Posts Tagged ‘IVF’

More “Octomom” Fall-Out, should her doctor lose his license?

October 16, 2010 | By:

According to a report in a Los Angeles newspaper today, the Octomom’s doctor is facing a hearing on Monday where he may lose his license.  Personally, I think what he did was malpractice and showed tremendous lack of forethought regarding the impact on this woman’s life and her family.  I don’t know that he could have predicted the societal impact and the repercussion in the reproductive medical industry.  But I wanted to know what you think!

With all the recent emphasis on single embryo transfer, and avoidance of multiple pregnancy (a twin pregnancy is now considered a management failure at some IVF Clinics), should patients in consultation with their doctors be the ones to choose to how many embryos to transfer or should doctors face regulation or possible loss of their medical license for listening to their patient when she asks to have multiple embryos transferred when it might be advisable to limit the number transferred?

Here’s the link to the article for more info:#mce_temp_url#

(in case the link doesn’t work, cut and paste this URL  http://www.whittierdailynews.com/news/ci_16351124)

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It’s Confirmed: 40 Really is the New 30! Except . . . Wait . . . Watch Out For the NOvary

September 23, 2010 | By:

Most people who know me, know that I am in my mid-early 40’s.  Turning 40 wasn’t a big deal for me.  I have such a baby face that sometimes I have a hard time getting people to take me seriously.  Turning 40 for me was a milestone of maturity I had long waited for.  You have to take a woman in her 40’s seriously.  If for no other reason than you’ve got the mileage to deserve it.  And yes, thanks to amazing strides in modern medicine (not to mention Botox® and Viagra®), people are living longer and are taking the time to enjoy their life; people are doing things later in life and enjoying them with the vigor and spirit of someone fifteen to twenties years younger.  No longer are we rushing ala “Mad Men” into marriage and childbearing in our 20’s.  Women are taking the time to establish themselves and find the right mate.   Forty has thus become to the former Twenty-Somethings, what 30 was to our parents’ generation.

There is a lot more fun to be had and work to be accomplished, praise to be garnished and shopping for hot “Jeggings” (well maybe not for me) to be done in one’s 40’s.  The “not your mom’s kind of jeans” have given way to a new look for those of us who are fabulous and 40: long hair and tight jeans are acceptable on a 40 year old woman’s body. No longer are these considered unacceptable for a woman of a “certain age”!  No longer does turning 40 qualify you as a “woman of a certain age” and for that matter, neither does turning 50!!  As a dear friend of mine recently turned 40 and all her friends gave her a shout-out on Facebook (and yes, someone not yet 40 begged my friend to confirm that 40 is the new 30), it was generally considered among her already 40 friends that turning 40 was a cause for celebration.   So yes, my friends, your 40’s are a decade to be embraced and not dreaded.

Except for one small, “eensy weensy” factor of which no woman should ignore and most women to my surprise are unaware of . . . have you met

The NOvary?

Who or What is the NOvary?  Well, let me fill you in!  The NOvary is the any-woman’s ovary who has decided not to cooperate with her plans to become a mother.  The NOvary does not care if you’re 30, 35 or 40.  She can and does reside in all women of all ages.  However, she tends to emerge with more Attitude at or around the time you turn 35.  And by the time you turn 40, the NOvary has almost universally decided to take over your reproductive system and your Plan.  The NOvary defies what medical science and a good cosmetic dermatologist have allowed us to enjoy — another decade of productivity and passion for all things, most especially those career, clothing or relationship related.  Because let’s face it, not every woman is ready to, or wants to have a child, in her 30’s.  Indeed, we have been taught to wait and enjoy, and to relish life!  And we should!!  But then as we turn 40 and we’ve lined all our nice little ducks in a row, or decided we don’t need our ducks to be in a row, and we consider parenting, we come face to face with the not-so-new but seemingly unknown nemesis to pregnancy and motherhood:

The NOvary.

