FEBRUARy 2010 YOUR GUIDE TO CREATING A HEALTHLY FAMILY

• General information • Emotional support • 24/7 EMD Serono fertility support 1-866-LETS-TRY www.fertilitylifelines.com • Insurance assistance 2 an independent supplement from mediaplanet in the wall street journal an independent supplement from mediaplanet in the wall street journal 3

infertility

CONTENTS 2 Foreword By AFA Creating A Healthy Family 3 Fertility Treatment 3 Male Fertility… 3 Making Fertility Treatments Infertility. We’ve often described it as a sensitive subject, and 2009 saw this sensitivity Affordable With a Money-back heightened in many ways. A recession that enveloped the world took its toll on those Guarantee struggling with infertility. One of the findings presented at the annual meeting of the 3 The Opportunity Of American Society for in Atlanta stated that 58 percent of the cou- 4 ples diagnosed with infertility decided against treatment citing cost as the primary factor. By: KEn MOSESIAn, ExECuTIVE DIRECTOR 4 ThE AMERICAn FERTILITy ASSOCIATIOn 4 Pinpointing Ovulation even percent of couples with sons The AFA is proud of our partnership Third, vitrification, or the rapid freez- and with less cost and reduced stress and 5 Panel Of Experts embryos in storage from October with Mediaplanet is that we have the op- ing of oocytes, is becoming more wide- anxiety. S2008 to March 2009 decided to dis- portunity to talk about the work happen- spread. The benefits over the slow-freezing The American Fertility Association is card them to save storage fees, represent- ing in the field of reproductive medicine, method is that no ice crystals form, and here to help consumers dealing with all ing a three-fold increase over the previous the vast majority of which is good. the data suggests better results than slow- things fertility: from infertility prevention, six months. There are a few key issues for 2010 that freezing in terms of survival, implantation to trying to conceive/trying to adopt, to The Catholic Church weighed in on the immediately come to mind. First, even and . Fourth, ovulation kits and male reproductive health to family build- INFERTIlITy topic of assisted reproduction multiple as the economy seems to be improving, fertility monitors for at-home use are be- ing for the LGBT community. Through our times, reminding the faithful of its opposi- what can we do, from working to help coming far more widespread, and will extensive online library, our toll-free sup- Publisher: Max Friend [email protected] tion to IVF in particular, as stated in Donum mandate insurance coverage for assisted continue to do so, decreasing the need for port line, our webinars, support groups, vitae and other Church documents. This reproduction to providing lower cost solu- more expensive treatments for a segment online education modules and education Contributor: Jill Coody Smits further challenged those with a diagnosis tions for those desiring to build families? of the population, and bringing down the outreach programs, we assist people in Debra Gordon of infertility who were also Catholic. What Are we doing enough to adop- overall cost of trying to conceive. And fi- sorting through the huge amount of infor-

Designer: Carrie Reagh does one do when faced with infertility, tion as a viable family building choice nally, attention is being given to the male mation that keeps growing on a daily basis, [email protected] the desire to create a family, and one’s love and not something one considers only biological clock. It’s ticking, more slowly and make of it. If we can be of ser-

Printer: Dow Jones for the Church? The AFA hosted a webinar after exhausting other solutions? Second, than the female’s clock, but it’s ticking vice, please contact us. That’s our mandate. in December to help equip people strug- indications are that the 24-chromosome nonetheless. The AFA has been working And our commitment. Photos: ©iStockphoto.com gling with these complex issues so they test, by providing thorough, accurate and with other non-profit organizations and For more information about supplements could have respectful and productive comprehensive screening of embryos, has the Centers for Disease Control and Pre- in the daily press, please contact: Kayvan Salmanpour, 1 646 922 1400 conversations with their Pastors. aided physicians in determining the most vention to make male reproductive health [email protected]. Media coverage was for the most part viable embryos to implant, resulting in a priority for 2010, with the intention of

This section was written by Mediaplanet sensational and negative. One of the rea- significantly reduced miscarriage rates. helping more people conceive sooner, Ken Mosesian, Executive Director and did not involve The Wall Street Journal or Editorial Departments. a very special www.mediaplanet.com thanks to... EMD Serono, Inc., an affiliate of Merck KGaA, Darmstadt, Germany, is a leader in theu S biopharmaceutical arena, integrat- ing cutting-edge science with unparalleled patient support systems to improve people’s lives. EMD Serono has more than 1000 employees around the country and fully integrated commercial, clinical and research operations in Massachusetts.

