In honor of National Infertility Awareness Week, you are invited to join Dr. Sameh K. Toma and other fertility experts for a two night webcast offering free education to help couples seeking more information and support along their journey to parenthood. Register Now >

When: Tuesday, April 24th & Wednesday, April 25th
(National Infertility Awareness Week)

Where: Registrants will be provided with a link to the online webcast
(Pre-Registration is Required)

Topics to Be Covered:

Tuesday, April 24th: 7:00pm – 8:30pm
Infertility Basics: Birds & the Bees
IVF 101
Polycystic Ovary Syndrome (PCOS)

Wednesday, April 25th: 7:00pm – 8:30pm
Third Party Reproduction
Advances in Reproductive Surgery
Adoption 101

Register Now

Few other studies have looked at the effects of egg-harvesting procedures on the future reproductive health of women who donate eggs.

Some experts question whether hormonally stimulating the ovaries — which makes them produce extra eggs — and removing those eggs from a healthy, young woman could later increase her chance of infertility, but others contend there are no serious long-term risks.

“Egg donation has been offered to patients in Belgium since the 1980s. We were not surprised by the good reproductive outcomes in ex-egg donors,” Dr. Dominic Stoop, medical director at the Center for Reproductive Medicine in Brussels, Belgium and lead author of the study, wrote in an email to Reuters Health.

The researchers gave a telephone questionnaire to 194 women who had donated eggs at the Belgian center between 1999 and 2010. The surveys were conducted an average of four to five years after those procedures.

At the time of donation, women averaged 30 years old.

Sixty past egg donors reported trying to get pregnant since the procedure. Of those, 57 women conceived without help. The other three women required fertility treatment, though two of them sought treatment because of their partner’s infertility.

Sixteen percent of donors had changes in their menstrual cycle after donation. However, none of the women reporting these changes had fertility problems.

“Menstrual pattern could be disrupted temporarily by hormonal changes due to ovarian stimulation, much like how menstrual changes also appear after stopping an oral contraceptive,” said Stoop, whose study is published in Fertility and Sterility.

“In the short term, egg donation appears to have no effect on fertility,” said Dr. Orhan Bukulmez, an infertility specialist at University of Texas Southwestern Medical Center in Dallas who wasn’t involved in the new research. But longer-term studies of egg donors are needed, he told Reuters Health.

Although some researchers argue that the extra hormones women are given before the procedure and possible trauma to the ovaries during it could lead to early menopause in egg donors, studies haven’t found reasons to be concerned so far.

Egg donation is a well-established form of fertility treatment. In the United States, roughly 12 percent of all treatment cycles in 2009 used donor eggs, according to the Centers for Disease Control and Prevention.

Future research is needed to also consider possible fertility risks for women who have their eggs harvested and frozen for their own future personal use, according to Stoop.

Originally explored as a way for women undergoing cancer treatment to preserve their fertility, the American Society for Reproductive Medicine still considers that type of egg freezing experimental.

Bukulmez cautioned that the results of the current study cannot be generalized to include women seeking to freeze their own eggs.

Egg donors are a very select group of patients that are chosen for their healthy ovaries, according to Bukulmez. “They may not be representative of the fertile female population as a whole,” he said.

Read more: http://www.foxnews.com/health/2012/04/13/study-egg-donors-remain-fertile-after-procedure/#ixzz1sVJXoUQp

What is endometriosis?

Endometriosis is a painful, chronic disease that affects at least 6.3 million women in the U.S. and millions across the globe. Approximately 35 to 50 percent of women with infertility also have endometriosis. Building awareness of this disease is critical in aiding effective diagnoses and infertility treatment.

Each month when women menstruate, they shed the endometrial lining found in their uterus. When the endometrial tissue normally found in the uterus grows outside the uterus and in other places of the body, it is known as endometriosis.

Endometrial growths have been found on the ovaries, fallopian tubes, bladder, on the outside of the uterus, lining the pelvic cavity and between the vagina and rectum. While rare, growths have also been found in the arm, thigh and lung. Each month, endometrial tissue continues to break down and shed as it would during a normal menstrual cycle. Without the ability to drain from the body as it would in normal menstruation, inflammation and pain result.

