How to advise the couple planning to conceive: Modifiable factors that may (or may not) impact fertility
|
|
- Juliana McGee
- 6 years ago
- Views:
Transcription
1 How to advise the couple planning to conceive: Modifiable factors that may (or may not) impact fertility I have nothing to disclose Disclosures Heather Huddleston, MD Associate Professor of Clinical Medicine University of California-San Francisco LEARNING OBJECTIVES Evolution At the conclusion of this presentation, participants should be able to discuss the role of the following in impacting fertility: Obesity Common Vices: caffeine, smoking, alcohol Nutrition Exercise Stress OBESITY The human reproductive system evolved over millions years But its only recently that we look like this 1
2 Age-adjusted Prevalence of Obesity and Diagnosed Diabetes Obesity (BMI 30 kg/m 2 ) Diabetes No Data <14.0% 14.0% 17.9% 18.0% 21.9% 22.0% 25.9% 26.0% No Data <4.5% 4.5% 5.9% 6.0% 7.4% 7.5% 8.9% >9.0% CDC s Division of Diabetes Translation. National Diabetes Surveillance System available at SART DATA: The Role of Obesity in IVF Success Rates when using your own eggs Underweight 1.07 ( ) Normal ( ) 1 REF Overweight ( ) 1.07 ( ) BMI ( ) BMI ( ) BMI ( ) BMI ( ) BMI > ( ) AOR for NOT achieving clinical pregnancy AUTOLOGOUS eggs n=45,000 For example: A BMI of between increases chance of a negative pregnancy test by 26% Model adjusted for age, race, fertility diagnosis, nulligravidity, height Adapted from Luke et al F and S 2011 SART DATA: Role of OBESTIY in Women using Donor Eggs >35 AOR for not achieving a clinical pregnancy for DONOR EGG CYCLES Underweight.96 Normal 1.00 Overweight 1.00 ( ) ( ) ( ) ( ) ( ) >50.76 ( ) No Significant Difference in Pregnancy Rates by BMI when using donor eggs Luke et all 2012 Fertility and Sterility Obesity Donor Cycle Outcomes: Bellver et al 9,587 first cycles of ovum donation with ova from normo-weight donors Recipients divided according to BMI In vitro fertilization lab parameters did not differ according to BMI Implantation, pregnancy, clinical pregnancy, twin and live birth rates were reduced as BMI increased Bellver et al Fertility and Sterility
3 Obesity and Impact on Donor Egg Success Rates Racial And Ethnic Differences with BMI Adjusted odds of failure to achieve live birth relative to white This ethnic difference between White and Non- White are more pronounced in obese c/w non obese Adapted from Bellver et al F and S 2013 Amongst obese women, Asians, Hispanics and Blacks are roughly twice as likely to NOT get pregnant. Luke et al Fertility and Sterility 2011 Summary: Impact of obesity Role of obesity in reducing pregnancy rates is clear in women using their own eggs Data suggests possible impact on those using donor eggs. There is lack of clarity on whether obesity is related to egg or endometrium; though it is likely that there is impact on multiple systems. Impact on Non-whites appears to be more significant relative to White Audience Question: You are seeing a 39 year old infertile patient with BMI of 35, planning to proceed with IVF. You recommend: A. Proceeding with treatment B. Taking six months to work on weight loss with a diet C. Taking six months to increase exercise and healthy habits. 57% 15% 28% 3
4 Physical Activity: Wise et al Pregnancies Cycles Unadjusted model a Adjusted model b FR 95% CI FR 95% CI Vigorous physical activity, h/wk None 500 2, (ref.) 1.00 (ref.) < , , , , Moderate physical activity, h/wk < , (ref.) 1.00 (ref.) , , , , To Adverse impact seen with vigorous only Wise et al Fertility and Sterility 2012 Randomized Trial of a Lifestyle Program in Obese Infertile Women Women with BMI of 29 or higher were randomized to a six month life-style intervention preceding treatment for infertility 290 women were assigned to six month lifestyle intervention program preceding 18 months of infertility treatment 21% discontinued lifestyle after median of 2.8 month Mean weight loss after 6 months (if not pregnant) was 4.4 kg in intervention group and 1.1 in control group (p=.0001) 287 were assigned to prompt infertility treatment for 24 months In first six months: 37.7% ost 5% of original body weight. None of the women in control group did. Mutsaerts et al NEJM 2016 Lifestyle Intervention and Livebirth How do common vices impact fertility? Singleton live birth rate: Intervention: 27% versus Control: 35.3% Rate Ratio: 0.77 (95% CI ) Overall Livebirth rate: Intervention: 43.9% vs 53.9% 0.82 ( ) Mutsaerts et al NEJM
