Nearly all of us are deficient in vitamin D. Ninety percent of our body’s vitamin D comes from the sun, meaning cholesterol in our skin is converted into vitamin D3 (cholecalciferol) by the action of UV rays from the sun. Vitamin D3 is then converted by the liver and kidneys into the active form of vitamin D. The other 10% of out body’s vitamin D3 comes from our diet. If you live in Canada you are probably vitamin D deficient. The rates are so high the BC government health plan no longer pays for testing - they want us to just assume we are deficient.
Dr Beth Taylor MD, FRCSC
I remember writing my Royal College of Physicians exam to get certified as an obstetrician/gynecologist and thinking “please, please don’t ask me much about adenomyosis.” Adenomyosis is a fairly uncommon disease of the uterus that is hard to diagnosis, hard to treat and causes a slew of terrible symptoms like pelvic pain, heavy periods and infertility. In the past decade or so sinc
My blog went stale the past few weeks. I really didn't want that to happen. I haven't posted in a really long time... I think I got a bit busy, was feeling like I didn't have much interesting to say (research published in the last couple of months has been rather boring - either too esoteric or too silly), I started watching Game of Thrones and just kind of felt like I was in a funk.
I think sunscreen typifies the anxiety that has been bred by the internet and media. Is it good or bad? Fifty years ago we would assume it is good as our doctor would have told us to use it, teachers in school would remind us it is important and we'd have no or few resources to check whether they were right. If the doctor and teachers were right this was a better time. We would have been saved google searches that doubted the doctor. I think there would be less anxiety. Of course, the big assumption is that the doctor and teachers are right.
We can all agree friends don't use the phone much any more. So, much so that if someone does phone me I assume something horrible has happened. In my mind, if my phone rings it is either (1) the hospital calling about a patient (2) someone I don't know managed to get my number and wants to sell me something (3) someone I love has died,.
A friend of mine always hates her job. Every job she has ever had has been "the worst." She moves from job to job and inevitably after the 2 month mark in a new job complains how terrible it is. I once bought her a greeting card that read "You hate your job? Why didn't you say so? There's a support group for that. It's called 'everybody' and they meet at the bar." She didn't laugh like I did.
Ever notice when you get something in your head you start seeing that thing everywhere? I remember when I was a teenager I wanted a cordless telephone. I begged my parents for one with the claim that "everyone had one." It did seem like they did: Carrie, my short, rebellous friend would walk around her house on one for hours, Monica down the street had one she'd hide from her brother, Radio Shack had them prominently on display. It felt like I was the only person without one and I had the 1980s version of FOMO.
Let's talk about IVF paradigms. In a nutshell, IVF involves stimulating the ovaries to produce multiple eggs all at once. The egg are then removed, fertilized with sperm and embryos are created. The embryo(s) are then put into a woman's uterus in hopes a pregnancy will occur.
#1in6 You've probably seen that hashtag and you probably don't believe it. Last week was infertility awareness week in Canada and since 1 in 6 Canadian couples experience infertility we promoted that hashtag to raise awareness of how common infertility is.
About 11 years ago I heard Jonathan Tilly speak at the American Society of Reproductive Medicine (ASRM) meeting. His research suggested in mice new eggs could be made. This raised the question "what if our understanding that women are born with all the eggs they'll ever have, is wrong?" What if we could make new eggs for women? Huh. A basic premise of human reproduction is that you can't. All evidence so far has supported the idea that women are born with about a million eggs and rapidly lose them, running out at menopause.
I'll make this brief because it is 10pm on Friday night and Netflix is calling, but: please do not wait to try and get pregnant again after a miscarriage. We've known for years that you are more fertile and less likely to have an adverse pregnancy outcome if you get pregnant soon (within 6 months ideally) of a miscarriage. It's "old school" to tell women to wait a few months to get pregnant after a miscarriage, but this message is still being conveyed by some health care providers.
What about the guy? As fertility doctors we focus a lot of our energy on investigating the woman and counselling couples about the success rate, risks and outcomes as they relate to the woman. Partly this is because testing of the male is more straightforward and partly because the success rate is usually more dependant on female factors, but outcomes are different: the male matters more than we previously thought.
