It has been an interesting few days in the world of social media and fertility.  Inside the pages of Facebook, we have continued our discussions about egg donation – focusing on the education of the egg donor and the documentary “Eggsploitation: The Fertility Industry Has a Dirty Little Secret”.

Everyone seems to agree that we have a huge void in egg donor education – with conversations running from what is truly informed consent, to the lack of support that is given to books that try to educate the consumer on egg donation. There seems to be lots of information for the couple who needs egg donation – so why not the egg donor?

And then the question becomes who is the best qualified and the most unbiased when it comes to  egg donor education and information? Does anybody not have a horse in this race? Let’s break down all of the stake holders and my list is not a ranking!

1. Infertile couples who need donor eggs to build their families (which by the way includes people of all races and ethnicity, plus every  social economic group.  Women who need egg donation are not simply rich women looking to exploit poor women as Eggsploitation’s expert on the trailer which  is show cased on their website  says with conviction (Yes – that really raised the feathers on the back of my neck!).

2. Egg donors

3. Reproductive Endocrinologists and other  fertility medical experts such nurses, therapists and embryologists  who supply the services that make donor egg a possibility.

4. Pharmaceutical companies who supply the medications that produce the abundance of eggs needed for egg donation.

5. Egg Donation Agencies who are often chosen by the infertile couples over IVF Centers as a source for donor eggs.

6. Reproductive Medicine Attorney’s who help with contracts, legal issues, and sometimes are in the egg donation business.

7. Patient Associations who represent not only the consumer – but are often supported by stake holders in the fertility field.

8. Professional Associations – Whose membership consist of many of the stakeholders.

9.  Right to Life Groups who don’t want embryos created and possibly discarded. These groups often view outlawing any form of IVF as an important bridge to outlawing abortion.

10. Angry former patients – this group includes former and current egg donors, and individuals who used donor egg -  who feel that they were not given informed consent or where things just went sour. Regret is a powerful emotion.

11. Politicians who want to appeal to certain voting demographics.

12. The Media – who love a good story to tell.

13. Centers or Committees on Ethics and Public Policy,  Certified Health educators, and Government offices – These groups are often filled with folks who think they need to keep the rest of us “safe”.

14. Parents, friends  and advocates of the children created through donor egg.

15. Parents, friends and advocates of egg donors.

16. Fertility Consultants: people who have made a career out of guiding people who are trying to conceive and work with all the stake holders.

17. Happy, and Satisfied Patients who have often have nothing but good things to say about their experiences. This group also includes egg donors and recipient individuals.

I don’t know about you – but to me it looks like there are a lot of horses in this race – and every one has an agenda. That is simply a reality.  Does that make the points of view that come through each lens invalid?  I don’t think so – but I think it is good to know where your information is coming from and to take the information in knowing each agenda.

What’s my agenda? I would like for this conversation around the education of egg donors to continue. I think it is past time. The fact sheet that I wanted to develop is ancient history (yeah, I am still angry).

Perhaps the answer is not to look for unbiased information – because perhaps that simply does not exist.  Right now – I just would vote for information to be created and for folks to know who is supplying it! If “Eggsploitation” does one thing for this community filled with passionate, caring people from every corner – it may be to get all of us to wake up, load our horses into the gate and go!

Posted under "Eggsploitation", "Google Baby", Donor Egg, Egg Donation, Egg Donor Compensation, Facebook, Fertility, Fertility Blogs, Fertility Coach, IVF, Infertility, Infertility Consultants, Infertility Funding, Long Awaited Children, egg donors, eggs

Yesterday, I blogged about “Eggsploitation: The Fertility Industry Has a Dirty Little Secret” And then I did what I do – and put it on Facebook and Twitter.  I have all kinds of “friends” – people that I know and don’t know which include many “insiders” in the fertility industry. And  what I saw was the beginning of what has been a gradual self examination practice when it comes to the business of egg donation – and the beginnings of a discussion about how the industry educates egg donors. I would love to help encourage that discussion to continue.

The education of egg donors has been important to me for a very long time.  I may have told this story before – but it is worth telling again.  It also speaks to how money controls public education.  In my day of running patient organizations I had to get funding for all of my educational fact sheets (because there is no federal funding of patient organizations as there exists in some countries like The Netherlands). Getting industry funding for fact sheets at patient organizations is a practice that continues today across the board at many non profits.  Just check the fact sheets – you will see sponsorship listings.  There is no big secret there.

