martes, 29 de septiembre de 2015

Oncofertility. When is the right time to do something?

Oncofertility. When is the right time to do something?

 

Cancer. This difficult and complicated disease that has increased its onset of presentation, having affected millions of people worldwide, and it does not discriminates between age, race, religion, sex, etc. It is simply a disease that we all come with, and our genetics predispose each one of us of having it active at any moment during our life, specially when we have a family history of this disease.

 

Oncofertility is a field that bridges fertility with oncology in a way to provide options to cancer survivors of becoming parents in the future using their own gametes. It is known that treatment for cancer (chemotherapy, radiation and surgery) can destroy completely the gametes of female and males, making them impossible for them to conceive children in their future. Also, the number of cancer survivors has increased with the onset of new technologies for diagnose and on- time treatment of the disease. For this reason, having an increased number of cancer survivors and their desire to become parents, oncofertility was created as a perfect alternative of preserving gametes for future use.

 

It is known we do have technologies to cryopreserve human gametes and tissue. They can be frozen for many years and then being used in the future with no harm or possible complications. Every year, thousands of cryopreservations are made, providing patients with the opportunity to use their gametes in the future.

 

 

In case of a severe cancer that needs to start an immediate treatment, there are options of tissue cryopreservation. This technique was not possible to be used 10 years ago with confidence. Today, we can say with confidence this technique has provided good results with the later re-implantation of this healthy-cancer free tissue and viable eggs have been obtained. In the case there is a chance of hormonal stimulation (which requires 10-15 days of hormonal treatment) it is possible to obtain eggs. These can be frozen as eggs or create embryos if the woman is sure who she would like to use the embryos with.

 

In cases of male cancer, there are even more chances of freezing sperm, because the process of obtaining sperm it is through a simple masturbation. It makes it easier to be obtained and stored for future use.

 

Each person signs a consent form to declare in writing what they wish to do with their samples in any case of absence, incapacity to make decisions or death.

 

Because cancer does not discriminates between age, we do know more than 20% of patients fighting this disease are on their reproductive years, most of them less than 40 years old.

 

The main problem today is the cost of these treatments...Continue reading

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lunes, 28 de septiembre de 2015

Did you know that?

Did you know that?

Did you know that? by Lucy Coleman

– Infertility is defined as he inability to conceive after one year of unprotected intercourse or the inability to carry a pregnancy to live birth.
– 7.4 million women, or 11.9% of women, have ever received any infertility services in their lifetime.
– 1 in 8 couples (or 12% or married women) have trouble getting pregnant or sustaining a pregnancy.
– Approximately one-third of infertility is attributed to the female partner, one-third attributed to the male partner and one-third is caused by a combination of problems in both partners or, is unexplained.

– A couple ages 29-33 with a normal functioning reproductive system has only a 20-25% chance of conceiving in any given month. After six months of trying, 60% of couples will conceive without medical assistance.
– Approximately 44% of women with infertility have sought medical assistance. Of those who seek medical intervention, approximately 65% give birth.

– Approximately 85-90% of infertility cases are treated with drug therapy or surgical procedures. Fewer than 3% need advanced reproductive technologies like in vitro fertilization (IVF).
– The most recently available statistics indicate the live birth rate per fresh non-donor embryo transfer is 47.1% if the woman is under 35 years of age, and 37.9% if the woman is age 35-27.
– 1 in 7 marriages are between spouses of different ethnicities. And multiracial children have increased 50% in the past decade...Continue reading

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domingo, 27 de septiembre de 2015

Connectivity.

The following video is courtesy of UFO Disclosure Group.

Astrophysicist Dr. Neil DeGrasse Tyson was asked by a reader of TIME magazine, “What is the most astounding fact you can share with us about the Universe?” This is his answer.

viernes, 25 de septiembre de 2015

How to know how many is too many?

How to know how many is too many?

When it comes to fertility treatments it is really hard to make choices or to know when it is time to step back and reconsider what we are doing.

Most patients are so focused in having a successful treatment that they spend most of their time planning how to make it possible. I understand this and can relate to the story myself. Patients become too obsessed with positive results, and when they do not get them, there is too much disappointment because their expectations were set too high. Also considering the amount of money that cost having these type of treatments.

