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PCOS (Polycystic Ovary Syndrome) Treatment Simplified: What You Need to Know
Fertility Health

PCOS (Polycystic Ovary Syndrome) Treatment Simplified: What You Need to Know

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Dealing with PCOS can be overwhelming, but understanding its symptoms and treatments doesn’t have to be. Here we look at effective lifestyle changes, an overview of medication options, and explore fertility treatments designed to address PCOS complications.. By focusing on these key areas,  you’ll be empowered to manage PCOS symptoms and navigate fertility treatments with confidence. Use this guide as a resource to take control of your health and fertility, with comprehensive PCOS treastment information.  Managing PCOS with Effective Lifestyle Changes A go-to answer for PCOS management is weight loss, but do not discount the benefits from lifestyle adaptations focused on diet and exercise. Modifying your nutrition is crucial for achieving hormonal balance, while incorporating physical activity can significantly alleviate PCOS symptoms. Adjust Your Diet to Support Hormone Balance Adapting your diet can have a profound impact on hormonal balance. Prioritize foods high in fiber and low in sugar to help regulate blood sugar levels, which is key for individuals with PCOS. By increasing fiber intake and avoiding spikes in sugar, you help your body maintain stable insulin levels which can reduce the severity of symptoms and support overall reproductive health.  Including lean proteins, vegetables, and whole grains while minimizing processed foods and sugars is a strategy endorsed by nutritionists for improved PCOS management. Making big dietary changes and be tough, be sure to choose foods that you enjoy to help form long term eating habits. Trying new vegetables or new cooking methods may help you in your goals.  Incorporate Regular Exercise for Symptom Relief Regular exercise is a crucial step for women battling PCOS. Engaging in physical activity reduces insulin resistance—a common issue in polycystic ovary syndrome —and can improve the body’s sensitivity to insulin. Exercise also helps manage stress, a known factor that can exacerbate PCOS symptoms, providing a dual benefit. If you stick to consistent movement, whether through strength training, or flexibility exercises, you’ll be supporting hormonal balance.’ As with diet changes, you should be implementing exercises that are comfortable and something you can incorporate in your life easily. Starting small and sticking with it daily goes a long way. Try taking morning, lunch, and/or evening walks, a yoga routine, or an activity like hiking, or dancing.   Making lifestyle changes with both diet and exercise can be challenging, making small changes slowly will go a long way in forming better long-term habits. Remember, missing a day or two, does not remove the progress you’ve made and does not derail your ability to try again tomorrow.  Understand Medication Options for PCOS Treatment Understanding medication options is a key component in managing polycystic ovary syndrome. Hormonal birth control can help regulate menstrual cycles and manage symptoms, while insulin-sensitizing drugs target insulin resistance inherent in PCOS. Both approaches aim to restore balance and improve the condition’s overall manageability. Learn About Hormonal Birth Control Benefits Hormonal birth control can be a stabilizing force for women dealing with PCOS , as it addresses irregular menstruation, a major symptom. Contraceptives containing estrogen and progestin help regulate menstrual cycles and alleviate additional concerns associated with PCOS such as excessive facial hair and acne. Beyond menstrual regulation, hormonal birth control can reduce the formation of ovarian cysts—a prominent feature of PCOS.  Explore Insulin-Sensitizing Drugs for PCOS Insulin-sensitizing drugs like metformin present a viable option for addressing insulin resistance in polycystic ovary syndrome. These medications improve the body’s ability to utilize insulin, resulting in lower blood sugar levels and improved ovulatory function. For many, metformin serves as a cornerstone in their PCOS management, fostering a healthier metabolic profile and enhancing ovulation. Consider Fertility Treatments for PCOS-Related Infertility Assisted reproductive technology can provide more advanced support for someone with PCOS who is experiencing infertility. By inducing ovulation and fertilizing eggs outside of the body, these treatments can circumvent the body’s pathways and hormone disruptions.  If you are considering finding support for an infertility treatment, the information on this link may be helpful.  Ovulation Induction Medications  Ovulation induction medications, such as clomiphene citrate and letrozole can be used to help aid in various treatment options, including supporting at-home attempts for pregnancy. . These medications stimulate the ovaries to release eggs, enhancing the likelihood of conception for individuals challenged by anovulation – a common symptom of PCOS.  For optimal outcomes, it is essential that treatment with ovulation induction agents is closely monitored by a healthcare professional. Regular ultrasounds and hormone tests can precisely guide the dosage and timing, ensuring each cycle is tailored to the individual’s unique physiology, thereby increasing the success rates of pregnancy.  Understand Assisted Reproductive Technologies Assisted reproductive technologies, particularly in vitro fertilization (IVF), offer a substantial chance for women with PCOS-related infertility to become pregnant. Through the IVF process, eggs are removed, and fertilized with sperm in a controlled laboratory setting, and the resulting embryos are transferred into the uterus, bypassing many of the barriers encountered with PCOS. The precise control during each phase of IVF enhances the likelihood of successful implantation and pregnancy for those affected by the polycystic ovary syndrome. Another technique, known as intracytoplasmic sperm injection (ICSI), can be an added advantage for PCOS sufferers facing additional male-factor fertility issues. Here, a single sperm is injected directly into an egg, increasing fertilization rates as part of the IVF procedure. These methods, backed by a healthcare provider’s expert guidance, help tailor fertility treatment plans to the individual’s needs, offering hope and a clearer path toward parenthood.  Conclusion Effective management of PCOS requires a structured approach, with lifestyle changes like tailored dietary habits and regular exercise serving as foundational steps toward hormonal balance and symptom relief. Exploring medication options, such as hormonal birth control and insulin-sensitizing drugs, offers additional pathways to stabilize symptoms and enhance metabolic function. For those dealing with PCOS-related infertility, understanding and utilizing ovulation induction medications and ART can be essential steps toward parenthood. This comprehensive guide aims to simplify the complexities of the polycystic ovary syndrome treatment, leading individuals toward better health and improved outcomes.

