Fertility Road Issue 34

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SCIENCE ometimes iteded arets wot e ale to oose or ow some of tese elemets ased o were tey lie or were tey ursue treatmet may loatios su as i te iteded arets oies ad aess to otetial door iformatio will e limited oters su as i te mu more otetial door iformatio ad otios will e aailale ile tese are all imortat fators for iteded arets to osider i door egg oe of tem diretly imat o teir ae of suess ad a ealty ay all iludig door egg suess is diretly orrelated to aig a suffiiet umer of geetially ealty ad romosomally ormal emryos derstadig wat oies tey a mae wit tis i mid is ey ere is o sigle umer of emryos tat defies suffiiet ut geerally more is etter as tis roides iteded arets more otios if tey oe to ae more ta oe ild ad greater assurae if teir first attemt is ot suessful IN ALL IVF, INCLUDING DONOR EGG, SUCCESS IS DIRECTLY CORRELATED TO HAVING A SUFFICIENT NUMBER OF GENETICALLY HEALTHY AND CHROMOSOMALLY NORMAL EMBRYOS. Family History Screening: t is imortat for a geeti ouselig eert to sree te otetial doors ad serm roiders family istories to loo for aytig tat migt e assoiated wit ireased ris for geeti disease irt defets learig rolemsautism ad adultoset disorders i te future offsrig oeied usig a artiular doors eggs f tis sreeig idiates a otetial ris iteded arets a oose to selet aoter door wit wom tere is o eidee of similar oers Genetic Disorder Carrier Screening: irtually eeryoe is a arrier for some reessie geeti disorder toug tey may ae o sigs of te disorder ad tere may e o family istory of te disorder ome geeti disorders are more ommo i ertai eti grous ay are deilitatig or life treateig if a ay is or wit te disease e te egg door ad serm roider are arriers for te same disorder tere is a ae tat ay ay or from tat mat will ae tat disease reeig a egg door ad te serm roider a idiate weter ot are arriers for te same geeti disorder ad terefore may ot e a good mat tis ase iig a differet egg door wo is ot a arrier for te same disorder as te serm roider a ameliorate te ris is form of sreeig is ossile wit a lood or salia samle ad is aailale troug arious tests tat sree for differet aels of geeti disorders to aryig degrees of auray Medical Indicators of the Donor ere is a orrelatio etwee te umer of mature eggs retrieed from a door ad te ae of ultimately aig a suffiiet umer of geetially ealty ad romosomally ormal emroys s tere is a atural dimiutio from te umer of eggs retrieed to te umer tat fertilise grow to te astoyst stage ad are romosomally ormal geerally ree elemets merit igligtig as tey a diretly otriute to te goal of aig a suffiiet umer of geetially ealty ad romosomally ormal emryos geeti sreeig redoor seletio medial idiators of te door ad trasferrig a romosomally ormal emryos oor sreeig ad aroal y teir lii as well as treatmet oies made y iteded arets are ot ritial elemets i aieig tis goal ofusigly for iteded arets door sreeig aroal rotools ad aailale treatmets a differ widely etwee liis i differet outries ad ee witi te same outry Genetic Screening Pre-Donor Selection e fat of seletig a egg door allows iteded arets te uiue oortuity to loo after te future ealt of teir family roriate geeti sreeig redoor seletio allows iteded arets to oose a door tat is a good mat wit te serm roider from a geeti ealt ersetie | fertilityroadom | fertilityroadmag | follow us @fertilityroad
SCIENCE speaking the more eggs mature retrieved the better. As a consequence, some donors are simply medically better suited for the donation process. Whether a woman is finally approved to be a donor will depend on how rigorous a clinic is in their medical screening and approval process. Age: A woman’s peak fertility is during her 20s. As she ages, diminished ovarian reserve and the rate of chromosomally abnormal (possessing extra or missing chromosomes) embryo formation make it less likely that her eggs will result in a healthy baby. From 35 years of age these two factors increase significantly. In some countries the average age of donors approved by clinics tends to be higher than in others. Body Mass Index (BMI): When a woman’s BMI is more than 29 the effectiveness of the fertility medications that stimulate her ovaries may be reduced, leading to a risk of fewer mature eggs being retrieved. Increasing the doses to compensate for reduced effectiveness can raise the risk of Ovarian Hyperstimulation Syndrome which can endanger the health of the donor. Donors with a healthy BMI of between 19 and 29 will have the best chance of optimal response to stimulation. Ovarian Reserve: A woman’s ovarian reserve is the capacity of her ovaries to provide eggs capable of fertilisation. Basal Antral Follicle (BAF) count and Anti-mullerian