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The Truth About Trying

Redbook & Resolve have come together to help spread the word about infertility awareness. Watch has several celebs, including Padma Lakshmi and Sherri Shepherd, come together to get the message out!

Read more about “The Invisible Pain of Infertility.“

“You’re not broken.”

Anna went through infertility treatment and came out on the other side with two beautiful young boys. Watch her video as she remembers being told she was going into premature ovarian failure at age 33.

Watch more videos at http://www.redbookmag.com/health-wellness/advice/infertility-video-series.

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Norine Dworkin-McDaniel
October 18, 2011
Source: REDBOOK
Infertility can be devastating, and it’s time we openly acknowledged that. “You walk around with this feeling of a missing piece,” says Paige Nolt, 29, in the video she posted for REDBOOK’s “The Truth About Trying” campaign.

There’s nothing the tabloids love more than a baby reveal. And lately, many of the celebs cradling adorable downy-haired infants are 40-somethings. We hear about their designer nurseries, the mini couture outfits, and how they chose their exotic names, but we rarely hear about the fertility issues they endured. Going by the statistics, some certainly did: By age 40, a woman has only a 5 percent chance of conceiving during each cycle. “Regardless of how well you take care of yourself, ovaries age at a constant rate, and there’s nothing you can do to halt it. That clock ticks on,” says Robert Gustofson, M.D., medical director of the Colorado Center for Reproductive Medicine in Denver. “By 45, the chance of having a child with your own eggs is 1 percent.”

Along with celebs, millions of unfamous women keep their baby-making challenges under wraps. Everyone has the right to privacy, of course, but that secrecy has left so many women to cope alone, in pain, and often uninformed. “It’s frustrating that our society is not more open about infertility,” says Barbara Collura, executive director of RESOLVE: The National Infertility Association. “When women dealing with infertility can communicate with others in their situation, they get through it in a much better state of mind and also share needed information about their options.”

Those are some of the key reasons REDBOOK has joined forces with RESOLVE to launch “The Truth About Trying,” an online video campaign to start an open conversation about infertility, which strikes one in eight women in the United States. The message of those speaking out: It’s not always easy to get pregnant, and there’s no shame in that.

“It’s crazy to me that this topic is still taboo,” says participant Rosie Pope, 31, who talks about her battle to become a second-time mom — and her shock at all the denial out there — in her video. The star of Bravo’s Pregnant in Heels says, “A lot of people who have gone through IVF and managed to have kids shove it under the rug and pretend it never happened. In Hollywood, you can talk about your drug addiction or divorce, but not infertility. It’s a real disservice to women.”

Most of the fertility specialists and support-group leaders REDBOOK spoke with confirm that couples often conceal their fertility problems. Even when they find a community online, the exchanges are largely anonymous; in real life, they are typically silent. Indeed, in a survey of couples having difficulty conceiving, conducted by the pharmaceutical company Merck, 61 percent of respondents hid their infertility from family and friends. Nearly half didn’t even tell their mothers.

It’s time for infertility to come out of the closet. In their “Truth About Trying” videos, women put names, faces, and voices to this disease (yes, it’s a disease). They are raw, brave, helpful, and warm, and together they offer a powerful resource for you or a friend, sister, daughter — anyone coping with infertility.

What we’re not saying (and hearing)

The official definition of infertility: an inability to get or stay pregnant after a year of trying if you’re under 35, or six months if you’re older. Twelve percent of reproductive-age American women — about 7.3 million — are having trouble conceiving or carrying a baby to term, up from about 9 percent in 1988, according to the Centers for Disease Control and Prevention.

Some of that rise reflects the fact that more people are waiting longer to start families, and the older you are, the more likely it is that you’ll have issues like early menopause or a risk of miscarriage. Some 7 to 10 percent of men are infertile; in about 20 percent of situations, both partners have problems. And anywhere from 10 to 20 percent of infertility is “unexplained,” as in, there’s no medical answer for why you’re not pregnant, except that you’re not. “I work out every day. I just did a triathlon. You think, If I’m healthy, this will happen,” says Lori LeRoy, 39, of Indianapolis, who began trying to conceive naturally at 33. She went on to do in vitro fertilization (IVF), and now she and her husband are in the midst of adopting a little boy.

A quick refresher course: With IVF, egg and sperm meet in a petri dish, then embryos are placed in the uterus, helping the process along. While the procedure improves on the 20 percent chance of pregnancy women have when their fertility is at its peak, the success rates drop steeply with age. For women under 35, the odds of carrying a baby to term are 41 percent per IVF cycle. At 38, the chance of birth is 22 percent; at 41, 12 percent; and at 43, 5 percent — slender odds that don’t come cheap, given that most couples pay for treatment out of pocket. “When we started getting the bills, I thought, If only I’d started sooner, I could’ve put the money toward my kids’ college tuition,” says Angelique Jones, 41, of Thorndale, PA, now pregnant with twins.

