There is a new product in stores (Walgreens & CVS) called SpermCheck^® Fertility that allows men to check their sperm count in the privacy of their own home.

The reason this is so exciting is that most men aren't checked for fertility problems until after the woman has already gone through extensive testing and perhaps even costly procedures. Given the fact that up to half of the fertility related difficulties couples experience can be attributed to male factor problems, early testing is critical.

Women regularly visit their gynecologist, and typically any fertility related problems begin to be addressed here. Men don't have this same opportunity, so they tend to fly under the radar. If no one suggests testing (and who would suggest testing if they’re not seeing a doctor for fertility?) they don’t get a semen analysis. When someone finally does suggest an analysis, many men are reluctant. Women are used to being poked and prodded and checked down there, but men aren’t, and the thought of going to a doctor to give a sperm sample can make a man feel embarrassed and sometimes even emasculated. Being able to start the process of simply ruling things out from home is a promising step.

It is important to keep in mind that the test only measures normal or low sperm count. The test won't detect problems with morphology or motility. So, while this is a good first step, a "Normal" reading should still be followed up with a lab analysis to rule out any other problems. If there is a problem with sperm count, this test offers the opportunity to catch it earlier in the process. Often, supplementing the diet with formulas designed to improve sperm quality can be all that is needed.

For more information: Richmond Times-Dispatch Article

The Secret

I'm not sure why this information is so top secret, but most women going through in-vitro fertilization (IVF) aren't told prior to egg retrieval that the anesthesia will most likely cause constipation and that there is something they can do to minimize it, or that drinking fluids that contain electrolytes a few days before and after their retrieval can help to minimize the bloating that occurs when the follicles fill back up with follicular fluid.

The Tip

So here's the top secret retrieval tip that I encourage you to share with anyone you know who is going through IVF, and even with any of the fertility doctors and nurses you work with.  I would love it if the fertility centers would make this a part of their IVF patient calendars:

When you are told to do your trigger shot (hCG, Ovidrel), that's your cue to start eating easily digested foods and drinking fluids that contain electrolytes.

What are easily digested foods?

Clear soups, fruits, salads, vegetables, bran cereals, etc.  Anything the body can easily digest.

I know it can be tempting to go have a celebratory steak because you’ve finally finished your stimulation meds (who would blame you?), or to have a quick easy pizza or fast-food type of meal because you’re so busy, but for these next few days, don't do it! 

In order to retrieve your eggs you will be placed under anesthesia, and the anesthesia will likely cause constipation.  Eating foods that the body can more easily digest and process just a few days prior to your retrieval will minimize your discomfort and help your body get back to normal faster.  After your eggs are retrieved, your follicles will fill back up with follicular fluid.  Drinking fluids that contain electrolytes (like Sobe Lifewater, Propel, Gatorade, etc.) a few days before and after your retrieval will help to minimize this bloating – just watch the sugar content.

Why start this with your trigger shot?

The IVF process is made up of specific events, such as the trigger shot, which occur on a very regular basis regardless of the facility you are with or the protocol used.  Linking this change in diet with your trigger shot helps you remember to do it and gives your body a few days to prepare.  Eating easily digested foods and drinking plenty of fluids that contain electrolytes a few days prior to your retrieval can help minimize the discomfort by giving your body something easier to work with.

Don’t forget Acupuncture!

Because of the constipation created by the anesthesia and the bloated feeling that can be experienced from the egg retrieval, some women feel miserable the day after.  Acupuncture can help.  I’ve had clients call to cancel their post-retrieval appointment because they’re feeling so bad.  We do our best to encourage you to keep your appointment, because we know if we can get you in for acupuncture, you will leave feeling better than you did when you came in.

Organic
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No Hydrogenated Oils
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Sounds aweful, doesn't it?  But these crackers are sooo good!

"Organic Mary's Gone Crackers" have a dark roasted nutty flavor and are my most recent good for you but tastes good too find.  I just had to share!

They're available at Costco on Morena Blvd in San Diego, and you can learn more about them at www.facebook.com/MarysGoneCrackers.

PCOS ladies, these are gluten-free, whole grain and contain 140 calories and 0g of sugar in 13 crackers.

Irritable Bowel, Celiac Disease, Crohn's and Gluten Intolerance sufferers, these crackers are gluten-free, low in fat and high in fiber.

If you "crave the crunch" - you know what I mean! - these crackers are a real treat.

We are frequently asked if acupuncture is considered a qualified health care expense for Health Reimbursement Accounts (HRA), Health Savings Accounts (HSA) or Health Care Flexible Spending Accounts (FSA).  The answer is yes!

Acupuncture is also a tax deductible expense (IRS Pub 502), so make sure you keep track of what you are spending or contact your acupuncturist's office at the end of the year and request a statement.