5 Smoking Audience Response Question: When taking a social history: Reduces IVF pregnancy rate by about one half Increases miscarriage by almost one fourth Reductions are also seen with donor eggs Second hand smoke has lesser but still significant effects A period of 3-6 months from smoking cessation is recommended Can be a powerful motivator to quit A. I never ask about caffeine B. I ask about caffeine and recommend discontinuing its use C. I ask about caffeine and recommend limited intake 40% 1% 59% Pineles et al Am J Epi 2014 Caffeine and IVF Outcomes Alcohol and IVF Outcomes Associations of live birth and caffeine consumption in 2,742 IVF Couples (female consumption) Unadjusted OR for Live Birth No Caffeine 1 1 Adjusted OR for Live Birth Odds of Live Birth for those drinking >4 drinks per week (n=2454 couples undergoing IVF) >0-800 mg per week > mg per week >1400 mg per week.99 (.83,1.18) 1.0(.83, 1.21) NS.80 (0.64,0.99).89 (0.71,1.12) NS.88 (.72,1.09) 1.07 (0.85,1.34) NS No Significant Effects Seen! Choi et al J of Caffeine Res 2011 Rossi et al Obset and Gynecol
6 DIET Couples planning pregnancy visiting outpatient OBGYN clinic completed questionnaire. Six questions based on dietary recommendations of Netherlands Nutrition Centre covered the intake of six key nutrients fruits, vegetables, meat, fish, whole products and fats). Calculated PDR (preconception Dietary Risk Score) Selected 199 couples who underwent IVF/ICSI within six months of preconception visit Preconception Diet and IVF Outcomes What about Dairy? PDR: OR 1.65 ( ). Logistic regression analysis shows association between PDR of woman and probability of ongoing pregnancy: Chance of pregnancy increased 65% with one unit increase PDR. Model controlling for: treatment indication, age of woman (squared), BMI and smoking status Twight et al Human Reproduction 2012 M.C. Afeiche et al. Hum. Reprod. 2016;31:
7 Exercise Audience Question: You see a 39 year old infertile patient with BMI of 32, planning to start fertility treatment. She has increased her exercise over the past year to improve her health. She tells she runs 4-5 hours per week. You recommend: 93% A. Decreasing her exercise a little bit B. Stop exercising completely until IVF is completed C. Continue as she has been doing D. Taking six months to increase exercise and healthy habits. 4% 2% 2% Vigorous Exercise: Wise et al 2012 Internet based observational study of Danish women planning a pregnancy Total of 3,628 women aged at baseline Questionnaires regarding exercise Baseline Characteristics: Vigorous positively correlated with: education, higher frequency of intercourse, Vigorous inversely associated with: BMI Waist Caffeine Current smoking Parity Report of doing something to time intercourse. Women in highest category of PA tended to have longer and irregular cycles Wise et al Fertility and Sterility
8 Exercise: Effect Modification by BMI Hours of Exercise per week BMI GROUP None >5 <25 Fertility Ratio BMI 25 Fertility Ratio ( ) 1.00 (ref.) 1.12 ( ) TAKE HOME: Moderate exercise is fine 0.79 ( ) 1.15 ( ) 0.76 ( ) 1.16 ( ) 0.72 ( ) 0.76 ( ) 0.58 ( ) 1.22 ( ) Vigorous may have adverse effect on thin, but not overweight women Adapted from Wise et al F and S 2012 A population based health survey HUNT 1 was conducted during in Nord Trondelag county, Norway Followup from (Hunt 2) 3887 women who completed two two assessments with data collected on diet, exercise, and fertility problems at the second followup. Gudmundsdottir et al Human Reproduction 2009 Exercise: North Trondelag Health Study Women with the highest levels of physical activity had the highest frequency of fertility problems. However exercise at the submaximal level did not show an association Physical activity prior to IVF in obese women Retrospective Review of all IVF ICSI between Inclusion was obese women with Stable BMI between IVF scheduling and actual IVF procedure (generally six months) Data on exercise was derived from standardized questionnaire administered at scheduling and at IVF. Gudmundsdottir et al Human Reproduction 2009 Palomba et al Reproductive BioMedicine Online
9 Physical activity prior IVF in infertile obese women Regular Physical Activity n No Regular Physical Activity Age NS BMI NS Waist Hip M2 Oocytes NS Fertilization rate NS High quality embryos 36.5% 37.6% NS Total pregnancies 39% 15%.001 Miscarriage NS Live births.004 P value Adapted from Palomba et al Reproductive BioMedicine Online 2014 Conclusions Obesity clearly has adverse effects on fertility. Smoking is detrimental to fertility efforts. There is no clear data suggesting adverse effects caffeine. A healthy and balanced diet, such as the Mediterranean is a prudent approach and may have benefit. Moderate exercise is fine for all women and possibly beneficial for overweight/obese Lean women with high levels of vigorous exercise can consider substituting moderate exercise. My Strategy Advanced End Glycation Products Stick to recommendations that would benefit patient s overall health (ie, things you would tell them even if they weren t trying to conceive). Patient s often experience increased stress and self blame, if they feel they are causing their own fertility. Exercise care in making recommendations that aren t backed by strong evidence. Jinno et al. Hum. Reprod
