Do The Risks Of Ovarian And Borderline Ovarian Cancer Increase With IVF Treatment?

Does infertility treatment cause ovarian cancer?

We are commonly asked if IVF increases the risk of ovarian cancer. Studies conducted over iStock 000004344837XSmall 150x150 Do The Risks Of Ovarian And Borderline Ovarian Cancer Increase With IVF Treatment?the past 20 years have tried to answer this question. A recent publication by van Leeuwen, et al., examined this issue carefully and produced some very interesting results.

What were the study basics?

The study published recently in Human Reproduction involved a very large retrospective analysis (data collected from the past) in the Netherlands of 25,152 infertile women (19,146 IVF and 6,006 non-IVF infertility patients) who received their infertility treatment between 1983 through 1995. The extensive follow-up period, which averaged about 15 years, made this study unique amongst others.

Why might infertility treatment result in ovarian cancer?

It has been theorized that the risk for ovarian cancer, which is estimated to be a 1/72-lifetime risk in the US, would increase because of ovarian stimulation and/or multiple ovulation sites forming across the surface of the ovary. Partially dispelling these concerns, this study did not show any increased risks for ovarian cancer for non-IVF infertile patients treated with either oral or injectable fertility medications. Also, further debunking the theory was the fact that the risk for ovarian cancer did not increase as the number of IVF cycles increased.

Is there something special about the IVF patient that increases her risk for ovarian cancer?

iStock 000014074296XSmall 150x150 Do The Risks Of Ovarian And Borderline Ovarian Cancer Increase With IVF Treatment?We also have wondered if the IVF patient simply has something wrong with her ovaries that predispose her to infertility, IVF treatments as well as ovarian/borderline ovarian cancer. The fact that there was a much larger percentage of “unexplained infertility” patients in the IVF-treated group suggests the IVF and non-IVF patient groups were indeed very different from each other.

Also understanding that borderline ovarian cancers normally make up only 20% of all ovarian cancers and are not anywhere as lethal as the more common ovarian cancers, it was somewhat unexpected to find that 46% of all ovarian cancers identified in the infertility patients in this study were borderline cancers. This high percentage of borderline lesions also suggests that something was unusual about the IVF-treated patient population.

What were some of the important findings in the study?

In reading this paper carefully, I was able to identify the following important points, some of which were not emphasized in the study:

  • Tubal infertility IVF patients (i.e., past and/or chronic pelvic infections) were twice as likely to have invasive or borderline ovarian cancers.
  • Those IVF patients who never conceived were twice as likely to have any ovarian cancers and three times more likely to have borderline ovarian cancers.
  • In the study, the actual risk for any ovarian cancer by age 55 was estimated 1/141 (0.71%) in the IVF group compared to 1/222 (0.45%) for the normal population, an overall increased risk of 1/3rd but still a very rare event.
  • Also in the study, the actual risk for borderline ovarian cancer by age 55 was approximately 1/600 for the IVF patients compared to 1/1,200 for the general population, essentially doubling the risk. Still the actual incidence was still very, very rare.

What did we really learn from the study?

While I feel the authors did an amazing job collecting and analyzing the data, I felt the discussion section missed a few very important points:

  • Those that underwent IVF, especially unexplained infertility patients, may still differ in some way which may increase their risk for both prolonged infertility and ovarian/borderline ovarian cancers.
    • In other words, it may not be the IVF procedure itself as much as the underlying characteristics of the IVF patients, which predispose them to ovarian cancer risks.
  • Acute or chronic pelvic infections may very well increase the risk of borderline ovarian cancer.
    • The fact that IVF-treated patients were far more likely to have past pelvic infections may have been responsible for many of the findings described in this study. To the best of my knowledge, this has not been described before. Interestingly, chronic inflammation in other areas of the body also predisposes to some forms of cancer. Perhaps the pelvis is the same.
  • If one conceives through IVF, the risks for ovarian and borderline ovarian cancers drop to normal levels.
    • Either the pregnancy helps reduce the ovarian cancer risks or those who conceive are inherently at a reduced risk for ovarian cancer compared to those who never conceive.
    • This point has been found to be true with past studies that showed an increased risk of borderline ovarian cancers with the use of oral clomiphene citrate when used for more than 12 cycles without an eventual pregnancy. Once pregnancy occurred, even resulting in a miscarriage, the borderline ovarian cancer risks normalized (Rossing MA, et al. 1994).
  • Current regimens used to stimulate the ovaries are very different from those used prior to 1995.
    • The current risk factors could be better, worse or the same as those described in the study because IVF protocols have significantly changed since 1995.