Lori and Angelique are open about their experiences but acknowledge they were unusually forthcoming. One reason infertility is considered hush-hush is that it’s wrapped up in sex, a subject Americans are notoriously squirmy about. “If you start discussing infertility, you have to talk about ovaries and semen and all kinds of things you don’t usually discuss over dinner,” says Paige Nolt, 29, of Charlottesville, VA, who’s been trying to get pregnant for two years. “Just dealing with my own emotions was difficult enough, so I didn’t talk about it at all.”

Many women dread hearing what family and friends might say, which is why 43 percent of 549 people surveyed by RESOLVE stayed quiet. “I didn’t want people putting pressure on me; I already felt like a failure,” says Fran Meadows, 38, of Queens, NY. “I’d grin through baby showers, then cry my eyes out afterward.”

The keep-it-on-the-down-low mentality only perpetuates more secrecy, says Sharon Covington, director of psychological support services at Shady Grove Fertility Center in Washington, DC. “Women think there’s something wrong with them while the rest of society has no problem getting pregnant.”

That sense of being defective can be even stronger among women of “advanced maternal age” — those over 35. “I felt I couldn’t do this thing women are supposed to do,” says Anna Maynard, 43, of Manassas, VA, who tried to conceive naturally for a year before opting for egg donation. “I thought maybe I shouldn’t have moved around so much for jobs, and tried to meet someone earlier to settle down with. I was angry at myself for waiting too long and wasting my fertile years, and jealous of the young girl who had plenty of eggs while I was like a beggar at her door.”

The benefits of opening up

Paige Nolt suffered in silence for months. “I was overwhelmed by the loss of the family my husband and I envisioned,” she says. “One day, coworkers were all cracking up about something that had happened in the office. They looked at me and I was the only one not laughing. I came home and told my husband I couldn’t be a victim anymore, so I started an infertility support group.” Paige also appears in a “Truth About Trying” video. “It’s a hard issue to talk about, but it would have been so great if someone had told me early on, ‘I know exactly what you’re going through because I went through it too.'”

Women who put their infertility out there often find instant connections — and comfort. “I felt like I was alone,” says 36-year-old Anika Palm, of Orlando, FL, in her video. “To my surprise, after I was open about it, people came to me and told me their experiences.” When Keiko Zoll, 29, of Salem, MA, announced she was infertile on a Facebook update during National Infertility Awareness Week in the spring of 2009, “I immediately received emails from three friends admitting they were facing similar issues,” she says. “We gave up our anonymity for something better: mutual understanding and hope.”

More openness could also help families afford help. Only seven states require insurers to cover at least part of infertility treatment. “It’s still beyond the means of most Americans,” says Alice Domar, Ph.D., executive director of the Domar Center for Mind/Body Health at Boston IVF. “We need to create a lot of noise to get more coverage.”

Speak out to support other women and yourself, says Carla Corbitt, 28, of Beaverton, OR. “I’m proud that I can look back on my journey to motherhood and know that not only did it strengthen my marriage and make me more resilient as an individual, but I was also able to give hope to others,” she says in her video. “I wish I had sat down a long time ago and started the conversation. I’m just glad that I eventually realized that infertility is not my fault.”

The latest fertility breakthrough

Breast exam, pap smear, banking your eggs: A new fertility technology called vitrification could become standard medical procedure in coming years. It allows women to flash-freeze their eggs so they can implant them in their wombs years or even decades later. Unlike conventional slow-freezing, which often led to the formation of ice crystals in the eggs, this high-speed method greatly improves success rates.

So, will women in their 20s or early 30s rush to put their eggs on ice? Not in the near future, thanks to the $10,000 to $15,000 price tag. And the procedure — which includes daily hormone shots for two weeks to stimulate egg production, followed by egg-retrieval surgery — isn’t fail-safe: “Freezing a batch of eggs when you’re 30 gives you a 60 percent chance of a baby,” says Jamie Grifo, M.D., Ph.D., director of NYU Fertility Center’s division of reproductive endocrinology and infertility. “That means there’s a 40 percent chance you don’t get pregnant.”

Costs should come down over time, and the odds may well improve. Ultimately, whether you bank your eggs as a hedge against potential infertility really depends on your life plans, says Erika B. Johnston-MacAnanny, M.D., assistant professor of reproductive medicine at Wake Forest Baptist Medical Center in Winston-Salem, NC. “I wouldn’t offer this to every 20-year-old who walks into my office. But if a young woman has absolutely no intention of getting pregnant until she’s 40, I’d be comfortable providing egg freezing. I’d want her to know her options.”

