Gynecology & Gender Selection

Page in Hindi for Gender Selection

I have just added a new home page in Hindi (translated by a Indian computer expert) on my web site.  This way individuals will be able to find out about gender selection in their native language.

Can I Still Become Pregnant at My Age?

The commonest question that any fertility gynecologist has to answer is, can I still become pregnant at my age?  It is well known that peak fertility in the human female is around age 25, and it declines as she ages.  The critical question is, can she still become pregnant at her present age?  In my experience answering this question prior to having the patient enter into the treadmill of advanced reproductive technology including IVF, is extremely valuable.  She will know her chances prior to starting, and she will not waste both time and money when there is little likelihood of success.  In a woman who has delayed childbearing, for various reasons, there is a simple way to assess her fertility.  I strongly recommend performing an ovarian assessment consistent of her fertility potential by measuring anti-mullerian hormone, inhibin B, FSH, LH and estradiol on cycle day 2 or 3.  These tests will provide an algorhythm as to the number of eggs recovered in an IVF cycle compaired to women of her age.  Clearly, the more eggs recovered the greater than chances of conception, and having a child.

Gender selection via Ericsson Sperm Separation combined with IVF/PGD

Over the past several years we have been working very hard on a unique approach to gender selection.  We have selected sperm for the desired sex using The Ericsson Method of sperm separation prior to fertilization of eggs obtained via an IVF protocol.  The advantage of this combined procedure is to increase the yield of embryos of the desired sex prior to transfer. Once fertilization occurrs the embryos are screened via PGD for the normal chromosome complement as well as the sex chromosomes.  In those couples who carry a transmissible chromosome abnormality, one of the cells of the growing embryos is also screened with a genetic probe for the specific defect.  By using this procedure the couple can be reassured if they conceive the child will be normal.  The procedure is demanding for both the couple, and dedicated team.  It requires an effort on the part of physicians, nurses and laboratory personal.  In the short span of several years we have 6 pregnancies that have delivered the child of the gender that they have always desired.  Currently we are completing a statistical analysis prior to submitting the paper for publication.  We anticipate that this combined technique is revolutionary in it's approach to gender selection.

Holisitc Methods in Gynecology

Holistic methods have become very popular in the US, and have become incorporated into allopathic (Western) medicine.  The methods are not very expensive and are usually more gentle than mainstream Western medical therapy.  I have incorporated holistic methods frequently using naturapathic products into my infertility/gynecology practice.  The most frequently seen conditions that I see in my practice are: 1.  chronic BV (bacterial vaginosis) which results in a foul smelling vaginal discharge; 2.  human papilloma virus (HPV) which frequently results in abnormal pap smears, and depending upon the nature of the virus may increase the risk of developing cervical cancer.  Both of these conditions respond well to holistic methods.  Please check my web site www.holisticgyn.com for further information.

Secondary Infertility and failed IVF

Recently I have seen several couples who have a child, but have had difficulty in conceiving a second time.  Their first child was conceived easily, and they consulted with specialists after failing to conceive within 6 months of trying.  In both case, the fertility groups didn't bother to perform a routine infertility investigation, but recommended going straight to IVF (in vitro fertilization).  The logic of the fertility experts was why bother to diagnosis the problem, and instead focus on the objective; getting the patient pregnant.  Never mind that the groups stood to gain a significant revenue stream to their practice by recommending the IVF procedure. 

Both couples diligently followed the recommendations of the specialists, and pluged into the IVF protocol.  Unfortunately for both couples they both went through two cycles of IVF without conceiving.  The majority of the eggs obtained resulted in abnormal embryos after fertilization, and were not transferred.  This is the norm for most IVF cases in that there is a high percentage of abnormal embryos are produced in the process.  Clearly with approximately a 20 to 25% clinical miscarriage rate in humans, these embryos either would have not resulted in a pregnancy if produced as a result of intercourse.  So the critical question remains, are many of those embryos obtained in an IVF cycle abnormal, or is there something about the  IVF process itself that results in abnormal embryos.

After both couples consulted with me I strong recommended a traditional infertility work-up.  In both instances each couple had a minor problem that was picked up in the work-up.  They were both treated appropriately, and both of them conceived and delivered a normal child.  In fact, one couple has had a second child with appropriate therapy.

