Women with decreased ovarian reserve often face challenges trying to conceive due to poor egg quantity and quality. Recent evidence provides hope that supplements such as dehydroepiandrosterone (DHEA), melatonin, and myo-inositol may improve egg quality and ovarian reserve. DHEA supplementation may improve ovarian function, increase pregnancy chances, reduce miscarriage rates, and over time appears to objectively improve ovarian reserve. The article below published in Reproductive Biology and Endocrinology in 2011 provides an excellent summary supporting the use of DHEA to improve ovarian function. http://www.biomedcentral.com/content/pdf/1477-7827-9-67.pdf Another article published in Natural Medicine in 2012 provides further evidence that DHEA, myo-inositol and melatonin may improve egg quality. Although these are preliminary findings, they offer a ray of hope to women with poor ovarian reserve. http://www.naturalmedicinejournal.com/article_content.asp?edition=1§ion=2&article=332
We are clearly seeing a decline in our fertility and increased rates of poor birth outcomes and birth defects as well as increased rates of childhood diseases (such as autism). We must turn our attention to other factors that include the environment as possible contributors to these trends. I can't do a better job than the authors of the articles listed below in describing how the environment affects our fertility. Both articles are must reads. Written for health care providers, but easily read by those of you who are not. The article below was published in September 2012 in American Journal of Obstetrics and Gynecology. If you don't have time to read the whole article, just go to page 3 and look at the table that shows the relationship between commonly found chemicals in our environment and their reproductive/developmental health impacts. http://rds.epi-ucsf.org/ticr/syllabus/courses/84/2012/04/19/Lecture/assignment/2012%20Sutton,%20Woodruff%20et%20al%20AJOG.pdf Page 20 of this publication has a great summary of how toxins in the environment can affect our fertility: http://www.cumulativeimpacts.org/documents/June.pdf This link will have data about your cosmetics and other personal care products: http://www.ewg.org/skindeep/ Hope this helps!
This information is in no way to make you feel guilty for trying fertility treatment but we should pay attention to worldwide trends toward delay in age of first birth in this country. Women are following the social norms and not making bad choices but we should pay attention to the correlation between age at pregnancy and risk of developmental disorders. There is no definitive evidence of cause and effect between fertility treatment and developmental disorders. There is suggestive evidence in animal studies. Fascinating interview on NPR today. Go to this link and read the article and listen to the show: http://www.npr.org/2013/01/17/169497668/grayest-generation-older-parenthood-in-the-u-s More background information here: http://healthland.time.com/2012/05/07/the-link-between-infertility-treatments-and-birth-defects/ http://www.tnr.com/print/article/politics/magazine/110861/how-older-parenthood-will-upend-american-society Please talk to your personal physician about your own individual risk of having a baby with birth defects given what your doctor knows about you before moving forward with treatment.
A recent study published in Human Reproduction showed that there maybe an increased risk of asthma in children born to parents who went through IVF. You shouldn't worry. Of all the children in the study, 15 in 100 were found to have asthma. Of the children in the ART (assisted reproductive technology) group, 24 in 100 had asthma, which is not much higher than the estimated risk of 20 in 100 for all children in the UK. More research needs to be conducted with larger groups of children conceived through ART to investigate this link before we can be sure that ART is a risk factor for childhood asthma. Long story short, don't let the headlines worry you. Ask your doctor about what you can do now to have the healthiest pregnancy possible. Great link with a full summary of the published data: http://www.webmd.boots.com/asthma/news/20121206/fertility-treatments-child-asthma?page=2
Vitamin D deficiency during the first trimester of pregnancy has been linked with a significantly increased risk for the development of diabetes in pregnancy (known as gestational diabetes) by the second trimester in a study of 655 pregnant women. This makes sense because we already recognize that Vitamin D plays a role in insulin resistance in that women with insulin resistance (a risk factor for gestational diabetes) have also been known to be at higher risk of vitamin D deficiency. Please read a great summary of this research here and get your vitamin D checked: http://www.obgynnews.com/index.phpid=11192&tx_ttnews%5Btt_news%5D=137721&cHash=ec5a7da3e345c382660d95dbeb23e0a5
I've blogged about BPA exposure before: https://draimee.org/the-bpa-study-released-today-what-you-should-know/ A new study shows that women with the highest BPA levels during their IVF cycle had the fewest number of eggs retrieved and the lowest fertilization rates (percentage of eggs that became embryos). The researchers didn't have access to pregnancy data so they couldn't comment about any possible relationship to pregnancy rates. While the study design can't show a cause and effect relationship it certainly hints that higher BPA levels can lower fertility rates. Read more about the study here: http://www.foxnews.com/health/2012/10/10/bpa-may-worsen-women-fertility-problems/
Intrauterine insemination (IUI) refers to a procedure where semen is separated from sperm cells and sperm cells are then placed at the top of the uterus through a long thin catheter to get sperm cells as close to the eggs as possible. Have you been through multiple IUI cycles without success? If you're a patient of mine, and we've done IUI without success, we will meet and talk about why IUI may not be working for you. Understanding basic reproductive physiology like where the egg and sperm come together is important. When an egg is released from the ovary, it travels into the fallopian tube. Sperm cells travel through the cervix into the uterus to also make it into the tube where they meet and hopefully fertilize an egg. Once an egg gets fertilized, an embryo then grows and travels down the tube over the course of a few days before landing and implanting in the uterus. This is how a pregnancy starts. IUI puts the sperm at the top of the uterus. That's it. When you do IUI you aren't fertilizing an egg. You rely on nature to take care of the following 3 steps: 1. Egg makes it...