FORTY IS THE NEW THIRTY, RIGHT?
|
|
- Joleen Patterson
- 5 years ago
- Views:
Transcription
1 FORTY IS THE NEW THIRTY, RIGHT? by MARGO R. FLUKER, MD, FRCSC Co-director, Genesis Fertility Centre It s a sign of our times: fit, healthy, fabulous-looking women in their forties and even in their fifties. And some of them are pushing baby strollers. How do they do it? The baby part, I mean. REALITY CHECK The average age of a woman giving birth in Canada is now 30 years, and has been rising steadily for decades. Almost one in five births occur in women 35 years or older. That is nearly four times more frequently than a generation ago. Women today have access to options that their mothers and grandmothers didn t have. We can control our fertility. We have access to effective, reversible forms of birth control. We can delay childbearing to pursue educational and career goals. However, this comes with a price in terms of our fertility. The pronounced age-related decline in fertility means that most women lose their ability to become pregnant in their early to mid-forties. This is often the stage where we start to feel settled financially, socially and emotionally. For many of us, the right time to start focusing on having a family is the same time that our fertility is ending. 8 Creating Families FALL / AUTOMNE 2008
2 AGE MATTERS As women, we re born with a limited number of eggs, and we spend them. We spend some of them every single month, from the time we re born until the time we go through the menopause, typically in our early fifties. Our ovaries constantly select follicles (the tiny fluid-filled sacs that contain immature eggs) out of the resting stage. In our teens and twenties, a few dozen immature eggs may start to grow each month in order for one to mature and ovulate. In contrast, in our early forties, only a few eggs remain to start growing each month. The eggs that don t ovulate in a given month will disintegrate. This process continues even when we re pregnant or on the birth control pill. It is inevitable and irreversible. Fertility specialists refer to the eggs that remain in our ovaries as our ovarian reserve. The progressive, yearly decrease in the number of eggs is known as the age-related decline in ovarian reserve. Although each woman is slightly different, we can t slow the process down, and there are no medications that will let us put the process on pause to save eggs for later. There are, however, many factors that will speed up ovarian aging, such as: cigarette smoking chemotherapy radiation to the pelvis extensive ovarian surgery family history of early menopause diagnosis of premature ovarian failure (1% of women under 40 years) Most of these are not under our direct control, with one exception cigarette smoking. QUALITY VERSUS QUANTITY The age-related decline in ovarian reserve usually involves a steady decrease in both the number and quality of the eggs that remain in our ovaries. It is estimated that a 38- year-old woman has only 10% of her eggs remaining. From that point onward, the progressive yearly decline in a woman s fertility will start to become one of the biggest factors in her ability to conceive. FALL / AUTOMNE 2008 Creating Families 9
3 SO, HOW OLD ARE MY EGGS, ANYWAY? The easy answer is that our eggs are as old as we are. No matter how well we ve taken care of ourselves, we never get any younger, and neither do our eggs. However, some women s egg quality or egg quantity declines much earlier than expected. This is a difficult problem to assess because we can t actually see the eggs to evaluate them, except during a cycle of in vitro fertilization (IVF). Figure 1. Pregnancy and Miscarriage vs. Age in Healthy and Fertile Women Once we re in our forties, only a few eggs can start to grow each month. Those remaining eggs are of lower quality than in our teens and twenties. It is harder to get them to ovulate, to fertilize, to implant and to grow normally. This translates into lower pregnancy rates, higher miscarriage rates, and a higher risk of chromosomal abnormalities in the few babies that are born to mothers at this age. Fertility specialists worry about declining ovarian reserve in the following situations: a high FSH level (follicle stimulating hormone) on menstrual cycle day 3 a low antral follicle count on ultrasound (the follicles that have been selected in a given month, see figure 3) low numbers of follicles developing in response to injectable fertility medications IVF cycle that produces few eggs, or low quality eggs or embryos At some point, fertility medications become ineffective, because the ovaries can no longer select more than one egg at a time, or because the quality is too low. TOP TEN MISCONCEPTIONS ABOUT AGE AND INFERTILITY 40 is the new 30. Everyone says I look great for my age. I know lots of women who got pregnant in their 40s. I can t be infertile. I had a baby 5 years ago. I come from a very fertile family. My grandmother had her 9th child when she was 45. I ve been on the birth control pill for years, so I ve been saving my eggs I exercise regularly and I take good care of myself. When I decide to get pregnant, I know it will happen. I had a miscarriage 2 years ago, when I was 43, so I know I can get pregnant. There must be something wrong with my uterus that prevents me from staying pregnant. If did it, so can I. (fill in the name of your favorite 40+ pregnant movie star) I m too young to go through the menopause. Figure 2. Predicted FSH Levels on Menstrual Cycle Day-3 Versus Age Day 3 FSH level. FSH levels rise progressively in the last decade prior to menopause (see Figure 2). Depending on the individual lab and fertility clinic, levels greater than IU/L usually indicate decreased ovarian reserve. FSH levels can fluctuate markedly from one month to the next, so one normal level does not guarantee a normal ovarian reserve. In contrast, one abnormal level is usually a sign of decreased ovarian reserve. Once FSH levels are consistently above IU/L, the peri-menopausal stage is usually approaching. 10 Creating Families FALL / AUTOMNE 2008
