Male Fertility – It is all in the Packaging

Scientists from Cold Spring Harbor Laboratory may have discovered an important event in sperm development vital for male fertility. Infertility affects about 3 million men in the United States. Many of these men seek help from fertility clinics in New York City but the success of any in vitro fertilization, or IVF, procedure and successful delivery depends on a healthy sperm and egg; healthy DNA is especially important to a healthy sperm and baby. Researchers may now be closer to understanding how a special protein may control how DNA information is packaged inside sperm.

Sperm is merely a tiny delivery vehicle for a man’s genetic code; it is basically a motor-powered ball of DNA. Each sperm measures about 50 micrometers, or about 1/500th of an inch, from head to tail. By comparison, the female egg is massive – about 30 times larger than a sperm. The sperm’s small size makes it incredibly mobile but it also presents a challenge: cramming all that genetic code into a miniscule space.

Because each cell contains the entire human genome, every cell in the human body struggles with this challenge. Most cells deal with it by winding genetic information, which would measure nearly six feet long if unwound, like thread around protein spools known as histones. Scientists refer to wound-up DNA as chromatin. In this state, DNA is well-protected and inaccessible. When the cell needs to access the genetic code, it simply unwinds the chromatin from the spool until it reaches the spot with the DNA information it wants.

To overcome their special acute packaging problem, sperm replace the spool-like histones with tiny proteins, known as protamines. In other words, sperm repack DNA into a still smaller space. Scientists refer this repackaging process as “chromatin remodeling.”

Chromatin remodeling is extremely important to male fertility. Cold Spring Harbor Laboratory researchers a protein, called Chd5, as a key regulator of chromatin remodeling during sperm development. The scientists removed the Chd5 gene from male lab mice. These mice subsequently showed severe fertility defects, including low sperm counts and decreased sperm motility. Furthermore, the sperm failed to fertilize eggs when the researchers performed in vitro fertilization.

The scientists found that a missing Chd5 gene disrupts chromatin remodeling. When Chd5 is absent, sperm cells do an inefficient job of replacing histones with protamines, resulting in repackaged DNA that is uneven and compacted as tightly.

The researchers found that poor packaging could actually damage the double-helix structure of DNA, causing breaks at multiple points during the genome. These gaps and mutations in genetic code are passed to subsequent generations and could cause illnesses such as autism and cancer.

For more information on this researcher, in vitro fertilization or male infertility, contact your local New York Fertility clinic.

Top 3 Ways Fertility Clinics Are Reducing Multiple Births

A multiple birth can be a frightening prospect for women receiving fertility treatments. Many patients at New York fertility clinics are already aware of the heightened risk of multiple births—especially for women receiving IVF treatment.

While a multiple birth can ultimately be a blessing, there are undoubtedly many risks associated with carrying more than a single baby. These risks include a higher rate of delivery by cesarean section, preeclampsia, and miscarriage, among others.

In recent years, fertility clinics have worked to reduce the rate of multiple births associated with fertility treatment. Here are three of the most successful ways physicians have reduced the number of multiples:

1. Reducing the number of transferred embryos

Decades ago, IVF required more embryos to be inserted because the success rate was lower. According to the New York Times, the number of IVF treatments that transferred four or more embryos dropped from 62 percent in 1996 to 21 percent in 2004. Improved IVF techniques have yielded stronger embryos, reducing the need to transfer so many.

Today, for a patient that is under 35 years old, physicians rarely transfer more than two embryos during an IVF cycle. This reduces the chance for a risky multiple gestation.

2. Multiple IVF cycles and freezing

Single embryo transfer is ideal for reducing the risk of multiples. However, single-embryo transfer has a lower rate of success.

If a patient agrees to two cycles of IVF, a single embryo can be transferred, while a second embryo is frozen. If the first cycle of IVF fails, the second embryo can be transferred later. Transferring a single embryo is a less costly process, and this approach boasts similar success rates to transferring two embryos at a time, while nearly eliminating the risk of a multiple gestation.

