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…..

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, 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.

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