Tag Archives: IVF

Top 5 Things You Should Know About Egg Quality

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While you are undergoing and IVF cycle you will no doubt have a lot on your mind. Most people don’t think about egg quality, it’s not necessarily on the top of their list. One of the single most important aspects to a successful IVF cycle is however, the quality of the eggs. The better quality the eggs, the better quality your embryo will be. In order to help give you some insight and knowledge on egg quality here are 5 things to help your journey to parenthood a little bit easier.

1) From birth women are already born with all of the eggs that they will ever make. Apart from sperm, there is no constant replenishment. Once a woman hits menopause, the ovaries have a more difficult time producing eggs and ovulation eventually stop completely. This doesn’t usually occur in women until they are between the ages of 30-50. As women get nearer to menopause, the ovaries have a more difficult time producing eggs, which is one of the reasons why the number of eggs retrieved in an IVF cycle varies from patient to patient. Remember that when you come for egg retrieval you can’t compare the number of eggs you have retrieved with the number someone else has retrieved. Quality is better than quantity! Keep in mind at your retrieval that the number of eggs you retrieve is not always predictive of cycle success and even those with small egg numbers can achieve a pregnancy.

2) Egg quality is of course affected by age but there are many other factors as well. There are ways to help improve the health of your ovaries and the egg quality. Our diet, environmental influences, hormonal issues, and stress are the most important factors to good egg quality. Contact your physician to discuss ways in which to maximize your egg quality and what you can do to use influence on egg quality to your advantage

3) Certain conditions can also affect your egg quality. Some of these are history of ovarian surgery, smoking, chemotherapy/radiation, and endometriosis. If you happen to have one or more of these conditions, it is extremely important that you discuss with your physician ways that may help positively influence your egg quality

4) Even if your physician tells you that you have decreased or poor egg quality, this does not mean you can’t or won’t get pregnant. This may mean however, that it will be more difficult for you, depending on the situation. If poor egg quality is a factor in your infertility and attempts to improve egg quality do not work, knowing this may help to make the decision to use donor eggs a bit easier.

5) Being realistic right from the get-go about your fertility is the best approach you can take. It’s possible that despite doing everything possible to improve egg quality, you still may not get pregnant. Make sure you find a good, caring physician, reduce stress as much as possible, and maintain a healthy lifestyle and weight. These are things you can do to improve your fertility but remember, be understanding of the hand you’ve been dealt. There are no guarantees. If you have been told you have poor egg quality and have tried all efforts to improve egg quality, moving forward and thinking about a donor egg can be the best chance for success.

 

Lesbians and Donor Insemination

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Traditionally, lesbian partners may become parents through donor insemination. Though donor insemination is a somewhat simple solution, a lot will depend on the quality of the sperm. Donor insemination is an option for lesbian women or partners who cannot have a child naturally and still wish to have a biological connection to their child. Some couples may choose to use an anonymous sperm donor through a sperm bank or fertility center, or a known donor that may be a friend or relative.

Lesbian insemination that uses donor sperm from a sperm bank can essentially provide the highest success rates with the shortest interval to conception. A combination of ovulation induction with oral medications, like Clomid, and two precisely timed donor inseminations, assures perfect timing and the highest success rates for pregancy. On the average it takes 2-3 insemination cycles to achieve a pregnancy. The type of insemination that the couple decides to use will be based on a number of factors, including personal preference, cost, and fertility potential.

Types of insemination include:

Intravaginal insemination (IVI). Unwashed sperm is placed into the vagina around the time of ovulation using a syringe or cervical cap. IVI can be done in a physician’s office or at home.

Intracervical insemination (ICI). Washed or unwashed sperm are placed in the cervix using a thin catheter and a syringe which pushes the sperm through the catheter. ICI is done in a physician’s office.

Intrauterine insemination (IUI). Washed sperm are placed in the uterus with a thin catheter that is passed through the cervix. IUI is performed in a physician’s office.

