be completed before drawing any conclusions about overall fertility or additional testing. The following is a chart representing the World Health Organization’s Standards for semen parameters.

Semen Parameter WHO 2010 Standard
Liquefaction 20-60 minutes the coagulated semen should liquefy
General Appearance The color and viscosity will be observed: the semen should not be red or pink which would indicate the presence of red blood cells
Volume The volume or amount of semen should be 1.5 mL or more
pH 7.2 or lower is considered normal
Count Greater than 40 million cells/mL
Motility Is presented as a percent; you will see a simple motility which should be 50% or greater
Vitality If a sample has a low motility, a viability stain should be done to determine if the sperm are dead or only immotile.

If the male partner’s specimen cannot be used to achieve pregnancy, the couple has the option of working with a sperm bank to purchase donor sperm for insemination. Couples are able to search through the available donors on the sperm bank’s donor search to identify the perfect donor match for them. They can look for donors with similar ethnic origins to the male partner, similar physical features, etc. There are hundreds of sperm donors available through commercial sperm banks which allows for a diverse group of couples the ability to find a good match.

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Improving the Odds When TTC

Posted on March 4, 2014 by admin

Blog written by Cryobank Staff JM

So you’re ready to try to conceive. Perhaps you’re in the right place in your career, in your relationship, in your life to start building a family, or maybe you’re ready for a new addition to the family you already have.

Have you thought about improving your chances for conceiving and for a healthy pregnancy?

Having a pre-conception consultation with your doctor is a great place to start! There are so many questions and considerations. Here are a few examples:

• Should you lose a few pounds?

• Have you been taking prenatal vitamins or folic acid supplements?

• Should you chart your basal body temperature and cervical mucus?

• Do you have any health issues that could make TTC difficult?

• Should you have pre-conception testing to determine if you’re a carrier of any genetic disorders you could pass along to a baby?

Is a pre-conception consultation necessary or required? Of course not. But it can be a really helpful tool when you’re TTC. Think of it as a way to open the lines of communication with your doctor. You may learn something you didn’t know.

For instance, did you know that taking folic acid supplements prior to conception (usually in the form of pre-natal vitamins) is one of the most important things you can do to prevent certain birth defects, like Spina Bifida and other neural tube defects. In fact, many doctors recommend starting folic acid supplements at least 3 months before TTC.

CLI Blog smallSo why not improve the odds? Have a pre-conception consultation before you start TTC!

 

 

 

 

 

 

 

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Infertility Insurance Coverage

Posted on February 25, 2014 by admin

An interesting article for those who are dealing with infertility issues was published in the Salt Lake Tribune today.  The news story is following a proposed bill that would introduce infertility coverage to insurance plans in Utah.

The article “Bill would allow insurance for infertility treatments” discusses how it would be financially beneficial in covering some of the costs associated with infertility. There appears to controversy about the proposed bill and its limitations in who would be allowed this coverage option.

The American Society for Reproductive Health has great links to “Headlines in Reproductive Health.” This is a great resource for anyone looking for the most up to date news about infertily topics.

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What Sort of Guy Donates Sperm?

Posted on February 19, 2014 by admin

Blog written by Laboratory Staff JM

Sperm donors. We can generally say they’re attractive, educated, healthy men. Some are taller than others, differences in hair and eye colors abound, not to mention ancestry! I’m just scratching the surface here on all the physical characteristics. But I’d like to talk about what’s behind the handsome face. What sort of guy donates sperm?

Being in the laboratory, we see the donors in our program frequently, and we get to know them pretty well. 　Overall, they are a nice group of fellas. 　Typically, they ask how your day is going, and they enjoy sharing exciting news or happenings in their lives as well.

Some of the donors are quite talented artistically or musically. One donor went on a concert tour in Europe, as the main act! Another is a gifted author.

Some of the donors enjoy giving back to their communities, and have chosen careers as teachers, physicians, police officers, and firefighters. Some have even served our country in the military.

Academically, some of the donors in our program are brilliant! Some study abroad, some have earned scholarships and awards based on merit. Some speak many languages.

Others are athletically gifted; track stars, swimmers, and baseball players, to name a few.

These young men lead full, active lives, while taking the time to also contribute as sperm donors. Many of them enjoy knowing what a wonderful contribution they have made, in helping people build families.

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Embryo Implantation

Posted on February 10, 2014 by admin

A great article from Live Science briefly explains some new research that may answer some questions about why certain embryos do not implant during IVF procedures.

The article Fate of a Fertilized Egg: Why Some Embryos Don’t Implant talks about having the proper levels of trypsin for preparing the body for implantation of the embyro. This finding may allow for future improvements in IVF procedures.