Fertility Health, oldposts

Books About Infertility

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When the people around you don’t understand your experience with infertility, you can always connect with people who have been there and written about that. Here is a selection of books on infertility and the process of IVF, infertility memoirs, mind-body infertility resources, and childfree, not by choice resources. Books on Infertility & IVF These books focus on explaining the procedural aspects of infertility or IVF. We’ve kept the list to current books to make sure they are still relevant. The Fertility Doctor’s Guide to Overcoming Infertility  Buy on Bookshop This is a current guide (2020) on everything-infertility written by a doctor specializing in the area. Dr. Mark Trolice offers a general overview on topics from ovulation to preserving fertility from cancer. It’s a cross between a self-help book and an encyclopedia that offers practical tips along with accessible explanations. Who is it for: Readers looking for a general overview of many aspects of infertility are open to writing that offers advice. Conceivable: The Insider’s Guide to IVF Buy on Amazon Science journalist Jheni Osman offers an overview (2020) of IVF that extends beyond the medical procedures’ ins and outs. Chapters include how IVF works, choosing a clinic, egg, sperm, and embryo donation, cryopreservation, and when IVF doesn’t work. Conceivable has expert commentary and personal experiences woven throughout and is an easy read. Who it’s for: Readers from the UK who are new to the world of IVF and are looking for an overview from a patient perspective. (The book has a UK angle: resources, prices, terminology, etc.) Get A Life: His & Hers Survival Guide to IVF Buy on Amazon Buy on Bookshop Get a Life (2017) is a casually written field guide to IVF by Richard Mackeny & Rosie Bray that focuses on the roles that both men and women have in the process and the feelings that may come with each stage. The “his and hers” format leads to a few gender stereotypes—but likely also provides insight into what your partner might be experiencing and feeling. It’s UK-focused (resources, terminology), but not in a way that makes it UK-exclusive. Who is this book for? It’s a good book for couples looking to understand their partner’s role and feelings during IVF. The Trying Game: Get Through Fertility Treatment and Get Pregnant without Losing Your Mind Buy on Amazon Buy on Bookshop Part memoir, part how-to guide, Amy Klein writes about the process and emotional ups and downs of getting pregnant through fertility treatments. Drawing on her own experience and framed with research-driven info and expert interviews, she discusses everything-infertility in terms of what you need to know and what your choices are. Who is this book for? This book is suitable for a wide range of readers—anyone who is interested in better understanding the experience of infertility and the realities of fertility treatments. Pregnancy and the birth of a child are discussed. IVF & Infertility-Focused Memoirs These books focus on personal experiences with infertility, and that often include expert interviews and research. The Art of Waiting: On Fertility, Medicine, and Motherhood Buy on Amazon Buy on Bookshop Belle Boggs (2016) offers a series of essays on infertility, IVF, and birth, touching on topics like the two-week wait, seeing pregnancies everywhere, the infamous “just adopt” advice, financial barriers, and the fear of, after everything, bleeding during pregnancy. Who is this book for? This book is suitable for a wide range of readers, particularly anyone looking to help put words to feelings. The book mentions pregnancy and successful IVF after a first transfer. Through, Not Around: Stories of Infertility and Pregnancy Loss Buy on Amazon Buy on Bookshop Edited by Allison McDonald Ace, Caroline Starr, Ariel Ng Bourbonnais This book is a collection of essays (2019) that reflects the emotional ups and downs and physical struggles resulting from infertility and pregnancy loss experiences. Who is this book for? Readers looking to engage with raw and honest first-person experiences with infertility and loss. Some stories end with pregnancy or the birth of a child. The Seed: Infertility is a Feminist Issue Buy on Amazon Buy on Bookshop Journalist Alexandrea Kimball explores the relationship between infertility and feminism, where the right to not have a child is arguably more prevalent than the right to have a child. Who is this book for? This is a short yet dense read for people looking to really engage with how infertility fits into feminist theory, cultural norms, and popular culture. This isn’t a how-to or a memoir as much as it is a deep analysis of an underexamined issue. Conceivability: What I Learned Exploring the Frontiers of Fertility Buy on Amazon Buy on Bookshop Elizabeth Katkin writes about her extensive experience with fertility treatments while examining the often murky ethics involved in the process. Katkin speaks to the range of infertility treatments— from Clomid to egg donation — in a way that reads more like a story than a reference book. Who is this book for? Anyone looking to better understand the big business of assisted reproduction or intense perseverance in trying to have a baby. Mind and Body-Focused Infertility Books These books address how infertility can spill over into every aspect of your life. Buy on Amazon Buy on Bookshop Conceiving with Love: A Whole-Body Approach to Creating Intimacy, Reigniting Passion, and Increasing Fertility Denise Wiesner is a practitioner of Traditional Chinese Medicine with an integrative East-Meets-West approach (think chakra balancing) towards building intimacy and ultimately a passionate sex life. We don’t love everything about the book, but losing intimacy to infertility is a problem, and there might be something in it that helps you turn it around. Who is this book for? Couples looking to re-engage physically who are open-minded enough to work through exercises including breathwork and gratitude practice. Child-Free Not by Choice Books that cover what happens when infertility doesn’t end with pregnancy. Silent Sorority: A Barren Woman Gets Busy, Angry, Lost and Found Buy on Amazon Buy on Bookshop

