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Boxers or Briefs - Common misconceptions about conception

All low tech and high tech questions will be answered

April 25, 2006 - Tuesday
7:47 PM to (EST)
Guest Speakers: Serena Chen, MD
Saint Barnabas Institute for Reproductive Medicine and Science

Categories
Endometriosis • Fertility • Infertility • PCOS • Pregnancy • Pregnancy Loss


Session Date: April 25 , 2006 - Tuesday
Guest Speaker: Serena Chen, MD
Saint Barnabas Institute for Reproductive Medicine and Science
Topic: Boxers or Briefs - Common misconceptions about conception.
All low tech and high tech questions will be answered.

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Kbrigham Hello Mellissa, Hello Deb
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melissa3 hello
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Kbrigham Hello Dr. Chen
Dr_Chen Hello!
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Dr_Chen Tonight our topic is Boxers or Briefs? Misconceptions about conception - but all infertility questions will be answered
Dr_Chen For more information about infertility, miscarriage, trying to conceive, etc, please visit our websites at www.sbivf.com and www.serenachen.yourmd.com
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deb_capone Good evening everyone...sorry i missed the bell.
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deb_capone I was going to do a pithy little play on Dr. Chen's title...but truthfully, I think she has it wrapped...
deb_capone Welcome, Dr. Chen...and thanks in advance for answering that burning question: boxers or briefs....what is the magic underware!
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deb_capone I am Deb Capone and I am your moderator. I can tell already by the fervent typing from the audience that you are not going to need me...but if you do, just double click on my name in the left column and talk to me privately.
Renee Can you please tell me the effect of smoking on your fertilty. We have been trying for 2 years and the stress has led me to smoking... not good I know but... Is this just making things worse, really?
deb_capone Dr. Chen, let the games begin.
Dr_Chen By the way - Boxers are no better than briefs when it comes to making babies. Some scientists have actually studies this and found that sperm parameters are the same in both populations of men. They looked at infertile men and did not find any differences in prevalence of boxers or briefs. What a relief!
Kbrigham How can an OBGYN say you have PCOS but the you go see an Endocronlogist and she says you have PCOS like Symptoms... Now The OBGYN did an Utra Sound and the Endocronlogist did a C - T Scan
dklaustin1 Can previous infections cause poor egg/embryo quality?
Dr_Chen Renee - Please stop smoking asap! If you need to use nicotine patches or even zyban (under MD supervision) that would be better than smoking. A very large British study done recently demonstrated much higher rates of infertility, miscarriages and birth defects in women and men who smoked. The most disturbing aspect of the study is that these effects were seen even in people who did NOT smoke, but were exposed to second hand smoke. Set a quit date, throw out the cigarettes - QUIT NOW!!!!!
Renee Another question I have is why would you be able to conceive the first time right away and the second is not happening.... yet no problems have been identified with me or my husband.
Dr_Chen Renee - take a look at www.serenachen.yourmd.com in the "Quit Smoking" section for some helpful advice and resources.
Renee Thank you and I know
Dr_Chen Dear Kbrigham - PCOS can be a little controversial when it comes to diagnosis because we still do not really know what causes pcos and it can have a very wide range of symptoms.
Kbrigham Ok I just found it hard for one to say you have it and the other to say you just have the symtoms it all made no sense to me
kelly Besides Pre Seed, what other sperm safe lubricants are there? Thank you!
Dr_Chen The diagnosis of PCOS involves ruling out other similar issues like thyroid issues or prolactin problems and tumours, then you need 2 out of 3 things - 1 - pcos appearing ovaries - 12 or more small follicles in at least one ovary, 2 - elevated male hormone levels or evidence of that - extra hair growth for example, 3 - irregular periods - cycles longer than 35 days on a regular basis
Dr_Chen Dear dklaustin1 - previous infections that are cured should not cause any issues with embryo quality
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eddie I know you said heavy smoking will effect fertility, particularly sperm count. My husband spent the week smoking and sitting in a hot tub on vacation a week before his SA. How low can they cause his sperm count to go? He also had an undescended testicle as a child and now they want to check that out. However, we have an entire month before the doctors can fit us in for an appointment. Is there anything he could be doing in the mean time.
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Dr_Chen Renee - secondary infertility is always puzzling. One factor is age - you are older than when you conceived your first child that means that the eggs are not quite as fertile and you may have developed things as you grow older that could affect fertility - scar tissue, endometriosis, fibroids, etc. Many cases of secondary infertility are unexplained and have to be attributed to just age . . .
