Recent News

FSH Levels Under 15 Still Viable for ART/IVF

Women younger than 40 years old with basal follicle-stimulating hormone (FSH) levels between 10 and 15 IU/l produce oocytes with significant pregnancy potential, say researchers.

Elevated basal FSH levels are often used to predict poor assisted reproductive technology (ART) outcomes, but in their study of 191 ART cycles, Rieko Kojima (National Center for Child Health and Development, Tokyo, Japan) and colleagues found that women with FSH levels of up to 15 IU/l could still expect good outcomes.

Significantly more oocytes were retrieved in women with FSH levels below 10 IU/l than in those with levels between 10 and 15 IU/l, at 8.7 versus 5.5. But they had similar numbers of fertilized oocytes (4.6 and 4.0, respectively) and pregnancy rates per embryo transfer (31.3 and 38.1 percent, respectively).

The rates for women with FSH levels of at least 15 IU/l tended to be lower than those for the other two groups, at 2.2 retrieved oocytes, 1.4 fertilized oocytes, and pregnancy rate per embryo transfer of 10.0 percent, but the differences were not significant.

The researchers note that women with the highest FSH levels needed significantly longer ovarian stimulation and at higher doses than women with lower levels. They therefore suggest that "the basal FSH level reflects the ovarian response to gonadotropin stimulation, rather than pregnancy potential for each oocyte."

Caffeine and Pregnancy

New research out Monday may have expecting moms rethinking their drinking habits. During pregnancy, caffeine can inhibit blood flow to the placenta. A new study has found that pregnant women who consumed more than 200 milligrams of caffeine a day, equivalent to about two cups of coffee, had twice the risk of miscarriage as the women who consumed no caffeine at all. The findings are published in Monday's Journal of Obstetrics and Gynecology.

Previous studies have found similar results, but Dr. De-Kun Li, lead author and investigator with the Kaiser Permanente Division of Research, is quick to point out the significance of his findings. "We were able to address the issue of if the increase is really due to caffeine or due to women changing their drinking patterns. Other studies have reported the same results but had some biases in the research."

The Kaiser study looked at 1,063 women in the early stage of pregnancy. Among women who consumed no caffeine, the miscarriage rate was 12.5 percent. In comparison, 25.5 percent of women who consumed more than 200 mg of caffeine a day miscarried. Although there was an increased risk for women who consumed fewer than 200 mg of caffeine a day, the lead investigator says the increase is not statistically significant.

Researchers say it made no difference whether the caffeine came from coffee, soda, tea or hot chocolate.

Caffeine is dangerous during pregnancy, Li said, because it can cross through the placenta to the fetus and can be difficult for the fetus to metabolize the caffeine. Caffeine may influence cell development and decrease blood flow to the placenta, he added. If arteries are constricted it may restrict blood flow which can result in miscarriage.

Dr. Jennifer Wu, a New York obstetrician who has no ties to this study, said the research is, "accurate and has found a definitive correlation between caffeine consumption and miscarriage." Wu says expecting moms should significantly decrease the intake of caffeine during pregnancy.

Issue 02: 21 Jan 2008

Source: Fertility and Sterility 2008;in press

Mean menstrual cycle length is an age-independent predictor of success in assisted reproduction, according to new findings from a prospective study of more than 6,000 fertility treatment cycles.

Specialists from centers in Uppsala, Sweden, performed a study of 6,271 IVF/ICSI treatment cycles in 3,228 women in the period 1999-2005, to investigate the relationship between menstrual cycle length and assisted reproduction success rates.

Before starting treatment, the women provided a menstrual history of the previous year, enabling the researchers to estimate mean menstrual cycle length. Previous studies have indicated that women recall their menstrual history relatively well, and that there is a high concordance between prospectively recorded cycle lengths and those stated by women before recording. In the new study, cycles were excluded if there was any use of hormonal therapies.

The researchers found that increasing age was associated with a small but significant reduction in mean menstrual cycle length. The mean menstrual cycle length was 30 days in women aged 28 years or younger, decreasing to 28.1 days in women aged 40 years or older.

Mean menstrual cycle length was significantly correlated with pregnancy and delivery rates, and this correlation persisted after adjusting for age. Women who had a mean menstrual cycle length of more than 34 days had a delivery rate per embryo transfer that was almost double that of women who had a mean menstrual cycle length of less than 26 days.

Overall, the percentage of the study population in each category of menstrual cycle length, and their delivery rates, were as follows:

Mean menstrual cycle length less than 26 days: 7 percent of the study population; delivery rate per embryo transfer (ET) 16.9 percent.

26 or 27 days: 20.4 percent of population, delivery rate/ET 23.7 percent.
28 or 29 days: 46.5 percent of population, delivery rate/ET 25.3 percent.
30 or 31 days: 14.7 percent of population, delivery rate/ET 28.2 percent.
32, 33 or 34 days: 5.7 percent of population, delivery rate/ET 31.3 percent.
More than 34 days: 5.7 percent of population, delivery rate/ET 30.9 percent.
The researchers also found that mean menstrual cycle length was significantly correlated with ovarian response to FSH/hMG stimulation and with embryo quality.

Discussing their findings, the researchers note the implications of their findings for fertility counseling and family planning, pointing out: “Given the strong trends to delayed childbearing in Western society, often combined with an over-optimistic attitude to fertility at advanced reproductive age, [menstrual cycle length] may be used as an easily accessible screening for ovarian reserve.”

They say a shortened mean cycle length may indicate that a woman’s fertility is declining, and that a more thorough investigation of ovarian reserve should be performed: “If such an evaluation confirms a reduced ovarian reserve, she may choose to establish a family earlier than otherwise intended.”

National Infertility Awareness Week

Thank you to everyone who joined us for our Fertility Expo, it was a big success. We would like to especially thank Drs. Rakoff and Morales for taking the time to meet with participants for free consultations.

We look forward to seeing everyone next year.

For more information, on becoming a part of the 2007 expo please contact Reproductive Wellness at (877) 843-7100, or email info@reproductivewellness.com.

Monthly Educational Lectures

Reproductive Wellness will be having free monthly educational lectures on various topics:

Wednesday, November 15th, 2006: Stress and Infertility: The Myths, The Facts, The Solutions
Where: 12625 High Bluff Dr., Suite 101, San Diego, Ca. 92130
Time: 6 – 7:30pm
Cost: Free (To RSVP Click Here!)

We will be taking the month of December off for the holidays and resuming our educational lectures in 2007. Topics for the new year include:

1. How Acupuncture can help balance your hormones and prepare you to conceive

2. The affects of Arvigo Technique for Maya Abdominal Massage on your fertility

3. Integrative Medicine for the treatment of Sexual health

4. Therapuetic Yoga for the enhancement of your Fertility

Reproductive Wellness Fertility Yoga Class now forming. For more information please contact Rachel Krentzman at (877) 843-7100, or email info@reproductivewellness.com.