National Adoption Month

There are lots of ways to have children in your life. One way is through adoption. November is National Adoption Month. There are three main ways couples find children to adopt:

1. Adopt a foster child. These children are often over the age of 4 and have special social or medical needs. These children are referred to as “waiting children,” a term which breaks my heart to even type. The BC Ministry of Children and Family Development has information on these children on their website.

2. Adopt a local infant. The BC local infant adoption program helps couples who decide while pregnant or soon after, that they are unable to care for their child and wish to place the children for adoption. To enter this program you must use an adoption agency licensed in BC, of which there are four.

3. International adoption. Countries like China, Korea, Vietnam, and others allow Canadians who meet certain criteria to adopt children. Like local infant adoptions, these adoptions are arranged by one of the four licensed BC adoption agencies.

A good place to start if you are considering adoption is the Adoptive Families Association of BC website.

 

Mother’s Menopause

If you are a woman planning to hoping to conceive please call your mother, if you can, and ask her when she went through the menopause. Specifically ask her what her age was when her periods stopped completely. This information is highly predictive of your fertility.

We are born with a set number of eggs and slowly run out of them over our lives. By the menopause we have none left. The rate at which we run out of eggs is genetically determined. If your mother ran out early (i.e. had the menopause early) you are more likely to do the same.

About 1% of women enter the menopause before the age of 40 and about 10% enter it between 40 and 45. In the years leading up to the menopause, as egg numbers are getting low, you become less fertile and in many cases completely infertile. We can get a sense of just how many eggs you have left by measuring yourAMH level, your FSH level and your antral follicle count (AFC) by ultrasound. If any or all of these tests suggest a low egg count then fertility is decreased.

A study published this month in the journal Human Reproduction, analyzed 527 women’sAMH, AFC and their mother’s age at menopause. They found both AMH and AFC declined faster in women whose mothers had an early menopause (before the age of 45) compared to women whose mothers had a late menopause (after the age of 55).

This is yet another reminder of the importance of conceiving when you are young. Waiting until your late 30s or 40s, especially for women’s whose mother’s had early menopause might mean it’s hard or even impossible to conceive.

Sooner the better…..

Nuts in pregnancy

These days it seems a lot of children have allergies or allergic illnesses, like asthma. In pregnancy many women have been avoiding nuts out of fear that eating them will increase the chance their child has a nut allergy or asthma. Well, a recent study tells a different, more positive story.

A large, well-designed study published this month observed that maternal peanut and tree nut consumption in pregnancy actually decreased the risk that the child would develop asthma. Compared with mothers consuming no peanuts, children whose mothers reported eating peanuts 1 or more times per week were 40% less likely to have been diagnosed with asthma.

So it seems there is no need to avoid nuts in pregnancy!

Sperm from stem cells

Earlier this week I received a call from an old friend saying he was recently diagnosed with cancer. He starts chemotherapy next week. Fortunately, in the all the upset of being diagnosed with cancer, he thought of his future fertility and has stored sperm with us.

In today’s BBC on-line an article discusses the use of a male’s stem cells to create sperm after cancer treatment. Many cancer treatments damage sperm producing cells in the testicles leaving men with low or no sperm afterwards. Currently we try to encourage boys and men to freeze their sperm (if there is time) before they start their cancer treatment but many do not. In the BBC referenced study stem cells were taken out of male monkeys. The monkeys then had chemotherapy which destroyed all of their sperm. Then the stems cells were put back (into the bone marrow, where they came from) and the monkey’s started to produce sperm again. This work has been done in female mice in the past so we know it’s possible. This work is exciting because it’s in primates – whichusually means the results can be achieved in humans too.

So, the future for boys and men with cancer may involve them storing stem cells prior to treatment. It’s more invasive than just ejaculating and freezing sperm but it does hold the promise of a spontaneous conception after cancer treatment, and it offers an option for those who can’t store sperm before treatment.

Genesis Fertility Centre
Reproductive Endocrinology & Infertility

CDC ART Report

The US Center for Disease Control (CDC) monitors many different diseases and health outcomes. Today they released their report on Assisted Reproductive Technology for 2009 today. They have some 2010 data on their website, but the most recent formal report is today’s 2009 publication. While the report seems out of date, live births are recorded so it takes time (e.g. someone who did an IVF cycle at the end of 2009 wouldn’t have a live birth until mid to late 2010).

In 2009, a total of 146,244 ART procedures were reported to the CDC and they resulted in 45,870 live-birth deliveries and 60,190 infants, or 1.4 % of U.S. births.

The full report can be read here.

It’s an interesting read on the trends in ART, how it varies state by state (political undertones here!), and the outcomes of ART pregnancies.

There’s an app for that

The Apple App store has 3 apps to help a woman predict when she is fertile. A woman is fertile around the time of ovulation. These apps and the numerous websites that also offer to help determine your fertile time (e.g. fertile friend, babycenter.com) are based on these principles:

1. most women have a period about once per month
2. there are two parts to a menstrual cycle: the first part which runs from the start of bleeding until ovulation (follicular phase) and the second part which runs from ovulation until bleeding starts again (luteal phase).
3. 90% of women have a luteal phase of 14 days.
4. the follicular phase can vary
5. We count the first day of bleeding as menstrual cycle day 1

So, if someone has a menstrual cycle that is 30 days (i.e. they have a period every 30 days) then 30-14 = 16. They will likely ovulate on cycle day 16. If someone has a menstrual cycle that is 26 days then 26-14 = 12. They will likely ovulate on cycle day 12.

Big box

I am not sure the rules around internet postings and corporate rights so I’ll be indirect. Today I was at a large membership-based big box store in downtown Vancouver. I was buying the usual 12 packs of things I don’t need. I walked past the pregnancy tests. The store was selling a four pack of pregnancy tests for about $19. I had to take a second look as I thought surely it must be 40, and not four, for that price. No, it was for four. This is very, very expensive. They are available for far less money on-line.

Now, everyone knows someone who will tell you that the cheap urine pregnancy tests didn’t work, or that no urine pregnancy tests (cheap or expensive) worked to detect their pregnancies but for MOST people MOST of the time the less expensive urine pregnancy tests you can buy on-line will be accurate.

I am not trying to undercut store-front merchants but simply trying to put downward pressure on their prices. When I was buying pregnancy tests I bought them from a Canadian-owned, online retailer. I paid about $1 per test. A quick google tonight confirms that there are several such Canadian retailers charging around that same price today.

Full disclosure: I am not pregnant, I do not need pregnancy test strips for personal use and have no plans to be pregnant again.

I am posting this as a public service announcement: please do not spend big dollars on brand name pregnancy test strips as the less expensive test strips almost always work just as well.

Genesis Fertility Centre
Reproductive Endocrinology & Infertility

Get your pap smear

If you are like many people, you do not have a GP. It’s an unsettling place to be as you worry that no one you know is going to take care of you if you get sick and no one is monitoring your health. Fortunately, most young women really don’t need to see a GP regularly, except for their pap smear. How do you get a pap smear without a GP?

The BC Cancer Agency (BCCA) has come to the rescue. The BCCA has a campaign going from October 22-28 where clinics will be set up around the province just to do pap smears.

So, if you need a pap smear you can just going to a clinic. To find a clinic participating in this campaign, called the LACE Campaign go towww.lacecampaign.com

Genesis Fertility Centre
Reproductive Endocrinology & Infertility

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