Fertility Health, oldposts

Understanding Male Infertility

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Although fertility problems have often been considered a female problem, both men and women can contribute to infertility. In the United States, around 9% of men and 11% of women of reproductive age experience fertility issues. With couples experiencing infertility issues approximately one-third is related to male infertility, one-third female infertility, and one-third combined male/female or no answer. Infertility should be seen as a shared challenge, no matter where the diagnosis lies. The Male Reproductive System The testes are the most important part of the male reproductive system. This is where the sperm are made and stored, as well as the site of testosterone production, the hormone that gives men their masculine characteristics and helps sperm development. The testes are made up of very small tubules called the seminiferous tubules where the sperm mature. Nature has designed the anatomy of a man so that the testes are kept suspended away from the body; this is to keep them approximately 1 degree cooler than the rest of the body. In colder weather, the scrotum contracts to pull the testes closer to the body to maintain a constant temperature. As the sperm mature, they pass from the testes into the epididymis, a tightly coiled tube at the top of the testes (stretched out it would be approximately six meters — about 19 feet — long!). Here, they further mature and develop their ability to swim. It takes approximately 12 weeks for the full cycle of sperm development and 10 to 15 days for them to travel to the end of the epididymis before entering the vas deferens. The vas deferens is a long curving tube that carries the sperm from the epididymis up into the groin. pouch-like glands called seminal vesicles at the far end of the vas deferens produce most of the fluid (semen) in the ejaculate. A man who has had a vasectomy can still produce semen because the vas deferens has been cut close to the epididymis so that the seminal fluid can still leave the body, but the sperm stay trapped. The prostate gland is the largest of all the male reproductive glands and lies just below the bladder. The prostate gland also produces some of the seminal fluid discharged into the urethra during ejaculation. This fluid helps to change the pH of the semen, which neutralizes the acidic environment of the vagina. The Role of Sperm in Fertilization After ejaculation, the sperm swim through the cervical mucus and enter the uterus. They then swim up into the fallopian tubes where they meet an egg at the far end closest to the ovary. Although millions of sperm are deposited in the vagina, only a couple of hundred reach the egg, and only a single sperm is needed for fertilization. The sperm binds with the outer shell of the egg and enters it in a process called the acrosome reaction. As soon as this happens, the shell of the egg changes to stop any more sperm from entering. The DNA is then released from the head of the sperm and combines with the DNA of the egg to form the embryo. Causes of Male Infertility Sometimes the male partner is found to have a problem with his sperm. A semen analysis will identify problems involving the sperm count (numbers) and morphology (the shape and size) or motility (the movement). If a specific problem is identified, then the cause can be investigated by a specialist. Most often the only advice is to change environmental and lifestyle factors that may be contributing to a low sperm count. But occasionally further testing is needed to eliminate underlying health conditions or undiagnosed genetic disorders. Causes of fertility problems in men include the following: Obstructive problems (blockages in sperm-carrying tubes) Testicular injury and disease Varicocele (a varicose vein in the scrotum) Sperm disorders Genetic disorders Problems with erections and ejaculation Hormonal problems General medical disorders that reduce fertility Drugs that reduce fertility Environmental toxins and radiation Sperm Quality Factors in Male Infertility Sperm quality influences not only rates of fertilization but also subsequent embryo development. Remember, half of the genes come from the father. The male partner may carry a chromosomal abnormality that is responsible for him having a low sperm count and that increases the risk of implantation failure and miscarriage. A standard semen analysis usually tests sperm count, motility, and morphology. Several tests that are more advanced can be carried out if the sperm count is low for no apparent reason or if several treatment cycles fail without explanation. Several studies have shown increased sperm quality when a man takes vitamin supplements for a prolonged period. This is especially true if the supplement contains vitamin C, zinc, and folic acid. Eating a balanced, healthy diet with plenty of fresh fruit and vegetables, along with good quality proteins and healthy oils, has also been shown to improve fertility in men. Interestingly, most of the sperm found in a man’s ejaculate is actually abnormal, even in men with normal fertility. This is a case where the body is focused on quantity rather than quality. Semen Analysis One of the first investigations done by a fertility doctor is a semen analysis. This is done by the man producing a semen sample through mastrubation into a sterile container. This may be done at a clinic in a special room or potentially at home if you live close by. The clinic will supply you with a container and sperm-safe lubrication, so don’t use any household products or this may affect the results. Getting the sample When you get your semen assessment done, your doctor will receive a report from the lab with all the findings. The following table shows the normal ranges for sperm count, motility, and morphology. Normal Value Sperm concentration 2.0 mL or more Concentration 20M per mL or more Count 40M or more Total Motility 40% or more Progressive Motility 32% or more Morphology 4% or more Vitality (% alive) 58 Interpreting a

Fertility Health, oldposts

Understanding Blocked Fallopian Tubes

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Getting pregnant is a complicated business. The egg and sperm have to meet and fertilize and the resulting embryo has to grow and implant in the uterus. Most of this early part of conception takes place in the fallopian tubes. These thin tubes, around 8-10 cm long, stretch between the ovary and the uterus. After ovulation, the egg is picked up by the open end of the fallopian tube which is close to the ovary, where it begins its journey towards the uterus. Millions of tiny hairs called cilia line the end and the inside of the tubes. These cilia beat hundreds of times a second and help to catch the egg and move it through the tube towards the uterus. The cells lining the fallopian tubes provide lubrication for the egg on its journey and nourishment for the sperm, egg, and developing embryo. If sperm is present around the time of ovulation, the egg and sperm will meet in the second portion of the tube known as the ampulla. The egg and sperm combine to form the embryo, which starts its life as a single cell for the first 24 hours and will then continue its journey through the fallopian tube to the uterus. Fallopian Tube Disorders You can imagine that any serious dysfunction of the fallopian tubes will prevent conception, in which case in vitro fertilization (IVF), which bypasses the fallopian tubes, may be needed. As well as acting as a transport system for the egg, sperm, and embryo, the tubes are the site of sperm capacitation and storage, fertilization, and early embryo development. The tubes are an important contributor to the nutrition and development of gametes and embryos. Any changes in the delicate cells lining the fallopian tubes can affect a woman’s ability to conceive. In addition to being patent (open), the tubes must be healthy and disease-free to allow normal function. Identifying tubal occlusions, or blockages can be done using ultrasound or radiological imaging of the tubes after filling them with saline or a special dye. This investigation is usually done soon after you visit your doctor to discuss your fertility because the results will determine whether a couple should continue trying on their own or if they need surgery or the help of IVF. HSG: Diagnosing Issues with Fallopian Tubes A hysterosalpingogram (HSG) is a common test used to determine whether the fallopian tubes are patent (open) and if the uterine cavity is normal. During an HSG, a catheter is placed through the cervix into the uterus, and a contrasting dye is injected into the uterine cavity. Several X-rays are taken of the pelvic area to identify if the dye is traveling through the tubes, indicating that they are clear and whether there are any uterine abnormalities. An HSG is preferable to a sonohysterogram (which uses saline) because it provides more detailed information about the reproductive system, including the fallopian tubes. An HSG is part of the basic testing done in the early stages of diagnosis. It is performed between Days 5 and 11 of the menstrual cycle, and a woman can attempt conception in the same month. This test is typically performed by a radiologist in the X-ray department of a hospital or clinic and usually takes 15 to 30 minutes. You may feel some cramping similar to menstrual cramps during the test and for a short time after. Most women with blocked fallopian tubes do not have any symptoms. If only one tube is blocked, a woman can still get pregnant naturally, although usually only in the months when she ovulates on the side with the open tube. In rare cases, women have gotten pregnant when they ovulated on the side with the blocked tube, so it’s still worth trying every month if this is the case. It is also possible for a tube to be partially blocked, this increases the chances of an ectopic pregnancy, so it’s important to have a full investigation done if you are trying to conceive and have a history of pelvic infection. What Causes Blocked Tubes? The most frequent cause of blocked fallopian tubes is pelvic inflammatory disease (PID) which is usually the result of an infection. Salpingitis is the medical name given to enflamed fallopian tubes. Here are some of the common causes of blocked fallopian tubes and their symptoms: Salpingitis This inflammation of the fallopian tubes is usually caused by a bacterial infection and is one of the most common causes of blocked fallopian tubes. Salpingitis is sometimes called pelvic inflammatory disease (PID), although PID can also refer to inflammation of other parts of the reproductive tract. Salpingitis may have no symptoms. In other cases, signs may include abnormal vaginal discharge, spotting between periods, painful periods, pain during ovulation or sex, and lower back pain. Treatment options include prompt antibiotics when an infection is identified. Infection of one tube can easily lead to infection of the other tube because of their proximity. Diagnosing salpingitis involves several tests, including: General examination: to check for localized tenderness and enlarged lymph glands Pelvic examination: to check for tenderness and discharge Blood tests: to check the white blood cell count and other factors that indicate infection Mucus swab: a test to identify the type of bacteria causing the infection Laparoscopy: a way to view the fallopian tubes with a slender instrument inserted through abdominal incisions Sexually transmitted diseases, especially Chlamydia and Gonorrhea, can cause the tubes to become blocked. If you have a history of STDs and are having trouble conceiving, talk to your doctor about testing to see if your tubes are healthy. Uterine infections caused by pregnancy termination, surgery, or miscarriage can also lead to blocked tubes so make sure you mention any relevant history to your doctor. Hydrosalpinx A hydrosalpinx is a blocked fallopian tube filled with clear fluid; this is usually in response to an infection or other cause of PID such as endometriosis or surgery. Symptoms vary. Some patients have low, recurring abdominal