3. Improved embryo selection

In order to increase the chances of a successful transfer in a single-embryo IVF cycle, physicians must select the embryo most likely to survive.

Some of the criteria physicians use to select the most viable embryos include:

  • Shape
  • Number of divisions
  • Chromosomal abnormalities
  • Genetic screening

Examining these criteria helps physicians to select the most viable embryos, which increases the likelihood of success in single-embryo transfer.

These techniques have combined in recent years to improve the viability of single-embryo transfer in IVF. While there are many factors that can affect how many embryos should be transferred, single-embryo transfer drastically reduces the chance of a multiple birth.

Single-embryo transfer is not only less costly than multiple-embryo transfers, but it also greatly reduces the risk of complications arising from multiple gestations during pregnancy. Any woman who is concerned about the risk of multiple births should discuss this option with her physician.

Five Common Infertility Myths: – Debunked

Five Common Infertility Myths: – Debunked

By: Dr. Jin-Ho Lim

“The pill will make it harder for you to get pregnant!”

“Stay away from certain food groups, they’re bad for fertility!”

“If you don’t get pregnant in three months, something is wrong with you.”

Seemingly everyone has an opinion on fertility, but many times these opinions – like the aforementioned examples – are very different from the facts.  To help clear up some of the misconception surrounding infertility, here are five common myths dispelled:

Myth #1: With today’s technology, I can have babies well into my 40s.  

FACT: Advancements in fertility treatments are helping to increase the instances of mothers having babies in their 40s, but that doesn’t mean conception at this age is easy.  Science tells us that the amount of eggs in a woman’s body decreases annually, and at 37.5 the amount drops exponentially. Additionally, the quality of eggs drops in the 10-15 years prior to menopause, which can affect some women as early as age 40.  While there is no magic number for when women can stop getting pregnant, it is important to understand these realities and how they affect the possibility of pregnancy later in life.

MYTH #2: If I don’t get pregnant within three months of trying, something is wrong with me.

FACT: There is no set amount of time or specific schedule to conceive that couples should follow when they start trying to have a baby. A good rule of thumb is to consult a doctor if you’re still not pregnant after several months or up to one year of trying. But remember that even then, just because you’re not pregnant yet, doesn’t necessarily mean there is something wrong with you. Every couple is different, and there are many different factors involved.

MYTH #3: Fertility treatments are so expensive – I won’t be able to afford them.

FACT: There are a variety of treatment options available with different prices.  The most common method, IVF is certainly on the costlier side, but there are other effective and more affordable options. IVM is newer to the U.S., but has seen great results worldwide. It also requires fewer drugs, ultrasounds, and blood tests, making it ideal for women with hormone-sensitive issues like PCOS. Other options to consider may include IUI, IVF/M, and others. Regardless what method is right for you, check with your insurance provider to see what they cover, and check with clinics for financing or special arrangements to make the cost more affordable.  Remember, a clinic’s price isn’t indicative of its quality.

MYTH #4: It only takes “one good egg” in order to get pregnant.

FACT: Having more eggs increases the chances of your success, especially when undergoing fertility treatments. For treatments like IVF or IVM, for example, we take multiple eggs from the woman to fertilize and place back in the uterus. This helps raise the chances of how many eggs will stay in place and begin developing.

MYTH #5: I should stay away from certain foods or food groups that can cause infertility

FACT: A balanced diet gives you the best chance of conception. Unless specific medical testing has ruled out certain foods for you, your diet should consist of lean meats, fruits, veggies, whole grain breads and cereals, healthful oils, and nuts. .

Remember, you’re not alone. If you have questions about conceiving, talk to your doctor – whether it’s your regular OB-GYN or a fertility specialist, they are the best sources for accurate information about fertility. Don’t be afraid to ask for second opinions, and speak openly about your questions and concerns. At Neway Fertility, we work closely with each patient to understand their specific needs, and determine which option will give them the best possible opportunity to fulfill their dream of starting a family.