The NOvary is the Ovary that says NO to all your carefully defined and created plans.  In the world of fertility, or rather infertility, 40 is from the reproductive endocrinologist’s standpoint, the death of your childbearing years.  The NOvary has not run a slick social media champagne – in fact it’s quite the opposite – she has been enjoying our ride along with us all the while knowing her little secret, and enjoying her secret power.  The NOvary is the Ovary that no longer makes healthy eggs and she is so stealthy and sophisticated that you can actually conceive on your own for a few years as she gains her power and comes into her prime.  But even though she hasn’t hit her full capabilities to destroy your dreams (or so you think) her influence over the eggs she releases on your behalf will cause you to miscarry, and miscarry again.  Lulled into a false sense of security that your eggs are working because you are getting pregnant, she continues to work her evil spell, pushing you farther and farther into her control.

So powerful is the NOvary that she can continue to elude you into believing that you are still fertile even though you’re 40.  So powerful is the NOvary that she can fool even the smartest of reproductive endocrinologists who will look at all your Day-3 data, manage to retrieve some very “healthy” looking eggs from your ovaries, only to find that those fertilized eggs and “beautiful” preembryos don’t turn into the baby you are longing for.  The NOvary can place the cleverest of masks on eggs that are on the verge of retiring, and making them look as fabulous as you do in your 40 something glory.  But the NOvary knows: your eggs have long since passed their expiration date.

How do I know this?  How did I meet the dreaded and feared NOvary?  Over hundreds (and I unfortunately mean hundreds) of my clients have battled her, failed to defeat her, and then faced the reality that (whether they are Thirty-Somethings or Forty-Somethings, married, career in place, or otherwise just determined to become a mom), if they want to realize their dreams of becoming pregnant and having a baby that they would need to bypass the NOvary altogether.

Yes, we can defeat the NOvary.  You still have options and a powerful weapon to defeat the NOvary; one of those options is donor eggs and your success rate using donor eggs is about 50 to 60 times higher (perhaps more than that) than your chances are of defeating the NOvary. Yes, you read that correctly, success rates for using donor eggs are (at some fertility clinics) close to a 60% live birth rate!

Just as medical science has preserved your beauty and created a body that does not look, act or feel anywhere near 40, it has created a technology that can put the NOvary out of business!  But be warned, while 40 is truly the new 30 . . . the NOvary has no intention of catching up with the rest of us, and if you want to have a baby and you haven’t yet decided to TTC or the TTCing isn’t going anywhere, consider the fact that she may be up to her devilish deeds.

Celebrate your age and enjoy your life . . . but please don’t forget she’s out there . . . looming in the shadows and finding new ways to avoid detection by physicians and scientists alike . . . and her name is the NOvary!

Liz

p.s. up next, another option for defeating the NOvary . . . stay tuned!

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Some thoughts on making egg donation work

May 13, 2010 | By:

As I get closer to finishing my E-Book on egg donation, I seem to have more and more clients asking me some of the essential nuts and bolts questions about egg donation.  It is urging me to write faster and get the first of the three book series finished.  In the meantime, I have taken an old article I wrote for the then Hartford Chapter of RESOLVE on egg donation, and modified it for this blog post.

Here’s How One Woman Made Egg Donation Work:

Through the gift(s) provided by an egg donor, many infertile women are now able to experience pregnancy; sharing their thoughts, feelings, blood supply and the sound of their voice with their baby; and to deliver their child into the world.  The success rates offered by many egg donation programs are staggering (nearing the 70% mark at most clinics), making this one of the more popular options in modern family building for women with diminished ovarian reserve or other issues of egg quality.

Egg donation is often so successful that you can potentially build your entire family from one egg donation cycle.  Of course not every egg donation results in a pregnancy; but more often than not a carefully selected donor not only gets the recipient mother pregnant but there are extra embryos frozen for future family building.

Let us consider Janet[1], and her experience with egg donation.  Janet is in her late thirties and after several failed IVF cycles, Janet’s doctors told her that her best chances for becoming a mother were through egg donation or adoption.  Janet wanted to experience pregnancy, and so chose to pursue egg donation.