Fertility Health, oldposts

Cervical Position and Fertility

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In addition to the commonly charted cervical mucus changes and Basal Body Temperature (BBT) changes of the menstrual cycle, cervical position, texture, and openness can be a useful guide in identifying the fertile time. Below is a guide to using cervical observations to chart your fertility. Where is the Cervix Located? While the cervix is often referred to as if it is a discreet thing, it is actually the name given to the lower portion of the uterus. It is the part of the womb that extends into the vagina and can be palpated with your finger. It is also the passageway that a baby must pass through when being birthed vaginally. When unaroused, a vagina is typically 3-4 inches long, with the cervix located at the end. The cervix can be easily palpated with an index finger. It should feel like a “snout” at the end of your vagina. How Does the Cervix Change During your Cycle? The cervix, as part of the uterus, is affected by the dozen ligaments that suspend it in the pelvic cavity. Levels of relaxin, a hormone, fluctuate throughout the cycle and influence how the ligaments hold the uterus within the pelvis. This can cause the uterus (and cervix respectively) to raise and lower within the vagina. In turn, this changes the angle of the cervix within the vagina. The opening to the cervical canal, the “tunnel” between the vagina and the uterine cavity, is called the “os.” The os must open in order to allow cervical mucus out and to allow sperm in. For this to happen, the entire cervix softens. When the cervix is soft it feels like the texture of your lips. When it is hard it feels like the cartilage in your nose. Why Does Cervical Position Fluctuate? Cervical changes serve several functions: An open os allows the release of cervical mucus, which is pivotal to supporting sperm survival in the vagina. An open os also allows passage of sperm into the cervix, so they can make their way through the uterus and into the fallopian tubes. A high cervix facilitates deeper penetration during intercourse, increasing pleasure for both partners and increasing the chance of orgasm and pregnancy. A cervix that is directly in line with the vagina increases the chances of sperm getting into the cervix (bull’s-eye!). After ovulation has passed, the os closes, the cervix hardens, and the uterus shifts down. The closed os prevents bacteria from entering the uterus, thus decreasing the chances of the uterus being infected with a virus. Cervix During a Fertile Time At ovulation, the cervix should optimize the chances of conception. This means: Open – The cervical os should be open, to allow sperm transport into the uterus and to allow cervical mucus out of the crypts and into the vagina. Soft – The texture of the cervix should be soft, like your lips. High – Ideally, the cervix will be high, however, there may be many reasons why it is not (see below.) Straight – The cervix should be directly in line with the vagina. Cervix During Low Fertility At times of low fertility, the cervix should protect the uterus from infection. This means: Closed – Considered to be the least open position. Hard – A hard cervix is normal between menstruation and the onset of cervical mucus, which marks the shift into the fertile phase of the cycle. The cervix is also hard after ovulation and up until menstruation when it softens and opens again to allow menses to flow out of the uterus. Low – Typically, a low cervix indicates a time of low fertility. Tilted – The uterus should be resting fairly horizontally, just above the bladder, meaning the cervix should be tilted towards the rectum. However, this can vary by individual based on the unique alignment of the pelvic organs within the pelvic cavity How to Perform A Cervical Check Be sure your nail is short and not freshly cut to avoid scratching yourself. For hygiene purposes, be sure to perform your cervical check using clean hands, and be certain you do not leave soap residue that could cause irritation. Get into a comfortable position (squatting or having one foot up on a toilet are ideal). Insert an index finger gently into your vagina. Feel for a “snout-like” protrusion at the end of your vagina. Press lightly on it to ascertain whether it is hard or soft. Feel for the small hole in the center. Does it feel open or closed? Lastly, notice whether your cervix feels directly in line with your vagina (e.g., right at the tip of your inserted finger) or whether it feels angled to the front or back (e.g., the front pad of your finger). These distinctions—hard/soft, open/closed— are easiest to make when you have experienced the full spectrum of changes, so observing and charting through one entire cycle is usually necessary before being able to differentiate with any level of confidence. Be sure to sit or stand in the same position whenever doing your cervical examinations as your cervix will feel different depending on how gravity is acting upon your organs. Individual Variation in Cervical Position The most important aspect of charting cervical changes is determining what is fertile for you. This requires charting for a full cycle and comparing observations against other primary fertility signs. Variations in pelvic floor health, amount of relaxin production, previous pregnancies, individual anatomy, and obesity can all impact the positioning of the reproductive organs within the pelvis. For this reason, identifying the change that marks the shift into fertility is what is important, more so than the individual position.

