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Treatments pediatric cancer patients endure can reduce their chances of having children in the future. However, an experimental treatment available at University of Pittsburgh Medical Center (UPMC) could preserve fertility for young boys going through radiation.
The treatment is called spermatogonial stem-cell transplantation, and it involves taking a sample of testicular tissue and turning pre-sperm cells into viable samples. Then, when re-inserted into testes, even if they’re damaged by radiation and chemotherapy, the sperm stem cells function as they would naturally and become sperm.
This service is offered to the parents of any prepubescent boy undergoing radiation. If a boy is old enough to give consent, they’re asked a series of questions to ensure they understand and agree to the procedure. If they are too young to give consent, the decision is shifted to the parents or guardian. So far, 110 boys have their samples stored at UPMC.
A similar treatment is available for prepubescent girls undergoing cancer treatment. This involves harvesting and freezing an ovary to be re-implanted in the future. This process is also in the experimental phase, and UPMC currently has 25 frozen ovaries saved.
For decades, the re-implanting process has been studied on animals and there has been success. In animal trials, the samples have been viable for up to 14 years. Health professional believes that it is time to study the re-implanting process in human subjects.
When Julie Schlomer got the news that she was finally pregnant at the age of 43, her thoughts went to the other mothers she had come to know. There were three of them in all, and they shared an extraordinary bond made possible by 21st century medicine and marketing.
All the mothers were carrying half-siblings.
Under a cost-saving program offered by Rockville, Md.-based Shady Grove Fertility, the women split 21 eggs harvested from a single donor who had blue eyes, was dark-haired, and had a master’s degree in teaching. Each of the women had the eggs fertilized with her partner’s sperm and then transferred to her womb. Schlomer gave birth to twins, a son and daughter, now 3. She hopes her children will one day connect with their genetic half-siblings. “I would love to see pictures of the other kids, to talk to them,” Schlomer said.
The multibillion-dollar fertility industry is booming, and their experiments with business models are changing the American family in new ways. Would-be parents seeking donor eggs and sperm can pick and choose from long checklists of physical and intellectual characteristics. Clinics now offer volume discounts, package deals and 100 percent guarantees for babymaking that are raising complicated ethical and legal questions.
According to the Centers for Disease Control and Prevention, 12 percent of American women 15 to 55 — 7.3 million — have used some sort of fertility service, and because of that the use of assisted reproductive fertility technologies has doubled in the past decade. In 2015, these procedures resulted in nearly 73,000 babies — 1.6 percent of all U.S. births.
Most couples use their own eggs and sperm, turning to doctors to facilitate pregnancy through techniques such as in vitro fertilization. But the use of donor gametes is on the rise. The donor-egg industry, in particular, has taken off in the past decade with the development of a safe and reliable egg-freezing process. The number of attempted pregnancies with donor eggs has soared from 1,800 in 1992 to almost 21,200 in 2015.
In the United States, the industry remains largely self-regulated, and because of that a group of donor-conceived adults documented numerous ethical lapses in the industry, including donors who lied to prospective parents about their health histories and other qualifications. They called on the Food and Drug Administration to provide more oversight of the “cryobanks” that gather, store and sell the precious sperm and eggs used.
The Food and Drug Administration said it is reviewing the matter, but cannot predict when it will have a response in the near future because of other FDA priorities. In the meantime, the business of assisted reproduction remains a mostly unregulated frontier. Shady Grove Fertility, the nation’s largest clinic, offers refunds if couples don’t go home with a baby. New Hope Fertility in New York City held a lottery earlier this year that awarded 30 couples a $30,000 round of IVF. And the California IVF Fertility Center is pioneering what some refer to as the “Costco model” of babymaking, creating batches of embryos using donor eggs and sperm that can be shared among several different families. Prospective parents can filter and sort potential donors by race and ethnic background, hair and eye color, and education level. They also can get much more personal information such as audio of the donor’s voice, photos of the donor as a child and as an adult, and written responses to questions that read like college-application essays.
A prescreened vial of sperm sells for as little as $400 and can be shipped via FedEx. A set of donor eggs (as many as 30, depending on the donor) can cost $10,000 or more to compensate for the risky and invasive medical procedure required to harvest eggs from the donor’s ovaries.