Cigna has a very good web page that explains what FSA, HRA and HSA expenses are reimbursable.  On it they state, "You can use your HRA, HSA or Health Care FSA to reimburse yourself for medical and dental expenses that qualify as federal income tax deductions (whether or not they exceed the IRS minimum applied to these deductions) under Section 213(d) of the tax code."

If your tax professional is unsure, these are good resources to provide to them.

I get asked for referrals from people all over the country, and I wish I knew more acupuncturists!

Here are a few suggestions for how to locate an acupuncturist in your area who specializes in fertility:

1. Referral From Someone You Know - this is typically one of the best sources, because someone you know and trust is likely to refer you to someone they know and trust.  If at all possible, get a personal referral.

2. Fertility Support Groups - RESOLVE: The National Infertility Association  has local fertility support groups all over the country.  Here in San Diego, our local group is called the San Diego Cookies Support Group.  These are women who are dealing with various fertility issues, and they are here to help each other.  Ask for a referral.

3. Continuing Education Groups - Two groups that provide continuing education and certifications to acupuncturists who wish to learn more about infertility and how to treat it are The Fertile Soul and ABORM.  Both groups can provide lists of practitioners who have been through more extensive fertility training than what is taught in acupuncture school. There are many well educated and well practiced practitioners who's names are not on these lists, but if you don't know where to start, this is a good place.

4. Assisted Fertility Centers - Whether you are thinking of IUI, IVF or simply trying to conceive naturally, contact fertility centers in your area and ask them if they are currently working with any acupuncturists.  Often times they can provide you with a referral list.

5. Your Doctor - Ask your OB/Gyn or primary care physician for a referral.  Acupuncture continues to be more and more accepted in the medical community, and many western physicians have established relationships with acupuncturists and naturopaths.

6. Internet Search - If none of these other options work for you, a starting point might be a search on Acufinder.com's database of acupuncturists.  You will need to do some follow up to make sure the practitioner you choose works with fertility, but if you are in a smaller town, this might get you headed in the right direction.

Legislation will remove financial barriers for infertility treatments

RESOLVE:  The National Infertility Association applauds Senator Kirsten Gillibrand (NY) for introducing a bill in the U.S. Senate that would provide eligible taxpayers a tax credit for the out-of-pocket expenses incurred with infertility medical treatment.

Appropriately named the “Family Act of 2011,” the bill, S 965, would apply to expenses related to in vitro fertilization and treatments to preserve fertility for cancer patients.

The Bill was introduced just days after RESOLVE’s successful Advocacy Day in Washington, D.C.  Advocates from across the country met with their Members of Congress to advocate for the tax credit.   Enthusiasm was very strong for the tax credit among the Advocates, who see the need for immediate financial relief for infertility patients.

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What YOU can do:

Now that it is introduced, S 965 needs co-sponsors in the U.S. Senate.  We need EVERYONE who is facing infertility (and their friends and family) to contact their two U.S. Senators.

1. Contact your two Senators right now.  It takes 3 minutes through RESOLVE’s Action Alert System. PLEASE review the online letter and personalize it with your story.  Personal content is far more impactful than a form letter.
2. Ask your friends and family to send letters  too!  Forward this link so they can take action today. http://www.resolve.org/taxcredit
3. Share the information about the tax credit on your Blog or Facebook page!

I received a call today from a gentleman wanting to set up an appointment for a sperm analysis.  We gave him the information he needed, and I thought I'd share the information here as well.

You'll first need to get a prescription from your doctor, but in San Diego the two facilities we refer to for sperm analysis are:

San Diego Fertility Center
11515 El Camino Real, Ste 100
San Diego, CA 92130
(858) 794-6363
www.sdfertility.com

Fertility Center of California, San Diego
6699 Alvarado Rd, Ste 2208
San Diego, CA 92120
(619) 265-0102
www.spermbankcalifornia.com

RESOLVE of San Diego
Free Monthly Educational Meeting

The affects of male factor infertility are often hidden, both medically and emotionally. If you and/or your partner have been diagnosed with male factor infertility, or if you have unexplained infertility, please join us on June 17 to explore the male reproductive function and the factors that may impair your fertility.

Male Factor 101
Thursday, June 17, 2010
San Diego, CA
6:30PM

Featured Speakers
Dr. Martin Bastuba, Male Fertility Specialists
Dr. Sanjay Agarwal, Reproductive Partners
Bruce Thomsen, Coast Reproductive

The Grand Del Mar - Bobby Jones Villa
5300 Grand Del Mar Court
San Diego, CA 92130
(858) 314-2000

Learn more and register online at www.southwest.resolve.org

This is a question that we hear more frequently than perhaps any other, and it’s a terrific question!  Before you begin any treatment plan, you want to know what kind of commitment you’re going to have to make both in time and money.  Often this question is answered with, “It all depends on your situation”, which is very, very true, but here are some guidelines that should actually give you a little more to work with.

