Infertility in (Celebrity) News
From reality TV stars to Oscar nominees, celebrities are talking about infertility and their efforts to have a family.
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Gestational carrier? Egg vitrification? Anti-mullerian hormone (AMH) test? Understanding celebrity gossip practically requires an MD.
Infertility affects about 7.3 million men and women in the U.S., which is about 12% of the reproductive-age population. Yet, many people experiencing infertility consider it too private to discuss with their friends and family. While sometimes it seems like celebrities make a living by over sharing, in this case their openness is refreshing, brave and even admirable. After all, the more we know about infertility, the more likely couples are to seek treatment when needed. And if we are all a bit more comfortable talking about infertility, maybe more couples will have success in having a family.
So what does it all mean? Here is the scoop, celebrity by celebrity.
Diagnostic Testing and Consultations with Fertility Specialists
Thanks to the support and urging of her sisters, Khloe Kardashian went to a fertility specialist after she and husband Lamar Odom failed to get pregnant after several months. Women who are under 35 years old and have been trying to get pregnant for more than a year should see a fertility specialist. For women over 35 years old, this timeframe should only be six months.
For women, a typical consultation with a fertility specialist includes sharing family and medical history, as well as conducting blood tests and a physical exam. Through a transvaginal ultrasound, fertility specialists have a chance to evaluate your uterus and ovaries. Other diagnostic tests may include a saline infusion sonogram (SIS), Basal Antral Follicle Count and hysterosalpingography (HSG). Blood is taken for AMH blood test and day 3 follicle stimulating hormone (FSH) blood test.
If a couple is having trouble getting pregnant, then both the man and woman will be examined. In approximately 40 percent of infertile couples, the male partner is either the sole cause or a contributing cause of infertility. For men, a physical exam and lab work are used to rule out impediments to male fertility, including low sperm count.
“It is important for patients to understand that their first visit with a fertility specialist is a consultation where we gather information,” says Dr. Spencer Richlin, surgical director of Reproductive Medicine Associates of Connecticut (RMACT), which has offices in Stamford, Danbury, Norwalk and Trumbull. “Sometimes we are able to help couples through simple solutions such as a change in diet; other times we recommend a treatment plan that includes medically advanced procedures such as IVF.”
Inspired by Khloe’s trip to a fertility specialist, Kim Kardashian claims to have decided to freeze her eggs before she got pregnant on her own with boyfriend Kanye West. Women who are not ready to have a family or want to preserve their fertility may elect to vitrify, or freeze, their eggs. The recent news about vitrifying eggs is that last October the American Society for Reproductive Medicine (ASRM) determined that freezing and thawing of egg cells is now a proven method for preserving a younger woman's ability to have children, removing the technique's "experimental" label which has been in place since 2008.
Part of the reason the ASRM Committee changed this recommendation is due to advances in egg freezing; the process used to take about four hours but now vitrification only takes 15 minutes. This speed results in virtually no crystallization (and therefore eggs remain undamaged).
Patients may choose to freeze their eggs for a variety of reasons. Patients who benefit from egg freezing are women about to undergo chemotherapy, women who simply are not ready to start a family yet, couples embarking on IVF who have ethical issues with freezing embryos, and couples whose diagnosis includes male infertility who are going through IVF.
“Egg vitrification is one of the most significant advances in the reproductive field,” says Dr. Richlin, who was named a 2013 “Top Doc” of Fairfield County by his peers. “While this technology can enable patients to fulfill their family dreams in the future, age is still an important factor to consider. ASRM was very clear that this is not a license to delay childbearing.”
When a couple decides to see a fertility specialist, Dr. Richlin recommends seeing a board-certified reproductive endocrinologist, which is a physician who specializes in hormones and reproductive health. He also suggests that couples look into the pregnancy rates for the practice; all fertility practices are required to share data with the Society of Assisted Reproductive Technologies (SART), which posts the results on www.sart.org.
Hugh Jackman recently opened up to Katie Couric about his and his wife’s struggles with multiple miscarriages. This experience was part of the reason they decided to adopt, although he clarified that adoption is something they were interested in regardless. For many couples, adoption is their path to starting a family after unsuccessful fertility treatments or when a diagnosis indicates that this is their best option for having a family.
In the past five years, there has been significant progress in the reproductive field that gives patients with recurrent miscarriages more options. One such advancement is Comprehensive Chromosomal Screening (CSS), which safely evaluates biopsied embryos prior to transfer during an IVF cycle. Through this advanced form of pre-implantation genetic diagnosis (PGD), reproductive endocrinologists are able to assess whether or not an embryo has abnormal chromosomes that will lead to a miscarriage. For this reason, CCS can be used to identify the best embryos to transfer. CCS can also be used to help couples who have experienced multiple miscarriages determine if they should consider working with an egg donor.
“CCS is a milestone development for the reproductive field,” says Dr. Richlin, whose practice is the only fertility practice in Connecticut to perform CCS. “During our clinical study of CCS, pregnancy rates were dramatically increased to more than 90 percent and miscarriage rates were lower compared to the control group because during CCS we select chromosomally normal embryos.”
Giuliana and Bill Rancic recently had their first child through a gestational carrier after years of well-documented attempts to have a baby through fertility treatments such as in vitro fertilization (IVF). A gestational carrier agrees to carry a couple’s embryo, which has been created from an egg (either from the intended mom or a third party’s donor egg) and sperm (most commonly from the intended dad). For legal reasons, the gestational carrier does not provide the egg and therefore is not genetically related to the child.
Ideally, gestational carriers are women who have had a previous uncomplicated pregnancy and delivery, and are medically and emotionally healthy as well as financially stable. It is generally recommended that both the intended parents and the gestational carrier undergo medical and psychological evaluation and legal counsel prior to finalizing the arrangement. There are agencies that specialize in matching intended parents with gestational carriers.
“Infertility can be overwhelming, but it is the job of a fertility specialist to guide couples through the experience,” says Dr. Richlin. “Couples who think they may need help getting pregnant or women who want to keep their options open for the future should see a reproductive endocrinologist to get a better understanding of their reproductive health.”
Fertility Centers of Excellence: RMACT is one of just 11 leading In Vitro Fertilization (IVF) centers nationwide chosen by In Vitro Sciences to participate in its Centers of Excellence program. RMACT’s board-certified fertility specialists are extensively trained in reproductive medicine and are eager to help you start or expand your family.
RMA has offices located in:
Norwalk, CT 06850
Stamford, CT 06905
Danbury, CT 06810
Trumbull, CT 06611
- or call Patient Services directly at 800-865-5431