Fertility Health, oldposts

Should I Donate Eggs Again?

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You made it through at least one egg donation cycle and now you’re thinking about doing another—but you likely still have questions. How much time does my body need to recover? Can I increase my fee or negotiate new contract terms? Will I run out of eggs? Can I freeze some eggs for myself? Does doing multiple cycles increase the risk to my health? These are all important questions, and things you will likely want to investigate before undergoing multiple egg donation cycles. If your last donation cycle was successful—for example, if you produced a lot of high-quality eggs that became embryos and the intended parents (IPs) reported a positive pregnancy—it is likely your egg donor coordinator will contact you again soon to schedule your next cycle. They may even provide you with birth control pills as you leave the clinic, so you are ready to go for another cycle, or they may ask if you’re interested during a follow-up exam (and yes, it is in your best interests to have a follow-up). You may feel elated if and when you find out your IPs are pregnant—or need the money to pay bills—but whatever the case, it is likely best to step back; it might be beneficial to see how your body recovers and take stock of your experience rather than immediately agreeing to do another cycle. Deciding to donate eggs again is entirely up to you—but it is typically in your best interest to not agree to do more than one cycle at a time. Here are some things to think about when considering another egg donation cycle. How did my body respond to fertility drugs? The first thing to consider before deciding to do another cycle is how your body responded the first time. If you experienced extreme discomfort or bloating—an indication of ovarian hyperstimulation syndrome (OHSS)—you are highly likely to have the same or worse experience on the next cycle. This is especially true if the doctor uses the same medication protocol he or she used during your last cycle. Some medications are more likely to cause OHSS, and others have different effects on the body. Some people are more sensitive than others. If you had no negative side effects throughout the process, and it went smoothly for you, hopefully, that will still be the case for your next cycle. But every cycle is different and there are no guarantees. Read: The Egg Donation Medical Process: For Egg Donors How much time does my body need to recover? Many donors report feeling pressured to do another cycle right away. Sometimes there are recipients anxiously waiting for a donor to be available, and this time that donor is you. Yes, it may feel good to know people want you, but this is your body and your first commitment is to your own health and well-being—and taking time for a full recovery is important. The length of time it takes to recover is different for everyone. Some women feel back to normal within a few days, and others may still be sore, bloated, and uncomfortable for months. A good rule of thumb is to wait for at least two or three menstrual cycles before undergoing another donation cycle and surgical procedure. Your ovaries were most likely quite large and need time to settle down to normal size. You will also want to make sure you have normal periods before proceeding with another cycle. Give yourself time to observe your body and make sure you’re not having any lingering pains in your abdomen or ovaries. Will I be able to ask for a higher fee? Or negotiate my contract? Every egg donation cycle will require a new contract. If there was something you didn’t like about your last contract, this is the time to make sure you negotiate better terms for yourself. You can also ask for a higher fee—especially if your eggs produced a pregnancy. Read: What Egg Donors Should Know About Egg Donation Contracts If you are working through an agency it is likely that you will be sent to different clinics and different doctors on subsequent donations. This also means you may be given different medication protocols than you had on your last cycle. If you had a protocol that worked well for you, ask the new doctor if you can use that one again. If your other protocol did not work well for you, ask to have it adjusted. This is a whole new cycle, and since you’ve donated before you have a pretty good idea of how everything works. Use the knowledge you’ve gained to advocate for yourself. Will I run out of eggs? Every female is born with about two million eggs and they do not make any new eggs during their lifetime. Every month some eggs die off. By the time a girl reaches puberty she has about 400,000 left and by the time she reaches thirty, that number is about 100,000. Of course, every woman is different, and some suffer from premature ovarian failure (POF)—meaning they entered menopause before they were supposed to. During an egg donation cycle, the fertility drugs increase the number of eggs that come to maturity in that cycle, but this does not necessarily mean that you are losing eggs faster by being an egg donor. However, that said, some egg donors do go on to face their own infertility. With the lack of research, no one really knows if being an egg donor increases a woman’s chance of becoming infertile. Can I keep some of my eggs for myself? With recent advances in egg freezing a lot of donors are asking: Can I save some eggs for myself? At many fertility clinics, the answer to this is “no.” However, there are some fertility practices that are now offering donors the ability to “freeze and share.” This means that during an egg donation cycle you will give half of your eggs to an intended parent, and keep