I do my best to explain the implications of fertility treatments, the advantages and disadvantages than come with it, the emotional burden that causes, and the cost of trying too many times. Even when sometimes feel I have been too strong or harsh explaining the case and probabilities of success, I do so because it is better to know the true than live in a dream. And that is exactly what I like my patients to know, the true. Many times the true it is not pleasant, but helps to prepare for any circumstance and event that might arise prior, during and after the fertility treatment.

How to know when do you need to stop? When you have had 3 un-successful attempts for intrauterine insemination or in vitro fertilization (IVF/ICSI). Take a step back for a while, reconsider the probabilities and possibilities of a future successful attempt, and talk to your doctor about your feelings and doubts.

I have found many patients coming to our clinic looking for answers. Some of them have had several prior attempts, sometimes more than 6 in a row. And if we try to discuss the alternatives, the possible causes and what they had done, 80% of them have no idea of what procedure they had, how many embryos they got and even if they still have frozen embryos. What I concluded is that 1 in 4 couples coming to our practice and coming from other clinics, do not remember what was discussed with their doctors and the type of treatment they had or will have.

To undergo a fertility treatment it is necessary some preparation. It is not for everyone to understand and digest all the information that will be provided in the clinic...Continue reading

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jueves, 24 de septiembre de 2015

How to approach you partner and talk about fertility issues?

How to approach you partner and talk about fertility issues?

As I have mentioned before in previous articles, it is not an easy task to realize the fact of being challenged in the fertility area, and to acknowledge it. Once we know there is something going on, measures should be taken. If you are in a stable relationship then communication is important. It is crucial to speak the truth and find solutions together.

If you are faced with infertility issues, talk to your partner in an open, honest and direct way. Communication is one of the main ingredients of a relationship. Communication in fertility treatments is key. If you address this at the beginning is better. There are signs and symptoms that tell us something is wrong when we decide to conceive. If you have had previous long-term relationships and had sex without protection this might be a sign that something is happening. If you are having sex with your actual partner for over a year without protection and no pregnancy is achieved that is another sign. If you are under 35 years and have sexual relationships without pregnancy, if your partner has children from previous relationships but fails to have them with you, etc. There are several signs that help us realize something is not working properly. When you spot one or more of these signs then is important to speak to your partner and address the concerns properly in order to find the best alternatives, then visit a fertility specialist.

I have seen patients during the fertility consultation that clearly have a lack of communication with their partners, and everything turns to be more difficult. During the whole procedure, fertility specialists need the collaboration of the couple. If one member of the couple is collaborating but the other still in negation, and denies to be treated then the procedure might fail. The same as when the procedure starts and information is given to the couple to be discussed together and they do not communicate and make decisions without consulting the other party, it creates problems...Continue reading

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miércoles, 23 de septiembre de 2015

Einstein and Pi (π)

Einstein and Pi (π)

It came to my attention the fascinating fact of Albert Einstein’s birthday and its coincidentally celebration with Pi (π) day this year.

Albert Einstein is known as one of the greatest minds of all time. German-born theoretical physicist. He was born on March 14, 1879, in Ulm, Germany. His life in science started early, with special interest in mathematics and physics.

Among his 300 scientific papers, there were two very important ones. The general theory of relativity and the photoelectric effect. Both of them had a deep effect in the quantum field. He began to think in depth at the age of 16. He asked himself questions like: How would a beam of light appear if you could chase it at high velocity? And he concluded that the speed of the light beam should appear to be exactly the same whether an observer is traveling toward or away from it.

The general theory of relativity , written in 1905, was his work resulting from trying to reconcile Newton’s classical mechanics with the laws of the electromagnetic field. One of its conclusions is that nothing with mass can ever reach the speed of light, and that matter and energy can be transformed, one into the other (E=MC2). For him time and motion were entirely relative. He showed that massive objects create warps in the space-time. This paper has an effect in quantum mechanics.

His other paper written the same year 1905, the photoelectric effect was the one by which he was given the Nobel Prize in Physics...Continue reading

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How do embryologists select the best embryos?

How do embryologists select the best embryos?

The procedure of in vitro fertilization is complex and involves several important and necessary steps in order to increase the chances of success. The scientific personnel needs to be prepared for any last minute event that might arise as consequence of dealing with cells. These gametes can show different behaviors at any moment during each hour they spend in the laboratory.

 

It has been said that the embryology laboratory is a surrogate environment resembling the same environment provided to the cells by the uterus inside the body.

