Advanced Maternal Age and Statistics

October 26, 2004 - Tuesday
2:34 PM to 3:34 PM (EST)
Guest Speakers: Richard Paulson, MD - USC Reproductive Endocrinology & Infertility

Categories
Donor Egg • Egg Donation • Infertility • IUI • IVF

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csronis	hello - we musy be early
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Lisa_Rosenthal	Hey everyone! Glad to see you here!
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schnauzerpal	Are we waiting or what?
joycew7	I thought this was for Dr Paulson?
schnauzerpal	I think this is for oldies like me-over 46 yo
schnauzerpal	I mean I am 46
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Dee_Dee	I'm 47 yrs old
Corey	Hi you're both right - the chat is for us "older" women, moderated by Dr. RIchard Paulson
joycew7	I am 46 too and he is my new RE
Dee_Dee	Cool
schnauzerpal	Does anyone live in OK?
joycew7	CA here
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Dee_Dee	I'm in California, Irvine CA
Lisa_Rosenthal	Welcome to everyone who is joining us this evening.
Dr._Paulson	Hello!
Lisa_Rosenthal	Dr. Paulson will be here, and there he is!!
Lisa_Rosenthal	Welcome Dr. Paulson!
Dr._Paulson	Hi, it's great to be here.
Lisa_Rosenthal	Please feel free to post questions for Dr. Paulson
Dee_Dee	Any ground rules? I've never participated before?
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carolyn	I wonder what might affect the success rates of donor egg recepient
local	[332] Advanced Maternal Age and and Statistics with Richard Paulson, M.D., (USC Reproductive Endocrinology and Infertility)
Lisa_Rosenthal	DeeDee and everyone, please feel free to post questions at any time.
Dr._Paulson	Carolyn, the rates are the same for all ages
Lisa_Rosenthal	You may want to copy and paste your questions and repost if they are not answered.
Dr._Paulson	So you are just as likely to get pregnant with egg donation if you are 50
carolyn	Yes, but rates vary from clinic to clinic
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Dee_Dee	I'm 47 yrs old. Last Thurrsday I had two uterine fibroids removed. How soon can I start pursuing infertility treatment again?
Dr._Paulson	as if you are 30.
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iwant2bamom	Hi all
carolyn	why would one have a rate pf 40% and another of 89%
Dr._Paulson	Carolyn, rates do vary from clinic to clinic.
Lisa_Rosenthal	I ask that you keep personal conversations to a minimum, please use the private button to chat among yourselves! I hope that helps in terms of "rules".
local	[332] Advanced Maternal Age and and Statistics with Richard Paulson, M.D., (USC Reproductive Endocrinology and Infertility)
carolyn	Yes, what makes such a vast differance?
Dr._Paulson	Carolyn, I would suggest that you look at the SART data as opposed to what you get on the website
Dr._Paulson	That kind of difference is not very likely
carolyn	rather than the CDC website?
Dr._Paulson	Nobody can do 89%, I'm sorry.
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Dr._Paulson	There are differences because of patient selection and also, you can get on a "lucky" streak
carolyn	the clinic I go to has a 75% rate posted (sorrym not CDC, but other national site)
Dr._Paulson	You have to look at other factors besides the pregnancy rates, like reputation, and the bottom line: do you feel comfortable at this clinic?
Dr._Paulson	Dee dee, about your fibroids
Dee_Dee	Yes
Dr._Paulson	I don't believe in waiting very long before getting started again,
Lisa_Rosenthal	Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Richard Paulson, (USC Reproductive Endocrinology and Infertility) joining us this evening. We will be discussing the topic "Advanced Maternal Age and Statistics". Thanks for joining us this evening! Lisa Rosenthal, Educational Coordinator for The AFA.
barbara65	I'm 39 and on 3rd cycle of 150mg of clomid and had my first unsuccessful IUI how soon should I move on to injectables
Dr._Paulson	because it takes a while for the uterus to grow during pregnancy. Therefore, I only wait 6 weeks after the myomectomy to start. best of luck
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ivytone	What is the average sucess rate for a 44 year old to have a live birth?
Dr._Paulson	barbara65, at 39, you shouldn't do more than 3 cycles of clomid
Dr._Paulson	move on to injectables, and after 3 months of that go to IVF
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Dee_Dee	Thanks Dr Paulson for your feedback
barbara65	thank you Dr. Paulson
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Dr._Paulson	ivytone, donor egg can get you 50%
Dr._Paulson	your own eggs at 44 years of age is a long shot
carolyn	How will a vericocele repair affect morphology
Lisa_Rosenthal	Ladies and Gentlemen, another wonderful way to make sure that you are seeing a wonderful physician is to call our toll free hotline and get a doctor referral. The doctor's on our referral list have to meet a very high standard.
Dr._Paulson	that's a way of saying "less than 5%"
Dr._Paulson	carolyn, varicocele repair is still very controversial
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carolyn	so, what does that mean? Have there been successes?
Dr._Paulson	I have to tell you that I have seen varicocele repair help maybe 5 men in my 20 years of infertility practice
Susan	Can you please explain how quickly age can become a factor? For example, a year ago I had CD3 labs done and and FSH was >8. I did a long stim protocol IVF cycle in March (stimmed perfectly) and got pregnant with an ectopic. In July I moved to a microdose flare protocol and had to quit because of poor response. In September we went back to long stim protocol (proven method) and got only three follicles. Can my age become such a factor so suddenly (I am nearly 38)?
Dr._Paulson	Most men achieve pregnancies even with the varicocele unrepaired
Dr._Paulson	Susan, you are experiencing a decreased sensitivity to fertility meds
Dr._Paulson	This is not the same as saying you are becoming less fertile.
Susan	would stepping out for several months help?
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Lisa_Rosenthal	Please call our toll free hotline to ask our patient advocate for doctor referrals in your area. That number is: 888-917-3777 and our patient advocate is Lori Masi.
Dr._Paulson	We're not sure why some patients appear to respond less well over time, but we don't think this represents a decrease in overall fertility potential
Dr._Paulson	Susan, at 38 I wouldn't wait
Dr._Paulson	Susan, keep on with the microdose flare
Susan	Thank you.
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Dr._Paulson	You're welcome, but you gotta understand that I haven't seen all of the cycle details, right?
Susan	yep
carolyn	When using a proven egg donor - is there a chance that they could have a bad cycle? In other words, is there a benefit to going with a proven donor over an unproven one (chances of a bad cycle??)
joycew7	Would you suggest anything else to help conceive? Diet? I have had 3 failed donor egg cycles and a myomectomy in June
Dr._Paulson	Joycew7, there is no information about diet.
durango	Is there a way to increase success for a 44 year old doing IVF? Such as acupuncture, complete avoidance of alcohol and caffeine, meditation or anything that has been documented?
Dr._Paulson	We do recommend vitamins, and I like the omega-3 fatty acids
Dr._Paulson	But there really is nothing scientific.
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Dr._Paulson	The problem is that reversing the age of the egg is like trying to reverse all of aging
Dr._Paulson	And that is something medicine really doesn't know - if it's ever going to be possible
Dr._Paulson	carolyn, a proven donor gives you peace of mind,
Dr._Paulson	but you should know that there is nothing scientific that substantiates them being any better
Dee_Dee	Any tips on choosing an egg donor, other then a proven egg donor?
Dr._Paulson	in fact, studies seem to imply that it's all just random, and you're just as likely to have success with a new donor as with a proven one.
Dr._Paulson	Dee dee, that's why I say, pick a donor that you like, not one that necessarily has prior success
Dr._Paulson	joycew7, myomectomy doesn't appear to be a problem
Dee_Dee	Thanks for the feedback
Dr._Paulson	And as I said earlier, we only wait 4-6 weeks after myomectomy to start again
carolyn	Dr, after the run-around in fertility treatments, NOTHING gives me peace of mind, except honest answers, which I appreciate from you!
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Dr._Paulson	The one caution that I would add is make sure the inside of the uterus is normal after myomectomy
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Dr._Paulson	I have seen patients who ended up having a tiny fibroid inside the cavity that nobody noticed and that can interfere with conception
Lisa_Rosenthal	Dr. Paulson, you are doing a wonderful job!!!
ivytone	You said the sucess rate for a 44 year old is less than 5%. Is this statistic also true for a woman getting married at 44, fot the first time, who has never tried to have a baby before?
