Infertility Treatments, in Your HomeColoCRM2018-12-07T15:44:07-07:00
Infertility Treatments, in Your Home
More would-be parents explore over-the-counter products to aid conception—in some cases before, during and after medical treatment
January 18, 2016 By Melinda Beck
Juliana and Greg Tomlinson started trying to have a baby on their wedding night, October 8, 2011. After a year without success, the Lancaster, Pa. couple says doctors diagnosed double trouble: Greg has a low sperm count and Juliana has polycystic ovarian syndrome (PCOS), a hormonal disorder that can make ovulation irregular. The Tomlinsons endured months of hormone treatments, and a heartbreaking miscarriage in 2014. Their Catholic faith put in vitro fertilization out of consideration.
Last February, their hopes soared when Juliana noticed an at-home insemination kit at the pharmacy. The over-the-counter device, called the Stork, helps deliver sperm to the cervix and keeps them there for hours, to increase the chance of fertilization. Their first attempt with it was unsuccessful. But the Tomlinsons are on a vitamin regime and plan to try the Stork again. “It’s important to keep your hopes high,” Juliana says.
Many would-be parents are turning to at-home products to help them conceive—before, during and after seeking professional treatment for infertility. The growing do-it-yourself arsenal ranges from devices that mechanically assist the uniting sperm and egg, to tests that diagnose what’s going wrong. Some are Food and Drug Administration approved; some are MacGyver-esque uses for ordinary household items.
They all offer couples more privacy than going to a fertility clinic, and at far less cost. A standard workup for fertility issues can cost hundreds of dollars. A cycle of invitro fertilization costs $12,500 on average, according to the American Society for Reproductive Medicine, and is seldom covered by insurance.
Fertility experts say some at-home products are helpful but others may be harmful. They caution couples against believing everything they read online. “There’s a lot of emotion surrounding pregnancy and people look to do whatever they can to increase their odds and avoid seeing me,” says reproductive endocrinologist Brian Levine, New York practice director for the Colorado Center for Reproductive Medicine, a multistate fertility practice.
An estimated 10% to 12% of U.S. couples are struggling with infertility, defined as not being able to conceive despite frequent unprotected sex for at least one year, or six months for women over age 35. Many more are impatient, experts say. And a growing number of single women and gay and lesbian couples eager to start families are using do-it-yourself conception kits with donor sperm or surrogates.
Doctors say the most useful products help couples understand and monitor the woman’s monthly cycles. “Some couples are just having sex at the wrong time,” says Dr. Levine.
Tests that predict or confirm ovulation, by detecting hormone changes in urine, have been on the market for decades, and some have gone high-tech. Dozens of smartphone apps help women graph their monthly cycles. Some include wearable sensors that monitor body temperature and chemical changes in the skin. Other at-home predictors test for a “ferning” pattern in saliva that appears up to 72 hours in advance of ovulation.
After nearly two years of trying with a variety of ovulation predictors, April Schweitzer, a Chicago attorney, and her husband, Jonathan, both 31, used the ClearBlue Advanced Digital Ovulation test ($27), which showed a smiley face during her two most fertile days. They are expecting a baby this summer.
Doctors say ovulation predictors are especially useful for women who have irregular cycles or may not ovulate every month. But predictor kits aren’t infallible; they can be thrown off by illness or fertility drugs, and success-rate claims are hard to verify.
About 40% of fertility problems originate with the male partner, experts say. For about $40, men can check their own sperm concentration with an at-home test. A normal level is considered 20 million per milliliter of semen.
Fertility experts say at-home tests shouldn’t substitute for a formal semen analysis (costing about $100), because such tests can’t determine whether sperm are properly shaped and able to swim. “If you have 100 million sperm per milliliter but they are all dead or moving around in circles, it could be false reassurance,” says Owen Davis, a New York fertility specialist and president of the American Society for Reproductive Medicine.
Packaging information for SpermCheck Fertility notes that a negative test isn’t definitive, either, since some 10% of men who have fathered children have sperm counts below 20 million per milliliter.
Home tests that assess how many eggs remain in a woman’s ovaries (the supply dwindles with age) also tell only part of the story, experts say. Most of the tests measure follicle stimulating hormone (FSH), which the brain sends to the ovaries to spur ovulation; a high FSH level may indicate diminished quality or quantity of eggs. Physicians say they now measure a different hormone made directly in the ovaries, or use ultrasound to see how many egg follicles are developing. Ovarian reserve test kits say an elevated FSH suggests further testing may be warranted.
The protective secretions that sperm must swim through can be another source of fertility problems. Some nutritional supplements claim to help make cervical mucous more hospitable for conception. Some couples also use over-the-counter cough medications that thin out mucous. “I know some providers who swear by it. But it’s an off-label use and there is little hard evidence,” says Dr. Levine.
Some dietary supplements, herbal products and teas also claim to aid in conception and even to improve sperm count and stimulate ovaries to release eggs. Ethan Lynette, a partner at Fairhaven Health, which makes and sells some of them, says “there’s a ton of clinical data behind the ingredients in these products” and doctors frequently recommend them. The FDA urges couples to check with a health-care professional before using them. “Just because you see a supplement product on the store shelf does not mean it’s safe,” says FDA spokesman Eric Pahon.
When intercourse isn’t an option—say, for a single woman, or for couples using donor sperm—syringes can serve as a stand-in. Amber Carpenter, 31, and her wife, Nicole Posluszny, 33, were successful on their first try using a male friend’s sperm, a plastic Ziploc bag and the syringe from a bottle of liquid baby aspirin. “We thought, Why not try it at home first and if it doesn’t work out, we’ll go to a doctor,” says Ms. Carpenter, who had a baby boy 17 months ago. The couple used the same donor and method again, and now Ms. Posluszny is expecting a baby boy in March.
Doctors say it’s crucial when using the so-called turkey baster method to make sure all items are sterile. Most recommend obtaining sperm from a licensed and FDA-regulated sperm bank, where donors are screened for genetic problems and infectious diseases and sign away all parental rights. A vial of sperm from a bank generally costs $300 to $500; insemination at a doctors’ office can cost several hundred more, depending on the method.
A type of assisted insemination called cervical cap insemination holds semen in a cup-like device against the cervix, giving sperm more opportunity to swim through. Engineer Stephen Bollinger invented the Stork by using a racquetball split in half; he says it helped his wife and him conceive their two children. The $80 over-the-counter device got FDA clearance in 2014.
Rinovum Women’s Health, maker of the Stork, says a study found the product concentrated three times as many sperm at the cervix as natural intercourse. Fertility experts say that doesn’t necessarily mean a higher chance of conception, especially if sperm have motility issues. They also note that cervical cap insemination shouldn’t be confused with intra-uterine insemination (IUI), a medical procedure in which sperm is placed directly into a woman’s uterus.
Terrell Joseph and Jarius Goudeau, a gay couple in Atlanta, used the Stork when they started a family. The two men found and hired a surrogate mother in Florida, tracked her monthly cycles and drove five hours one night in November when an ovulation predictor said she was ovulating. Using the Stork and Mr. Joseph’s sperm, she became pregnant and is due to deliver later this year. The couple figures they saved $10,000, which they plan to spend on their daughter or son. “I can’t express how overjoyed we are,” Mr. Joseph says. “It’s like winning the Powerball.”