The medical physician will suggest that whoever is going to conceive should have a medical screening prior to trying. The doctor will suggest that whoever is to consider carrying the child, have a healthcare testing before trying. This allows identifying the health of both the mom and the child during the length of the pregnancy.

An appointment with a lawyer focusing on method issues is a must, usually one who has encounter and understanding utilizing same sex mother or father, is suggested. They can help with any necessary certification regarding lawful position as parents, or to identify the part of a known sperm contributor.

For more information about the procedure of contributor insemination speaking with your doctor is a key starting point, also read our book Getting to Baby. Our publication represents our trials, tribulations and triumphs that we went through on our journey to getting to our babies.

“Lesbians and Donor Insemination – Fertility & Infertility”

Surrogacy Through In Vitro Fertilization (IVF)

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So you and your partner have made the decision to start a family – that’s wonderful! Congratulations! But for same-sex couples, the choices for creating a family are slightly different. Yes, adoption and fostering are two possibilities for bringing children into a home and family life, but another option that deserves consideration is surrogacy via in vitro fertilization (IVF).

Why in vitro? Some couples may have preferences for a newborn, and oftentimes foster children are older than the newborn stage. Another reason could be the wish to carry-on certain genetic traits – the biological result – of in vitro. And in one of the two methods of surrogacy, IVF is the process used to reach fertilization.

In vitro fertilization works by joining an egg and sperm outside of the female’s body, usually a Petri dish in a controlled laboratory environment. The meaning of ‘in vitro’ is  ‘outside’. Once the two are joined, or fertilized, its then placed into the uterus for the duration of the pregnancy term.

Back to the topic of surrogacy; there are actually two types of surrogate options. A Gestational Surrogate is a host for the embryo and has no relation to it. Usually a donor egg is combined with the intended father’s sperm using the IVF method. Once fertilization is complete, the embryo is transferred to the surrogate host, who then carries the baby to term.

Probably the most common idea of surrogacy is the one known as Traditional Surrogate. In this instance, the surrogate is offering both egg and gestation surrogacy – hosting of the embryo until the baby reaches full term. The actual fertilization of this type of surrogacy is different from IVF; it’s called intrauterine insemination. This involves a Doctor transferring sperm from either the intended father or donor, and inserting into the surrogate so that natural fertilization can occur.

The total expense of surrogacy varies depending on a number of factors, not the least of which includes the selection of your fertility clinic, any surrogacy clinics, the types of insurance options you choose to protect yourself with on top of a whole host of other fees and expenses. According to Surrogatemothers.com and Growing Generations (a LGBT-focused fertility clinic), prices can wildly range between $15,000 to upwards of $150,000! Of course, rates could change if there is one baby or two (twins), there’s legal necessities to be taken care of on top of medical bills, possibly counseling and whatever else is contracted between the couple and surrogate.

No matter what your process to starting your family, it’s incredibly personal and unique. We’ve happily shared our journey in Getting to Baby, which brought us twins via surrogacy. You can download a free chapter here.

Surrogacy Journeys

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Our babies, Christopher and Katherine, were born in the spring of 2010. Our book, Getting to Baby, also came into being in the spring of 2011. In it we chronicle our optimistic expectation of easily achieving pregnancy, the disappointments of the world of infertility, the trudge through failed IVF, miscarriage, failed adoption, and then finally our joyful SUCCESS through surrogacy.

Ours is just one story with a happy ending. Every year, hundreds of others forge their own successful paths through surrogacy. Many have stories just like ours — gay or lesbian couples who find a path to parenthood through the generosity, trust, and love of surrogates and donors.

When you are riding the roller coaster of infertility, adoption, surrogacy, and pregnancy, the support not only of friends and family but of others going through the actual experience is so important. The blogosphere gave us essential information, encouragement, and support  — and is one reason we created GettingToBaby. We want to create a central, collaborative place for the kind of support, referrals, and education we had to really work to find, and really depended upon to make our dream of becoming parents a reality.