Four Goals, One Organization Infertility Trying to Conceive/ Male Reproductive LGBT Family Prevention Trying to Adopt Health Building

THEAMERICANFERTILITYASSOCIATION www.theafa.org [email protected] 888.917.3777

Western Region Centers

Arizona: Success is in the numbers Arizona Reproductive Medicine Specialists (ARMS) www.arizonarms.com 602.343.2767 Over the last 25 years, our fertility centers have And did we mention that our AttainTM IVF helped tens of thousands of patients become Refund program has a 75% success rate? California: parents. We’re proud to say that we’re now in 34 Reproductive Partners Medical Group Beverly Hills/LA states at 121 locations with over 180 doctors who See how the numbers look in your favor. www.reproductivepartners.com perform 25% of all IVF procedures nationwide. Talk to one of our fertility experts today. 877.273.7763

Reproductive Science Center of the San Francisco Bay Area www.rscbayarea.com 888.377.4483

Colorado: Colorado Center for Reproductive Medicine www.colocrm.com 303.788.8300

Idaho: Idaho Center for Reproductive Medicine www.idahofertility.com 866.865.2229

Oregon: OHSU-Portland Oregon Health & Science University www.fertilityoregon.com 503.418.3700

Nevada: Nevada Center for Reproductive Medicine www.nevadafertility.com 775.828.1200

Utah: Utah Fertility Center www.utahfertility.com 866.865.2229

Washington: Seattle Reproductive Medicine www.seattlefertilitycenter.com Celebrating 25 years of fertility success 877.777.6002 If you’re having difficulties conceiving, speak to one of our fertility experts today. 866.968.7483 or www.integramedfertility.com 2 an independent supplement from mediaplanet in the wall street journal an independent supplement from mediaplanet in the wall street journal 3

