Showing posts with label ivf. Show all posts
Showing posts with label ivf. Show all posts
Wednesday, September 2, 2009
Coming up
It's been a while since I posted, but I've just been so busy with the twins. I am gearing up to get back to posting and continuing providing information about IVF and infertility in general. Even if I can help one woman with her cycle question, or provide at least some insight on what to expect from this madness of infertility - it's worth every minute because I've been there for 2 years and I know how painful and hard it can be! I wish this didn't happen to me or to you. I truly wish we didn't have to be here and I wish you did not want to read this blog because infertility would never touch your life. But you are. I wish I could give you a hug and tell you that this too shall pass. And here I am after 5th successful IVF cycle still trying to let go, still trying to heal the scar that was left so deep in my heart, still trying to rebuild all the bridges burnt by this cruel infertility struggle.
Wednesday, March 25, 2009
Vegetarianism & IVF
I belong to a couple of forums that are dedicated to IVF. Many times I see women ask questions whether them being a vegetarian or not eating enough meat negatively effects their cycle.
Again, I am not a doctor, but if your do the research, you will see, that it does not. To my opinion being a vegetarian can actually help.
I am a vegetarian for ethical reasons. I guess not a complete vegetarian because I do eat fish and eggs that are organic and were harvested from free-run (cage free) chickens. I constantly hear that vegans and vegetarians also do not usually get adequate amounts of vitamin B12, zinc, iron and folic acid. But, hello!, who does not take vitamins or supplements these days?! If you take multivitamin, this problem disappears.
Contrary to popular opinion, protein intake in vegetarian and vegan diets is sometimes only slightly lower than in meat diets. For example, an average portion of roast chicken breast contains 24g protein. On average one vegetarian sausage/burger contains 27g of protein. Since becoming vegetarian I get more protein than ever. My suggestion - read labels.
If anything you are probably doing your eggs good by following vegetarian diet. There are over 20,000 different drugs, including steroids, antibiotics, growth hormones and other veterinary drugs that are given to livestock animals. These drugs are consumed when animal foods are consumed. The dangers herein, in secondary consumption of antibiotics, are well documented.
Vegetarians eat a lot of soy and that actually may help with IVF success!
High doses of soy estrogens can improve pregnancy rates in women undergoing in vitro fertilization and embryo transfer, Italian researchers have found.
Women who took 1,500 milligrams of soy isoflavones per day, along with progesterone injections, had significantly greater rates of implantation, ongoing pregnancy and delivery than women given progesterone injections with placebo, Dr. Vittorio Unfer of the Obstetrics and Gynecology Center in Rome and colleagues report.
Also, many RE’s would agree that there is no conclusive proof that your specific diet would affect the number of recruitable follicles in your ovaries (which is really what ovarian reserve means) if you are cycling, and of normal weight.
You should meet with a nutritionist to make sure that you are eating a balanced diet and getting adequate calories, fats, proteins and other nutrients as are important for any pregnancy to proceed well.
You know, many countries where overpopulation is an issue (India for example) have populations that eat a mainly if not exclusively vegetarian diet!
Hope this information will help you to start out on your own quest to better nutrition.
Wishing you good luck, as always!
Again, I am not a doctor, but if your do the research, you will see, that it does not. To my opinion being a vegetarian can actually help.
I am a vegetarian for ethical reasons. I guess not a complete vegetarian because I do eat fish and eggs that are organic and were harvested from free-run (cage free) chickens. I constantly hear that vegans and vegetarians also do not usually get adequate amounts of vitamin B12, zinc, iron and folic acid. But, hello!, who does not take vitamins or supplements these days?! If you take multivitamin, this problem disappears.
Contrary to popular opinion, protein intake in vegetarian and vegan diets is sometimes only slightly lower than in meat diets. For example, an average portion of roast chicken breast contains 24g protein. On average one vegetarian sausage/burger contains 27g of protein. Since becoming vegetarian I get more protein than ever. My suggestion - read labels.
