Happy New Year!

In this issue, you'll find:

• A Letter to the Members: FOX and "Who's Your Daddy?"
• AFA Telecoaching Groups
• The Fertility Dream 5K Arizona
• This month's featured article: Aging and Infertility
  

A Letter to Members

Dear Members,

By now you've probably heard about the program that aired on FOX on Monday, January 3, entitled "Who's Your Daddy?" Most adoption experts and advocates - including the AFA - are appalled by FOX as well as the premise and execution of the program.

In fact I felt so strongly about the negative and simplistic light this show cast on the complexities of adoption, I didn't want to even watch it. I didn't want to waste an hour of my time; yet alone give :30 seconds of it to any advertiser ill advised enough to run a commercial on the show.

I also wanted to let you know that The AFA has written to FOX and has issued a press statement expressing our dissatisfaction and outrage at the show's trivializing of a life-altering event for many adopted children, birth parents and adoptive parents.

If you would like to contact FOX executives to tell them how you feel about the show, please write, call or e-mail:

Peter Chernin, Chairman, Fox Entertainment Group
10201 W. Pico Blvd. Bldg 100, Los Angeles, CA 90035
Phone: 212-852-7111, Fax: 212-852-7145

Mitsy Wilson, Senior VP, Diversity Development, Fox Entertainment Group
1211 Avenue of the Americas, New York, NY 10036-8799
Phone: 212-852-7111, Fax: 212-852-7145
E-Mail: diversityquest@fox.com

Justin Pierce, Senior VP Corporate Communications, Fox Television Studios
10201 W. Pico Blvd. Bldg 100, Los Angeles, CA 90035
Phone: 310-369-2731, 310-369-3881, Fax: 310-369-5175, 310-286-6334
E-Mail: justin.pierce@fox.com

What I wanted to remind all our AFA members about is that adoption is a beautiful and rewarding family building option; one that has fulfilled the lives of so many. Don't allow a prime time "reality show" - and I use this term loosely here - to define adoption for you. The complexities of emotions surrounding adoption are completely lost in FOX's attempt to garner ratings.

I leave you with one last thought on the airing of any future episodes of the "Who's Your Daddy" program - don't watch.

Regards,
Pamela

AFA Telecoaching Groups

Fulfill Your New Year's Resolution: Move Forward with Your Family Building Plans. The AFA is pleased to offer two free New Year's Group Coaching sessions via phone:

Adoption Group: Thursday evening, February 10th

Fertility Group: Thursday evening, February 17th

Keeping the momentum going on family-building efforts can be challenging. The AFA can help you stay focused and motivated, wherever you are on the treatment or alternative family-building track. These Coaching Groups are for individuals and couples who desire supportive contact with others who are in the midst of treatment or are weighing the adoption option. Groups will focus on common questions and areas of concern that naturally arise during this process. The groups are one hour in length and will be co-led by Sara Barris, (psychologist and adoptive parent) and Bob Bamman (psychotherapist and adoptive parent).

Space is limited! Registration deadline is the Tuesday prior to the group meeting date.

For registration information, please contact:

Adoption Group: Sara Barris at 718-544-0932 or SaraBarris@aol.com

Fertility Group: Bob Bamman at 646-872-9032 or BobBmmn@aol.com

The Fertility Dream 5K Arizona

On your mark. Get set. Race for a great cause!

The AFA invites members and friends across the country to participate in a healthy activity for a great cause. The AFA's Fertility Dream 5K Arizona will take place near Tucson, Arizona. The AFA seeks a nationwide community of people who care deeply about fertility issues and who would like to raise fertility awareness.

If you are interested in participating in the race or sponsoring a participant, please visit our Web site - www.TheAFA.org - or call (888) 917-4777. Participants who collect at least $150 will be cordially invited to attend a luncheon with John "The Penguin" Bingham, renowned Runner's World columnist and author of "The Courage to Start: A Guide to Running for Life."

Your hard work pays off! Donations collected from the Fertility Dream 5K will help fund "Footprints: The IVF Children's Health Study," a comprehensive study the health and development of IVF children. Funds will also ensure that The AFA's "No Barriers" program remains free for all those who need it.

So what are you waiting for? Dust off your running shoes and register today! Visit the AFA web site www.TheAFA.org or call (888) 917-4777 to register.

Aging and Infertility
Janet M. Choi, M.D.
Zev Rosenwaks, M.D.