 

Once we obtain the eggs and make possible the fertilization with the sperm, in a few hours we will start having consecutive divisions that are crucial to the process of selecting the best embryos. First we need to take into account the fact that 16 to 18 hours after fertilization we need to pay attention to the formation of the pronuclei. Normal fertilization of the egg will show the presence of two pronuclei, not one, three, four, five, and so on. If we observe anything different than two together, symmetrical and centered then we need to suspect something is not right. This is what we should have:

 

 

And this is an example of an abnormal fertilization:

 

 

 

After this time we will observe subsequent divisions each day, starting from the early cleavage stage during the first 24 hours post-fertilisation, and day 2 and 3 embryos (morula) with 2, 4, 6, 8 and 16 cells).

 

 

Now the selection of the embryos is a key factor even for a well-trained embryologist. Involves the selection of the embryo/s that are considered stronger, with high quality and bigger chances of implantation, and the discarding or freezing of the ones that look less likely to succeed.

 

How to select the embryos if we have seen in our practice success with poor/low quality embryos developing into a healthy baby? And we have also seen not successful procedures using very good/high quality embryos? Not an easy task for us.

 

Some might guide for their pure scientific knowledge than a good quality embryo it is likely to succeed rather than a slow, poor quality one. Some might use their embryologic instinct of using the embryo they considered to be stronger based on some of their qualities like good timing during fertilization and divisions, low fragmentation (rupture of the cells), cell symmetry, good zona pellucida, etc. There may be several factors to consider scientifically speaking. Also clinically it is important to judge the quality of the endometrium and the response of the embryo receptor to the treatment given to prepare for the embryo transfer...Continue reading

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martes, 22 de septiembre de 2015

Talking about ironies.

Talking about ironies.

 

I am amazed of how ironic life can be. Anything happens without a cause, there is no luck. Every person that crosses your life has a meaning. Either you play a role to them or they will play a role to yours. No matter of small or fleeting your interactions, there are no chance encounters in this world. Each person in your life was sent your way to teach you a lesson.

 

Every day I meet new people that teach me new lessons. I feel profoundly grateful for the life I have lived and for each person who has crossed my life, either to play a positive or negative role on it. I appreciate the good things and also the bad ones because they have taught me lessons I can pass on to others.

 

Life can be an irony itself. Because it is filled with situations that sometimes would not even be possible if we try to plan them. They just happen when they have to happen. Why? Simple. Because we need to live our experiences and learn from them. Because we are souls in search of life and love, the pure love that exist in that other dimension where we will go someday again, just to go back home. It is an irony we need to come to this physical dimension to have all kinds of experiences of fear, frustration, anger, hate, doubt, insecurity and envy, in order to grow. It is the way for our souls to learn to overcome each one of those negative feelings and fill ourselves with light and pure love. It is difficult to love someone that hurts us deeply, but we do not need to feel anything negative, instead send that person light and love to grow someday. Hard?..Continue reading

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The era of the Back-ups. Fertility cryopreservation.

The era of the Back-ups. Fertility cryopreservation.

As we all know, this is an era of a staggering increase of people looking to back-up their gametes in order to preserve their genetics and future fertility.

We see advertisements offering women the opportunity to save their eggs, in places called Cryobanks. Their offer is focused in women as well as men. We know men freeze their sperm for future use. Couples freeze their embryos, because most fertility procedures get remaining embryos that might end in future babies named back-up babies. This information sounds quite overwhelming when we put it together, but let’s simplify things.

Today more women freeze their eggs for several reasons. Most women are simply not prepared to become mothers during their best fertile years, and once they are finally prepared, their reserve of eggs has depleted considerably and the risk of genetic diseases increases. Having this panorama, it is a great idea to have a back-up plan, which was not available a few years ago, and freeze the eggs when their fertility is at its best. It is difficult to argue this is a clever plan. There is a huge number of successful women who are not prepared to give up their jobs and careers to become mothers; for them this is a great alternative, a win-win situation.

Another important reason to freeze eggs is when a woman has not found the right partner yet. Once she finds it in the future, it will be possible to create healthy embryos using her partner sperm. Those embryos will have the age she had when she froze them...Continue reading

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The economics of the fertility market. Is it worth the try?

The economics of the fertility market. Is it worth the try?