Endometriosis affects fertility, bowel function, gynecological health and most importantly, quality of life. The cause of endometriosis remains unknown, as does a permanent cure. Research continues to focus on establishing the underlying cause, genetic patterns and refined treatment options.

Doctors are now able to alleviate symptoms as well as increase fertility once a diagnosis has been determined.

Common symptoms:

Painful menstruation
Pain during sexual activity
Painful urination or bowel movements during menstruation
Infertility
Fatigue
Gastrointestinal issues such as nausea, constipation and diarrhea
Recurrent yeast infections
Chemical sensitivities
Allergies

Scarring and adhesions from endometriosis can restrict movement of the ovaries, change the position of the fallopian tubes and ovaries as well as block the fallopian tubes. Endometriosis can also increase production of prostaglandins, hormones that affect fertility.

To improve fertility, doctors can surgically remove adhesions and scar tissue in the female reproductive system. Surgical options are not always necessary to achieve pregnancy, however. Stimulation of the ovaries with fertility medications and in vitro fertilization will often overcome the impact of endometriosis on fertility. IVF allows doctors to bypass any damaged tissue due to endometriosis.

Approximately 60 to 70 percent of women with endometriosis conceive and not all individuals with endometriosis are infertile. I have treated hundreds of patients who have overcome infertility due to endometriosis and have had happy, healthy children. Rest assured, many of us in the field of reproductive medicine are working tirelessly to increase success rates through scientific study and further advancement in technique.

Women with PCOS have three characteristic symptoms. Women are diagnosed with PCOS when they have at least two of these three symptoms:

Irregular periods
Excess androgens — either measured in the blood or seen through symptoms such as acne or excess hair growth
Polycystic ovaries — seen on ultrasound

Women with PCOS may have irregular periods. They may have only 6 to 8 periods per year. They may get their period every month for a few months and then skip a month or two or they may go many months without having a period. Many women with PCOS will have infertility associated with their irregular menses. Also, when women with PCOS do become pregnant, they have an increased rate of miscarriage.

Another common symptom of PCOS is acne or oily skin. Acne may occur over the face but may also be found over the back or chest. This is due to relatively higher levels of testosterone circulating in the bloodstream. Testosterone is a hormone that is found in much higher levels in men. Women with PCOS do not have male levels of testosterone but the levels of testosterone may be higher than expected for females. These higher levels of circulating testosterone can also cause excess facial hair on the chin or upper lip or excess hair growth on the chest and abdomen. The hormone imbalances seen in PCOS can also cause a type of hair thinning which occurs at the front of the scalp. Sometimes blood tests can show excess levels of testosterone in women with PCOS but other times they do not.

The third common feature of PCOS is what is called polycystic ovaries. This can be seen on a transvaginal ultrasound. This is actually a misnomer as the ovaries of women are not really full of cysts but rather ovarian follicles that each contains an egg. All women have these follicles in their ovaries and each month a group of follicles start to develop, with one going on to be the dominant follicle that ovulates the egg. The ovaries of women with PCOS may contain many small follicles that do not go on to ovulate an egg each month. These follicles fail to develop normally because of the hormonal imbalances in PCOS. Because the ovaries do not grow and ovulate an egg each month, women with PCOS may also experience difficulty getting pregnant.

Obesity is also common in women with PCOS. Up to 50-60% of women with PCOS are obese. Symptoms of PCOS such as those described above can be worsened by obesity. The hormonal imbalances found in women with PCOS may cause them to be more likely to gain weight and become obese. Women with PCOS are also prone to developing insulin resistance in which the body produces excess amounts of insulin. This is thought to be a precursor to Type II diabetes. Women with PCOS are at greater risk of developing diabetes and therefore all women with PCOS should be screened for insulin resistance.
Treating the Symptom of PCOS

There are treatments available for women with PCOS. These treatments do not cure the disease but rather help improve the symptoms of PCOS. For women with PCOS who are obese, diet and exercise to maintain a normal body weight may alleviate many of the symptoms of PCOS. In fact, for obese women, losing even 5-10% of body weight may help. Oral contraceptive pills are often given to correct some of the hormonal imbalances found in PCOS and can help decrease acne and excess hair growth as well as regulate menstrual cycles. Acne can also be treated with topical ointments or antibiotic creams. Women with excess hair growth often find laser electrolysis helpful. Metformin is an oral medication that may be prescribed to women with PCOS who are insulin resistant.