4 Antral follicle count. This is not a regular pelvic ultrasound from a local ultrasound facility looking for an abnormality in your uterus or ovaries. Instead, it s a vaginal ultrasound done by a fertility specialist. The goal is to count the number of immature (antral) follicles that have been selected out of the resting stage that month. This test helps your fertility specialist predict whether your ovaries will respond to the injectable fertility medications that are used in an IVF cycle. As a rough rule, perhaps half of the antral follicles will grow in response to the injectable medications. However, each mature follicle won t necessarily contain an egg. For example, 10 antral follicles in one ovary might produce five growing follicles, from which four eggs might be available for IVF. WILL USING FERTILITY DRUGS MAKE ME RUN OUT OF EGGS FASTER? Good question. Thankfully, the answer is no. In a normal menstrual cycle, our ovaries pick several eggs out of the resting stage, but only one will be chosen to ovulate. The rest will disintegrate and be reabsorbed. With fertility medications, we try to encourage several of those immature eggs to grow. We re actually making better use of the ones that were recruited, rather than letting so many disintegrate. Figure 3. Antral Follicle Count FALL / AUTOMNE 2008 Creating Families 11
5 However, the number of eggs recruited will depend on how many remain in the ovaries. The older we are, the lower the number of eggs that can begin growing each month, and the fewer that will respond to fertility medications (see Figure 3). THE GUILT TRIP Why didn t someone tell me? If only I d known Why don t they teach girls about this in high school? Comments like these are heard all too often in an infertility specialist s office. None of us can turn the clock back, but we can be proactive about seeking treatment, and about spreading the message. Each of us can help to raise awareness about age and infertility by talking about it to friends, relatives and co-workers. ADVICE FROM A FERTILITY EXPERT If you re trying to conceive, be proactive. See your family physician or gynecologist to talk about your general health, your risk factors for infertility, and how long you should try before you start to undergo infertility testing. Early testing and/or referral to a fertility specialist may be appropriate if you or your partner have any of the following infertility risk factors: Irregular or absent periods History of IUCD use (especially if it was removed for pain or bleeding) History of endometriosis History of ovarian or tubal surgery, or extensive abdominal/pelvic surgery History of pelvic or genital infection (either partner) History of sexually transmitted disease (either partner) History of prostate infection (male) History of undescended testicles or bilateral hernia repairs in childhood (male) History of vasectomy or tubal ligation 12 Creating Families FALL / AUTOMNE 2008
6 The easy answer is that our eggs are as old as we are. No matter how well we ve taken care of ourselves, we never get any younger, and neither do our eggs. If you don t have any risk factors for infertility, these are some general guidelines for when to start infertility testing: Women under 35 years: after 12 months of trying Women years: after 6-12 months of trying Women over 39 years: after 3-6 months of trying Women or men with a history of infertility risk factors: start testing sooner WHAT CAN TECHNOLOGY DO? Advanced technologies such as IVF are the final treatment option when all other simpler efforts have been unsuccessful. Although complex and expensive, these treatments usually offer the best chance of pregnancy. However, the success of IVF depends on stimulating a woman s ovaries to produce several eggs at a time. From those, a few top quality embryos are chosen to replace in her uterus. Ovarian reserve testing (day 3 FSH and antral follicle count) can help to identify women with reduced ovarian reserve. In such cases, the ovaries are unlikely to produce a reasonable number of eggs, and those women are unlikely to be successful with procedures such as IVF. If you re over 40, or find that you have limited ovarian reserve, ask yourself (and your partner) if you are willing to consider alternatives, such as donor eggs, adoption and child-free living. A FEW GOOD EGGS Egg donation is a variation of IVF for women who have difficulty achieving a healthy pregnancy with their own eggs. You may be a candidate for egg donation if you: have low ovarian reserve have gone through an early menopause have had your ovaries removed have not had good egg or embryo quality during previous IVF attempts FALL / AUTOMNE 2008 Creating Families 13