Hormone (AMH) are two measures that can help assess ovarian reserve. BAF count uses a transvaginal ultrasound to count the number of follicles that contain immature eggs capable of being stimulated. A higher number of follicles is an indicator that more eggs may be able to be retrieved for donation. AMH is produced by the follicles growing in a woman’s ovaries and women with higher levels tend to respond better to the stimulation and have a greater number of eggs retrieved. Generally speaking, donors with higher BAF and AMH test results will have better chances of more mature eggs being retrieved. Prior Donation Information: If a woman has donated previously and the details of her prior egg donation(s) are available, this can give a good indication of the potential for future success. The details of a woman’s prior egg donation(s) can be more insightful that ovarian reserve testing which is most important for firsttime donors. Relevant factors include the number of eggs retrieved; the fertilisation and 5-day blastocyst formation rates; the rate of normal embryo formation if analysed; and ongoing pregnancy or live birth outcomes for other intended parents. In addition, information from her prior donation may indicate her responsiveness to the fertility medications and whether dosage protocols may be adjusted to optimise results. In some countries this type of information on donors will be available to intended parents to consider as part of their choice of donor. In any case, intended parents should understand the screening and approval standards of the IVF clinics they are considering. Transferring a Chromosomally Normal Embryo The formation of chromosomally abnormal embryos is a natural phenomenon. Around 25% of embryos from a young woman’s eggs can be naturally abnormal and this rate increases with age. In some cases, even with a young women’s eggs, this rate may be higher. Transferring a chromosomally abnormal embryo is the most common cause of failed implantation and miscarriage in IVF, or can lead to a pregnancy and birth of a baby with a disorder linked to chromosomal abnormality (such as Down’s Syndrome). It is not possible to assess whether an embryo is chromosomally normal from a visual assessment. Testing embryos with Comprehensive Chromosome Screening (CCS) is the only way to know which embryos have screened as chromosomally normal and will provide the best chance for success and a healthy baby. In addition to these three elements, overall excellence in IVF – including customizing treatment protocols and the quality of an IVF clinic’s laboratory – will play a significant part in any IVF patient’s chances for success on their first attempt. As with most things, all IVF and all donor egg IVF is not equal. Intended parents should arm themselves with the knowledge they need to fully evaluate prospective IVF clinics and their egg donor programs so that they can choose for success. More information on Donor Egg IVF treatment in the US can be found on the website oregonreproductivemedicine.com | fertilityroadmag | follow us @fertilityroad fertilityroad.com | 51
Page 1 and 2: INSIDE THIS ISSUE: EMMA CANNON •
Page 4 and 5: FertilityRoad ISSUE 34 Contents MIN
Page 6 and 7: Contributors The people who made th
Page 8 and 9: THE FERTILITY SHOW 2016 Baby it’s
Page 10 and 11: FR News & Views NATIONAL FERTILITY
Page 12 and 13: FR News & Views se POTENT NEW IVF
Page 14 and 15: FR News & Views ‘WAITING FOR THE
Page 16 and 17: FR News & Views Sponsored by MALE F
Page 18 and 19: MIND drea eiter THE CARE(LESS) PRO
Page 20 and 21: MIND EXPERT: Kathy Payne LIVING A F
Page 22 and 23: MIND eig aware of your fertile sig
Page 24 and 25: MIND mma ao ACUPUNCTURE DOUBLES TH
Page 26 and 27: BODY • Refined starches: su as we
Page 28 and 29: BODY blackberries as they nourish b
Page 30 and 31: BODY MYNUTRICOUNTER’S MENU TO FER
Page 32 and 33: BODY Lunch Salmon & Asparagus Tart
Page 34 and 35: BODY FERTILITY SUPERFOODS Nutrition
Page 36 and 37: www.klinikkhausken.no TECHNOLOGY AN
Page 38 and 39: FERTILITY JOURNEYS 2016 FERTILITY J
Page 44 and 45: SCIENCE iard estoy WHY DO INTENDED
Page 46 and 47: SCIENCE | fertilityroadom | fertil
Page 48 and 49: SCIENCE fertilityroad Get Fertility
Page 52 and 53: Are you struggling to have a baby?
Page 54 and 55: MEN ONLY i agger is eetig a ild wit
Page 56 and 57: MEN ONLY ussell ais BIG BOYS DON
Page 58 and 59: MEN ONLY IS IT TIME YOU TOOK YOUR S
Page 60 and 61: FERTILITY LIFE LETTER FROM THE HEAR
Page 62 and 63: FERTILITY LIFE BEFORE YOU WERE HERE
Page 64 and 65: FERTILITY LIFE BEFORE YOU WERE HERE
Page 66 and 67: FERTILITY LIFE IVF CUBE Fertility C

Fertility Road Issue 34

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