Conceivability_What I Learned Exploring the Frontiers of Fertility

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by Elizabeth L. Katkin


  cummings, e. e., 115

  custody issues, 120, 121

  Cyprus, 117

  cystic fibrosis, 78, 149, 155

  cysts, ovarian, 10–12, 97

  cytoplasmic transfer, 231

  DeCherney, Alan, 184

  Denmark, 128, 154

  depression:

  effect of Clomid on, 8

  and PCOS, 10–11

  detox plan, 138–39, 140

  dietary therapy, 28

  diethylstilbestrol (DES) hormone, 96, 102

  dilation and curettage (D&C), 42, 94, 95, 131

  Dillard, James, 26

  Dinesen, Isak, 85

  Discovery Communications, 220

  DNA:

  and blastocysts, 81

  and citizenship issues, 195

  creation of, by meiosis, 201

  and genetic mutations, 78, 230–31

  importance of folate to, 204

  testing, and children of donors, 151

  use of gene editor for, 233

  Donor Sibling Registry (DSR), 152–53

  Down syndrome, 66

  drugs, see fertility drugs; specific drugs

  Dubai, 193

  Eastern fertility treatments:

  complementary and alternative therapies, xv, 14, 22–33

  vs. Western, 27–30, 33

  Edwards, Robert, 174

  egg donors and donation:

  and anonymity, 150, 152–53, 155, 195

  compensation for, 170–72

  cost of, in US, 179

  profitability of, for clinic, 185

  quality of, and success rate, xix

  same-sex couples, 157–58

  selection of, 157–61

  and surrogacy, 134–48, 134–53

  as third-party parenting, 14

  eggs, maternal:

  age of, and meiotic errors, 80

  assessing quantity of, 15, 17

  changes in over time, xvii, xix, 137–38

  different medical perspectives on, xvi

  environmental factors affecting, xix, 203–7

  improving quality of, 11, 94, 200–203

  Eggtivin therapy, 214

  Egli, Dieter, 232

  elective single embryo transfers (eSETS), 191

  electroacupuncture, 29

  Eliot, George, 198

  embryologists, 184, 216, 223–24

  embryos:

  cost of donation of, in US, 179

  creation of, and use of federal funds, 176

  disposition of unused, 227–28

  elective single embryo transfers (eSETS), 191

  euploid, 82

  mosaic, 79–82, 199–200

  storage of, 228

  success rate of donated, 229

  transfer of frozen, 60–62

  endocrine disorder, PCOS as, 97

  endocrine disruptors, 203–4

  Endocrine Society, 203–4

  endocrinologists, 185

  endometrium, 8, 28, 31, 61, 67, 98, 122, 208

  endorphins, 31

  environment and impact upon healthy eggs, 203–7

  estradiol (E2), 15

  estrogen:

  acceptable level of, for IVF, 64

  early use of, in IVF research, 174

  effect of BPA on, 205

  effect of Clomid on, 8

  effect of letrozole on, 8

  effect of Progynova, 8

  ethics:

  of donated embryos, 229

  of gene editing, 233

  and lack of federal funding, 234

  Lister Fertility Clinic and surrogacy, 117–18, 142

  of mitochondrial donation, 232

  of number of embryos that may be transferred, 167–68

  of reproductive technology, xix

  of spindle nuclear transfer, 231

  of surrogacy, 128

  Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 184

  euploid embryos, 82

  Facebook:

  advertisements for donors on, 150

  and fertility treatments benefits, 220

  Facebook Live, 183

  family balancing, 193

  Fauser, Bart, 207, 209

  federal support for research, lack of, 176, 234

  Federal Trade Commission (FTC), 165

  Femara (letrozole), 11–12, 97, 172, 209

  Fertile Thoughts, 224

  Fertility and Sterility, 184, 225

  Fertility Authority, 224

  fertility clinics:

  and blastocyst transfers, 76

  “cherry-picking” patients, 182, 189, 223

  as commercial industry, 178, 184–89

  conflict of interest issues, 165, 185–87

  cost of successful treatment, 179

  on embryos and PGS, 83

  evaluating, 65, 70–72, 164, 167

  level of technology in, 83–84

  up-to-date protocols and success, 74, 92

  use of advertising, 165, 185

  use of PGS, 66, 83, 92

  see also success rates; specific clinics and countries

  Fertility Clinic Success Rate and Certification Act (1992), 165

  fertility drugs:

  cost of, in US, 179

  global cost of, 178

  and possible link with cancer, 173

  shopping around for, 219–20

  see also specific drugs

  Fertility Friends, 224

  FertilityIQ, 220, 225

  Fertility.org, 224

  fertility patients:

  assessing clinics’ success rates, 3, 19, 70

  and information from doctors, 221–24

  information gathering and sharing among, 221–22, 224–25

  fertility specialists:

  conflict of interests among, 185

  evaluating, 65, 70–72, 74

  first visit to, 15–18

  and sharing information with patients, 221–24

  fertility tourism, 192–97, 221

  fertility treatments:

  advantage of low-cost IVF vs. regular, 209–10

  cost of, in US, 178–79

  Eastern vs. Western, 27–30, 33

  five categories of, 14

  loans and lotteries to pay for, 180–84

  see also insurance; specific treatments

  Fetal Medicine Centre, 40, 86

  Fett, Rebecca, 206–7

  Finland, 150

  fluorescence in situ hybridization (FISH) testing, 79, 80, 83, 199

  folic acid, 204

  follicles:

  active, in ovaries, 18

  antral, 15

  definition of, 10

  follicle stimulating hormone (FSH; Puregon), 8, 15–16, 17, 20, 57, 73, 97, 138

  and inhibin level, 213

  follicular phase of menstrual cycle, 98

  Follistim, 20, 57

  Food and Drug Administration (FDA):

  approves Clomid, 7

  approves IVIG, 111

  approves letrozole, 11

  bans LIT, 109

  regulation of egg and sperm donation, 148, 149

  regulation of IVF treatment, 166, 173

  stops cytoplasmic transfer, 231–32

  Fortune, 220

  France, 128, 217

  Francis Crick Institute, 233

  Frankfurt, University of, 67

  Friends (TV show), 127

  frozen embryo transfer, 60–62

  FSH, see follicle stimulating hormone

  gamete donation and storage, 166

  ganirelix (GnRH antagonist) protocol, 58, 73

  gender selection, 53, 193

  gene editing, 229, 233–34

  GENERA Centres for Reproductive Medicine, 73

  Genesis Genetics Institute, 92

  genetic diseases and testing:

  cost of, 179

  mitochondrial donation to prevent, 232

  through PGS, 68

  geneticists, 216

 
Georgia, 129, 226

  Germany, 128, 150, 192

  germ modification, 231

  gestational surrogacy, 117, 127–33, 225

  Giambi, Jason, 9

  global fertility services market, 178

  Glucophage (metformin), 97–98

  GnRH agonist (Lupron downregulation) protocol, 73, 74, 173

  GnRH antagonist (ganirelix) protocol, 58, 73

  gonadotropin-releasing hormone (GnRH), 58, 209

  lack of, in natural IVF, 211

  gonadotropins (superovulatory drugs), 20–21, 31

  Gonal-f, 20, 57, 144

  Google Baby (documentary), 193

  Gordon, Louisa, 29

  Gregorie, Jane, 8, 28, 30

  Grifo, Jamie, 33

  Groundhog Day (movie), 76

  Hagar (Biblical figure), 127

  hair growth, excessive, 10

  Hammurabi, King, law code of, 127

  Harley Street, 40, 46, 57

  Harvard Medical School, 118, 174, 185

  Harvard T. H. Chan School of Public Health, 205

  Harvard University, 78, 212

  Hastings Center, 192

  Hawaii, 129, 226

  HCG (human chorionic gonadotropin), 58, 73–74

  headaches, 4, 8, 23–24, 163

  Health Department, US, 176

  heart defects, 149

  Heel (German company), 138

  heparin (Clexane; Lovenox), 53, 55, 59, 68, 95, 106–7, 112, 113–14

  herbs, 27, 28, 30, 105

  high-resolution next generation sequencing (hrNGS; PGS 2.0), 80–81, 82, 83

  HIV, 149, 154

  Homeland Security Department, US, 197

  homeopathic remedies, 138

  hormones:

  assessment of, at first visit to fertility specialist, 15–18

  discovery of, 7–8

  imbalances in, as cause of miscarriage, 96–100

  to improve egg quality, 212–14

  to stimulate breastfeeding, 124

  see also specific hormones

  House That Glue Built, The (Williams), 13

  Hoylman, Brad, 129

  HPO axis, 31

  HRC Fertility, 193

  hrNGS (high-resolution next generation sequencing; PGS 2.0), 80–81, 82, 83

  Hughes, Mark, 78, 92

  human chorionic gonadotropin (HCG), 58, 73–74

  Human Fertilisation and Embryology Authority (HFEA), 149, 175

  Hunter, John, 154

  hypertrophic cardiomyopathy, 233

  hypothalmic amenorrhea, 28

  hysterosalpingogram (HSG), 69, 101, 102, 103

  hysteroscopic metroplasty, 103

  Illinois, 128, 217, 218, 226

  Immigration and Nationality Act, 195

  immune system:

  and APS, 53

  problems related to recurrent miscarriage, 107–10

  suppression of, by IVIG, 67

  Imperial College London, 87, 189

  India, 144, 192, 193, 203

  infectious diseases, 149

  infertility:

  Clomid as treatment for, 5, 6, 9–10

  effect upon sex life, 47

  initial assessment of and treatments for, 19–20

  IUI not recommended for unexplained, 50

  and maternal age, 19

  and PCOS, 10

  philosophies on treating, xvi

  polycystic ovarian syndrome as cause of, 3–4

  see also fertility clinics; fertility specialists; fertility treatments

  Infertility Cure, The (Lewis), 29

  information:

  gathering and sharing among patients, 221–22, 224–25

  researching adoption and surrogacy alternatives, 199

  sharing between doctors and patients, 221–24

  inhibin, 213

  Inhorn, Marcia, 193

  insomnia, 5

  insulin, in PCOS

  insurance, xviii, 17, 93, 112–13, 132, 153–54, 216

  impact of changing definition of success on, 191–92

  malpractice, 184

  for surrogacy, 132

  in US, 164–65, 180–81, 217–19

  Intel, 220

  intendedparents.com, 119, 120

  International Federation of Gynecology and Obstetrics, 203

  International Pharmacy Organisation, 219

  Internet:

  for adoption and surrogacy information, 119

  advertising for donors on, 171, 185

  for information for medical procedures, 222

  and state laws, 128

  intracytoplasmic sperm injection (ICSI), 19, 67–68, 179

  intrauterine insemination (IUI):

  combined with acupuncture and TCM, 32, 48

  cost of and success of, 49–50

  one of five main assisted-fertility treatments, 14

  intravenous immunoglobulin (IVIG), 67, 68, 108, 111–14

  invasive assisted reproductive technology, 14

  in vitro fertilization (IVF), 51–53, 63

  acupuncture and TCM to supplement, 22, 26, 29, 32–33

  aneuploidy cause of failed, 92, 199–201

  assessing risks of, 172–73

  basics, 56–60

  for blocked tubes, 19

  chromosomal abnormalities as possible result of, 202–3

  cost of and financing for, xviii, 179–84, 180

  definition of cycle in, 190–92

  ethics of, 53–54

  financial assistance for, 180–84

  and gestational surrogacy, 127–28

  lack of regulations for, 165–72, 165–73

  low dosage (“mini”), 207–10, 211, 220

  natural cycle, 210–12

  one of five main assisted-fertility treatments, 14

  philosophy of, xvi, 137–38

  possible changes in measuring success of, 190–92

  protocols for, 64, 72–74, 209, 211

  quantity vs. quality of eggs for, 18

  religious opposition to, 175

  risks of multiple pregnancies from, 168–69

  and superovulatory drugs, 20–21

  surrogacy and egg and sperm donation, 134–48

  techniques as possible cause of aneuploidy, 200–201

  travel for, 121–23, 125–26, 145–48

  use of blastocysts for, 60–62, 64, 65, 74–77

  use of PGS and PGD for, 66–68, 77–84

  see also Brown, Louise; fertility clinics; success rates

  Ireland, 128

  Israel:

  citizenship issues and surrogacy, 194–95

  fertility research in, 209

  fertility tourism, 221

  ordering drugs from, 220

  same-sex couples and surrogacy, 193

  studies on acupuncture and IUI, 32

  success rate of clinics, xviii, 135, 137, 192

  surrogacy restrictions in, 128

  Italy:

  research in, 73, 81, 203, 204

  restrictive laws in, 128, 150, 192

  It Starts with the Egg (Fett), 206–7

  IVF, see in vitro fertilization

  Ivy Leaguers, as egg donors, 171

  Japan:

  conflicting laws in, 150

  philosophy of egg quality in, 137–38, 203

  pioneer of natural cycle IVF, 210–11

  and studies on BPA, 205

  Jews, as egg donors, 171

  “Jobs With Infertility Coverage,” 220

  Johns Hopkins University, 212

  Joint Commission, 166

  Karolinska Institutet, 233

  karyomapping, 78

  Kass, Leon, 51

  Katya (translator), 140–41, 143, 146–47

  Keller, Helen, 134

  Kidman, Nicole, 115

  King’s College London, 232

  Kramer, Ryan, 152

  Kramer, Wendy, 152

  Krystos (shipping agent), 125

  Kushnir, Vitaly, 187, 188

  Lanner, Fre
drik, 233

  Lao Tzu, 45

  laws and legislation:

  determining parental rights, 225–33

  and Internet, 128

  regarding egg and sperm donation, 140, 144, 148–53

  regarding surrogacy in US, 119

  see also specific countries and states

  le Carré, John, 235

  Leech-Wilkinson catheter, 101, 102

  Legend, John, 53

  Legro, Richard, 11–12

  Leigh syndrome, 230

  letrozole (Femara), 11–12, 97, 172, 209

  Lewis, Randine, 29

  LH (luteinizing hormone), 8, 15, 97

  lifestyle modifications, 28, 138–40, 206–7

  Lister Fertility Clinic, 67, 68, 77, 84, 117–18, 142

  LIT (lymphocyte immune therapy), 109

  Lithwick, Dahlia, 186

  loans for fertility treatment, 181, 183

  Loeb, Nick, 228

  lottery for fertility treatments, 183–84

  Louisiana, 128

  Lovenox (heparin), 53, 55, 59, 68, 95, 106–7, 112, 113–14

  low dosage IVF (“mini”), 207–10, 211, 220

  Lupron downregulation (GnRH agonist) protocol, 73, 74, 173

  luring (advertising for egg donors), 171

  luteal phase deficiency (LPD), 98

  luteinizing hormone (LH), 8, 15, 97

  lymphocyte immune therapy (LIT), 109

  Maine, 226

  Malcolm X, 215

  male infertility:

  acupuncture and TCM to treat, 31

  IUI not recommended in UK for, 50

  malpractice insurance, 184

  Manchester Fertility, 183

  Manheimer, Joan, 151

  March of Dimes, 89

  Marfan syndrome, 155

  Marketdata Enterprises, 177

  Martine (acupuncturist), 141, 144

  Maryland, University of, School of Medicine at, 212

  maternal age:

  and blastocyst transfer, 76

  and effect upon fertility, 19

  and meiotic errors in egg, 80

  mosaicism not factor in, 80

  PGS and implantation rates, 83

  see also eggs, maternal

  Medicare, 217

  meditation, 28

  meiosis, 80

  impact of BPA on, 205, 206

  process of, 201–2

  Mendell, Patricia, 151–52

  Menogon, 20

  Menopur (FSH and LH), 20, 73

  menstrual cycle:

  effect of birth control pills on, 57

  FSH as primary hormone in, 16

  goal of TCM in regulating, 27, 32

  phases of, 98

  mental illness, 149

  mental retardation, 78

  Meridian Medical, 32

  meridians (pathways), 31

  metformin (Glucophage), 97–98

  metroplasty, 103

  Mexico:

  fertility tourism to, 192, 193, 221

  and spindle nuclear transfer, 177, 230–231

  Michigan, 128, 226

  microflare protocol, 73

  Middle East, 193

  Middlemarch (Eliot), 198

  mini IVF (low-dosage), 207–10, 211, 220

  minimally invasive fertility treatments (IUI), 14, 32, 45–50

 

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