So once upon a time, I wanted to do a fact sheet for potential egg donors – and I asked a big famous doctor at a big famous IVF Center to sponsor it.  I got a big fat yes – and I began the process of writing it. When the doctor got a hold of the fact sheet – he screamed that he was withdrawing the funding because the fact sheet was going to encourage the egg donor to ask too many questions – and answering these questions would take precious time away from the business of running his program.  Would I like to pay him for the time lost in answering egg donor questions that the fact sheet would provoke?

That fact sheet was never created because no one wanted to fund it. It was bad for business.

No matter how conflicted I feel about “Eggsploitation” (you can read their press release here) – especially their portrayal of the egg donor recipient as shown in the trailer on their website, I am glad that The Center For BioEthics and Culture Network produced it. Because while it may be extreme in it’s point of view – it is telling a point of view that needs to be told – and is not being told anywhere else. We need to make room for this perspective on egg donation – because it is real. These young women who are telling their stories are real – even if they don’t represent the majority of the egg donor experiences – it doesn’t make their experience any less valid or important. We need to hear them.

Everyone in the baby making world wants to feel like they are doing the right thing by egg donors, egg donor recipients, and most of all – the children that are created from that match. But money influences the waters. And without egg donor compensation there would be no egg donors. We all know that.

And money influencing the fertility field is not unique to the fertility field – it is a constant factor in every field – that is why big Pharma can’t buy dinner, or even give out pens anymore. We have all begun to acknowledge that fact.  It doesn’t matter how big or how small the donation is – money has this awful habit of controlling things.  And I have no answers – because every one needs money – and money pays the bills to keep the doors open for everyone. Even The Center for Bio Ethics and Culture Network has funders with a point of view.

But I do get disturbed with I see patient organizations with more professional/industry invested board members than patient board members.  And I do get even more disturbed – when I look deeper at who is running the ships – and there is an over abundance of board members in one part of the industry that we as a fertility community depend on for our unbiased information.  It is not that folks who serve in the industry or on non profit boards are evil doers – it is just that we need balance.  And without that balance of professions and areas of interest – there is an  influence in very quiet ways in regard to  the information that the consumer receives.

Yes – it is time for us to go deeper and really look at what information is shared with the consumer – how the information is being positioned – and who in the end – the creation of the educational materials are truly serving.  We must always keep in the front of our brains that consumer education is not marketing.

Posted under Advocacy, Egg Donation, Egg Donor Compensation, Facebook, Fertility, Fertility Blogs, Fertility Education, Fertility Marketing, IVF, In Vitro Fertilization, Infertility, Infertility Funding, egg donors, eggs, patient advocacy

A colleague of mine sent me a link to “Eggsploitation: The Fertility Industry Has a Dirty Little Secret” late last night – her email simply had the link – and word “WOW”.

I sat watching with my mouth looking like a bass fish  – open and gaping – as several young women told their horrifying story of being an egg donor in the United States. They spoke of feeling enticed by the money into donating their eggs – the poor explanations of what they could experience – and the tragedy of the complications that they unexpectedly faced as egg donors. The trailers on the website are riveting – and appalling.

It is certainly not a view – that recipient couples, egg donor coordinators, fertility specialists, and egg donor agencies will likely be comfortable seeing. But does that make it any less valid an exploration?

That is the struggle that those of us who live inside the fertility “industry” really have to grapple with.  So often – when these types of images of the fertility field are presented – we shout “foul play”! We pound our chests – and blog our hearts out about how unfair the media is to our field. You can hear us shout that
the entire story is never told – that the world of infertility is highly sensationalized  and distorted in order to sell magazines – or this evening news story.

Quite frankly – there is a great deal of truth in that opinion and outrage.  Frankly – even in the title of the documentary – calling the experience of egg donors a “dirty little secret’ is beyond over of the top. But the producers of the film  are marketing a documentary! If there is no dirty little secret – why buy a ticket?

And there will be people who will watch the clips – and perhaps even go see the documentary – who will come out drawing an analogy of these young women to aviation safety records – “You know – airplanes land safely every day across the country – thousands of them – and you never hear about that! But if ONE plane goes down – boy does that make the news!”  That’s because there is tragedy when even one airplane goes down – and we need to hear about it.

That is how I feel about “Eggsploitation” even where it fails in it’s own sensationalism. I am still wanting to hear the stories of these young women. It’s that important.  Look -  I didn’t like the trailer featuring the “experts” who said that egg donation is about rich older women taking advantage of younger women with good eggs. That is really horse shit – and shows a complete lack of understanding about the women who need donor egg.  I have never met a woman who needs donor eggs who is anything but grateful to donors. And the majority of the women who need donor egg are not rich.  That characterization was frankly wrong and horrifying – and in my mind brings down the messages that perhaps “Eggsploitation” is trying to get out.