The take home message: there is good indication to perform a traditional infertility work-up in couples who have secondary infertility.  Most therapy is not very costly nor dangerous, and the success rate is very high.

If I eat yams will I have twins?

There are some fertility experts who claim that the high consumption of yams explains the higher than expected rate of twins pregnancies in the Igbo-Ora population in Nigeria.  It is well known that yams contain phytoestrogens, which can be converted to human estrogens.  If fact, the first source to make estrogens used in birth control pills was extracted from the yam.  It is also interesting that if you give a woman additional estrogen in the early part of her menstrual cycle you can actually suppress ovulation making her infertile.  Also in those populations that consume large amounts of soy beans (also containing phytoestrogens) there is no reported increase in twins in the population.

Most twin pregnancies result from the release of two eggs in the same menstrual cycle.  If both eggs fertilized and implanted there would be a higher than expected number of twin pregnancies.  I would be more likely that higher levels of FSH (follicle stimulation hormone) are released which would lead to the maturation and ovulation of two eggs simultaneously.  Such an effect is seen when taking the drug Clomid, which has an increase rate of twin pregnancies of 6 to 8%.  So it would seem that a diet containing a high consumption of yams would unlikely be the explanation of the increase of twin pregnancies in the Igbo-Ora population.  The more likely explanation would be a genetic predisposition toward twins which somehow gave this population a selective advantage to survive in their environment.

Becoming pregnant after secodary infertility

Becoming Pregnant

Within the last year I have seen several couples who have had difficulty conceiving a second child.  Both of them were told that IVF was the only option, and neither of them had a "traditional" infertility work-up.  Both couples took the advice of their infertility physicians, and went through the several IVF cycles.  In each case, all the eggs recovered fertilized, but each embryo was chrosomally defective.

With a fairly easy work-up their problems were apparent.  Each was treated appropriately, and both couples conceived with minimal medical intervention.  One couple actually conceived a second time again with minimal medical help.

I guess that the moral of the story is that there is sense in completing a "traditional" infertility work-up.  Both the costs and the time commitment to complete a proper work-up are minimal. The rewards are unlimited!

 

"The Baby Gender Choice - The Ultimate Guide"

Over the last several months I seen many ads for the above book on posts on
Twitter.  The web site gives many testimonals, but no references to scientific articles in the medical literature on the method.  Clearly if you want to spend $55 on a book that does not have documentation in the medical literature that's your choice, but I'd like the public to know that there is an alternative.  The Ericsson Method of sperm separation, which has been available for over 25 years, has numerous medical publications attesting to it's validity.  This method is not something that you can do at home on your own, but it's success rate is 70% in having a boy or girl with over a 25 year history.  You can check out my web site www.gender-select.com for further information on how to get pregnant as well as choosing the sex of a baby via gender selection.

Recent Modification of the Gender Web Site now Includes the Work-up of the Infertile Couple

The proper work-up of the infertile couple is outlined.  Each aspect of the work-up for both the male and the female partners is covered and discussed. For the female the following is covered: 1. hormonal evaluation, 2. confirmation of ovulation, 3. cervical factors, 4. tubal patency, and 5. laparscopy.  In the male the following is covered: 1. hormonal evaluation, 2. semen analysis, 3. mucus penetration, and 4. the zonal free hamster penetration.

Having Sex at Specific Times of Your Cycle & Still Not Pregnant

Any couple that is having Timed Intercourse may not be conceiving because of the time in the cycle that they're trying!  The male's sperm lives for about three days in ideal cervical mucus after relations, but the egg is only able to be fertilized for 24 hours after ovulation!  If you timing intercourse based upon the urine testing of ovulation you may be "missing the boat", because if you waiting to have sex till the urine test turns positive the mucus qualitity has already decreased it's ability to transport sperm.   Ideal female mucus is at it's best for sperm transport several days prior to ovulation, and it decreases it's sperm transport ability on the day of ovulation.  In my practice, I've found that the best way to get a handle on ovulation, especially if a woman isn't aware of her own cervical mucus, and when to have sex is to use the OvWatch, which predicts ovulation five days prior to it's occurrence.  The technology is based upon measuring the cloride content in skin secreations.  Chloride content peaks in skin secretions about 5 days prior to ovulation. The technology was develped in Canada, but the product is marked in the States.  It's accurate, cost efficient and sure beats peeing on the urine sticks!  Most importantly, it tells you when to have sex to conceive.