infertility

Fertility … Male Fertility… What no One tells you The First Line Of Treatment The need to reproduce is natural and the male anatomy There is no magic pill that can cure all reproductive prob- medication such as cetrorelix (i.e. Cet- is there to do its job. When it doesn’t, it can be difficult to lems. But fertility drugs are a key component in treating rotide) to prevent premature ovulation,” accept—admitting that something is wrong is not easy. says Daniel Potter, MD, Medical Director small and large fertility issues. with the huntington Reproductive Cen- Men struggling with infertility have reported fearing ter in Laguna hills, California. “When tests others will judge them as inadequate. and with less cost and reduced stress and ore than 30 percent of • Clomiphene ( e.g. Clomid) - Oral medi- show the follicles are mature, we give a anxiety. patients can achieve cation that helps establish normal ovu- third medication called hCG, which com- ertility LifeLinesTM, a free patient fronted with infertility as women,” says The American Fertility Association is“M pregnancy with fertility lation by causing the to pletes the final step of egg maturation. resource provided by EMD Serono, Dr. Stanton honig, director of the Male here to help consumers dealing with alldrugs alone and more than 80 percent can increase the FSh output which stimu- Approximately 35 hours later, we are able Fand Men’s health network (Mhn) Infertility and Sexual Dysfunction Clinic things fertility: from infertility prevention,benefit from fertility drugs in conjunction lates the . to remove the eggs.” released new survey data highlighting at the university of Connecticut School of to trying to conceive/trying to adopt, towith other therapies,” says Keith Blauer, • Letrozole ( e.g. Femara) - Oral medica- In terms of effectiveness, Dr. Potter men’s concerns and misconceptions about Medicine who wrote the foreword to the In male reproductive health to family build-MD, senior reproductive endocrinologist tion that helps establish normal ovula- says today’s fertility drugs are quite good, fertility health. nearly half (45 percent) of The Know booklet. ing for the LGBT community. Through ourat Reproductive Care Center, utah. tion by suppressing produc- though there is room for improvement in the men surveyed would wait more than a To receive a free copy of the In The Know extensive online library, our toll-free sup- Ovulation disorders account for most tion by inhibiting the conversion from other areas. year to seek medical attention after strug- booklet, register with Fertility LifeLines™ port line, our webinars, support groups,fertility problems, and many of them, in- androgens. Though not yet FDA ap- “As far as drug therapy, there isn’t much gling to conceive with their partner, even at www.FertilityLifeLines.com/intheknow online education modules and educationcluding polycystic ovarian syndrome, are proved for infertility, reproductive spe- more we can do other than making them though most of the men surveyed (84 per- or call the toll-free, confidential hotline at outreach programs, we assist people intreatable with medication. These ovula- cialists have been using this oral drug easier to administer. At some point, we cent) agreed that infertility is a significant 1-866-LETS-TRy (1-866-538-7879). sorting through the huge amount of infor-tion-inducing agents work in a variety of successfully for more than 10 years. hope to find a way to make the medica- medical condition. mation that keeps growing on a daily basis,ways to cause the release of hormones If a patient’s fertility problems involve tions less expensive.” It is commonly recommended that cou- and make sense of it. If we can be of ser-that trigger or enhance ovulation. something more complex than an ovula- For now, Dr. Potter says fertility drug ples seek help from a fertility specialist if vice, please contact us. That’s our mandate. Fertility drugs that fall under this cat- tion disorder, standard treatments still typ- costs vary widely and suggests patients they are unable to conceive after one year And our commitment. egory include: ically involve some form of drug therapy. comparison shop before purchasing of regular, unprotected intercourse, or six Millions of men • Follicle stimulating hormone or FSh “Standard protocol for in vitro fertiliza- . months if the woman is 35 years old. (e.g. Gonal-F) - Injected medication that tion (IVF) typically involves injecting the “Fertility drugs are commoditized to Fertility LifeLines™ and Mhn now offer in the directly stimulates egg development patient with FSh to cause eggs to mature some degree, so the prices vary with sup- a booklet entitled In The Know: What No within the ovaries. and grow, then administering another ply and demand. I recommend checking One Tells You About Male Fertility. This help- United States Ken Mosesian, Executive Director with multiple pharmacies, including mail- ful guide provides an overview of male order pharmacies, to find drugs at the infertility, tips on dealing with stress, ways struggle with fertility drugs are commoditized to lowest price.” to communicate with your partner and a As with any prescription medications, checklist of questions to ask your health- reproductive some degree, so the prices vary with there are risks and benefits that should be care provider and insurance company. discussed with a doctor. “Millions of men in the united States issues. supply and demand. struggle with reproductive issues. In fact, it’s just as common for men to be con- Making Fertility Treatments Affordable With A Money-Back Guarantee With the cost of infertility treatment the greatest barrier to couples seeking such vice president of marketing. “That elimi- The costs of the programs vary depend- services, finding ways to make procedures like in-vitro fertilization (IVF) affordable nates any potential or perceived conflict ing on the treatment type and fertility of interest.” center, Weiss explained, but are typically has long been a major industry focus. Since the program began in 2005, slightly more than the cost of two IVF cy- about 25 percent of couples have received cles. Couples can also access low-interest he high cost and uncer - frozen cycles. Donor program based on a set of clinical guide- a refund, Weiss said, with the company re- loans through an IntegraMed partner to tainty around the outcomes egg recipients can receive unlimited fro- lines. For instance, women should be able turning nearly $24 million in payments. help pay for the program, Weiss said, an “Tof assisted reproductive zen embryo transfers for a single price. If to complete all three IVF cycles before Overall, he said, more than 10,000 couples important option given today’s tight credit. techniques (ART) have prevented a lot couples don’t take home a baby—even turning 38 (although they can be older have applied to the program, more than IntegraMed currently contracts with of people who would benefit from ART if they get pregnant—they are refunded if they are using donor eggs) and should 8,000 have been approved and about 39 fertility centers in 34 states, but Weiss from pursuing it,” said Pamela Schumann, 70 percent of the fee they paid for the IVF have day three hormone tests within nor- 5,000 have completed it for an overall suc- said the company will explore adding president of the consumer services divi- treatment plans; 100 percent of the fee for mal limits. Clinicians associated with Inte- cess rate of about 75 percent. other centers. sion at IntegraMed, a Purchase, ny-based the donor egg cycles. graMed—but not with the woman’s fertil- In October, IntegraMed began offering specialty healthcare services company “By fixing the cost, making it predict- ity center—also consider her weight, the its Attain IVF Multi-Cycle Program, which By fixing the that provides services to fertility clinics able, we give couples the peace of mind health of her fallopian tubes and uterus, provides an option for couples who might throughout the country. of knowing that the financial aspects of and review her partner’s semen analysis as not medically qualify for the Attain IVF cost…the Among IntegraMed’s programs are two IVF are out of the way,” said Schumann. part of their decision-making process. “It’s program or who are looking for a lower designed to help patients pay for infertil- It also enables couples to pursue several important to note that our review of medi- cost option. With this program, couples financial aspects ity services. The first, called Attain™ IVF, cycles, rather than just one or two, increas- cal information is not conducted by the can receive up to four IVF cycles for one enables couples to pay one fixed price and ing their chance of success. doctors who will be performing the pro- price, but they do not receive a refund if of iVf are out of undergo up to three IV cycles and three Couples are accepted into the IVF Attain cedures,” said Doug Weiss, IntegraMed’s the IVF is unsuccessful. the way The Opportunity Of Surrogacy Surrogacy has come out of the shadows. With a feature film on the topic in theaters two years ago (called, ap- propriately enough, “Surrogate”), and celebrities like Joan Lunden and Sarah Jessica Parker talking freely about the surrogates who carried and delivered their own children, the idea of partnering with a woman to have your child is receiving newfound respect.

