Dr. Potter, Huntington Reproductive Center

This is a pilot study that we are starting. It may provide the opportunity for couples to access IVF with minimal expense. Study Title: Creation of differentiated, patient-specific stem cell lines through somatic cell nuclear transfer Institutional review board: University of California, Irvine Study locations: Fullerton and Laguna Hills 12 patient pilot study Patients must be under 30 with normal ovarian reserve Patients receive free complete IVF cycle including ICSI and some medications Summary: HRC is proud to collaborate with Hans Kierstead, PhD on pioneering pilot study. The study may be expanded after the initial 12 patients have been enrolled. Dr. Keirstead is associate professor at the University of California, Irvine where he co-directs the Bill and Susan Gross Stem Cell Research Center. In this study, patients receive IVF treatment at no charge along with some of the medicine needed for the treatment. The couple will get the first 8 mature eggs. The remainder of the eggs will undergo somatic-cell nuclear transfer (SCNT) from fibroblasts harvested by HRC from spinal cord injured volunteers. The goal is to create patient-specific, differentiated stem cell lines. Contact: Bonnie, 949-472-9446 or cynthiaa@havingbabies.com

Hello everyone. I am posting this as the most common questions I get are "is there anything that will predict success BEFORE my cycle? or what are my chances?". Assuming that you are using one of the two proven methods for gender selection, MicroSort or PGD, here is the answer,,,,

part 1 There are two main components that determine the relative probability for a successful gender selection cycle, the age of the female partner and the results of valid ovarian reserve testing. The sperm count, whether or not the tubes are open and the presence of other fertility issues usually only influences which treatment options are viable.

Today we will discuss the age of the female partner. The first and most important factor in determining prognosis is the age of the female partner. As women get older, even if they are perfectly healthy, the percentage of genetically abnormal embryos increases. This results in embryos that are potentially metabolically strong that don’t implant. Obviously, unless someone has a time machine (which according to currently accepted laws of physics would require attaining a speed greater than the speed of light), we cannot do anything about one’s age.

The eggs begin the process of meiosis, going from 46 to 23 chromosomes, while the patient is still inside her mother before her first birthday! In the ensuing years, the eggs sit, partially divided, being struck by background cosmic radiation and exposed to whatever environmental toxins the patient ingests. The resulting damage to the spindle apparatus (responsible for the even division of the egg’s chromosomes) is cumulative.

You therefore have more eggs where there are too many or too few chromosomes with advancing age. Eggs with too many or too few chromosomes, with rare exceptions (i.e. Down Syndrome, Turner Syndrome, Klinefelter Syndrome, Edwards Syndrome, Patau Syndrome, Jacob Syndrome, XXX syndrome), do not implant or cannot result in a live-born human child.

In addition to this, there is a set process that causes the eggs to die off at a certain rate. Women have well over 2,000,000 eggs shortly before their birth but have only several hundred at the time of their menopause. Eggs continue to die regardless of whether a woman is on the pill, pregnant, breast feeding or otherwise not ovulating. In fact, most of woman’s initial supply of eggs is lost before the woman has her first period!

So the relentless process of reproductive aging causes a constant decrease in the reproductive potential of females from the time of the first menstrual period. I know that this is depressing but we must understand the truth to master it! So as women age, the number of available eggs and the percentage of these eggs that are chromosomally capable of creating a normal child both decrease. Like the proverbial apple barrel, the eggs left at the end tend to have a higher likelihood of being either genetically or metabolically abnormal.

In my next post, we will discuss the tests available to determine how many competent eggs you have remaining and how the results of these tests, along with your age, are the two most important indicators of success with fertility treatment for gender selection or any other reason for that matter!

------ Daniel A. Potter, MD is the Medical Director of the Huntington Reproductive Center and the MicroSort West gender selection facility. Dr. Potter also serves as the Laboratory Director of GeneSecurity.net and clinical assistant professor of obstetrics and gynecology at the Keck School of Medicine of the University of Southern California. Dr. Potter is the co-author of the popular fertility guide What to do when you can’t get pregnant (De Capo Press, 2005). Dr. Potter is a leading proponent of gender selection for family balancing and is a board certified reproductive endocrinology and infertility specialist in private practice in Laguna Hills, California

Infertility is a risk factor for breast cancer.  The only studies that have shown a connection between fertility meds and breast cancer have compared fertility patients taking fertility medications to fertile controls.  When looking at infertile patients, there is no difference in cancer rates when takers of medications are compared with infertile patients that did not take the fertility drugs.  Unfortunately, the study comparing fertile to infertile med takers got a lot of press but it was not a valid study.  So as far as we know, there is no connection between fertility drugs themselves and cancer.  The fertility drugs used in IVF have been in continuous use in the US since the early 60s so if there was an effect, it would have been discoved by now.  So, no, fertility drugs do not cause breast cancer.  Clomid is a drug that is very similar to Tamoxifen and also does not cause breast cancer.  If you have a strong family history of breast cancer, you may consider being tested for the BRCA gene.

Hello Everyone,

I have been answering questions in the forum for about 2 weeks now.  What great questions.  Your questions have challenged me and also prompted me to do more background on some the gender prediction kits and other 'low tech' items.  The more you look into these things, the worse they look unfortunately.  The Baby Gender Mentor by AccuGen makes the incredible claim that it is 99.9% accurate.  Better than virtually any medical test ever devised....ever!  They make this claim without having a single shred of peer reviewed data published and without revealing the methods of their supposed near perfect test.  If these claims were really true and backed by credible published data, the scientist involved would be in line for international accolades and maybe even a Nobel prize.  The test cost $25 for the kit and another $250 for you to have it run.  I was absolutely stunned by the cost of this.  I mean, there are scams but this is pretty brazen. 

