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IVF 101: Sara’s Guide to IVF (Part III)

You may remember my last post, in which I described the midst of my IVF cycle, mastering  the administration of the HCG shot (it wasn’t that bad!) and  waiting for the big day: The Retrieval. The retrieval day was both nerve-wracking and exciting. This was the moment that I had been working so hard for these past few days. All the shots and pills that I took were all leading up to this moment: the retrieval of my eggs.

Based on the ultrasounds done prior to retrieval, I had a good sense of how many mature follicles I had, but no one really knows how many eggs will be retrieved until the doctors get in there. My day went a little something like this:

I arrived about an hour or so before the scheduled time to fill out any necessary paperwork and prepare for the retrieval. Then I headed upstairs to get dressed into a pretty paper gown and cap. Since the procedure involves a light form of anesthesia – similar to the strength you have during other procedures like a colonoscopy – I had to first meet with the anesthesiologist.

Once I was dressed and the nurse and doctors had reviewed the procedure with me, it was time to drift off to dream land while the doctors got to work. The doctor uses a fine hollow needle guided by ultrasound to extract the eggs. Obviously, this is painless since you’re “out” during the procedure (finally something that is painless, right?). The entire procedure took less than 30 minutes.

Meanwhile, my husband was busy doing his part by producing a semen sample. He was instructed to head upstairs to a room to “take care of his business” and then the sample was transferred to the lab upstairs (all of these steps take place within CHR’s facility – like one-stop shopping).

Finally, the eggs and sperm met up in a culture with the hope that magic was going to happen. For more details on this procedure, check out these pages on CHR’s website.  In some instances the lab technicians may need to perform some additional procedures to help along the good old-fashioned egg meets sperm and makes embryo scenario. Examples are ICSI (Intracytoplasmic Sperm Injection) or AZH (Assisted Zona Hatching), both of which just help “move things along” with regards to fertilization of egg and sperm. If you do need ICSI or AZH, note that YOU are not doing anything  all of this happens in the lab under the technicians’ supervision. Your only job is to lie under anesthesia until the retrieval is finished.

At the end of the retrieval, I woke from under the anesthesia felt the need to rest a bit in the procedure room. I definitely took my time “coming to.” Afterwards, I was updated with information on the eggs retrieved and received a medication update and discharge information. I took the rest of the day off, went home and relaxed. I would suggest that to everyone. You’ve earned it! Over the next few days, science was going to do Mother Nature’s job in the lab and I was eager to be back for the next part of IVF: the transfer day! Stay tuned for Part IV of my IVF story in an upcoming post and don’t forget to stop by my own blog for more stories on infertility.

Stay positive,


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IVF 101: Sara’s Guide to IVF (Part II)

In my last post I described the early stages of the process of an IVF cycle. Now it’s time to move on to Part II­­ – the midst of an IVF cycle.

By this point, I had mastered the art of injections and had my medication administration down to a science. I was super organized, with a gigantic to-go pillbox filled and ready, and a bathroom that looked like a hospital with injections and the medical waste container on proud display on the vanity.

My morning monitoring appointments with the medical staff were also  beginning to pick up speed. That is, I started to get poked and prodded every few days, which soon thereafter increased to every other day.  It was during this ovarian stimulation period that my blood levels were closely monitored and the doctors were observing the growth of my egg follicles via ultrasounds. The doctors were checking that I was reacting positively to the hormones, which were designed to ensure that my follicles (which are ultimately where the eggs live) were maturing. They told me that regular monitoring was important because there was a chance that my body might not respond well to this hormone dosage and the doctors would need to adjust my prescriptions.

As the cycle progressed, my doctors worked to determine the right day for the retrieval procedure that would produce the optimal amount of mature follicles. From a layperson’s understanding, the doctors look to delicately balance waiting to retrieve until you have enough mature follicles without sacrificing slow and/or speedy growers. For example, you could have one ovary that has only a few follicles but they are growing at a much faster rate than the other follicles so the doctors might feel the need to hedge the bets in one direction versus another.  I could tell that my retrieval day was quickly approaching when my monitoring increased from every few days to every other day. Of course, having the medical staffer tell me “It’s time!” was also a sure-fire signal.