Dr_Chen Dear Kelly - vegetable oil is much cheaper and just as good!
Renee Thanks, The onlt thing after a slew of tests revealed that I had an elevated 17-OHP level. Do you think this alone could effect??
Kbrigham I have almost all the syptoms of PCOS and the Ultra Sound showed Cysts in my Ovaries but over the summer the CT Scan didn't show any and there are days that my Androgen I think thats the one goes over in the thoundsands and they haven't done anything about it because the next time they do blood work everything is normal but yet I go 6 months at a time with no period
dklaustin1 Can a high protein diet improve egg/embryo quality?
Dr_Chen Dear eddie: Your husband needs to avoid the hot tub and quit smoking. Good diet, getting to or maintaining normal weight, drinking alcohol in moderation, taking a multivitamin each day, all can help. There are no magic bullets but things that promote good general health are always a good thing.
Renee Here is a myth for you all - what is the deal with baby asprin?
Kbrigham I have no Tumors so thats good I forgot to add that
kelly Will you please clarify the effect that Robitussin and V8 Splash have on cervical mucous?
Dr_Chen Dear Kbrigham - CT is not very good at looking at the ovaries - the ultrasound results are more accurate. It does sound like you might have pcos. You should see a board certified reproductive endocrinologist for a full evaluation.
Renee I've heard Muscinex (SP??) is supposed to incease mucus like/more than Robitussin
Dr_Chen Dear dklaustin1 - there are no particular diets that are associated with good embryo quality - we think that there are probably hundreds of factors that can affect eggs. I would recommend a healthy diet - nothing extreme.
katie I was going to do IVF, so I started birth control pills april 3, then we decided against it and I stopped after 3 days, and i'd like to know when you think I'll ovulate. If I haven't already.
Dr_Chen Dear kelly: It is possible that robitussin may help make the cervical mucus thinner and more hospitable to sperm. I am not aware of any studies on V8 splash - perhaps this is thought to affect the pH of the mucus. The bottom line with regard to mucus is that it is very difficult to assess and the best treatment is to make sure someone is ovulating normally, has no cervical infections and then consider intrauterine insemination to make absolutely certain that the cervical mucus has no effect.
dklaustin1 What is your view on immune testing?
Dr_Chen Dear Renee:
Dr_Chen Dear Renee: baby aspirin is helpful for people with an above average risk of cardiovascular disease, but it should be used carefully in women trying to conceive. It is possible that first trimester exposure to baby aspirin may increase the risks of certain types of birth defects, so baby aspirin should only be used for a reason. It seems to be helpful in donor egg cycles in women with a thin lining. It also seems to be helpful in certain types of recurrent pregnancy loss patients. It should not be used in everyone.
Dr_Chen Dear Renee: Mucinex is similar
Symharmony I'm having a lap in a couple of weeks to rule out Endo and such...if it ends up showing I do have Endo what are alternative treatments other than Lupron? The side effects of Lupron worry me, especially since osteoporosis runs in my family.
Dr_Chen Dear katie - you should count day 1 as the day you stopped the pills - so if you usually ovulate on day 14, you will probably ovulate 17 days after starting the pills
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kaylalunaava Dear Dr. Chen: To prevent, symptoms of OHSS, I've been told to drink gatorade,and protein rich drinks. Should I avoid salt, increase my potassium? What electrolutes found in food should I be consuming more of? Thanks!
Dr_Chen Dear dklaustin1: Immune testing is not helpful in infertile couples. Some immune testing - testing for antiphospholipid syndrome - is helpful in some women with recurrent pregnancy loss.
katie thanks. do I stand a chance of getting pregnant, given I had breakthrough bleeding right when I stopped the pill? it was like having my period for a week. So--would that affect the ovulation situation?
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Dr_Chen Dear Symharmony: Treatments for endo depend upon what you are trying to accomplish. If you are in pain, then surgery followed by continuous birth control pills works extremely well, without a lot of the side effects generated by lupron. If you are trying to get pregnant - just proceeding with agressive fertility therapy is your best best. Pregnancy is a great "treatment" for endometriosis.
dklaustin1 How long after a lap will endo come back?
Dr_Chen Dear kaylalunaava: I would avoid excessive salt. You should drink mostly lots of water. Do not drink only gatorade. Pedialyte is another good drink
Dr_Chen Dear katie:
Dr_Chen Dear katie: No really should not - just delays it
Symharmony Thanks....yeah, I've been trying to get pregnant for almost two years so I don't want to interrupt my chances with Lupron or birth control pills. Do you know how long after the Lap surgery that you can start trying again?