Fertility Health

Our Journey to Pregnancy With Donor Eggs

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It’s not exactly living the dream but, for thousands of women each year, (women like me who have struggled to conceive despite years of fertility treatment) getting pregnant with another woman’s egg can suddenly become the only viable option if achieving a healthy pregnancy is your goal. That was my reality, aged 44, after two miscarriages, six in vitro fertilization (IVF) treatments, and five years of sorrow and shame. Why Egg Donation Couples turn to donor-egg conception for several reasons—from genetic concerns to age-related issues. For me, it was the latter. After our first two unsuccessful IVFs, our consultant introduced the idea of donor-egg conception. Our treatments to date had resulted in a decent egg yield and OK fertilization rates but extremely poor embryo quality. Everything pointed towards the fact that my eggs were of poor quality. My first reaction was to ‘fix’ the problem. So, preparing for IVF #3, I embarked on a strict regime of acupuncture (fair evidence it does not improve results), Chinese herbs (insufficient evidence regarding results), vitamins, and high doses of Coenzyme Q10 which, I’d read, could help improve egg quality. We did see an improvement in embryo quality —so much so that, by IVF #5, we achieved blastocysts for the first time – which, finally, resulted in a pregnancy! But that was short-lived— a chemical pregnancy, it was over almost before it had begun. “Rotten luck,” said our consultant. That last cycle yielded our one and only frozen embryo, which also came to nothing. By this point, I was done. Now, aged 43, it was tough to finally accept ‘defeat’ but I still wasn’t ready, by any means, to contemplate donor conception. A major part of my hesitation towards donor conception was the moral and ethical questions involved. Our Donor Conception Hesitation We spent a further 12 months mentally jostling the pros and cons of childlessness vs. adoption vs. other routes with the help of a fertility counselor who proved instrumental to our well-being and our decision-making. A major part of my hesitation towards donor conception was the moral and ethical questions involved. Hundreds of “whys” and “what-ifs” addled my brain, making it near-impossible to move forward: How would my decision impact a future child? Am I setting them up for a lifetime of angst and misery? Could I love a child that wasn’t my ‘genetic’ baby? How would family and friends react; would they accept a donor-conceived baby? Would I be judged? These are but a few of the many worries I battled with. In the end, our counselor helped us refine our thinking: I made a list of all the things keeping me up at night and then I crossed out the ones that could apply to any parent! Suddenly my concerns became a lot more manageable, I could focus my energies on a few important questions. There was still the adoption question. I decided I still wanted my husband to have the chance to be a genetic parent… but I still wasn’t ready to start the donor process. Better Understanding Perspectives on Donor Egg Conception At this point our counselor encouraged us to visit an open evening with a UK-based donor agency we had read about, having decided that if a donor was the way forward, we’d prefer a ‘traceable’ UK donor. This event provided the final ‘light-bulb’ moment; there we heard from a young adult who was donor-conceived, a woman who had conceived using a donor egg, and an egg donor. All three perspectives suddenly helped reassure me that my concerns were perfectly natural and that the process wasn’t as freakish as I’d feared. I recognize that everyone’s story is different but, just hearing it was possible to grow up and feel loved and ‘normal’ as a donor-conceived child… that it was possible (natural, even!) to joyfully and unconditionally love a donor-conceived baby—these were the final pieces of our mental jigsaw. “Sign us up,” we said! Finding Our Donor Match The process of finding a donor was fascinating (and stressful). The agency we used matches donors based on physical attributes as well as values and personality. For me, it wasn’t straightforward; my mixed-race heritage meant it wouldn’t be easy to find me a visual match—but we carefully briefed the agency about the characteristics we were hoping for. Choosing a donor felt like a life-changing decision—yet it was hard to do with only a childhood photo and a short written profile about themselves including why they’ve chosen to voluntarily donate (to protect their anonymity) to guide us. But we also recognized that we needed to make a leap of faith and we soon found a donor that we felt a connection with, we were GO! Sadly, after several weeks, it became apparent that our donor couldn’t proceed, due to a family bereavement. So, the search began again for a new donor. Thankfully, we didn’t have to wait too long—and, if it’s possible, we found a new donor that was almost a better match than before! It’s important to say that donor-IVF still doesn’t guarantee a pregnancy at the end of it. A Team of People Behind a Pregnancy of My Own After a few months of waiting for various test results and synchronizing our periods, our first donor-egg IVF treatment began. It’s important to say that donor-IVF still doesn’t guarantee a pregnancy at the end of it—but my odds suddenly went from 5% to 70% and, finally, luck was on our side, the first time around. I am now six months pregnant. As soon as I saw a healthy baby in my belly, at 12 weeks and again at 20, my fears about donor conception melted away. I think of my donor every single day. I will tell my baby, from an early age, about the amazing lady that helped me to become a mommy. But every kick I feel reminds me that it’s me who’s pregnant with our baby and I couldn’t be more excited. I know that there

Fertility Health

Fertility Blogger of the Month: Caro of The Cuckoo Mama

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Our blogger of the month from our list of Top Fertility Blogs is Caro Townsend of The Cuckoo Mama. We think her Twitter game is an A+ and through her writing, we get the sense that she'd be the kind of stranger that you wouldn't hesitate to approach. She has written about her multiple IVF cycles, miscarriage, and ectopic pregnancy and currently finds herself winging motherhood and working to break the taboos which surround infertility and miscarriage. This is what Caro had to say about blogging about fertility: Q: Tell us about yourself I’m Caro, the creator of one of 2018 and 2019’s top ten UK fertility blogs, The Cuckoo Mama. I’m also a freelance writer. I’m very happily married to my best friend, Hugh, and we have Sam, human, and miracle, and his big sister Pepper pup, not so human but very much thinks she is! We live in a village in Mid-Sussex and can often be seen donning wellies and stomping through fields come rain or shine! I’m a foodie and love the way food brings folks together; our home is pretty much always full of family and friends! I’m mischievous, a self-confessed pedant and get itchy feet if we haven’t traveled for a while! “I am not afraid of storms, for I am learning how to sail my ship” – Louisa May Alcott Every time I come across this quote it fills me with inspiration #inspirational #quotestoliveby #louisamayalcott — Caro Townsend (@thecuckoomama) January 8, 2019 Q: How did your experience with infertility start and how has the story unfolded? I never, ever expected we’d struggle to conceive. We got married, started “trying” and… absolutely nothing happened. It turns out my husband has a chromosomal defect, which he’s likely had since birth and will never cause him any issues, except with his fertility. After 28 months of eating millet, drinking cough syrup, laughing at clown videos and, eventually, burning every book we’d bought boasting the secret art of conception, we started ICSI. As much as I never expected we’d struggle to conceive, I also never imagined ICSI would, or could, fail. But it does and it did. It took a further three years of back to back treatments, miscarriage and an ectopic pregnancy, whilst I was pregnant before our son arrived. He’s a little frostie and I am so in awe of his creation, his resilience and his determination to survive and meet us. I’m regularly proud of my husband but incredibly so today. It’s never easy talking about #infertility yet his courage to speak out about the male factor is inspirational. Here’s hoping it can help others, a little, in the same situation #maleinfertility #IVF #united https://t.co/0Ps5uNrHKU — Caro Townsend (@thecuckoomama) January 12, 2019 Q: Why did you start blogging? I’ve always had a love of writing. I’m a journalism graduate who somehow ended up working in Private Equity but always wanted to write! After a couple of years of stay at home mum-ing, I decided it was time to do something for myself, so I did and started out trying to create a fluffy-filled parenting blog. I’m not sure why, but I was NEVER going to write about infertility. And then it all changed! One day I felt hugely compelled to write about our story and that’s where my words have taken me. Finding my voice didn’t happen overnight, I tried out various styles until I realized, I just needed to be me. Which is hopefully what I am. I’ve found a place where I can raise my voice and shout from the rooftops that IVF is tough, infertility is cruel, and miscarriage is heart-breaking. I’ve found a place where I can raise my voice and shout from the rooftops that IVF is tough, infertility is cruel, and miscarriage is heart-breaking. Q: What are three words that describe your blog? Resonating. Open. Companionable. Q: What's the story behind the name? The village where I live is named after the cuckoos who, apparently, still come and visit! As I initially set up as a parenting blogger I wanted something which would convey my bonkerness, my motherhood, and love of the outdoors; The Cuckoo Mama did that. When my writing became predominantly infertility-related, I did wonder whether I needed to change it but actually liked the connotation of the cuckoo laying eggs in different nests; it somehow seemed to echo how my son had been incubated in his petri dish “nest,” whilst feeling resonant of how medical science helps create families in so many differing and wonderful ways; we don’t all have to be conventional in conception! Although please note—I don’t advocate throwing eggs out of trees! Q: What topic do you find yourself covering most often and why? The emotions of infertility. To begin with, I was an incredibly naïve infertile, but perhaps we all are. I always thought I was coping with complete aplomb when I was actually spiraling into despair, with bitterness and rage causing me to disconnect from others. I didn’t know how to exist. I lived with shame and guilt, believing I’d somehow wronged the universe and this was all my fault. I’ve never felt as alone or ostracised or as misunderstood as I did during my journey to become a mother. It grieves me to think that others could be experiencing that same isolation. I’m a huge believer that we need to keep talking and breaking taboos, to stand united, either in shared experience or compassion. I want anyone living with infertility to know they are not to blame and, despite the tears, are brave and strong and beautiful. I'm part of a community who stand united, supporting, fighting and being the true warriors we are; raising awareness, making debates happen and changing perceptions. And to me, that's empowering.#infertility #ivf #warriors https://t.co/En2QLzdNp6 pic.twitter.com/b5Pf09YJQD — Caro Townsend (@thecuckoomama) December 27, 2018 Q: Who is your target reader? It’s a real mix. Naturally, I hope it’s a supportive place for those walking through

