This is your home for learning more about fertility factors--medical, emotional, and physical. Our team of bloggers, from physicians to nurses, financial counselors to patients, are all dedicated to giving you news, information and thoughts relating to the the fertility journey. Please explore and let us know if there other topics of interest to you.

Our New World-Class Facility

We’re Moving…to a world class facility!

NulsenDanspachBatMaslowSueldoConstruction on our new, state-of-the-art fertility center in Farmington is well underway and the opening is planned for January 2015. Designed for patient comfort and convenience, the new location is conveniently located off I-84, Rt. 9 and Farmington Avenue at 2 Batterson Park Road, Farmington. It holds 22,000 square feet on two floors and offers free parking for almost 100 cars.

“Moving into our own building has allowed us to endow our facility with the maximum in comfort and convenience for our patients, plus the absolute latest in technology and science,” stated John Nulsen, M.D., Medical Director. “Everything in the building has been carefully designed based upon a beneficial impact on developing embryos and maximizing pregnancy rates. All of our physicians and staff are very excited for the move.”

The Center’s highly advanced IVF laboratory was custom designed by its team of fertility experts and engineered by Alpha Environmental, Inc., a leader in environmental engineering for research and clinical labs. The Center also features the LifeAire system, a state-of-the-art patented air purification system to support the growth of the human embryo during In Vitro Fertilization (IVF).

The Center will continue to be affiliated with the University of Connecticut School of Medicine, and will continue to run the fellowship program in Reproductive Medicine and Infertility at the University of Connecticut Health Center.

More information about our new facility can be found here.

See photos of our building in progress here.

 

 

 

Infertility: A Hushed Topic?

So many couples are struggling with infertility and feel like they are alone because people rarely talk about it. Why don’t people talk about infertility? See the article below by Michelle Howell Miller of the Huffington Post.

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Sex… and 3 Other Reasons Infertility Is a Hushed Topic

Infertility affects nearly 1 in 6 couples. According to a recent research report, the number of couples with infertility issues globally was nearly 50 million. Think of everyone you know — your friends, relatives, coworkers — and chances are that many of them have silently struggled, or are currently struggling, to conceive.

When we decided to start a family, we never considered the possibility of not being able to get pregnant. It didn’t occur to us that so many people found it difficult to do what we’d been taught since our teenage years only takes one mistake.

Why didn’t we realize it was an issue for so many? Because people rarely talk about it. There are four main reasons infertility is a hushed topic:

SEX
Trying to conceive, and failing at it, involves sex. And talking about sex is taboo in our society. Even close friends who can tell each other anything don’t usually talk about what goes on behind closed bedroom doors — unless you’re a character from Sex and the City. To be infertile means having unprotected sex for more than a year without conceiving. And there’s that word again. Sex. The topic we don’t talk about.

EXPECTATIONS OF MOTHERHOOD
Most of us are brought up with the expectation that we will be mothers some day. There is a stigma for those who cannot bear children. We’ve come a long way since the stone ages, but it is still there. And it’s another reason why many women don’t share their challenge to conceive.

I didn’t feel like a failure when we were going through infertility. I understood rationally that infertility was a disease, like cancer. That it wasn’t something I should blame myself for. Or be ashamed of. However, that didn’t make it any less painful.

MASCULINE PRIDE
There is a sort of masculine pride to becoming a father. In our culture, masculinity and sexuality are closely tied. Talking about infertility isn’t the most macho conversation you can have. But I do it anyway, because I feel for the all of the other guys who are riding the infertility roller coaster. Most men stay silent on the topic, and that may not be a good thing. Infertility can impact a man’s psyche just as much as it does a woman’s, even if we are less open about our feelings.

INFERTILITY IS AWKWARD
There are many reasons couples stay in the closet about their failure to conceive. Infertility is awkward to talk about. It shows weakness. It often results in pity. It is hard for anyone who hasn’t been through it to understand the pain. People still say insensitive things, even when you’ve shared your secret.

Reasons aside, it is time to break the silence. We’re passionate about helping other couples navigate through the journey of infertility because we understand how hard it is to be in those shoes. We’ve been there. We get it. And so do the millions of others who have walked this path.

You are not alone.

