ACRM

Ovarian Reserve

By: Robin H. Fogle, MD, ACRM

Women are born with a certain number of eggs. That number is thought to be around 2 million, a number significantly lower than the 6 to 7 million originally present in the female fetus. Eggs are constantly undergoing cell death, a process that starts before we are born and continues throughout our reproductive years. So, though we may be born with 2 million eggs, we will only ovulate ~400-500 eggs during our lifetime. The other eggs are absorbed back into the ovarian tissue. This explains why women start having more difficulty conceiving around the age of 35. By that time, a significant number of eggs have been “lost”, and ovarian reserve is diminishing.

Being Still

By: Mark A. Lewinter, L.Ac., ACRM

The beauty of acupuncture is that it can help one achieve balance by providing a state of deep relaxation and open perspective, as well as slowing the mind down.  This can all immediately happen with the placement of just a single needle.  When this state occurs, we feel more freedom around all issues in our lives, including the fertility process. 

Some of the most common words after a patient’s first acupuncture treatment are, “Wow! that was very relaxing.”  It can be shocking to realize how tense one has become.  After that first treatment, many patients feel a return to the “true” part of themselves and restored in subtle but meaningful ways.

Unfortunately, all too often, it is only when we reach a point of being overwhelmed that we will take a positive action to restore the body and mind. But it doesn’t have to be that way.  Creating moments of renewal during the fertility journey is paramount.  We all know it takes effort to create opportunities for stillness, but the gift in return is peace and confidence.  The more effort placed on achieving states of deep stillness while trying to conceive, the better. 

As we enter into any journey, it is so important to maintain our resources in the process.  When a significant amount of resources go in to a hyper identification with all of the aspects of our mind, our thoughts, feelings, and emotions, we have wasted energy that could have been put to better use.  Acupuncture is an energetic medicine, so in every treatment the acupuncturist is focused on helping the patient’s mind and body use its resources in the most wholesome way. 

There is so much that patients can’t control in the fertility process; however, I am pointing to something that can be managed, the practice of stillness.  Simply put, when our resources are managed in the best possible way, it is always a step in the right direction.

Sperm Mystery Solved?

By: Chad Johnson, PhD, HCLD, ACRM

Scientists may have solved a 20-year mystery regarding the molecular mechanism by which human sperm detect an egg. There is a special channel in the sperm that senses compounds given off by the egg. The findings, published in a pair of papers, state that nature may aid fertility researchers determine how to enhance fertility in couples seeking treatment.

Prior to fertilization a cloud of cumulus cells surrounding the egg release progesterone (the female sex hormone).  This progesterone release triggers a calcium influx into the sperm. The flood of calcium causes the sperm to beat their tails rapidly, an action necessary to penetrate though the egg's protective jelly-like protein coating. Progesterone has also been implicated in providing a chemical gradient by which sperm can navigate toward the egg.   This knowledge may assist the IVF staff at ACRM by helping them select different methods used to assist fertilization. 

Timed Intercourse

By: Jim P. Toner, MD, PhD, FACOG, ACRM

Lots of people wonder when the “best” time for intercourse is, and how often they should be having intercourse.  The goal is obviously to have lots of sperm around when the egg is released.  Two things are important to know: 1. Sperm live for a few days in the female genital tract, while an ovulated egg lasts only 12 or so hours unless it gets fertilized, and 2. Intercourse every other day is essentially as good as intercourse every day.

So, for women with regular cycles, there are two sensible approaches.  The low tech approach is to have intercourse every other day from day 8 through 16 for those with 28 day cycles.  The other approach is to use ovulation predictor kits, and to have intercourse the day of, and the day after.  The kit detects imminent ovulation (peak or two-line or smiley face depending on the device).

Am I Covered Too?

By: Steven C. Gerson, CPA, MPAcc, Chief Financial Officer, ACRM

So often we see patients who think “My friend has ‘XYZ’ insurance; I have insurance with the same insurance company.  My friend told me she has coverage for infertility care.  Since I have insurance with the same insurance company, that means I must also have coverage.”

 

Be really cautious with this line of thinking.  What a particular insurance plan covers and does not cover is totally driven by what the person’s employer decided to have included.  This is especially true with infertility care.  Infertility coverage often is a separate rider that can be added to a policy by the employer.  Thus, when comparing two policies side-by-side, everything might be identical, except that one may have infertility coverage and one may not.

 

Even if infertility coverage is provided for in an insurance plan, read it really carefully to determine what it covers.  Is it only covering the diagnostic phase of care?  In other words is it covering only the care rendered to determine why the infertility exists?  OR – does it cover care given after the cause is determined to actually help the patient try and achieve a pregnancy, through say IUI or IVF?

 

So . . .the big take-away here is study your plan.  Know what it does and does not cover, and be certain you understand any restrictions or exclusions.  This will help take the “surprise” factor out of your infertility journey in terms of insurance.