We have to be very, very careful – with the young women who step up to donate their eggs.  We need to be careful about donor compensation being so high that young women feel enticed. We have to do a better job educating donors about the risks of egg donation – no matter how good everyone in the fertility field feels they are already doing it – we will have to do it better. These young women are making what I call “life time decisions” when they decide to donate their eggs. Even when their cycles go perfectly well (and most of them do) – these young women are giving up their genetic material forever – and exposing their bodies to a lot of unknowns in the process at a very young age.  That is simply real.

And we all have to cop to the fact – that no matter how careful we are – no matter how much time is spent – and how carefully these young women are consented and educated in the best of circumstances – people make all kinds of informed  decisions – for all kinds of reasons.

And sometimes – things just don’t go as planned.  And all we are left with is regret, pain and anger.

Posted under Egg Donation, Egg Donor Compensation, Fertility, egg donors, eggs, infertiity

Last Thursday I dropped in on a seminar on egg donation in Argentina.  You see “Cross Border” reproduction,  “Fertility Tourism” or whatever you want to call it works both ways. People come to the United States for fertility treatment because they cannot access certain reproductive technologies  in their countries (such as egg donation and surrogacy) and people leave the United States because they cannot afford to pay for treatment.  It’s kind of wacky – isn’t it? And in all of the coming and going of patients – from one country to the next – has opened a kind of free market among fertility centers to work at attracting them to their centers. I know this. I have done this.

As I sat in the room that Dr. Demian Glujovsky from “Fertility Argentina”  rented in Manhattan – I watched the couples and single women roll in. I introduced myself – I got the feeling that Dr. Glujovsky was not thrilled that I was there. I was not a potential patient. He didn’t offer me any bottled water the way he offered the other maybe 20 people who sat with me and listened to a bit of tourism rolled into low cost baby making.

Did you know that Argentina is famous for tango dancing? We were shown pictures of a beautiful town outside of Buenos Aires where one could go skiing in the winter….or swimming in the summer. Very nice. I was reminded of how the American programs spoke about visiting NYC or Washington DC  to the lovely potential patients in the United Kingdom.

My stomach clenched in the memory. Yep – I think that I even did that at the Fertility Fair in London. Somehow – I was liking it less now. Interesting huh? Mirror, mirror on the wall?

We learned about the time line – how long it would take to make a baby via egg donation the South American way – about three months….The time one would spend in the airplane – about ten hours each way – Dr. Glujovsky assured us that “You can do it!” – and that egg donors were paid modestly and shared 2.6 ways to help reduce the cost.  2.6? I never understand numbers like that. I mean – who gets the .6?  I found myself mentally counting potential off spring from each donor – so if the donor donates 6 times – that is a lot of half sibs in the world….

Potential patients were told that they could count on getting four eggs and two embryos.  Fertility Argentina was not into cryo preservation.  If you didn’t get pregnant – come back. So was it really cheaper after all? I found myself playing with the numbers – I guess it depended on your luck. But what if you were not so lucky – was the price really cheaper then? I wasn’t sure.

I left before the seminar was over. I had heard enough. Dr. Glujovsky seemed like a nice enough man – and reputable enough as well.  His center in Argentina did a tremendous amount of cycles. There was nothing shady going on. No big expose to write.

Certainly flying 20 hours round trip to Argentina – seeing tango dancers – eating good beef and making a baby for less money – was an option.  Just as flying to NYC, seeing a Broadway show, the statue of Liberty of Liberty – and getting access to egg donation with American protocols was also an option for the patients that fly into the US every day to build their families.

So what was bothering me? I have to be honest – I am not really sure.

Perhaps it is that this is necessary at all.  That no matter which way the patients are flying – to the United States or out of the United States – that they are forced to leave their homes to get access to care to build their families. Perhaps it is the commercialization of infertility – the heavy marketing  – the hard sells.  I mean – it used to be that people went to IVF Clinics because they wanted a baby desperately – should we even be talking about museums?  Do other fields of medicine do this? What do you think?

Bottled water anyone?

Posted under "Cross Border Fertility Treatment", Donor Egg, Egg Donation, Egg Donor Compensation, Fertility, In Vitro Fertilization, Infertility, egg donors, eggs

So in case you missed it – right now in Rome is the  26th annual meeting of the European Society of Human Reproduction and Embryology (ESHRE).  The studies are coming fast and furious – as are the press releases.  I loved the title of this one:

“Studies of women’s attitudes to ’social egg freezing’ find that young professionals put career ahead of motherhood, while older women are still waiting for Mr. Right”

Ya think?  I could have told them that! But it is always good to have a study right to confirm what we already know to be true. And it was a good study.  I have been talking about preserving fertility, and “social egg freezing” for years now – way before the technology caught up with the need and the language.  I predict that one day – women will freeze their eggs when they are in college as routinely as young girls put on braces in middle school.  It’s about preparing for the social reality of being a woman in today’s world.