10 Advanced glycation end products in serum and follicular and IVF OUTCOMES Masao Jinno et al. Hum. Reprod. 2011;26:
Infertility: A Generalist s Perspective
Infertility: A Generalist s Perspective Learning Objectives Fertility and Lifestyle: Patient education Describe the basic infertility workup Basic treatment strategies unexplained Heather Huddleston, MD
More informationInfertility in Women over 35. Alison Jacoby, MD Dept. of Ob/Gyn UCSF
Infertility in Women over 35 Alison Jacoby, MD Dept. of Ob/Gyn UCSF Learning Objectives Review the effect of age on fertility Fertility counseling for the patient >35 - timing - lifestyle - workup Fertility
More informationYour environment: Your fertility
Your environment: Your fertility Strong Fertility Center Education Series September 25, 2008 Shanna H. Swan, PhD Professor Obstetrics & Gynecology University of Rochester School of Medicine Has fertility
More informationThe study of correlation between BMI and infertility. Dr. seyed mohammadreza fouladi
The study of correlation between BMI and infertility Dr. seyed mohammadreza fouladi Female Infertility Infertility is a generally defined as one year unprotected intercourse without contraception. Approximately
More informationHonorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive FIGO s Distinguished Merit Award for Services towards women s health.
Prof.Duru Shah Founder President The PCOS Society (India) President Elect of the Indian Society for Assisted Reproduction (ISAR) Honorary Fellow of the Royal College of Obs. & Gyn. First Indian to receive
More informationDr Devashana Gupta. Dr Karen Buckingham. Obstetrician and Gynaecologist Repromed. Repromed Auckland
Dr Karen Buckingham Obstetrician and Gynaecologist Repromed Dr Devashana Gupta Repromed Auckland 8:30-9:25 WS #93: Optimising Fertility - Periconception Management 9:35-10:30 WS #105: Optimising Fertility
More informationMyths About Success Rates Do they truly reflect quality of care
Myths About Success Rates Do they truly reflect quality of care Barry Behr PhD., HCLD Professor and IVF Laboratory Director Division of Reproductive Endocrinology and Infertility Dept OB/GYN Stanford University
More informationFertility Treatments & Your Lifestyle
Fertility Treatments & Your Lifestyle How You Can Improve Your Fertility Through Lifestyle Choices Where patients become parents It should come as no surprise that the lifestyle you lead directly affects
More informationSmoking Status and Body Mass Index in the United States:
Smoking Status and Body Mass Index in the United States: 1996-2000 Jun Yang, MD, PhD and Gary Giovino, PhD Roswell Park Cancer Institute Elm and Carlton Streets Buffalo, NY 14263, USA Society for Research
More informationRecommended Interim Policy Statement 150: Assisted Conception Services
Southampton City Clinical Commissioning Group (CCG) took on commissioning responsibility for Assisted Conception Services from 1 April 2013 for its population and agreed to adopt the interim policy recommendations
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 informationInfertility services reported by men in the United States: national survey data
MALE FACTOR Infertility services reported by men in the United States: national survey data John E. Anderson, Ph.D., Sherry L. Farr, Ph.D., M.S.P.H., Denise J. Jamieson, M.D., M.P.H., Lee Warner, Ph.D.,
More informationPolicy statement. Commissioning of Fertility treatments
Policy statement Commissioning of Fertility treatments NB: The policy relating to commissioning of fertility treatments is unchanged from the version approved by the CCG in March 2017. The clinical thresholds
More informationCOMMISSIONING POLICY. Tertiary treatment for assisted conception services
Final Version COMMISSIONING POLICY Tertiary treatment for assisted conception services Designated providers for patients registered with a Worcestershire GP BMI The Priory Hospital, Birmingham - 1 - Commissioning
More informationPolycystic ovary syndrome (PCOS)
Information for patients Polycystic ovary syndrome (PCOS) What is polycystic ovary syndrome? Polycystic ovary syndrome (PCOS) is a condition which can affect a woman s menstrual cycle, fertility, hormones
More informationLooking Toward State Health Assessment.