Repsonding to Infertility Advice

There are a lot of articles on what not to say to the fertility challenged. The soundest advice is to avoid sharing your advice. But we humans have a tough time keeping in our opinions. So the advice will come. And when it does, here’s what we can do about it.

 

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3 Ways to Respond to Infertility Advice

(Published in the Huffington Post by Michelle Howell Miller)

For those who haven’t dealt with infertility, it’s difficult to imagine the plight. That is understandable, since it’s even hard for those of us who have experienced infertility to explain it in words.

How do you convey the feelings of longing for a child? Something you’ve never known, but can still feel? Like a piece of your heart is missing or a wish that is always just out of reach. How do you describe the poison that grows at the pit of your stomach with each failure? How do you label what is not so much physical pain, but an emotional weight pressing heavier and heavier against your body? How can you possibly help others fathom your relentless despair?

Make the Most Of It

We’ve all heard it. “Just relax.” “Go on vacation.” “Stop stressing — it will happen!” Most of the infertility advice is not very helpful, but sometimes there are nuggets that just might surprise you. People share their stories with you because there is hope in them. The “magic pills” that worked for their friend who tried to conceive for years and then got pregnant after a couple months. The “Robitussin trick” that makes it easier for sperm and egg to meet. The great acupuncturist who helped your cousin get pregnant when the fertility doctors said she had no chance.

Don’t assume their advice isn’t valid. You just might find that sometimes, there are helpful nuggets to be found if you don’t tune all of the advice out.

View Their Advice as Love

When the well-meaning advice comes rolling in, imagine the words surrounding and comforting you. Instead of steaming over what seems like a careless comment, avoid the negative energy and see it as a positive. Your friends and family are trying to help. Sometimes, they just don’t know how. Yes, the advice can be very annoying. But you have the power to view the glass as half full instead of half empty.

Tell Them How to Help

You can help your loved ones by telling them what they can do for you. Are they good at research? Ask them to find an answer to a question that’s been nagging at you. Are they good listeners? Tell them you’ll reach out to them when you need a shoulder to cry on. Do they have a flexible schedule? Bring them along to some of the tougher appointments when your partner can’t be there with you.

Be honest with them. Tell them the encouraging words, “I love you, I’m here for you, and I’m listening,” are more helpful than anything else they can say.

Infertility is a tough road to travel alone. Having friends and family by your side will give you the extra strength you need on the toughest days.

Infertility + Plastics and Cans

New studies have been conducted testing the risks to women posed by the widely used industrial compound bisphenol A, or BPA, found in plastics and cans. See the New York Times article below.

In Plastics and Cans, a Threat to Women

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(Published in the New York Times by )

A few years ago, Jodi Flaws, a bioscientist at the University of Illinois, began testing a theory about the risks to women posed by the widely used industrial compound bisphenol A, or BPA.

A series of studies had suggested that it could damage developing ovaries. But nobody knew how. So for a month, Dr. Flaws dosed young female mice with a BPA solution at a level comparable to estimated human exposure in the United States. She then examined their ovaries, focusing on the follicles, which contain the eggs.

The effect of the BPA was immediately obvious.

Compared with normal mice, the follicles of the treated mice were fewer and smaller. Further analysis showed that estradiol, the sex hormone essential for normal reproductive development, was not being produced at normal levels. BPA, it seemed, interferes with enzymes essential in the production of such hormones. Another study published by her laboratory this spring found that treated mice stopped producing viable eggs at an abnormally young age.

Scientists have discovered similar effects across an increasingly broad range of mammals, from sheep to monkeys to, alas, humans. The accumulating research fuels rising concern among scientists that childhood exposure to BPA may well contribute to female infertility, and that adult exposure may result in a shorter reproductive life span.

“I think most scientists working today agree that BPA is an ovarian toxicant,” Dr. Flaws said. A review of research into BPA, published this summer in the journal Environmental Health Perspectives, noted that ovarian toxicity is among the most consistent and strongest effects found “in both animal models and in women.”

Discovered in the late 19th century, BPA came into wide commercial use in the mid-20th century. It is an ingredient in products like polycarbonate plastics, thermal coatings on cash register receipts and protective linings in cans and pipes.