According to the press release:  ” Women of different ages differ in their reasons for wishing to undergo egg freezing, show two studies presented to the 26th annual meeting of the European Society of Human Reproduction and Embryology today (Monday). A large number of female university students would be prepared to undertake egg freezing in an attempt to combine career success and motherhood, said Dr. Srilatha Gorthi, a research fellow at the Leeds Centre for Reproductive Medicine, Leeds, UK, adding that her team’s research emphasised the importance of educating young women about their biological clocks in order that they could take informed decisions about future reproduction.

Dr. Gorthi surveyed 98 medical students (group A) and 97 students of education and sports studies (group B) from the University of Leeds. Information regarding egg freezing was provided, including the fact that they would have to finance their own egg freezing. The average age was 21 with age range from 18-30 years in both the groups; 63.3% of the medical students were not in a relationship, as opposed to 25.8% in group B, probably reflecting the level of commitment and time needed for their courses.

While 85.7% in group A said that they would be prepared to delay starting a family, only 49.5% in group B said they would consider this. Eight out of ten from group A said they would undergo egg collection and freezing, compared with only half as many (four out of ten) from group B. In group A, 85.3% were prepared to undergo up to three cycles of egg collection to bank enough eggs to give them a realistic chance of pregnancy. In contrast, the majority (79%) of those who would bank their eggs from group B said they would be prepared to undergo only one cycle of egg collection.

“Career considerations were given as the commonest reason to delay starting a family in group A, followed by financial stability and marriage or a stable relationship,” said Dr. Gorthi. “However, in group B, financial stability came first, followed by a stable relationship and then career reasons. We think that this is the first time that young women’s attitudes to egg freezing have been studied in this way.”

Egg freezing is still a relatively new technology; a woman has to go through an IVF treatment cycle, which takes two to four weeks and carries certain risks: ovarian hyperstimulation, haemorrhage, infection and a possible, albeit small, effect on future natural fertility.

Until a few years ago, egg freezing was largely restricted to women undergoing chemotherapy for cancer because the chances of an egg surviving the slow freezing and thawing process was as low as two percent. Now, thanks to new techniques such as vitrification, where water from the eggs is removed and they are flash-frozen, frozen eggs are as good as the fresh ones. Women seem to have a realistic prospect of delaying motherhood if they wish to do so, similar to men. The average cost of egg freezing is around £3000 per attempt and some women may have to undergo up to three cycles in order to cryopreserve a good number of eggs.

At a time when women are increasingly delaying having children until their late 30s and even 40s, clinics offering egg freezing are in need of information on the attitudes and expectations of young women in order to enable them to tailor counselling more appropriately. “There has been a vogue for offering freezing for social reasons to women, especially those embarking on their careers, or those who haven’t found their Prince Charming, as a kind of insurance policy for later life. Research has proven that young eggs have a better genetic competency than older ones, and the chance of egg freezing working also declines with age. While the best results are likely to be in those under 30 years old, in reality it is predominantly women in their late thirties who are requesting egg freezing,” said Dr. Gorthi.

“There is still a lot of misinformation about the age at which the women could start their families, the likelihood of success of treatment and the number of oocytes that need to be retrieved and frozen in order to give a realistic prospect for future success. Women thinking about undergoing this procedure must be provided with accurate information and have counselling to both the benefits and limitations of oocyte freezing compared with other options. This will enable them to take the decision which is right for their circumstances,” she said.

“In addition, support from society is warranted for young women who choose to have a family when they are ready without compromising their careers. Experience from clinics who offer egg freezing for social reasons has shown that the use of frozen eggs is considered the last resort when women fail to conceive naturally,” Dr. Gorthi said.

In a second study, Dr. Julie Nekkebroeck*, a senior psychologist at the Centre for Reproductive Medicine, UZ Brussel, Brussels, Belgium, found that a group of highly educated and financially secure women with an average age of just over 38 years had applied to have their eggs frozen because they had not yet found the right partner with whom to have children. Dr. Nekkebroeck and colleagues interviewed the 15 egg-freezing candidates in order to ascertain their reasons for wishing to undergo the procedure.

“We found that they had all had partners in the past, and one was currently in a relationship, but they had not fulfilled their desire to have a child because they thought that they had not found the right man,” she said. The women found out about the possibility of egg freezing via the internet; before that, 46.7% had thought about becoming a single mother through the use of donor sperm, and 26.7% of them had considered adoption or staying childless.

