A new study has been released, further increasing the mounting data that toxins in our environment are harming our fertility.  It appears that these chemicals, called perfluorinated chemicals are contained in many common household and other products.  These products accumulate in the body, have a long half-life, and there is a connection between high levels of these in women and those women having difficulty getting pregnant.

It is going to be a long-haul to get a definitive, well-done scientific study done on this subject, as there as so many variables to control when it comes to fertility.  But, the connection does seem to be there and it makes sense.   These chemicals are found in food packaging, dental floss, shampoos, and non-stick substances (cookware and ScotchGard.)   An example of this would be the grease-proof wrappers for hamburgers at fast-food restaurants.   When these get hot (fresh hamburger), these chemicals are released into the food and then ingested.  The big problem is that these chemicals have a long half-life, as long as eight years.

Some common sources of these chemicals ( are:

PFCs are used to make textiles and leather resistant to water, dirt, and oil.

Grease-resistant food packaging and paper products, such as microwave popcorn bags and pizza boxes, contain PFCs.

Carpet - PFOS was used until 2002 in the manufacture of 3M’s Scotchgard treatment, used on carpet, furniture, and clothing.

PFOA is used to make DuPont’s Teflon product, famous for its use in non-stick cookware.  If Teflon-coated pans are overheated, PFOA is released.

PFCs are in cleaning and personal-care products like shampoo, dental floss, and denture cleaners.

You can see that these compounds are contained in many, many products.  I will try to include more on this important subject as I learn more.

Irresponsible!!!

In one word this sums it up!!!  I am delighted at the news that the octuplets were brought into this world safely even though they have a long road ahead of them, I sincerely wish them the best.  However, as for the parent and the doctor responsible for their conception, I have other not so delightful thoughts.  I have read a number of reports and it seems to date that the story is still not entirely clarified. From what I have gathered so far, the mother of the octuplets was 33 years old, she already had 6 children at home and she had no male partner.  I have heard different versions……everything from she treated herself, to she had a frozen embryo transplant of 4 embryos and they all split, to she had a fresh IVF cycle and 8 embryos were implanted.  Either way, any of these versions are frankly IRRESPONSIBLE.  At the age of 33, ASRM or the American Society of Reproductive Medicine, recommends that no more than 2-3  embryos be implanted.  So even if four were implanted and they all split, which is highly unlikely, then that is still too many.  A multiple gestation pregnancy has a lot of risks.  I counsel my patients at length on the risk of multiples when undergoing any form of fertility therapy.  The wonderful thing about IVF is that the number of embryos that land in the uterus can be controlled, as opposed to injectable medicine with intrauterine insemination.  In the United States, we are very fortunate to have the freedom to transfer multiple embryos.  There are several scenarios where I could possibly see a reason to transfer more than 3.  IF the person is over the age of 38, or if the person had failed multiple IVF cycles, or in some cases of recurrent miscarriage where PGD was not performed.  Otherwise it is totally IRRESPONSIBLE !!!  Unfortunately, now that the system has been so blatantly abused, regulations may come about which prevent the freedom of performing multiple embryo transfers, which we are able to perform in the United States.  This will directly impact the people who fall into any of the above mentioned categories who may benefit from multiple embryo transfer.

In my clinic, almost every patient that I have seen over the past week has inquired about this.  I would like to inform anyone who is concerned that we are very responsible here at Red Rock Fertility Center and we practice according to the ASRM guidelines as to the recommended number of embryos that should be transferred.  In addition, we have also structured our financial packages in a way that you are not penalized financially if you choose to transfer less embryos and are not successful.  This allows the patients and myself to make the decision together on what we both are comfortable with.  I went into medicine to help people, not to harm them.  I think whoever was responsible for the creation of the octuplet pregnancy needs to reread the Hippocratic Oath!!!  That’s my opinion on this, hopefully in the upcoming weeks we will learn more details on this subject matter.

There are a very large number of herbal remedies on the market for fertility treatment.  The one that I generally recommend is FertilityBlend, as it is the only one that has been scientifically proven to have a positive effect on fertility.  The research that was done on it was actually done at Stanford University, where I trained.

Unfortunately, there are many patients that concoct their own herbal treatments.  Just because something is labeled as “all natural” or “herbal,” does not mean that is safe.  There have been numerous herbal therapies that have resulted in patient deaths.  Probably the most prominent herbal treatment that cause many deaths was ephedra.  It was used widely in the late 90’s and early 2000’s as a weight loss supplement and energy booster.  Unfortunately, the levels of ephedra varied widely from manufacturer to manufacturer and some people took too much, which stressed their hearts, and killed some patients.

