BONUS 285: Advanced Reproductive Age

November 13, 2020

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Infertility Coaching with Heather Huhman

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Shelby’s first IVF cycle resulted in her son, and now they are trying for a second child. Their last retrieval yielded no embryos. She has made lifestyle changes to be healthy and asks what else she can do to get healthy embryos.
  • Teresa has been trying to conceive for 20 cycles with no pregnancies. With an arcuate uterus, low AFC, and subclinical hyperthyroidism, she asks what they can do to speed things up.
  • Vivian is 40 and has unexplained repeat implantation failure. She’s had three transfers that resulted in two failures and a chemical pregnancy. She asks about the cause of her implantation failure.
  • Tamara has had hypothalamic amenorrhea for ten years due to anorexia and overexercising. She asks if HA can suppress AMH levels.
  • Jane’s husband has a low sperm count and has been taking supplements to help. Their doctor recommended Clomid for three months to improve his count, so Jane asks if they should proceed with IVF without Clomid or postpone the cycle to try Clomid first.
  • Emily has unusual PCOS with regular cycles and a healthy BMI. Of her four Letrozole cycles, two were IUIs with no success. Their next step is mini-IVF with INVOcell, so she asks if there is anything else they should try first.

Dr. Rodgers and Heather continue the episode by discussing advanced reproductive age for women and men:

For women:

  • How do you define advanced reproductive age in women? Is it only age that matters?
  • Is there an AMH or AFC range that you look for in these women?
  • What impact does advanced reproductive age have on embryo development, pregnancy, and live birth rates?
  • Take us through a fertility awareness checkup.
  • How do you approach conversations with women of advanced reproductive age about their prognosis?
  • What treatment and family-building options are available to these women?
  • Are there any supplements you recommend or that you recommend against?
  • Do you recommend PGT for all advanced reproductive age patients, even if they only have a few embryos? Why, or why not?
  • I want to get your take on a 2019 ASRM ethics committee opinion on this topic.
  • Not that all or most of these cases with advanced reproductive age are futile, but is it true that you’ll cut off treatment at a certain point?
  • What recent research has been done about advanced reproductive age in women?
  • Are there any new technologies or treatment techniques that might benefit these women now or in the future?
  • Is there anything else you’d like to add about the woman’s side of this topic?

For men:

  • How do you define advanced reproductive age in men? Is it only age that matters?
  • Does a man’s age impact the embryo development, pregnancy, and live birth rates?
  • During embryo development, is there any way to tell if a problem is an egg issue or a sperm issue?
  • Take us through a standard semen analysis and what’s considered normal and abnormal.
  • Where does DNA fragmentation fall into this process?
  • Does a man’s age ever become part of the conversation you have with clients?
  • Are there any supplements you recommend for men or recommend against?
  • Can you explain what antioxidants are? Can you give examples?
  • What recent research has been done about advanced reproductive age in women?
  • Are there any new technologies or treatment techniques that might benefit these women now or in the future?
  • s there anything else you’d like to add about the woman’s side of this topic?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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