The main reasons for opting for oocyte freezing were taking the pressure off the search for the right partner (53.3%), and giving a future relationship more time to blossom before bringing up the subject of their desire for a child (26.7%), whereas for 33.3% it was an insurance against future infertility. All 15 candidates had shared their intentions with their family and close friends and none of them felt discouraged by their entourage.
Out of the 15 women, 53.3% felt that the financial cost was a disadvantage of undergoing treatment, and 26.7% considered that the use of hormones was a deterrent. However, all of them accepted that they needed to undergo treatment while they were still healthy and fertile and they were also willing to repeat the treatment at least twice.

“The average age that the women thought they would use their frozen oocytes was 43.4 years, an age at which, for most women, there is considerable difficulty in achieving a spontaneous conception. But if they found a suitable partner, most of them would prefer to try to become pregnant spontaneously, rather than perform IVF with fresh material or, in the last instance, use their frozen oocytes,” said Dr. Nekkebroeck.

If the women did not need their oocytes, 46.7% said that they would donate them for scientific research, 13.3% would donate them to another woman, and 26.7% were unsure about what to do with them.

“We intend to continue interviewing these women in order to confirm our preliminary results and will also arrange follow-up interviews after their egg collection and freezing, and when they return to the hospital to collect and use their vitrified eggs. Because women have only just gained access to this efficient method of preserving their fertility, we believe that our results will add to the continuing debate about egg freezing for social reasons. Such research seems to indicate that social freezing might be added to the list of preventive measures to be taken against future age-related subfertility in women, besides fertility awareness campaigns, but only on the understanding that these women are properly counselled and educated about success rates, fees, treatment procedure etc.,” Dr. Nekkebroeck concluded.”

Really it’s about making egg freezing technology accessible, reliable and affordable.  The need is clear.

Posted under Egg Banking, Egg Freezing, eggs

I have been speaking to women who are struggling with infertility for what feels like a life time. From my time as the President and then Executive Director of RESOLVE NYC to my time as the founder and first Executive Director of The American Fertility Association.

Now, I am hearing again from woman through this blog. The stories are all different and they are all the same. It is the regret that always gets me – that rips my heart. The level of self punishment that many of the women are putting themselves through because they blame themselves, even while they tell me that nobody ever offered them education about their fertility. And the pain that vibrates through the phone or an email is palpable. Often the woman makes apologies for the life that she had lived. There might have been an abortion. There was waiting too long to start trying once she was married….If only she had been better…if only she had been “a good girl”.

What I want to say here – is that the system has failed so many women. They have not failed themselves. Where were they supposed to get this information? From the air? When I was in school – I was taught about sex, STDs’ and birth control. That was it. Sex Education was about pregnancy prevention. That was it. Woman need to be given all the facts about reproduction starting from a young age. We need the complete story and that does include safer safe, information about STD’s, birth control and information about our reproductive potential as women.

These days – I spend about as much time directly with gynecologists as I do patients.  I drop in – and chat with them about fertility – and also the importance of talking to women about the getting a fertility evaluation.

Recently, I met with a young female GYN – and in the beginning the gynecologists agreed with us that the woman that they see have no idea of their biological clock – and they understood why giving them this information is important. And then, as it sometimes happens – this lovely female gynecologist got nervous about getting her patients nervous about their biological clocks. I told her that I really get nervous going for my mammograms and my pap smears – but that I go – because the information obtained from those tests can change my life.

I talked to her about the importance of women getting this information so that they could plan their own reproductive lives and perhaps stay out of reproductive endocrinologist’s offices. It is all about the possibilities that women now have – that if they learn that they are in a borderline place when it comes to their fertility – and they are not ready to start their families that they can freeze their eggs.

By the time that I left that office – I knew that I had created change. I had brought this office more than bagels and coffee – I had brought them information and a point of view that this office had not heard before – and it was a big office. By making these house calls of GYN’s, perhaps I  had changed the course of the reproductive lives of some women. I know that this sounds dramatic – but it is dramatic. This one practice with several gynecologists literally sees hundreds of women. By enrolling these doctors into our quest for better education for women around their fertility. I feel like we are building an army of educators one office at a time. We even talked about ways to introduce this information. And before the coffee and bagels were finished – they got it.

When I got home there was a letter from a woman waiting for me. She was full of regret. She was sure that how she had lived her life was the reason for her struggles to conceive. I wrote to her and I told her about all of the possibilities that still awaited her…for there were still many possibilities…the world still had much to offer up. That this was not about some notion that she had not lived a good life. That the infertility that she was now struggling with was not some kind of punishment. Why do we always go there? Why do we as women always blame ourselves? I wish that she had gotten information earlier – but that was my only regret for her – but that was it. And then I sent her this poem by Mary Oliver – perhaps this poem will touch you too…perhaps it is for all of us…no matter where you are in your life….