7 The woman who donates her eggs must be a healthy young woman (usually under 35 years) who undergoes extensive screening for medical, genetic and infectious disorders. After using injectable fertility medications, several eggs would likely be taken from her ovaries, and then fertilized using your partner s sperm (or a donor sperm sample). To be a recipient of donor eggs, you must have a normal uterus, and be healthy enough to expect that you could safely carry a pregnancy (usually under 51 years). One or two top quality embryos would typically be replaced in your uterus. Depending on the stage and quality of the embryos, most fertility programs anticipate delivery rates of 50% or more in such circumstances. REMEMBER For some women, the diagnosis of decreasing ovarian reserve finally provides some answers for previously unexplained infertility. However, it s also devastating news that often aggravates the sadness and grief they already feel from their struggle with infertility. Feelings of anger, denial, guilt and loneliness are common. Remember that you re not alone in this journey, although it may feel like it sometimes. Infertility affects about one in six couples overall, and at least half of all women over 40 who are trying to conceive. Remember to be proactive about seeking evaluation and treatment, and about spreading the message to others about the effects of age and infertility. Remember that the age-related decline in fertility is the factor that infertility specialists may not be able to overcome. Although it s not easy to move beyond the dream of having your own genetic children, other options are available, including donor eggs, adoption and child-free living. Being infertile doesn t mean that you can t be a parent in some way. Figure 4. Livebirth Rates in IVF Cycles Using a Woman s Own Eggs Versus Donor Eggs (US-IVF Registry, 2005) Lastly, remember to seek support from your partner, your friends and family, the various members of your health care team, the network of professional infertility counselors, and support groups such as IAAC. We are here to help. In Canada, we can only accept altruistic, or volunteer donors. These are friends or family members who are not being paid for their participation, and with whom you are comfortable sharing this experience. Some women find it necessary or preferable to search for an anonymous donor, a woman who is recruited, screened and paid by a fertility clinic, often in the US. This adds to the cost and complexity of the process, but may make egg donation available to women who don t know a suitable volunteer donor. These are not easy choices to make, and not ones to make alone. In addition to your personal support network, the doctors, nurses and counselors at fertility clinics will help you examine these issues. About the author Dr. Margo Fluker is the co-founder and co-director of Genesis Fertility Centre in Vancouver. She has published dozens of research papers, textbook chapters and national guidelines in the areas of reproductive endocrinology and infertility, premature ovarian failure, and age-related infertility. While nurturing Genesis through its growth into one of Canada s largest and most successful IVF programs, she has also taken responsibility for the Centre s donor egg program. She is passionate about her work at the clinic, adventure travel, and any activities that take her outdoors. FALL / AUTOMNE 2008 Creating Families 15
Puberty and Fertility. Normal Female Puberty PUBERTY! What about girls with Galactosemia? E Puberty and Fertility Badik Spencer 1
Puberty and Fertility Jennifer Badik*, MD Pediatric Endocrinology and Jessica Spencer*, MD, MSc Reproductive Endocrinology and Infertility Part One PUBERTY! *no conflicts of interest to report Every girl
More informationInfertility F REQUENTLY A SKED Q UESTIONS. Q: Is infertility a common problem?
Infertility (female factors). In another one third of cases, infertility is due to the man (male factors). The remaining cases are caused by a mixture of male and female factors or by unknown factors.
More informationClinical Policy Committee
Clinical Policy Committee Commissioning policy: Assisted Conception Fertility assessment and investigations are commissioned where: A woman is of reproductive age and has not conceived after one (1) year
More informationTreating Infertility
Treating Infertility WOMENCARE A Healthy Woman is a Powerful Woman (407) 898-1500 About 10% of couples in the United States are infertile. Infertility is a condition in which a woman has not been able
More informationPlanning for Parenthood After a Cancer Diagnosis
Cancer and Fertility Planning for Parenthood After a Cancer Diagnosis If you or someone you love is facing cancer, preserving fertility may be the last thing on your mind. But if you re a woman of childbearing
More informationFertility, Egg Freezing, and You. If you have questions, we can help you get answers.
Fertility, Egg Freezing, and You If you have questions, we can help you get answers. Let s talk about fertility If you re thinking about having a baby someday but aren t ready now, you should learn all
More informationHow to Select an Egg Donor
How to Select an Egg Donor How to Select an Egg Donor Egg donation entails the fertilization of eggs of a young woman and transfer of the resulting embryo or embryos into the intended mother uterus. In
More informationACT TRYING TO HAVE A BABY? YOUR STEP-BY-STEP GUIDE TO ASSISTED CONCEPTION THE ACT PATHWAY
ACT TRYING TO HAVE A BABY? YOUR STEP-BY-STEP GUIDE TO CONCEPTION THE ACT PATHWAY ACT HOW TO USE THE ACT PATHWAY BOOKLET Firstly: You are not alone. Up to 1 in 6 couples around the world will experience
More informationInformed Consent Flipchart. Version 1.0, 30 Jan 2018
Informed Consent Flipchart Version 1.0, 30 Jan 2018 Knowledge is Power Did you know? Across the world, young women are at high risk of getting HIV. In Africa, more than half of people living with HIV are
More informationClinical Policy Committee
Northern, Eastern and Western Devon Clinical Commissioning Group South Devon and Torbay Clinical Commissioning Group Clinical Policy Committee Commissioning policy: Assisted Conception Fertility treatments
More informationINTRODUCTION TABLE OF CONTENTS. If you want to become a parent after cancer, we would like to give you the information you need to make that happen.