Women who are having difficulties conceiving may take a medication called clomiphene citrate or clomid to help them ovulate regularly. In women with PCOS who take clomid, about 80% will ovulate in response to the medication and 30-40% will become pregnant. About half of women will ovulate when taking one pill a day (50 mg) on cycle days five through nine. The other 50% of women do not ovulate on this dose of clomid and may need a higher dose or another medication. Using clomid increases your chances of having a multiple pregnancy to 8-13%, with twins being the most common. If pregnancy does not occur after six cycles of clomid use, further evaluation or a change in therapy is recommended.

If you think you may be experiencing any or all of the symptoms of PCOS, it is important to see one of our specialists at NCCRM for diagnosis and treatment.

Women who are generally healthy and have been unsuccessful in conceiving after several months of unprotected sex should consider getting help from a specialist. American Society for Reproductive Medicine guidelines recommend that women under the age of 35 consult with a fertility specialist after one year of unsuccessfully trying to conceive, while those 35 or older should schedule a consultation after six months. For women over the age of 40, a consultation with a fertility specialist is highly recommended as soon as possible.

In addition, if you have a known pre-existing condition that may prevent you from conceiving, it is time to seek medical help.
Many patients considering fertility treatment do not know what to expect or even what questions they should ask to get started.

Is fertility treatment something I need at this point?
How does it work?
Will it be time consuming?
How will I pay for it?
Will it work?

These are just a few of the fears and concerns our patients face. Our experienced staff at NCCRM is here as a resource to listen to you, answer your questions, address your fears and prepare you for your next steps. Our focus is to help set your course for the journey ahead from the first phone conversation.

Dr. Sameh K. Toma, Medical Director of the North Carolina Center for Reproductive Medicine, warns patients to beware of treatment options that could drain what little medical or prescription coverage you may have.  For example, if a patient has a lifetime benefit of $5000, she should carefully consider how to move forward by choosing the path that would result in the best chance at conceiving a child.

At NCCRM, most patients get pregnant without having to go through in vitro fertilization (IVF), by means of timed intercourse, ovulation induction and intrauterine insemination (IUI).  
Here is an example of a basic treatment plan and its associated costs compared to other fertility clinics in our region:

Pregnancy rates for both of these treatment plans are usually within 5% of each other, resulting in a 10% – 15% chance of conceiving per cycle.  Yet, the cost is dramatically different.  “Examine your benefits and look at the best chance of getting pregnant,” says Dr. Toma.  “Just because a treatment costs more doesn’t mean it has higher success rates.”  

Many patients also may need a laparoscopy to evaluate the fallopian tubes, presence of endometriosis, polyps, fibroids and other issues.  Another procedure often recommended by OBGYNs and fertility specialists is a hysterosalpingogram (HSG).  It’s a special kind of x-ray that involves placing an iodine-based dye through the cervix and taking x-rays to help evaluate the shape of the uterus and whether or not the fallopian tubes are open or blocked.  “It’s important to note that an HSG only confirms whether the fallopian tubes are open but says nothing about the freedom of the tube to pick up eggs from the ovary,” explains Dr. Toma.  Instead, a saline ultra sound followed by air infusion into the fallopian tubes can assess the patency of the tubes as well as the HSG, but would be covered as a gynecologic procedure rather than a fertility procedure with a woman’s insurance company, thus saving any fertility coverage she may have for other procedures.  The saline ultrasound also is used to detect polyps and fibroids.