hat respect is particularly strong or IVF, in which eggs from the potential among gay couples, says Karen mother (in a heterosexual couple) or donor TSynesiou, chief executive officer of eggs are fertilized with sperm from the the Center for Surrogate Parenting (CSP). potential father or donated sperm. The re- unlike infertile heterosexual couples, in- sulting fertilized eggs are allowed to grow vitro fertilization isn’t an option. They also in a petri dish for a few days, after which often face difficult legal challenges with they are inserted into the surrogate’s adoption. hence, many turn to surrogacy uterus and, hopefully, she becomes preg- to have a genetically similar child. nant. After delivery, the surrogate returns “We’ve been providing surrogacy the baby over to the recipient couple. services to gay couples for more than 25 Synesiou’s center, with offices in Encino, years,” said Synesiou. “It is just delightful Calif., and Annapolis, Md., is one of the to see.” oldest surrogacy practices in the country. She finds that gay couples are often Since its founding nearly 30 years ago, the more “hands-on” during the surrogacy ex- Center has participated in the birth of more perience than husband and wife couples. than 1,500 babies, many of them to gay “Surrogacy provides their only exposure to couples, said Synesiou. yet the Center has the whole pregnancy and birth adventure,” never had a surrogate mother change her she said. So gay couples often ask for a sur- mind and try to keep the baby, a common rogate who will let them participate fully in fear yet relatively rare occurrence. the pregnancy. she said. In fact, Synesiou The reason for the Center’s success? said, some surrogates specifically request Screening. The Center requires that both to work with gay couples because they the surrogate and the prospective parents enjoy the emotional intimacy and close undergo rigorous psychological screening. relationships that develop. “If you look at the history, the main reason The totally cost ranges from $80,000 surrogate mothers change their mind is to $100,000, which includes all legal and to protect the child from the parents,” she medical costs as well as a payment to the said. “But if the couple is who they say they surrogate mother. The surrogate becomes are and they don’t lie to her, then no sur- pregnant through in-vitro fertilization, rogate mother changes her mind.” 4 an independent supplement from mediaplanet in the wall street journal an independent supplement from mediaplanet in the wall street journal 5