TABLE OF CONTENTS INTRODUCTION INTRODUCTION 1 MEN Fertility Risks 2 Fertility Preservation Options 3 Possible Fertility Outcomes 4 Parenthood After Cancer Options 5 Important Tips for Men 6 WOMEN Fertility
More informationWhat to do about infertility?
What to do about infertility? Dr. M.A. Fischer Section Head, Division of Urology, Department of Surgery Assistant Clinical Professor, Department of Obstetrics and Gynecology Hamilton Health Sciences, Hamilton,
More informationThe facts about egg freezing
The facts about egg freezing 1800 111 483 qfg.com.au Who might benefit from egg freezing? Age-related infertility in women is one of the most common issues presented to fertility specialists each day when
More informationCancer Fertility. Fertility Options to Consider Before Treatment Begins & Parenthood Options After Cancer
& Cancer Fertility Fertility Options to Consider Before Treatment Begins & Parenthood Options After Cancer If you or someone you care about is faced with a cancer diagnosis, preserving fertility may be
More informationX-Plain Ovarian Cancer Reference Summary
X-Plain Ovarian Cancer Reference Summary Introduction Ovarian cancer is fairly rare. Ovarian cancer usually occurs in women who are over 50 years old and it may sometimes be hereditary. This reference
More informationThe birth of tomorrow's world One in six couples in Canada have trouble conceiving, but there's hope
Thursday» May 24» 2012 The birth of tomorrow's world One in six couples in Canada have trouble conceiving, but there's hope Lina Toyoda The Province Thursday, May 17, 2012 After five years of trying to
More informationEvaluation of the Infertile Couple
Overview and Definition Infertility is defined as the inability of a couple to fall pregnant after one year of unprotected intercourse. Infertility is a very common condition as in any given year about
More informationEgg freezing. what you need to know
Egg freezing what you need to know With over 30 years of experience in IVF treatment, we offer clinical excellence at an affordable cost in an environment that understands and caters specifically for women
More informationBRCA genes and inherited breast and ovarian cancer. Information for patients
BRCA genes and inherited breast and ovarian cancer Information for patients This booklet has been written for people who have a personal or family history of breast and/or ovarian cancer that could be
More informationGENA2. Source Booklet. General Studies (Specification A) General Certificate of Education Advanced Subsidiary Examination June 2011
General Certificate of Education Advanced Subsidiary Examination June 2011 General Studies (Specification A) GENA2 Unit 2 AS Science and Society Source Booklet Source for use with Questions 1.1 to 1.30.
More informationRealizing dreams booklet.indd 1 5/20/ :26:52 AM
Realizing dreams. 18891booklet.indd 1 5/20/2010 11:26:52 AM The Journey To Parenthood The first Gator Baby was born in 1988 through the in vitro fertilization program at the University of Florida. Since
More informationWHAT IS A PATIENT CARE ADVOCATE?
WHAT IS A PATIENT CARE ADVOCATE? Fertility treatments can be overwhelming. As a member, you have unlimited access to a dedicated Patient Care Advocate (PCA), who acts as your expert resource for discussing
More informationWhat?! Why?! Emergency Contraception. physical consequences. emotional consequences
HealthCHAT Emergency Contraception What?! Emergency contraception is a series of pills that can be taken by a woman to prevent pregnancy after having unprotected sex. Why?! Emergency contraception allows
More informationSymptom Management. Fertility and You
Symptom Management Fertility and You Table of Contents 3 Will cancer impact my ability to have children? 4 How do I talk to my children about preserving their fertility during cancer treatment? 5 What
More information16 East 40 th St, 2 nd Fl, New York, NY Ph fax
Page 1 of 9 16 East 40 th St, 2 nd Fl, New York, NY 10016 Ph 212-679-2289 fax 212-679-2288 Please complete the following: Fertility Evaluation Name: Date of birth: Age: Partner s Name: Date of birth: Age:
More informationTiming is everything. Ovulation Tracking. 3 Cycles bulk-billed
Timing is everything Ovulation Tracking 3 Cycles bulk-billed Contents Getting pregnant naturally 3 Getting pregnant the basics 3 What is ovulation? 3 Menstrual cycle 4 When does ovulation take place? 4
More informationDiscover the birth control you ve been looking for. Highly reliable. Virtually hassle-free. Totally hormone-free.
Discover the birth control you ve been looking for Highly reliable. Virtually hassle-free. Totally hormone-free. Over 70 million women worldwide use a nonhormonal IUC like ParaGard. Millions of women with
More informationBiology of fertility control. Higher Human Biology
Biology of fertility control Higher Human Biology Learning Intention Compare fertile periods in females and males What is infertility? Infertility is the inability of a sexually active, non-contracepting
More informationInfertility. F r e q u e n t l y A s k e d Q u e s t i o n s. Q: What causes infertility in men? A: Infertility in men is most often caused by:
Infertility Q: What is infertility? A: Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to
More informationPROTECT YOUR FERTILITY
PROTECT YOUR FERTILITY A GUIDE FOR PREVENtion American Society of Reproductive Medicine What is Infertility, Anyway? INFERTILITY IS NOT MERELY AN INCONVENIENCE. INFERTILITY IS NOT JUST A WOMAN S PROBLEM.