Once the doctors decided I was ready for the follicle retrieval, I next had to give myself an HCG shot, otherwise known as the trigger shot, 34 hours before the procedure. For an overly simplified explanation, the HCG is a hormone called human chorionic gonadotropin, which, in IVF, pushes the eggs through the last stage of maturation process and triggers ovulation. (HCG would also come into play later on, as a hormonal indicator of successful implantation in a series of pregnancy tests.) The HCG shot was unlike any of the other injections I had administered so far.  As one of the clinical coordinators told me, it was my turn to be Cinderella. No, I didn’t get all dressed up in a gown and sparkly tiara; but I did have to wait until about midnight (give or take 30 minutes) to receive the HCG shot.  In actuality, the timing of the shot directly correlated with the time of the retrieval procedure.  To be ready for a retrieval scheduled for Thursday morning, I had to have the shot at midnight on Tuesday.

Knowing the importance of the HCG injection, unfortunately, brought yet another level of stress: I only got one “shot” at it.  It wasn’t like some of the other injections where if I made an error in drawing, mixing, etc., I could just pull out a new dose from the box and start over.  (Then again, based on the exorbitant cost of these medications, this same stress was actually present with all of my injections).  The HCG needs to be administered intramuscularly, i.e., in your buttocks. Luckily, I was already familiar with this process since my hormone stimulation meds were administered the same way.  So, once again, my husband and I mixed up the meds and then I got ready to bend over and inject. One, two, three, and it’s over.  There is one positive aspect to the HCG shot: for the next 24 hours I got a reprieve from constantly poking myself and was able to focus on waiting for the big retrieval day!

Check back soon for Part III of my IVF story, where I’ll discuss the day this has all led up to: retrieval! And in the meantime, head over to my blog for more stories on laughing at infertility.

Stay positive,


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CHR family featured in the New York Times!

At CHR, we meet with couples every day who have long dreamt of having a child of their own. We love that we can help them make that dream a reality, and we never get enough stories of our patients after they leave CHR. Recently, we heard from one of the CHR families, with surprising news that a CHR baby made an appearance on the New York Times.

Referred by a friend, Krystal and Claudia came to CHR ready to start their family. The couple spent some time working with CHR staff to evaluate their needs. After a successful IVF cycle, Claudia became pregnant, and nine months later their family grew as their new son Malaya was born.

Fast forward one year, the new family is as happy as can be, and we were thrilled to see their recent appearance in the New York Times, discussing tax laws for same-sex couples. As Krystal wrote to Maria, one of our clinical coordinators, “a CHR baby made the New York Times!” Check out the beautiful video of the couple and Malaya on the Times article here.

We wish Krystal, Claudia, and Malaya the best as their family continues to grow!

Category: Media

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Dr. Gleicher and Dr. Barad named ACOG Mentors of the Year

We’re proud to announce that CHR’s Medical Director and Chief Scientist Norbert Gleicher, MD, and Director of Clinical ART and Senior Scientist David H. Barad, MD, MS, were both recipients of the 2014 ACOG Mentor of the Year Award.

Each year, the American Congress of Obstetricians and Gynecologists (ACOG) recognizes those professionals who go above and beyond to educate and mentor young clinicians and researchers in the field of women’s health.

As leading physicians and researchers in the field, Dr. Gleicher and Dr. Barad have been active educators on the topic of reproduction and infertility. In addition to regularly presenting their research at conferences around the world, both physicians have had an active role in enhancing research and education efforts here at CHR. One example is our regular Continuous Medical Education (CME) GrandRounds events offered free of charge to the local community of obstetricians/gynecologists, reproductive endocrinologists and scientists working in related fields.

With a commitment to education built right into our core mission (Clinical Care – Research – Education), we at CHR will continue in our efforts to lead discussions and analysis of the latest topics in the reproductive field.

Congratulations on your awards, Dr. Gleicher and Dr. Barad!

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Is low-cost IVF actually cheaper?

The number of babies conceived through IVF continues to grow, with ASRM recently reporting that 1.5% of all 2012 births were results of IVF. Mixed in with reports of the growing popularity of the procedure are discussions surrounding its high costs and the alternatives available.

A recent article in the Wall Street Journal takes a look at a less-expensive, milder form of IVF (often called mini-IVF) that some doctors and patients are turning to as a solution to alleviate the higher costs of traditional IVF.