CELEBS BREAK THE SILENCE

Marissa Jaret Winokur, 38, Rosie Pope, 31, Sherri Shepherd, 44, and Padma Lakshmi, 41, are among the stars sharing personal stories of infertility in the “Truth About Trying” video campaign sponsored by REDBOOK and RESOLVE. “Telling a woman who’s struggling, ‘It took me four tries to get pregnant’ can give her hope,” says Winokur, who’s had one child via a surrogate. See all of the videos at redbookmag.com/truthabouttrying.

Read more: Dealing With Infertility – Trying to Get Pregnant – Redbook

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SGF Nurse

Miriam Falco – CNN Medical Managing Editor
October 18, 2011
Source: CNN

E! News anchor Giuliana Rancic’s efforts to conceive have been the main theme of her reality show “Giuliana and Bill.” On Monday she revealed she has to postpone her next round of IVF after her new fertility expert insisted she get screened for breast cancer, even though she is only 36 years old.

Rancic said, on the Today Show, that her doctor told her “I don’t care if you’re 26, 36. I won’t get you pregnant if there is a small risk you have cancer. If you get pregnant it can accelerate the cancer. The hormones accelerate the cancer.”

> Watch Giuliana’s announcement on the Today Show.

Her doctor may have been taking the step as a precaution.

“There’s no evidence for a link between breast cancer and infertility treatment,” says Dr. Eric Widra, who chairs the Society for Assisted Reproductive Technology. A 2005 study looked at a possibility but the study authors concluded a link to breast or ovarian cancer had not been found.

Dr. George Sledge, co-director of breast cancer treatment at Indiana University’s Simon Cancer Center, says there are no good data to show that IVF accelerates breast cancer. “Not having a child and infertility in itself increases the risk for breast cancer,” he says. Sledge isn’t familiar with Rancic’s medical history, but he says the younger you are when you have your first child, the less likely you are to have breast cancer.

“Breast cancer at 36 is rare, and it’s fortunate for her that it was detected early,” says Widra, a physician at Shady Grove Fertility in Washington, D.C. However, he doesn’t agree with Rancic’s doctor that women in their 20s or 30s should get a mammogram before starting IVF. The American Society for Reproductive Medicine recommends the same guidelines as the American College of Obstetrics and Gynecology, he says: Begin screening at the age of 40, unless there’s family history.

> Schedule Appointment with Shady Grove Fertility

But it appears things can vary from clinic to clinic. Dr. Andrew Toledo, a fertility specialist at Reproductive Biology Associates in Atlanta, says in his clinic, “We want a baseline mammogram [for our patients] between 35 and 40, unless they have a family history.”

Rancic had previously undergone two rounds of IVF. The second did result in a pregnancy, which ended in a miscarriage. She says she plans to try to get pregnant again after having surgery this week and undergoing six weeks of radiation treatment.

Sledge, who is the past president of the American Society of Clinical Oncologists, says the use of estrogen in general in women who’ve had breast cancer makes doctors nervous because some cancers are fueled by hormones.

But Widra says women who have successfully completed their cancer treatment can try to get pregnant again, typically five years after they have been disease-free. Widra, who is not familiar with Rancic’s specific case, points out that even after surgery and radiation, breast cancer patients may need to undergo even more treatments, like taking the drug tamoxifen, which can reduce the risk of breast cancer coming back by blocking the activity of estrogen in the breast if the breast cancer is fueled by estrogen – not all cancers are.

When a woman tries to get pregnant after undergoing breast cancer, her treatment needs to be individualized, says Dr. Mitch Rosen, director of the Fertility Preservation Center at the University of California-San Francisco. He says he sees many patients facing this question and he says it’s incredibly important that women receive good counseling. “It depends on your cancer, your age, what kind of cancer you have,” he says. If a woman has the type of tumor that is fueled by estrogen, tamoxifen (or other hormone-disrupting drugs) need to be taken for five years.

> Learn more about Fertility Preservation at Shady Grove Fertility.

If a cancer patient is 22, Rosen says he would recommend she wait the full five years before trying to get pregnant. If she’s 38, for example, getting pregnant gets harder with age – then, he says, he would probably recommend taking the hormone-blocking medication for tw0 years, taking a break to get pregnant, and then resuming the drug for three more years.

> Watch SGF patient, Heather, diagnosed with Endometrial Cancer during treatment.

If a patient has a type of cancer that is not dependent on hormones to grow, then surgery and radiation are usually followed by chemotherapy to kill any lingering cancer cells.

In those cases, Rosen says he recommends that his patients wait at least six months, better a whole year, before trying IVF again, just to reduce the possibility of birth defects caused by the cancer treatment.