More informationInfertility: Current Testing and Treatment Methods
Transcript Details This is a transcript of an educational program accessible on the ReachMD network. Details about the program and additional media formats for the program are accessible by visiting: https://reachmd.com/programs/clinicians-roundtable/infertility-current-testing-and-treatmentmethods/9902/
More informationAttitudes toward Egg Donation among Individuals with Infertility. Request for Cooperation
Attitudes toward Egg Donation among Individuals with Infertility Request for Cooperation Q. When did you start to worry about fertility issues? Please circle one of the following responses.. Within the
More informationEmbryo Selection after IVF
Embryo Selection after IVF Embryo Selection after IVF Many of human embryos produced after in vitro fertilization carry abnormal chromosomes. Placing a chromosomally normal embryo (s) into a normal uterus
More informationUnderstanding ovarian cancer An information sheet for women with ovarian cancer, their family and friends If you or someone you love has recently been diagnosed with ovarian cancer, you re sure to have
More informationGETTING PREGNANT. Facts, Myths, and Secrets To Fertility
GETTING PREGNANT 101 Facts, Myths, and Secrets To Fertility For most people, the process of getting pregnant begins with plenty of hopes. You imagine your future child, shop for maternity clothes, consider
More informationthe IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD the IUD your guide to
your guide to Helping you choose the method of contraception that s best for you IUD IUD the e IUD IU IUD the IUD 2 3 The intrauterine device (IUD) An IUD is a small plastic and copper device that s put
More informationAccess to IVF. Help us decide Discussion paper. South Central Specialised Commissioning Group C - 1
Access to IVF Help us decide Discussion paper South Central Specialised Commissioning Group 1 C - 1 Access to IVF treatment Contents 1. Background 3 2. Developing a single policy for NHS South Central..4
More informationNICE fertility guidelines. Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic
NICE fertility guidelines Hemlata Thackare MPhil MSc MRCOG Deputy Medical Director London Women s Clinic About the LWC 4 centres around the UK London Cardiff Swansea Darlington The largest sperm bank in
More informationTiming is everything. Ovulation Tracking. 3 Cycles no out-of-pocket* Patient Information Booklet
Timing is everything Ovulation Tracking Patient Information Booklet 3 Cycles no out-of-pocket* Contents Getting pregnant naturally 3 Getting pregnant the basics 3 What is ovulation? 3 Menstrual cycle 4
More informationWHY INVESTIGATE FOR INFERTILITY
WHY INVESTIGATE FOR INFERTILITY Intrauterine Insemination 1 About this booklet This series of booklets has been developed and written with the support of leading fertility clinics across Australia, and
More informationFertility Policy. December Introduction
Fertility Policy December 2015 Introduction Camden Clinical Commissioning Group (CCG) is responsible for commissioning a range of health services including hospital, mental health and community services
More informationFamily Planning UNMET NEED. The Nurse Mildred Radio Talk Shows
Family Planning UNMET NEED The Nurse Mildred Radio Talk Shows TOPIC 9: IUD/COIL Guests FP counsellor from MSU, RHU& UHMG Nurse Mildred Nurse Betty Objectives of the programme: To inform listeners about
More informationRegardless of your reasons, think about your future.
Regardless of your reasons, think about your future. Genea Horizon is an egg freezing clinic in the heart of Sydney s CBD. The first of its kind and drawing on over 30 years of experience in IVF treatment,
More informationAdoption and Foster Care
GLOSSARY Family building via Adoption and Foster Care October 2018 www.familyequality.org/resources A Anonymous Donor: A person who donated sperm or eggs with the intention of never meeting resulting children.
More informationThe friendly guide to fertility
hannamfertility.com The friendly guide to fertility Written by fertility doctors, translated for everyone. Visit FERTILITY.CA for more info Get busy. Just starting? Many women get pregnant the first month
More informationCITYHEALTH. Hey, baby! 5 Ways to Avoid. Knee Surgery. A Doggone. feline. photobombs See page 32 for our lovable. *See pages for upcoming events!
*See pages 37-39 for upcoming events! FALL 2014 CITYHEALTH >> Patient Story Hey, baby! fertility Advances make more births possible at Medical City 5 Ways to Avoid Knee Surgery Peyton Freeny is named for
More informationFERTILITY & TCM. On line course provided by. Taught by Clara Cohen
FERTILITY & TCM On line course provided by Taught by Clara Cohen FERTILITY & TCM FERTILITY AND TCM THE PRACTITIONER S ROLE CAUSES OF INFERTILITY RISK FACTORS OBJECTIVES UNDERSTANDING TESTS Conception in
More informationTranscervical Sterilization
Q UESTIONS & ANSWERS A BOUT Transcervical Sterilization A New Choice in Permanent Birth Control Choosing a Birth Control Method Women and their partners now have more birth control choices than ever. How
More informationCervical Cancer. Introduction Cervical cancer is a very common cancer. Nearly one half million cases are diagnosed worldwide each year.
