TOOLS FOR SUCCESS
Cutting-edge medical advances offer new and improved fertility treatments
UNTIL 2012, freezing one’s eggs was classified as experimental by the American Society of Reproductive Medicine. The practice is now a common mainstream procedure (and major industry), chatted about over brunch and on TV sitcoms.
That’s just one example of how quickly and dramatically things are changing around fertility and pregnancy. Here, experts in the field share some notable trends and advancements — from changing attitudes to cutting-edge tests.
IT’S NOT ALL ABOUT THE EGG
“For a long time, there hasn’t been enough attention on the quality of the male partner,” said
Dr. Brian Levine, the founding partner and practice director of CCRM New York in Midtown.
Sperm selection and filtration have improved a doctor’s ability to select healthy sperm for in vitro fertilization. And, there’s an awareness that infertility isn’t just a women’s issue: it’s 40 percent related to the man, 40 percent the woman, and 20 percent combined or unexplained.
And, lifestyle choices impact men, too. Levine counsels men to lose weight, exercise, take a multivitamin and lower their intake of inflammatory foods, such as white sugar and gluten, to improve their chances of having a baby.
He also saw one patient’s semen parameters — which includes sperm count, motility, volume and other metrics — decline significantly after having COVID.
EAST MEETS WEST
Dr. Janelle Luk, the medical director at Generation Next Fertility in Midtown, says she’s seeing more and more patients combining alternative therapies, like acupuncture, with medical intervention like IVF, and doctors are increasingly open to it. “If it doesn’t hurt, why not?” she said.
She notes that there isn’t definitive clinical data that things like acupuncture aid with conception, but it does seem to help some patients relax and potentially do more. “You have to be respectful of alternative medicine,” she said, but cautioned, “I don’t think it’s right for everyone.”
FEWER NEEDLES
Doing IVF doesn’t always mean enduring two weeks of injecting medications to stimulate egg production, said Luk. Roughly half of her IVF patients are able to opt for “gentle IVF,” which requires lower doses of medication given over a shorter span of time (sometimes as few as seven days) and some meds that can be taken orally instead of injected.
“People feel much better,” said Luk. But, it’s not for everyone. “I’m not going to sugarcoat it,” she said. “Some people need the traditional way.”
GENETIC TESTING OF EMBRYOS
Decades ago, a woman undergoing IVF might have three or four embryos implanted to up her chances of conceiving, sometimes resulting in a multiple pregnancy. That’s no longer necessary.
“We’ve developed a technique where we can biopsy a late stage embryo, called a blastocyst, which is like a Day 5 embryo, test the chromosomes, and find the embryos that make babies, or the one that makes miscarriages and/or Down syndrome,” said Dr. James Grifo with NYU Langone Fertility.
It’s “a tool that allows a high success rate with a single embryo transfer,” says Dr. Lora Shahine, author of “Not Broken: An Approachable Guide to Miscarriage and Recurring Pregnancy Loss.” “With the goal of one healthy baby at a time, patients can have a high success rate without the risk,” added Grifo. “We’ve solved one of the problems of IVF.”
EARLY SCREENING
A relatively new crop of blood tests now enables doctors to
screen for genetic abnormalities early in pregnancy.
The tests, which include those with names like Panorama and Harmony, require a simple blood sample from the mother. From that blood, the lab can pull the fetal DNA and screen for potential issues.
The tests detect potential risk factors, but do not offer a firm diagnosis. However, they are far less invasive than diagnostic tests like an amniocentesis, and can be done much earlier in pregnancy, at around eight weeks, as opposed to 15 to 20 weeks for amniocentesis.
TOXIN AWARENESS
“It’s now been six years since I first wrote about the impact of toxins such as BPA and phthalates on fertility,” said Rebecca Fett, author of “It Starts With the Egg” (Franklin Fox Publishing). “At the time, the idea of minimizing plastic and fragrance while trying to conceive was seen as quite controversial. I’m really pleased that the science has become more widely known and avoiding these chemicals has become commonplace for women going through IVF.”
BETTER DETECTION OF ENDOMETRIOSIS
Endometriosis (a condition where tissue from the lining of the uterus grows outside the womb) can often go undetected, lessening the chance of achieving pregnancy. Now, doctors can run a test to detect so-called silent endometriosis, which can then be treated with two months of medication such as Lupron.
While women can achieve pregnancy while suffering from endometriosis, Grifo noted that if the condition is treated, “they have a much better chance of success. When odds are working against you, you have to do things to increase your odds.”