Minimal-stimulation IVF uses smaller and milder doses of fertility drugs than traditional IVF, which can reduce the medication costs and costs associated with monitoring of ovarian stimulation, making the procedure more affordable. This milder form of IVF can also reduce the fertility treatment’s physical demand on a woman’s body, particularly for women who are at high risk for ovarian hyperstimulation syndrome.

However, the success rates for mini-IVF are a concerning factor for some. Mini-IVF aims to retrieve fewer eggs per cycle than traditional IVF. Consequently, many women end up having to repeat the procedure incurring the treatment cost repeatedly, ultimately matching or exceeding the costs of traditional IVF.

CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, was quoted in the article about the success rates of mini-IVF. Dr. Gleicher authored a study on the topic (published in Reprod BioMed Online in 2012) that compared 14 women under age 38, with normal ovarian function, who underwent low-intensity IVF to 14 who used regular IVF. The study found that the low-intensity IVF “reduced pregnancy chances without demonstrating cost advantages.”

For some time now, CHR has been vocal about the often-undisclosed disadvantages of mini-IVF in peer reviewed publications as well as in newsletters. CHR does offer a low-intensity IVF treatment called ECO-IVF, but recommends that interested patients discuss their individual case with a CHR physician to see if they are a good candidate for the procedure.

Dr. Gleicher discusses the pros and cons of EcoIVF: 

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FDA weighs in on genetic fertility procedure

The Food and Drug Administration is currently discussing the scientific issues surrounding a particular fertility procedure that uses genetic material from three people to prevent passing on genetic mutations to offspring.

The FDA will weigh in on the scientific issues of the procedure – risks to the mother or child, the structure of future studies, etc. – to determine whether it is safe to perform in humans.

The procedure in question is largely based off the work of Dr. Shoukhrat Mitalipov, a researcher at Oregon Health and Science University studying early embryo development and stem cell biology, who has also discussed his work at recent a CHR GrandRounds event on March 12, 2013.

Dr. Mitalipov has successfully performed the procedure – which involves replacing defective mitochondria cells with healthy cells from another woman – in monkeys and says it is ready to try in humans.

The topic is not without controversy, as researchers debate the ethics of such genetic modifications, with experts falling on both sides of debate and waiting to see how the FDA’s determination will affect the future of this genetic research.

We asked CHR’s Medical Director and Chief Scientist Norbert Gleicher, MD, to weigh in on the discussion:

Norbert Gleicher, MD: “Dr. Mitalipov’s work is potentially revolutionary, and not only to treat mitochondrial diseases, as suggested in this New York Times article. The significance lies in the fact that, using this technique, infertility treatments can be improved (or enhanced) far beyond that. Dr. Mitalipov’s technique opens new avenues to treat a whole variety of female infertility, potentially including the treatment of advanced female age if  this work can be confirmed by other laboratories.

Ethical concerns, of course, are valid. The British fertility Authority, however, felt that benefits outweigh potential concerns, when last year approving similar experiments in human trials. It, therefore, appears likely that the FDA will reach similar conclusions and also allow closely controlled human research.

In making these comments, it is important to note that CHR investigators have a potential conflict of interest because CHR recently announced a research collaboration with investigators at Rockefeller University and Dr. Mitalipov, which is based on Dr. Mitalipov’s work.”

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Discussing fertility preservation and “social” egg freezing

Fertility preservation is an appealing concept for many women who hope to press pause on their ticking biological clocks. By freezing their eggs at a younger age, many women hope to feel more in control of their fertility, ensuring that down the road, when they are ready for motherhood, aging ovaries won’t hold them back. But fertility preservation is never a guarantee, and egg freezing can instill new concerns and anxieties.

In a piece recently published on the New York Times’ Motherlode blog, Sara Elizabeth Richards (author of Motherhood Rescheduled: The New Frontier of Egg Freezing and the Women Who Tried It) discusses her own experiences with egg freezing and fertility preservation.

In the piece, Richards describes her anxieties about freezing her eggs, addressing concerns about how many eggs to freeze and the likelihood that those frozen eggs will result in successful pregnancies, as well as the lacking consensus from fertility experts regarding these issues.

Richards’ experience is all too common for women considering fertility preservation, and so we asked CHR’s Medical Director and Chief Scientist Norbert Gleicher, MD, and Physician and Associate Scientist Vitaly A. Kushnir, MD, to share their thoughts on the topic:

Norbert Gleicher, MD: “The piece by Sarah Elizabeth Richards is telling because it very well describes some of the shortcomings of the ‘industry’ that have arisen in recent years around ‘social’ egg freezing.