Wild Geese
by Mary Oliver

You do not have to be good.
You do not have to walk on your knees
for a hundred miles through the desert repenting.
You only have to let the soft animal of your body
love what it loves.
Tell me about despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
are moving across the landscapes,
over the prairies and the deep trees,
the mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
are heading home again.
Whoever you are, no matter how lonely,
the world offers itself to your imagination,
calls to you like the wild geese, harsh and exciting –
over and over announcing your place
in the family of things

Posted under Egg Banking, Egg Freezing, Fertility, Fertility Education, Fertility Preservation, Fertility Support, eggs

Ah Springtime! The time of year when mother nature is showing off her buds! And those of you with lawns and gardens are adding fertilizer to the soil. But what about us? What are some “Fertility Do’s ” for us? Well….I just happen to have some – of course I do!

Fertility Do’s:

1. Do get those annual exams done! If you are thinking about getting pregnant – get your annual exams done first! You know what I am talking about – get your teeth cleaned and any x-rays done.  What about you mammogram and your pap? If you have been trying to conceive for a year – please take a short break and do your annual exam again! We want you to be a healthy parent!

2.  If You Are Under The Age of  of 34 and not planning on getting pregnant right now:  Do Get a Fertility Evaluation.

3. If you are sexually active and you are not in a monogamous relationship or only “fluid bonded” to one person – Do use condoms. Sexual Transmitted Diseases (STD’s) is a leading cause of infertility.

4. Do see a Fertility Specialist if you are 35 years old and have been trying for six months or longer. Too many women waste precious years sitting in their gynecologist’s office cycle after cycle. Or on too many cycles of clomid.

5.  Do make friends with your body. Your relationship to your body does count. Get in touch with yourself. What is your body trying to tell you through physical symptoms? Read “Women’s Bodies, Women’s Wisdom: Creating Physical and Emotional Health and Healing” by Christiane Northrup, MD. Learn about how the effects of nutrition, stress reduction, complimentary medicine, sex and lifestyle can impact on your fertility.

6.  If you use a intimacy lubricant when making love,  Do use a product that is fertility friendly, and organic such as  YES Baby.

7.  If you find yourself going through infertility,  Do build yourself a “Fertility Support Team”.  A Fertility Support team could consist of your everyday friends and family. For some people that is the best – and for others the idea of talking about infertility with close family and friends is really edgy. But there can be lot of components to a “Fertility Support Team”.  For peer support there are lots of great on line opportunities for connection. Check out Fertility-Ties for a great on line 24/7 community of peer support and professional answers, or INCIID has a great network of message boards.  If you prefer meeting face to face check out the in person support groups that are offered by RESOLVE and Parents Via Egg Donation.

8. Do think about hiring a “Fertility Consultant” if you are able to afford one (and some of them are not too pricey at all). It is wonderful to have your own personal guide through the world of reproductive medicine.  Your Fertility Consultant acts as a kind of “Conception Life Coach”  You don’t need to live in the same town or even state as your consultant. Most of the work is usually done on the telephone.  A short resource list would include - “My Fertility Plan”,  and “Lotus Blossom Consulting”.

9. Do get a second opinion if you are working with a doctor and have not achieved a pregnancy in six months to one year.  A great way to get a second opinion is to take advantage of free consultations. To learn more about free consultations and second opinions read this blog entry.

10.  Do read fertility blogs like The Fertility Advocate or The Fertility Doc. There are all kinds of fertility blogs on line and they are wonderful and different.  It is a great way to feel like you are not alone – get daily support and information – and learn about the reproductive medicine community. There are doctor blogs,  reproductive attorney blogs,  patient blogs, and “Tell it like I see it blogs”!

Fertility Authority has a great blog community – but there are lots of independent fertility bloggers out there, (I only linked to a few here) with so many unique stories and points of views. Go investigate community sites like Blogher, and Empowher. You will find just what you are looking for…..

11.  Do explore the websites of the fertility industry’s professional organizations such as The American Society of Reproductive Medicine and The Association of Reproductive Health Professionals. These professional organization often have good patient information on them – and you can get familiar with fertility practice guidelines there. Also the medical information may be more updated then the fact sheets that are on the patient organization’s websites. I was just checking some of those out – and I was shocked to see some fact sheets that were older than ten years old on some of these sites. Check for dates! Don’t just assume that fact sheets are current just because they are there (uh-oh a “Don’t” slipped in here!).

12.  Do Investigate your clinic’s success rates by jacking into The SART Report. And remember when you are reviewing success rates that small differences mean nothing.