Fertility Health, oldposts

Facts on Weight and Fertility

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Weight is a sensitive subject for everyone, but for those trying to conceive, it is important to review and understand its impact on fertility and pregnancy. Being either underweight or overweight can make it more difficult to get pregnant, decrease success rates with fertility treatments, and lead to complications in pregnancy. However, you can optimize your chances for a healthy baby by learning more about the impact weight can have on fertility and taking steps to reach a healthier weight. Body mass index (BMI) is a simple calculation based on height and weight. While not perfect for predicting health, it’s an easy way to study and compare the impact of weight on health and is used in most scientific studies. (You can calculate your BMI here). The World Health Organization established the following categories of weight based on BMI in 2004 (1): Underweight if BMI <18.5 kg/m2 Optimal weight if BMI 18.6-24.9 kg/m2 Overweight if BMI 25.0-29.9 Obese if BMI >30.0 kg/m2. By this definition, in the United States, 50% of reproductive-age women are overweight (2) and 37% of all adults (men and women) are obese (3). Being overweight impacts overall health by increasing the risk of hypertension, diabetes, cardiovascular disease, sleep apnea, osteoarthritis, cancer, and overall mortality (4). The impact of weight on fertility can often be overlooked because couples seeking help to conceive can be young and the effects of these chronic conditions may not yet be evident. Anyone seeking fertility treatment or trying to conceive should be aware of lifestyle factors that can influence the chances of pregnancy, with or without treatment. Physicians often recommend quitting smoking, limiting alcohol, sleep hygiene, and self-care, but they often leave out the weight discussion. Weight is a difficult and sensitive subject to bring up to a couple who is already struggling with another difficult and sensitive subject: infertility. But we cannot ignore the weight discussion if we really want to help patients conceive and bring a healthy baby to term. Optimizing weight can empower patients to increase their chances of pregnancy, with or without fertility treatment, and improve the chances of a healthy pregnancy and baby! Here are the facts: Weight Impacts Fertility for Women Being under or overweight can impact fertility in women in multiple ways: Weight can influence menstrual cycles and ovulation. Some underweight women stop menstruating while some overweight women have very irregular menses and ovulation, which makes tracking cycles and attempting conception difficult. Studies show that women with anovulation who reach a healthy weight can start ovulating regularly and have a higher chance of conceiving naturally (5,6). Weight can impact responsiveness to fertility treatment. Studies show that women who are overweight require higher doses of stimulation medication (at a greater cost to the patient) and have lower responses to medication for fertility treatment (7-11). Weight impacts success with fertility treatment. Studies in both humans and animals undergoing IVF show poor egg quality, lower fertilization rates, and lower blastocyst formation (advanced embryos) as BMI increases (11,12). A systematic review of over 27 clinical trials showed that women with a BMI >25 kg/m2 have a 10% lower success rate with IVF compared to women with a BMI <25 kg/m2 (13). Weight impacts the uterine environment and success with embryo transfers. One study in gestational surrogates showed a lower implantation rate in women with a BMI >35 kg/m2 compared to women with a lower BMI (14). Weight Impacts Fertility for Men Obesity has been associated with poor sperm parameters on semen analyses, but studies are conflicting on the impact of male obesity on fertility treatment and pregnancy outcomes: Studies have shown lower sperm counts and poor sperm parameters in obese men (20). Other studies have shown lower fertilization rates and blastocyst formation rates in obese men (21). Some studies have shown a lower live birth rate and a higher miscarriage rate in couples with obese men (21,22). Weight Impacts Pregnancy Outcomes Being an unhealthy weight can increase risks in pregnancy: Being overweight is associated with an increased risk of miscarriage. Multiple studies including over 40,000 patients in the analysis have shown the risk of miscarriage increases in women who conceive with a BMI >25 kg/m2 (15,16). Being overweight increases risks for multiple pregnancy complications, including gestational diabetes, hypertension, preeclampsia, preterm delivery, stillbirth, cesarean or instrumental delivery, shoulder dystocia, fetal distress, early neonatal death, and small- as well as large-for-gestational-age infants (17-19). Obesity has been associated with a higher incidence of multiple birth defects, including heart defects, neural tube defects, and more (2). How Can You Optimize Your Weight? Awareness is the first step, and by reading this information, you are taking a positive step forward. Absorbing all of this information at once can seem overwhelming, but knowledge is power. Not all couples with obesity will have the poor outcomes listed above, but fertility and pregnancy at an unhealthy weight does carry more risks, and we all need to be aware of what these risks are. If you are underweight, gaining weight with the help of a nutritionist can be key. If you suffer from an eating disorder and struggle with body image and weight gain, start by asking for help. If you are overweight, here are some steps you can take to move towards a healthier weight: Ask for help. There are many resources out there. Find the one that’s right for you. Some people like the accountability and group mentality of a weight loss program while others appreciate a more private approach with a nutritionist/registered dietician or physical trainer. Find a buddy. Try to find someone with similar goals and help each other out. There are different apps with groups that people can join to encourage each other to keep moving and stay on track towards goals. Get a monitor. There are many brands out there and ways to keep track of online or connect with others to keep track of goals. Write things down. Get a nutrition and exercise journal and keep track of what you’re