CONNECTICUT DEPARTMENT OF PUBLIC HEALTH Policy, Planning and Analysis. Looking Toward 2000 - State Health Assessment. Table of Contents Glossary Maps Appendices Publications Public Health Code PP&A Main
More informationSupport for Fertility and Infertility Treatment
Support for Fertility and Infertility Treatment Obesity causes an alteration to the hormones associated with women fertility Many different studies have concluded that obesity is related to impaired fertility.
More informationMetabolic Syndrome. Shon Meek MD, PhD Mayo Clinic Florida Endocrinology
Metabolic Syndrome Shon Meek MD, PhD Mayo Clinic Florida Endocrinology Disclosure No conflict of interest No financial disclosure Does This Patient Have Metabolic Syndrome? 1. Yes 2. No Does This Patient
More informationSHIP8 Clinical Commissioning Groups Priorities Committee (Southampton, Hampshire, Isle of Wight and Portsmouth CCGs)
SHIP8 Clinical Commissioning Groups Priorities Committee (Southampton, Hampshire, Isle of Wight and Portsmouth CCGs) Policy Recommendation 002: Assisted Conception Services Date of Issue: September 2014
More informationTrends in Egg Donation. Vitaly A. Kushnir MD Center for Human Reproduction
Trends in Egg Donation Vitaly A. Kushnir MD Center for Human Reproduction Disclosures No relevant financial relationships to disclose CHR views the commercial trade in human oocytes with considerable ethical
More informationFolate intake in pregnancy and psychomotor development at 18 months
Note: for non-commercial purposes only Folate intake in pregnancy and psychomotor development at 18 months Charlotta Granström Susanne Petersen Marin Strøm Thorhallur I Halldorsson Emily Oken Sjurdur F
More informationNutrition and Cancer Prevention. Elisa V. Bandera, MD, PhD
Nutrition and Cancer Prevention Elisa V. Bandera, MD, PhD The Causes of Cancer in the US. Sedentary lifestyle 5% Other 12% Family history 5 % Occupation 5% Tobacco 30% Reproductive factors 3% Pollution
More informationBACKGROUNDER. Pregnitude A Fertility Dietary Supplement for Reproductive Support Offers an Additional Option for Women Who Are Trying to Conceive
BACKGROUNDER Pregnitude A Fertility Dietary Supplement for Reproductive Support Offers an Additional Option for Women Who Are Trying to Conceive Studies find that increased chances of ovulation, menstrual
More informationDr Kate Van Harselaar
Dr Kate Van Harselaar Obstetrician and Gynaecologist Fertility Associates Dunedin 8:40-9:00 Modern Fertility - Social Changes Impacting Fertility Modern Fertility Social Changes Impacting Fertility Dr
More informationFemale Demographic Information
We re glad you found us here at Reproductive Medicine Associates of New Jersey (RMANJ). Perhaps you re struggling to conceive for the first time or have experienced multiple miscarriages. Maybe you re
More informationMEN S HEALTH AFTER CANCER WHAT YOU NEED TO KNOW: INFERTILITY
UW MEDICINE TITLE OR EVENT MEN S HEALTH AFTER CANCER WHAT YOU NEED TO KNOW: INFERTILITY KEVIN A. OSTROWSKI, MD OSTROWSK@UW.EDU TOM WALSH, MD WALSHT@UW.EDU LEARNING OBJECTIVES At the conclusion of this
More informationMONITORING UPDATE. Authors: Paola Espinel, Amina Khambalia, Carmen Cosgrove and Aaron Thrift
MONITORING UPDATE An examination of the demographic characteristics and dietary intake of people who meet the physical activity guidelines: NSW Population Health Survey data 2007 Authors: Paola Espinel,
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 informationNorth Staffordshire Clinical Commissioning Group. Infertility and Assisted Reproduction Commissioning Policy and Eligibility Criteria
North Staffordshire Clinical Commissioning Group Infertility and Assisted Reproduction Commissioning Policy and Eligibility Criteria Policy Infertility and Assisted Reproduction Commissioning Policy and
More informationReproductive Technology, Genetic Testing, and Gene Therapy
Michael Cummings Chapter 16 Reproductive Technology, Genetic Testing, and Gene Therapy David Reisman University of South Carolina 16.1 Infertility Is a Common Problem In the US, about 13% of all couples
More informationDoes a woman s educational attainment influence in vitro fertilization outcomes?
Does a woman s educational attainment influence in vitro fertilization outcomes? The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters.
