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February 2007 Archives

February 27, 2007

Free Fertility Seminar in Bakersfield - Come hear me speak!

I want to let you all know about a speaking engagement I have this weekend, Saturday, March 3. I will be speaking at the Bakersfield Wellness Center at 1 p.m. as a part of a free fertility seminar.

The free event is being hosted by the Advanced Women’s Health Center, Inc. and offers attendees a chance to hear from local fertility experts. I would like to extend an invitation to anyone who will be in the area this weekend.

I, along with a local OB/Gyn, my Laboratory Director, and my Nurse Practitioner will be speaking about some of the most commonly asked questions and treatment options on: basic infertility treatments, intrauterine insemination (IUI) with ovulation induction (OI), in-vitro fertilization (IVF) and advanced reproductive technologies (ART); and laboratory procedures including intracytoplasmic sperm injection (ICSI).

This is a great opportunity to hear first hand from fertility experts such as myself. I would really like to see you there, so come and join me. The Bakersfield Wellness Center is located at 4850 Commerce Drive in downtown Bakersfield. The seminar is free, but RSVP is necessary. Please call (661) 952-9477 to RSVP.

See you on Saturday!

February 16, 2007

eMax Health Article - "IVF May Be Increased With Use of Ultrasound"

Here is another article I wanted to share. Happy reading...

IVF Success May Be Increased With Use of Ultrasound

Couples who have difficulty conceiving and turn to in vitro fertilization for assistance may increase their chances of pregnancy with the use of ultrasound rather than the traditional method, a new review has found.
The systematic review evaluated two techniques used to transfer an embryo into a woman's uterus after fertilization — ultrasound guidance and "clinical touch" — and concluded that ultrasound appears to improve pregnancy rates.
"The results did not surprise us," said lead author Julie Brown, M.D., of the University of Auckland in New Zealand. "We would intuitively expect a better outcome with respect to pregnancy rates with ultrasound-guided transfer over a 'blind' procedure … and it was nice to have this proven in our meta-analysis."
The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.
According to the reviewers, about 80 percent of women who undergo in vitro fertilization will reach the embryo transfer stage with good-quality embryos, but "only a small proportion will then go on to achieve a clinical pregnancy and fewer will achieve a live birth."
It is estimated that up to 85 percent of replaced embryos fail to implant due to a few factors: poor embryo quality, lack of uterine receptivity or the transfer technique itself.
In the clinical touch transfer technique, the clinician uses a catheter to place the embryos into the uterus. It's considered a blind technique because it relies on the clinician’s touch to judge when the catheter is in the correct position to inject the embryos. Many clinicians say this method may be the reason why some embryo transfers fail.
Ultrasound-guided embryo transfer (UGET) has been studied to reduce the number of failed implants. According to clinicians, the use of the ultrasound machine makes it easier to confirm the catheter is in the proper location in the uterus before release.
The Cochrane reviewers analyzed 13 studies that included women who were all undergoing embryo transfer. Participants were randomized into groups being administered either ultrasound-guided or clinical touch embryo transfer technique.
Although no studies reported on live births, the reviewers were able to obtain this information from the authors for two studies. Another six studies reported ongoing pregnancies. Compared to the clinical touch group, the number of live births or ongoing pregnancies for women randomized to the ultrasound group was significantly higher. This means that "for a population of women with a 25 percent chance of pregnancy using clinical touch, this would be increased to 32 percent by using UGET," the reviewers say.
Except for blood on the catheter tip following the transfer procedure, which was more likely with the clinical touch method, the Cochrane reviewers found no statistically significant difference between the two groups in the rate of adverse events, such as ectopic pregnancy, miscarriage and multiple pregnancies.
Experts believe these techniques used by clinicians for embryo transfer will continue to be improved in coming years to increase the number of women who are able to conceive with the procedure.
"IVF, as such, has a small success rate of about 30 to 35 percent and this can further vary in different labs," said Ashok Agarwal, Ph.D., director of research at the Reproductive Research Center at the Cleveland Clinic. "In the future, these methods can further be improved upon to achieve a better pregnancy rate, but that will need multiple studies to make sure the right technique is being used and that evidence shows it is these techniques that are improving the success rate."
IVF was first introduced in 1978, and according to the American Society for Reproductive Medicine, accounts for less than 5 percent of all infertility treatment in the United States. Most couples seeking fertility treatment have success with medications or corrective surgeries.
For women wishing to undergo the technique, UGET appears widely available and physicians agree it has it benefits.
"We have used this technique for a number of years," said Randall Hines, M.D., director of the division of reproductive endocrinology and infertility at the University of Mississippi Medical Center. "My experience tells me that in many cases, clinical touch will be successful, but that ultrasound guidance is most helpful for difficult transfers."
"I would encourage women to ask for this approach, and it is used around the country," Hines said. "As the numbers indicate, the use of this approach would be unlikely to make a tremendous difference in pregnancy rates, but can make a difference in a few cases."

February 7, 2007

Comment on 67 year old woman giving birth

There has been a lot of news coverage regarding the 67-year old (“World’s Oldest Mother.”) It’s important to know that for women, who utilize donor eggs, our cut-off age for treatment is 50 years. Of concern to all those who treat patients in this age group (50 years and above) is that there is not a lot of data on the issues surrounding assisted reproductive treatments and the outcome.

And, of all the events in a woman’s life, pregnancy is by far one of the most stressful and physiological on her body. There are a number of steps women between 45-50 years go through before receiving treatment, including seeing a maternal–fetal specialist who can advise of any associated risks including:
• Hypertension
• Gestational diabetes
• Greater risk for premature labor -- It’s important the patient know about these risks.

We also do a full medical exam and that includes a liver function study, test for electrolytes, kidney function, pulmonary test with chest X-ray, EKG and mammogram.

For this group of patients you want to know their baseline is normal before starting any treatments and preparing them for pregnancy.

All patients also have to undergo psychological screening so they are aware of the emotional risks involved.

About February 2007

This page contains all entries posted to Dr. Werlin's Fertility World in February 2007. They are listed from oldest to newest.

January 2007 is the previous archive.

March 2007 is the next archive.

Many more can be found on the main index page or by looking through the archives.

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