Dee_Dee	How will the Reprod Endrol know that the inside of uterus is ok? Through ultrasound?
joycew7	What about caffeine? I drink 1-2 diet cokes a day but in the past have cut them out per my accupuncturist
Dr._Paulson	ivytone, you hit then nail right on the head!
Dr._Paulson	ivytone, we don't know what the statistics are for women just getting married!
Dr._Paulson	I suggest they try at home for a while, then come in for egg donation, because if we do IVF, they get less than 5%, but you hear about people getting pregnant at home
durango	Does your success rate at 44 increase for having been pregnant 4 times (miscarriage 2x)?
gl1999	What are the odds of successful pregnancy resulting from FET? Does maternal age have any impact on FET success? After 6 miscarriages, we were finally successful on our first try at IVF 4 years ago. We have four embryos in storage. I just turned 41 but would prefer to wait until next year before trying the FET.
Dr._Paulson	joycew7, I really don't believe that caffeine is bad
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Dr._Paulson	deedee, to look for a fibroid inside the uterus, you have to do a saline injection ultrasound, or (better) and office hysteroscopy
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Dr._Paulson	durango, miscarriages are common at 44, so I would think it's better to have been pregnant and miscarried than not pregant at all
Dr._Paulson	but again, no real data!
joycew7	Dr Paulson you did a hydrosono on me should it have been a hysteroscopy?
schnauzerpal	Dr Paulson-Have you ever heard of Gilbert Haas in OKC? or his stats with donor egg. Since 12/03, I have gone through one cycle of donor egg with A rated eggs(2) and a frozen trf in 4/04. Both unsuccessful. I was told my lining was great. Dr Haas was my doctor. Also, what is myomectomy. I have had 2 surgeries to remove fibroids-were these know as myomectomies?
Dr._Paulson	gl1999, the frozen embryos are good for a long time, and your age at the time of the transfer doesn't matter.
carolyn	does the timing of an IUI affect success rates (24 hrs after injection rather than 36?)
Dr._Paulson	joycew7, both are OK
local	[332] Advanced Maternal Age and and Statistics with Richard Paulson, M.D., (USC Reproductive Endocrinology and Infertility)
gl1999	What are the odds of success for an FET?
Dee_Dee	What is a FET?
Dr._Paulson	schnauzerpal, Gil Haas is a very good dr. myomectomy is the term for removing fibroids
Susan	For IVF cycles, my center doesn't dose more than 225IU each when doing Gonal-F and Repronex. Is that standard in the field? Last cycle I produced only 3 follicles (3 eggs, excellent embryo quality), I am wondering if I went elsewhere and upped the dose to 300IU or 375IU might be a better option for me to produce more follicles.
Dr._Paulson	gl1999, FET results depend on the age of the egg at the time of retrieval. FET rates are about 40% for donor egg, and about 2/3 the fresh rate for women using their own eggs
schnauzerpal	what are your thoughts about embryo glue?
Dr._Paulson	carolyn, I like the IUI as close to ovulation as possible, and 36 hours is closer
Lisa_Rosenthal	Dr. Paulson, you have a wonderful group here tonight, lots of great questions! Thanks to everyone for joining us this evening.
ClaraS	Dr. I have severe PCOS. My RE is not able to see my ovaries cause they are 2 high. I have done one injectible cycle with Follistim AQ IUI. With no success. He has told me IVF is out of the question for me because of my high ovaries. Is there really no other choice for me?
carolyn	Thanks - I wonder why my clinic insists on 24 hours.
Dr._Paulson	Susan, it sounds like you got 225 of Gonal f and 225 of repronex, which is 6 amps, and that's probably maximum response.
Dr._Paulson	Susan, we do go up to 8 amps total, but I really don't know if that's any better than 6.
Susan	yes, that's right. Thank you
Dr._Paulson	shnauzerpal, there are several "embryo glues". which one are you talking about?
gl1999	Thanks Dr. Paulson. Dee Dee, FET is Frozen Embryo Transfer.
carolyn	Is there any reason not to use Lupron for an IVF cycle?
