The Hemp Connection + women's health tips

Advanced Maternal Age, the PGS Technique, and PCOS

Sometimes I find interesting medical news in somewhat unusual places, namely the July 1, 2009 issue of the Wall Street Journal. On the front page of the “Personal Journal” section, there’s an article entitled “Fertility Methods for Older Women Spawns Doubts: Evidence Fails to Support Use of Popular Technique for Screening Embryos.”

The technique, PGS (pre-implantation genetic screening) is believed to reduce the risk of serious chromosome-related disorders, such as Down syndrome. While PGS is routinely practiced by reproductive endocrinologists (the doctors who are there to help you get pregnant when you’re struggling with infertility), the American Society of Reproductive Medicine (www.ASRM.org) now states that numerous clinical trails have concluded that live birth rates are not enhanced by the use of PGS.

What does this mean for you if you’ve got PCOS, you’re over 35 (not so charmingly referred to as “AMA,” or “advanced maternal age,” which pretty much instantaneously places you in the high-risk category) and you’re trying to get pregnant? I am an AMA PCOS patient, and I’m aware that it means several things, all of which point to the need to be a proactive patient:

Be aware of where you stand in terms of fertility timeframes – as stated above, biologically speaking, the clock really starts ticking at an accelerated rate once you hit 35. Although we hear about celebrities who are giving birth well into their 40s, they are almost always taking advantage of assisted reproductive technology when doing so. Thinking you have another decade to go before your fertility declines is neither realistic nor helpful, especially if your goal is to have more than one pregnancy.

Know your doctor’s practices – while there are commonalities among reproductive endocrinologists in the ways they practice, refer back to the ASRM for “best practices” guidelines and see if your physician is in compliance. If you aren’t comfortable with what you know, talk to your doctor, and ask questions until you’re satisfied. If you’re still not satisfied, consider changing physicians.

Know your doctor’s tendencies – is he or she precise, analytical, thorough, and well-versed in the very latest in reproductive medicine? Do you feel like your doctor is treating you as an individual, and not just a member of a particular demographic? You have the right to comprehensive assessment, a detailed treatment plan, and enough explanation about the doctor’s policies, procedures, practices, and success rates.

Exercise your right to say “no” — your doctor may not have read the very latest research, or may adhere to a belief that PGS or some other technique constitutes the best treatment for you. Your doctor is here to advise, consult, and treat, not dictate (except in life-threatening circumstances), so take the time to study proposed treatments and tests before making a decision. By the way, PGS is considered an experimental technique, and it is a costly one – adding approximately 20% to the average $10,000 cost of a round of IVF.

In the journey through assisted reproductive technology, the AMA PCOS patient needs to be aware, realistic, thorough in her research, and unafraid to question the value and price of technology. To learn more about assisted reproductive technology, I recommend the ASRM website, as well as RESOLVE: The National Infertility Association (www.RESOLVE.org).

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Advanced Maternal Age, the PGS Technique, and PCOS + women's health tips