Posted under Clomid Therapy, Egg Donation, Fertility, Fertility Authority, Fertility Blogs, Fertility Coach, Fertility Message Boards, Fertility Preservation, IVF, In Vitro Fertilization, Infertility, Infertility Consultants, Micro-IVF, PVED, STDs, Sexually Transmitted Diseases, The Association of Reproductive Health Professionals, The Fertility Advocate, The Fertility Doc, The SART Report, conception tips, eggs, miscarriage, sexual health, sexuality

The blogosphere is jumping with the Springtime vigor of fertility, sexuality and the urge to renew! After all – it is the season! We have spent the last few weeks literally surrounded by every possible kind of egg and bunny – the trees are full of blossoms, and the tulips are coming up.  This  beautiful and abundant time of year can actually be  really rough  if you are going through infertility.

Mother nature is showing off her fertility every where we look – and the customs and holidays of this season dances perfectly with the message that it is time to go forth and multiply!! Like now.

So – it’s not surprising to me that I am reading posts by folks TTC that some of them are feeling “angry for no reason at all”.   Or at least a reason that they can’t quite name.   If I was to name it  – to say why this season is the hardest of all for those TTC – it’s because this is the season of fertility! It can be overwhelming to be surrounded by images of fertility everywhere – and those winter coats are off – and the pregnant parade has begun!

There has been a lot of Spring advice on the blogosphere this week.  Dr. Rob, always an advocate of positive thinking is encouraging those TTC to meditate on the words “I AM FERTILE”.  For further “Fertile” meditation instructions by Dr. Rob, and  accessing the positive – check out his blog “Mind-Body-Smile”.

Over at Fertility Authority – Kristen Magnacca is inviting us to access our inner Goddess Aphrodite ( the Greek Goddess of fertility, sexuality, love and beauty).

Now – I bet you are wondering – what Spring time advice does The Fertility Advocate have to offer up? Well dearies – first let me say that there is no way around it – it can really stink to be having difficulty TTC  in the season of wild public displays of fertility.  It’s like there is a great big party going on – and you have not been invited.  So let’s just put that one out there.  If you are feeling especially grumpy right now – that might be the reason. So I am sending cyber hugs.

Next – here comes my wise words for what they are worth:

I like Kristen’s advice – so check out that blog entry.  It might be a great time to feel your own inner feminine goddess again.  I know that she  is in there – whether she is having trouble ovulating that perfect egg or not.  Your beautiful feminine energy is alive and well – she is just probably feeling neglected.  For some more practical advice on finding her again – I encourage you to check out two entries that I wrote in January: “Attention Ladies:  The Fertility Advocates Top Ten Recommendations for Making 2010 a Sensual New Year” and “More Recommendations For Making 2010 a Sensual New Year”.  Have an open mind – and take a read. Perhaps some of what is out there might actually help a little bit.

How has the holidays been for you? Has Spring brought feelings of renewal and fresh hope – or have you felt out of sync with Mother Nature?  What do you think about the advice – that it might be fun and healing to get into touch with you inner Aphrodite?  Leave a comment.  I would love to know!

Posted under Body Image, Coping with the holidays, Creating our own happiness, Female Self Image, Female Sexual Desire, Fertility, Fertility Advocate's Hot List, Fertility Authority, Fertility Blogs, Fertility Rites and Symbols, Fertility Support, Infertility, Sex, The Fertility Advocate, What Every Women Can Do To Take Care of Themselves, conception tips, eggs, sexuality

The fact is that most people still do not have insurance coverage for in vitro fertilization (IVF), forcing many patients to make treatment decisions based on their budget and not on best practices. And then comes the question – what IS best practices? Do they simply live in the ASRM guidelines? Or are best practices something that is still influenced by the dollar in IVF Centers around the country. Unfortunately, fertility clinics have not made care more affordable to assist their patients in making better decisions.

Most people do not have insurance coverage for in vitro fertilization (IVF), forcing many patients to make treatment decisions based on their budget and not on best practices. Unfortunately, fertility clinics have not made care more affordable to assist their patients in making better decisions. Without good options, patients often resort to less expensive treatments including ovulation inducing hormones that stimulate multiple eggs to ovulate resulting in high risk, costly multiple pregnancies. IVF can avoid these multiple pregnancies by limiting the number of embryos transferred. In this way, affordable IVF saves money with less need for hospital beds, NICU beds and disability care.

“It is my strong belief that every infertility center in the United States needs to restructure their costs in some way even if means making less money,” says David Kreiner, MD FACOG| Medical Director at East Coast Fertility (ECF). “Our clinic’s Single Embryo Transfer Program incentives transferring one embryo at a time so patients don’t have to feel they must hedge their bets and transfer more embryos to increase the chance of pregnancy.”

