June 01, 2015

Source: O Magazine
Author: Bonnie Rochman

A Clearer Outlook

Individual fertility assessment tests are gaining in popularity as a way for women to gauge the quality and quantity of their actual egg supply. Sure, your doctor can rattle off statistics for women in your age range, but they’re hardly a true indicator for you personally. “You can’t just look at a chart, because each individual is very different,” says William Schoolcraft, MD, founder and medical director of the Colorado Center for Reproductive Medicine. That’s why Schoolcraft strongly recommends the tests for anyone who suspects infertility. An ultrasound counts your resting follicles, which contain your eggs, while a blood draw analyzes levels of AMH (anti-Müllerian hormone) and FSH (follicle-stimulating hormone). “With these results, doctors can generally determine whether a woman’s eggs will be viable for one, two, or five years,” he says. “Then we can give her some tools to plan her life.”

Better Odds
Though fresh embryos have long been considered the best bet for IVF (doctors would retrieve eggs, fertilize them, and transfer the resulting embryos within a week), the new thinking is that keeping embryos on ice for a while has its benefits. Before egg retrieval, hormones are injected into a woman’s body, “but we’ve found that elevated hormone levels can cause changes in the uterine lining that may affect implantation,” Schoolcraft says. Waiting at least a month after the shots gives your body a chance to recalibrate. And indeed, a 2013 study found that women who waited and then relied on IVF transfers using frozen embryos were 1.3 times more likely to become and stay pregnant past ten weeks.

Picture-Perfect
With time-lapse imaging, a relatively new noninvasive way of assessing embryo quality, a computer-automated camera captures images every few minutes while embryos created through IVF go about the business of cell division. The pictures help embryologists identify those most likely to implant. Owen Davis, MD, a reproductive endocrinologist and ob-gyn at Weill Cornell Medical College and president-elect of the American Society for Reproductive Medicine, is optimistic about the technology. “This system has significant potential,” says Davis, whose clinic has adopted time-lapse imaging. “It’s still too early to say how effective it will be, but some clinics believe it has improved their pregnancy rates.”

Q: Will HPV Affect My Fertility?
If you’re among the 79 million Americans infected with HPV and concerned about your ability to conceive, here’s good news. When screening suggests precancerous lesions, many women go on to have treatments (such as the loop electrosurgical excision procedure, or LEEP) to remove the cells that could lead to cervical cancer. While doctors know that some of these procedures may lead to preterm birth, limited research has been done on whether they make it harder for women to get pregnant in the first place. But according to a new study that examined pregnancy rates among nearly 100,000 women over 12 years, the treatments don’t appear to affect fertility. In fact, women who had undergone the procedures actually had a higher rate of pregnancy. Researchers aren’t sure why—the reason could simply be that the women were having more sex, or there could be a genetic connection.

Bonnie Rochman

O Magazine