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Low DHEA Levels Linked to Aging, Infertility

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premature ovarian failureAn important, naturally produced steroid in female bodies, dehydroepiandrosterone (DHEA), begins to decline after women enter their twenties and continues to do so through the aging process. Studies have shown low levels of DHEA can speed up a variety of health problems normally seen in older patients such as cancer, heart disease, dementia, and premature infertility.

DHEA is normally secreted by the adrenal gland. Over the last few decades, scientist have been working to reverse the cycle for women who suffer low DHEA levels and have developed various ways to use the hormone for infertility treatments.

Since 2000, DHEA supplementation has been used as a remedy for premature ovarian failure, also known as primary ovarian insufficiency, a condition where females lose ovarian function before the age of 40. According to New York’s Center for Human Reproduction, premature ovarian failure can affect women at various ages from teenage years to thirties.

Women with the condition are at a greater risk of a range of health issues, including osteoporosis, estrogen deficiency (hot flushes, vaginal dryness, etc.) and heart diseases. These issues can usually be managed well with hormonal replacement. However, in an infertility context, premature ovarian failure poses a challenge, as the loss of ovarian function means that the probability of pregnancy in women with the condition is greatly reduced.

Although it is sometimes called early menopause, premature ovarian failure is different from menopause because it is not a result of natural aging process of a woman. They are distinct because women with the condition may continue to have menstrual cycles, though they may be irregular, which means a small percentage of women with premature ovarian failure can conceive naturally.


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Award-Winning CHR Paper Gives Hope to IVF Patients with Low AMH Levels

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CHRJune 11, 2012 (New York, NY) – A recent paper(1) by researchers at the Center for Human Reproduction (CHR) in New York City – which describes reasonable live birth chances in women with extremely low ovarian reserve – received the prestigious Austrian Hugo Husslein Prize. The prize is awarded biannually by the Austrian Society of Obstetrics and Gynecology.

The paper, published in the journal Human Reproduction, reports on the “moderate but reasonable” live birth chances in women with extremely low ovarian reserve, demonstrated by either completely undetectable or very low anti-Müllerian hormone (AMH) levels. Women in the study were also older, with mean age approaching 41. Despite these poor prognostic indicators, the authors were able to establish clinical pregnancies in 15.6% of these women.

“With extremely low serum AMH levels, moderate but reasonable pregnancy and live birth rates are still possible. Extremely low AMH levels do not appear to represent an appropriate marker for withholding fertility treatment,” concluded the paper.

Based on CHR’s protocol, women in the study received DHEA supplementation prior to starting their IVF cycles. While the result of this study may not be applicable to women without DHEA supplementation, the results brings hope to women struggling to achieve pregnancy after 40, as well as to younger women with premature ovarian aging (POA).

“It was a great honor to receive the prize,” says Andrea Weghofer, MD, Associate Professor of Obstetrics and Gynecology, Medical University Vienna – a Visiting Associate Scientist at CHR and lead author of the study. She continues: “but the real honor was in demonstrating that these women, who are likely to be turned away by most fertility centers based on poor prognosis, can still be helped with their own eggs with reasonable success rates.”

“This really echoes our philosophy at CHR,” adds Norbert Gleicher, MD, Medical Director and Chief Scientist of CHR. “We never turn away patients who fully understand their limited chances, and our entire clinical team literally fights for every egg and every embryo.”

CHR, over the years, has made many breakthroughs in treating women with poor prognosis, who failed at other centers or have been refused treatments because of presumed small chances. The center’s IVF success rates in such patients have been improving year to year, reaching another record height in 2011.

(1)Weghofer A, Dietrich W, Barad DH, Gleicher N. Live birth chances in women with extremely low serum anti-Müllerian hormone levels. Hum Reprod 2011;26(7):1905-9.

 

About Center for Human Reproduction

The Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com/), is one of the world’s leading fertility centers in New York City with international patient following. CHR has a worldwide reputation as the “fertility center of last resort,” specializing in treatment of infertility in women with diminished ovarian reserve due to advanced age or due to premature ovarian aging (POA). Dr. Weghofer and Dr. Gleicher are available for further comments.