I didn't want my blog to become stale but lately I haven't been writing much. I blame myself and Facebook and Instagram and Netflix and a few other life distractions. I am sure in the pre-social media years I got a lot more done. Then again, maybe I didn't and I am just glamourizing the olden days. Anyway, I am on vacation this week so thought I'd put fingers to my keyboard.
At least once a month I have a woman in my office crying because her IVF cycle didn’t work and she believes in her heart that she is to blame. Typically she will say she “did too much after the transfer.” Women are so hard on themselves.
Happy New Year’s Eve 2016! Now that I have eaten my body weight in chocolate and chips, it’s time to make resolutions. First, stop eating my body weight in chocolate and chips. My other resolutions are pretty similar to previous years:
There are a few main infertlity journals I read: Human Reproduction, Fertility and Sterility (F&S) and the Journal of Clinical Endocrinology & Metabolism. It is in these journals the latest fertility research is published, useful topics are reviewed and in F&S they have a section called "Inkings." This is the section I enjoy the most, honestly. Inklings are short musings, generally by well respected fertility doctors and scientists. They write about their "gut feelings" or their pet theories about disease or treatments.
The word on the internet is that Janet Jackson is pregnant at 50. This is wonderful news - I am always happy to hear about new life, new light, being brought into the world. There is something that makes me deeply happy when people grow their families. It is why I do the work I do. It is why I have children. It is why I tear up at every birth announcement and thank you note I receive from patients.
I remember a lovely couple whom I helped conceive with IVF once emailed me to ask about their children's intelligence. The child was 3 or 4 at the time and, according to the parents, exceptionally good at everything. They believed their daughter was intellectually gifted, among other gifts. They asked me if she was so special because, as an embryo, she has been selected from a field of many as the "best looking" and "strongest."
We all have genes in the DNA of our cells. Genes determine our hair colour, eye colour, height, and about 20,000 other things about us including which diseases we will develop. Over the past decade scientists have figured out the "spelling," or sequence of nucleotides, of every gene in humans. This project was called the Human Genome Project. Since this project of sequencing of all human genes was completed, the focus shifted to figuring out which gene mistakes, or mutations (or misspellings), cause which diseases.
Lets' talk about intracytoplasmic sperm injection (ICSI), pronounced ick-see. During IVF treatment a woman takes medication to grow multiple eggs at once. We then extract the eggs and fertilize them. You can fertilize an egg in one of two ways:
- Insemination - several thousand sperm are placed in a dish around the egg
- Intracytoplastic sperm injection (ICSI) - one sperm is injected into the egg
I just got back from a family vacation in Nova Scotia. There I gained about 10 lbs, never exercised, and listened to countless funny stories about relatives I've never met. I do the same thing every summer and while it objectively sounds boring, it's actually quite fun. Food is love and the more sugary and buttery the food they serve, the more a maritimer loves you. So visiting old friends and family on vacation meant eating plenty of butter-soaked lobster, ice cream, and potato chips. Again, a lot of fun. Now I have a rich-food hangover and jet lag.
Maybe it's my mother's influcence but I do think things happen in threes. Yes, since my birth, my mother has been warning me that after two relatives die, it's only a matter of time before a third one bites the dust too. After two stubbed toes, two bad hair cuts, two car accidents, two divorces, two failed anything, a third one is inevitable. I am not sure why bad but not good things run in threes, but it's best not to question superstition too much anyway.
Every job has good days and bad days. Today was 90% good and 10% bad.
A couple brought their 6-month-old daughter from IVF by to meet us, a woman who has been trying to conceive for a few years brought us a gift to say "thanks for trying so hard" for her, a couple who has twins on the way sent a "thank you" note, and a box of chocolates came from another successful couple.
Is there a diet you should follow to promote fertility? The Environment and Reproductive Health (EARTH) study is trying to answer this question. Since 2006, women at a Boston IVF program are being studied with questionnaires on diet, lifestyle, and other environmental factors that might impact fertility. Some results from this work are starting to be released.
Today the Vancouver Sun ran a story about a lawsuit against a fertility clinic and a sperm bank. The lawsuit alleges that the sperm bank improperly screened a sperm donor. Two families in BC and more in Ontario used donor sperm purchased from the USA sperm bank, Xytex.