infertility

Reproductive Technology Cryopreservation Egg freezing. Genetic and chromosomal screening of abnormal embryos the pregnancy rates new Challenges, new Opportunities embryos. Single-embryo transfers (and ). would shoot right up,” he said. “The hope These are just some of the exciting directions in which is that if we can test all 24 chromosomes we In the world of infertility, sperm banks might be consid- can eliminate those embryos that cause IVF ered the great-grandfather of assisted reproductive tech- the assisted reproduction technology field is heading as to be so inefficient.” it enters the second decade of the 21st century. Another major advance is the ability niques. The banks were around long before the advent of to freeze a woman’s unfertilized eggs, or in-vitro fertilization (IVF), providing couples with donated he biggest challenge to the patients who agree to undergo single- oocytes, said Andrew Dorfmann, who sperm for more than 40 years when the male partner specialty of infertility is the embryo transfer. Women who have at least directs the embryology laboratory at the was infertile. But like everything else in this fast-moving “Treduction of multiple preg- two high-quality embryos and another Genetics and IVF Institute in Fairfax, Va. nancies,” said Arthur L. Wisot, MD, of two to freeze, are under age 35 or using Centers around the world, including his, industry, today’s sperm banks bear little resemblance to Reproductive Partners Medical Group, with donor eggs, in good health, and with no have reported several live births using their early predecessor. offices throughout California. “We not only underlying medical reason for their infer- frozen eggs. Rather than the slow freez- want to eliminate higher-order multiples, tility (like endometriosis) are the best can- ing method typically used for embryos, like triplets and quadruplets, but we even didates, as are couples with male-factor however, egg freezing uses vitrification, in oday’s sperm banks have screening to provide recipients with the want to reduce the number of be- infertility and those choosing IVF because which the eggs are frozen very quickly to reinvented themselves as healthiest donor available,” he said. For cause pregnancies are higher-risk of their need for preimplantation genetic prevent the formation of ice crystals. They “Tcryopreservation storage instance, California Cryobank now screens pregnancies.” Thus, he said, “The move diagnosis (PGD). are typically fertilized using intracytoplas- facilities and as real adjuncts to the as- for several genetic diseases, including now is to select patients for single-embryo Which brings us to another exciting area mic sperm injection, or ICSI, in which a sisted reproductive world,” said Michael cystic fibrosis and spinal muscular atro- transfers,” i.e., transferring just one embryo in today’s assisted reproduction arena. In single sperm is injected into an egg. Tucker, PhD, the chief executive officer phy. Donors also undergo more extensive rather than two or more. traditional PGD, an embryologist removes “There are three reasons why freezing of xytek Cryo International in Augusta, psychological screening these days, said The problem, says Dr. Wisot, is because one or two cells from an embryo and tests oocytes is the future of IVF,” Dormann said. Ga. That’s because more men, even those Tucker, to “tease out” their motivations for most couples pay for in vitro fertiliza- them for signs of genetic diseases like “To preserve fertility in women undergo- with very few viable sperm, can take ad- donating. tion (IVF) themselves, they want the best cystic fibrosis. Thanks to the use of mul- ing for cancer treatment; vantage of an assisted reproductive tech- Another major industry change is the possible chance at a pregnancy. To many, tiple genetic screening tests, however, to provide an option for women who put nique known as intracytoplasmic sperm shift to the era of “open .” that means transferring two or more some centers are beginning to use PGS: childbearing on hold while focusing on injection, or ICSI, in which a single sperm Many sperm banks offer connections be- embryos despite the risk of a multiple preimplantation genetic screening, or their careers; and to improve processes in is injected into an egg. This significantly tween donors and recipients (if they so de- pregnancy. yet the difference in the preg- aneuploidy screening, which screens for which donor eggs are used.” For instance, if reduces the demand for donated sperm sire) and nearly all maintain sibling regis- nancy rate between single and multiple- a variety of chromosomal abnormalities, egg donors can freeze their eggs they don’t from infertile couples, said Tucker, but cre- tries so recipients can track other children embryo transfer in high-quality clinics is said Gary harton, PGD scientific director at have to synchronize their menstrual cycle ates new opportunities for sperm banks. conceived with the same sperm. California very small, said Dr. Wisot. Genetics and IVF Institute in Fairfax, Va. with the egg recipient for transfer. “Instead “Men can have their own sperm banked Cryobank even provides recipients with an To encourage his patients to choose “Estimates are that upwards of 70 per- of waiting lists to line up donors with recip- for longer-term use for IVF and ICSI,” he audio file of the donor’s voice. single-embryo transfer, Dr. Wisot’s clinic cent of embryos have chromosomal ab- ients,” Dorfmann predicted, “donors could said. his facility and others also provide One important advance in the indus- began the Elective Single Embryo Trans- normalities on day three,” he said. Embryos freeze their eggs in advance and they could long-term storage for embryos that cou- try, said Tucker, is the development of fer (eSET) Encouragement Program, or with such abnormalities are unlikely to im- be offered to recipients much like sperm is ples may, one day, wish to have implanted. an industry-wide donor gamete regis- eSET. The clinic waives freezing and stor- plant, or can result to early miscarriages. offered through sperm banks.” “Many couples are more mobile now, so try. Last year, four of the leading sperm age charges for six months for qualified “It stands to reason if we could screen out they don’t want to take their embryos with banks, Cryobiology, Inc, Fairfax Cryobank, them,” he said. “This way they can have California Cryology and xytek, formed the them shipped to a centralized location and nonprofit Association of Gamete Donor we take care of them.” Eventually, xytek Providers (AGDP), which will help the Destination: family By BARBARA COLLuRA, ExECuTIVE DIRECTOR RESOLVE: ThE nATIOnAL InFERTILITy ASSOCIATIOn and similar cryopreservation institutions banks share information and services, en- hope to create donor egg banks as well as hance educational programs and develop Did you know that one in eight women will be affected by infertility? That is 7.3 million Americans! sperm egg banks, similar to those already policies and activities to benefit those who We wish it was not so, but it’s true, and the numbers are rising. The Centers for Disease Control and operating in various parts of the country. provide and use donor sperm. The organi- Prevention tell us that one in eight couples have difficulty conceiving after one year of trying, and its Sperm banks are also taking advan- zation has also created a database to track actually 6-months of trying if the woman is over 35. If you are unable to get pregnant, you may be faced with countless doctors’ tage of new genetic testing technol- anonymous sperm donors. “This addresses appointments, tests, and other procedures as part of your medical treatment regiment. If you decide to build your family through ogy to provide prospective parents with what has been a fairly constant criticism of adoption or other means, you may be unfamiliar with the process and how to proceed. more genetic information about donors, the industry in the past,” said Dr. Tucker, Infertility is tough to handle alone. you need to find a place where you are not alone on your family building journey. Research said Cappy M. Rothman, MD, co-founder “which is the potential for men to deposit has shown that getting the right support during your journey can improve your chances of success. Whether it is through in- and medical director of California Cryo- sperm at multiple banks and achieve in- person and online support communities, helplines, and local or online educational offerings, you need to find a place where your bank. “We think sperm banks are going ordinate numbers of offspring in limited needs are being met by people that have been there. Also, remember, though it is difficult to focus on anything else, as a com- to become more dependent on genetic geographic gene pools.” munity, we must stay active in the halls of Congress and in the state houses to ensure open access to all family building options. Together, we can make a difference! RESOLVE: The national Infertility Association (RESOLVE), the premier patient advocate organization, exists because women and men diagnosed with infertility need and deserve a community that connects them to others, empowers them to find opportuni- ties for resolution and provides them with a voice that demands greater access to quality and affordable family building options. Don’t take your infertility journey alone; contact RESOLVE and find out how our resources can assist you in every aspect of your life—physically, mentally, emotionally and financially. For more information, visit RESOLVE online at www.resolve.org. Pinpointing Ovulation Using Saliva to identify Women’s Most fertile time