Dr_Chen Dear dklaustin1: If your symptom is pain, then about 50% of patients will have recurrence of pain within 1 to 2 years. Endo never really goes away so it is difficult to put a number on it. If you are infertile we would try to avoid surgery regardless of recurrence
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Dr_Chen Dear Symharmony: I would have you start trying right away, but you should check with your doctor.
Symharmony Ok...thanks
Kbrigham Can you tell me why they don't do Ovarian wedge resecion?
katie this is kind of explicit, so if you can't answer I understand: are there any positions that are better than others? I've heard all kinds of answers to that.
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dklaustin1 I had a lap in dec 05 and was diagnosed with moderat to sever endo. I have not been able to concieve as of yet. How long before another lap should be done?
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ktsmom is ther a topic I am new here
Dr_Chen Dear kbrigham: ovarian wedge resection can cause a lot of adhesions and there are so many other non-invasive ways to treat pcos, that wedge resection is rarely needed any more. take a look at my article on pcos on www.serenachen.yourmd.com
eddie Thanks. Would we see a difference if he took a mulit vitamin, cut alcohol and cut down on caffeine, and cut back but didn't quit smoking. We moved to a high altitude about 2 1/2 years ago and last time he tried to quit his lung collapsed.
Symharmony Isn't the lap the only way to find out if you have Endo or other problems? I had an ultrasound done about 5 years ago and they saw nothing wrong. My only problem is infertility and I have cramps with my period. I've always had cramps with my periods and they have improved with age. Does that sound like Endo to you?
Kbrigham Can A Patient Request To Have A Edge Resection done?
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Kbrigham My mother had one done and she had 3 children after
Dr_Chen Dear katie: great question! this is a common myth - no positions are better than others - in fact the "best" thing is to have sex when you want - couples will naturally tend to have sex during their most fertile times. In women who have a 28 day cycle, having sex 2 times from day 10 to 17 should be enough to conceive. Having sex more often does not improve your chances of success. If you have not conceived within 12 months of trying this way (6 months if you are over 35 years old), then you should have an infertility evaluation
dklaustin1 I know cytoplasmic transfer is not available in the US, but what is your view on this?
Dr_Chen Dear eddie: You may not actually see a difference in the counts, but pregnancy rates tend to be higher.
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alexandria07 Is their another option if you don't repond to follistum and repronex? Also I have severe endometriosis, I'm 31.
eddie thanks
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Dr_Chen Dear Symharmony: finding out if you have endometriosis when your ultrasound is normal will not help you to get pregnant. The treatments for mild endoemtriosis are the same as for unexplained infertility. It would be more helpful for you to undergo fertility treatments such as fertility drugs and insemination or IVF rather than undergoing a laparoscopy.
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Dr_Chen Dear kbrigham: Since a wedge resection involves the risk of an invasive procedure, this is not something that most physicians would agree to unless all alternative, non-invasive treatments had failed first.
ktsmom My daughter had sever endo and a lap in Oct o4 another after Lupron series, in June of o5 She is eight weeks pregnant after an IUI with injections after 41/2 years of infertility. She has been bleeding for a week after leaving infertility doc and being taken of progesteron. The ultra sounds show healthy twins but bleeding behnd sac . The ob says nothing to be done ..She may likely misscarry. She started to take progesterone on her own this weekens and her bleeding has slowed. Becasue she is now with OB their mindset is not like the fertility doctor. She left a message with him toady but is afraid he will not deakl with her. any suggestions for help
Dr_Chen Dear kbrigham: The studies only demonstrate a very mild increase in the pregnancy rates - just 1 to 2% increase - so your mom did well, but there are much better alternatives available today.
Symharmony Is the Laparoscopy a bad thing to have done? I just want to know what is wrong with me but I don't want to put myself in any unneccessary risks.
