Laurence A. Jacobs, MD , Infertility Doctor - Blog

A recent Dr. Oz show opened up a can of worms when it asked the question “When Are You Too Old to Have a Baby?”  Many women felt the show portrayed older mothers negatively and made sweeping generalizations about the use of fertility treatments and egg donors. Some even said that waiting to have children was selfish.

The fact is women wait to have children for many reasons — often for reasons that are far beyond their control. (Read Why Women Wait to Have Babies.) The important thing is to understand your fertility and not underestimate the impact of age.

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One of the greatest joys of being a fertility doctor is when a family has a successful pregnancy and birth. Even more wonderful is when I hear from them years later and find out more about how their life is going and any new developments.

Such was the case recently from a former patient who received my January newsletters with my blogs: Life Is Not a Dress Rehearsal ... The Time Is Now for Fertility Resolutions and 2012 and Beyond. I was very touched that this patient took the time to write such a wonderful email — it's things like this that remind me why I love what I do.

Here is what she wrote:

 

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Even though the Mayan Calendar says otherwise, I really don't believe the world is going to end in 2012. If I'm right, that means it's time to get busy and take control of your life and your fertility in 2012.

 

As your fertility doctor, I will do all I can to help you have a successful pregnancy and birth, but you need to do your part. Empower yourself - take control. 

  

Here are some helpful suggestions and comments.  We can discuss your specific details face-to-face in the office, since I have many ideas, resources and programs that can help you.  

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January is the time when the desire for making positive life-changes is in the air, and yet it often doesn't last long. It seems like men and women have good intentions, but they usually lose steam as they roll through the year. Research indicates that couples who make resolutions together are much more likely to adhere to them if one partner does. So keep helping each other!

 

Many of my patients feel absolutely miserable because of their infertility situation. So how can we change that? This article may seem a bit harsh to some, but I am being honest ... with tough love. I'm trying to help. To quote Dr. Phil: "You need to hear what you need to hear."

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The holidays can be painful for anyone, but as a practicing reproductive endocrinologist, I see how painful they are for my infertility patients. Many of them know the holidays are going to be stressful, and they are reluctant to go to visit family members and face the inevitable questions like "Isn't it time you started a family?"

 

Sometimes, my patients ask me for advice on how to deal with the holidays, and this is what I tell them:

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Yaz, Yasmin, etc., are known as combination oral birth control drugs because they contain a combination of the hormones estrogen (ethinyl estradiol) and progestin (drospirenone). These oral contraceptive drugs  have  been linked to serious, life-threatening injuries including blood clots, strokes, heart attacks and death.   Studies have found carry a higher risk of blood clots than another type of progestin known as levonorgestrel, which is found in older birth control pills.

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Half of all cases of infertility are due to male factor, and recent news articles and research have put male fertility back in the spotlight.

The good news is that unlike women who are born with all of the eggs they will ever have, men continue to produce sperm. So what a man does now can improve his fertility two to three months from now.

Diet, lifestyle and nutritional supplements — all can affect a man's fertility. These factors can also affect a couple's chances at a successful in vitro fertilization (IVF). A recent Brazilian study of 250 men who were undergoing IVF with intracytoplasmic sperm injection (ICSI) published in the journal Fertility and Sterility found that the chances of a successful IVF increase if men have diet high in fruit and grains, and low in red meat, alcohol and coffee. The men's weight and diet had an effect on sperm concentration and motility (how well sperm swim).

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The U.S. Food and Drug Administration (FDA) is raising concerns about the safety of oral contraceptives containing drospirenone following a review of two new studies. Drospirenone is a synthetic progestin that is used in birth control.

The studies found that women taking oral contraceptives containing drospirenone were at a greater risk to develop venous thromboembolisms, which are blood clots that form inside the veins, than women on older forms of birth control.  

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A recent study demonstrates how removing fibroids that distort the shape of a woman's uterus can help prevent recurrent miscarriage. The British researchers looked at data from a large tertiary referral recurrent miscarriage clinic on women who had at least three consecutive miscarriages up to 24 weeks gestational age. They wanted to determine if fibroids were causing the repeated miscarriages and whether removing the fibroids would lead to improved outcomes.

The researchers divided the women into three groups: those with cavity-distorting fibroids who underwent surgery, women with fibroids that were not distorting the cavity and did not undergo any intervention, and a control group of women who had unexplained recurrent miscarriage. With exception of age, patient demographics across the groups were similar. However, on average,  the patients with fibroids were slightly older than those women with unexplained recurrent miscarriage.

 

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Fertility Centers of Illinois Is still offering the  Fertility Awareness Check-Up!

This is an INEXPENSIVE opportunity for individuals or couples to obtain an overview of their fertility potential.
 
The Fertility Awareness Check-Up provides basic fertility testing for individuals or couples for just $90. This will help individuals or couples in their quest to plan a family by providing an inexpensive initial overview of reproductive potential. The Fertility Awareness Check-Up will help alleviate stress and save valuable time and financial resources in your journey to become a parent.
 
 Here are six frequently asked questions about the Fertility Awareness Check-Up …

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As National PCOS Awareness Month draws to a close, I’d like to point out 10 important things you need to know about polycystic ovarian syndrome.


PCOS is a condition in which there is an imbalance in a woman’s female sex hormones, which causes problems with ovulation.