The problem for fertilty patients, is that there are many herbs and supplements that are not necessarily toxic to the person taking them, but they are toxic to their eggs, the developing embryo, or their uterus.  Some can cause uterine contractions, such as Blue Cohosh and Pennyroyal, which Rosemary has been shown to cause implantation problems (problems with the fertilized egg implanting into the uterus.)  Many herbs were actually used historically as abortion treatments.  You can read about some of them on the SisterZeus site by clicking here.

In general, try to follow the teachings of Thomas Edison, who said “everything in moderation.”  A patient experiencing fertility problems should try to eat a balanced diet, exercise, and reduce their stress levels.  Here is an interesting article about how stress can affect fertility.

I have also started a page on my website about fertility health.  It includes a list of herbs that fertility patients should avoid, as well as a list of other supplements that can cause problems with fertility treatment.  You can view the page by clicking here.  As always, if you have any questions about this, please consult your physician or a nutritionist.  The number and variety of herbs and supplements out there is huge and it is not easy for non-medical people to sort through all of them.

Many patients who come to my clinic are amazed at how busy I am.  They comment about how many of their friends in other cities are also coping with infertility.  While the US does have a high incidence of infertility, it seems to be even higher in other countries.  Here is a link to an article in the Economist that gives more information about fertility treatment in other developed countries.  They have a very interesting chart about 2/3rds down the page.

In the US, about 1 out of every 100 births is from IVF.  In Belgium and Denmark, it is almost 4 per hundred.  This may be because of the higher overall number of births in America, but they are some pretty eye-opening numbers.  The most recent statistics state there are 6 million people in the US suffering from infertility, so the total number worldwide probably approaches 60 or 80 million.  I can only imagine what the incidence of infertility in China is going to be, because of the significant amount of pollution happening there.

Nonetheless, we are facing a world-wide epidemic of infertility.  FSH levels are rising in younger and younger women.   Sperm counts continue to decrease.  Thankfully, people are starting to realize that environmental factors can affect fertility.  I think we are going to see a drop in bottled water usage and couples that are TTC eating less soy products, as well as more organic food.  Overall health is key for maintaining reproductive health.

The cost of fertility treatment is a common topic in the news, as well as on fertility discussion boards.  Last year, according to the CDC data, there were approximately 150,000 IVF cycles performed in the USA.  The average cost of a complete IVF cycle, excluding medications, was $10,500.  The cost of fertility treatment at Red Rock Fertility is only slightly higher than that, though we do include more options in our IVF package.

As the economy has taken a turn for the worse, there have been a number of places worldwide that are offering discount fertility services.  While some of these places may be able to offer quality care at a discount, it is a difficult thing to do.  There have now been two instances of poor quality medical care being offered at discount prices here in Las Vegas.  One was the GI center fiasco with Dr. Desai and now, Valley Eye Center has been shown to have ruined the vision of almost 30 patients.  The people running their LASIK center were not even eye doctors.

My husband paid around $3500 to have his eyes fixed about 6 years ago.  Valley Eye Center advertised specials for $250 per eye.  When I used to see their commercials on TV, I always wondered how they were able to discount prices so much, as most centers have to buy a new laser every 3 years, since the technology is always improving.  Well, now it is clear, they didn’t have the best technology and they did not have qualified personnel running the clinic.  Here is a link to the article describing the situation.  The eye doctors that they flew in from Colorade evidently had a pretty significant malpractice history.

The situation at the GI clinic was somewhat different, as they did have trained GI doctors performing the procedures, but they cut corners at every possible step.  I have heard rumors that Dr. Desai would only allow his staff to purchase KY Jelly for the colonoscopes if they had a coupon.  They re-used their sterilization fluid and even performed the heinous act of re-using syringes, which led to the Hepatitis C outbreak.  Dr. Desai’s clinic was extremely busy and the only GI center on many insurance plans.  Why was this?  Because he was the cheapest.  Insurance companies love cheap doctors, as they are able to keep more of the premiums.  Heaven forbid an insurance company be concerned about quality.  Here is a link to an article detailing the endoscopy center situation.

A recent patient of mine went to the Czech republic for IVF treatment.  She did feel that the clinic was reasonably well run and clean, but the patients seemed to all get plugged into the same protocol.   She stated that she felt like she was “On a conveyor belt.”  They did not spend the time to adequately diagnose her problem and she did not get pregnant.