If anything you are probably doing your eggs good by following vegetarian diet. There are over 20,000 different drugs, including steroids, antibiotics, growth hormones and other veterinary drugs that are given to livestock animals. These drugs are consumed when animal foods are consumed. The dangers herein, in secondary consumption of antibiotics, are well documented.
Vegetarians eat a lot of soy and that actually may help with IVF success!
High doses of soy estrogens can improve pregnancy rates in women undergoing in vitro fertilization and embryo transfer, Italian researchers have found.
Women who took 1,500 milligrams of soy isoflavones per day, along with progesterone injections, had significantly greater rates of implantation, ongoing pregnancy and delivery than women given progesterone injections with placebo, Dr. Vittorio Unfer of the Obstetrics and Gynecology Center in Rome and colleagues report.
Also, many RE’s would agree that there is no conclusive proof that your specific diet would affect the number of recruitable follicles in your ovaries (which is really what ovarian reserve means) if you are cycling, and of normal weight.
You should meet with a nutritionist to make sure that you are eating a balanced diet and getting adequate calories, fats, proteins and other nutrients as are important for any pregnancy to proceed well.
You know, many countries where overpopulation is an issue (India for example) have populations that eat a mainly if not exclusively vegetarian diet!
Hope this information will help you to start out on your own quest to better nutrition.
Wishing you good luck, as always!
Friday, February 27, 2009
Poor Egg Quality...Really???
I always hear stories of doctors telling their patients after a failed cycle that their egg quality is not good. Usually a patient entrusts their self into the hands of a doctor and leaves the office with a prognosis of future donor eggs. I don't like when that happens. I truly believe that some doctors take advantage of patients that do not do their own research and believe everything they say.
First, let me ask you this - Did your RE explain exactly how your eggs are bad quality? What exactly is wrong with them? You should be able to find out that information.
For example an egg is comprised of a shell (zona pellucida or just“zona”) and the cytoplasm (ooplasm) which, after fertilization, will grow and develop into the embryo. Every lab inspects eggs upon retrieval and they usually have to make notes of their findings. For example, a good egg would have a zona that is perfectly round, that does not have any distortions/deformities and is most often tightly surrounds the actual egg inside. So, if you have a poor egg quality, your RE should be able to to tell you, whether your eggs have a zona that is way too thick or deformed, which can prevent normal fertilization, embryo hatching and thus implantation. Also, you may have a cytoplasm that is way too big to properly surround and "snug" the egg, thus the actual egg within could potentially become damages from “floating” around. There are many more standards by which your eggs are evaluated like fragmentation, color, etc. Poor eggs sometimes will have dark color and look “degenerative” under the microscope.
You must also know that currently, there is not one single test out there that can conclusively determine egg quality. There is no one perfect test for egg quality. Therefore most labs, and RE’s base their assumptions of your eggs ability to become fertilized and produce normal embryos. Therefore I also believe that just one or two failed IVF’s is not the end of the road, since in every cycle your eggs will differ depending on which particular eggs will be produced during that particular cycle. Each cycle is different with different eggs playing the game of baby making. Know that a normal looking egg may possess underlying genetic problems where an egg that appears “poor” may be chromosomally normal and go on to becoming a healthy baby.
So please, don't take one doctor's opinion and give up on having your own babies. Like I said before, having a PhD does not mean they are not human and can predict your fate...You are strong and can’t try again, go for second opinion, third, forth if you need to. Also there are some clinics that specialize in giving women that other doctors gave up on, their own babies. I've heard amazing things about Cornell Center for Reproductive Medicine and Infertility in New York; Colorado Center for Reproductive Medicine; SHER Institutes For Reproductive Medicine.
Do your research and stay strong, don't give up. This road is tough but your are a fighter and you will hold your baby in your arms someday.
First, let me ask you this - Did your RE explain exactly how your eggs are bad quality? What exactly is wrong with them? You should be able to find out that information.