Dee_Dee	Thanks gl1999
Dr._Paulson	claraS, that's a tough one. you can always get to the ovaries, by laparoscopy if necessary. you might want a second opinion.
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schnauzerpal	Well, I am not sure-they had to special order it for my cycle since I requested it. It was a brand name.
ClaraS	I asked him specifically Dr.
ClaraS	and he said it would be hard to find a dr. that would do that now a days
ClaraS	the last cycle
ClaraS	I had sever OHSS cause he could not see my ovaries and just thought I was not responding
ClaraS	so I went up to 600iu of follistim AQ
Lisa_Rosenthal	ClaraS, please feel free to call our hotline for a doctor referral...
Dr._Paulson	schnauzerpal, there is a "glue" that is added to the transfer medium, and it thickens it, and supposedly helps the embryos stay in, or something. I doubt it!
ClaraS	I did Lissa he is on there
Dr._Paulson	carolyn, lupron is just fine, we use it all the time
carolyn	Many women in my e-suppirt group have doctors that refuse to use Lupron - they have all had cycles cancelled - just wondering why this would be the Dr's choice
joycew7	What are your thoughts on injectable estrogen and progesterone compared to pill or suppositories?
Dr._Paulson	carolyn, some places do IUI after 24 hours because of a study that suggested it was better.
barbara65	Dr. Paulson, in your opinion how much does being overweight effect fertility?
Dr._Paulson	but maybe they were ovulating early; i like 36 hours
carolyn	thanks!
Dr._Paulson	you're welcome!
durango	Does alcohol have any affect on the ability to conceive or hold a pregnancy? Meaning if you have a couple of glasses a week before stimulating meds is that a problem or does it reduce your ability to get pregnant?
Dr._Paulson	barbara65, it definitely plays a role.
Dee_Dee	Any thoughts of transferrring the older egg contents into a new egg? I forget what the process is called. I saw this on a PBS Nova special.
Dr._Paulson	weight influences how you respond to medication
ClaraS	Also.. Dr. sorry to keep bothering you But on Follistim AQ are bloating and aches part of the cycle? or is it a danger? I have like aching feelings through out my body.
Dr._Paulson	also overweight women have ovaries that "float" and are hard to see
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Dr._Paulson	they are difficult to get eggs from
Dr._Paulson	durango, i doubt that it has much effect (or our generation wouldn't be here), but it's politically incorrect to say anything like that
Dr._Paulson	so don't drink
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Dr._Paulson	deedee, you're talking about cytoplasmic transfer
Dr._Paulson	also known as nuclear transfer, and that is on the horizon, but not here yet
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Dr._Paulson	sorry about capitalization, ladies, this seems faster
Dr._Paulson	claraS, bloating and aches are part of ovarian hyperstimulation, and that can happen with any injectable medications
ClaraS	I have dull pains in my bottom part of my legs..and my belly feels full
Dr._Paulson	joycew7, pills and suppositories work as well as injections
ClaraS	heavy may be more appropriate
barbara65	one more question about weight Dr. Paulson, would you suggest a 39 year old take time to lose weight before IVF or due to the age proceed?
Dr._Paulson	barbara65, at 39, i recommend you proceed with treatment
barbara65	thank you..
Dr._Paulson	my pleasure
carolyn	is there a "prime" age range to look for when choosing a donor?
barbara65	I wish you were in NY.. : )
ClaraS	so do I
Dr._Paulson	carolyn, we looked at this a long time ago, and we had the same results with donors up to age 36
Dr._Paulson	so I'm not a fan of finding the 21 year old.
Dr._Paulson	In fact the 21 year olds make me nervous
barbara65	LOL
carolyn	My daughter (17) wants to donate her eggs for us - is she too young?
Dr._Paulson	Thanks, you're very kind, airplanes are getting cheaper...
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Dr._Paulson	carolyn, YES
carolyn	I keep telling her that! Why does 21 make you nervous?