Cervical Cancer Introduction Cervical cancer is a very common cancer. Nearly one half million cases are diagnosed worldwide each year. Most cases of cervical cancer can be prevented by getting regular
More informationAge and Fertility. A Guide for Patients Revised 2012 Copyright 2012 by the American Society for Reproductive Medicine
1 Age and Fertility A Guide for Patients Revised 2012 Copyright 2012 by the American Society for Reproductive Medicine INTRODUCTION Fertility changes with age. Both males and females become fertile in
More informationGrowing up. W Worksheet 3.1: Percentile growth charts
3.1 W WWorksheet 3.1: Percentile growth charts Growing up From the day we are conceived, each and every one of us follows a life cycle. The human life cycle can be divided into stages such as baby, child,
More informationOlder. Freezing your eggs? Information about the procedure of retrieving and freezing eggs or a section of an ovary.
Older Freezing your eggs? Information about the procedure of retrieving and freezing eggs or a section of an ovary. Good to know. This information is for younger people who, due to cancer treatment, may
More informationI MAY NOT HAVE ALL THE ANSWERS BUT AT LEAST I HAVE THE QUESTIONS TO GET THE PROPER. care guidelines
I MAY NOT HAVE ALL THE ANSWERS BUT AT LEAST I HAVE THE QUESTIONS TO GET THE PROPER care guidelines Hi, Being diagnosed with breast cancer is tough at any age, but being diagnosed when you re young makes
More informationConquering Infertility You can look fabulous, but your ovaries have been around since you were conceived
Those old directions for How To Make A Nuclear Family grow up, find a man, get married, and have a baby seem so dated, so simplistic, it s almost laughable. Modern women are staying in school longer, going
More informationCancer & Fertility: Patient Education Booklet. information suppor t hope
Cancer & Fertility: Patient Education Booklet information suppor t hope 1 table of contents introduction 1 men Fertility Risks 2 Fertility Preservation Options 3 Possible Fertility Outcomes 4 Parenthood
More informationSperm Donation - Information for Donors
Sperm Donation - Information for Donors The donation of sperm to help someone to have a child is one of the most generous gifts anyone can give. Many donors feel a sense of pride, knowing the joy they
More informationIntrauterine Insemination - FAQs Q. How Does Pregnancy Occur?
Published on: 8 Apr 2013 Intrauterine Insemination - FAQs Q. How Does Pregnancy Occur? A. The female reproductive system involves the uterus, ovaries, fallopian tubes, cervix and vagina. The female hormones,
More informationWelcome to Mirena. The Mirena Handbook: A Personal Guide to Your New Mirena. mirena.com. Mirena is the #1 prescribed IUD * in the U.S.
Mirena is the #1 prescribed IUD * in the U.S. Welcome to Mirena The Mirena Handbook: A Personal Guide to Your New Mirena *Intrauterine Device Supported by 2015-2016 SHS data INDICATIONS FOR MIRENA Mirena
More informationFertility Assessment and Treatment Pathway
Rejected referrals sent back to GP Fertility Assessment and Treatment Pathway Patients with fertility problems go to the GP GP Advice and Assessment GP to inform patient of access criteria for NHS-funded
More informationRabson, Mia. (2012, April 14). Fertile ground for controversy. Winnipeg Free Press. Retrieved
Rabson, Mia. (2012, April 14). Fertile ground for controversy. Winnipeg Free Press. Retrieved from http://www.winnipegfreepress.com/local/fertile-ground-for-controversy- 147422385.html Key Questions 1)
More informationPatient Overview: Invitro Fertilisation
Patient Overview: Overview IVF stands for in-vitro fertilisation i.e. literally fertilisation in a glass dish. You may also hear the term ART used which stands for Assisted Reproductive Technologies. IVF
More informationDRAFT Policy for the Provision of NHS funded Gamete Retrieval and Cryopreservation for the Preservation of Fertility
NHS Birmingham and Solihull Clinical Commissioning Group NHS Sandwell and West Birmingham Clinical Commissioning Group DRAFT Policy for the Provision of NHS funded Gamete Retrieval and Cryopreservation
More informationInformation for Egg Sharers
Information for Egg Sharers Thank you for considering egg sharing. In egg sharing a woman undergoing IVF treatment donates half of the eggs collected during the treatment to another woman. In return, the
More informationOvarian Cancer. What you should know. making cancer less frightening by enlightening
Ovarian Cancer What you should know making cancer less frightening by enlightening ovarian cancer the facts Over 360 cases are diagnosed in Ireland annually It is the 6th most common cancer in women 4
More informationApproved January Waltham Forest CCG Fertility policy