‘Social’ egg freezing is the term given to attempts at fertility preservation via egg freezing for non-medical reasons. Richards is a very typical case of ‘social’ egg freezing, as she so well describes in her article; typical for the motivations that brought her into egg freezing, typical for the emotions surrounding egg freezing and, unfortunately, also typical for the frequent lack of information with which many women enter the process.

For example, it is difficult to understand how Richards only discovered after her first egg retrieval that 9 eggs may not be enough to give her a good chance for future fertility preservation. At CHR, the topic of how many eggs a woman may have to cryopreserve and how many cycles of egg retrieval this may require is at the core of our initial discussion with every patient who approaches the center with fertility preservation in mind.

In her piece, Richards noted that there is no consensus amongst specialists in the field about how many eggs need to be preserved. There are good reasons for this lack of consensus, and it is essential—both for good medical practice and proper informed consent—that patients be advised of this before they make a commitment to the process. The primary reason why there is no consensus is a lack of data. No studies have been published anywhere in the world that would provide answers. Indeed, studies that have been published, and claim ‘to know,’ should be approached with considerable caution because they usually are underpowered (too small patient numbers) and are not controlled for ages of women at time they freeze their eggs. Whether a woman freezes eggs at age 21 or 41 years, of course, matters, even though, at present, nobody really knows whether it still makes sense to freeze eggs at age 41 or how many eggs a 21-year-old should freeze to have a high likelihood of at least one child. Of course, even less is known about attempts at securing two or, possibly, three children, as Richards apparently is trying to do.

It is for this lack of knowledge that ‘social’ egg freezing is still widely considered an ‘experimental’ procedure by authoritative professional bodies, and why CHR performs ‘social’ freezing only after patients acknowledge this fact by signing an ‘experimental procedure’ consent. Unfortunately, this is not the case everywhere, which brings us back to what I above called the ‘industry’ that has arisen around ‘social’ freezing.

Offering women the opportunity to attempt to preserve their fertility has, indeed, become an ‘industry.’ It is much easier to promise an outcome for some time in the future (often never tested at all) than being forced to deliver on a promised outcome in an imminent IVF cycle. Most women who have, in recent years, frozen eggs at various centers have so far not yet attempted to use them. This is another major reason why so little is known about egg freezing outcomes. It is, however, very convenient for these centers not having to prove your representations within a relatively short time period. It, therefore, is unfortunately very easy to make promises, which many years later may be unfulfillable.

In contrast to egg freezing, embryo freezing is much more predictable in outcome because the profession has seen increased success with cryopreserved embryos for almost 30 years. Here, age-specific data should be available to most IVF centers, and predictions on how many embryos have to be frozen to reach a minimum level of certainty for achieving at least one successful pregnancy are much more reliable. But embryo freezing, of course, requires commitment to a source of sperm contribution, and many women interested in social fertility preservation are not willing to make such a decision, in hope that a future husband may still want to contribute his sperm.

These are difficult decisions to make but, here at CHR, we always make it a point to raise the option of embryo cryopreservation as an alternative to egg freezing. We do it not only for above noted reasons, but also because we want to make absolutely certain that every woman entering the process of fertility preservation fully understands all of her options.

In this context, it is important to note that such women are usually older, which automatically suggests that any future husbands will be older, too. This, in turn, suggests that such future husbands, likely, will be in their second marriage and will already have children. In other words, it will be less important for them to have another child than for the woman, a reason why we urge women to be ‘selfish’ in considering this option. Another reason for such ‘selfishness’ is, of course, the possibility that they will not get married, and will later in life decide to become single mothers. In both of these situations, the availability of frozen embryos will give them, likely, better pregnancy chances than the availability of frozen eggs.

‘Social’ fertility preservation is, therefore, not a simple process that only encompasses the freezing of eggs. It should be a collaborative and deliberate process between patient and physician, one in which women have to make a difficult decision about their future in a process that can give them a level of comfort, as Richards notes in her piece, but, unfortunately, not certainty.”