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 informationGetting Pregnant, Staying Pregnant & Post Pregnancy by Siobhán Boucher.
Getting Pregnant, Staying Pregnant & Post Pregnancy by Siobhán Boucher www.siobhanboucher.com Getting Pregnant, Staying Pregnant and After you have your baby 1. Types & Causes of infertility 2. What can
More informationBROUGHT TO YOU BY. Blood Pressure
BROUGHT TO YOU BY Blood Pressure High blood pressure usually has no warning signs or symptoms, so many people don't realize they have it. According to the Center of Disease Control, CDC, about 75 million
More informationWest Hampshire Clinical Commissioning Group Board
West Hampshire Clinical Commissioning Group Board Date of meeting 25 July 2013 Agenda Item 9 Paper No WHCCG13/089 Priorities Committee Statement Assisted Conception/IVF Key issues An Interim Policy Statement
More informationInformation for you. What is polycystic ovary syndrome? Polycystic ovary syndrome: what it means for your long-term health
aashara Polycystic ovary syndrome: what it means for your long-term health Information for you Published in February 2005, minor amendments in June 2005 Revised 2009 What is polycystic ovary syndrome?
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 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 informationCEL 09 (2013) 15 May Dear Colleague
Director General Health and Social Care and Chief Executive NHS Dear Colleague Provision of Infertility Services in Scotland (updated IVF criteria) As you know a National Infertility Group was convened
More informationOOCYTE DONATION: AN OVERVIEW
OOCYTE DONATION: AN OVERVIEW *Nalini Mahajan Mother and Child Hospital, New Delhi, India *Correspondence to dr.nalinimahajan@gmail.com Disclosure: The author has declared no conflicts of interest. Received:
More information3. Metformin therapy for PCOS
1. Introduction The key clinical features of polycystic ovary syndrome (PCOS) are hyperandrogenism (hirsutism, acne, alopecia) and menstrual irregularity with associated anovulatory infertility. 1 The
More informationNutrition & Physical Activity Profile Worksheets
Nutrition & Physical Activity Profile Worksheets In these worksheets you will consider nutrition-related and physical activity-related health indicators for your community. If you cannot find local-level
More informationWhat is polycystic ovary syndrome? What are polycystic ovaries? What are the symptoms of PCOS?
What is polycystic ovary syndrome? Polycystic ovary syndrome (PCOS) is a condition which can affect a woman s menstrual cycle, fertility, hormones and aspects of her appearance. It can also affect your
More informationLaboratoires Genevirer Menotrophin IU 1.8.2
Important missing information VI.2 VI.2.1 Elements for a Public Summary Overview of disease epidemiology Infertility is when a woman cannot get pregnant (conceive) despite having regular unprotected sexual
More informationIVF Health Risk 503,000 Hit in Google in 0.2 seconds
Assisted Reproductive Technologies and Perinatal Morbidity: Interrogating the Association Kurt Barnhart, M.D., MSCE. William Shippen Jr Professor of Obstetrics and Gynecology and Epidemiology Perelman
More informationA multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of
A multi-centre, multinational, cross-sectional, incident case control study on Factors associated with the development of Endometrioma and deep infiltrating endometriosis Professor C. Chapron and the Group
More informationAppendix 1. Evidence summary
Appendix 1. Evidence summary NG7 01. Recommendation 1 Encourage people to make changes in line with existing advice ES 1.17, 1.31, 1.32, 1.33, 1.37, 1.40, 1.50, 2.7, 2.8, 2.10; IDE New evidence related
More informationFEMALE MEDICAL & REPRODUCTIVE HISTORY (There are 5 pages - please ensure you answer all questions)
2347 Kennedy Rd. Suite 304 Scarborough, ONT M1T 3T8 Tel: (416)754-1010 Fax: (416)321-1239 Date: FEMALE MEDICAL & REPRODUCTIVE HISTORY (There are 5 pages - please ensure you answer all questions) General
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 informationNHS FUNDED TREATMENT FOR SUBFERTILITY. ELIGIBILITY CRITERIA POLICY GUIDANCE/OPTIONS FOR CCGs
NHS FUNDED TREATMENT FOR SUBFERTILITY ELIGIBILITY CRITERIA POLICY GUIDANCE/OPTIONS FOR CCGs CONTENTS Page 1. INTRODUCTION 2 2. GENERAL PRINCIPLES 2 3. DEFINITION OF SUBFERTILITY AND TIMING OF ACCESS TO
More informationASSISTED CONCEPTION NHS FUNDED TREATMENT FOR SUBFERTILITY ELIGIBILITY CRITERIA & POLICY GUIDANCE