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Dr_Chen Dear alexandria: a different protocol may be helpful or higher dosing. Hard to say because this will depend on your FSH levels, ovarian appearance and how much drug and the type of protocol that was used previously.
slgraves I just started fertility treatment -- 32 yrs old & been trying to conceive for 2 years -- the doctors have diagnosed me with PCOS. The doctor has recommended an anitsperm antibody test for my husband... could you explain the procedure, etc.
ktsmom ddr chen is this part of the infertility situation. OB makes her feel like she can not carry maybe. thank you
Dr_Chen Dear ktsmom: you could call the infertility doc and request to be put back on the progesterone. Many infertility patients will bleed in the first trimester - it does not always mean that a miscarriage is inevitable.
alexandria07 I was on 400 follistum and 150 repronex. Prior to that I was on gonal f and repronex. My highest fsh level was 17, then it was 5.8, and then 9.
ktsmom Is there a chance that the fertility doctor will see her after she went to OB he sent her to the OB because she has hyperemeisis and was in the hospital for fluids for 3 days last week and that is when her bleeding started, Thankyou
Dr_Chen Dear slgraves: antisperm antibody testing is just a test added to the routine semen analysis. There is nothing more to it than just providing the sample. Good luck
sunnynanc Dr. Chen, What is your opinion of supplementing infertility treatments with accupuncture and Chinese herbal teas?
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Dr_Chen Dear ktsmom: it cannot hurt to call both doctors and let them know your concerns
katie how dangerous is alcohol when trying to conceive? My husband has 1-2 drinks a night. his sperm count at a recent spermanalysis was really great. I don't want him to be drinking but I will defer to science on this one.
deb_capone I want to take a moment to thank Dr. Chen. This has been a fantastic session. We haven't given her a chance to take a breath. But I do have to sound the ten minute warning. One way that we get great docs like Dr. Chen to spend an evening with us is that we promise to respect their time and end at 9pm on the dot.
Kbrigham Dr. Chen what do you think about people stoping the treatments the doctors have offered and started taking Fertility Blend as I have a few friends who have PCOS and other unexplained fertility problems that have taken Fertility Blend and have carried children to full term
ktsmom Thank you I will she is feeling discouraged becasue he left her feeling like it is a wait and see nothing to be done. I will relay the message good eveining
Dr_Chen Dear alexandria07: it sounds like you were on a high dose of medications. With a FSH of 17 in the past, a low response is quite common. However, since you are young, you might still have a chance for pregnancy if you have IVF done at a lab experienced with low responders.
alexandria07 thank you
Dr_Chen Dear katie: 1-2 drinks a night for your husband is probably not a huge issue. I would prefer 1/2 or one drink though
deb_capone Here's the commercial: if you aren't a member of the AFA...join now-its free and the benefits are fantastic. Go to www.theafa.org. Secondly, you can read Dr. Chen's article "TTC" (Trying to Concieve) in our archives. It will also be published in our annual Resource Directory (you'll get one as an AFA member. Finally, you can meet Dr. Chen in person at the AFA "Family Matters" conference on May 7th in NYC. Dr. Chen and other members of the AFA's Faculty gather at the largest Fertility and Adoption Conference in the Country to help you gather information quickly and easily.
Dr_Chen Dear kbrigham: there is not enough data on fertility blend to know if it is really helpful in pcos.
deb_capone All AFA members and attendees at the conference will be recieving our new issue of inFocus-this on specific to PCOS.
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Dr_Chen Thanks everyone! Come visit me or my partners anytime on our message board at www.sbivf.com
sunnynanc Dr. Chen, What is your opinion of supplementing infertility treatments with accupuncture and Chinese herbal teas? Have you had any patients with full-term pregnancies?
Kbrigham Thank You Dr. Chen
Symharmony Thank you
deb_capone Dr. Chen had done a brilliant job at answering our questions and I know we could go on for hours more...but alas, we are nearing the end of our time. Dr. Chen would you take one more question and then make some closing comments.
eddie Thanks Dr. Chen
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dklaustin1 I left the room for a moment, did you respond to the cytoplasmic transfer question?
Dr_Chen Dear sunnynanc: we use accupuncture as an adjunct on a regular basis, but ask everyone to stop herbal remedies
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deb_capone Dr Chen, you are so generous with your time and expertise. This has been one of the best sessions that I have seen! Thank you so much and if we twisted your arm, would you consider a reprise?
Dr_Chen Of course! Thanks again for having me - good night everyone!
sunnynanc thanks
Symharmony good night
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kelly thank you!
deb_capone On behalf of the AFA and Serono's Fertility Lifelines, Good night to everyone. We will see you next week! Same time and channel.
deb_capone We also hope to see you at the Conference on May 7th. Check out www.theafa.org/events for a full program schedule and partial faculty list!
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kaylalunaava Thank you DR.Chen! It was certainly very informative!
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