In summary:

The risks for ovarian and borderline ovarian cancer for infertility patients undergoing IVF may be incrementally increased compared to the non-IVF population. Interestingly, far less lethal borderline ovarian cancers are found in a greater percentage in this very special patient population. Confounding factors, such as tubal factor infertility with acute/chronic infections, may increase the risk for ovarian malignancy in this patient population.

No matter how statistically significant the findings are, one still must note that the actual risks described in this study for women age 55 are still extraordinarily rare: 1/141 for any ovarian cancer and 1/600 for borderline ovarian cancers.iStock 000014266359XSmall 150x150 Do The Risks Of Ovarian And Borderline Ovarian Cancer Increase With IVF Treatment? These risks also are unlikely to deter a highly motivated infertility patient. Keep in mind that the average risk for a genetically abnormal child in IVF-treated patients is probably closer to 1/100, which is far higher than any of the risks for cancer listed in the current study. Let us all keep our perspective.

Still, we need to collect further data as many of the women in the study were only in their middle 50’s and the risks for ovarian cancer generally increase with age.

Above all, an IVF conception may very well reduce the ovarian cancer risks significantly. If conception never occurs, this may signal physicians to monitor the unsuccessful patients more carefully for future potential ovarian malignancies, although the actual incidence of the disease may still be quite rare.

Congratulations to the researchers who put an amazing amount of work into this study and we thank them for their dedication to infertile patients and to those of us who care so much for them.

Craig R. Sweet, M.D.
Reproductive Endocrinologist
Specialists in Reproductive Medicine & Surgery, P.A.
Fertility@DreamABaby.com

References:

van Leeuwen FE, Klip H, Mooij TM, van de Swaluw AM, Lambalk CB, Kortman M, Laven JS, Jansen CA, Helmerhorst FM, Cohlen BJ, Willemsen WN, Smeenk JM, Simons AH, van der Veen F, Evers JL, van Dop PA, Macklon NS, Burger CW. Risk of borderline and invasive ovarian tumours after ovarian stimulation for in vitro fertilization in a large Dutch cohort. Hum Reprod. 2011 Dec;26(12):3456-65.

Rossing MA, Daling JR,Weiss NS, Moore DE, Self SG. Ovarian tumors in a cohort of infertile women. N Engl J Med 1994;331:771–776.

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Admin2, December 20th 2011 | Tags: , , , , , ,
Posted in Cancer, Diseases, IVF, Research

Why This Florida Infertility Doctor is Concerned About Mississippi Initiative 26

iStock 000002208443XSmall 150x150 Why This Florida Infertility Doctor is Concerned About Mississippi Initiative 26Today, the good people of Mississippi will go to the polls to exercise their constitutional right to vote. One of the items they will cast their ballot on is Mississippi Ballot Initiative #26, which would give “personhood” to a fertilized egg. If enacted, this law will cause a chilling effect that will be felt throughout the infertility field as other states like Florida and Ohio, to name just two, gear up for similar referenda in 2012. The passage of Mississippi Initiative 26 will signal the start of a dangerous precedent, that if it gains momentum, will cause dire consequences for many of my patients.

This isn’t just about abortion, although this is what the proponents would like you to believe. Let me be clear, I don’t think the intention of the well-meaning individuals who may vote for this Initiative want to do harm. In fact, I am certain, people voting for the initiative probably feel they are saving lives. The problem is that Initiative 26’s proponents have not given the voters the right facts about the law’s devastating consequences in the state of Mississippi. The list of unintended consequences extends far and wide and involves women’s healthcare, the legal world and the infertile patient as well as the providers of their medical care.

Consequences to Women’s Healthcare

The following are very likely consequences of the passage of the amendment:

    • - The total outlawing of abortion, even in the cases of incest and rape.
    • - Outlawing of the vast majority of contraceptives including the IUD, the “morning-after pill” and Depo-Provera. Even hormonal contraceptives including oral contraceptives, patches and rings will thin the uterine lining preventing implantation. If interpreted as such, they will be outlawed. The only contraception that will probably remain will be condoms and we know how much men like to take a shower with a raincoat on….
    • - How can a physician surgically remove a tubal ectopic pregnancy thus terminating the life of an “embryo-person”? No, really, could someone tell me how a physician will be able to care for a patient with a life-threatening ectopic pregnancy?
    • - Are we really going back to the “good old days” when women were dying on a regular basis from botched backstreet abortions? Who will take care of the orphans?

      Consequences to the Legal World

      There are literally thousands of instances where the word “person” is written in the Mississippi statutes, each of which will have to be carefully reviewed to see how three-day old eight-cell stage embryos fit in. Think of the possible consequences:

      • - How will cryopreserved embryos inherit? Exactly what rights will they have?
      • - If embryos are created in Mississippi by a couple visiting from another state or another country, are they instantly going to be US citizens or citizens of the state of Mississippi?
      • - Will all embryos that do not survive have to undergo a burial? If they die unexpectedly, are they to undergo an autopsy?
      • - Women who smoke, drink in excess or use recreational drugs are at an increased risk for miscarriages. Are they to be charged with manslaughter or perhaps even murder if they are aware that their behavior could end the life of an “embryo-person”?

      Disastrous Consequences to the Infertility Patient and Provider

      It is clear that the proponents of initiative 26 feel the infertile patients are expendable. They don’t care that women and men’s lives and the families of Mississippi will be severely affected:

      • - Embryologists might be charged with manslaughter if embryos fail to survive in the laboratory.
      • - Will the laboratory even try to thaw frozen embryos understanding that at least 10-20% of them will not survive the thaw? Will the less expensive frozen embryo transfer procedures just disappear?
      • - If the physician transfers the embryos but the patient doesn’t conceive, will the physician be blamed? Will the doctor be accused of manslaughter for the failed implantation?
      • - Will frozen embryos be able to be moved outside of or into the state of Mississippi? Will Fedx take the chance of being accused of manslaughter should a transport tank fail in transit?

      What will probably happen is that IVF will continue but physicians will only remove 2-3 eggs in a cycle. This will greatly increase the cost of the infertility treatment and result in much lower success rates. Those that can afford will go elsewhere. Who cares? For one, I do and I will bet every one of my patients will if Initiative 26 passes in Mississippi and they move on to other states, including Florida.

      Well-Meaning Intentions With Unintended Consequences

      This initiative is a really bad idea and has far more unintended consequences that I can even outline here in this short blog. The abortion decision is a personal decision between a woman, her partner, her conscience, her religion and her creator. We’ve been through this for years and years and the majority of Americans agree with this statement.

      If Mississippians pass this law today, I know my work fighting the consequences of the iStock 000003859819XSmall 150x150 Why This Florida Infertility Doctor is Concerned About Mississippi Initiative 26Personhood Movement has just begun. Florida most likely will be one of the next states in their crosshairs. I will be forced to spend time, money and effort fighting these initiatives that I could otherwise devote to building families by encouraging the donation of unused embryos to patients in need. Instead of helping bring children into this world, I will be working diligently so I can prevent similar misguided political acts from destroying my patients’ dreams. Let’s hope the voters of Mississippi don’t find out too late that their actions have stymied the very goal they were trying to achieve – building loving families that would otherwise not exist.

      Vote “No” on Initiative 26.

      Craig R. Sweet, M.D.
      Medical & Practice Director
      Reproductive Endocrinologist
      Specialists In Reproductive Medicine & Surgery, P.A.

      3 Comments

      Admin2, November 8th 2011 | Tags: , , , , , ,
      Posted in Health Care Reform, In The News, Politics, Reproductive Politics

      Polycystic Ovarian Syndrome: A Review Written for Patients

      How common is polycystic ovarian syndrome?

      Polycystic ovarian syndrome (PCOS) is one of the most common endocrine diseases affecting about six percent of reproductive age women. PCOS is one of the main reasons women have difficulty conceiving. About half of all women who do not ovulate on a regular basis will be diagnosed with PCOS.

      In recognition of PCOS Awareness Month, I’ve developed this review for patients dealing with this disease.

      How is PCOS diagnosed?

      As a syndrome, PCOS is a constellation of findings. Alone, it really is not a disease but simply a label. But physicians use these labels to our patients’ advantage. If we suspect PCOS, we will search for the problems that commonly accompany PCOS, minimizing their effect while possibly changing the course of the illness.

      PCOS requires at least two of these three problems for a diagnosis:

      1. Ovulatory dysfunction: irregular cycles or blood progesterone levels that indicate failed ovulation.
      2. Ovarian hyperandroginism: excess male hormones including an unusual amount of facial/body hair or elevated male hormones, such as testosterone, in blood tests.
      3. Polycystic ovaries on transvaginal ultrasound: more than 12 small 3-9mm follicles within each ovary as seen on an ultrasound. At times, we will see the signs of a classic “necklace,” with small cystic follicles located on the periphery of the ovary and which look like a pearl necklace.

      iStock 000001871786Small 150x150 Polycystic Ovarian Syndrome: A Review Written for PatientsClinically, there seem to be two main types of PCOS: 1) Patients who were essentially born with the problem and have never really had normal cycles, and 2) Patients who have had normal cycles but demonstrate symptoms as they gain weight. Upwards of 80% of all PCOS women are heavy, but 20% can be quite slender.

      Other issues include thyroid problems, elevations of the pituitary hormone prolactin and a handful of rare inheritable enzyme deficiencies. These problems need to be screened for and ruled out before settling on the diagnosis of PCOS.

      PCOS is probably the single most common diagnosis we see in our patients. Its incidence has been increasing over the last 20 years as the US population has shifted from normal weight to the overweight, obese and morbidly obese categories.

      How do you diagnose pre-diabetes in the PCOS patient?

      To diagnose insulin and glucose problems, commonly called pre-diabetes, we prefer a 10-12 hour fast with baseline glucose and insulin levels rather than fasting glucose levels alone. The endocrine system is then challenged by having the patient drink 75 grams of glucose (Glucola®), which is called a Glucose Tolerance Test (GTT). Two hours later, insulin and glucose levels are repeated to complete the study. We do not require blood tests every 30 minutes as some protocols suggest, since the fasting and two-hour results are sufficient.

      Insulin resistance or actual diabetes is present in nearly half of all PCOS patients. The more the patient weighs, the more likely the diagnosis.

      What really causes PCOS?

      While many women believe their hormone imbalance is mainly caused by testosterone, insulin seems to be the key hormonal culprit. Excess insulin stimulates the ovaries to produce excess male hormones. Also, excess insulin predisposes the PCOS patient to numerous medial problems, including cholesterol elevation, hypertension and possibly heart disease. Insulin is the key.

      How is PCOS best treated?

      Treatment in the overweight PCOS patient includes diet, exercise, weight loss and aggressive prevention and treatment of pre-diabetes (insulin resistance and/or glucose intolerance).

      Beyond this basic treatment, there are generally two treatment pathways: the “quality of life path” and the “pregnancy path”.

      Quality of Life Path

      PCOS patients who are not trying to get pregnant should follow the quality of life path and focus on treating the signs and symptoms. Because they don’t shed the inner endometrial lining on a regular basis, PCOS patients are at greater risk for abnormal uterine bleeding, anemia, endometrial polyps, pre-cancer and eventually, even cancer of the lining of the uterus. Hormonal control is used in this pathway. We also suggest aggressive treatment for hair growth, including the use of hormones, electrolysis or laser hair removal. The psychological affects of excess facial and body hair on women should not be minimized and may be the primary concern for PCOS patients.

      Pregnancy Path

      We recommend that PCOS patients who want to get pregnant use a winning combination of diet, exercise, weight loss and anti-diabetic medications such as metformin (Glucophage®) that are combined with ovulatory medications. Metformin helps in a number of ways including dropping male hormone levels in half and assisting in weight loss. Gas and diarrhea results when too many carbohydrates are consumed while taking metformin, so patients must learn to eat better to avoid the symptoms.

      Our practice commonly uses letrazole (Femara®) to stimulate ovulation but sometimes we need to prescribe the old tried and true clomiphene citrate (Clomid®). We occasionally have to suppress the adrenal male hormones through the addition of dexamethasone. We need to be very careful about prescribing injectable follicle stimulating hormone (FSH) medications for PCOS patients since they tend to open the floodgates, resulting in a release of multiple eggs and the potential for a multiple pregnancy. Overstimulation of the ovaries can also lead to significant illness.

      Miscarriages seem to occur more often in the PCOS patient. It may have to do with their weight and abnormal insulin levels. While somewhat controversial, even PCOS patients without obvious glucose/insulin problems may benefit from metformin treatment. It must be understood that while these drugs have been extensively studied in the treatment of diabetes, insulin resistance, glucose intolerance and PCOS, the FDA has not granted official approval for the use of these drugs for PCOS.

      PCOS patients also more commonly experience gestational diabetes during pregnancy. Weight gain during pregnancy should be held in check as excessive amounts of weight gained can result in insulin dependent diabetes during pregnancy and even afterwards. Pregnancy complications are more common in patients with gestational and insulin dependent diabetes, so an obstetrician will need to carefully monitor a PCOS patient during her pregnancy.

      What are long-term concerns for the PCOS patient?

      Women with PCOS are at significant risk of developing insulin and non-insulin dependent diabetes mellitus, uterine cancer, elevated lipids, hypertension and cardiovascular disease.

      Will a PCOS diagnosis and treatment be covered by insurance?

      The coverage of PCOS will depend upon the insurance company. Your physician will try to emphasize the medical diagnoses that are seen with PCOS, such as an ovulatory dysfunction, hirsutism, glucose intolerance or insulin resistance, but coverage cannot be guaranteed. The diagnosis of infertility for the PCOS patient is less often covered but it entirely depends on the particular insurance plan. Medications such as metformin are commonly available free at some pharmacies and supermarkets, so co-pays aren’t even necessary to obtain the medication.

      Can PCOS be cured?

      In patients that have always had menstrual issues, even when young and slender, an actual cure has not yet been found. meds iStock 101841378 150x150 Polycystic Ovarian Syndrome: A Review Written for PatientsHowever, in the population who became symptomatic after weight gain, diet, exercise, weight loss and medications may actually result in a cure. This “cure” continues as long as the patient’s weight remains close to the level when ovulation and regular cycles returned.

      PCOS is a metabolic disease and will require careful control for most patients throughout their lives. That doesn’t mean that the PCOS patient can’t have a family or will always have to suffer the symptoms. Through dedication by the PCOS patient with the assistance of your obstetrician/gynecologist or your friendly neighborhood reproductive endocrinologist, the signs and symptoms of PCOS can certainly be controlled and minimized.