For Schlomer and her husband, before they decided to use donor eggs, they had been trying to have a baby for two years. Their insurance paid for early infertility treatments, but nothing worked. The couple, from Lexington Park, Md., about 60 miles east of Washington on the Chesapeake Bay, was psychologically ready to take the next step. But a set of eggs and up to six attempts at embryo transfers cost $55,000–none of it covered by insurance.
But as they studied the material from Shady Grove Fertility, the Schlomers discovered that the clinic offered a huge range of payment options. If Schlomer split the eggs with one other mother, the cost would go down to $39,000. If she split the eggs with two other mothers, the cost would be $30,500. Schlomer’s husband noticed that they could cut the cost even more, to $24,500, if they agreed to use only one set of eggs and forgo the right to ask for more. After the Schlomers drained their savings account, borrowed $10,000 from their 401(k) retirement fund and sold a Toyota Prius, they set aside a quiet weekend to look for a donor. Schlomer had two main criteria: One, the donor had to have blue eyes. Second, the donor had to have a graduate degree. She found 12 matches and looked at their profiles. They went with the one whose personality spoke most to Julie.
The donor said she was a “homebody” who loves taking pictures and being with family on the beach. Her personal goals, she wrote, include being “the best possible mom I can be for my children. I want to be ‘present’ when I am with them and invest into their lives. I want my life to matter.”
Schlomer put in the order, and it wasn’t long before the clinic found two more women to join her group. Within a few weeks, the eggs were harvested from the donor, fertilized and implanted.
Alyssa and Logan were born in 2013. Both have very blue eyes and have been very healthy. Julie is grateful that there’s no chance they inherited lupus, a serious autoimmune disorder in which the body attacks its own organs and tissue, that she inherited from her mom.
When the time is right, Schlomer thinks she will explain to her children that they are “high-tech babies” and impress on them the importance of memorizing their donor number, in case they happen to “run into another donor-egg kid.”
- To put it simply, pregnancy does a lot to a woman’s body, and those changes might affect getting pregnant again. From cycle issues to previous hypertension problems, the first pregnancy could cause some damage.
- Many times, trying to get pregnant the second time is more difficult because the mother is older, and age is associated to difficulties getting pregnant.
- While it’s true that it’s healthiest for women’s bodies to maintain a wide age gap between children, they should know that they could be simultaneously risking being able to have a second in the first place.
- What also complicates things is the fact that if a woman had a cesarean delivery, then she should wait at least nine to 12 months before getting pregnant again to ensure the scar in the uterus has adequately healed.
All in all, when considering age and general health, it is even more important the second time around to take care of yourself. When trying to get pregnant for the second time, a woman has to take her daily prenatal supplement to ensure she takes enough folic acid to prevent fetal malformations. Folic acid, part of the vitamin B family, is very important for a strong pregnancy and healthy fetal development, and it has been shown to not only decrease the risk of neural tube birth defects like spina bifida, but it has also been shown to reduce other birth defects, such as congenital heart conditions.”
What is also important to think about is the health of your partner. A recent study found that sperm count has decreased an estimated 50 percent in Western men. And half of couples with fertility issues have a significant male issue. To facilitate their fertility health, supplements are tight is as well.
Besides age, women breastfeeding longer can also have a serious impact on the body, because breastfeeding affects fertility by delaying ovulation. It is important to note, though, that if a woman ovulates regularly and has regular menstrual periods, concerns about breastfeeding and fertility decrease.
In the end, prospective second-time moms should talk to their health professionals when trying to conceive, even if it was easy the first time. This is especially true for women who may have had any issues before or during their first pregnancies.
In addition, women under 35 should see a specialist after one year of trying unsuccessfully, while women over 35 should see a specialist after six months.
It looks like getting your tonsils out could have some unexpected benefits (besides providing you with an excuse to eat a ridiculous amount of ice cream). A recent study found that getting your tonsils or appendix removed could increase your chances of getting pregnant. Whether your tonsils are swollen or not, that could be hard to swallow. Let’s break it down.