Vitaly A. Kushnir, MD: “Because tests are now available to assess ovarian reserve, young women should be offered the opportunity to do so initially in their mid-20s. Those discovered to have low ovarian reserve early in their reproductive life can then make more educated decisions about when to start their families or pursue fertility preservation. Fertility preservation should also be offered to girls and women undergoing treatments that can decrease future fertility such as chemo or radiation therapy. Egg (oocyte) freezing is a promising technology, but it is just an option. Our professional organizations, The American College of Obstetricians and and Gynecologists (ACOG) and The American Society for Reproductive Medicine (ASRM) state: ‘there are not yet sufficient data to recommend oocyte cryopreservation for the sole purpose of circumventing reproductive aging (i.e. ‘social freezing’) in healthy women because there are no data to support the safety, efficacy, ethics, emotional risks, and cost-effectiveness of oocyte cryopreservation for this indication.’”

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IVF 101: Sara’s Guide to IVF (Part I)

In a previous post, I described the process of deciding that CHR was the place for my husband and me to battle our infertility issues.  After our medical consultation with Dr. Gleicher, we learned that that IVF was our only option and the best chance we had of having genetically-linked children of our own. So we committed with full force.

Committing to IVF is a big deal – both emotionally and financially. But once you “get there,” you now know that you have a plan. So what can you expect from an IVF cycle?  Here is my personal guide to the process of IVF, Part I.

Chapter 1: Preparing for a cycle

After the initial medical consultations were through, we knew our IVF cycle was upon us in a matter of weeks. In preparation, our first step was to order all the medication I would need for the full cycle (which spans from prepping my body for ovulation through to the pregnancy test). I should note here that everyone’s cycle at CHR is different, and the doctors really tailor it to your own case. In my situation, my medication included an estrogen patch, various oral medications, and injections. The nurse, who also acted as my clinical coordinator, reviewed all the medications that were prescribed for me. It was during this meeting that we reviewed the process of how to inject myself with the stimulation medications, which I was told (and read about later online) work to stimulate the ovaries in an effort to produce multiple eggs.

My first reaction to these instructions was: “What do you mean my husband and I have to administer shots? And where exactly are these shots going? We don’t need medical training? You just trust that we can mix medicine and draw the proper amount into a syringe and voila?” The nurse clearly explained how to mix the meds (there is a process of mixing vials of water solution with a powder to create the right amount of prescribed medication). So after a thorough tutorial, I came to understand the mixing process, but still had more questions: “How do you pull the syringe? Where exactly do you put it?” Well, the nice – and very patient – nurse also covered that, too. In fact, I had such great, attentive care that the nurse drew where to administer the shot. I mean she literally drew on me. She took a pen and made a circle on my buttocks to show us where to inject the intramuscular shots. Needless to say, I tried not to wash that area for a week or so for fear of not knowing what to do when we were home and left to ourselves.

Chapter 2: Getting the green light

Once I was an expert in shots and picked up my medications at the pharmacy, the next step was to monitor my menstrual cycle and prepare for the official kick off of IVF. In my case, I began to use an estrogen patch on day 21 of my cycle. Then my instructions were to wait for my period to begin and come back to the office on day 2 of my new cycle. On that day, my blood was drawn and tested to ensure my body was ready to start the injections.

Blood work and ultrasound monitoring at CHR takes place early in the morning … usually ending by 10 a.m. This is very convenient for just about anyone on a schedule. I felt I had to be the first patient to be seen for monitoring (for fear of running late to work) so I always arrived first to the office – sometimes before the doors were open for business (early bird catches the worm, right?)  Once I walked in and got my paperwork/spot in line, I made myself comfy in the waiting room and enjoyed the daily croissants and bagels, as well as a cup of the coffee from the best and craziest coffee machine I’ve ever seen. What a lovely way to start your day: croissants and cappuccino as preparation for the needle poking and/or ultrasound wands.

After I was fed and caffeinated, my name was called and I went in for my blood work. Just a few minutes later (probably before 8am) I was finished and was told that I’d get a phone call later with the next steps. Sure enough, later that afternoon the nurse called me to give us the “green light” to start the oral medication and one of the injections (microdose lupron). The stimulation injections (Bravelle and Menopur) would begin a few days after that and then I was to return to CHR for blood and ultrasound monitoring.