Generally speaking, if you are a woman trying to conceive, the most important times to have acupuncture are during the follicular phase -  day 5, 6, 7 or 8 of your menstrual cycle (day 1 being the first day of heavy flow), the day of, day before or day after ovulation (as indicated by your LH surge), and during implantation time (7 – 10 days after ovulation).  This works out to be approximately once a week except when you’re menstruating, so most women should be receiving acupuncture treatments roughly three to four times per month.

If there is something more significant going on, like lining issues for example, your acupuncturist may want to see you twice a week until it is properly addressed.  However, the majority of the women we treat fall into the once a week category.

If you are going through an IVF cycle, it’s best if you can start acupuncture 6 to 8 weeks prior to transfer.  The most important times to have acupuncture are the same as above, however, once you begin your stimulation medications you may be seen twice a week depending upon information gathered from your ultrasounds.

In an ideal world, we would like to begin seeing you 3 – 4 months prior to conception/transfer so that we can help with egg quality, work on any cycle or lining irregularities, address any nutritional concerns, and help reduce stress.  If you are going through IVF, FET or DET we are also working to prepare you for your transfer.

If you are considering acupuncture, I encourage you to get in for your initial visit as soon as you can.  That way you and your acupuncturist can develop a treatment plan that best suits you, even if you don’t start the treatment plan until later.  Getting that first appointment under your belt also allows you the opportunity to determine if acupuncture is right for you and if it’s something you want to continue to pursue.

If supplementation or herbs are warranted, they take time to work, so beginning earlier is best.  Even if you decide to wait to start acupuncture, don’t wait to start supplementation.  It takes 3 – 4 months for an egg to mature.  If you can get started on a good quality preconception formula 3 – 4 months prior to conception/transfer, your eggs are going to have the opportunity to grow and mature in a nutrient rich environment.  Our experience is that women who supplement their diets with appropriate amounts of vitamins and antioxidants typically have embryos with less fragmentation.

Why acupuncture?  Blood flow, blood flow, blood flow!  This is how we nourish every single cell in our bodies – blood flow.  We want to get you into a deep state of relaxation, taking you out of your fight and flight mode, and encourage blood flow to the internal organs.  Why acupuncture?  Acupuncture helps regulate and balance the hormones by affecting the hypothalamic-pituitary-ovarian axis and is a very important tool in the fertility process.

Do you need to come twice a week?  Probably not.  Do you need to come once a week?  It all depends on your particular situation (you knew I was going to say that, right?).  If you are 4 months away from your IVF transfer, maybe you need to come every two weeks.  If you’re 60 days away, maybe once a week.  If your lining is thin, maybe twice a week.  It really and truly does depend on where you are in the process, what specific difficulties you are experiencing, and how you are responding to your treatments.

National Infertility Awareness Week has passed, but I think awareness is something we can strive for everyday, and in particular on Mother's and Father's days.

I truly believe in my heart that most people mean well, but if you haven't walked in the shoes of a person who is struggling with fertility, it can be difficult to understand how hurtful even well meant comments and circumstances can be.

I want to share this article from CNN.com in honor of Mother's Day and in advance of Father's Day to simply help remind all of us to not only appreciate the lives that our parents gave us, but to remember that life truly is a gift.

I still can't believe it's already May, but I have to say, I'm ready for a little sunshine!

In my life I spend a lot of time focusing on fertility issues, trying hard to help men and women achieve their goal of having a child by helping them to conceive.  I think sometimes it's good to remember that not all families begin this way and that for some of us there are alternatives.

May is Foster Parent Appreciation Month, and in an effort to help all of us become more aware and perhaps open our hearts to something we aren't yet truly familiar with, I want to share a letter with you that I received from a client and friend.

Dear Friends and Family-

As you know we have been a part of the Angels Foster Family Network as Foster Parents for some time now. Angels has been a very rewarding experience for us and we want you to know more about them. Angels is the only foster family agency in San Diego specializing in infant care and inclusive of all races and ethnicities.  Angels is a licensed, private, non-profit foster family agency, run solely on private donations.  What makes Angels unique is they have created a solution to prevent RAD (Reactive Attachment Disorder) an incurable disorder, by rescuing foster babies in the earliest months of life and placing them in loving, nurturing homes (like ours) where they can heal and learn to trust again.

Facts about Child Abuse in San Diego:

• Nearly 5 children die every day as a result of child abuse, of which more than 75% are under the age of 3.

• There are currently over 7,000 foster children in San Diego County, with more than 1/3 of them under the age of 3.

• Since 2000, more than 30 children have died in foster care in San Diego county.

• If a baby does not have one consistent caregiver with whom he/she can bond with in the first 24 months of life, that baby may be doomed with Reactive Attachment Disorder (RAD) meaning the chances of that baby being able to develop the ability to bond with others in its lifetime is highly unlikely.