I thought I’d share a few great blogs of babies in progress—and babies brought home:

Babies in progress:
Special Delivery follows the journey of Kelli, a gestational surrogate carrying twins for Ian and Troy.  Ian’s sister Leandra donated the eggs, which were fertilized with Troy’s sperm. Kelli is halfway through the pregnancy, and their story is being made into a movie called “More than a Village” by documentary filmmaker Edward McDonald. Follow the film by following Edward on twitter: @edwardmcdonald

Bernadette and Duane share their roller-coaster ride of surrogacy in India at Rasta Less Traveled. We look forward to following their tale to a happy ending.

Babies at home:
George and Farid are the proud parents of Gustavo and Milena, born on November 6, 2011, to gestational surrogate Jeni. Their beautiful story is chronicled on Jeni’s blog Love Makes a Family.

Jeni, Kelli, and Bernadette also list other blogs they follow — so check them out.

Brings a smile to my face.  How about you?

Natural IVF: A tested and affordable option with fewer side effects

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At a 50th birthday party last weekend for my friend Maggie, I noticed one of the guests, Kristin, receiving quiet congratulations. I quickly deduced she was newly pregnant: 6 weeks. I knew Kristin had been trying to conceive for at least a year, and I was naturally pleased and curious to learn about how she “got to baby” — or at least to pregnancy.

I went over and offered Kristin my own congratulations and we started chatting about her journey and swapping war stories. I was intrigued to learn she was successful with natural cycle IVF, a low-medication alternative to standard IVF. (Another alternative is called minimal stimulation IVF or Mini-IVGF  Mini-IVF uses Clomid, an oral medication that has been in use since the 1960s.) I did some quick investigation and learned that natural IVF has been around since the late 80’s early 90’s — but it’s not the first option offered by many clinics.

 Natural cycle IVF is similar to standard in vitro fertilization but doesn’t rely on expensive and painful follicle stimulating hormones (FSH) medications to stimulate the ovaries to make multiple eggs. In natural cycle IVF,  follicle development during a normal ovulatory cycle is tracked by blood work and ultrasound, and when the follicle is ready to release, it is retrieved and fertilized using conventional IVF procedures. Natural cycle eggs are typically considered to be of a higher quality than traditional IVF.  Like traditional IVF, not all eggs result in an embryo. But when an embryo is produced and transferred successfully to the uterus, the pregnancy success rates are similar to conventional IVF.

With a new generation of infertile women pursuing holistic health solutions, it’s little wonder that natural cycle IVF is attracting new clients and researchers. The University of Southern California (USC) is recruiting participants today to take a fresh look at how advances of the last 20 years may influence outcomes (no discount on treatment, but this is a way to help other women know if this is a better option in the future).

 This is a safer, less costly approach for IVF. It’s not for everyone, but according to several clinics it’s a good option for many women, including those with elevated FSH (lower ovarian reserves), failed conventional IVF cycles, tubal disease, or male factor issues.

 So why isn’t natural cycle IVF promoted more? Perhaps the main reason: it can statistically lower the overall success rate for a clinic, because clinic data on stimulated and unstimulated (natural) cycles are lumped together (although the CDC tracks each separately). Not surprisingly, clinics don’t want to skew their success rates, so natural IVF is not the go-to option for many clinics.

Infertility treatment is never fun, but it seems this method takes the “sting” — both physically and financially – out of a painful situation.

 Kristin? She got lucky. Worked on the first try. Congratulations to her!

 Meanwhile, we’d love to hear about your experiences au naturel IVF. We’ll keep an eye on the USC study and keep you posted on this perhaps overlooked and statistically disadvantaged approach to Getting 2 Baby.

