Scrotal temperatures and laptop computer use

It has long been know that for normal sperm production to occur in humans, scrotal temperatures must be 4-7 degrees Fahrenheit below core body temperature. With the increase in use of laptop computers, which can produce increased heat near the scrotum, concern has been raised about their contribution in men to abnormal sperm production.

Researchers at the State University of New York at Stony Brook studied the effect of laptop computer use on scrotal temperature with and without the use of a laptop heat shield. They found that the most important contributing factor to raising scrotal temperature was the leg position typically used with a laptop computer. Even when a heat shield was used, if the thighs were close together, scrotal temperature would increase. The increase in scrotal temperature that would affect sperm production occurred within 11 minutes with thighs together and no heat shield, 14 minutes with thighs together and a heat shield, and in 28 minutes when the man positioned his thighs at least 70 degrees apart and used a heat shield.

In summary, this study demonstrated that a laptop heat shield pad is insufficient protection against scrotal temperature elevations that can lead to abnormal sperm production.

Read complete study on scrotal temperature >>

Community Reproductive Endocrinology, in conjunction with Assisted Fertility Services in Indianapolis, Indiana offers a full range of andrology services for male infertility, including semen analysis, sperm washing for interuterine insemination procedures, sperm cryopreservation (freezing) and sperm DNA assessment.

To set up a consultation, please call 317-621-0600.

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More is not necessarily better

When patients undergo an in vitro fertilization cycle, they take injections of hormones called gonadotropins to increase the number of ovarian follicles that mature, and thus increase the number of eggs obtained. Sometimes our patients are concerned that they do not have enough eggs, and that their chances of pregnancy are directly related to the number of eggs that are retrieved.

In looking at our data, we find that more is not necessarily better, and that we can get very good pregnancy rates with a fairly low number of retrieved eggs. Here is a breakdown of our pregnancy rates compared to the number of mature eggs retrieved:

Less than 6 eggs: 75% pregnancy rate
From 6-10 eggs retrieved: 77% pregnancy rate
Greater than 10 eggs retrieved: 79% pregnancy rate

Our philosophy is to try and manage the patient’s stimulation such that we avoid overstimulation of the patient. Overstimulation can cause ovarian hyperstimulation syndrome, which can lead to hospitalization in some cases. Historically our pregnancy rates are not increased, and may even be lowered, in cycles where a very high number (> 20) eggs are retrieved. This could be do to the very high hormone levels found in such cycles, or due to poorer egg quality in such cycles.

So if we tell you we are anticipating 6 eggs, no need to worry. Your chances of pregnancy are still very good, and your chances of complications are very low!

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Marita’s fertility success story

Marita’s succesful delivery in February 2011 was the result of undergoing surgery to treat endometriosis. Dr. Carnovale performed a laser laparoscopy using the da Vinci surgical robot to remove the endometriosis. Below is Marita and family’s new baby at two weeks old. Read Marita’s complete success story.

Marita's baby was born after endometriosis treatment for infertility

Marita's baby was born after endometriosis treatment for infertility

To learn more about laparoscopy (da Vinci laser surgery) for endometriosis, please call Community Fertility at 317-621-0600.

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Meet Carter William Gross

Baby Carter, born from IVF, with mom Lindsay and Dr. Carnovale

Baby Carter, born from IVF, with mom Lindsay and Dr. Carnovale

Baby Carter was born to Lindsay and Doug on August 26, 2010 after consultation with Community Reproductive Endocrinology and a successful IVF cycle.

Carter William Gross
Date: August 26, 2010
Weight: 7lb, 5oz
Length: 20″

Right: Mom Lindsay with baby Carter and Dr. Carnovale.

Lindsay and Doug met with Dr. Carnovale in October 2009. At that time he suggested that, based upon Lindsay’s history, the best approach would be in vitro fertilization (IVF). He further discussed with them that he would place the embryo a little lower into her uterus to decrease the chance of it floating up into her fallopian tube from the uterine side. This would help reduce the chances of another ectopic pregnancy. Read the full success story.

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IVF success at Community Reproductive Endocrinology featured on Fox59

Alexander Grayson Schwenk, an IVF success story

Alexander Grayson Schwenk, a Community Reproductive Endocrinology IVF success story

In this Fox 59 Health Key segment, Community Reproductive Endocrinology patients Kelly and Justin Schwenk discuss their success with in vitro fertilization after nearly four years of trying to get pregnant. Alexander Grayson Schwenk was born June 22, 2010 (right).  Medical director Dr. David Carnovale also discusses fertility issues and IVF fertility treatment.

