Sunday, November 17, 2013

A meeting with the Pope (kind of)

We took a day trip to NY to meet with His Holiness, Dr. Braverman, yesterday.  We left @ 5 am & thankfully the traffic gods smiled upon us, as wel as the weaher gods.  Afterwards we went shopping @ the giant Indian grocery store nearby & had a nice South Indian lunch (Vid's people) before heading back home.     
Overall, it went well. DH was impressed with his office set up (4 monitors = comp sci prof's dream) & his liquor bottle collection, LOL.  He was very approachable with a good sense of humor & also wasn't afraid to use big words with us.  I like big words!

We're starting out with testing for karyotyping & basic immune stuff. He's also testing my AMH. The nurse will call to set things up next week, hopefully locally to us, or @ least nearby in Boston where Reprosource has an office, which is way closer than Long Island.  He says results should be in by around New Year's or so.

For IVF #2 we did "low & slow" with a Clomid kickstart, adding Follistim, Cetrotide & Menopur which by far gave us our best results. Based on this he thinks we need a flare type protocol but is not sure about micro flare Lupron given a disaster IVF #1 was. He also suggested maybe straight Menopur.

He did a pretty in depth exam/ultrasound & found something interesting: the blood flow in & out of my right ovary is very restricted. He asked if I knew how many eggs were retrieved there vs. left as well as mature eggs out of left vs. right & I said I don't know. I told him I feel it when I ovulate out of lefty but never out of righty. While he doesn't suspect endo it's in the back of his mind & depending on other tests I might have another lap.

When it comes to my weight he does not think it's what's preventing me from becoming pregnant. He does suggest going back on Metformin since it can normalize leptin levels which tend to be higher in obese folks who don't have IR. Leptin affects the release of LH among other things.

For the hubs, based on his sperm frag test & low morph he says to try the FertilAid & see what happens. Clomid might also help with the morph. Ensuring my other half takes his pills will likely be the most challending part of all.  He doesn't think Vid being the product of a cousin marriage is an issue. Also suggested a course of antibiotics prior to cycle which we also did with IVF #2.

Wednesday, November 6, 2013

More about the war on infertile fat people

Over the years I've been blogging you know how passionate I am about advocating for better treatment of those of us with elevated BMIs who are also dealing with infertility.  Too often, otherwise healthy fat folks are told to lose weight & magically we'd get pregnang on our own.  I've posted several articles written based on data gathered from studies on overweight & obese women.  This time, it's the men's turn:
A study cited in Renal and Urology News (November 2013) found that "While those who underwent surgery had increased sexual function as well as increased luteinizing hormone, follicle-stimulating hormone, and testosterone, their semen parameters went completely unchanged."
So just like the study I wrote about a year ago about women who underwent gastric bypass surgery not having their fertility improved by the surgery, the same apparently goes for men.  Furthermore , just like their female counterparts, infertile men had a libido increase that may be explained by the fact they were given false hope that this surgery would allow them to finally become a parent.  Once again, if the researchers followed them more long term, the level of sexual desire probably decreased with each cycle they didn't impregnate their partner.
I'm not minimizing the fact that obesity likely does play a part in some people's infertility.  We all know it's associated with many medical problems besides an inability to conceive.  However, if an overweight or obese person doesn't exhibit any of the associates comorbidities, then why suggest people go through ultra-invasive, extremely risky surgery to correct a problem when there appears to be no evidence it will acheive the desired, supposed affect of improved gamete quality?

Sunday, November 3, 2013

Infertility conference recap

In all my years as an infertile I've never attended the Resolve of New England.  I've always wanted to but the cost made me pause.  Then, I found out you could attend for free if you volunteered.  So, I did.   I was a room monitor which basically meant I did a head count of the room, collected feedback forms @ the end, kept the speaker on time & trouble shot any issues that came up.  Using "strategery", I volunteered to monitor the sessions I wanted to attend for information purposes, so it was a win for RNE as well as myself. :)

I met the new doc @ my RE's office & she's super chill. Probably my age? From Greece originally. She's also on the board of RNE. I told her about starting up a peer group in Providence soon & she said she would be willing to let me use office space for it.  Did I mention that I am going to be a peer leader?  Yeah.  Because I don't have enough going on.  But seriously, I'm looking forward to it!

I met the dude who invented the sperm frag test Vid recently had done! He gave me a sperm pin, lol. I got a ton of cool swag (pens, sticky notes, lip balm, stress relief egg, a book on love & infertility).  Here's a pic to prove it really happened:

I also met a really nice Indian couple who were also unexplained & had gone through 5 (!) IVFs so far. I've already been e-mailing back & forth with the wife. She is also thinking about going to Braverman for immuno testing too.

Some stuff I learned:
  • 2nd hand smoke is as detrimental to gamete quality as smoking yourself is. Yet another reason for me to be looking for another job since most of my patients are smokers (people with a mental health dx smoke @ a rate 3x that of the general population).
  • PICSI does not increase fert but does decrease m/c risk.
  • B6 levels are naturally higher in fertile women. My B vit levels are low normal as I'm a vegetarian. However, due to my having beta thalessemia my body does not manufacture iron well & I've probably avoided having to have blood transfusions in my life since I don't eat meat. A lot of oral B vits have iron additives which could be dangerous. Given this, might be time for vit injections according to the RE who did the talk.  What's another needle @ this point?
  • High omega 3 levels are associated with increase in prostate cancer & increased morph issues (interesting since DH eats a ton of seafood).