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NY Fertility Clinic Sees Huge Increase in IVF Success Rates in Women Over 44

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June 4, 2012 (New York, NY) – Center for Human Reproduction (CHR), a New York fertility center with special expertise in treating CHRwomen with “older-behaving” ovaries, reported significantly improved ongoing clinical pregnancy rates for 2011 at practically all age groups. The improvement was, however, most pronounced in women above age 44 years, where the rate doubled from the previous year.

Pregnancy rates are calculated by dividing the number of clinical pregnancies by that of embryo transfers. While most age groups saw increases in IVF pregnancy rates, the most dramatic improvement in pregnancy rates were observed in women at ages 44-49, where pregnancy rates increased to 10.3%.

“This pregnancy rate for women 44-49 is almost unbelievable, considering that patients at these ages, at most other IVF centers in the world, are no longer even given the chance of pregnancy with use of their own eggs and are usually advised to use donor eggs, “ notes David H. Barad, MD, Director of Clinical ART at CHR. “These results reflect our center’s fight for every egg and every embryo in older women seeking fertility treatment, based on the accumulated results of very active, decade-long research in how to successfully treat ‘older’ ovaries.”

In concentrating most of the center’s research on “older-behaving” ovaries, CHR developed many major clinical breakthroughs, like DHEA (androgen) supplementation, which has since become standard treatment around the world. CHR investigators also recently confirmed the importance of androgens (male hormones) for follicle and egg maturation.

“What makes these pregnancy rates even more remarkable are the patients in whom we achieved them,” adds Norbert Gleicher, MD, Medical Director and Chief Scientist of CHR. As a result of premature ovarian aging (POA), even younger patients of CHR, in most cases, have ovaries that behave like those of much older women.”  Dr. Gleicher continues: “The majority of our patients have previously failed IVF cycles elsewhere, and have been turned away by other fertility centers as ‘hopeless’ unless willing to use donor eggs. CHR was their fertility center of last resort. Achieving pregnancies at these rates in these women is practically unprecedented.”

 

About Center for Human Reproduction

The Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com), is one of the world’s leading fertility centers, with, currently, over half of the center’s patients coming from outside the larger New York tristate area, approximately a quarter from overseas and Canada. CHR has a worldwide reputation as the “fertility center of last resort,” specializing in treatment of infertility in women with diminished ovarian reserve due to advanced age or, in  younger women, due to premature ovarian aging (POA).

Dr. Gleicher and Dr. Barad are available for further comments.


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Infertility Treatment Leader CHR to Collaborate with University of Rochester School of Medicine and Dentistry

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May 10, 2012 (New York, NY) – The Center for Human Reproduction (CHR), a prominent New York City-based clinical and research center specializing in female and male infertility treatment, announced a research collaboration agreement with the University of Rochester School of Medicine and Dentistry (URSMD) to commence on July 1st, 2012. This collaborative effort between investigators at URSMD and CHR aims to combine two institutions with strong common interests and expertise in exploring the process of follicle maturation, and especially the role of androgens in female reproduction.

Lead investigators are Aritro Sen, PhD, Research Assistant Professor, and Stephen R. Hammes, MD, PhD, Professor, both in the Division of Endocrinology and Metabolism at URSMD and who have published pioneering work on the subject in a rodent model; and Norbert Gleicher, MD, CHR’s Chief Scientist, and David H. Barad, MD, MS, Senior Scientist at CHR, who by introducing the androgen dehydroepiandrosterone (DHEA) into infertility treatment have revolutionized the treatment of women with low ovarian reserve worldwide.

“The goal of this research collaboration is to combine complementary animal and laboratory expertise at URSMD with clinical expertise at CHR,” explains Dr. Gleicher. “By combining research in URSMD’s unique animal model and CHR’s large clinical human experience, we aim to better understand how DHEA, as well as other androgens, improves female fertility.”

“This is a very exciting development,” adds Dr. Barad. “We have known for years now that DHEA improves pregnancy chances but only very recently learned that this very likely occurs through conversion of DHEA to testosterone. For all practical purposes, this means that the process very likely involves the androgen receptor (AR) on granulosa cells.” Dr. Barad continues: “For this kind of work, our colleagues at URSMD have the ideal mouse model.”