For example an egg is comprised of a shell (zona pellucida or just“zona”) and the cytoplasm (ooplasm) which, after fertilization, will grow and develop into the embryo. Every lab inspects eggs upon retrieval and they usually have to make notes of their findings. For example, a good egg would have a zona that is perfectly round, that does not have any distortions/deformities and is most often tightly surrounds the actual egg inside. So, if you have a poor egg quality, your RE should be able to to tell you, whether your eggs have a zona that is way too thick or deformed, which can prevent normal fertilization, embryo hatching and thus implantation. Also, you may have a cytoplasm that is way too big to properly surround and "snug" the egg, thus the actual egg within could potentially become damages from “floating” around. There are many more standards by which your eggs are evaluated like fragmentation, color, etc. Poor eggs sometimes will have dark color and look “degenerative” under the microscope.
You must also know that currently, there is not one single test out there that can conclusively determine egg quality. There is no one perfect test for egg quality. Therefore most labs, and RE’s base their assumptions of your eggs ability to become fertilized and produce normal embryos. Therefore I also believe that just one or two failed IVF’s is not the end of the road, since in every cycle your eggs will differ depending on which particular eggs will be produced during that particular cycle. Each cycle is different with different eggs playing the game of baby making. Know that a normal looking egg may possess underlying genetic problems where an egg that appears “poor” may be chromosomally normal and go on to becoming a healthy baby.
So please, don't take one doctor's opinion and give up on having your own babies. Like I said before, having a PhD does not mean they are not human and can predict your fate...You are strong and can’t try again, go for second opinion, third, forth if you need to. Also there are some clinics that specialize in giving women that other doctors gave up on, their own babies. I've heard amazing things about Cornell Center for Reproductive Medicine and Infertility in New York; Colorado Center for Reproductive Medicine; SHER Institutes For Reproductive Medicine.
Do your research and stay strong, don't give up. This road is tough but your are a fighter and you will hold your baby in your arms someday.
Monday, February 23, 2009
Pineapple - Miracle fruit?
I don't think so...
I don't believe in it. But here is the info if it helps.
Pineapple Juice
Usage: There is an old wives' tale floating around that pineapple juice will help a fertilized egg implant. However, pineapple juice is not recommended for use in TTC and/or pregnancy. In large doses, it can actually cause uterine contractions and bring on spontaneous abortions (miscarriage).
Recommended Dosage: Drink only in small quantities, if at all.
Side Effects: Large doses may cause uterine contractions, miscarriage, vomiting, diarrhea, skin rash, very heavy menstrual periods. Unripe pineapple is poisonous, causing excessive diarrhea.
It’s not the pineapple itself but what is inside of it. Pineapple contains a chemical called Bromelain. Only fresh pineapple contains it and not pineapple juice where the enzyme bromelain is destroyed through heat/processing. Bromelain is a proteolytic enzyme that breaks up proteins that inhibit embryo implantation.
Pinapple should not be consumed too early in the cycle because it can actually affect your vaginal and cervical mucus PH, making it more acidic. Sideeffect of too much pineapple (bromelain injestion) include nausea, vomiting, diarrhea, menorrhagia (excessively heavy menstrual flow) and possible allergic reactions. One study has also associated bromelain with increased heart rate. Also bromelain is contraindicated during pregnancy as it may cause uterine contractions.
I don't believe in it. But here is the info if it helps.
Pineapple Juice
Usage: There is an old wives' tale floating around that pineapple juice will help a fertilized egg implant. However, pineapple juice is not recommended for use in TTC and/or pregnancy. In large doses, it can actually cause uterine contractions and bring on spontaneous abortions (miscarriage).
Recommended Dosage: Drink only in small quantities, if at all.
Side Effects: Large doses may cause uterine contractions, miscarriage, vomiting, diarrhea, skin rash, very heavy menstrual periods. Unripe pineapple is poisonous, causing excessive diarrhea.
It’s not the pineapple itself but what is inside of it. Pineapple contains a chemical called Bromelain. Only fresh pineapple contains it and not pineapple juice where the enzyme bromelain is destroyed through heat/processing. Bromelain is a proteolytic enzyme that breaks up proteins that inhibit embryo implantation.