The American Society for Reproductive Health has great links to “Headlines in Reproductive Health.” This is a great resource for anyone looking for the most up to date news about infertily topics.

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Plan, Prep, Important Steps: Being Recognized As the Parent – For Lesbian Couples

Posted on February 5, 2014 by admin

Blog written by Cryobank Staff JM

One of my friends, I’ll call her Jane, is expecting her first child, due this spring.  It’s wonderful to witness the joy on her face, and to see how excited her wife is!  They have been planning and preparing for each moment in this amazing journey for a very long time.  It hasn’t always been easy, but they are finally in the home stretch – Baby Boy will be here in just a few short weeks!

A little about their journey:

First, they decided it was time to build their family.  They reviewed dozens of donor profiles from a few different cryobanks before they found one that was their perfect match.

Then, Jane’s wife tried to conceive via donor insemination.  After a few failed attempts, they decided that Jane would try next.

Well, Jane had her first insemination, and got her BFP 3 weeks later!  Lucky on the first try!  They were thrilled, but refrained from making an announcement to friends and family until 13 weeks.

Fast-forward to seven months along…The nursery is painted, furnished, and decorated in the most adorable airplane theme ever.  Family and friends have showered the Mommies-to-Be with oodles of baby gifts – clothes, toys, diapers.  Jane and her wife are attending natural childbirth classes and have chosen a name.

Then, they realized that they had overlooked a really important step.  Ensuring that Jane’s wife has parenting rights!  Depending on what state you live in, this can be a complicated and costly process.

I’m happy to report that they have found a wonderful attorney who specializes in Family Law and LBGTQ issues, and are working on second parent adoption.

A message from Jane to anyone in a LBGT marriage who is planning a family:  “Find out what options are available to you in your state.  Ask if your child is protected if you move to another state.  Get informed and don’t overlook this critical step in the process of building your family!”

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Conceiving Naturally

Posted on January 27, 2014 by admin

From the American Society for Reproductive Medicine (ASRM) fact sheet on Optimizing Natural Fertility.

What can I do to improve my chances of conceiving naturally?

Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition, she should seek advice from a medical professional before conceiving (becoming pregnant).

What are my chances of conceiving?

There is no simple answer. For women with regular menstrual cycles, your age and number of months that you have been trying to get pregnant are two factors that affect your chance of success. You and your partner have the highest chance of conceiving in the first three months of trying. For young fertile couples, the chance of conception is between 20% and 37% during the first three months. The chance of success increases to 80% by one year and 90% after two years of trying. Women over the age of 35 and men over the age of 50 have lower fertility rates.

What is the fertile window?

The fertile window is the time in a cycle when pregnancy can occur and is usually the six-day interval ending on the day of ovulation. Generally, ovulation occurs 14 days prior to the next menses (period), so a woman with a 28-day cycle will ovulate around cycle day 14 (that is 14 days after the start of her last menstrual period). That means that intercourse is most likely to result in pregnancy if it occurs within the six-day interval ending the day of ovulation.

How do I know when I am ovulating?

Because the fertile window is defined by the date of ovulation, it is important to know when the woman is ovulating. Several methods of determining ovulation have emerged. Cervical mucus and vaginal secretions start to increase 5-6 days prior to ovulation and peak 2-3 days prior to ovulation. These changes can be monitored to successfully identify the fertile window in many women. Urinary ovulation predictor kits can also be used to detect the rise in luteinizing hormone (LH ) that happens just before ovulation. LH is the primary trigger that results in the eggs being released from the ovary.

Does diet affect fertility?

Fertility is clearly decreased in women who are very thin or obese, but there is no evidence that normal diet variations affect women who are normal weight (body mass index 19-25) and having regular periods. The one exception is that a diet rich in mercury (found in some seafood) is associated with infertility. Smoking, heavy alcohol consumption (> 2 drinks per day), heavy caffeine consumption, and the use of recreational drugs have all been associated with reduced fertility. Therefore, women considering pregnancy should reduce alcohol and caffeine use; and they should also avoid smoking and all recreational drugs while trying to conceive.

ASRM is an excellent resource for reproductive facts. Please check out their patient resources website at http://www.reproductivefacts.org/.

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Ectopic Pregnancy Information

Posted on January 15, 2014 by admin

From the American Society for Reproductive Medicine (ASRM) fact sheet on Ectopic Pregnancies.

What is ectopic pregnancy?