Fertility Health

Blogger of the Month: Kristen of Embrace Your Unicorn

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Our blogger of the month from our list of Top Fertility Blogs is Kristen of Embrace Your Unicorn. This blog initially caught our eye when she linked to some of our content. We needed to know more—unicorn what? After reading most of her posts (a terrific use of time!), we wanted to share her story. After being diagnosed with a number of issues (including a unicornuate uterus—get it?), Kristen is creating a supportive community for people with aspects of their lives —unicorns, if you will— that they are learning to accept. Putting your life out there for public consumption isn't easy, but we are sure glad there are people like Kristen who are willing to go there. This is what she had to say about the process of blogging about fertility. Q: Tell us about yourself Hi! I’m Kristen, a speech language pathologist by day, blogger by night (and weekend and early morning). My life’s main mission: help people…and make ‘em smile while doing it. In my blog, I share my infertility story ever since being diagnosed with a unicornuate uterus…and low ovarian reserve…and endometriosis in May 2018. (Basically every diagnosis that makes it difficult to make a baby.) I aim to share my story in a light-hearted, informative, and authentic way. My husband, Cory, and I live in Denver, Colorado. We are goofy: laughing until our stomachs hurt as we sing our family's theme song we wrote together. We are existential: dissecting life and our emotions and our experiences for hours at our small dinner table. We are sentimental: saving every theatre ticket and hand-written note left for one another. We are open: sharing our infertility experience, the highs, and the lows, the hilarious and the disappointing. Q: How did your experience with infertility start and how has the story unfolded? After six months of trying to get pregnant, my OBGYN put me on Clomid, a (usually) harmless ovulation-stimulating medication. I ended up developing ovarian cysts that became hemorrhagic (read: exploded) and were so heavy that my ovary started to rotate like a twisting a water balloon. Unable to control the pain, we raced to the ER. The pain radiated from my lower right abdomen around my side to my lower back. As if one Clomid-inspired devil wrung my insides like a wet towel while another stabbed me over-and-over with a red-hot fire iron. After reviewing my MRI, the physician assistant came into my room and told me, without warning, that I had a “uterine abnormality” and that I was probably “infertile” because of it. BOOM. In the middle of my writhing pain, she decided to punch me in the gut with this diagnosis, a diagnosis she was unqualified to make and news she was inept at sharing. This was the day Cory and I stepped onto our infertility roller coaster. The past six months have been a blur of stressful ups and downs, of new diagnoses and hard decisions. Now for our infertility journey a nutshell: I was diagnosed as having a unicornuate uterus, low ovarian reserve (AMH: 0.54) and endometriosis. In August 2018, we started our first IVF cycle. Because of my poor egg quality, we only had one genetically normal embryo from the first round of IVF (better than none!). And because my type of uterus has a 37% miscarriage rate, we decided to do a second round of IVF to try to get a couple more embryos just in case. We finished our second cycle in November 2018. In the middle of my writhing pain, she decided to punch me in the gut with this diagnosis, a diagnosis she was unqualified to make and news she was inept at sharing. Q: Why did you start blogging? When I was diagnosed with a unicornuate uterus and obtained my new “unicorn” status, my life turned into a nightmare. It was not a lovely dream where a kind-hearted unicorn sings Julie Andrews-esque melodies and poops delicious rainbow frozen yogurt. In was a nightmare in which a Dr. Frankenstein-created evil unicorn ravages an unsuspecting village by shooting laser beams from her eyes and puncturing townspeople with her razor-sharp horn. The unicorn in this nightmare was unwelcomed, unexpected, angering, and the bearer of the most severe grief. I started blogging to expel this literal and metaphorical unicorn nightmare from my mind. I used writing as a way to take the reins and break her in. That's the first reason I chose to start blogging: to help myself. But there was another motivator behind starting this blog: to help you. I started the blog to pave the way for you to embrace your "unicorns," the things in life that you’re learning to accept. Embrace Your Unicorn is a blog that uses the sharing of one’s story as a gateway to catharsis and to cultivate awareness, compassion, and community. The unicorn in this nightmare was unwelcomed, unexpected, angering, and the bearer of the most severe grief. Q: What are three words that describe your blog? In my Embrace Your Unicorn Facebook group, I asked the members to describe my blog in three words. They responded with: funny, real, raw, honest, sweet, heartfelt, vulnerable, freaking hilarious, inclusive, safe, compelling, informative, inspirational. Reading those words felt like sweet hot chocolate and buttery mashed potatoes for my soul. Especially the words safe, vulnerable, and inclusive. (It was nice to hear that someone thinks I’m “freaking hilarious” too.) Q: What's the story behind the name? I started my blog as a way to process and learn to embrace my unicornuate uterus, and thus Embrace Your Unicorn was birthed! I also share my experiences learning to embrace my other “unicorns” including disordered eating/exercise recovery, anxiety, rheumatoid arthritis, and people-pleasing-perfectionism. Q: What topic do you find yourself covering most often and why? My blog primarily covers the topic of infertility. I predominantly share my journey with IVF and my unicornuate uterus, and my guest writers share their stories about a variety of other infertility topics including miscarriage,

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FertilitySmarts was founded by Kelly Park several years ago with the intention of providing educational resources for individuals facing fertility challenges. In 2023, IVF Store, LLC acquired the platform, aiming to perpetuate Kelly’s mission while enhancing its content through contributions from esteemed fertility clinicians and experts globally. Presently, FertilitySmarts stands as a premier online information hub, featuring articles authored by recognized specialists in the realm, elucidating the scientific intricacies of fertility issues.

 

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