View the video below or watch it on Fox 59.

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Why IVF?

Over the last few years reproductive medicine specialists have increasingly been advising infertility patients to move to in vitro fertilization (IVF) sooner. This change in the treatment algorithm away from superovulation IUI cycles is the result of two main factors. First, IVF pregnancy rates have continued to increase, while superovulation with IUI cycles has remained stable. Second, with the continued decrease in embryos transferred during IVF, cases of higher order multiple pregnancies are almost exclusively the result of superovulation/insemination cycles. Now a new, large, randomized control trial has shown that this advice is in the patient’s best interest, based on sound evidence.

As reported in the August 2010 issue of Fertility and Sterility*, Richard H. Reindollar, M.D., et al., at Dartmouth-Hitchcock Medical Center, showed that for couples aged 21-39 with infertility who failed three clomiphene citrate ovulation induction cycles, moving to in vitro fertilization “saves money and results in a greater proportion of couples with the delivery of a live-born baby.” The authors went on to state that “it was found that gonadotropin/IUI use was of no added value.”

Comment

This was an extremely well done, large (504 couples), randomized control trial performed by an excellent group of infertility specialists. The study was done in an environment where insurance mandates infertility coverage, including in vitro fertilization. The groups involved were looking at the validity of insurance mandates that force patients to undergo superovulation with gonadotropins combined with intrauterine insemination before they are eligible for in vitro fertilization. Based upon the results of this trial, providers would be able to advocate on behalf of their patients to allow them to move to insurance-covered in vitro fertilization earlier. This would avoid putting patients at risk for higher order multiples for a therapy that they showed had a success rate of 9% per cycle.

At Community Fertility Specialists, we have been presenting this paradigm shift to our patients so that they are fully informed about their options. We feel that with the low number of embryos we typically transfer with in vitro fertilization, in conjunction with the much higher pregnancy rates compared to superovulation/IUI, that early IVF makes sense. If anyone would like a copy of the study or to discuss the findings and recommendations further, please feel free to contact Dr. Carnovale or Dr. Boldt at 317-621-0600.

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New sperm DNA testing

Assisted Fertility is now offering a test to evaluate damage to the sperm’s DNA.  The test is called a Halosperm test.  Using this test we can determine if men have an elevated number of sperm with DNA damage.  For such individuals, we can recommend therapies such as antioxidant treatments.  Current evidence also shows that in such cases pregnancy rates can be significantly improved by using in vitro fertilization (IVF) with sperm injection.  Feel free to contact our office at 317-621-2414 for more information.

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Success story: Genesis and Gary

Gensis's ultrasound showing fertility success storyGenesis and Gary were unable to get pregnant due to Genesis not having regular ovulation. She had conceived her first child after using injections of ovarian stimulating medication. Now, the couple wanted another baby. After trying on their own for six months, they saw Dr. Carnovale. He recommended trying clomiphene for ovulation induction before using the injectible medications again. At her baseline ultrasound before taking clomiphene, Genesis was found to have an ovarian cyst. Dr. Carnovale advised her to wait for the cyst to shrink on its own before using the clomiphene. After two months, the cyst had shrunk and Genesis was able to take the clomiphene. She developed two mature follicles and took HCG to induce egg release. Intrauterine insemination, or IUI, was added to improve the couple’s chances. After their first try Genesis was pregnant. They have been referred back to her ob/gyn for ongoing care.

Read more success stories!

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Congratulations Erin and Kevin!

Congratulations Erin and Kevin on the birth of your son!

Erin and Kevin's baby boy, born with the assistance of Community Reproductive EndocrinologyDate: August 30, 2010
Weight: 8 pounds, 14 ounces
Length: 21.5 inches

Read their success story.

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October/November IVF cycles with early morning hours

Special morning hours to get you to work on time; morning ultrasounds starting at 6 a.m.

Who: For couples with infertility who need IVF

What: Special very early morning IVF monitoring hours

When: October & November 2010 IVF cycles

Where: Community Reproductive Endocrinology (location information)

Why: To relieve the stress of getting to work on time during treatment

Please contact our office at 317-621-0600 as soon as possible if you are interested in participating in our upcoming October or November IVF cycles. Ask for Jodi, Sarah or Carrie.

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