For those who pursue the path of becoming doctors it is a long ride, filled with obstacles, loneliness, sleepiness, loss of social life and challenges that sometimes make us reconsider if we took the right path. Then the very long career followed by a longer specialization, postgraduates, masters, doctorates and the headache of getting the job. No any job, I mean “the job” we worked so hard for.

 

Well, looking it this way even I would not have considered becoming a doctor in the first place.

 

 

Fortunately the investment it is worth the try, definitely. But there is a catch, as always. What do geniuses and successful people have in common? Each one of them have something unique to offer to the world. That something unique is the secret to be successful, and it is easily accomplished proportionally to the level of commitment one has with their passion. When we decide to take any path in life, to do anything we want to become, passion plays a key role, because it is the force that drive us forward to make anything possible. Passion without fear is unstoppable, makes us become a high power rocket, and allow us to read people’s minds, to understand their doubts, fears, needs and problems. That way we will fix several problems at once, and trust me the world it is filled with problems.

 

 

So, if we were going to invest years of our lives (specially the best years), time that represents a sacrifice itself, with stress and the huge economic investment to be where we want to be, there is a huge need of those two very important elements: passion without fear and understanding people’s needs.

 

The day I made the decision of getting into the fertility business by myself was the day I realized the power of those two elements, the rest of the elements came along by themselves without me looking for clues. And it was one of the best decisions ever...Continue reading

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lunes, 21 de septiembre de 2015

The search for life on Earth

The search for life on Earth

Past, present, future. Infertility was, is and will still being a challenge in the world, actually it is increasing dramatically and will become a bigger challenge than what it is today. We Doctors strive to learn more and more everyday about the peculiar behaviors of Mother Nature, however we still far from the truth.

My deceased grandmother used to say: “the problems of today will become the plagues of the future”. Today I understand what she meant. We are trying to solve problems today that will be very harder to solve in the future. Let’s analyze the way we humans behave. We do have natural resources which we are consuming without the appreciation and gratefulness deserved. We do have amazing, perfect and healthy bodies, which we damage and destroy, with our daily habits. We are part of a perfect designed universe that wants us to learn and grow; instead we are stuck in our stubbornness and believe that we do not need anything else. We think very highly of ourselves when we discover something new, however we still have a lot more work to do with what we’ve accomplished, to collaborate with futures generations’s accomplishments. There is no reason or logic for our lives, according to most humans. We fight the challenges that are put in our way without understanding that those challenges were there for a reason. That is the life we are living right now, and it is not a healthy life.

Continue reading

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Thanks for the knowledge and Thanks for letting me see into your cells.

Thanks for the knowledge and Thanks for letting me see into your cells.

“When I see into the stars, it gets easier for me to understand most of the answers still out there, in the universe around us”.

I wake up everyday early in the morning, drink a large glass of water, watch some news, run for 10 minutes, get my breakfast, and head on to the clinic. I get there, get changed with clean clothes and it takes me around 5 minutes to get ready; I need to be as clean as possible. I do not wear a watch so do not need to be concerned about the time. Once I am ready, with my hair and shoes covered, and clean hands and face, I start my favorite part of the day: to go inside my embryology laboratory.

To be part of that, the place where amazing things happen, it makes me feel grateful for the opportunity of being there.

It was hard work though. Several years on the medical school, several years specializing in human reproduction, long working hours at fertility clinics in several places around the world, many hours of studying and reading new advances and research. Although I have not been a researcher publisher myself, it has been a pleasure to read new developments and achievements in the reproductive field. Everyone takes different paths. Mine was something else. To have spent long hours inside the embryology laboratories amazed by the perfection of life. I mean any life...Continue reading

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domingo, 20 de septiembre de 2015

How to talk to your fertility specialist?

How to talk to your fertility specialist?

Once you acknowledge something is not working properly in the fertility area, it is advisable to find a fertility specialist. This way you will get a proper guidance and the next steps to diagnose the possible causes.

The first important thing to do is to select the right fertility specialist. This is not easy as many specialists are available, most of them with impressive curriculums and studies, however once you get to know them it might be disappointing to find out they are not the person you were looking for. Others are very difficult to get appointments with, because they are so good that the waiting list is very long. It seems like a matter of luck to find the right one. I make emphasis in this because the relationship you establish with your specialist needs to be based in trust, otherwise you will not get the expected results.