PCOS can have many variable and subtle symptoms. This is why a physician may overlook the diagnosis in a young woman who is not trying to get pregnant.

There is no single test to definitively diagnose PCOS; however, many women with PCOS have cysts on their ovaries, which are found via ultrasound.

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As a member of the Medical Advisory Board at the Chicago Center for Jewish Genetic Disorders, I am working to spread the word on the importance of being screened for Jewish genetic diseases, such as familial dysautonomia, Tay Sachs, cystic fibrosis, Gaucher disease, Canavan disease and Niemann-Pick disease.

Recent studies have shown that 1 in every 3.3 Ashkenazi Jews (descendants of Jewish communities along the Rhine in Germany) carry at least one of 16 detectable diseases. Just within the last year our capabilities for screening have increased significantly from 16 to 19, and this number is up from 11 in 2009.

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Every day I see patients who are experiencing infertility that is caused or exacerbated by excess body fat. And I am often asked why being overweight matters and why a patient should try to lose weight before trying to get pregnant or undergo a fertility treatment such as in vitro fertilization (IVF).

Here’s why: There are several adverse effects associated with excess body fat that inhibit conception and a healthy pregnancy.


Overweight women often have hormonal imbalances and abnormal endocrine function, which results in a disruption of regular ovulation. Polycystic ovarian syndrome (PCOS) is one specific type of endocrine condition that is generally associated with obesity.

Insulin resistance (a condition that can develop into type 2 diabetes) is a common problem for overweight or PCOS patients and further interferes with ovulation.

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Recently, I did a series of videos for FertilityAuthority. Here is the one on "Does Losing Weight Increase Fertility?" in which I describe what I tell patients about losing weight before they get pregnant. You can check the video out on YouTube or on FertilityAuthority or below.

 

 

 

 

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Recently, I filmed two videos on unexplained fertility for FertilityAuthority: What Is Unexplained Infertility and How Is Unexplained Infertility Treated? Because unexplained infertility is a very frustrating diagnosis for couples — the fertility doctor is basically saying that he or she can find no defined reason why you’re not achieving a pregnancy — it merits further discussion here.

 

 

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One of the most frequently asked questions among couples who are trying to conceive is: How do I know when it’s time to see a fertility doctor? (And what is a fertility doctor anyway?)

To answer the second question first, fertility doctors are reproductive endocrinologists. Reproductive endocrinology and infertility (REI) is a surgical subspeciality of obstetrics and gynecology (Ob/Gyn) that addresses hormonal functioning as it pertains to reproduction and infertility in both women and men. Reproductive endocrinologists have Ob/Gyn specialty training before they undergo subspeciality training in reproductive endocrinology and infertility. In the United States, a reproductive endocrinologist has four years of Ob/Gyn training and a three-year fellowship.

So, when should you see a reproductive endocrinologist? Here are 12 indications:

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Are you trying to get pregnant and wondering why you haven’t conceived yet? Or maybe you are in the planning stages and want to make sure everything is in working order.

At Fertility Centers of Illinois (FCI), we are offering the new Fertility Awareness Check-Up for a limited time. Because 40 percent of infertility involves men, 40 percent involves women, and the other 20 percent is a combination, this program provides an inexpensive opportunity for individuals or couples to gain an understanding of their fertility potential with basic fertility testing.

The Fertility Awareness Check Up  provides an inexpensive initial overview of reproductive potential. This information will help alleviate stress and save valuable time and financial resources in your journey tobecome a parent.

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Patients with fertility issues who live in Illinois are more fortunate than many throughout the United States because of the Illinois Family Building Act, which requires companies who meet certain requirements to pay the costs of four in vitro fertilization (IVF) egg retrievals in a patient’s lifetime, as well as an additional two if a baby is born as a result. In addition, there are no limits to low-tech or less invasive procedures such as intrauterine insemination (IUI).

However, not everyone works for a company that requires this kind of insurance coverage for fertility treatment. In my practice as a fertility doctor (reproductive endocrinologist), approximately 50 percent of my patients do not have infertility insurance. A tax credit for individuals who incur out-of-pocket expenses for IVF would be very helpful for these patients and the many throughout the country who live in states with no insurance mandates for infertility.

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We are fortunate to be living in Illinois, a state that is friendly to the family-building goals of gay and lesbian parents. Over the years I have seen an increase in gay and lesbian couples utilizing reproductive technology to build their families via such methods as reciprocal in vitro fertilization, donor sperm and surrogacy.


It is a wonderful thing.



When all is said and done, a gay parent is no different than a straight parent — it is the amount of love that you show the child that is key. I support diversity in family building and believe ALL couples should have the opportunity to try for the family they want.



 



 

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Much research has found that lifestyle can affect fertility, and now investigators are finding more proof  that diet matters when trying to conceive.

The latest research conducted in mice has found that calorie-restricted diets for longevity also may have the benefit of increasing fertility. In "Prevention of maternal aging-associated oocyte aneuploidy and meiotic spindle defects in mice by dietary and genetic strategies," published in Proceedings of the National Academy of Sciences, researchers from Massachusetts General Hospital tested the effects of caloric restriction (a diet that had been shown to slow the ravages of age in mice) on the quality of mature eggs produced by aging mice. They found that 12-month-old female mice who were on a 40 percent calorie-restricted diet from the age of 3.5 months produced eggs that were of significantly better quality than mice who were fed a normal diet.

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