 

Dr. Jin-Ho Lim is the founder of Neway Fertility Clinic in New York City, and a foremost expert and pioneer in fertility worldwide. Previously, Dr. Lim built the Maria Fertility Hospital Network in Asia, which today is one of the leading fertility networks in the world, with ten clinics and more than 50,000 IVF babies born. A leader in IVF treatments, Dr. Lim has also pioneered the use of natural alternatives in the US and around the world, including IVM and Natural cycle IVF/M. Neway offers a full range of fertility treatments, leveraging innovative techniques and a personalized approach to deliver some of the highest success rates in the country.

How Polycystic Ovarian Syndrome Affects Fertility

How Polycystic Ovarian Syndrome Affects Fertility

One common hormonal disorder in women is polycystic ovarian syndrome (PCOS), also called polycystic ovary syndrome. The condition takes its name from the appearance of the ovaries in many of the patients who develop it.

What Exactly is PCOS?

Between 10 and 20 percent of females of childbearing age suffer from PCOS, according to Womenshealth.gov. The condition affects up to 5 million U.S. women and can occur in girls as young as 11. While its cause remains unknown, experts think several factors could be culprits. Genetics is one of them.

Fertility clinics in New York City make a diagnosis of PCOS if a woman has two of the three characteristics noted by the American Society for Reproductive Medicine: an inability to release an egg from her ovaries on a monthly basis, elevated levels of male hormones and/or increased hair in the midline of the body, and ovaries that look polycystic when imaged with ultrasound.

Conditions commonly linked to PCOS are abdominal obesity, high blood pressure, insulin resistance, diabetes mellitus, acne, and cholesterol abnormalities. Around half of patients who visit our New York fertility clinic for this disorder are obese. Women who don’t ovulate regularly face an elevated risk of uterine cancer due to excess estrogen.

The Link to Infertility

Infertility is a frequent result of PCOS. The ovaries produce a woman’s eggs and contain small fluid-filled sacs known as follicles. As soon as an egg matures, the follicle ruptures and releases it to complete ovulation.

In polycystic ovarian syndrome patients, an ovary fails to produce all the hormones necessary for an egg to reach maturity. Follicles sometimes begin to grow and amass fluid. Ovulation fails to occur, and some follicles remain as cysts. Because there was no ovulation, the body does not produce progesterone, causing an irregular or absent menstrual cycle.

Treating PCOS

Women with this disorder seeking to get pregnant have several avenues of treatment. Our fertility clinic in NYC emphasizes natural therapy approaches and stresses the importance of an individualized treatment plan for each patient with PCOS.

One helpful step for many women is adopting a healthy diet that limits manufactured carbohydrates like pasta, bread, and cereal, according to Northwestern University’s Feinberg School of Medicine. Substituting more whole-grain products, lean meats, and fruits and vegetables is a positive move. Even a 10 percent weight loss can help cycles become regular.

For some patients, fertility drugs such as clomiphene or gonadotropins are successful. If these medications don’t cause a response, laparoscopic surgery on an ovary is an additional option. A fertility specialist will also advise how in vitro fertilization might help a woman with PCOS to become pregnant.

Understanding Your Test Results: Assessing Female Infertility

Understanding Your Test Results: Assessing Female Infertility

With approximately 10% of couples in the United States affected by infertility, understanding underlying health problems that may contribute to reproductive difficulties is essential. Fertility clinics in New York City will help you identify the contributors to fertility, whether it is a problem with one partner or a combination of factors in both partners. With proper diagnosis, treatment plans to maximize chances of fertilization success can be promptly implemented.

Common Causes of Female Infertility

There are numerous causes that may contribute to fertility challenges in women. Ovulation problems, in which the egg is not properly produced or released, decrease the likelihood of successful fertilization. Other common contributors are structural problems with the reproductive system, including blocked Fallopian tubes, or diminished quality of eggs.