      Craig R. Sweet, M.D.
      Medical & Practice Director
      Reproductive Endocrinologist
      Specialists In Reproductive Medicine & Surgery, P.A.

      Documents of Interest to the PCOS Patient:

      ASRM PATIENT FACT SHEET, Ovarian Drilling for Infertility
      http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/OvarianDrilling.pdf

      ASRM, Hirsutism and Polycystic Ovarian Syndrome, Patient Information Series
      http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/hirsutismPCOS.pdf

      ASRM, Patient Fact Sheets, Polycystic Ovarian Syndrome
      http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/PCOS.pdf

      ASRM, Patient Fact Sheet. Ovarian Drilling for Infertility
      http://www.reproductivefacts.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/OvarianDrilling.pdf

      PCOS Links of Interest:

      The PCOS Challenge:
      http://www.pcoschallenge.com/

      PCOSupport
      http://www.pcosupport.org/

      2 Comments

      Admin2, September 27th 2011 | Tags: , ,
      Posted in Diseases, Infertility, PCOS, Polycystic Ovarian Syndrome

      Free Contraceptive Insurance Coverage: A Good Idea?

      The National Institute of Medicine finally suggested that women obtain contraceptive care with full insurance coverage and without large co-pays. From one perspective, it was about time. Nearly half of all pregnancies are unintended and families should be expanded when there is true intent and not because contraception was not available. Also, since men have medications for erectile dysfunction covered by insurance, it’s seemed only fair.

      That stated, there might be a downside. Since no co-pays will be obtained, will the insurance companies increase payment to make up the difference (doubtful) or will the physician’s office loose the income in an already existing atmosphere of dwindling reimbursements (more likely)?

      Will the frequency of unwanted pregnancies and abortions really fall? Even though condoms have been made available at some clinics for free, having the contraception easily available didn’t mean it was used at all or used correctly. When one provides something for free, is as appreciated as when one has to pay an amount, no matter how small, to increase personal responsibility?

      When care becomes free or nearly free, there is almost always an increase in utilization. Is contraception one area of medicine that we would a woman taking contraceptive pills3 150x150 Free Contraceptive Insurance Coverage: A Good Idea?welcome increased utilization? Most, except the religions that do not believe in contraception, will agree this is ultimately a step in the right direction. Even so, there is no free lunch. Will insurance companies increase the premiums to pay for the office visits and the contraceptive medications and pass the costs to everyone else? We suspect the answer is probably yes.

      At first glance, requiring insurance companies to pay for female contraception seems like a great idea but there is the issue of unintended consequences. Please share your thoughts on our Facebook page where we’ve started the discussion. We’d love to hear from you!

      1 Comment

      Admin2, August 10th 2011 | Tags: , , , ,
      Posted in Family Planning, Health Care Reform, In The News

      What to Say & What Not to Say to the Infertile Patient

      DrSweet Headshot 17 03 28 150x150 What to Say & What Not to Say to the Infertile PatientBy: Dr. Craig R. Sweet, Medical Director & Founder

      (Reprinted from Florida Parenting News, February, 1994, revised September, 1999 and again April, 2011.)


      Introduction:

      Infertility affects nearly one in six couples. Approximately 40% of the time, the problem is related to the female partner, another 40% is related to male difficulties and 20% of the time both partners will have medical problems. Most of the time, infertility is a symptom of an underlying disease process, a disease process that the infertile patient has no control over. To these patients, infertility can be a crisis of the deepest kind. Every menstrual cycle represents a failure and is a time of grief for the potential child that never came to be.

      The infertile patient or couple will often express their feelings through anger, frustration, feelings of inadequacy, depression and guilt. Relationships with family members who have children can suffer, marriages and relationships are strained and well-meaning friends and family can overload the patient with advice and pressure. Family and social gatherings become a reminder of infertility. Baby showers can be a traumatic experience. Mother’s and Father’s Day are often very, very difficult.