Dr. Sen, who will become a Visiting Assistant Scientist at CHR, chimes in: “we are very much looking forward to this collaboration, which should be very beneficial for both institutions.”

 

About Center for Human Reproduction
Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com) is a leading fertility center in New York City with a worldwide reputation as a “fertility center of last resort,” offering cutting-edge, research-based treatment options to infertility patients. CHR introduced DHEA supplementation into infertility care in 2004. Dr. Gleicher, Dr. Barad and Dr. Sen are available for additional comments.


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FERTINATAL™ DHEA Supplement for Diminished Ovarian Reserve Hits the Market

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FertinatalApril 13, 2012 (New York, NY) – FERTINATAL™, the first and only dehydroepiandrosterone (DHEA) nutritional supplement designed to enhance female fertility, has entered the market today.

The launch took longer than expected, because Fertility Nutraceuticals, LLC – which developed the supplement – made unusual efforts to ensure that FERTINATAL™ DHEA for women would fulfill all of the required specifications which the product was designed for, with consistency across every tablet, according to Fertility Nutraceuticals. The required repeat rounds of quality-assurance testing at independent laboratories delayed the launch, initially scheduled for January.

“It was extremely frustrating, especially since we have seen increasing demand since we announced FERTINATAL last December,” notes Yu Kizawa, the company’s Director of Marketing and Sales. “Now, we are excited to be able to offer probably the most reliable micronized DHEA product on the market, and the only one specifically designed for women who have a difficult time conceiving.”

FERTINATAL™ was developed with strict adherence to the specifications of the Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com), a research-driven fertility center in New York City that introduced DHEA supplementation for women with diminished ovarian reserve. Because of the high quality standard of FERTINATAL™, CHR, the only holder of female fertility-related U.S. patents for DHEA supplementation, endorses FERTINATAL™.

“Over-the-counter DHEA products can be very inconsistent in quality, even within the same brand,” explains Norbert Gleicher, MD, medical director of CHR. “Based on the unique quality control process of FERTINATAL™, we are confident that this new product will deliver the kind of consistency and quality we, up to this point, have been able to achieve only through pharmacy-compounded DHEA by prescription.  We, therefore, feel confident in endorsing FERTINATAL™.”

FERTINATAL™ is available for purchase at $69.50 per box (a one-month supply), online at http://www.fertinatal.com.

 

About Fertility Nutraceuticals, LLC
Fertiltiy Nutraceuticals, LLC, is a company specializing in nutritional supplements for women in reproductive years. The company is dedicated to developing highest-quality nutritional supplements for women with fertility problems, trying to achieve healthy pregnancies. FERTINATAL™ is the company’s first product, with additional products planned for rollout throughout 2012.


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Efficacy of “Mini IVF” Under Question, New Study at Center for Human Reproduction Reveals

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CHRApril 4, 2012 (New York, NY) —A new study by New York’s Center for Human Reproduction (CHR) has cast doubts on the efficacy of low intensity IVF (LI-IVF) programs, marketed under various names like “mini IVF” and “natural IVF.” According to the study, LI-IVF programs, which utilize lower doses of fertility medications to reduce costs and monitoring visits, do not live up to their proponents’ claims of pregnancy rates comparable to those in conventional low cost IVF.

To evaluate the claims that LI-IVF is more economical and more “patient-friendly,” researchers at CHR matched patients in LI-IVF cycles to comparable patients undergoing traditional IVF cycles. In the resulting study, just published online in the medical journal Reproductive Biomedicine Online1, patients in LI-IVF cycles produced significantly fewer oocytes and embryos, and faced much lower pregnancy rates. Lower pregnancy rates for LI-IVF patients were observed both in initial IVF cycles and cumulatively, taking account of subsequent transfers of cryopreserved embryos.

Most surprisingly, however, when overall costs to achieve a pregnancy were compared, highly touted “cost savings” with LI-IVF were nowhere to be observed. Lower pregnancy rates associated with LI-IVF meant that LI-IVF patients on average needed more cycles to have a take-home baby, which meant the lower per-cycle cost of LI-IVF did not translate into lower cost to achieve a successful pregnancy and delivery. Patients in LI-IVF cycles also took longer to conceive.