The nurse had instructed us to administer the injections between 7-10am and 7-10pm. Because I am a huge planner and very detailed-oriented, I decided that we were going to do the shots at 7:30am and 7:30pm – on the dot. That meant that sometimes, my husband and I would be sitting there, me getting ready to bend over and watching the clock, 7:28, 7:29 and ah . . . 7:30. I put reminders on my calendar that listed each pill I had to take and which side we administered the shot in the day before as to prevent bruising. I even had a printed calendar that I checked off after we did the shot or I took a pill. It was like crossing out the days on a wall calendar as they pass.  I acknowledge that I may have some compulsive, controlling tendencies.  But to defend my behavior, this was a few years ago before the word “app” was part of our vernacular. Today there are many useful smartphone apps out there to help keep your medication routine organized. To be honest, when you are taking a lot of medications, things can seem overwhelming. For me, being so organized helped me to feel in control of a very uncontrollable situation. It also helped to know that I was doing everything I could physically do to ensure a successful cycle.  So however you keep up with medication process, whether digitally or handwritten, just be organized.

All in all, the first half of an IVF cycle doesn’t require too much of your physical time – obviously mental time is another topic/post all together. You have some morning monitoring, which includes mundane waiting room time, but your actual monitoring should be quick and easy. (If you’re like me, you’ll of course strive to be #1 on the list). Things get a bit more time consuming as you move closer to your ovulation and retrieval days. I’ll go into that part of the cycle in IVF 101, Part II, so be sure to check back soon for the rest of the story. In the meantime, stop over at my own blog for more on overcoming infertility and laughing along the way.

Stay positive,


Posted by Sara Raber

Report shows decrease in use of infertility services

A recent article in USA Today discusses the findings of a new report released by the National Center for Health Statistics that examined trends in infertility service use in the United States. The report showed that, despite a growing awareness and availability of infertility services, use of those services has declined.

Focusing on men and women between ages 25 and 44 (the age when “infertility service use may be more prevalent”) the report found that 17% of women had at one point used an infertility service – “a significant decrease from 20% in 1995.”

The most common infertility services used included receiving advice (29%), infertility testing (27%), and ovulation drugs (20%), with only 7.4% and 3.1% using artificial insemination and assisted reproductive technologies (ART), respectively.

The article suggests that the high cost of infertility treatments – often not covered by insurance – could be one deterrent for couples considering infertility services, however that does not always have to be the case.

“Not everyone needs expensive or high-tech treatment,” Kurt Barnhart, president of the Society for Reproductive Endocrinology and Infertility, told USA Today. “Maybe simple treatments and advice is all they need. When people don’t come in to get the consult, they don’t know if simple solutions would have helped them.”

Another explanation for the decline is that the survey was conducted during difficult economic times, when many men and women saw decreases in average incomes. This is a connection we have made before at CHR, and so we asked the center’s President and Chief Scientist, Norbert Gleicher, MD, to share a few thoughts:

“As noted in this article, the under-utilization of infertility services is nothing new. It has also been known that utilization of fertility services varies with economic conditions. Approximately 2 years ago, we here at CHR investigated national U.S. IVF cycle numbers in reference to national GDP changes in association with the 2008 recession and found a close correlation between declining IVF cycle numbers and declining national economic activity. In other words, utilization of infertility services declines in difficult economic times, whether that is due to less available disposable income for fertility treatments or increased hesitance to have children in such difficult economic times. Declines in utilization, indeed, preceded declines in GDP by a few months, suggesting that IVF cycles could be viewed as a highly sensitive early indicator of national economic activities.

Maybe the most interesting aspect of the article is an observation, mentioned by the author only on the periphery: ‘Ever-use’ of fertility services was the highest amongst older women and childless women. This addresses a widely unreported phenomenon in infertility, the “graying” of infertility services, as younger women with infertility increasingly quickly conceive with modern treatments, while older women, with much more difficult to treat infertility, accumulate in infertility centers. This also is a subject we recently thoroughly investigated here at CHR, with study results submitted for publication.”

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CHR Specialists Caution Against Unsupervised Use of Nutritional Supplements

Following an alarming report published in the New York Times warning against the problems that nutritional supplements can cause to liver function, physicians at CHR issued a caution to fertility patients against taking nutritional supplements unsupervised during infertility treatment.

Although popular infertility nutritional supplements such as DHEA (dehydroepiandrosterone) and CoQ10 can both be bought over-the-counter, Dr. Gleicher, CHR’s Medical Director and Chief Scientist, warns that these “strong chemical compounds” shouldn’t be taken without the supervision of a fertility specialist.

To read more from our doctors about safety and nutritional supplementation during infertility treatment, click here.

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