Concerns about its health risks didn’t really arise until the late 1990s, when researchers first reported that it appeared to disrupt normal hormone function. Consumer worry led the Food and Drug Administration to ban it in baby products, such as bottles, and manufacturers voluntarily scaled back its use in other goods. But because good substitutes are hard to find, BPA is still used in many materials, and studies have found that a majority of Americans still test positive for exposure.

What that means for our health has turned out to be a complicated subject; manufacturers have pointed out that more than decade of research has produced often inconsistent results. Still many experts worry that the evidence that this chemical damages young ovaries is consistent — and growing.

“There are so many studies of BPA that it’s often difficult to weed out the real effects,” said Tracey Woodruff, the director of the program on reproductive health and the environment at the University of California, San Francisco. “But on this question of ovarian toxicity, all the studies are starting to line up.”

Genetics, lifestyle, and other chemical exposures also play a role in infertility, and scientists are still struggling to figure out where BPA ranks among the risks. “We’re incredibly difficult creatures to study, especially because we’re looking at effects that may take a generation to show up,” said Patricia Hunt, a genetics professor at Washington State University.

She and her colleagues decided to study the compound’s effects in another primate species, the rhesus monkey. They exposed monkeys in the second and third trimesters of pregnancy to levels of BPA comparable to those that humans received. The investigators were looking for the effects on developing ovaries, similar to the changes in rodents. And they found them. The exposure in both trimesters altered follicles and oocytes (the germ cells that develop into eggs). Similar effects might easily occur in developing human females as well, Dr. Hunt concluded.

Researchers at Harvard University have been trying to assess how BPA affects humans through studies of women enrolled at in-vitro fertilization (IVF) clinics. In a recent study, 80 percent of the women tested positive for BPA in urine. Higher BPA levels were linked to a reduced number of follicles — and therefore fewer fertile eggs.

Noting that BPA also turned up in follicular fluid, the investigators also looked at 357 discarded oocytes from more than 120 women visiting the clinics. Higher levels of BPA were linked to stunted human oocytes, as well as indications of chromosomal damage – a finding also found in animals studied by Dr. Hunt. “Together with prior animal studies, the data support the negative influences of BPA on oocyte maturation,” the Harvard team concluded.

Despite the growing body of research, a more complete assessment of BPA’s effects on human reproduction remains a tricky prospect.

“As a species, we tend to have a lot more chromosomal abnormalities anyway than animals like mice,” Dr. Hunt said. “And then people are waiting longer to have children, and that’s also a complicating factor.”

Dr. Woodruff said that a detailed systematic review of BPA was in the works, part of a National Toxicology Program reassessment of chemical risks. It should provide a better sense of how to navigate through recent findings. Her best advice for now? Avoid the compound when possible and, other than that, “don’t drive yourself crazy.”

“We’re still figuring this out, and the burden is on us — researchers, health care providers, manufactures — to do that well,” she said.

PCOS Awareness

September is National PCOS Awareness Month. Polycystic ovary syndrome (PCOS) is the leading cause of infertility among women. It is a condition in which there are many small cysts in the ovaries. These cysts can affect a woman’s fertility because they disturb hormone cycles. Usually women with PCOS have low levels of follicle stimulating hormone (FSH) and high levels of androgens (male hormones).

PCOS affects 1 in 10 women and over 50% do not know they have it. The more than 50% that do not know they have PCOS are in danger of Diabetes or Pre-Diabetes, risk of heart attack, high blood pressure, high cholesterol, increased risk of Breast Cancer and Heart Disease.

With the help of blood tests and pelvic ultrasounds PCOS can be detected early enough to treat the many symptoms and ward off any serious diseases.

Symptoms of PCOS
The symptoms of PCOS can vary from woman to woman. Some of the symptoms of PCOS include:

Infertility (not able to get pregnant) because of not ovulating
Infrequent, absent, and/or irregular menstrual periods
Hirsutism (HER-suh-tiz-um) — increased hair growth on the face, chest, stomach, back, thumbs, or toes
Cysts on the ovaries
Acne, oily skin, or dandruff
Weight gain or obesity, usually with extra weight around the waist
Male-pattern baldness or thinning hair
Patches of skin on the neck, arms, breasts, or thighs that are thick and dark brown or black
Skin tags — excess flaps of skin in the armpits or neck area
Pelvic pain
Anxiety or depression
Sleep apnea — when breathing stops for short periods of time while asleep

More information can be found here: http://www.pcosaa.org

Questions About Fertility?