Pinapple should not be consumed too early in the cycle because it can actually affect your vaginal and cervical mucus PH, making it more acidic. Sideeffect of too much pineapple (bromelain injestion) include nausea, vomiting, diarrhea, menorrhagia (excessively heavy menstrual flow) and possible allergic reactions. One study has also associated bromelain with increased heart rate. Also bromelain is contraindicated during pregnancy as it may cause uterine contractions.
Thursday, February 12, 2009
Crinone - Once or Twice?
Well, someone asked me why some women use Crinone (Progesterone Gel) once a day and some use it twice a day.
I am not a doctor but I have some thoughts on this. Also, medical community still does not have a final verdict on what is better (as you can see by example studies below) so I believe it depends on individual cases.
For example, lets take my case. Usually one dose is sufficient enough because it is a very concentrated gel. I was originally prescribed only one. Once I became pregnant, I had unexplained bleeding for 2 weeks of bright red blood and passing clots. Freaky, I know. I decided to add one more dose just to be safe and my doctor agreed, but she said it might not have any advantages, but if I felt like it, just for my piece of mind, then go for it. After I started using two a day, my bleeding still continued, but at least I felt good about doing everything I can with respect to extra progesterone. Crinone 8% is generally used once a day though. Each doctor will individualize the correct dosing of Crinone 8% based on the patient’s needs and their situation.
First, it depends whether you are prescribed Crinone 4% or Crinone 8% gel.
Crinone 8% is generally used once a day though. Each doctor will individualize the correct dosing of Crinone 8% based on the patient’s needs and their situation.
Structure:
Each applicator delivers 1.125 grams of Crinone gel containing either 45 mg (4% gel) or 90 mg (8% gel) of progesterone in a base containing glycerin, mineral oil, polycarbophil, carbomer 934P, hydrogenated palm oil
glyceride, sorbic acid, sodium hydroxide and purified water.
Due to sustained release properties of Crinone, progesterone absorption is prolonged with an absorption half-life of approximately 25-50 hours, and an elimination half-life of 5-20 minutes.
Possible explanation
Assisted Reproductive Technology--Crinone 8% is administered vaginally at a dose of 90 mg once daily in women who require progesterone supplementation. Crinone 8% is administered vaginally at a dose of 90 mg twice daily in women with partial or complete ovarian failure who require progesterone replacement.
Further, Jobanputra et al, in a donor-egg IVF study, showed that 100% “in-phase” endometrial biopsies, reassuring pregnancy rates (46–48% vs. 41%) and mis-carriage rates (14–33% vs. 25%) were seen at both the twice and once-daily dosing levels compared to intra-muscular therapy. Pregnancy rates were as high with vaginal as with intramuscular therapy. There were no significant differences in clinical pregnancy and implantation rate using twice-daily Crinone or once-daily Crinone.
(Jobanputra K, Toner JP, Denoncourt R, Gibbons WE. Crinone 8% (90mg) given once daily for progesterone replacement therapy in donor egg cycles. Fertil Steril 1999;72:980–4.)
Although, In their study, Ho et al 1 report that using vaginal progesterone gel twice daily for luteal support resulted in better pregnancy outcomes than intramuscular progesterone. Vaginal progesterone gel seemed to offer more “targeted” delivery of progesterone to the uterus and improved endometrial receptivity.
(Ho CH, Chen SU, Peng FS, Chang CY, Yang YS. Luteal support for IVF/ICSI cycles with Crinone 8% (90 mg) twice daily results in higher pregnancy rates than with intramuscular progesterone. J Chin Med Assoc 2008;71:386–91.)
Whatever you may choose at the end, make sure you consult with your doctor first.
I am not a doctor but I have some thoughts on this. Also, medical community still does not have a final verdict on what is better (as you can see by example studies below) so I believe it depends on individual cases.
