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Cover Story

THE TRUTH ABOUT YOUR BIOLOGICAL CLOCK…The facts you need to know

• Most women who think they can wait until their mid thirties or later and have a baby without the help of medical intervention really can’t. • Fertility declines at a much earlier age than is generally assumed. If you’re a healthy woman, most likely your fertility will peak in your mid-twenties and start to decline at about age 27 and the decline accelerates once a woman reaches her mid-30’s.

• The clock keeps on ticking for men, too. Recent studies indicate that men may start losing their fertility as early as 35.

The reproductive roadblocks are different in every case, but in 40% of the time the problem stems from the male,

another 40% from the female. 10% will learn both partners contribute, and the remaining 10% are left with an unexplainable mystery.

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So what’s behind the “biological clock” for women?

Women are born with all the eggs they’ll ever have; a gener-ous endowment of seven million eggs, give or take a million. And most ova never reach maturity; they’re resorbed into the body. By puberty, roughly 250,000 to 300,000 eggs remain, the number dropping with each ovulation and passing year. But it’s more than a numbers game. There’s quality. Those eggs age right along with the rest of your body. The older the egg, the greater the potential for chromosomal abnormalities which can lead to miscarriage or a bad result at amniocentesis. The reality is that a woman may have no trouble getting pregnant at 34, but she may suffer one or more miscarriages when she is 38. She become discouraged and not want to risk having another miscarriage or having a child that may have severe genetic abnormalities. The chromosomal abnormalities are often the result of a faulty meiotic spindle. In cell biology, the spindle fibers serve as the structure that separates the chromosomes into the daughter cells during cell division. As eggs age the spindle fibers become entangled or stuck together causing problems with chromosome separation. Passing chromosomal errors to the embryo typically results in one of three outcomes at IVF (in vitro fertilization): a negative pregnancy test, a miscar-riage, or a bad result at amniocentesis.

At present there’s no magic pill to solve the problem of aging eggs. While eggs can be preserved via cryopreservation, there’s no diet, exercise regiment or anything else that can impede the aging process.

Screening embryos for chromosome errors

“By screening embryos, we can transfer into the womb an embryo with a normal karyotype (complete set of chromo-somes),” explains Dr. Bush. Screening embryos for chromosome errors has been shown to improve a couple’s chances of conceiving and de-livering a healthy baby through in-vitro fertilization (IVF). This may be particularly important for women above the age of 35, women with a prior history of miscarriage, and women that have had an unsuccessful IVF cycle. The first technique used chromosome screening was called fluorescent in situ hybridization or FISH and involves analysis of only 5 to 9 chromosomes leaving the other chro-mosomes unchecked. A newer technique is utilized by Con-ceptions in collaboration with GSN (Gene Security Network). A laser biopsy is performed in-house at Conceptions on the early placenta of a day 5 embryo and the tissue is analyzed by GSN to determine if the embryo has the normal 23 pairs of chromosomes.

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much more likely with multiple gestations. Single embryo transfer decreases complications associated with multiple gestations (twins and triplets). A review of Conceptions IVF cycles as reported to SART (Society for Assisted Reproductive Technology) demonstrates a low average number of embryos transferred per IVF cycle in compliance with SART guidelines. The end results are low multiple pregnancy rates, while still maintaining extremely high pregnancy rates.

Meet Dr. Mark Bush…

Congratulations are due to Dr Bush as the recipient of the Joyce M. Vargyas, M.D. Visionary Award presented by The American Fertility Association at a special event held here in Denver held on March 4th, 2011. Illuminations is a very limited event series that takes place across the country celebrating the work of individuals and or-ganizations who have made a positive difference in the fields of fertility, reproductive health and family building. Dr. Mark Bush is board certified in both Obstetrics and Gy-necology and Reproductive Endocrinology and Infertility. He has extensive experience in all aspects of Reproductive Endo-crinology, Infertility, and Assisted Reproductive Technologies. He served with distinction as the Reproductive Endocrinology & Infertility Division Director at two academic institutions during the six years following the completion of his fellowship. Among his many awards is the American College of Obstetricians and Gynecologists CREOG National Faculty Award in 2001.

Since launching this therapy in January of 2009, Concep-tions has performed over 100 cycles involving screening of embryos prior to placing them in the mother’s womb. An-other distinct advantage of this technology is that for the abnormal embryos, they can determine whether the error came from the egg or sperm – very important information in guiding future therapies. Dr. Bush co-authored an abstract presented at the Ameri-can Society of Reproductive Medicine this past Fall and co-authored an abstract to be presented this year at the Pacific Coast Reproductive Society in Rancho Mirage, California, in April, involving the biopsy of embryos in IVF cycles prior to im-plantation and the impressive results of subsequent pregnan-cies resulting from this technology.