In our effort to provide you with more information about infertility, we have created a “Learning About Fertility” section on our site so that you can better understand the different elements involved with fertility treatments.

We hope you’ll find that this section will help: answer questions; recommend books from reliable, credible sources; confirm or deny historical infertility myths; define terms used in the language of infertility and also provide some interactive forums for you to ask questions; solicit input and provide us with information about yourself, if desired.

Your First Visit

Taking the first steps on the path to seeing a fertility specialist may be difficult or even overwhelming.

Knowing what to expect at your first visit may offer reassurance and help alleviate some of these concerns. Below is a video that tells what you can expect at your first visit.

At the Center for Advanced Reproductive Services, we strive to make this a comfortable, stress-free process for all of our patients.

We offer free fertility phone consultations for patients at different points in their fertility journey. Your fertility phone consultation will be an opportunity for you to obtain information about our program and learn about general treatment options. Simply fill out this form to request your free fertility consultation.

New Research: Male Infertility

HD690720spermSperm’s Anti-Germ ‘Shield’ Might Play Role in Fertility
(Published in U.S. News and World Report – HealthDay by Randy Dotinga)

Preliminary new research points to the possibility that some infertile men could benefit from boosting a protein shield that protects sperm cells from germs. While it’s too early to know if the research will lead to any new treatments, one infertility expert said that any treatment would most likely be applied only to sperm used in the process of in-vitro fertilization.

Still, the expert, Gary Cherr of the University of California, Davis, noted that “this study adds another piece to the puzzle” surrounding men who are infertile for no apparent reason because it suggests something may be wrong with the germ-fighting sperm shield.

At issue in the new study are proteins known as defensins, which provide protection against germs. In particular, the researchers looked at one protein known as human beta-defensin 1, which is found in a variety of types of tissue in the body, “but its role in the male reproductive tract is not clear,” said study co-author Hsiao Chang Chan, a professor at the school of biomedical sciences at the Chinese University of Hong Kong.

Other research has suggested that men may become less fertile if these proteins are missing. Cherr noted, “Sperm would need antimicrobial protection from microbes that are present in the female reproductive tract.” This fact raises the possibility that boosting the levels of the proteins would provide more protection against germs as sperm try to survive long enough to fertilize a female egg. The new study tested this idea in the laboratory.

The researchers checked the levels of human beta-defensin 1 in the sperm cells of men who suffered from poor sperm motility (asthenozoospermia), meaning that their sperm don’t move properly, or a fairly common infection within the genital tract known as leukocytospermia. The investigators found that the protein levels were lower than in men without fertility problems.

The researchers also boosted the levels of the protein in the sperm cells and found they moved more efficiently, had greater germ-fighting powers and could penetrate eggs more effectively. Chan said the researchers included the sperm of 325 infertile men and 190 fertile men. The next steps are to continue research and understand whether boosting the levels of the protein is safe, Chan noted.

Other questions remain as well. Cherr, who studies infertility and is a professor of environmental toxicology and nutrition at UC Davis, said it’s not clear why boosting human beta-defensin 1 on sperm would have an effect on fertility since the protein is found in the female reproductive tract also and would presumably fight germs there. An estimated 10 percent to 15 percent of couples are infertile, the study authors noted. According to the American Society for Reproductive Medicine, men are fully or partially responsible for infertility in 40 percent of couples who are unable to conceive.

The study is published in the Aug. 13 issue of Science Translational Medicine.

Expecting Better 2014

The National Partnership for Women & Families did a state-by-state analysis of laws that help employed mothers and fathers when a new child arrives. The good news? Connecticut ranked 2nd, just behind California. The bad? No state is doing enough.

Read the article below from The National Partnership for Women & Families.