The study, published in Fertility and Sterility, was conducted by Scottish researchers at the University of Dundee. The researchers examined 25 years of medical information on more than 500,000 women, comparing the history of surgeries with the rate of the women’s pregnancies. They found that women who had had their tonsils removed had a pregnancy rate of 53 percent, while women who had their appendix removed had a rate of 54 percent. The rate of pregnancy in women who never had either operation? 44 percent! Now, brace yourselves: women who had had both surgeries had a pregnancy rate of a whopping 60 percent!
Researchers are not completely sure. One guess is that the removal of the tonsils and appendix protects the ovaries and the uterus. This is because both the tonsils and the appendix are prone to infections and inflammations.
Does this mean I should get a tonsillectomy or appendectomy to increase my chances of getting pregnant?
Doctors do not recommend getting these surgeries to improve your chances of conception. These results simply show that you should not be concerned that an appendectomy or tonsillectomy have negatively affected your reproductive health.
When should I get my appendix or tonsils removed?
1 in 20 Americans experience appendicitis, which occurs when the appendix becomes inflamed and fills with pus. This condition requires immediate surgery, so you should head to the emergency room if you are experiencing these symptoms:
- Dull pain near the naval area that sharpens as it moves to the lower right abdomen
- Fever of 99-102 degrees Fahrenheit
- Abdominal swelling
Tonsillectomies, on the other hand, might be an option for you if you have frequent episodes of tonsillitis, experience sleep apnea or heavy snoring, or are struggling with halitosis. Talk to your doctor about your options.
Once again, neither surgery should be considered as a direct route to increased fertility. Still, if you have had to undergo either of these operations, enjoy these unexpected benefits and maybe celebrate with some more ice cream!
Chlamydia might be the most frequently reported bacterial sexually transmitted disease in America, but many people are unaware of the harmful effect it can have on their fertility. Let’s start with the basics.
What is chlamydia?
Chlamydia is a sexually transmitted infection that is spread through oral, vaginal, or anal intercourse. It is estimated that 1 in 20 sexually active young women between the ages of 14 to 25 has chlamydia. When left untreated in women, chlamydia can lead to pelvic inflammatory disease, tubal factor infertility, ectopic pregnancy, and chronic pelvic pain.
Chlamydia can also be passed on to the baby if a pregnant woman is infected.
What are the symptoms of chlamydia?
Here’s the problem: there are very few symptoms of chlamydia. Many people are unaware when they have contracted chlamydia. Studies have found that only a small percentage of people infected with chlamydia show symptoms. Women that do have symptoms experience burning during urination and abnormal vaginal discharge.
This means it is extremely important to get regular screenings. The Center for Disease Control recommends that all sexually active women under the age of 25 should receive yearly chlamydia screenings. Older women with risk factors such as multiple partners should also be regular tested. Pregnant women should also be screened for chlamydia during their first prenatal care visit.
The CDC does not recommend routine screening for men, but men who have sex with men (MSM) are at a higher risk for rectal infection from chlamydia if they engage in receptive anal sex.
How does chlamydia affect my fertility?
If chlamydia in women is left untreated, the infection can spread to the fallopian tubes, causing the tubes to become blocked at the ends. This also leads to the development of scar tissue around the fallopian tubes, making it harder for the tube to pick up the egg at the time of ovulation. These problems can lead to infertility in women.
How is chlamydia treated?
Thankfully, chlamydia is very treatable when detected. Antibiotics can cure chlamydia if taken as directed. Couples should abstain from sexual intercourse until the treatment is complete and both partners should be tested if one person is found to be infected.
If you are regularly screened, you will be able to prevent this infection from having any effect on your fertility. When it comes to your reproductive health, knowledge is power. By staying educated on STIs, you are already ahead of the curve.
We have bad news: Western sperm counts are declining. Many elements might be to blame for this: environmental factors, lifestyle choices, and the increase of obesity. But that doesn’t necessarily mean you’ll never get pregnant. Don’t worry, we’ll walk you through this!
Where is this happening?
This is happening everywhere in the Western world. A study published in Human Reproduction Update found that across Europe, North America, Australia, and New Zealand, sperm counts have declined by 50 to 60 percent since 1973.