After doing research, Janet decided to work with an egg donation agency, rather than using her clinic’s in-house program. While some clinics are very flexible, Janet found she had more options when using an egg donation agency.  By working with an agency Janet had greater flexibility in choosing her donor, didn’t have to share eggs with another infertile family, and would have greater control over her finances.  Because she was on a tight budget, most of the agencies she spoke with encouraged Janet to select a donor who lived near the clinic she would be using, thus avoiding substantial travel expenses.  Using an agency, Janet also had a greater selection of donors with compensation rates to fit her budget, compared with the fixed rates offered by most clinics.

One donor Janet considered (we’ll call her Leslie[2]), was twenty-six years old, single, had near perfect SAT scores, attended an Ivy League college, graduated at the top of her class and was attending medical school.  Despite Leslie’s outstanding academic credentials (which sometimes result in higher compensation rates) Leslie’s requested compensation was within the middle range of both ASRM’s and the Society for Assisted Reproductive Technologies’ (SART)[3] guidelines for egg donor compensation: $3,000-$7,000 per donation.  Leslie also visibly resembled Janet and lived near their fertility clinic thus helping to make the cycle more affordable for Janet and her partner.  Leslie seemed like the perfect donor.

Leslie, however, had no “track record” donating eggs.  She had never been an egg donor before and didn’t have any children of her own.  Although statistically, carefully screened first-time (or “unproven”) donors have the same success rates in helping infertile women/couples achieve pregnancy, Janet was concerned that she would spend money to have Leslie donor undergo the first part of the necessary screening process, only to find out that Leslie was not sufficiently fertile and had been disqualified from being an egg donor.

Janet and her partner were also considering matching with a donor named “Julie”.   Julie also was twenty-six, had high SAT scores, had attended college, and had never been an egg donor before.  Julie was requesting the same compensation as had Leslie ($5,000) and lived near Janet’s clinic.  However, Julie was married, and had two-and-half-year old twins and a one-year old baby.  Julie was clearly fertile (she had children) and thus would be more likely to produce healthy eggs, which to Janet and her partner meant she presented a lower risk of being “screened out” by their fertility clinic.

Once Janet and her partner selected Julie as their donor, Janet’s egg donation agency presented them with a list of attorneys to help prepare their egg donation agreement, and it arranged for Julie to be represented by separate counsel in connection with the negotiation and drafting of their agreement. The egg donation agreement is a critical aspect of the egg donation process and all parties should be represented by independent counsel.  The egg donation agreement will protect your rights as parents and govern your relationship with your donor for years to come.  You should have the right to select your own attorney, one who is an experienced reproductive lawyer.

Each egg donation agreement is unique; some agreements provide for complete disclosure of names and addresses and others are completely anonymous.  Whatever your comfort level or that of your donor may be regarding future contact, please consider that your agreement should ensure that you can contact your donor in case of a future medical emergency.  Among other things, your egg donation agreement should specify your rights to utilize and/or dispose of the eggs/embryos created from the cycle, require that your donor follow medical directions, address what happens if your donor breaches your agreement or if the cycle needs to be rescheduled for some reason (like a death in the donor’s family), and/or how medical bills are handled if she experiences a complication like ovarian hyper-stimulation.

Within four months of the time Janet initially contacted their egg donation agency, Janet, Julie and their respective partners had negotiated their agreement and their cycle got underway.  Julie produced seventeen eggs of which fifteen fertilized.  Janet conceived a beautiful baby girl on the first embryo transfer and when Janet’s daughter was about a year-old, Janet and her partner went back and did a frozen embryo transfer; this time conceiving twin girls (it is admittedly rare for a frozen cycle to result in a twin pregnancy but in this case it did)!


[1] Janet is a combination of several of my clients, a fictitious character created for purposes of this blog to help demonstrate a typical egg donation process from a more “real life” perspective.

[2] Names have been changed to protect people’s privacy.

[3] ASRM (The American Society for Reproductive Medicine) and SART are related organizations which, among other things, establish ethical and regulatory guidelines that many clinics and agencies agree to comply with.  For more information, visit their websites:  #www.ASRM.org# and #www.sart.org#

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