ExpectingBetter

A new state-by-state analysis released just days before a major White House convening focused on working families shows how little the nation supports and protects employed mothers and fathers when a new child arrives. The study, Expecting Better: A State-by-State Analysis of Laws That Help New Parents, is the most comprehensive analysis to date of state laws and regulations governing paid leave and workplace rights for new parents in the United States.

The analysis was conducted by the National Partnership for Women & Families. The full report, which grades all 50 states and the District of Columbia based on enactment of select laws that expand upon federal leave and workplace protections, can be found here. California earned the highest grade, receiving an “A-.” Eleven states earned a grade of “B;” eight states earned a grade of “C;’ and 14 states earned a grade of “D.” Seventeen states received failing grades for not having enacted a single policy to help new parents who are in the workforce.

“New mothers and fathers should not have to experience financial hardship at what should be one of the happiest times of their lives,” said National Partnership President Debra L. Ness. “Yet tens of millions of expecting and new parents struggle because our nation fails to provide paid leave and other basic workplace protections. As the president, lawmakers, businesses, workers and advocates gather in the nation’s capital next week to discuss these issues, this study shows how much work lies ahead. America’s families expect and deserve much better. We need national family friendly workplace standards now.”

Ness will be participating in the White House event on Monday to discuss the benefits to businesses, workers, families, communities and the country when employers adopt – and lawmakers enact – family friendly programs and policies.

Public support for family friendly policies like paid family and medical leave, paid sick days, and pregnancy accommodations is strong. A growing body of evidence shows that they promote the health and economic security of families and strengthen businesses and the economy. Yet Expecting Better finds that no state is doing enough to provide these basic workplace supports. Most states are doing something to expand upon minimal federal protections, but not nearly all they could.

“This report shows that progress toward a family friendly America is possible, and history demonstrates that state activity can pave the way while providing needed support to working families,” explained Ness. “But the ability of working people in this country, including new and expecting parents, to manage their responsibilities at home and on the job should not depend on where they live. Lawmakers at all levels should take a close look at this study and the evidence that shows the benefits of providing leave and other workplace protections, and then move quickly to establish the standards people urgently need and deserve.”

At the national level, attention to and support for policies that support new and expecting parents has increased in recent years. Hundreds of organizations including the National Partnership are calling on Congress to pass legislation that would establish federal-level protections, including: the Family And Medical Insurance Leave (FAMILY) Act, which would establish a national paid family and medical leave insurance program; the Healthy Families Act, which would set a national paid sick days standard; and the Pregnant Workers Fairness Act, which would help to combat pregnancy discrimination.

President Obama recently called for family friendly workplace policies, including in his State of the Union address this year. For the fifth year in a row, his budget includes a state paid leave fund that would help support states that want to create their own paid leave programs. Only California, New Jersey and Rhode Island currently have paid family leave insurance programs. And the White House Summit on Working Families on Monday will showcase policies that would help working parents and families while bringing the country’s public policies in line with the rest of the world. Members of Congress are also increasingly discussing the challenges working families face.

The United States is one of few countries that do not guarantee working people access to paid leave. Paid leave for new mothers is guaranteed in 181 other nations, and 81 nations guarantee paid leave for new fathers. The United States guarantees neither and has just three national laws – addressing pregnancy discrimination, unpaid family and medical leave, and nursing mother’s rights at work – that help some new and expecting parents. The federal Family and Medical Leave Act provides new parents up to 12 weeks of unpaid leave, but just under 60 percent of the workforce is eligible for its protections and many cannot afford to take the unpaid leave it provides.

To determine the state grades included in this third edition of Expecting Better, the National Partnership reviewed different but overlapping public policies aimed at helping new parents in each state and the District of Columbia. It looked at laws governing both private sector and public sector state employees. The full report is available at www.NationalPartnership.org/ExpectingBetter.

 

 

Academics & Research

Did you know that the Center for Advanced Reproductive Services is a vital part of the University of Connecticut School of Medicine? We are responsible for running the fellowship program in Reproductive Endocrinology and Infertility, which offers one of less than 40 postgraduate fellowships for Reproductive Endocrinology and Infertility (REI) in the United States. Due to The Center’s national reputation as a “Center of Excellence” acceptance to one of our fellowship positions is very competitive.

More information here: http://fertilitycenter-uconn.org/about-us/academics-research/