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Posted: 10:36 AM Nov 4, 2006
Fine-Tuning Fertility
Researchers look to improve odds At any given time, 10 to 15 percent of American couples face infertility. If the problem involves ovulation, help might be on the way.
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At any given time, 10 to 15 percent of American couples face infertility. A problem with ovulation, releasing the egg, is one of the most common issues but a new device helps predict when ovulation occurs.
Now, researchers are hoping to find out if combining the device with a new drug might increase the likelihood that women wanting children can get pregnant.
Nicole Cheroff and her husband have three dogs that are like children, but they would really like to add a baby to the family.
Nicole says, "We’ve talked about it for years and finally decided, hey, we’re ready.”
She hasn’t had any luck conceiving, so she’s getting help from fertility specialists. She’s also part of a new study that requires her to take fertility drugs and wear something called an OV watch.
Cheroff says, "What they’re trying to find out is if the watch works for women who do not always ovulate every month and their cycles are not as regular as some women’s.”
She takes her medicine, wears the watch for six hours a day and keeps a log of its readings.
Dr. John Park says, "It has sensors on the back side that maintain contact with the skin. And as it's being worn, it takes periodic measurements over six hours to look at what the average chloride concentration is.”
A surge in chloride tells the watch that ovulation is just days away and the timing might be right to get pregnant.
Dr. Park says, "Once this has been detected by the watch, it then begins to tell the patient of their fertility status and when their quote-unquote fertile window occurs.”
So far, 20 patients are enrolled in the study.
Dr. Park says, "Our goal is to have double that number of patients to determine whether or not this device can work. And at the same time, we’re also going to be comparing the results of the OV watch to the results of urinary ovulation predictor kits. And we hope to see whether or not there would be a difference in the ability to predict ovulation.”
The study is still enrolling volunteers. You can find more information on the Web. Researchers hope to complete the study in June 2007.
Fast Facts:
The Menstrual Cycle
The average female menstrual cycle is 28 days. The cycle begins on the first day of bleeding, or shedding of the endometrium. The bleeding lasts for an average of 3 to 6 days. On days two to 14 of the menstrual cycle, the endometrium starts to grow again. The egg follicles in the ovary become active and cervical mucous thins. Ovulation, or release of an egg from an ovary, usually takes place about half-way through the menstrual cycle. After the egg is released (from about days 15 to 22) the uterine lining thickens to provide a nutritious medium for implantation of the fertilized egg. If the egg is not fertilized, there is no implantation. Levels of the hormones estrogen and progesterone fall. That triggers the shedding of the endometrium (around days 25 to 28) and the start of the next menstrual cycle.
Infertility in Women/PCOS
Infertility is the inability to conceive – generally after one year of unprotected intercourse. According to the organization, RESOLVE, about 10 percent of American couples are infertile. In women, the most common cause of infertility is an ovulation disorder. A condition that can cause ovulation problems is PCOS (polycystic ovary syndrome). PCOS causes the development of small, benign cysts on the ovaries and changes in hormone levels. The Hormone Foundation estimates the condition affects about seven percent of women of childbearing age.
Treating Infertility
One treatment option for infertile women is an oral drug, clomiphene citrate (sometimes referred to as a fertility drug). The drug works by suppressing the levels of circulating estrogen. The body responds by producing greater amounts of the follicular stimulation hormone (FSH) and luteinizing hormone (LH). FSH and LH then stimulate the ovary to ripen a follicle and release an egg.
Sometimes doctors prescribe clomiphene citrate for women with PCOS who have difficulty getting pregnant. But pregnancy still can’t occur unless the egg and sperm are united. There is actually a very short window of opportunity for this to happen. Once an egg is released, it can only survive for about 24 hours. The window of fertility lasts about six days. That includes the four days before ovulation occurs (because sperm can survive for up to six days in the female reproductive tract), the day of ovulation and the day after. According to the American Fertility Association, about 20 percent of cases of infertility are caused by a failure of the couple to have intercourse when a woman is most fertile.
The FDA has approved a device to help women predict the fertile time in their menstrual cycle. The OV Watch® is used for women who ovulate regularly. Now, researchers at Emory want to find out if the device may be useful for women with PCOS who are taking clomiphene citrate to induce ovulation.
The OV Watch is a wrist-band with a watch-like device containing a display screen. Special sensors on the back of the “watch” periodically monitor chloride ions in sweat. About four days before ovulation, there is a surge in chloride ions. By detecting this surge, the watch can predict a woman’s window of fertility.
Emory investigators began the study in October 2005 and hope to enroll 40 women. The researchers will also compare the results of the “watch” with those of urinary-based ovulation predictor kits. The study is not expected to be completed until June 2007. However, doctors are hopeful the OV Watch will prove to be an important tool in helping women who need clomiphene citrate to determine their most fertile time and become pregnant.
Web Resources
For information on infertility and treatment:
