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The Not So Fertile Goddess

~ and here we go again…

The Not So Fertile Goddess

Category Archives: Infertility Education

Mosaic Embryos for the Win!

14 Wednesday Jul 2021

Posted by thenotsofertilegoddess in Infertility Education, Life After IVF

≈ 2 Comments

Tags

Infertility, IVF, Mosaic embryos, PGS testing

Photo by Anna Shvets on Pexels.com

Admittingly, it’s been a while since I’ve written here. My life has been filled with family, work, chaos, peace, and all the things life brings. I am grateful. I also want to occasionally run away screaming. But that’s normal, right? With two littles, and a husband starting up a new business, there’s never a dull moment. And I’m good with that (although I could use a few more ritual baths and date nights).

What caught my attention today is a new article from Embryoman. Side note: if you aren’t following him, you should be. He is a former embryologist who writes about the latest and greatest in infertility treatment technology from a scientific perspective. He has a knack for breaking down research papers, data, and outcomes with flair for everyone to understand. I appreciate his writing style and objective perspective. You can sign up for his free newsletter here, if you are so inclined, which is packed with accessible summaries of the most current infertility research. It really appeals to my research heart.

Back to the article in question. The headline read: No difference in euploid and mosaic embryo transfers! What’s that you say?! A recent study, that is pending publication, compares outcomes from transfers with euploid embryos (those are the “PSG normal” embryos you’ve heard so much about at the RE’s office and online support groups) versus mosaic embryos. Mosaic embryos are embryos where some of the biopsied cells come back “normal” and others are “abnormal” (meaning they have missing or duplicate chromosomes or parts of those). So there’s a mix of cells in the biopsy taken from the embryo, which leads doc’s to assume that the whole embryo is a mixed bag. Some mosaic embryos have a higher percentage of mosaicism, meaning that there are more abnormal cells present in the mix, and others have a lower percentage of mosaicism.

There’s been a lot of controversy surrounding mosaic embryos and PGS testing in and of itself. I must confess that I no longer have my finger on the current pulse of what common transfer practices are when it comes to PGS tested embryos. My most recent IVF baby is 2.5 years old (*gasp*) and I know how fast things change in the IVF world. When I was doing IVF, PGS testing was the norm, and, sadly, so was discarding PSG abnormal and mosaic embryos. I dove into every PSG-related article and study that I could find. I slowly came to the conclusion that PGS testing wasn’t right for me. I appreciated what PGS was trying to do, but I didn’t think that the science behind it adequately supported the treatment decisions that were being made. There was just too much they didn’t know. To ready more about my experience, the data I reviewed, and how I came to the decision that was right for me, check out this post. You can also read about how I ended up transferring an untested embryo and an abnormal embryo (*gasp again*) here and here, and the unexpected outcome of that transfer here.

Now back to that article. Embryoman explained that most of the studies that had been done previously looked at mosaic transfers after failed PGS normal transfers. The RE’s knew the PSG results of the embryos they were transferring, and when the mosaic’s failed, it was attributed to this flaw in chromosomes. But they were comparing PGS normal transfers (let’s call this group 1)  versus mosaic transfers after already having a failed PGS normal transfer (group 2). I’ve always said that the devil is in the interpretation when it comes to study results. It’s simply incorrect to attribute the failed mosaic transfer in group 2 to mosaicism with this study design. An alternative explanation is that there is a 3rd factor causing both the normal and mosaic transfers to fail in group 2 (remember the women had failed transfers with normal embryos before participating in those studies). So there may be something else going on that causes these women in group 2 to not have a successful pregnancy regardless of the PGS results of the embryo transferred.

In this new study, the RE’s transferred PGS normal and mosaic embryos without knowing which were which. This is called a blind study and reduces bias. It also means that they weren’t just transferring mosaic embryos to women who already failed with PGS normal embryos. The playing field was leveled. And the results are a big deal.

They found that there was no difference between the PGS normal group versus mosaic group in miscarriage or pregnancy rates, live birth rates, or prenatal outcomes. And if your jaw hasn’t dropped yet, they also found no difference between the groups when they further compared embryos with low (20-30%) or moderate (30-50%) mosaicism with the PGS normals. And of the babies born from mosaic embryos, none had any mosaic related abnormalities. Yes, that is a big, big deal.

Why is it such a big deal? Because for quite some time, and maybe still in some clinics, mosaic embryos were not transferred for fear of having a miscarriage or baby born with a disability. It’s a big deal because I know there are women out there who were told they would not be allowed to transfer mosaic embryos. There are women out there who, due to earlier testing methods, were only told that their embryo was either normal or abnormal, with mosaic embryos considered abnormal and cast aside. There are women who reached the end of their finances, emotional rope, or whatever the line may have been, who did not get to transfer embryos that could have brought them that baby they wanted so very badly with all their hearts. And for those women, I hold space. My heart breaks for them.   

For the women still in the trenches, I hope that this post gives you food for thought. Knowledge is power, and when it comes to infertility treatment we really do need to be our own best advocate. As I mentioned, I no longer know what is the most common practice in fertility clinics when it comes to PGS testing and transfers; and I know that in many medical fields, clinical practice tends to lag quite a bit behind scientific findings. But knowing that this research is currently being done gives me hope. Hope that clinics are keeping up to date on cutting edge research. Hope that they adjust their practices to be in line with new findings and recommendations. Hope that more women will have more chances with more embryos. Hope that you find you happy ending, whatever that may look like you for.

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Building a Village

25 Tuesday Feb 2020

Posted by thenotsofertilegoddess in Infertility Education

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Tags

Coping, Fertility Answers, Fruitful Fertility, Infertility, Infertility support, MedAnswers, mental health

sydney-rae-geM5lzDj4Iw-unsplashInfertility can be a very lonely place. Getting the right kind of support at the right time can make a world of difference when you feel like you are drowning in it. What is the right kind of support?

Sometimes it’s a kind friend who just listens, even if she has never been in the same situation.  Sometimes it’s a partner who holds you while you cry on their shoulder. Sometimes it’s a group of friends who distract you with a fun night out and never say a word about fertility or the lack thereof. Sometimes it’s a group of women on social media that you’ve never met in real life, but they understand the pain of another failed transfer like no one else in your life can.

Sometimes we need to vent, to feel understood, or to get advice from someone with shared experience. Sometimes we need someone brave enough to sit with us in our sadness without saying a word. Sometimes we need someone who can ask the hard questions. At different times we need different things. And the reality is, we need different people for these different things. Expecting one person to fulfill all our support needs is setting us (and them) up for failure. Why? Because each person brings a unique set of skills and life experiences to the table. And that’s fine, because we have lots of options out there to build our support system.

You may have family and friends that serve certain rolls in your support arsenal. That face-to-face contact is vital. Then there are online communities for solidarity and shared experience. These can be even more helpful when you find groups that are facing similar challenges as you, whether than be diagnostic issues or age-specific groups. I can’t tell you how much I learned from an IVF group for women 40 years and older. I’ve even developed friendships with women that I’ve met in these groups that have endured past IVF outcomes and births.

Through the process of it all, I found a couple more resources to add to my team; and I want to share those with you because it look me longer to find them and they can serve different roles than the rest.

fruitful

https://www.fruitfulfertility.org/

The first is Fruitful Fertility. Fruitful Fertility is a unique mentorship program. It matches people who are experiencing infertility with “mentors” who have been there done that.  It’s free to join, and you submit information about your background, experiences, and values. Then they match you with a mentor based on a variety of factors, which could include age, diagnosis, primary vs. secondary infertility, treatments, geographic location, or other information. You’ll receive an email or notification in the app when you have been “matched” along with info about the other person and preferred way to contact (e.g., email, text). I like Fruitful Fertility because it takes the invaluable support you can get from someone who has shared experiences and facilitates a more personal one-on-one relationship, which is often lacking in online support communities. I didn’t find Fruitful Fertility until I was at the end of my IVF journey. So I became a mentor and have had the honor of working with four mentees over the past two years. Sometimes online infertility groups can become overwhelming. Fruitful Fertility helps you connect with someone similar to you, without all the distractions or drama.

 

fertility answers

https://www.medanswers.com/

The second resource I’d like to share is an app called Fertility Answers created by MedAnswers, Inc.This app gives you free access to fertility specialists. You can submit anonymous questions privately that will be answered by specialists in a variety of fertility-related disciplines, including RE’s, embryologists, psychologists, genetic counselors, acupuncturists, pharmacists and more. Got diet and nutrition questions – there’s an expert for that. Got questions about egg quality – there’s an expert for that. Need help with stress related to infertility – there’s an expert for that. It’s a great way to get a second, third, or even fourth (because let’s face it, we want all the info we can get) opinion on any of your fertility related questions. You can even schedule phone or in-person consultations with an expert that you connect with. I like the convenience of submitting private questions anytime, anywhere and getting knowledgeable responses. One of the things I found pretty amazing about Fertility Answers is that the app is the brain child of Alice Crisci, who is a cancer survivor and fertility activist. Through her hard work, entrepreneurship, and her own personal experience with fertility challenges, she created has created a one of a kind resource to support you in your journey. I’m passionate about infertility advocacy and as a way to give back to the community that provided me with so much support when I needed it, I volunteer as a psychologist for Fertility Answers.

If you’re interested in expanding your support team, I hope you check out Fruitful Fertility and Fertility Answers. We all need a village!

 

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Fact or Fiction: The Truth About Getting Pregnant in Your 40’s and Beyond

26 Thursday Sep 2019

Posted by thenotsofertilegoddess in Infertility Education, Uncategorized

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Tags

Age, Donor Eggs, Education, Infertility, IVF, Over 40, TTC

food person happy smoke

When I went back to my trusty IVF clinic just months before my 40th birthday in pursuit of IVF baby #2, I didn’t realize how much harder it was going to be to find the golden egg. I had some vague notion that eggs get “worse” with age, but didn’t really know what that meant. No one was really talking about it.