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A few quick points from clinics specializing in the natural approach:

Advantages of Natural  / Minimal Stimulation IVF

  • Eliminates the risk of ovarian hyperstimulation syndrome (OHSS)
  • Significant cost savings: about half of most standard IVF procedures
  • No painful and expensive gonadotropin injections
  • Fewer office visits
  • Generally produces a higher quality egg
  • Produces one follicle, virtually eliminates risk of multiple pregnancies

Potential Problems

  • Cycle is cancelled, usually due to premature ovulation or LH surge.
  • Failure to retrieve the egg – in less than 10% of patients.
  • Failure to fertilize the egg – in less than 10% of patients.

Is it time to find another OB-GYN?

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If you have ever been very sick or seriously injured, or if someone you love has, you know how critical the doctor/patient relationship is. Your health and well being, your future — perhaps your very life — are in this person’s hands.

This is also true when you are seeing a physician not for an illness or injury, but in an effort to change your life another way: by having a child.

If you are undergoing infertility treatments, like artificial insemination or In Vitro Fertilization (IVF), it’s so very important to see a doctor you trust, and who will communicate with you about everything that’s happening. Does your doctor take the time to fully answer your questions? Does he or she make sure you completely understand what the treatments entail, and how they will affect your body? Is your doctor clear about what you can expect, and your chances for success?

It’s also so important that your doctor is truly qualified to handle your specific case. Just because an OB-GYN offers fertility treatments doesn’t necessarily mean he or she is the right doctor for you.

Some fertility problems are tough to diagnose; it may require a specialist to determine what’s going wrong in your case, and how best to treat it.

If you have been seeing an OB-GYN who does not specialize in fertility problems, and your treatments haven’t been successful after a reasonable number of attempts, you should consider finding a specialist. The average number of attempts at artificial insemination before success is between three and four. How many times have you tried?

Yes, it can be tough to leave a doctor you like and trust — but if he or she is not the right physician to help you, it may be a necessary step.

We understand

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We understand how important having a family is. My partner and I tried long years, with much confusion, plenty of doctor’s visits, lots of close calls and our share of heartbreak along the way until we finally had the opportunity to look into our twin babies’ beautiful eyes. We struggled against many odds, but we finally became parents. Believe it or not, no matter how frustrated you are or how difficult your journey has been to this point, you can get through this. There are many options available to you, some of which you might never have considered.

Do the different options seem daunting? Not sure how to approach them? There’s a lot to think about as you consider what path you’ll take while Getting to Baby. Although our book isn’t intended as a substitute for advice from medical professionals and other experts, it will help you to understand you’re not alone in your struggles. We’ve been through it, too, and we hope our personal journey will help in some way to prepare you to make the right choices and ask the right questions. We also hope we can provide a little moral support and some perspective.

Visiting this website shows you are someone who wants to learn as much as you can about what it means to become a parent and how you can get there, no matter who you are or what kind of relationship you’re in. We hope our website and book will help inform you and provide suggestions that could have helped us as we pursued our own path to parenthood.

We are Victoria and Jennifer Collier. As we endeavored to become parents, we tried everything from In-Vitro Fertilization, which resulted in a miscarriage, to several close calls on adoption before finally finding surrogacy, which ended up being the right choice for us. What’s the right choice for you? We can’t say, but we can tell you about our experiences with each option, preparing you for hidden pitfalls and tricky choices you might be faced with along the way. After all, knowledge is power. Being armed with the right knowledge from the outset can save you from missteps, frustration and heartbreak.

If you enjoy what you find on www.GettingtoBaby.com, we recommend checking out our book for a more in-depth look at not only our journey, but what your journey could be.

Support system

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Have you ever tried to explain something you just feel in your gut? For many people, it is not an easy process. That said, when you find yourself yearning for something completely life-changing, like a child, taking the bull by the horns and facing your own thoughts, feelings, fears and hopes is an absolutely essential process.

Once you and your partner, if you have one, understand what’s behind your desire to have a child, you can explore other aspects of the concept of parenthood. After all, even though society sets some protocols for who does what, when and how, that might not work for you. Will one of you be a stay-at-home mom? A stay-at-home dad? Perhaps neither of you will stay home, and in that case, childcare should be considered. What can you afford? How will you react to pressure or judgment from others?