Dr._Paulson	I've gone as young as 20 in a known donor, and of course, different people age at different rates
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Dr._Paulson	So a college student is not the same as a 20 year old with 2 kids
Dr._Paulson	The 21 year olds look so immature, and many are making a major decision without really understanding it.
Susan	When the IF diagnosis is male factor, are IVF success rates significantly better in the 38-40 age range?
Dr._Paulson	I think that donating is a wonderful thing to do, but I do like to think that they REALLY understand it
Susan	sorry, significantly better than CDC reports?
Dr._Paulson	Susan, all the diagnoses seem to do about equally.
Dr._Paulson	You should ask the clinic how ICSI works in their hands:
carolyn	So you are noyt speaking about fertility when you are discouraging younger donors, rather emotional issues?
Dr._Paulson	By this I mean, how good is the fertilization rate and what is the effect on embryo implantation
Dr._Paulson	Carolyn, yes
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Dr._Paulson	My preference is someone who is 25 or older
Dee_Dee	Are IUI and IVFs worthwhile doing for the advance maternal aged woman?
carolyn	if the CDC site lists a success rate for donor egg in 74%, is that reliable?
Dr._Paulson	I also don't like if the donor has her first sexual experience with the ultrasound probe...
ClaraS	Dr. Paulson.. so it's not uncommon to do retrieval through laparoscopy? Or impossible to find a dr. who would do it?
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ClaraS	lol
joycew7	Do you have a certain number of IVFs that you think someone should stop at?
Lisa_Rosenthal	The CDC site is a wonderful resource, but not the only way to choose a clinic or program.
schnauzerpal	In your experience with donor egg, what is the most times that someone has attempted before getting pregnant and carrying successfully?
Dr._Paulson	carolyn, go to the program, look them in the eye, get to know them and then ask yourself if you're comfortable
carolyn	Lisa, I have "chosen" doctors that I was comfortable with - that did not do me any favors. I now look to the statistics FIRST, then see if I like them
Dr._Paulson	claraS, yes, but you really need a second opinion, because the situation really doesn't seem to fit.
Dr._Paulson	joycew7, there is not a max.
Dr._Paulson	In the old days, 12 cycles was not unheard of.
Lisa_Rosenthal	My point about the CDC site is twofold. One, the statistics are not current and two they need to be read carefully as they are confusing.
ivytone	Are there any statistics for a 44 year old trying to have a baby naturally? Wasn't there a study of the Hutterites, I think, who don't practice birth control?
carolyn	Dr., comfort has a lot to do with it - but if they don't kbow what thy are doing, I am simply comfortable handing over all my time, emotions and money!
Dr._Paulson	Thant really seems kind of high, doesn't it? But there isn't any medical limit.
Dr._Paulson	schnauzerpal, the most we have had was conception on the 5th fresh cycle.
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Dr._Paulson	carolyn, I respect that.
joycew7	So as long as the person has the money you would tell them to keep trying? Would it be a matter of luck? As long as everything else looked good?
Dr._Paulson	ivytone, that was a population statistic, and it included a large age range, whereas we now know that every year plays a role.
carolyn	so, how else, besides statistics, do we know if a doctor knows whatthey are doing - especially since we older gals don't have a lot of time to waste?
Lisa_Rosenthal	Please call our toll free hotline to ask our patient advocate for doctor referrals in your area. That number is: 888-917-3777 and our patient advocate is Lori Masi.
Dr._Paulson	To the best of my knowledge, we don't have hard data on women conceiving naturally at 44
carolyn	Lisa - my doctor is on your list, I was referred by your list - and I wouldn't refer anyone else to the clinic knowing what I know now
Dr._Paulson	joycew7, that sounds not quite responsible. You have to individualize, and I think it's worthwhile looking at factors very carefullly before doing the 8th or 9th cycle.
carolyn	no disrespect, but how couls you know without feedback
Dr._Paulson	But this is clearly going on in other parts of the world, where insurance covers IVF
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Lisa_Rosenthal	Carolyn, we get feedback all the time about physicians. I certainly hope that you are planning on calling us to share your feedback, which is obviously not good.
Dee_Dee	Are IUI worthwhile for our age group?