For example, lets take my case. Usually one dose is sufficient enough because it is a very concentrated gel. I was originally prescribed only one. Once I became pregnant, I had unexplained bleeding for 2 weeks of bright red blood and passing clots. Freaky, I know. I decided to add one more dose just to be safe and my doctor agreed, but she said it might not have any advantages, but if I felt like it, just for my piece of mind, then go for it. After I started using two a day, my bleeding still continued, but at least I felt good about doing everything I can with respect to extra progesterone. Crinone 8% is generally used once a day though. Each doctor will individualize the correct dosing of Crinone 8% based on the patient’s needs and their situation.
First, it depends whether you are prescribed Crinone 4% or Crinone 8% gel.
Crinone 8% is generally used once a day though. Each doctor will individualize the correct dosing of Crinone 8% based on the patient’s needs and their situation.
Structure:
Each applicator delivers 1.125 grams of Crinone gel containing either 45 mg (4% gel) or 90 mg (8% gel) of progesterone in a base containing glycerin, mineral oil, polycarbophil, carbomer 934P, hydrogenated palm oil
glyceride, sorbic acid, sodium hydroxide and purified water.
Due to sustained release properties of Crinone, progesterone absorption is prolonged with an absorption half-life of approximately 25-50 hours, and an elimination half-life of 5-20 minutes.
Possible explanation
Assisted Reproductive Technology--Crinone 8% is administered vaginally at a dose of 90 mg once daily in women who require progesterone supplementation. Crinone 8% is administered vaginally at a dose of 90 mg twice daily in women with partial or complete ovarian failure who require progesterone replacement.
Further, Jobanputra et al, in a donor-egg IVF study, showed that 100% “in-phase” endometrial biopsies, reassuring pregnancy rates (46–48% vs. 41%) and mis-carriage rates (14–33% vs. 25%) were seen at both the twice and once-daily dosing levels compared to intra-muscular therapy. Pregnancy rates were as high with vaginal as with intramuscular therapy. There were no significant differences in clinical pregnancy and implantation rate using twice-daily Crinone or once-daily Crinone.
(Jobanputra K, Toner JP, Denoncourt R, Gibbons WE. Crinone 8% (90mg) given once daily for progesterone replacement therapy in donor egg cycles. Fertil Steril 1999;72:980–4.)
Although, In their study, Ho et al 1 report that using vaginal progesterone gel twice daily for luteal support resulted in better pregnancy outcomes than intramuscular progesterone. Vaginal progesterone gel seemed to offer more “targeted” delivery of progesterone to the uterus and improved endometrial receptivity.
(Ho CH, Chen SU, Peng FS, Chang CY, Yang YS. Luteal support for IVF/ICSI cycles with Crinone 8% (90 mg) twice daily results in higher pregnancy rates than with intramuscular progesterone. J Chin Med Assoc 2008;71:386–91.)
Whatever you may choose at the end, make sure you consult with your doctor first.
Friday, January 30, 2009
What now?
I am not going to blog about my pregnancy. I feel very lucky to get here but we've worked hard to sacrifice many things, emotionally and financially, sacrificed parts of our lives and relationships with friends and family. It was hard and it does not get easier until I hold my babies in my arms.
Having said that, I know your pain. I still feel it and instead of writing about my nausea and vomiting, I've decided I will do my best to try to find articles and new research information to try to help many many women that are still going through the nightmares of infertility.
Research was always important to me and by educating myself I tried to get what I needed and wanted from my RE. I don't take no for an answer. I don't believe of giving your reproductive future to a doctor. No matter how educated and specialized they are - they are us - HUMAN. They have their own opinions and many of them choose not to perform certain protocol "tricks" because they think it's not worth it. Well, it is!
Having said that, I know your pain. I still feel it and instead of writing about my nausea and vomiting, I've decided I will do my best to try to find articles and new research information to try to help many many women that are still going through the nightmares of infertility.
Research was always important to me and by educating myself I tried to get what I needed and wanted from my RE. I don't take no for an answer. I don't believe of giving your reproductive future to a doctor. No matter how educated and specialized they are - they are us - HUMAN. They have their own opinions and many of them choose not to perform certain protocol "tricks" because they think it's not worth it. Well, it is!
Wednesday, June 4, 2008
Implantation Failure???