Once you select the right fertility specialist, then comes the appointment. Most fertility clinics have a nice warm environment to promote relaxation and tranquility to patients.

If possible try to write notes with the questions you would like to ask. The meeting with the infertility specialist might be overwhelming and condensed with lot of information that will make you leave with even more questions. If you make notes it will be possible to address the previous questions before getting any new information that will result in even more questions accumulated.

Ask all your questions to your specialist...Continue reading

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sábado, 19 de septiembre de 2015

A lifestyle system that will boost your results!

A lifestyle system that will boost your results!

When it comes to lifestyle we presume it might have to be related to the activities we do on a day-to day basis. Well, yes, but partially. It also has a lot to do with us intrinsically. Our lifestyles today demand lots of activities, and when we fail to comply some of those activities we feel frustrated. It is normal to feel that way.

But what if we design a system that can work together with our activities, our health, relationships and the day-to-day situations of work or studies? I designed a system and proved it myself, with friends and patients, and showed to be amazing at increasing the results in many aspects of our lives.

Before I explain you the system, I would like to let you know some facts about my own experience.

A few years ago I found to have fertility problems and had several tests done. Hormones, ultrasound scans, hysteronsalpingography, hysteroscopy and several other tests. They were all showing serious problems with my uterus, ovaries and ovarian reserve (which is the number of eggs available to be used). I was crushed. I was a fertility specialist, looking to conceive, but it was going to be a huge challenge. I underwent several complex fertility treatments with horrendous results. Nothing seemed to be working as I expected. After careful consideration of the events and acceptance of my condition I made a decision: to study my lifestyle deeper. When I mentioned that word “lifestyle” to myself I realized it was a word mentioned just a few times in my life...Continue reading

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viernes, 18 de septiembre de 2015

If I don’t find you in this life, I will look for you in the next one.

If I don’t find you in this life, I will look for you in the next one.

One day I read someone’s article stating that in this lifetime she could not be happy with any men she had a relationship with, and that she knew perhaps he did not come to this lifetime this time to meet her. By the time I read the article I did not know the things I now know. I was not aware of the fact that we, as souls, can recognize each other with our energy. I know as a fact we all have souls that mean a world to us: an infinite love. It is not the love we feel for the rest of the souls, whom we also love very much. This is a much deeper love, so deep that it is difficult to explain with words.

Once we realize in any lifetime, that we are all connected, and our energies are capable of great things, we can see more clearly.

I have seen many people depressed and sad because they are on disturbed, unhappy, and disrespectful relationships, and they cannot understand why they are submerged into such unhealthy situations. For us who are on the other side of the line, it is counter intuitive that someone would live that way. However, for them it might be something they feel they have to live with. Perhaps, because society dictates it that way, or because they do not want to recognize they made a mistake in getting into the relationship on the first place. It is not an easy situation, and I am sure many of you have experienced it yourselves, or with friends and family.

People communicate to me that they feel as if they are paying for something bad committed in a previous lifetime, which is a very common way to see it...Continue reading

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Humans

Humans

How difficult is it being humans?

It should not be so hard. It has been wonderful to live here having a body after all.

I once met a remarkable person, who was ill with terminal lung cancer. He was young still and at the beginning he refused the idea of leaving this world being so young and not having the chance to accomplish his goals during this lifetime. He was devastated by the news. But then, a spectacular change occurred on him, he started being happy and grateful for each day. He lived each of his 90 last days on earth happy. He was determined to make them memorable and amazing. And he succeeded. Those last days with him were some of the most amazing days of my life.

We though humans most times do not value how amazing it is to live every day, and the many advantages of having a healthy vessel to do so, as it is our human bodies. He said: “When I come back I will definitely have a better and healthier body”...Continue reading

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miércoles, 16 de septiembre de 2015

How to make the decision about undergoing a fertility treatment or not?

How to make the decision about undergoing a fertility treatment or not?

It is not easy. Undergo a fertility treatment it means a lot for most couples.

Some of them feel scared about the treatment. They think it is anti-natural or counterproductive for their health. Some fear they might not get the expected results. Some simply do not have the money required. It is a tough decision. It is one of those situations when you do not until you live it.