Single embryo transfer

With the recent birth of octuplets to a California woman the issue of multiple births has been all over the news. After performing an in vitro fertilization (IVF), her doctor transferred 6 embryos; two of which produced twins and an amazing 8 children were born from this single procedure. Aside from the ethical issues raised by this event, more important health related matters are present in storiessuch as this and it has highlighted a growing trend to perform Single Embryo Trans-fer (SET). When it comes to the health of the new born child and the mother, it’s important to note that complications are

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Dr. Bush is a member of numerous medical societies includ-ing being a Fellow of the American College of Surgeons and has published numerous basic science and clinical papers in the field of women’s health. Dr. Bush is a sought after speaker from California to New York, lecturing on the management of PCOS, hypothalamic dysfunction, IVF in women who have poor egg health testing who want to use their own eggs, laparoscopic myomectomy and other surgical techniques, as well as innovative testing and management of recurrent pregnancy loss and implanta-

tion failure. He has also been a leader in the clinical applica-tion of CCS (complete chromosomal screening) of embryos prior to implantation.

“We are so grateful to have found Dr. Bush and Concep-tions. At age 40, we are finally holding our beautiful daughter (and suffering the late-night feedings) just as we had always wanted. My husband and I underwent a six-year long journey, involving multiple IVF cycles performed in two states, no fewer than five doctors (by circumstances and not by choice) and a king’s ransom worth of medical costs. We were exhausted and devastated after the last failed cycle at another “well-known” clinic. Looking back on it, I am not sure how we had the strength to pick up the phone and call Conceptions. Dr. Bush’s medical skills and intuition, and his use of cutting-edge technology were essential. Dr. Bush was thorough in his review of our records, straight forward in sharing his thoughts and thoughtful in designing the treatment protocol. He made us feel comfortable with proceeding one more time in his good hands. Looking at our daughter’s beautiful eyes, we are so grateful of the dream that the Conceptions team helped us realize.” (One of several patient testimonials taken from the website www.conceptionsrepro.com)

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Meet Dr. Von Wald

Dr. Von Wald is board certified in Reproduc-tive Endocrinology and Infertility and Obstetrics and Gynecology. She completed an obstet-rics and gynecology residency at the Univer-sity of Kansas School of Medicine-Wichita and Wesley Medical Cen-ter in Wichita, KS. She obtained her fellowship training in reproductive endocrinology and infertility at Beth Israel Deaconess Medical Center, Boston IVF, and Harvard Medical School in Boston, MA. Dr. Von Wald then returned to Wichita in 2007 to work in private practice seeing a broad range of infertility and repro-ductive endocrinology patients. During this time, she also held the position of assistant professor at the University of Kansas School of Medicine-Wichita and was actively involved in both clinical research and teaching of residents and medi-cal students. In addition, she holds a masters degree in public health from the University of Kansas School of Medicine. Dr. Von Wald is a member of the American Society forReproductive Medicine, the Society for Reproductive Endocri-nology and Infertility, and the American Medical Association.She is also a fellow in the American Congress of Obstetrics

and Gynecology.nology and Infertility, and the American Medical As-sociation. She is also a fellow in the American Congress of Obstetrics and Gynecology.

Meet Dr. Swanson

Dr. Michael Swanson is a diplomate of the American Board of Obstetrics and Gynecol-ogy. He is a fellow of the American College of Ob-stetricians and Gynecologists and a member of the American Society of Reproductive Medicine, the American Association of Gynecologic Laparoscopists and the American Institute of Ultrasound in Medicine. Dr. Swanson earned his degree in Chemistry with high distinction at Colorado State University and his M.D. from the University of Colorado. He completed an internship and a residency in Obstetrics and Gynecology at the University of Colorado Health Sciences Center. Since 1981, Dr. Swanson has been in the private practice of Infertility, Gynecology and Obstetrics. He has given numerous continuing medical education lectures and public seminars on infertility, assisted reproductive technology, endometriosis, laser and endoscopic surgery. He has served as chairman of quality assurance in Obstetrics

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clinical expertise, from initial consultation to surgical options, ovulation induction cycles through the latest techniques in IVF.

Learn more about Conceptions at www.conceptionsrepro.com

Conceptions Has 3 Fertility Clinics Serving Denver Metro Area

Littleton, Colorado Address (NW of Broadway & 470)271 W County Line RdLittleton, CO 80129Phone - 303-794-0045

Denver, Colorado Address 4500 E. 9th Ave #630Denver, CO 80220 Phone Number - 303-720-7887

Lafayette, Colorado Address300 Exempla Circle #370Lafayette, CO 80026Phone - 303-449-1084

and Gynecology at Swedish Medical Center and was on the founding medical executive committee at Littleton Hospital. Several times in recent years, 5280 has chosen Dr. Swanson as one of Denver’s “Top Docs.” He has performed in vitro fertiliza-tion (IVF) since 1988 and has assisted thousands of couples in their dream of becoming a family.

About Conceptions…

For nearly twenty years, Conceptions Reproductive As-sociates of Colorado has been helping couples to realize their dreams. As a leader in the field of reproductive medicine, Conceptions offers a full spectrum of the most advanced treatments available. Their physicians are experts in the diagnosis and treatment of infertility. Throughout the years, the clinic has performed thousands of IVF cycles with exceptional results. Their highly acclaimed clinical and embryology teams consistently achieve pregnancy rates among the highest in the country. At the forefront of infertility technology, the Littleton facility boasts 17,000 square feet of state-of-the-art equip-ment. The Clinic’s relaxing, comfortable environment is host to several medical suites and treatment facilities. Onsite access enables them to maintain strictest quality standards and provide their patients with continuous support and superior