Philip Regas, chief executive officer of Colorado-based day for intercourse if they want to get Zetek, Inc., has talked to thousands of women during the pregnant. Women can also purchase an optional vaginal sensor that evaluates so- 20 years his company has been manufacturing ovulation dium levels in the vaginal mucus to confirm detection systems. ovulation and show when fertility ends. Another test on the market, the KnOW- reproductive ut he will never forget the woman the brain which, in turn, triggers certain WhEn™ Saliva Fertility Monitor from with polycystic ovarian syndrome, changes in the saliva,” explained Regas. So newark, nJ-based hiLin Life Products, is a Ba condition that interferes with new ovulation monitors evaluate salivary lipstick-sized, reusable, mini-microscope. Care Center ovulation, making pregnancy difficult. levels of sodium chloride, which rise as es- Women place a drop of saliva on the lens This woman, he said, had been trying to trogen levels increase during ovulation, to of the monitor, peer through and evaluate get pregnant for seven years. She’d spent identify a woman’s most fertile time. their fertility based on the salt patterns more than $100,000 on fertility treatments That’s important, since research shows that appear as the liquid dries, called “sali- A Comprehensive Utah and still no baby. Then she heard about that women are most likely to conceive vary ferning.” Zetek’s ovulation sensor. After using the from intercourse that occurs a day or two Women then track the result on the device for three months to pinpoint ex- before ovulation (sperm can hang out wait- included fertility tester diary card. After Infertility Center actly when she was ovulating and when ing for an egg for several days!), although three cycles, explains hiLin Marketing her chance of pregnancy was highest, she they can also conceive on the day of ovula- Director Irina Polunina, women should Diagnosis and Treatment became pregnant, eventually delivering a tion itself. Miss that magic window and you know their most likely times of the month healthy baby. “It’s just a wonderful story,” have to wait another month. for ovulation. Regas says. Zetek’s OvaCue Fertility Monitor is its “Because women can know within a IVF • ICSI • TESE • Donor Egg • Donor Embryo Welcome to the 21st century of fertility latest in a line of fertility monitors. About five-day window when they will be most tracking. Whereas women used to have the size of a cell phone, the monitor has an fertile, they have an increased chance of PGD • Surrogate Cycles • Guaranteed Refund Plans to chart their basal body temperature (the attached spoon-shaped collecting compo- conception,” said helen Denise, hiLin’s Low Cost IVF Options • • IUI temperature first thing in the morning be- nent that a woman puts on her tongue for chairman and CEO. fore getting out of bed) or pee on a stick a few seconds each morning. The device Both devices have been approved by the to identify their most fertile times, today it evaluates salivary electrolyte levels, storing Food and Drug Administration. Both Zetek can be as easy as placing a spoon-shaped the information and using it to identify pat- and hiLin claim 98 percent reliability for sensor on your tongue or looking at a drop terns to predict ovulation up to seven days their devices, although published studies of your saliva under a special microscope. in advance. show varying levels of accuracy. “The biologic process of ovulation is The information is displayed in calen- 801-878-8888 FertilityDr.com triggered by the release of hormones in dar form, clearly showing women the best 4 an independent supplement from mediaplanet in the wall street journal an independent supplement from mediaplanet in the wall street journal 5