Dr._Paulson	carolyn, look at other factors: are they respected in the professional community? does your doctor know this doctor? have they published any studies? have they written books?
carolyn	Of course! I respect that this is a new frontier - and I feel like I am in the wild west
Lisa_Rosenthal	Also, speaking to our patient advocate would give you more than a doctor referral, she would be trying to match your needs to the many qualified, but different doctors in your area.
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Dr._Paulson	deedee, IUI's are worth trying, but not for long
Lisa_Rosenthal	All of Dr. Paulson's suggestions for how to evaluate a physician are excellent.
Dee_Dee	how long?
Dr._Paulson	the data on IUI's is not great
durango	I had a friend who conceived naturally at 46 and gave birth (1st child)and another at 48 (3rd child). What is it about their eggs that are so different than someone at 44 in great health who has gotten pregnant before?
ClaraS	Dr. I want to thank you. NOt many doctors would take the time to help us without a dollar sign attached to it. THANK YOU
Dr._Paulson	And pregnancies after 42 are rare, so I don't go over 3 cycles
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carolyn	Yes, thanks
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Dee_Dee	thanks
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Dr._Paulson	my pleasure
Lisa_Rosenthal	ClaraS, we are very lucky to get the highly respected, wonderful, compassionate physicians that we do on our online sessions.
Dr._Paulson	durango, egg aging is like body aging
Dr._Paulson	except that you can't tell by looking at someone how their eggs are aging
Dr._Paulson	what I mean is that some people age faster than others
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ClaraS	I truly am impressed with the time and compassion of answering all our questions. It can be overwhelming.. It is for me and I am just reading
carolyn	Thanks so much for all your help- I have to go take care of the exchange student! Good luck to all!
Queens_College	Women in their early fifties, in good health, using donor eggs and perhaps donor sperm, , are they elevating their health risk by introducing required fertility medications? and, once pregnancy occurs, do cells of the developing fetus migrate in the mother to have what effect on her health?Type here
Dr._Paulson	ClaraS, this is what I do
Lisa_Rosenthal	The American Fertility Association has a set of message boards, several which are moderated by a physician daily. Please feel free to stop by and ask questions there as well! Also, "Connections" will meet every week for an online educational session. Please check the schedule on our home page.
schnauzerpal	I, too, greatly appreciate your responses tonight. One more question, does $10000 including all expenses for donor egg cycle sound about right?
Lisa_Rosenthal	Dr. Paulson, not everyone does it as well as you have this evening!!!
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Dr._Paulson	Queens_College, egg donation can be effective in women over 50. I don't know about cells of the developing fetus migrating into the mom, sorry
Lisa_Rosenthal	Welcome to The American Fertility Association's online educational session. We are pleased to have Dr. Richard Paulson, (USC Reproductive Endocrinology and Infertility) joining us this evening. We will be discussing the topic "Advanced Maternal Age and Statistics". Thanks for joining us this evening! Lisa Rosenthal, Educational Coordinator for The AFA.
barbara65	Dr. Paulson, my ccct was 5.8 on day 3 and 5.2 on day two. Does this mean I should respond well to stims and IVF?
joycew7	That sounds cheap to me Schnau
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Dr._Paulson	schnauzerpal, that would be the cost of the cycle without the cost of the donor or the agency
Dr._Paulson	barbara65, I assume you mean 5.2 on day 10, and yes, you should respond
barbara65	sorry.. yes that is what i meant..thank you again..
Dr._Paulson	QCollege, there is no evidence of a detrimental effect on health
Dr._Paulson	If anything, studies have suggested that older women having babies is a good sign for longevity
Dr._Paulson	Of course, older women having babies tend to be healthier, etc. so it's probably a selection bias.
irishslp	Dr. Paulson, can how ones eggs age be hereditary?
Dr._Paulson	irishslp, we know that the age of first menses as well as age at menopause tend to run in families
Dr._Paulson	the assumption is that fertility would also go with that, but there are no data on that
Lisa_Rosenthal	Ladies and gentlemen, the way that I get wonderful, compassionate, knowledgeable professionals scheduled for these online sessions is that I promise them that they will be done in one hour. That leaves us just a couple of minutes with Dr. Paulson, so please get your questions in and don't forget about our message boards that are moderated by our "web angels"!
irishslp	Thank you
barbara65	so if my mother had me at 41, 39 years ago, my chances are higher that I should be able to?