Female Fertility Test Components

At a New York fertility clinic, your doctor may recommend several tests to determine whether your reproductive system is functioning optimally. Possibilities include:

  • Hormonal levels. Numerous hormones contribute to female fertility. For example, follicle-stimulating hormone (FSH) initiates the development of an egg, while luteinizing hormone (LH) triggers ovulation. The relative ratios of these hormones are important. For example, low FSH and high LH may indicate polycystic ovary syndrome or luteal phase defect, both of which impair fertility. In contrast, high FSH and LH levels but low estrogen levels might suggest premature ovarian failure. Understanding hormone levels is complicated, so discuss what your levels mean with your fertility doctor.
  • Hysterosalpingography (HSG). HSG is an imaging technique used to determine whether a woman has blockages in her Fallopian tubes or structural differences in her uterus. A special dye is inserted into the cervix and flows up through the uterus into the Fallopian tubes. X-rays are then taken to visualize the dye and identify any blockages or abnormalities.
  • Hysteroscopy. Conditions such as endometriosis, polyps, or pelvic inflammatory disease may lead to buildup of scar tissue or other unwanted tissue. Hysteroscopy is used to view the uterus and identify any problems. This procedure is done under anaesthesia and may result in temporary discomfort.
  • Ultrasound. Ultrasound can be helpful for evaluating the health of the uterus and ovaries. Transvaginal ultrasound, in which the ultrasound transducer is placed into the vagina, can identify polycystic ovaries, fibroids, tumors, or urinary tract obstructions.
  • Tissue samples. Taking a sample of uterine tissue may be helpful to rule out certain common causes of fertility. In general, these samples are taken 1 or 2 days before the beginning of a woman’s period. The tissue is tested to determine if the egg’s follicle is producing progesterone.

Dealing with fertility issues can be frightening, upsetting, and frustrating. Working with great fertility doctors such as those at Neway Fertility, the fertility clinic NYC residents overwhelmingly endorse, makes the process easier. Your doctor can help you understand test results and find the best treatments for your unique reproductive needs.

When You've Had a Miscarriage

A special kind of grief

Only another woman who has experienced a miscarriage can fully understand the heartache it brings. A new life had started and with it, so many beautiful hopes, plans and dreams for the future. When a pregnancy ends, all these dreams end with it, and the loss is felt with deep grief.

When a pregnancy ends unexpectedly, well-meaning friends may say, “You can try again.” But, the woman who has lost a baby knows in her heart that this precious life will never come again, and she needs time to mourn the loss before she considers another pregnancy.

The causes of miscarriage

While a woman may, understandably, feel very alone when a pregnancy ends abruptly, miscarriages are really fairly common. In fact, most women will have one or more at some time in their lives. According to the U.S. Department of Health and Human Services’ Office on Women’s Health, as many as 10 to 15 percent of all confirmed pregnancies are lost. Even more may go unreported or may occur before a woman even knows that she is pregnant.

The common causes of miscarriages, according to the Mayo Clinic, include maternal health issues such as hormonal problems, thyroid disease, infections and uncontrolled diabetes. Most pregnancies that end prematurely, however, are the result of a problem with the developing fetus. Random chromosomal abnormalities, for example, can prevent the ovum, or egg, from forming into an embryo, or can keep the embryo from developing normally.

What can be done?

Once a miscarriage has started, there is little that medical science can do to stop it. If you are pregnant and experiencing abdominal cramps or vaginal bleeding, you should seek medical attention immediately. Your doctor will ensure that all the placental material has passed, and that you are not at risk for an infection.

Trying again

While miscarriages are quite common, consecutive losses, according to the Mayo Clinic, are much more rare. Only five percent of women have two consecutive miscarriages, and only one percent have three or more. Most women who have lost one pregnancy later go on to have a successful, full-term baby. The loss of one pregnancy does not mean the end of your plans for a family.

If a woman has lost more than one consecutive pregnancy, however, she should consider a thorough health evaluation before she plans her next pregnancy, to ensure that any of her own related health problems — if any — have been addressed. Because random chromosomal abnormalities play such a strong roll in unsuccessful pregnancies, if a woman is undergoing in vitro fertilization her doctor may recommend a pre-implantation genetic screening of her embryos.