This is a universal problem, although the causes of infertility might differ depending on where you are. In the Middle East, for example, the high rate of smoking in males and certain genetic defects are mostly to blame for infertility. The Middle East has been coping with male infertility for a long time. Islamic clerics were among the world’s first religious leaders to support IVF as a treatment for marital infertility. Today, the Middle East is one of the strongest sectors of IVF in the world. Consequently, there is arguably less of a stigma of male infertility.
So what can be done?
As reproductive technology improves, we have more options than ever to build the family we want. But infertility isn’t always an incurable condition. Making simple lifestyle choices, such as quitting smoking or losing excessive weight, can improve your reproductive health. Other causes of infertility can be corrected through surgical interventions. Understanding the cause of your infertility is crucial to repairing it.
If you can afford it, fertility treatments are available to help you create the family you desire. But the emotional and psychological consequences of being diagnosed as infertile shouldn’t be discounted.
Many people struggle with being labeled as “infertile.” Being diagnosed as infertile can be emotional for both men and women and feelings of inadequacy are common. In the West, medical intervention for infertility has become increasingly common and many women have spoken out about their struggles with conceiving. But male infertility is still spoken of in a derogatory way. “Shooting blanks” is a common way to refer to male infertility. To make things worse, many people confuse infertility with impotence.
The most important thing you can do to eliminate the stigma of infertility is to speak up about your experiences. Infertility is a health condition, not a personal failing.Your journey to parenthood should be something you are proud of. You deserve the family you want. And the good news? You are certainly not alone.
A recent study published in the journal Demography in August has demographers’ tongues wagging. The study focuses on China’s controversial one-child policy, which the study claims averted between 360 to 520 million births, aiding global environmental efforts.
China’s one-child policy was in effect from 1980 to 2016. While Chinese officials have argued that the policy prevented around 400 million births, many scholars have disputed the number and claimed that the policy violated human rights.
The study was published by Daniel Goodkind, an analyst at the U.S. Census Bureau in Suitland, Maryland. Goodkind extrapolated from countries that had a moderate fertility decline and found that the fertility policies reduced China’s population by 360 to 520 million births. Additionally, since birth-planning policies will have long lasting implications, he expects that the total number of avoided population could be 1 billion by 2060.
China’s Controversial One-Child Policy
China’s one-child policy has been a point of contention since its creation. Established by Deng Xiaoping in 1979, the policy was designed to limit population growth. The policy only applies to ethnic Han Chinese who live in urban areas. Fines and even forced abortions or sterilizations were used to enforce this policy.
Human rights activists have long decried the policy, pointing out the many problematic aspects. Under the policy, female infants have been known to be abandoned, neglected and even killed. Additionally, sex-selective abortion has been known to occur. Many scholars are angry at Goodkind for seemingly ignoring these abuses and have accused him of condoning the policy.
Problems With the Study
Zhongwei Zhao, a demographer at the Australian National University in Canberra, is one of many who is discrediting Goodkind’s paper. He points out that the ages of women who are marrying and giving birth have increased since the mid-1990s, which has nothing to do with government policies. By ignoring the effects of social change, he argues, Goodkind is not adequately addressing the factors that are influencing the fertility decline.
Others have criticized the paper for being immoral, as it could be used as a political tool that does not account for human rights violations.
It is difficult to gain unbiased information on the effectiveness of China’s one-child policy, but we can at least be grateful that we live in a country where we can have the family we want. As reproductive technology improves, you have more options than ever to build the family you desire.
The United States birth rate reached a record low, with only 62 births per 1,000 women of childbearing age in 2016. But does that mean women are less interested in having kids? Or are they simply waiting longer to start their families?
How Fertility Rates are Determined
Fertility rates are measured by dividing the number of total live births by the number of women who are of a childbearing age. The number is then multiplied by 1,000. The total fertility rate is calculated the same way and the results are used to estimate the number of children that each woman will have during her life. The current estimate is 1.8 (during a historic low in 1976, the estimate was 1.7).
Fertility rates allow us to track not only the total birth rates, but which age groups are procreating the most. And the results are pretty fascinating.
The Decline of Birth Rates in Younger Women
In 2016, the teenage birth rate dropped 9% from the previous year, with teenage births accounting for 20.3 births per 1,000 women. The teen birth rate has not been this low since 1940.