Providing high quality medical care is expensive.  The field of fertility is no different.  The training, equipment, and supplies are all very expensive and not getting any cheaper.  If you see advertisements for discount medical care, be sure to ask many questions, as the history of discount medical care is not particularly good.

There is a great deal of research going on in the IVF world on sperm quality.  For the past 20 years, most of the research has been done on oocytes (eggs,) but now there are new tests to better determine sperm quality.  About a year and a half ago, researchers at Yale University came out with a new test, called the PICSI Sperm Selection Device.  You can read more about it by clicking this link.

The main area of interest with this is when a couple is using ICSI to fertilitize the eggs.  This involves directly injecting the sperm DNA into the egg.  Traditionally, a trained embryologist picks the best looking sperm for this procedure.  The goal of the PICSI dish is to give the embryologist a test to see which sperm is the best.  The scientific theory behind this, is that the best sperm bind better to the Hyaluronan on the dish.  Their tests appear to confirm this.  Hyaluronan is a naturally occurring biopolymer in humans.  The data coming from the company appears to confirm the science behind the device.  Hopefully, it will be proven over time in the general fertility community.

This could be a very useful test for couples, as many couples opt to have intrauterine insemination (IUI) done, rather than IVF.  In many cases, this is appropriate, but in some cases, a couple could be letting valuable months go by.  One other use of this test is to determine if the male partner has good quality sperm.  If very few of the male’s sperm bind to the plate, it is very predictive that they will be unsuccessful with either natural intercourse, or IUI.  If this is the case, they would be better off to do IVF with ICSI, using one of the few sperm that actally bind.  One way to look at it, is that they may only have 2% of their sperm binding and it is unlikely that such as few number of “competent” sperm could achieve the feat of traveling through the cervix, up the fallopian tube and fertilizing an egg.  We will be offering this test at Red Rock Fertility in the near future.

I will try to address some of the economics and emotional issues that go along with failed fertility treatments in my next post.

When a couple experiences infertility, approximately 40% of the time, it is a sperm problem.  Many couples are surprised by that number, as many couples assume that just because there is ejaculate, there is functional sperm in it.  Unfortunately, that is not always the case.  There must be an adequate quantity of sperm and sperm that are moving produce much higher pregnancy rates than non-moving sperm.  We can get around the non-moving sperm problem with ICSI, which works quite well.

Men who have had vasectomies can get even more complicated.  Sperm live an environment that is protected from the human immune system.  Once a man has had a vasectomy, that protective environment is breached and sperm are “seen” by the human immune system and the immune system forms antibodies against the sperm.  Even if the man has his vasectomy reversed, or has the sperm aspirated from the testicle by a urologist, the sperm are often of low quality.  A new test is out that can be performed at home and give the couple and idea of whether or not the man has enough sperm to achieve pregnancy by natural methods.   Here is a link to the article.

One of the drawbacks of this test is that it does not measure quality.  This has to be done by a full semen analysis, which can be done at our clinic.  A full semen analysis measures not only quantity, but also quality.  Quality is measured by both appearance and function.  It is not enough to just have a good sperm count.  Function can be more important than number.  We have had a number of patients with almost normal sperm counts, but there wasn’t a moving sperm in the sample.  These types of results can influence whether a couple is a good candidate for intra-uterine insemination (IUI) vs. in vitro fertilization (IVF.)

At Red Rock Fertility, we are evaluating another sperm quality test that tests the ability of sperm to bind to a protein that is normally present on human eggs.  I think this is going to prove to be an excellent test to let patients know if IUI will work for them on not.  I will discuss this test in a future post.

Thank you for taking the time to visit our website and blog.  I hope to be able to keep the local fertility community updated on news and events related to Red Rock Fertility Center.  I am also going to bring up news items of interest to potential patients that may help them to make more informed decisions about their fertility journey.

The incidence of infertility is growing every year.  Thankfully, the resources available to patients is growing very fast.  If you haven’t discovered them yet, there are a number of infertility discussion groups available on the web.  I participate as a moderator on FertilityTies, though there are numerous other discussion boards, such as ivfconnections.com, fertilethoughts.com, and fertilitycommunity.com.  Many of my patients have found them to be quite useful, as they are able to learn about different treatments and what has worked, and hasn’t worked for people similar to themselves.