“LI-IVF appears to reduce pregnancy chances and prolong time to conception without offering any appreciable compensatory financial benefits,” summarizes Norbert Gleicher, MD, the study’s lead author and medical director of CHR. “When patients started asking for LI-IVF at our center, we, like many other IVF centers, decided to offer the procedure. In contrast to other centers, we, however, explained to our patients that LI-IVF should still be considered ‘experimental’ since no data existed, that compared this method of IVF to standard IVF.”

CHR required that patients sign “experimental” informed consents, and started accumulating outcome data.  Dr. Gleicher now notes: “As the result of our study well demonstrates, doing otherwise would have been rather unethical.”

“We must caution patients against resorting to ‘mini IVF’ or ‘natural IVF’ without carefully weighing their options,” warns David Barad, MD, another author of the study and director of clinical ART at CHR. “Until more data becomes available, physicians should offer LI-IVF only as an experimental procedure.”

1Gleicher N et al., A case-control pilot study of low-intensity IVF in good-prognosis patients. Reprod Biomed Online 2012; In press. [Epub ahead of print].

 

About Center for Human Reproduction
Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com) is a leading fertility center in New York City with a worldwide reputation as a “fertility center of last resort,” offering cutting-edge, research-based treatment options to patients with even the most complex cases of infertility. Dr. Gleicher and Dr. Barad are available for additional comments.

Posted in: Infertility

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Sofia Vergara Plans for Pregnancy After 40: InStyle Interview

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The beautiful Modern Family star opened up to InStyle magazine about her relationship with boyfriend Nick Loeb and planning for pregnancy after 40.

 

“I guess I am going to think about freezing my eggs,” mused Sofia in the April edition of the magazine. Sofia will be turning 40 this July, but says she is in no rush to start a family with Loeb.

 

Sofia, who is like many other celebrities that wait to have their first pregnancy after 40, is referring to a relatively new reproductive “anti-aging” technique where your eggs can be harvested from your ovaries and literally frozen in time until you are ready to use them.

 

“[Egg freezing] an insurance policy that you may or may not actually ever need,” explains Dr. Eric Windra of the Society for Assisted Reproduction to NPR. As a woman ages, the quality of her eggs declines placing her at significant risk for infertility by the time she is 40. By removing the the eggs from the body early on and freezing them, a women doesn’t have to worry about loosing the reproductive potential of her own eggs.  Then, when she decides that she are ready to get pregnant and should she have trouble doing so naturally, her frozen eggs can be thawed and used in an in vitro fertilization (IVF) procedure.

 

‘Why not?’,” said Sally Montgomery, a 30-something New Yorker who underwent the egg freezing procedure, to the NPR in an interview that was published last year.  ” I don’t think it’s a guarantee, but it’s a nice insurance policy, and I think it takes some of the pressure off.”

 

Other fertility treatment options for women trying to achieve a pregnancy after 40 include the use of donor eggs. However, with donor eggs the resulting child will have no genetic connection to the mother.

 

As for Sofia, she doesn’t seem all to concerned with her age, or starting a family, at this moment. “I don’t really care,” said Sofia when asked about how she feels about aging. “But doesn’t that sound hideous? I remember thinking when my mom was 40 that she was already done.”

Posted in: Infertility

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Detecting and Treating High FSH Levels Ahead of Time

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Though the chances of a woman getting pregnant drop significantly after age 35 and even more so after 40, a great many women are still able to conceive naturally after that age, and many more do so by turning to IVF treatments.

Couples looking to have children later in life can prepare themselves ahead of time for the possibility of infertility by taking a simple blood test. The FSH hormone test measures the amount of follicle-stimulating hormone (FSH) and gives doctors an idea of how sensitive the ovaries are prior to being stimulated. The test can help find the cause of infertility by evaluating egg supply in women and sperm count in men.

In women, FSH helps control the menstrual cycle and the ovaries’ production of eggs, while in men it helps control sperm production. Though the amount of FSH hormone in men normally remains contact, FSH levels vary throughout a woman’s menstrual cycle.

When dealing with follicle-stimulating hormone levels, lower numbers are always better. High FSH levels indicate poor ovarian reserve and suggest the eggs have a reduced ability to fertilize.

