Tuesday, September 30, 2008

Now, Fertility Spas


Blame it on that ever-expanding Jolie-Pitt brood: I've been reading lots of reports about the increasing popularity of fertility spa treatments. This is not limited to big cities, where career women may be postponing having children. In Ohio, BecomingMom, a "Pregnancy Spa and Imaging Center" offers a 50-minute Preconception Massage for $69, and Peaceful Beginnings in North Carolina offers the same at $40 for 30 minutes.
Many spas list causes of infertility as stress and accumulation of toxins, none of which are causes listed on the evidence based medicine websites. In fact, really the only cause listed that a woman struggling with infertility may be able to change on her own is consumption of too much caffeine. Traditional infertility treatments can be dangerous and expensive so spas have picked up on the need for something more gentle and less invasive, which may be a good thing. But are they peddling false hope? While alternative treatments may be worth a try, it's worth considering why so few of these spas offer infertility treatment for wannabe fathers.

Monday, September 29, 2008

A Biological Clock for Dads Too

Turns out women aren't the only ones with an expiration date on their fertility. An emerging body of research is showing that men, too, have a "biological clock."

Not only do men become less fecund as they age, but their fertility begins to decline relatively early - around age 24, six years or so before women's. Historically, infertility has been seen as a female issue, as has the increased risk of Down syndrome and other birth defects, but studies now also link higher rates of autism, schizophrenia and Down syndrome in children born to older fathers. A recent paper by researchers at Sweden's Karolinska Institute found that the risk of bipolar disorder in children increased with paternal age, particularly in children born to men age 55 or older.

It used to be that "if you had hair on your chest, it was your wife's problem," says Barry Behr, an associate professor of obstetrics and gynecology at the Stanford Medical School and director of Stanford's in vitro fertilization laboratory. Even now, he said, though about half of infertility cases are caused by male factors, such as low sperm count or motility, there are many more tests to evaluate a woman's fertility than a man's.

To some degree, that bias is rooted in biology. Women are born with as many eggs as they'll ever have - about a million. That number steadily diminishes, and "the best eggs are ovulated first," Behr says. The ones that remain - after age 35 or so, on average - are vulnerable to toxins, radiation and other insults that may degrade their quality and viability.

By contrast, men make new sperm about every 90 days, Behr says, so the logic has been that there should not be that much difference between a young man's sperm and an old man's. Indeed, men as old as 94 have been known to father children.

Still, the research suggests it gets harder with age. A French study published in the current issue of Reproductive BioMedicine Online found that in couples undergoing infertility treatment, the father's age had as much effect as the mother's on rates of pregnancy and miscarriage - the older either parent was, the less likely they were to get pregnant, and the more likely to miscarry. Other studies have found similar trends: on average, it will take longer than a year to conceive for 8% of couples in which the man is younger than 25; that percentage nearly doubles, to 15%, in couples with men age 35 or older. Data have also suggested that couples whose partners are the same age, or in which the man is younger than the woman, are more likely to conceive within a year, compared with couples in which men are at least five years older than their partners.

There are many possible explanations for the decline in male fertility, from a decrease in the number of sperm and their motility to lower testosterone levels to the effects of other age-related diseases like diabetes, which is associated with erectile dysfunction and lower levels of testosterone. But researchers think that genetic factors may be behind the link between paternal age and a child's risk of bipolar disorder and psychiatric disorders like autism and schizophrenia, whose origins are increasingly being attributed to DNA. Although sperm may be no more than 90 days old, the cells that make sperm may be subject to increasing DNA mutations as men age, affecting the quality of the sperm they produce.

In the Swedish study, published Sept. 1 in the Archives of General Psychiatry, researchers found that the risk of developing bipolar disorder began to increase in children born to fathers around age 40. The highest risk, however, occurred in men age 55 and older; their offspring were 37% more likely to develop the disorder than children born to men in their 20s. Children of older men were also twice as likely to develop early-onset disease - before age 20 - which studies suggest has a strong genetic component.

What does all this mean for would-be older dads? While women are used to seeing grim statistics about their decreasing chances of achieving pregnancy and the increasing risks of Down syndrome as they age, men have typically believed that they have all the time in the world. Perhaps now, men in their mid-30s will start sharing the same "now or never" pressure to conceive that women have long endured.