Approved January 2015 Waltham Forest CCG Fertility policy Contents 1 Introduction 1 2 Individual Funding Requests 1 2.1 Eligibility criteria 1 2.2 Number of cycles funded 2 2.3 Treatment Pathway 3 Page
More informationFertility What do GP s need to know? Richard Fisher Fertility Associates
Fertility 2010 What do GP s need to know? Richard Fisher Fertility Associates New Zealand Source: Max Planck Institute Average age of mother at first birth in New Zealand 35 30 25 20 15 10 5 0 Median Mean
More informationFemale Health Issues after Treatment for Childhood Cancer
Female Health Issues after Treatment for Childhood Cancer The effects of childhood cancer therapy on female reproductive function depend on many factors, including the girl s age at the time of cancer
More informationSpermComet DNA Test your results and what they mean
SpermComet DNA Test your results and what they mean Sperm DNA damage and why it is important for your fertility. You and your partner are each going to give some of your DNA to your baby, so the health
More informationWHAT YOU NEED TO KNOW ABOUT DONATING SPERM, EGGS OR EMBRYOS
14 February 2006 WHAT YOU NEED TO KNOW ABOUT DONATING SPERM, EGGS OR EMBRYOS Introduction The donation of sperm, eggs or embryos to help a couple have a child is one of the most generous gifts anyone can
More informationInfertility testing. Global infertility panel. Patient information. Informations for patients
Global infertility panel Infertility testing Informations for patients Patient information Each of your body cells contains your genetic information called DNA. DNA carries all the information you need
More informationTop 5 Fertility Secrets Revealed
Top 5 Fertility Secrets Revealed by Melinda Stevens Brought to you by http://www.pregnancy-online.info All rights reserved, 2007. Copyright 2007, Pregnancy-Online.info 2 Hi, thanks for downloading my free
More informationInformation Booklet. Exploring the causes of infertility and treatment options.
Information Booklet Exploring the causes of infertility and treatment options www.ptafertility.co.za info@ptafertility.co.za +27 12 998 8854 Faith is taking the first step even if you don t see the whole
More informationInformation for Informed Consent for Insertion of a Mirena IUD
Information for Informed Consent for Insertion of a Mirena IUD What is an IUD (intrauterine Device)? An intrauterine device (IUD) is a plastic device that is placed into your uterus to prevent pregnancy.
More informationFertility treatment in trends and figures
Fertility treatment in 2010 trends and figures Contents Page No: Foreword by the Chair of the HFEA 3 Summary 4 Section 1: Overview How many fertility clinics were there in the UK in 2010? 6 How many women
More informationPage 1 of 5 Official reprint from UpToDate www.uptodate.com 2012 UpToDate Patient information: Infertility in men (The Basics) Written by the doctors and editors at UpToDate What is male infertility? Male
More informationPREVENTING PREGNANCY: TALKING ABOUT AND USING CONTRACEPTION
PREVENTING PREGNANCY: TALKING ABOUT AND USING CONTRACEPTION Lesson 11 DIFFERING ABILITIES LEARNER OUTCOME Identify and describe basic types of contraceptives; i.e., abstinence, condom, foam, birth control
More informationNote: This updated policy supersedes all previous fertility policies and reflects changes agreed by BHR CCGs governing bodies in June 2017.
Fertility Policy 10 July 2017 Note: This updated policy supersedes all previous fertility policies and reflects changes agreed by BHR CCGs governing bodies in June 2017. Introduction BHR CCGs are responsible
More informationOptimizing Fertility and Wellness After Cancer. Kat Lin, MD, MSCE
Optimizing Fertility and Wellness After Cancer Kat Lin, MD, MSCE University Reproductive Care University of Washington Nov. 6, 2010 Optimism in Numbers 5-year survival rate 78% for all childhood cancers
More informationIVF while taking Estrace? 3,915 conversations on the web about experiences with taking Estrace before or after having a IVF.
IVF while taking Estrace? 3,915 conversations on the web about experiences with taking Estrace before or after having a IVF. Progesterone and estrogen after transfer - posted in Ask the Embryologist: Hello
More informationa nonprofit organization Cancer & Fertility: A Guide for Young Men supported by CBC Foundation
a nonprofit organization Cancer & Fertility: A Guide for Young Men supported by CBC Foundation Partners Fertile Hope is proud to partner with the CBC Foundation, the Lance Armstrong Foundation and Planet
More informationWill clomid work if you have low amh
Will clomid work if you have low amh Rebecca Matthews, embryologist at Oregon Reproductive Medicine, explains tests for ovarian reserve: FSH, AMH and Clomid Challenge for egg quantity quality. extremely
More informationThe Pregnancy Journey...
