what if?

My parents made me suspicious of insurance. They weren’t necessarily optimistic people, but they just felt they could handle bad outcomes themselves and didn’t trust that insurance help with be forth coming in the event of a disaster. They were mistrustful of those who were selling something for the “what if” scenarios of life. I think they understood numbers and felt that if the chance of a house fire was 1/10,000 then it was unlikely to happen to them so don’t get fire insurance. So far, so good.


Why do we need so many sperm?

Happy 2019!  Looking back at my blogs, it seems the most popular ones are the simplest.  The ones where I attempt to explain the every day questions of infertility.  Sure, chatting about fancy lab treatments like PGT-A is exciting, but most people are hoping they will never need a "fancy lab treatment" to get pregnant.  They have good questions about the basics of getting pregnant, or not.

Tank safety

There is not a day that goes by when I don’t think about the security and safety of the embryos, sperm and eggs we have frozen in our cryopreservation or cryo tanks. I am on vacation this week and was out for a run and our tanks were on my mind. Our lab director would say an hour doesn’t go by when he doesn’t think about our tanks.



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.


In my mind there are three parts to IVF success: the lab, the way ovaries are stimulated to grow eggs, and the quality of the eggs and sperm. 

1. Lab conditions and techniques have improved dramatically in the past ten years. We can now video monitor embryo development. We can biopsy embryos to determine whether they are chromosomally normal (called CCS or PGS). Incubators and media for growing embryos replicate the optimum female genital tract nearly perfectly. There is still room for improvement, of course, but the success of embryo growth in the lab is incredibly high.

Sperm Morphology

It's the New Year's Resolutions time of year! As I type, I am still crampy from all the turkey and regretting the sleeve of After Eights I just decimated. Anyway, full of "crappy eating" guilt I am making a list of resolutions for a better me in 2015. The first is to stop eating sleeves of After Eights. The others that I am mulling over involve simplifying my life and using fewer words to get my point across. I often talk too much, meaning I use too many words to tell a story or answer a question. I am aware of this. My father calls my talkativeness being a "Tuesday-Wednesday" storyteller.

Testosterone is bad for men

Okay, let me clarify that statement. Taking testosterone is bad for a man's sperm count. Four or five times per year, I will see a couple for severe male factor infertility,and find that the cause is the man has been taking testosterone. It might come as a surprise to learn that taking testosterone reduces your sperm. You see, the hormones (FSH and LH) that the pituitary gland in your brain produce to tell the testicles to make sperm also tell the testicles to make testosterone.

New Semen Test Coming

Sperm matters. If there is no sperm in the semen when a man ejaculates, he will not be able to get anyone pregnant. This lack is called "azoospermia." Azoospermia is either due to a blockage of the tube that brings sperm from the testicles out to the penis (called obstructive azoospermia) or due to the testicles not making any sperm (non-obstructive azoospermia). It is critical that we determine which type of azoospermia it is. If a man has non-obstructive azoospermia, he is not making sperm and there may not be any way we can help.