In summary, it’s critical that patients understand all aspects of their medical and pharmacy benefits.  Here is a list of specific questions every patient should ask their health insurance company and pharmacy benefit provider before moving forward with any treatment protocol:

Do I have benefits to cover testing for infertility??
Do I have benefits for reproductive technology procedures such as IUI and/or IVF?  If yes, what is the lifetime dollar maximum or the maximum number of attempts??
Do I have benefits for infertility drugs??
Is the fertility clinic an in-network provider with your insurance company?

Fortunately, NCCRM has a very experienced and knowledgeable team that can help patients navigate their way through the complex world of health insurance.  For more information, visit www.NCCRM.com.

Couples who require donor eggs before moving forward with in-vitro fertilization (IVF) already know the procedure comes with a hefty price tag. But here’s some good news…

The Scoop

Want to save some money on your donor eggs for your IVF treatment? The North Carolina Center for Reprodcutive Medicine is now offering a “shared egg” donor program that allows two women to use eggs provided by the same donor at the same time. Sharing eggs can save women 30 to 50 percent on the expense of conceiving a child with a donated egg, cutting treatment costs by thousands of dollars.

Though rates vary widely across the US, a typical cycle of Donor Egg IVF at NCCRM costs $13,500 plus medication, with most of the fees not covered by patients’ health insurance.  In the past, donors would supply eggs to only one woman, and often many embryos were never used. But by sharing donated eggs, the price drops.  NCCRM is offering a remarkably affordable price of $10,800 for a shared or split donor cycle.

By sharing the cost of acquiring donor eggs, recipients can save on expenses for intensive screening to identify appropriate donors and compensation for a donor’s time, which runs several thousand dollars. In addition, a donor receives fertility medicine in order to produce multiple eggs, which are then extracted through outpatient surgery. Shared costs also cover this procedure.  Even more encouraging is the pregnancy success rates using donor eggs from healthy, young women reach 70%.

Your Fertility

Will you need donor eggs? There are a variety of reasons why some women will require donor eggs in order to become pregnant. Age is the most common. While some women in their 40s have no trouble getting pregnant, eggs in other “older” women trying to conceive may no longer be viable for pregnancy. Premature menopause, detected problems with chromosomes in a woman’s eggs, and risk for inherited gene defects may also factor into the decision to use donor eggs.

If you are currently considering Donor Egg IVF, contact NCCRM at 800-933-7202 to see if a Shared/Split Egg Donor cycle is for you.

Kolsen Brantley Metz was born on May 2, 2011 at 7:45 AM in Greensboro, NC, weighing 8 lbs. 2 oz. and 21 inches long.  Parents Amy and Stacy are overjoyed. “It is amazing how much you can love somebody in an instant.  We both can’t quit staring at him and telling each other how beautiful we think he is.” Celebrating her first Mother’s Day with Kolsen has been a dream come true for Amy. “We are so thankful for the foundation because it is what got us to this special time in our lives.  We couldn’t say thank you enough,” says the new Mom.

The Metz family received a grant from the Pay It Forward Fertility Foundation in December of 2009 to help pay for fertility treatment in order to build their family. Years of trying to conceive led the Metz’s to the North Carolina Center for Reproductive Medicine (NCCRM) in Greensboro where they underwent In Vitro Fertilization (IVF). After a negative result and thousands of dollars spent, Amy and Stacy needed to fund another attempt at IVF to conceive. That’s when they decided to apply for a grant from the Pay It Forward Fertility Foundation.

The Pay It Forward Fertility Foundation is a non-profit 501 (c)3 organization that was created to help people afford expensive fertility treatments that are not covered by health insurance. The Foundation awards grants throughout the year to couples who live in North Carolina needing assistance in paying for assisted reproductive techniques such as in vitro fertilization (IVF), in vitro fertilization using donated eggs and embryo adoption. The Metz’s baby is the first child to be born from a couple who has received a grant since the Pay It Forward Fertility Foundation began awarding them in 2009. To date, six couples have been given financial assistance to build their families.