• 80% of prisoners nationwide have spent time in foster care.

• The annual cost resulting from child abuse and neglect in the US is $104 billion.

In recognition of  May as Foster Parent Appreciation Month, we are accepting the challenge to help raise money for Angels.  If each Angels family is able to raise $500 from all our friends, family and associates, Angels could place another 8 new babies in 2010, perhaps one that we’ll be lucky enough to care for!   Would you consider helping us help more babies in need by making a donation of any amount today.  You can do this by simply clicking the “donate now” link on our website, http://www.angelsfoster.org or by mailing a check today to Angels at, 6160 Fairmount Ave., Ste H, San Diego, Ca. 92120.

It truly “takes a village” to raise babies who fall victim to the foster care system, so please help us help these babies who can’t help themselves.  Please pass this on to all your friends as well – we’d like to be the family who raises the most money for Angels, so please help us in our efforts!

Thank you so much!

Click this link to donate now:  Angels Foster Family Network

Click this link to Visit the website:  http://www.angelsfoster.org

I stumbled across an article that does a good job of explaining the philosophy of Chinese Medicine compared to that of Western Medicine.  I adamantly believe that both forms of medicine are equally important and actually compliment one another.

The article, from preconception.com, more specifically discusses Chinese medicine and fertility.  More and more people are seeking help from acupuncturists for infertility issues from PCOS to male factor infertility to unexplained infertility.  One reason for this increased acceptance is that we’ve seen good success helping men and women conceive over the years.  However, another important reason is that through scientific research and patients advocating for themselves, Western physicians have taken notice of the positive role acupuncture plays both medicinally and emotionally and are actually being more proactive with respect to acupuncture and the role it may play in improving the odds of conceiving.

One caveat, they talk about working to raise FSH levels in the article.  Yes, Chinese medicine can be useful in raising FSH levels if they are low, however, we more often use Chinese medicine to lower FSH levels.

I started out this blog wanting to share an article with you, and it got me thinking about infertility and what exactly it means - because frankly, it means a lot of different things.  Some people have to try to change their lifestyles, reducing caffeine and sugar, and increasing exercise.  Others may need to add protein to their diet or actually reduce or revise exercise.  Some wade through the mysteries of male factor infertility.  Others struggle with PCOS, endometriosis, blocked tubes, poor egg quality, cancer, and a host of other causes.  Still others are lumped into the group of unexplained infertility where answers can seem few.  The medical and emotional aspects of infertility can be overwhelming.

All of these people, more than 7 million by most recent estimates, make their ways through this process as best they can.  And while they each may take a different path, they all share a similar goal.  They’re all striving to achieve essentially the same thing.

So in the spirit of National Infertility Awareness Week, I hope to help you become more AWARE of not only your particular situation, but also the situations so many others find themselves in.  Awareness does involve educating ourselves and those around us, but I think more importantly it speaks to compassion and empathy.  In sharing our hearts with others, we often find peace in our own journeys.

Delivering Hope: The Extraordinary Journey of a Surrogate Mom is a book that was written by local San Diego author, Pamela MacPhee.  Her story is this week’s San Diego Infertility & Miscarriage Examiner article.  This weekly column is written by another local author, Erin Miserlis.  If you haven't done so already, subscribe to her column.

Statistics show that nearly 12% (7.3 million) of US women ages 15 - 44 struggle with fertility. That percentage rises to more than 15% for US women ages 34 - 39.

I encourage you to become a Facebook friend of RESOLVE San Diego. Even if you aren't trying to conceive, someone you know probably is.

 RESOLVE: The National Infertility Association was founded in 1974 by a nurse with infertility, Barbara Eck, who started the first RESOLVE support group around her kitchen table. The same support groups meet today all over the country and is still a huge part of helping women and men diagnosed with infertility find resolution.

RESOLVE is the only non-profit organization with a nationwide network of chapters mandated to promote reproductive health and to ensure equal access to all family building options for men and women experiencing infertility. Across the U.S., RESOLVE local affiliates provide support groups, educational programs and opportunities to meet and connect with others experiencing infertility. Supported by a strong volunteer network, RESOLVE is a source of information and support for the family building journey.

RESOLVE has a variety of free online resources that address treatment, coping, third party reproduction, adoption and living childfree. www.resolve.org offers wide ranging information on the infertility journey. A robust online community provides virtual support to anyone. Information on membership, the RESOLVE network and an events calendar are easily accessible. Learn. Connect. Take Charge.

The Wall Street Journal published an intriguing article this week (03/23/10) entitled "Decoding an Ancient Therapy".  Health Journal columnist, Melinda Beck,  focuses on the growing scientific evidence for the effectiveness of acupuncture in the treatment of several different disorders, including pain and stress.