ASSISTED CONCEPTION NHS FUNDED TREATMENT FOR SUBFERTILITY ELIGIBILITY CRITERIA & POLICY GUIDANCE Version 1.0 Page 1 of 11 MARCH 2014 POLICY DOCUMENT VERSION CONTROL CERTIFICATE TITLE Title: Assisted Conception
More informationUnderstanding the metabolic syndrome
Understanding the metabolic syndrome Understanding the metabolic system Metabolic syndrome is the clustering together of a number of risk factors for heart disease, stroke and diabetes. Having one of these
More informationSample size a Main finding b Main limitations
1 Table 1. Available studies on the relation between endometriosis and miscarriage (1995-2015). Study (citation) Country Study period Study design Sample size a Main finding b Main limitations Matoras
More informationA healthy Nordic food index
A healthy Nordic food index Anja Olsen Danish Cancer Society Research Center Health effects of the Nordic diet November 13 th 2013 Outline Why study Nordic diet? How to construct a healthy Nordic food
More informationTitle: Studying the Complex Relationships Between Physical Activity and Infertility
Title: Studying the Complex Relationships Between Physical Activity and Infertility Authors: Kelly R. Evenson, PhD, MS Department of Epidemiology, Gillings School of Global Public Health, University of
More informationCENTER FOR HUMAN REPRODUCTION - CHR 21 East 69 th Street, New York, N.Y., Telephone: ; Fax:
CENTER FOR HUMAN REPRODUCTION - CHR 21 East 69 th Street, New York, N.Y., 10021 Telephone: 212.994 4400; Fax: 212.994 4499 PATIENT QUESTIONNAIRE (Please complete entire questionnaire prior to initial consultation
More informationHow to make the best use of the natural cycle for frozen-thawed embryo transfer?
How to make the best use of the natural cycle for frozen-thawed embryo transfer? Ariel Weissman, MD IVF Unit, Dep. Ob/Gyn Wolfson Medical Center, Holon Sackler Faculty of Medicine, Tel Aviv University
More informationAchieving Pregnancy: Obesity and Infertility. Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center
Achieving Pregnancy: Obesity and Infertility Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center Disclosures Speakers Bureau EMD Serono Board of Directors Nurse
More informationEFFECTIVENESS OF PHONE AND LIFE- STYLE COUNSELING FOR LONG TERM WEIGHT CONTROL AMONG OVERWEIGHT EMPLOYEES
CHAPTER 5: EFFECTIVENESS OF PHONE AND E-MAIL LIFE- STYLE COUNSELING FOR LONG TERM WEIGHT CONTROL AMONG OVERWEIGHT EMPLOYEES Marieke F. van Wier, J. Caroline Dekkers, Ingrid J.M. Hendriksen, Martijn W.
More informationPhysical activity, physical fitness and body composition of Canadian shift workers
Physical activity, physical fitness and body composition of Canadian shift workers Findings from the Canadian Health Measures Survey Cycles 1 & 2 Sarah Neil-Sztramko, MSc, PhD Candidate School of Population
More informationPrepare your first visit to Sakthi Fertility
Prepare your first visit to Sakthi Fertility Infertility History Form CONTACT INFORMATION FEMALE: First Name Middle Initial Last Name Date of birth (MM/DD/YY) / / Occupation Health card number Version
More information"FITNESS AND WELLNESS"
MAJOR PROGRAM POINTS "FITNESS AND WELLNESS" Part of the "GENERAL SAFETY SERIES" Quality Safety and Health Products, for Today...and Tomorrow Outline of Major Points Covered in the "Fitness and Wellness"
More informationUnderstanding IVF Processes in Surrogacy
Melvin H. Thornton II MD Medical Director CT Fertility Understanding IVF Processes in Surrogacy The Basics Surrogacy involves multiple parties IVF CLINIC Egg donors screening and matching* Medical process
More informationPublic Health and Nutrition in Older Adults. Patricia P. Barry, MD, MPH Merck Institute of Aging & Health and George Washington University
Public Health and Nutrition in Older Adults Patricia P. Barry, MD, MPH Merck Institute of Aging & Health and George Washington University Public Health and Nutrition in Older Adults n Overview of nutrition
More informationAntonia Trichopoulou, MD Dr. Trichopoulou is a Medical Doctor with State Certification in Biopathology (Laboratory Medicine) and has a Master in
Antonia Trichopoulou, MD Dr. Trichopoulou is a Medical Doctor with State Certification in Biopathology (Laboratory Medicine) and has a Master in Public Health and a PhD in Nutrition and Biochemistry. She
More informationPolycystic Ovary Syndrome (PCOS)
Polycystic Ovary Syndrome (PCOS) What are Polycystic Ovaries? Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (small cysts). Polycystic ovaries are very
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 informationDo it Once, Do it Right