In this guest post, Heidi Hayes dives into some of the myths and facts surrounding fertility in our 40’s. Heidi is the Executive Vice President of California Cryobank’s Donor Egg Bank. She has more than 20 years of healthcare experience and has worked extensively in the field of reproductive endocrinology. Having been unsuccessful at traditional IUI and IVF treatments, Heidi personally understands the struggles of infertility. After many years of trying to conceive, she ultimately built her family through adoption and donor egg treatment. She always believed that if she didn’t give up, her ultimate goal of becoming a parent would someday become a reality. You can connect with her here for more information.

Fact or Fiction: The Truth About Getting Pregnant in Your 40’s and Beyond

In a perfect world, human biology would allow women to conceive easily no matter their age. After all, every person is on their own timeline, and focusing on accomplishments like a career, travel, or finding the perfect partner can sometimes take precedence over getting pregnant. Unfortunately, biology often doesn’t work the way we wish it would. While there are many misconceptions about getting pregnant after 40, scientific research shows conceiving later in life can be increasingly difficult.

If you’re approaching your 40’s and are ready for a child, it’s crucial to understand the difference between reproductive facts and fiction.

Myth # 1: It’s Easy to Get Pregnant Naturally After 40

While there’s a chance for you to get pregnant after your 40th birthday, the likelihood of it naturally occurring is slim. In fact, studies show women over the age of 40 only have a 5% chance of conceiving each month. This difficulty is mostly a result of low ovarian reserves and poor egg quality.

Myth # 2: Healthy Women Don’t Have Fertility Issues

In most situations, maintaining a healthy diet and exercise routine is an excellent way to stay in shape and ward off potential ailments. However, no amount of running or kale will prevent your egg quality and number of eggs from deteriorating.

Every woman is born with a finite number of eggs. As she gets older, she loses some of those eggs every month. By the time she hits her late 30’s, her egg count will begin to decrease more quickly, making getting pregnant naturally harder to achieve.

Myth #3: I Can’t Get Pregnant Once I’ve Started Menopause

It’s a common misconception that menopause automatically means your days of conceiving are behind you. On the contrary, it’s entirely possible to get pregnant during its early stages.

While many women attribute menopause to the completion of their monthly periods, the process begins before this occurs. The perimenopausal stage lasts for approximately ten years and takes place before you stop having periods. During this time, you can get pregnant. However, the likelihood of this happening is quite small.

Myth #4: Age Doesn’t Affect a Man’s Fertility

The effect of age on a woman’s eggs is prevalently discussed in the medical community. However, this fact doesn’t mean women are the only ones who struggle. Male fertility is just as much of a risk factor in life.

Some of the effects age has on male fertility include:

  • Change in sexual function
  • Sperm motility
  • Sperm morphology
  • Seminal volume

Myth #5: Celebrities Don’t Deal with Infertility

Every year, mainstream pop culture shows us examples of famous women getting pregnant and having children later in life. While it’s possible some of them have gotten lucky and conceived naturally, there’s no miracle celebrity water to remedy infertility.

While some female celebrities have been open about their struggles with infertility, most treat it as the personal matter it is. Just because a celebrity is quiet about her conception difficulties, it doesn’t mean she didn’t suffer just as greatly as another aging woman.

Myth #6: Getting Pregnant After 40 Poses No Risk to the Baby

If a woman is blessed to become a mother after 40, the hard part is – regrettably – not over yet. Due to a variety of circumstances and conditions, older moms and their babies are at risk for several complications, such as:

  • Miscarriage/Stillbirth
  • Low birth weights
  • Chromosomal defects
  • Premature birth
  • Gestational diabetes

Myth #7: It’s Impossible to Have a Child After 40

While an older mother certainly faces more issues when trying to conceive, it doesn’t mean it’s impossible. Whether a woman can get pregnant naturally or not, there are options available for her to become a mother. Adoption and frozen donor egg IVF are two of the most popular alternatives used by couples and individuals.

Each of these solutions comes with a wide array of benefits; however, many women find egg donation to be their next best option.

When many women are ready to have a child, it’s not just the baby they’re looking forward to. A great number have patiently awaited the chance to carry a child and bring them into the world. With frozen donor egg IVF, they can turn this goal into a reality.

Getting Pregnant After 40: The Hard Truth

There’s no doubt about it; getting pregnant naturally after 40 is no easy task. If you’ve spent your life dreaming of having a family and finally feel ready, don’t let your age dissuade you from trying.

No matter what biology has to say on the subject, a life of lessons and experience make women in their 40s ideal candidates for motherhood. When you’ve blown out the candles on your 40th birthday cake, just remember: your next chapter as a family could be right around the corner.

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Recent Posts

  • Mosaic Embryos for the Win!
  • Building a Village
  • Life After IVF: 1 year after birth
  • Fact or Fiction: The Truth About Getting Pregnant in Your 40’s and Beyond
  • Age and Fertility

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