Gay, straight or single parent, one child or several, the logistics that must be considered are staggering, even if fertility isn’t an issue. And if getting pregnant is an issue, or is impossible for you and your partner, there’s a whole new universe of questions to be answered and feelings to be explored. What are your thoughts, feelings and attitude toward infertility treatments? In Vitro Fertilization (IVF)? Adoption? Surrogacy?

Although the thought is not one that many prospective parents want to wrap their heads around, you also need to consider your views on children with special needs. Some babies arrive with physical disabilities, while others suffer from developmental problems. Plenty of babies with special needs are already here and in need of adoption into good homes. In other cases, pregnancies are not successful. That’s the last thought any potential family wants to face, but it’s important to remember. Whether you’re planning a pregnancy, an adoption or to conceive through a surrogate, facing these possibilities is just as important as planning a budget and making lifestyle choices.

A good support system, from your partner or spouse to family and friends, can help you think through the details at the outset. People to bounce ideas off of are key, whether it’s a close friend or spouse or someone you rarely see. No matter who it is, having someone you trust and feel completely comfortable sharing with can provide perspective and comfort. This person can join in your joy, but also keep you in check, as you’re dealing with the dizzying prospect of caring for another person.

International Adoptions

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You’ve seen Angelina Jolie and other celebrities with children they’ve adopted from other countries. Like domestic options, international adoptions are certainly viable, as long as you approach them carefully and do your homework. Find experienced legal counsel early on to help you navigate the complicated and nuanced processes involved in international adoptions, which vary from country to country.

As heartless as it may sound, many fraudulent agencies have sprung up in recent years, especially on the international adoption scene, that will take your money, give you the runaround and leave you without a child at the end of the process. Work with your attorney to run background checks on any potential agencies you’re considering to make sure they’re not known for fraud. Get references. Figure out how the adoption agency you’re considering works, and whether you’re comfortable with their practices, pricing structures, reputation and success rates. How do they track down children? How many offices do they have?

While adoption processes are more standardized stateside, you might run into strange restrictions and regulations in other countries. Some countries won’t adopt to you if you’re over a certain age, while other countries will only allow adoptions to heterosexual couples or individuals. Others won’t allow single men to adopt a child, which means even if one member of a male couple presents himself as single, he won’t be successful.

If restrictions don’t create snags, be aware that although some countries can match you quickly with adoptive children, the adoption process can be exceptionally lengthy. That means that even if you’re matched from the outset with a newborn, that child could be eight months to more than a year old before you’re actually able to bring him or her home.

Children in other countries awaiting adoption are often living in orphanages, where they might not receive the best care or nurturing. That can result in emotional or physical issues you’ll need to address once the child arrives. Be sure to examine these possibilities up front, so you know what to expect.

Consider cultural issues as well. If your child comes to you as an infant, do you teach that child about his or her own culture as well as yours? If you get the child later in life, you may want to seek professional help as you approach bonding, which could be more difficult, depending on the situation the child has been in prior to being placed with you.

In Touch With Your Feelings

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Misgivings? Be honest about them.

I had some friends, a married couple, who were having fertility issues while Jennifer and I were trying to conceive. When they discovered they were unable to get pregnant, like many couples, they began considering their options. And like many couples, they started looking at adopting a child.

The woman was completely comfortable with adoption, and even started to like the sound of it. After all, her body wouldn’t have to go through everything a body endures during pregnancy. Her husband, however, had misgivings. And although those misgivings might offend some readers, they illustrate an important point.

He shared with his wife that he feared he wouldn’t be able to control his anger or frustration as easily without a genetic bond between himself and a child. Although he said it almost as a joke, he wasn’t kidding.

When you’re dealing with infertility, you might feel as though you’d bond with any child, regardless of genetic links. Whether you agree with the husband or not, though, he was right to share that concern with his wife. It’s important for both partners to be all in, no matter what path they’re pursuing.