Patients need to talk to their doctor and be made aware of the risks and options, so they can be comfortable with their decision on when and whether they should undergo IVF again.

View the article at: http://thechart.blogs.cnn.com/2011/10/18/no-proved-ivf-cancer-link-doctors-say/?hpt=hp_t2

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As a part of our 20th Anniversary celebration, we are asking patients, staff and our physicians to think of their own story with Shady Grove Fertility. Whether it is a great memory or successful fertility experience or someone still on their journey to parenthood – everyone that has walked through our doors has made an impact, and we hope that you can say the same of us.

Dr. Eric Widra, of our Washington, DC office, was eager to share his story.

I still remember my first IVF cycle as part of Shady Grove Fertility in 1996. I remember her personality and care vividly. As a young physician right out of fellowship, there is incredible anxiety over the trust patients give you. Do I know enough? Will I measure up to my mentors and colleagues? Why do they trust me with this instead of an older, more experienced doctor?

She was 35 and had been through failed IUI’s. For many reasons, the decision to move to IVF was more difficult in 1996 than it is now. It wasn’t nearly as successful, and embryo transfer decisions were more complex. But they trusted my advice and started their IVF cycle. With just 4 physicians and 3 offices, it was commonplace for us to come in for our own retrievals and transfers. I put on my best show of confidence as we went through it together, transferring 2 embryos on day 3.

Continuing to see patients and work over the next two weeks, the anticipation of their first pregnancy test grew. It was positive. Two weeks later, we saw the twins on ultrasound. I can still see myself fist-pumping the air when I got the first positive hCG.

SGF Nurse
Snooki & David Letterman Fist Pumping

So much has changed in the 15 years since my 1st IVF success, but one thing remains the same. Every afternoon, when I log into the day’s results in our electronic record, I feel the same anticipation for every pregnancy test. I’ve had many more fist-pumps and the occasional one-man wave over the years, and feel privileged to share this extraordinary journey with each of our patients.

So whether your story is fist-pump inspiring or a little more sentimental we ask you to share your story to help encourage those that are just starting out on their journey and looking for support. And for those looking for inspiration, click here to read our stories. Thank you.

Please visit JoyforGenerations.com to share your story.

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A medical mystery for a young Virginia couple trying to have a baby. When they couldn’t get pregnant, doctors told them not worry, but instinct told them there was something more serious going on.

Watch and listen as Dr. Greenhouse and patient, Heather, discuss her struggling with infertility and endometrial cancer.

View more videos at: http://nbcwashington.com.

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Dr. Ricardo Yazigi

by Dr. Eric Levens
Almost daily, I get questions about polycystic ovary syndrome (PCOS) and what the diagnosis means for fertility and overall health. PCOS remains the most common endocrine disorder in women of reproductive age. It affects approximately 5 -10 percent of the population and consists of a group of symptoms.

In order to be diagnosed with PCOS, a woman must have two out of three findings:

  1. Enlarged ovaries with multiple resting follicles
  2. Increased male hormones in the blood, balding, acne, or excess hair growth
  3. Absent or irregular menstrual cycles.

It’s important to remember that no single criteria is sufficient to make the diagnosis.

> Read “What is Polycystic Ovary Syndrome (PCOS)?”

How can PCOS affect me?

There are several important facets of PCOS to consider. The first has to deal with immediate fertility concerns. Other concerns include the long-term health consequences of PCOS and their impact on the health of a pregnancy. Today, we’ll focus on the fertility aspects.

Because the ovaries are not producing a follicle containing an egg each month (and sometimes no follicle is produced at all), without assistance, achieving a pregnancy can be very difficult, if not impossible. Oral fertility medications like clomiphene, which have been available for more than 50 years, continue to be widely used to produce an ovarian follicle containing an egg. Clomiphene acts by blocking the action of estrogen in the brain (the hypothalamus and pituitary). As a result, there is an increased production of follicle stimulating hormone (FSH) causing the development of one or more follicles.

> Read “What Happens in Your First Visit to a Fertility Doctor?”

Timed intercourse or intrauterine insemination (IUI) can then be scheduled around the development of the follicle(s), provided that the Fallopian tubes are open and the sperm counts are normal. The typical chances for success are about 15 – 25 percent per cycle with higher chances among younger women and lower chances for older women. In the end, several treatment cycles may be required to achieve a pregnancy and, if this process is not successful, then moving on to another treatment such as injectable medications or IVF may be necessary.

I hope that this information helps you better understand PCOS and what’s required, for many women with this condition, to achieve pregnancy.

> Read “Diagnosing & Treating PCOS?”

2026 Shady Grove Fertility

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