When older men father children, Behr says, the traditional response has been to "pat them on the back and buy them a beer." He has seen patients that he felt were too old to become fathers, but "plenty of people make decisions about parenthood that I wouldn't," he says. "Our responsibility is to educate patients with the facts, and they decide."

Sunday, September 28, 2008

Fluctuations

I had a bunch of Canadian dollars I needed to exchange, so I went to the currency exchange window at the local bank teller line.
Just one lady in front of me. . .an Asian lady who was trying to exchange yen for dollars and she was a little irritated . . .
She asked the teller, "Why it change?? Yesterday, I get two hunat dolla fo yen. Today I get hunat eighty?? Why it change?"
The teller shrugged his shoulders and said, "Fluctuations".
The Asian lady says, "Fluc you white people, too!"

Saturday, September 27, 2008

Lawyer Tale


Having already downed a few power drinks, she turned around,
faced him, looked him straight in the eye and said,'Listen up, Buddy.
I screw anybody, anytime, anywhere, your place, my place, in the car,
front door, back door, on the ground, standing up, sitting down,
naked or with clothes on, dirty, clean . . it doesn't matter to me.
I've been doing it ever since I got out of college and I just love it.'
Eyes now wide with interest, he responded,
'No kidding. I'm a lawyer, too. What firm are you with?'

Wednesday, September 24, 2008

Germicidal UVC Lights Improve Clinical Pregnancy Rates for IVF Lab, New Study Finds

A seven and a half-year study conducted in the In Vitro Fertilization Cleanroom Laboratory of the Lehigh Valley Hospital and Health Network found that the use of ultraviolet C or "UVC" lights installed in the HVAC system had a clinically significant impact on clinical pregnancy rates (CPR). In presenting the findings at the annual meeting of the American Society for Reproductive Medicine (ASRM), Kathryn C. Worrilow, Ph.D. reported that the + beta and CPR increased by an average of 17.8% and 18.2%, respectively, following 10 of the 13 change-outs of the Steril-Aire UVC Emitters(TM) over the test period.

Clinical success in an IVF lab is critically dependent upon the quality of the ambient air, which in turn, is directly dependent upon the HVAC system. The study led by Dr. Worrilow tracked three key components in the HVAC system -- particulate filters, gas phase filters and UVC lights -- and the timing of their replacement -- to determine whether these individual components affected markers of preimplantation embryogenesis and clinical pregnancy rates.

According to the findings, "There were no statistically significant differences...associated with the replacement of the particulate or gas phase filters in Testing Quarters 1-48. In contrast, immediately following 10 of the 13 UVC Emitter change-outs, the + beta hCG and clinical pregnancy rates increased 17.8% and 18.2%, respectively."

The study goes on to say: "UVC energy will destroy 90 -- 99% of airborne microbial contaminants. By targeting the DNA and RNA of microorganisms, UVC degrades and abates the proliferation of airborne and surface embryotoxic organics. Of equal significance to the developing embryo is the suggested impact of UVC irradiation on the degradation of VOCs. Our work has demonstrated that VOC levels as low as 2.2 ppb can be embryotoxic to the embryo cultured in vitro."

The authors conclude: "Although the use of UVC light represents a departure from the standard HVAC design used in many IVF laboratories, the current study suggests that the use of UVC germicidal technology in the HVAC system serving the IVF laboratory may play a critical role in providing optimal ambient air towards improved clinical outcomes. The current study demonstrated that a clinically significant relationship existed between the replacement of the UVC Emitters and the associated clinical pregnancy rates."

Robert Scheir, Ph.D., president of Steril-Aire, Inc., states: "This new data provides scientific evidence of the germicidal benefits of UVC technology. The potential benefits are far-reaching: not only for the potential to improve CPR in IVF clinics, but also for enhancing infection control in hospitals and healthcare environments, and for maintaining better ambient air in medical and pharmaceutical manufacturing clean rooms."

Scheir adds: "The study also confirms the importance of adequate UVC output and changeout frequency in achieving desired results. The study used high-output Steril-Aire UVC lamps with a changeout schedule of 6-9 months. In the 3 of 13 UVC replacement test quarters that did not result in improved clinical pregnancy rates, outside factors may have played a role in the outcomes. As long as the lamps were functioning properly and were changed on schedule, results were consistently positive. The message to anyone using UVC is that it is critical to select a device with adequate output and to replace the device consistently at required intervals to maintain that output. Otherwise, germicidal effectiveness will be diminished."