Do it Once, Do it Right Craig Reisser Andrea Speck-Zulak Families Through Surrogacy 2016 Founded in 1989 - more than 25 years building families patients from 40 countries One of the largest IVF clinics
More informationObesity does not impact implantation rates or pregnancy outcome in women attempting conception through oocyte donation
IN VITRO FERTILIZATION Obesity does not impact implantation rates or pregnancy outcome in women attempting conception through oocyte donation Allison Styne-Gross, M.D., a Karen Elkind-Hirsch, Ph.D., b
More informationConsideration of Anthropometric Measures in Cancer. S. Lani Park April 24, 2009
Consideration of Anthropometric Measures in Cancer S. Lani Park April 24, 2009 Presentation outline Background in anthropometric measures in cancer Examples of anthropometric measures and investigating
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 informationBody Mass Index and success rate of IVF
Journal of Family and Reproductive Health Summer 2007; (): 4-46 Body Mass Index and success rate of IVF Farshad Savadkouhi M.D., Mina Jafarabadi 2 M.D., Fatemeh Ramezanzadeh 2 M.D. Military University
More informationCOMMISSIONING POLICY FOR IN VITRO FERTILISATION (IVF)/ INTRACYTOPLASMIC SPERM INJECTION (ICSI) WITHIN TERTIARY INFERTILITY SERVICES V2.
COMMISSIONING POLICY FOR IN VITRO FERTILISATION (IVF)/ INTRACYTOPLASMIC SPERM INJECTION (ICSI) WITHIN TERTIARY INFERTILITY SERVICES V2.3 2017 Agreed at Cannock Chase CCG Signature: Designation: Chair of
More informationEFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY
ORIGINAL ARTICLE. EFFECT OF SMOKING ON BODY MASS INDEX: A COMMUNITY-BASED STUDY Pragti Chhabra 1, Sunil K Chhabra 2 1 Professor, Department of Community Medicine, University College of Medical Sciences,
More informationERA. Endometrial Receptivity Analysis. Patented since
Endometrial Receptivity Analysis Patented since 2009 www.igenomix.com ERA ERA analyzes by NGS the expression of 236 genes in order to determine the personalized window of implantation for each patient.
More informationCommissioning Policy For In Vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) within Tertiary Infertility Services
Commissioning Policy For In Vitro Fertilisation (IVF) / Intracytoplasmic Sperm Injection (ICSI) within Tertiary Infertility Services Reference No: Version: 2 Ratified by: EMSCGP006V2 EMSCG Date ratified:
More informationChris Davies & Greg Handley
Chris Davies & Greg Handley Contents Definition Epidemiology Aetiology Conditions for pregnancy Female Infertility Male Infertility Shared infertility Treatment Definition Failure of a couple to conceive
More informationWhen you lose sleep in a regular basis, it is very difficult to catch up. Sleep is a very important mechanism that your body uses to recuperate.
Common Ovulation Problems The following problems are common among women who are trying to conceive. I will seek to describe these issues in detail and offer solutions to help you if you're struggling in
More informationHealth Risk Reduction. Printable Materials
Health Risk Reduction Printable Materials Activity C: Activity Cards Activity Card #1 High Cholesterol About High Cholesterol High cholesterol is one of the major risk factors for heart disease. Decreasing
More informationSchool Physical Activity and Nutrition (SPAN)Survey Results for McLennan County
School Physical Activity and Nutrition (SPAN)Survey 2008 Results for McLennan County What is SPAN? SPAN is the School Physical Activity and Nutrition Project. The goal of SPAN is to monitor the prevalence
More informationCOMMISSIONING POLICY FOR IN VITRO FERTILISATION (IVF)/ INTRACYTOPLASMIC SPERM INJECTION (ICSI) WITHIN TERTIARY INFERTILITY SERVICES
COMMISSIONING POLICY FOR IN VITRO FERTILISATION (IVF)/ INTRACYTOPLASMIC SPERM INJECTION (ICSI) WITHIN TERTIARY INFERTILITY SERVICES Version number V2.3 Responsible individual Author(s) Barry Weaver Trish
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 informationIRB USE ONLY Approval Date: September 10, 2013 Expiration Date: September 10, 2014
Approval : September 10, 2013 Expiration : September 10, 2014 DESCRIPTION: The goal of Assisted Reproductive Technology (ART) is to help infertile couples to become pregnant. During treatment, some cellular
More informationHealth Service System City & County of San Francisco
Health Service System City & County of San Francisco Health Service Board Meeting Infertility Coverage January 12, 2017 Prepared by: Infertility Infertility is defined as not being able to get pregnant
More informationObesity and Fertility in Women: Can we and should we treat obesity prior to conception?