      We want to offer some tips that provide support to patients who have not yet had the blessing of a beautiful child to love. With your assistance, most patients going though the process of trying to conceive can maintain a positive attitude.


      What Not To Say…

      Don’t ask a childless person when they are going to have a child. They may be going through the process of trying to conceive, but have not yet achieved success. Asking them only reminds them of their problem and they need no extra reminders.

      Don’t relate stories of your fertility to them. Hearing “my husband just has to look at me and I get pregnant” is very annoying. While well meaning, the statement is insensitive and unhelpful.

      Don’t give advice such as “just relax,” “you are trying too hard” or “take a vacation.” All of these very common comments imply that patient has control of their fertility. Most of the time, these patients have absolutely no control over their fertility. Implying control leads to feelings of failure and guilt when this advice doesn’t work. It simply is not their fault and they are doubtfully doing anything wrong in what they have done thus far.

      Don’t offer advice such as sexual timing, position, herbal medications or other totally unproven therapies. There are literally hundreds of old wives’ tales that, when followed, can drive an infertile patient nearly crazy. Their physician will have covered those natural aspects of their care that may maximize their chances for conception. Once again, please to not imply that they have a sense of control as they lost it long ago.

      Don’t express your derogatory personal opinions regarding insemination procedures, test-tube babies or adoption. Sometimes, these are their only hope for having a child. These are your opinions and uninvited advice is rarely neither desired nor constructive. You are absolutely entitled to your opinion; simply keep it your own. If they ask for your advice, then feel free to state your opinions, but do so in a kind and considerate manner.  Please, do not be judgmental.

      Don’t place blame by accusing the couple of exercising too much, eating the wrong foods or drinking alcohol. These patients may already be blaming themselves. Their physician will have already covered the medical and reproductive consequences of obesity, smoking, alcohol and recreation drugs. Support them in the cessation of these activities and minimize the guilt associated with their consumption. The guilt rarely leads to cessation but often moves the individual to increased consumption.

        What You Can Say and Do…

        Do provide couples with plenty of emotional support by saying “It must be difficult to go through this” and “I’m here to listen if you need to talk.”

        Do remember that men can be just as emotional about the problem, sometimes even more so. They may feel their masculinity is at risk. Be sensitive to their egos and personality traits.

        Do understand the couple’s need for privacy.

        Do try to understand that if they are your employees, frequent doctor’s appointments may be necessary during business hours. Please try to accommodate them as much as possible. Not doing so may also be construed as a form of discrimination and place you at legal risk.

        Do understand why they may not make it to a baby shower or a holiday event. These frequent events can become overwhelming for an infertile patient.

          Do tell the infertile couple that there is hope.

            Conclusions:
            Please remember that the vast majority of infertile patients have minimal control of the diseases that causes their infertility. Giving them emotional support during this trying time is a wonderful way to assist them. Giving them subtle hints that they have control plants the seeds of personal failure in the minds of the infertile patient.

            Please be kind, be thoughtful and always be supportive.

            11 Comments

            Admin2, May 5th 2011 | Tags: , ,
            Posted in Family Planning, Infertility

            No Longer Silent – National Infertility Awareness Week

            NIAW No Longer Silent National Infertility Awareness WeekEach year, physicians such as myself, fertility patients, their caregivers and families dedicated to raising awareness about the disease of infertility which affects 7.3 million Americans. RESOLVE, the national infertility association, has coordinated this week, April 24 through the 30 and we fully support it and encourage you to speak up in support as well. For information on how you can get involved in infertility awareness projects around the country and upcoming Advocacy Day on May 5, visit RESOLVE at www.resolve.org/takecharge.

            At SRMS, we are committed to providing the highest quality care and support to patients and their families. Infertility is a disease, it is important and we are working to raise awareness on your behalf. For more information, visit www.dreamababy.com or call 239-275-8118.