The Pregnancy Journey... when you are living with HIV Authors: Angelina Namiba, Jo Manchester and Lucy Osman If you, or your partner, is HIV positive and you want to get pregnant, or you are pregnant or
More informationPolicy updated: November 2018 (approved by Haringey and Islington s Executive Management Team on 5 December 2018)
Islington CCG Fertility Policy First approved: 29 January 2015 Policy updated: November 2018 (approved by Haringey and Islington s Executive Management Team on 5 December 2018) Introduction Islington CCG
More informationFertility assessment and assisted conception
Fertility assessment and assisted conception Dr Geetha Venkat MD FRCOG Director Pulse Learning Women s health 14 September 2016 Disclosure statement Dr Venkat is a director of Harley Street Fertility Clinic.
More informationAssisted Reproductive Technologies
Assisted Reproductive Technologies Textbook pages 224 231 Section 6.3 Summary Before You Read What do you think the phrase test-tube baby refers to? Write your ideas on the lines below. Mark the Text Check
More informationEast and North Hertfordshire CCG. Fertility treatment and referral criteria for tertiary level assisted conception
East and North Hertfordshire CCG Fertility treatment and referral criteria for tertiary level assisted conception December 2015 1 1. Introduction This policy sets out the entitlement and service that will
More informationProduce Eggs. Fertility Preservation for Trans People who. LGBTQ Reproductive Options
for Trans People who Produce Eggs LGBTQ Reproductive Options Many trans people are interested in being parents and want to know their options. While many trans people may conceive on their own, this info
More informationInformation For Egg Recipients
Egg Recipients Royal Devon and Exeter NHS Foundation Trust Information For Egg Recipients What is egg donation? Egg donation is a type of in-vitro fertilisation (IVF) treatment in which eggs are collected
More informationTop 10 questions in fertility
Top 10 questions in fertility Mr Rehan Salim MD MRCOG Head of Reproductive Medicine Consultant Gynaecologist & Subspecialist in Reproductive Medicine Imperial College NHS Trust Learning objectives Patient
More informationFertility Apps Do not Help You Get pregnant
Fertility Apps Do not Help You Get pregnant Fertility Apps Do not Help You Get pregnant Beyond Regular Intercourse Many women use fertility apps to track their menstrual cycle and time intercourse. Tracking
More informationFACT SHEET. Failure of Ovulation Blocked or Damaged Fallopian TubesHostile Cervical Mucus Endometriosis Fibroids
FACT SHEET Overview of infertility If getting pregnant has been a challenge for you and your partner, you're not alone. Ten to 15 percent of couples in the Lithuania are infertile. Infertility is defined
More informationEgg sharing (Donor) Information for Patients and Partners
Egg sharing (Donor) Information for Patients and Partners Date of Issue: 29/06/2018 Doc 392 Issue 10 1 of 10 Who is this leaflet about and who is it for? This leaflet is produced to inform couples considering
More informationWhat women should know about. cervical cancer. American Cancer Society Guidelines for the Early Detection of Cervical Cancer
What women should know about cervical cancer American Cancer Society Guidelines for the Early Detection of Cervical Cancer One of the best things you can do so you don t get cervical cancer is get regular
More informationLOW RESPONDERS. Poor Ovarian Response, Por
LOW RESPONDERS Poor Ovarian Response, Por Patients with a low number of retrieved oocytes despite adequate ovarian stimulation during fertility treatment. Diagnosis Female About Low responders In patients
More informationFertility in the 21 st Century Dr Leigh Searle
Fertility in the 21 st Century Dr Leigh Searle Fertility Specialist, Obstetrician, Gynaecologist FRANZCOG, PGDipOMG, MBChB Dr Kate Van Harselaar Fertility Specialist, Obstetrician and Gynaecologist Overview
More informationDirector of Commissioning, Telford and Wrekin CCG and Shropshire CCG. Version No. Approval Date August 2015 Review Date August 2017
Commissioning Policy for In Vitro Fertilisation (IVF)/ Intracytoplasmic Sperm Injection (ICSI) within tertiary Infertility Services, in Shropshire and Telford and Wrekin Owner(s) Version No. Director of
More informationDr Manuela Toledo - Procedures in ART -
Dr Manuela Toledo - Procedures in ART - Fertility Specialist MBBS FRANZCOG MMed CREI Specialities: IVF & infertility Fertility preservation Consulting Locations East Melbourne Planning a pregnancy - Folic
More informationFertility 101. About SCRC. A Primary Care Approach to Diagnosing and Treating Infertility. Definition of Infertility. Dr.
Dr. Shahin Ghadir A Primary Care Approach to Diagnosing and Treating Infertility St. Charles Bend Grand Rounds November 30, 2018 I have no conflicts of interest to disclose. + About SCRC State-of-the-art
More informationWeight Management Clinic
Weight Management Clinic Information for Patients and Partners Date of Issue: 17/05/2018 Doc 609 Issue 05 1 of 9 What is this leaflet about and who is it for? This leaflet has been produced to give patients
More information