What to do? If you and your partner are completely convinced parenthood it is something very important and will make your relationship stronger, and if you have been trying to conceive for 6 months (if you are under 35) or one year (if you are over 35 years) without contraception, then you will need advice and guidance of a fertility specialist. Make some inquiries and go with the one you feel better with, listen all the explanations and choices they will give you. It is crucial to feel comfortable and supported by your medical team. They will guide you through the process and explain the pros and cons of having fertility treatments. You might even get surprised if the problem was easy to correct. In some cases the alteration is minimal and a mild treatment can do, without having to go through in vitro fertilization. I make emphasis on this, you need to feel comfortable with your medical team! If the feeling is not there, even if they are the top fertility specialists, that will impact the results at the end.

Fertility treatments are of course anti-naturals...Continue reading

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martes, 15 de septiembre de 2015

A bridge between Worlds. Witnessing life and death.

A bridge between Worlds. Witnessing life and death.

A bridge between Worlds. Witnessing life and death. By Lucy Coleman, MD.

How to describe the feeling of witnessing what I call “the bridge” between dimensions and realizing that feeling was always there, waiting to be explored further and understood in a deeper spiritual sense. The feeling is unimaginable. And this was my experience.

I am a doctor, specialist in Reproductive Medicine, a scientist, a former believer that everything could be demonstrated, even the things that have not being demonstrated yet, because their time to be demonstrated it is about to come. Now I know everything has a time.

I dedicated my entire life to science and medicine, believing that science had most of the answers. And most times found the explanation I was looking for, because it seemed they had the correct and scientific logic for most of the phenomena occurred in nature. My beliefs were that we had all the tools to find answers, explanations, reasons and logic. That was a fact until now, because realized I was far from being right. And the true was about to come to me. For some reason it was shown to me.

 

In Reproductive Medicine most events are amazing. From the beginning of the formation of each gamete, to the fertilization of the eggs, developing of the embryo, division, implantation, growing of the fetus, birth, every event is amazing. Research in this field had shown science is capable to find answers for most of the events happening during each step, and even go further to find explanations to events that before were unexplained. Scientist and observers have been looking at these events during centuries.

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Biological and Non-biological causes of Infertility

Biological and Non-biological causes of Infertility

 

There is an extensive information regarding the main causes of infertility. There are biological physical causes related to our bodies and non-biological causes related to our energy and well-being.

Regarding to biological causes we can separate them in female and masculine causes.

The female causes are:

– Ovulation disorders: these ones can be related to hormonal disorders, which prevents the egg to be released from the follicle of the ovary. These hormonal disorders may be related to genetic predisposition, disorders in our diet, tumours, injuries. Causes of these disorders can be related to polycystic ovarian disease, hyperprolactinemia, hypogonadotrophic hypogonadism, hypergonadotrophic hypogonadism.

– Endometriosis: which is presence of endometrial tissue outside the uterus. This can be painful and affect the function of the ovaries.

– Fallopian tube damage or blockage:

Fertility treatments for gays, lesbians and unmarried persons. Is it a matter of ethics?

Fertility treatments for gays, lesbians and unmarried persons. Is it a matter of ethics?

In occasions we have to make decisions that will definitely impact the future of the world in many ways. Some people argued that being gay comes with genetics. There is a great article about this topic I would like to refer to ( In this study Kenrick Vezina makes a pretty good work at understanding the claims of some geneticists regarding genetics homosexuality. Michael Bailey, a geneticists from Northwestern University and Kevin Mitchell from Trinity College in Dublin claimed homosexuality has a very strong genetic component linked to the Y chromosome.

For what I understood in their work there is a difference between sexual preference and sexual orientation, being the later related to the Y chromosome. Preference is whether you are attracted to males or females, however orientation is the one linked to that Y chromosome and it is moderately heritable. There are regions on this chromosome that influence the development of sexual orientation in men. They say there is no universal path to homosexuality across all people and heterosexuality is not a single default state. For such, there should be a set of other genes that work together and influence the sexual orientation. The conclusion of this work: homosexuality is not a choice, the same as heterosexuality it is not either. It should not be labeled as a disorder. I encourage you to have a look at that article and make your own conclusions.

Where are those people who labeled homosexuality as a disease? And what is the reason they do not like it?