            No Comments

            Admin2, April 20th 2011 | Tags: , ,
            Posted in Events, National Infertility Awareness Week

            Embryo Donation – Option for Infertile Couples & Waiting Lives

            I recently had the opportunity to be on Theresa Erickson’s Internet radio show, Voice America. Known as the Surrogacy Lawyer, Theresa is renowned for her work on behalf of many patients faced with infertility looking for third party options. During my interview, we discussed the option of embryo donation  from the physician, recipient and donor perspectives.

            One of our donors, Tori, discussed her infertility experience as well as her and her husband’s  decision to donate their remaining embryos following a  successful IVF procedure culminating in the delivery of her twins. You can see a picture of her twins and information regarding her amazing embryos by visiting our website.

            emb application 4becb569b8fc3 Embryo Donation Option for Infertile Couples & Waiting Lives

            Tori's Twins!

            Tori and her husband decided that they wanted to “pay it forward” to other infertile couples. Here is a combination of her own words during the interview and some other comments she told me separately:

            “Donating the embryos brought on a wide range of emotions; some expected such as the happiness to help another infertile couple, peace in setting the embryos ‘free’ by finally making a decision on their fate and others were a bit of a surprise  such as a brief feeling of sheer panic that I ‘forgot’ something after leaving the clinic. The donation experience to me is like paying it forward to other infertile couples. I did not see any reason to leave the embryos suspended in time, did not want to see them destroyed and there was no reason to donate them to stem cell research when there are so many infertile couples in the world going through the same anguish I went through.

            That feeling of anguish kept coming back, that longing and yearning for something that was so easy for others to have, yet so very difficult for me to obtain. I wanted to help someone relieve that awful feeling and by donating my embryos, I had a very good chance of doing just that.”

            To listen to the show, please visit our Audio Gallery and click the play button to the right.

            I am so thankful for people like Tori and other donors who consider giving their frozen embryos life while helping other people building their families at the same time. If you’d like more information on the process, please visit our embryo donation page on our Website, contact us at (239) 275-8118 or e-mail us at Fertility@DreamABaby.com.

            Also, for additional details on surrogacy or fertility via third party assistance, I encourage you to read Theresa’s book: Surrogacy and Embryo, Sperm and Egg Donation: What were you thinking?

            Please stay tuned for the launching of our expanded embryo donation program called Embryo Donation International! I hope that many couples will consider to “pay it forward” just as Tori and her husband did.

            Your thoughts and comments are always welcome.

            No Comments

            Dr. Craig Sweet, September 24th 2010 | Tags: , , , , , , ,
            Posted in Embryo Adoption, Embryo Donation, Infertility

            A “Sweet” update on “The Fertility Chase” couple

            We have an update on a family featured in “The Fertility Chase” which aired on weTV (Women’s Entertainment) cable network in May. Guy Walter Costello was born on Father’s Day, June 20, at 7:48 a.m., weighing seven pounds, four ounces. The proud parents, Amy and Walter Costello, tell us, “Guy is amazing and this whole experience has been so very special.” Click here to read more about the Costello family’s journey and their experience on “The Fertility Chase.” Congratulations to the proud new parents!

            No Comments

            admin, August 26th 2010 | Posted in Sweet Success Story, The Fertility Chase

            Thoughts on “The Switch”?

            Did you see the new Jennifer Anniston movie, “The Switch” this weekend? What did you think about how it portrays the subject of infertility? Did you appreciate its humor or just find it way off base? If you didn’t see it, do you plan to? Share your thoughts!

            No Comments

            admin, August 23rd 2010 | Tags: , , ,
            Posted in IVF, Infertility

            FAQs answered!

            You ask, we answer! Read some of our most frequently asked questions, along with some common truths and myths about fertility in this issue of Sweet Concepts. Sign up to receive our free e-newsletter!

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            admin, August 20th 2010 | Posted in FAQs
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