What you've heard about age and fertility is true-as a woman ages, her ability to conceive declines. This gradual decline in fertility starts very subtly in the late 20s to age 35 but then becomes more pronounced as age approaches 40 and older. In one French study, researchers found that the pregnancy rate over one year for women younger than 31 was 74%. For women between the ages of 31 and 35 the rate declined to 62% and to 54% for women beyond 35 years of age. In another study, 87% of women age 45 and older were no longer able to bear children. But the ticking of the biological clock is not as inexorable as it once seemed. Medicine and technology are developing ways for women to improve their chances of conceiving. This article will try to explain not only why fertility declines with advancing age but also how assisted reproductive technology can improve a woman's chances of becoming pregnant.

The reasons for the decreased fertility rate with age is multi-fold. Many women, married or unmarried, are waiting longer before attempting pregnancy. As sexually active women grow older, the likelihood that they might be exposed to sexually transmitted infections increases. These infections (such as chlamydia or gonorrhea) can permanently scar the pelvic organs which can hinder a woman's ability to become pregnant. The chance that a woman might experience fertility related complications from endometriosis or adenomyosis (disorders which involve uterine lining cells-endometrial cells-implanting in abnormal locations in the pelvis) increases with age as well.

One of the most important explanations for age-related infertility in women is the declining number of genetically normal available eggs. The peak number of eggs (also known as oocytes) is achieved long before women even consider becoming pregnant: when a female fetus is 4-5 months old, still in the mother's uterus, it possesses up to 6-7 million eggs. By birth, this number drops to 1-2 million and declines even further when, at the start of puberty in normal girls, there are 300,000-500,000 eggs. Several hundred oocytes are lost during the 3-4 decades a woman has regular menstrual cycles through the monthly development and ovulation of an oocyte. Many other oocytes are lost through triggered, natural cell death. When a woman reaches her mid- to late 30s, when she has about 25,000 eggs left in her ovaries, the loss rate of oocytes accelerates. In addition, as a woman ages the ability of her oocytes to divide and distribute the genetic contents normally declines. The likelihood that an oocyte with an abnormal number of chromosomes will be fertilized increases with age. Older women (particularly over the age of 35) have a gradually increasing risk of pregnancies which are genetically abnormal. Most of these genetically abnormal pregnancies are miscarried in the first or second trimester of pregnancy. Unfortunately, older women (again older than 35 and especially past the age of 40) have a higher risk of miscarrying even genetically normal pregnancies. Several studies have found that for women over 40, the overall risk of miscarrying a pregnancy is about 75%.

Assisted reproductive technology--using "fertility drugs" in conjunction with artificial insemination or in vitro fertilization--may enhance an older woman's ability to conceive. Using injectable (or, in some cases, oral) medications, a woman can increase the number of available oocytes which mature and are then available for fertilization. With artificial or "intrauterine" insemination, a doctor can insert sperm directly into the uterus and time it according to when the oocytes are mature. Although the overall pregnancy rate achieved with medications and insemination is around 14-17%, the success rate falls to less than 10% for women over 40. With in vitro fertilization (also known as IVF), a woman uses injectable hormones to stimulate her ovaries after which a doctor extracts the mature oocytes using a minimally invasive procedure. In the lab, the extracted oocytes are mixed with sperm or even directly injected with individual sperm. If embryos develop from this in vitro fertilization process, they are then transferred into the woman's uterus. The pregnancy success rate for IVF can be as high as 50-70% in women in their 20s or early 30s and though the success rate declines with age, some centers achieve success rates over 20% for women in their early 40s.

Unfortunately, not all 40-year-old (or even 30-year-old) women respond to fertility treatments in the same way. By measuring two hormone levels-- estrogen and follicular stimulating hormone (FSH)--on the third day of a woman's menstrual cycle, a doctor can assess the likelihood that a woman may respond to stimulation. Elevated estrogen and/or FSH levels (and the values vary from lab to lab) may indicate a decline in normal, available oocytes. A woman with abnormal day 3 hormone levels possesses a much lower likelihood of responding well to fertility treatments as well as a lower chance of becoming pregnant when compared to a woman of the same age with normal estrogen and FSH levels. For a woman with persistently elevated FSH levels and/or who has not responded well in past IVF cycles, donor egg is the last option. With donor eggs, a young donor (usually less than 35) is stimulated, her eggs are retrieved, fertilized with the sperm of the infertile woman's partner, and the resultant embryos are placed in the older patient's uterus. Even women in their late 40s or 50s can attain a pregnancy success rate of greater than 40-50% with donated eggs.

The one caveat is that all these scientific explanations of aging and fertility are not absolute. There are anecdotal accounts of women in their 40s having failed multiple IVF cycles who then become pregnant without assistance. Turning 40 does not mean a woman can no longer bear children, only that she might need medical assistance (and possibly someone else's eggs) along the way.