infertility

Cryopreservation Panel of Experts new Challenges, new Opportunities

COREy WhELAn WILLIAM huMMEL, MD BRAnDOn hAyES-LATTIn, MD KAREn SynESIOu DAVID STERn KEITh L. BLAuER, M.D. Program Director Infertility Specialist Medical Advisor Chief Executive Offi cer Executive Vice President Senior Reproductive The American Fertility Association San Diego Fertility Center Lance Armstrong Foundation Center for Surrogate Endocrinology at EMD Serono, Inc. Endocrinologist Parenting (CSP) Reproductive Care Center

Q: Is there anything I can do to Q: how should couples prepare Q: If one is diagnosed with can- Q: What advice would you give Q: In these difficult economic Q: What financial options are safeguard my fertility? for IVF ? cer, at what point should he or she to a couple that is considering times, what kinds of resources and available for couples pursuing consider fertility options? surrogacy? support does EMD Serono offer infertility treatment? A: yes. Smart lifestyle choices can A: Preparing for your IVF treat- to couples considering infertility impact your fertility; this is true ment will reward you with your A: The best time to bring up the A: never work with a surrogate treatments? A: The fi nancial costs of pursu- for both men and women. highest chance of success. issue is at the time of diagnosis, mother unless an independent ing infertility treatment are a First off, acknowledge your bio- Lifestyle changes preceding before treatment. The reason is psychologist has screened her, A: We recognize and understand legitimate concern, however there logical clock. For women, fertility your care will pay off as soon as there are several causes of infertil- even if it’s your own sister. As a the diffi culties couples face when are many options out there that begins to decline around age 27, you make them. These changes ity after cancer—the disease itself prospective parent, you want her struggling to conceive, especially enable couples to choose which and really starts to plummet at 35. may include discontinuation of in some cases, but the largest risk help so badly that you’re not really in this tough economic climate. course of action is best for them, For men, the magic number is 45. any smoking and alcohol. Men tends to arise from the treatment listening to her. Only an outsider FertilityAssist 2, a patient assis- and make the process finan- Don’t smoke! One potential should not use hot tubs, sau- of the cancer. can really evaluate a woman’s tance program, will provide up to cially feasible. For example, our impact of smoking is reduced na’s or jacuzzi’s while taking This affects women and men, ability to surrogate. Such experts $500 in savings on EMD Serono center offers a low stimulation, fertility. with antioxidants. but the important distinction see things that we might turn a medication to eligible cash-paying lower cost IVF option for $5,249, Keep healthy through diet Women should reduce their is that the fertility preservation blind eye to. patients during their second treat- as well as a single conventional and exercise. caffeine intake while taking a options are more complicated I would also remind couples ment cycle. Last year, through IVF cycle package for services Avoid toxins such as mercury, prenatal with Folic Acid. for women. In vitro fertilization that surrogacy remains largely Fertility Assist 2, patients saved $4 including IVF for $8,749 and an phthalates and bisphenol A. Stress reduction is very im- requires about 10 – 14 days of unregulated in the united States. million in drug costs. egg donor cycle for $18,526. We use condoms; protect your portant! Control what you can hormone shots before you can Literally anyone can hang up a At EMD Serono, we focus on also offer our global pre-paid dis- fertility by saying no to STD’s control (i.e. your stressful work harvest the eggs; but with some shingle and call themselves a helping patients through their counted fee for multiple IVF cycles Some infertility can’t be avoided, schedule) and let go of what you cancers, you may not have that surrogate center. That means you journey with Fertility LifeLines™, ranging from $15,438 (two cycles) but you can tip the odds in your have no control over (i.e. age). yoga, window before treatment. really have to do your research a free resource available at to $20,584 (four cycles), as well as a favor by making choices that will meditation, massage, acupuncture, As an oncologist, the most im- when choosing a surrogacy cen- 1-866-LETS-TRy (1-866-538-7879). money back guarantee plan for IVF safeguard you, and your baby to be. exercise or walking all contribute portant piece is thinking of this ter to partner with. Make sure Fertility LifeLinesTM is staffed with treatment for couples that qualify to a relaxed state of being—do stuff and informing patients of you fi nd a center that offers inde- infertility nurses and benefits which has been designed so that what feels best for you. A loving, the risks they may face and what pendent legal and psychological specialists who provide general more than 90 percent of our pa- caring and supportive role by your the options might be. There may support for both the surrogate infertility information, insurance tients who need IVF can qualify partner will be very important from still be options after treatment so and the family and that limits the assistance, local fertility special- for participation. We also offer a this time onward. Remain optimis- it’s never too late to bring up the number of times a woman can be ist referral, EMD Serono product 100 percent money back guar- tic and committed to your goal. issue, but the best time to consider a surrogate. At the Center for Sur- support and emotional support antee program for our IVF fees. fertility is at diagnosis. rogate Parenting, women are lim- through compassionate listening The medical community is now For more important information ited to two surrogate pregnancies. In addition, we provide educa- offering answers to the dilemma see www.fertilehope.org. tion and resources on FertilityLife- of cost, so that couples can focus Lines.com. on what is important: creating a healthy family.

