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Changes in success rates and the impact of obesity on fertility

April 11, 2014

This news flash from the European Society for Human Reproduction and Embryology (ESHRE) is somewhat of a downer in the report. I would disagree with the negative tone of the article. The gist is that the latest new testing and techniques have not significantly improved outcomes over what we had 5-10 years ago. What is not highlighted though is that the rates nearly doubled from 1990 to 2000. In the US, from the best success rates of 23-25% to nearly 45% in younger age groups. This is a phenomenal increase.

Having lived through both eras of reproductive medicine, I feel that the improvement dramatically helped patient success. I think our population has an unrealistic view of medicine today. With all the new technology we are impatient to have absolute cures for diseases like cancer, heart disease and infertility. The reality is even in this day of technology, improvements and advancements take time. We can’t expect to beat nature in a few short years. The natural (normal) pregnancy rates are 25% per cycle for a couple with no fertility problems. IVF today, can deliver up to 50% pregnancy rates. In my book, that’s fantastic. Also remember that the European success rates have traditionally been lower than in the US.

There’s no doubt though that the process is arduous and painstaking for the patients. We don’t mean to underplay that aspect and our practice is focused on addressing the non scientific aspects of the process. Another statement that is buried in this article has to do with Obesity. ”Doctors still say the most important factors influencing fertility are a woman’s age and things like smoking and being obese.” Obesity has been referenced in many studies. This association is true but it implies that obesity Causes infertility. We would point out that it is our strong belief that it is not obesity but rather Insulin hormone elevation that disrupts the egg development cycle that is responsible for the fertility issue. Obesity is merely a sign of or symptom of the underlying insulin elevation disease (same as type II diabetes). This is an important distinction. Unfortunately our medical system is focused on obesity and implicates it as the cause of many diseases of today such as hypertension, heart attack, stroke, diabetes, and now fertility. Again, it’s not the obesity but rather the high insulin that causes the obesity that is the problem with fertility.

The reason this is important is that treatment of this problem should be focused on this insulin elevation and not generically applied to the treatment of obesity. The outcomes are much different if the insulin is addressed. In our experience, our pregnancy rates have nearly tripled in patients that are successful with this treatment approach. We will cover this in much more detail in other blogs.

As always best wishes,
Dr. Michael Fox

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