Founder and Chair of the Pay It Forward Fertility Foundation, Lori Moscato, says the birth of Kolsen is a dream come true. “The foundation cannot be happier to welcome Kolsen to the world and the PIFFF family. We’re so glad Amy was able to celebrate this Mother’s Day as a Mom. Rob and I personally could not be more ecstatic. This is exactly what we wanted to help someone do – have the miracle of life,” says Moscato.

The Pay It Forward Fertility Foundation was started in December 2008 with a generous donation from Lori and Rob Moscato of Raleigh. The Moscatos conceived their daughter through in vitro fertilization (IVF). After giving birth to Sophia in 2007 they conceived their son Ryan on their own. “Rob and I feel so blessed and so fortunate to have two little miracles, each in their own way,” explains Lori Moscato. “We were fortunate to have health insurance coverage for our IVF treatments but we know most people don’t. We want to help those couples because we can’t imagine life without our beautiful children and we want to pay it forward.”

Infertility is a disease of the reproductive system and affects about one is six couples in the United States. The Pay It Forward Fertility Foundation currently has the full support and involvement from five NC based fertility clinics. The North Carolina Center for Reproductive Medicine, Carolina Conceptions, Duke Fertility Center, UNC Fertility and the Center for Reproductive Medicine at Wake Forest University are all represented on the Board of Directors and the Advisory Board. Their collaborative expertise and guidance play a critical role in the success of the Foundation and its mission.

Couples interested in applying for grants should visit www.payitforwardfertility.org.

About the Pay It Forward Fertility Foundation:
The Pay It Forward Fertility Foundation on is a non-profit 501 (c)3 organization, IRS identification number 26-3906064. The Foundation assists couples in North Carolina in pay for fertility treatments not covered by health insurance. www.payitforwardfertility.org

Legislation will remove financial barriers for infertility treatments

NCCRM applauds Senator Kirsten Gillibrand (NY) for introducing a bill in the U.S. Senate that would provide eligible taxpayers a tax credit for the out-of-pocket expenses incurred with infertility medical treatment.

Appropriately named the “Family Act of 2011,” the bill, S 965, would apply to expenses related to in vitro fertilization and treatments to preserve fertility for cancer patients.

The Bill was introduced just days after RESOLVE’s successful Advocacy Day in Washington, D.C.  Advocates from across the country met with their Members of Congress to advocate for the tax credit.   Enthusiasm was very strong for the tax credit among the Advocates, who see the need for immediate financial relief for infertility patients.

What YOU can do

Now that it is introduced, S 965 needs co-sponsors in the U.S. Senate.  We need EVERYONE who is facing infertility (and their friends and family) to contact their two U.S. Senators.

1. Contact your two Senators right now.  It takes 3 minutes through RESOLVE’s Action Alert System. PLEASE review the online letter and personalize it with your story.  Personal content is far more impactful than a form letter.

2. Ask your friends and family to send letters  too!  Forward this link so they can take action today. http://www.resolve.org/taxcredit

3. Share the information about the tax credit on your Blog or Facebook page!

To read the letter sent by Senator Gillibrand to other members of the U.S. Senate, click here.

Key provisions of the bill:

• The Family Act covers the out-of-pocket costs associated with in vitro fertilization (IVF) including diagnostic tests, laboratory charges, professional charges, and medications for IVF.
• The Family Act covers the out-of-pocket costs of fertility preservation procedures if the man or woman is diagnosed with cancer and the cancer treatment or disease itself may result in infertility.
• The Family Act has a cost sharing provision allowing 50% of all applicable medical expenses to be  covered up to a lifetime maximum of $13,360. You would need to have out-of-pocket costs totaling $26,720 to claim the entire credit in your lifetime.
• If you do not owe taxes in a particular year, do not owe enough taxes to use the whole credit, or do not reach the max amount in one tax year, it carries over to the next year for a max of five years after the first year you use the credit.
• The Family Act is available to couples filing jointly with adjusted gross incomes of less than $222,520, but the credit is smaller for those earning between $182,500 and $222,520.

Follow Family Act of 2011, S 965 on Facebook to keep up to date.