Obesity and Fertility in Women: Can we and should we treat obesity prior to conception? Richard S. Legro, M.D., Penn State College of Medicine, Dept of Ob/Gyn, Hershey, PA, USA Obesity and Fertility in
More informationIui Intrauterine Insemination
Iui Intrauterine Insemination 1 / 6 2 / 6 3 / 6 Iui Intrauterine Insemination IUI, intrauterine insemination is a fertility procedure with success rates depending on female age, sperm numbers and any tubal
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 informationNumber of oocytes and live births in IVF
Number of oocytes and live births in IVF Dr Sesh K Sunkara MD, MRCOG Royal Marsden Hospital, London Kings Healthcare Partners (Guy s & St Thomas NHS Foundation Trust), London, UK Background IVF results
More informationUniversal Embryo Cryopreservation: Frozen versus Fresh Transfer. Zaher Merhi, M.D.
Universal Embryo Cryopreservation: Frozen versus Fresh Transfer Zaher Merhi, M.D. Disclosure: None Fewer complications with IVF 1.5% children in US are born through ART 1.1 million children since 2006
More informationObesity and Breast Cancer Risk in Hispanics: Findings from the Breast Cancer Health Disparities Study
Obesity and Breast Cancer Risk in Hispanics: Findings from the Breast Cancer Health Disparities Study Esther M. John, PhD, MSPH Senior Research Scientist Cancer Prevention Institute of California AICR
More informationSimplifying Vide Contraception. University of Utah Department of Ob/Gyn Post Grad Course February 13, 2017 David Turok
Simplifying Vide Contraception University of Utah Department of Ob/Gyn Post Grad Course February 13, 2017 David Turok Background Objectives At the conclusion of this presentation participants will be able
More informationIntrauterine (IUI) and Donor Insemination (DI) Policy (excluding In vitro fertilisation (IVF) & Intracytoplasmic sperm injection (ICSI) treatment)
Leicester City Clinical Commissioning Group West Leicestershire Clinical Commissioning Group East Leicestershire and Rutland Clinical Commissioning Group POLICY DOCUMENT Intrauterine (IUI) and Donor Insemination
More informationAge 18 years and older BMI 18.5 and < 25 kg/m 2
Quality ID #128 (NQF 0421): Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan National Quality Strategy Domain: Community/Population Health 2018 OPTIONS F INDIVIDUAL MEASURES:
More informationMichael S. Blaiss, MD
Michael S. Blaiss, MD Clinical Professor of Pediatrics and Medicine Division of Clinical Immunology and Allergy University of Tennessee Health Science Center Memphis, Tennessee Speaker s Bureau: AstraZeneca,
More informationT39: Fertility Policy Checklist
Patient Name: Address: Date of Birth: NHS Number: Consultant/Service to whom referral will be made: Institution Lifestyle Information Latest BMI: Latest BP: Smoking Status: Has the patient been referred
More informationHALTON CLINICAL COMMISSIONING GROUP NHS FUNDED TREATMENT FOR SUBFERTILITY. CONTENTS Page
HALTON CLINICAL COMMISSIONING GROUP NHS FUNDED TREATMENT FOR SUBFERTILITY CONTENTS Page 1. INTRODUCTION 2 2. GENERAL PRINCIPLES 2 3. DEFINITION OF SUBFERTILITY AND TIMING OF ACCESS TO TREATMENT 3 4. DEFINITION
More information9. NUTRITION AND ADULTS
9. NUTRITION AND ADULTS Extract Obesity can lead to Type 2 diabetes and other illnesses. OVERVIEW In this module, we will cover the following topics: Common problems Diets to help deal with stress, fatigue,
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 informationFACTORS ASSOCIATED WITH DIZYGOTIC TWINNING AFTER IVF TREATMENT WITH DOUBLE EMBRYO TRANSFER
FACTORS ASSOCIATED WITH DIZYGOTIC TWINNING AFTER IVF TREATMENT WITH DOUBLE EMBRYO TRANSFER HUM REPROD. 2012 OCT;27(10):2966-70. E. GROENEVELD, M.J. LAMBERS, M.E.F. STAKELBEEK, T.M. MOOIJ, A.W. VAN DEN
More informationAssisted Conception Policy
Assisted Conception Policy NHS Eligibility Criteria for assisted conception services (excluding In vitro fertilisation (IVF) Intracytoplasmic sperm injection (ICSI) treatment) for people with infertility
More information