When you become pregnant, the embryo (fertilized egg) travels from your fallopian tube to your uterus (womb) where the embryo implants (sticks) and grows into a fetus. An ectopic pregnancy occurs when the embryo grows outside of the uterus. This usually takes place in one of your fallopian tubes, but can also take place in your ovary, cervix, or somewhere else in your pelvic cavity. An ectopic pregnancy is a very dangerous or life-threatening condition if it is not treated.

What causes an ectopic pregnancy?

Many women who have ectopic pregnancies have no obvious risk factors. However, you may be at risk for ectopic pregnancy if you:

  • Have had pelvic (lower belly) surgery
  • Have a history of a sexually transmitted infection
  • Have endometriosis (a condition where the tissue that lines your uterus grows in other places), which can cause scar tissue (adhesions)
  • Smoke cigarettes
  • Have undergone fertility treatment

How do doctors diagnose ectopic pregnancies?

By ordering a blood test and ultrasound, your physician may be able to determine if you have an ectopic pregnancy. The blood test measures how much of the “pregnancy hormone” (human chorionic gonadotropin or hCG) is in your blood. This blood test may be performed more than once to determine if the levels are rising appropriately. The ultrasound checks to see whether your pregnancy is developing inside or outside the uterus.

Will I have complications?

Even with treatment, an ectopic pregnancy may cause your fallopian tube to tear, which can be life threatening. Go to your doctor or hospital if you have pelvic, stomach, or shoulder pain — these may be symptoms of blood in your abdomen. If you have tubal rupture, you will need emergency surgery.

Will I be able to get pregnant after an ectopic pregnancy?

If you had an ectopic pregnancy, it might be difficult for you to get pregnant again. There is at least a 10% to 15% chance that you will have another ectopic pregnancy. Most of the time, your fallopian tube will remain open after treatment for ectopic pregnancy, and there is a 60% chance that you will give birth to a baby in the future. Fertility testing and treatment can improve your chances for a successful pregnancy.

ASRM is an excellent resource for reproductive facts. Please check out their patient resources website at http://www.reproductivefacts.org/.

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Know who you are working with to build your family

Posted on January 7, 2014 by admin

Blog written by CLI Laboratory Director, Michelle Ottey, PhD.

One of the best pieces of advice I can offer to any prospective parent who will be using donor sperm is to know the sperm bank you are working with to build your family; know their practices, policies, and all that they have to offer.

Several inquiries that often come up are: the number of children each donor may produce, how do sperm banks monitor limits they have, are there required limits, and are the donors informed of how many children have been born using their sperm.

When you choose CLI, you are choosing a sperm donor who has been tested above and beyond all regulatory requirements, has been screened vigorously, and who has provided a plethora of personal information to help you make your choice. All of our policies are available on our website for your review, but there are several that I would like to highlight for you.

1. In 2008 we adopted an internal company policy to limit each of our producing donors to 25 reported families in the US and up to an additional 15 outside of the United States.

What does this mean? This means that we monitor each donor closely and watch his production numbers as well as the number of reported families. If at any point a report of a 25th family is reported we stop distribution of that donor to the general public. At that point if units are available, they can only be purchased by recipients who desire to increase their family with a full sibling. In order to purchase additional units, the recipient must have already reported a child from the donor.

2. We rely on the pregnancy/birth reporting by you, our recipients. It is important that births are reported to CLI directly so that we can accurately monitor the number of families per donor.

Why not rely on the number of vials to determine the number of children and not rely on the recipients to report births? As you can imagine we have a very diverse population of recipients who are using our services for various reasons. There are simply too many medical variables that affect pregnancy outcome to rely on a vial number to predict the number of children born. One woman may use one vial and achieve pregnancy on the first try. Another woman may go through several cycles using several vials before achieving pregnancy. Some women may have multiple births where others have single births.

3. The American Society of Reproductive Medicine (ASRM) guidelines recommend no more than 25 births/population of 800,000 people.

Though we do monitor reported pregnancies by region, CLI made the decision in 2008 to stop distribution once we have 25 reported families in the US, though there is no regulation that requires this significantly lower total limit.

4. Our donors do not know any specifics about the number of children or who has used their samples.

When our donors enter the program they are informed and sign documents acknowledging our policies regarding confidentiality of information between donor, recipient, and offspring as well as and the family limits from the use of his samples.

At CLI we value the experience of our recipients and appreciate the trust you put in us. We also value feedback from our recipients about your experiences and the experiences of your children. We have built our policies and allowed them to evolve over time to meet your needs. We recognize and value each person’s unique and personal experience, especially the fact that there are many differences in each person’s experience and what they are looking for in a sperm donor and a sperm bank.

 

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