Conceivability_What I Learned Exploring the Frontiers of Fertility
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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