Dr._Paulson	my pleasure
Becca	I've researched my family history back to the 1500's and found that many of my ancestors had babies well into their 40's. Some had babies up to age 50! This was during a time when life expectancy for women wasn't much more than 50. Why was it so easy then vs now?
Dr._Paulson	barbara65, that is certainly a better history than saying your mom had menopause at 35!
ClaraS	Dr. should I be concerned of the dull aches in my legs being assoicated with the follistim AQ
irishslp	Are there any benefits with IUI without Meds?
Dee_Dee	What should a first time older mother expect from her body versus a younger mother?
Lisa_Rosenthal	Please call our toll free hotline to ask our patient advocate for doctor referrals in your area. That number is: 888-917-3777 and our patient advocate is Lori Masi.
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Lisa_Rosenthal	Dee Dee, do you mean as a parent or as a pregnant woman?
Dr._Paulson	Becca, it sounds like a good history. As with everything else in medicine, the best thing you can do is to choose good parents!
Dee_Dee	as a pregnant woman
yvohall	If early menopause runs in the famil (42-43) does that decrease my chances at 40.
Dr._Paulson	irishslp, I would only do IUI without meds with donor sperm, or if the couple can't have sex. Otherwise, there is no proven benefit.
Dr._Paulson	Deedee, I would direct you to our study in JAMA 2 years ago (find it at our website, USCIVF.org)
Lisa_Rosenthal	Dee Dee, I'll let Dr. Paulson explain the risk part, but certainly the fatigue factor is greater.
irishslp	Even though the seman analysis is good after the wash?
Dee_Dee	thanks
Dr._Paulson	The answer is high C-section rates, and higher incidence of diabetes and preeclampsia, but good overall outcome
Lisa_Rosenthal	The American Fertility Association has free membership! Please go online and you will have access to all our publications at "No Barriers".
Dee_Dee	thanks
Becca	Thanks for your time, Dr P. Have a good night
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irishslp	Thank you
Dr._Paulson	ClaraS, go talk to the dr, it sounds like nothing, but it could also be serious. Some women do develop blood clots, and that would be BAD
Lisa_Rosenthal	Dr. Paulson, you have done a tremendous job here tonight. I hope we can call on you again sometime?
barbara65	yes thank you so much::smile
Susan	yes, thank you very much!
Dr._Paulson	Any time
durango	Thank you!
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Dr._Paulson	my pleasure
ClaraS	ok Dr. thank you so much
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ClaraS	but would both legs bother me??
Dr._Paulson	::smile
Dr._Paulson	I had to try the smily face
Dr._Paulson	Some of this is still new to me
barbara65	LOL
ClaraS	lol
joycew7	That's just what I was thinking
Dr._Paulson	ClaraS, I think it's nothing, but I can't examine you via the internet...
ClaraS	wish you could
ClaraS	lol
ClaraS	Thanks very much
ClaraS	God Bless
Lisa_Rosenthal	Thanks to everyone for joining us this evening, especially Dr. Paulson, but what a great group of folks asking questions! Don't forget that "Connections" is a weekly event so check our website for our schedule!!
local	[332] Advanced Maternal Age and and Statistics with Richard Paulson, M.D., (USC Reproductive Endocrinology and Infertility)
Dr._Paulson	Thank you all for your questions and your interest
schnauzerpal	Lisa-thank you for your input tonight, also!
Dr._Paulson	There may be more stuff at uscivf.org
Lisa_Rosenthal	Thanks again Dr. Paulson for such a great job!
Dr._Paulson	Oh yes, and thanks, I really had a very nice time
Lisa_Rosenthal	Schnauzerpal, you are quite welcome, it is my pleasure
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Joly	Lisa and Dr. Paulson, thanks!!
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Rosie	Good night and thanks.
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Dr._Paulson	good night...
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Dee_Dee	Thanks much. ::smile
Ali	good night dr. paulson
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Cynthia	A pleasure as always Lisa!
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Lisa_Rosenthal	Good night everyone!
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