Women with high FSH levels, however, should not lose hope, as there are simple techniques available for bringing those levels down by improving the health of the ovaries. These include exercise, detoxification, and even acupuncture.

Taking part in activities such as yoga, walking, and low-impact aerobics is a good way to improve blood flow. This ensures that a steady supply of hormones and nutrients is reaching the ovaries and tells your body to stop producing FSH.

Similar to the effects of exercise on the body, acupuncture therapy is also known to increase blood circulation. In addition, research has shown that women undergoing fertility treatments have a somewhat higher chance of conceiving if they are receiving regular acupuncture treatments.

Finally, it is important to cleanse the body of any chemicals that may be disturbing regular hormone production, seeing as less follicle-stimulating hormone is produced when the ovaries are healthy. Establishing better health starts with the foods we eat, and women seeking to lower FSH hormone levels should stay away from caffeine and limit consumption of salty foods, as well as trans and saturated fat. It is also recommended to eat more vegetables and take plenty of vitamins and iron.


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Fertility Nutraceuticals, LLC Launches FERTINATAL Micronized DHEA Supplement for Enhanced Female Fertility

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FertinatalDecember 22, 2011 (New York, NY) – Fertility Nutraceuticals, LLC – a company specializing in nutritional supplements for women and female fertility enhancement – is announcing the launch of FERTINATALTM micronized dehydroepiandrosterone (DHEA) supplement.  The high-quality DHEA supplement is designed to augment female fertility.

Intrigued by anecdotal evidence received from one of their patients, physicians at New York’s Center for Human Reproduction (CHR) – a leading fertility and research center – initiated research on the relationship between DHEA supplementation and enhanced female fertility.  Although research on the effects of DHEA is still limited, the published results of CHR’s studies are encouraging.

FERTINATALTM was developed to offer the public exactly the same kind of DHEA utilized by CHR in the center’s research studies.  The product features the highest quality control standards, including a triple-step testing process with batch-testing by independent laboratories.  Furthermore, FERTINATALTM is micronized to the same particle sizes as used in those studies. The product’s three-step testing process ensures that FERTINATALTM delivers on its three promises: a plant-derived DHEA product of highest quality, micronized to appropriate sizes for good absorption.

FERTINATAL™ is the first DHEA supplement exclusively designed for women and female fertility enhancement.  To improve convenience, it is uniquely packaged in individual blister sheets, each containing seven (7) rows of three (3) daily tablets, representing one week of the suggested supply of DHEA supplementation.  Each box of FERTINATALTM contains four of these blister sheets (a four-week supply).  FERTINATAL™ is not intended for individuals under the age of 18, and potential side effects are described on the product’s packaging.

FERTINATALTM will become available exclusively through Fertility Nutraceuticals, LLC in January 2012.

 

About Fertility Nutraceuticals, LLC
Fertility Nutraceuticals, LLC is a newly established company exclusively dedicated to nutritional supplements for women and enhanced female fertility.  FERTINATAL™ DHEA supplement is the company’s first product, with as many as 2-3 additional products expected to arrive throughout 2012.  For more information, visit http://www.fertinatal.com.


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Will the Infertility Treatment Tax Credit Have Age Restrictions?

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On Wednesday house democrats presented an infertility treatment tax credit bill to the U.S. House of Representative, which would grant eligible taxpayers a tax credit for infertility medical treatment expense.

Under this bill, which has been named the “Family Act of 2011”, people using infertility treatments would get a tax credit of 50 percent of qualified expenses. The expenses could not be more than $26,720 in total, which equals a maximum tax credit of $13,000 per person.

The fact is that insurance coverage for infertility is rare leaving many couples to have to undertake the full cost of treatment, which can be very difficult to pay out of pocket.  For example, a standard egg donation program costs around $20,000. However, the Center for Human Reproduction, Egg donation and IVF New York specialist, began offering a discount egg donor program at half the cost. With the tax credit this option is even more reasonable.

However, it is not clear if there will be eligibility restrictions, apart from being a taxpayer.  As many women are waiting to have children until an age where they are more likely to deal with fertility problems, this tax credit, if passed with few eligibility restrictions, can have significant implications to women of all ages, struggling with fertility.


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