A patient in the ECF program pays only for the initial fresh cycle. Thereafter, the cryopreservation of the embryos, the storage of the embryos and unlimited frozen embryo transfers are free. This eliminates the financial need for the patient to put all her eggs in one basket.  In my view – this is a program that should be adopted at IVF centers around the country. I would love to see this as the standard of care.  And all it would take for this to be  the standard of care is for more IVF Centers to be willing to reduce their income by a very little bit.

ECF also offers a minimal stimulation program, MicroIVF, that not only is affordable ($3900) but eliminates the risk of hyperstimulation syndrome, uses fewer medications and minimizes the risk of developing a multiple pregnancy. MicroIVF is essentially the cost of IUI with ovulation inducing medications without the risk and better than twice the success.  The only reason that I can see that so few IVF Centers around the country offer Micro IVF is that is needs to be reported to SART and The CDC as a regular IVF Center – and therefore has the power to lower a IVF Clinic’s overall success rates because while it has higher outcomes than an IUI without the multiple births – it has a lower success rate than standard IVF.  In this day of high marketing and stiff competition for patients- doctors aren’t willing to give up their marketing edge. It has nothing to do with best practices for the patient when it comes to offering Micro IVF.

I am so proud to work with a clinic who is a leader not just in reproductive care but in reproductive ethics.
“My wish is to assist all patients in need with creating that healthy family of their dreams without adding unnecessary risk,” says Kreiner. “Our programs help them in their quest. Until the government and insurance companies step up with coverage, it is up to the IVF programs themselves to help patients get the IVF that they need to build their families.”

How is that for a call to action for IVF Centers around the country?

Posted under Dave Kreiner, Dr. Dave Kreiner, East Coast Fertility, Egg Freezing, Fertility, IVF, In Vitro Fertilization, Micro-IVF, Single Embryo Transfer Program, The CDC, eggs, infertiity, patient advocacy

Do you think it is easy to crank out these stunning, insightful and often politically charged entries everyday? It’s not always easy being The Fertility Advocate – finding stories and issues in the world of reproductive health worth commentary five days a week! But I can take comfort in the fact that I am not the only fertility sleuth that often has to search high and low for something noteworthy to write about.. after all ABC News just did a big story to report that Courtney Cox is “revving up her engines” to have another baby. That’s right folks – it’s news that Courtney Cox is THINKING about having another baby! Now that is something worth writing about….

Okay. Okay. This entry could go both ways now. I could get all snotty – and start to say things like “Courtney Cox better do more than just think about “revving up” her engines at age 45″.  That is if she is thinking about using her own eggs.  And I could dismiss this story as simply a celebrity puff piece – but really there is something worth writing about here – if you just look a little deeper at this story.

It’s the continuation of the myth that if you have enough money you can get anything you want. The fact of the matter is when it comes to our health and the possibilities of our bodies including our reproductive potential – money is often not enough. I am happy for Courtney that money is not an issue for affording her fertility care as it is for many Americans – it is true that is one stumbling block.  But even those that are not rich and famous can often find grants or infertility financing programs.

The issue that is facing Courtney and many women like her is the infamous biological clock.  Several years ago when I was the Executive Director of The American Fertility Association, I had this idea to do a study about what women knew about their reproductive potential.  You can still take the fertility quiz that landed me on Oprah and countless other media outlets around the world. It’s pretty sad – but most women thought that their fertility BEGAN to decline in their early forties! And to make matters worse – way too many thought that they should also wait two years before consulting a reproductive specialist! If these women really waited until their early forties to try to conceive and then if unsuccessful waited two more years to seek help – they might find out that they were in peri-menopause by the time that they got the opportunity to “rev up their engines”!

The fact is that the first measurable decline of a woman’s fertility is age 27. At age 45 – the likelihood of Courtney of any other woman conceiving with her own eggs is very, very, low.  The issue with celebrities and their miracle conceptions is that many of these high profile women are using donor eggs and not talking about it. Cheryl Tiggs is still holding to her story that at age fifty-something that her doctor found the “one perfect embryo”.  It’s kind of hard to get her doctor, Dr. Richard Marrs to comment on that…..

Good luck and best wishes to Courtney.  Whether it is her own eggs – or those of a donor that eventually help her conceive her second child – I wish her all the happiness in the world.  But let’s be clear here folks – at age 45 – any woman that is wanting a child better do more than just think about it.

Posted under Biological Clock, Courtney Cox, Dr. Richard Marrs, Egg Donation, Fertility, Infertility, egg donors, eggs