Additionally, the birth rate of women ages 20-24 dropped 4% from last year. Women ages 25-29 had a 2% drop. But it looks like older women are covering the gap.
The Increase of Birth Rates in Older Women
It’s a different story for these ladies. Women ages 30-34 had an increase of live births by 1% since last year, while women ages 35-39 had a 2% increase. Women ages 40 to 44 had the largest increase since last year, with a 4% bump.
What Is Causing This Shift?
During periods of economic downturn, it is common for people to procreate less. But as more and more women wait to have kids, it is more likely that the causes of these changes are due to family planning.
Many economists study fertility and birth rates as a way to predict the future of the job market and programs such as Social Security and Medicare. While fewer birth rates could be a cause of celebration for some, it’s possible that women are simply delaying pregnancy rather than avoiding it altogether, as evidenced by the increase in birth rates in older women. So next time you are stressing about when to start your family, relax. You have more time than ever before.
While no White House official has verified the veracity of the memo just yet, if the memo is real and its plans are true, the politics around women’s access to birth control could be changing.
The Trump administration wants to replace tried and tested birth control methods with “fertility awareness,” a family-planning technique that fails nearly a quarter of women every year. In the leaked memo, White House officials wrote that they intend to slash federal funding to the U.S. Agency for International Development’s family-planning budget and require “equal funding” for fertility awareness. The memo further specifies that fertility planning should be the sole birth control method made available to young girls.
Fertility planning, also known as the “calendar method” or “rhythm method,” requires women to diligently track their menstrual cycles and then pinpoint the days when they’re ovulating and avoid sex during that time. Because about 30 percent of women experience irregular periods, fertility planning has one of the highest rates of failure of any family-planning method.
Healthcare professionals believe an increased use in fertility planning could lead to more unintended pregnancies, some of which would be especially harmful to girls who don’t have an awareness of their bodies or of other evidence-based methods to prevent pregnancy.
Nowadays, rates of unintended pregnancy and teen births have hit record lows over the last two years. So has has the abortion rate. Experts agree that access to birth control and more information about effective ways to prevent pregnancy have contributed to this downward trend. However, Trump’s endorsement of calendar planning could send those rates soaring again if more women adopt the “calendar method,” which is not a suggested form of birth control.
It’s official: human sperm counts are in a state of long-term decline.
A national medical journal recently published a review of male fertility data that found that between 1973 and 2013, sperm counts have decreased by around 50 percent.
So is it time to panic?
What’s causing the decline?
There are several reasons that human sperm counts have declined. Here are a couple of the best guesses:
- Obesity: It’s no secret that obesity is a significant problem in the United States. However, you might not know that obesity has a negative influence on both male and female fertility. When men are overweight, their estrogen levels rise, which decreases the sperm count. Additionally, men who are obese could experience more warming of their scrotal area, which could negatively impact sperm development.
- Environmental Factors: Certain chemicals found in our everyday lives interfere with fertility. Pharmaceuticals, different pesticides, dioxins…all of these substances can negatively affect our reproductive health.
How can men preserve their fertility?
It’s important for men to regularly administer self-testicular exams and to keep up with regular appointments to ensure that everything is okay. If you have been struggling to get a woman pregnant for over a year, you might want to get a fertility evaluation.
Ideally, potential fertility problems can be spotted early in adolescents. For example, pediatricians can spot early signs of Klinefelter syndrome, which could impact later fertility, during puberty. If you are a parent, it is essential to keep up with your child’s pediatrician appointments.
What treatments are available to improve male fertility?
There are a variety of methods to treat male infertility, with the kind of treatment depending specifically on the cause. Sometimes simple lifestyle changes can positively improve reproductive health, such as losing weight or avoiding high heat exposure. You might also be put on medication if it is a hormonal issue. Surgery may be required if it’s an anatomical problem.
What the future holds
While sperm counts are on the decline, the information published in the recent study suggests that on average there are 47 million sperm per milliliter of ejaculate (the normal range is anything greater than 15 million). This means that despite the decrease of overall sperm counts, your chances of conception haven’t disappeared. People are still getting pregnant and you can increase your own chances by maintaining a healthy lifestyle and educating yourself on what could be impacting your fertility.