I think I might be...nuts
I am doing something weird and yes I know it, so please don't be shy if you think I've gone bonkers 
Somewhere deep down in my heart, I believe that the reason why I am not getting pregnant is because I have implantation failure. I think that even though my eggs get fertilized with my husband’s sperm and create normal embryos (as shown by IVF) they are just not able to implant either due to NK natural killer cells or because of blood-clotting.
My RE will most likely will not agree to go the blood-clotting test and NK activity test which have been studied as the cause of many unexplained infertility cases. In fact, some researches believe that it is "implantation failure”, and not poor egg/embryo number or quality that is often the root of the problem.
“Considering its importance, it is not surprising that failure of proper function of this immunologic interaction during implantation has been implicated as a cause of recurrent miscarriage, late pregnancy fetal loss, IVF failure and unexplained infertility. A partial list of immunologic factors that may be involved in these situations includes: anti-phospholipid antibodies (APA), antithyroid antibodies (ATA), and, perhaps most importantly, activated natural killer cells (NKa). Presently, these immunologic markers can be adequately measured by only a few (less than a half dozen) highly specialized reproductive immunology laboratories in the United States, from patient blood samples.”
So,
I did a research about therapeutic doses of aspirin and now I am taking 81mg everyday. I am also going to be using Pre-Seed when we BD and I am taking something to help with CM (Guaifenesin). Aspirin is suppose to help with uterine lining and help with even blood-flow (decrease clotting).
“For these patients, and even many without endometrial lining issues, we will typically recommend that she take a baby aspirin per day (81 mg) starting with gonadotropin stimulation. The rational for the use of baby aspirin is that on a micro-vascular level, vasodilation and decreased blood platelet aggregation occurs and therefore improves blood flow to the uterine lining, providing a lining with functional improvement. Blood platelets are the blood cells, which promote blood clotting. Two well designed studies confirm the benefit of baby aspirin use in improving pregnancy rates for patients with endometrial linings <8mm.>
Also an interesting fact that it has been found that aspirin, when taken 12 hr prior to donation of the blood sample causes an 80-100% reduction in the NK cell activity.
Somewhere deep down in my heart, I believe that the reason why I am not getting pregnant is because I have implantation failure. I think that even though my eggs get fertilized with my husband’s sperm and create normal embryos (as shown by IVF) they are just not able to implant either due to NK natural killer cells or because of blood-clotting.
My RE will most likely will not agree to go the blood-clotting test and NK activity test which have been studied as the cause of many unexplained infertility cases. In fact, some researches believe that it is "implantation failure”, and not poor egg/embryo number or quality that is often the root of the problem.
“Considering its importance, it is not surprising that failure of proper function of this immunologic interaction during implantation has been implicated as a cause of recurrent miscarriage, late pregnancy fetal loss, IVF failure and unexplained infertility. A partial list of immunologic factors that may be involved in these situations includes: anti-phospholipid antibodies (APA), antithyroid antibodies (ATA), and, perhaps most importantly, activated natural killer cells (NKa). Presently, these immunologic markers can be adequately measured by only a few (less than a half dozen) highly specialized reproductive immunology laboratories in the United States, from patient blood samples.”
So,
I did a research about therapeutic doses of aspirin and now I am taking 81mg everyday. I am also going to be using Pre-Seed when we BD and I am taking something to help with CM (Guaifenesin). Aspirin is suppose to help with uterine lining and help with even blood-flow (decrease clotting).
“For these patients, and even many without endometrial lining issues, we will typically recommend that she take a baby aspirin per day (81 mg) starting with gonadotropin stimulation. The rational for the use of baby aspirin is that on a micro-vascular level, vasodilation and decreased blood platelet aggregation occurs and therefore improves blood flow to the uterine lining, providing a lining with functional improvement. Blood platelets are the blood cells, which promote blood clotting. Two well designed studies confirm the benefit of baby aspirin use in improving pregnancy rates for patients with endometrial linings <8mm.>
Also an interesting fact that it has been found that aspirin, when taken 12 hr prior to donation of the blood sample causes an 80-100% reduction in the NK cell activity.
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