Oh, and they will give you your money back if they are wrong.  Like this is supposed to lend credibility to the operation.  Well it does not.  Let me explain this con for you: 

I know most of you ladies out there do not bet on sports and so are probably not as familiar with this type of scam as a sports fan would be but here is how it works:   You have your hot release, pick of the week.  You sell this information to your clients with a money back guarantee.  You give half of the clients one team and half the other.  You are guaranteed a good return on investment. 

With gender detection, they will be right at least half of the time.  If they are right, they keep your money.  If they are not right, only a fraction of wronged patrons will actually go through with the refund process.  This would be a profitable set up even if they used the magic 8 ball to predict the gender (don't get any ideas out there!!!).

So caveat emptor or ‘let the buyer beware’.

 

I am pleased to answer any questions that users might have regarding MicroSort and/or IVF for gender selection, so go ahead and send them....

 I am back from 'Ski Week' which is a mid-winter week off for kids in my area.  We went skiing in Deer Valley, Utah with several other families.  What a beautiful place and boy did we get some snow.  My 5 year old was completely fearless going banzai down the blue runs.  I finally got her to slow down and start doing some turns.  People are always interested in what I do and I met a number of people in Deer Valley that were interested in gender selection.  It is always amazing to me that highly educated people have no idea what so ever that gender selection techniques that work are actually available.  Increasing awareness is the key to increasing acceptance. 

I will start by answering the most common question posed to me by patients interested in gender selection: 

Does PGD decrease IVF success rates? 

The short answer is ' no'.  The truth is that PGD does not seem to lower pregnancy rates in experienced hands.  Nor does it improve pregnancy rates.  In my experience, IVF/PGD pregnancy rates are the same as IVF only pregnancy rates for patients of a given age and peak FSH level and even higher in gender selection patients than in the general fertility population.  Of the 300+ PGD cycles done at HRC in 2006, more than half were done solely for gender selection in patients with no fertility problems.  Pregnancy rates are obviously going to be better in a fertile population like gender selection patients than the general fertility population. 

The way pregnancy rates are reported is misleading so beware.  The whole idea of giving patients access to pregnancy rates is so that they can predict the probability that they will be successful in their own cycle.  The problem is that very few patients will have the actual pregnancy rate listed for their age group.  That is because the data as reported by SART includes all patients in a given age group regardless of their prognosis, peak FSH, number of embryos transferred or indication for IVF.   For example:  if pregnancy rate for a clinic in <35 year olds is 42%, what does this mean to you?  Answer:  nothing.  YOUR pregnancy chances can only be determined with a complete assessment of your ovarian reserve (Clomid challenge test for example), your age and indication for IVF.  The pregnancy rate for <35 yo patient with a normal Clomid challenge test (CCT) is twice that of patients with abnormal CCT results.  Which group are you in?  Pregnancy rates for <35 yo with normal CCT and no fertility problems (i.e. gender selection) is 10% higher than the rate for <35 yo with normal CCT that have never been pregnant.  Yet all of these categories are lumped together by SART so the "pregnancy rate" is really an average of the good and bad prognosis patients and represents a number between these two realities.  Send questions and comments.  Talk to you soon.

 Dr. Potter

 

Hello everyone, I am Dr. Daniel Potter.  I practice at the Huntington Reproductive Center and MicroSort facility in Laguna Hills, CA.  Our goal at HRC/MS is to provide personalized, compassionate and state of the art care to couples seeking gender selection as well as other fertility issues.  Being at one of only two facilities in the world with both MicroSort and PGD, I have particular expertise that I hope will be of interest to the users. I want to thank Maureen for allowing me to share my experience with you.   Here is a little background about me.  I am 42 years old.  I am married with two daughters (5 and 8) both conceived through IVF.  I am lobbying my wife for a third child using gender selection for male but she is not ready for a third at this time.  I grew up here in southern California, attending La Canada High School and USC for both undergraduate and medical school.  I completed my residency in OB/Gyn at Women's Hospital (USC) in Los Angeles and my fellowship in reproductive endocrinology at University of Texas Health Sciences Center with Dr. Robert Schenken.  I joined HRC in 1998 and have been fortunate to be associated with great doctors and staff here.

 

I am going to be posting to my blog as time permits.  The purpose of this blog is to help the users of the board obtain accurate information about gender selection, MicroSort and PGD.  I am particularly interested in helping couples determine their true prognosis when attempting gender selection using advanced technology.  I welcome your comments and will attempt to respond to any questions you may have. 

 

Gender selection is an area of particular importance to me.  I view gender selection as a reproductive choice that should be made by informed couples.  I was, therefore, very disappointed with the recent ACOG release stating that gender selection of any sort is tantamount to gender discrimination.  This is unfortunate change in position for ACOG.  Their previous position was that pre-conception methods, such as MicroSort, were fine if they could be proven safe and efficacious.  ACOG was previously only opposed to PGD for gender selection.  It is interesting that gender selection opponents have abandoned their previous arguments that somehow bestowed rights on the embryos.  They are also no longer saying that it is unethical to put someone through fertility treatments for the purpose of gender selection because it is too risky.  These positions were too hard for them to defend.  They have now switched to the position that gender selection is wrong because it may be used to perpetuate gender decimation.  This position completely disregards the fact that very little gender selection is actually done in the context that they are concerned about.  I have a hard time seeing gender discrimination in the case of the married couple with 2 boys that wants a girl.  This is 80% or more of the cases that we perform.  I am interested to hear your thoughts.  I will post more at a later time.  Dr. Potter