I have a great story. I have these great friends. They are both from well-educated backgrounds, both professionals and successful. They had been together in a stable relationship for over 10 years, even stronger and more solid than many heterosexual couples I have met. One day they made a decision, to have a baby and raise him/her with all the love they could possible give and the security of a stable home. They went for in vitro fertility treatment with an egg donor, and off course needed a gestational carrier. The treatment went well, and they had their first beautiful baby. She was gorgeous and bright. They could not be happier. I got used to check my Facebook every other day just to see the lovely photos they were sharing with all their love ones. I could not be more proud of them. She is today a very warm, lovely and smart baby girl, today almost three years old. They had another baby two years later.

In my practice, I have seen heterosexual couples that have lots of problems undergoing fertility treatments with third persons, as in the case of egg donation, sperm donation, embryo donation, surrogacy or gestational carriers. 1 in 5 couples using third persons will develop problems dealing with frustrations, anger, fear and doubt. In the case of my gay friends, I never saw any doubt. The procedure made them stronger and their relationship evolved and became more solid, full of love and joy.

Fertility specialists usually have doubts whether to treat or not same sex couples, much more than to treat unmarried ones (as to men and women). Most of them are motivated by ethics, religion or family background. For me it is hard to understand that today, there are still a number of specialists in reproductive medicine who do not approve to treat gay, lesbians or unmarried people.

I strongly agree with the American Society of Reproductive Medicine that an over-arching ethical question is whether it is acceptable to help unmarried individuals or couples to reproduce, regardless of their sexual orientation. Several investigations have concluded that children born and raised from these couples do not show difference from children born and raised from heterosexual couples. Also it is interesting to see that in 2011, 46% of all US births were to unmarried women. This also shows that a large percentage of professional women have decided to undergo the path of parenting without the need of a male partner, in this case they use donors chosen from sperm banks. This figure it is likely to be increasing in the next years.

Discrimination laws in several countries have been changing. Today it is a whole different story. We can even see sanctions applied to fertility doctors or any members of the fertility team who denies treatment to these patients. Although it is not a comfortable idea for these patients to have a medical team agree to treat them because they are forced, and not because they want to do it. It changes things. The doctor-patient relationship will be difficult in those cases.

Currently in the United States there is an estimated 6 to 14 million children being raised by at least one gay or lesbian parent, usually as a result of a heterosexual relation. The proportion of children born to unmarried mothers hit a record 47.5% (number of 346,595) in the UK last year. The figure has risen from 25% in 1988 and just 11% in 1979. The following data shows the number of household with children in the US:

Data taken from Lifelong adoptions website (www.lifelongadoptions.com)

Also, demographic data show significant diversity among same-sex couples with children. The percentage by regions varies as in the South 26%, New England 24% and the Pacific States 21%. In 2000 census about 65,000 children lived with same sex parents. In 2012 110,000 live with gay parents, over a 100% increase.

According to the American Society for Reproductive Medicine (ASRM), there is a ethical debate that includes three important factors:

1. The reproductive interest of unmarried and gay and lesbian persons.
2. The protection of the welfare of offspring.
3. Whether professional autonomy, combined with prevailing law, provides a limit on the duty not to discriminate on the basis of marital status or sexual orientation.

For this reason, given the importance to individuals of having children, there is no sound basis for denying to single persons and gays and lesbians the same rights to reproduce that other individuals enjoy.

This has been a very important step for countries to allow these patients to receive the same treatments as the other patients have. Having say that, there is not justification for discrimination. Gay couples, lesbian and unmarried persons have the same right to receive treatments and to use surrogacy as a way for them to make parenthood happen. If children born from these patients do not show differences in their upbringing in comparison with children born from heterosexual couples, what is the issue then?. After all, what does “normal upbringing means”?

The American Psychological Association concluded there is no scientific evidence that parenting effectiveness is related to parental sexual orientation. Lesbian and gay parents are as likely as heterosexual parents to provide supportive and healthy environments for their children.

Over the last years there has been a lot of controversy. Ethics committee’s reunions, multiple groups, religious groups, societies, governments, all reviewing this subject very carefully. Most of them concluded: the same rights for everyone, without discrimination.

However, still lot of controversy and discussion in some places where it is really hard to accept this equality and the refusal to change the society model that has been implemented for those people. It gets even harder in religious countries where those practices can be labeled as unbearable and aberrations.Some countries still penalising and punishing homosexuality.

It is important for me to have your opinion.

Should we all have the same rights irrespectively from sexual orientation or decision to become a single parent?

You can also have a look at this very interesting article from the American Society of Reproductive Medicine (ASRM) in the link attached.

fertility_gaylesunmarried

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