Egg Donation—An Industry on the Rise

According to the Centers for Disease Control and ing a recent issue involving an unethical For those prospective parents who do Prevention, about one out of 12 fi rst births in 2006 were company taking money from prospective opt for , Chiya says the suc- parents without delivering a service. cess rate is very high. “Many variables to women aged 35 years and over, compared with one But The Genesis Group CEO Page Tofi ghi come into play but, industry wide, in vitro out of 100 in 1970. says that company is not representative of fertilization with an egg donor results the industry as a whole. “Our industry is in pregnancy 70-80 percent of the time full of compassionate professionals whose the fi rst time because the eggs used are here are many possible explana- gay couples to start a family utilizing egg goal is to help people achieve pregnancy. younger.” tions for the trend—no partner, donation. “Egg donor agencies have been When we learned of the prospective par- Chiya says many of her clients go Tputting career fi rst, and wanting around for about three decades, but as ents who were wronged, the community through numerous emotionally and fi nancial security before children are just more intended parents want more op- came together to pick up the pieces.” physically draining fertility treat- a few. Whatever their reasons, though, tions, and egg donation becomes more Tofi ghi recommends that couples con- ments themselves before turning a ticking biological clock is translating accepted in society, we are seeing an in- sidering egg donation carefully research to her agency. When they do fi - into fertility problems for more and more crease in demand.” their agency of choice and seek a physi- nally have their child, she says it women. As an industry, egg donation has dealt cian recommendation before embarking is extremely rewarding. “Our cli- “you are born with all the eggs you’ll with a number of controversies, includ- on the process. ents have so much love for their ever have, so it’s an uphill battle for child. They will never take it for women in their late 30s and 40s,” says granted and it will always know Lisa Chiya, director of case management it was wanted intensely. at The Genesis Group, an egg donation …egg donation becomes more Without their drive, agency. this child would never A Comprehensive Utah Increasingly, Chiya says, prospective accepted in society, we are seeing have existed.” parents are turning to agencies like hers when egg quality is the root of their fer- an increase in demand. Infertility Center tility problems. It is also common for younger women with health issues and Diagnosis and Treatment

At the Genesis Group our goal has always been to assist our clients in the journey into parenthood. We believe that every individual has the right to govern their own fertility, as they 801-878-8888 FertilityDr.com feel fi t. We are here to support that basic right. We offer compassionate and professional www.genesiseggdonation.com customer care to every single client. the Genesis Group is the only agency in the nation with a “no strings attached” rematch policy. Should you not achieve pregnancy with your first iVf egg Donor cycle, we 9025 Wilshire Blvd. Suite 215 1425 K Street NW, Suite 350 will rematch you with another donor at no Beverly Hills, CA 90212 Washington, DC 20005 additional agency fee. 310.550.6889 202.587.5726