Sound Medicine for April 6, 2002

Sound Medicine -- April 6, 2002

Happy birthday to us! It's our first anniversary show. Thanks to our guests and listeners.

Barbara Lewis and Dr. Kathy Miller talk to physicians and researchers about:: Predictive testing for genetic diseases; Assisted reproduction using cryogenics; Male infertility

Listen to the show:
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Predictive testing for genetic diseases

If your family had a history of a debilitating disease that caused extreme memory loss or physical disability, a disease such as early-onset Alzheimer or Huntington disease, would you want to know your fate? What different life choices would you make after the diagnosis?

Dr. Kimberly Quaid directs the Predictive Testing Program at the IU School of Medicine. Dr. Quaid describes the process of testing individuals for such genetic conditions, from the initial counseling to the choices people make after discovering they indeed have inherited a disabling genetic mutation. In particular, she addresses the topic of screening a woman's eggs to make sure her child does not carry the devastating gene mutation.

Kimberly Quaid holds a Ph.D. in psychology and is associate professor of clinical medical and molecular genetics and psychiatry at the IU School of Medicine. She's also a core faculty member at the IU Center for Bioethics.

Resources: To hear more from Dr. Quaid, listen to the March 8, 2002 archived broadcast of the Diane Rehm radio show. (Scroll down for Friday's show.) Listen as Quaid and two other guests discuss the case of the woman with early-onset Alzheimer's who screened her eggs in order to have a healthy child.; Medical professionals can read more about the ethics of predictive testing and when it should be used in this March 1997 article in the Journal of the American Medical Association. (PDF format); Get more information on medical ethics at the Indiana University Center for Bioethics.

Assisted reproduction using cryogenics

The newest technology in fertility and genetic engineering allows people to have biological offspring -- people who even 10 years ago had no hopes of having children due to illness or injury.

Dr. Roger Gosden is scientific director of the Jones Institute for Reproductive Medicine in Norfolk, VA, which specializes in cryopreservation and other assisted reproductive technologies. Dr. Gosden describes using cryogenics to freeze and preserve biological substances, for example cryopreservation of human eggs when a woman anticipates injury or loss of ovarian function after cancer treatment. He explains the role of the procedure in in vitro fertilisation (IVF), regulatory issues, freezing eggs versus embryos, and "assisted hatching." Dr. Gosden also addresses the ethical issues faced by reproductive medical professionals.

Resources: The Jones Institute for Reproductive Medicine Web site offers clear definitions of assisted-reproduction procedures and insights into the latest research.; The International Council on Infertility Information Dissemination (INCIID) may well be the most comprehensive collection of fertility/infertility information available electronically.; The American Infertility Association Web site is filled with links for couples looking for information, support, and volunteer opportunities.; Child of My Dreams is another resource for adoption and infertility information. This patient-oriented site is filled with answers to common questions and problems.

Male infertility

For centuries, childless women were labeled barren and carried the blame for infertility, but today's society accepts that both men and women may be responsible for an inability to conceive, with about a third of cases involving factors from both. Dr. Samuel Thompson, urologist at Methodist Hospital in Indianapolis, specializes in male infertility. He answers questions about diagnosis, treatment, and possible causes of male infertility.

Resources: The Advanced Fertility Institute in San Diego offers interactive Q&A on both male infertility and assisted reproduction, along with a virtual tour through in-vitro fertilization.; The online Urology Channel is packed with links and information on all issues concerning male infertility.

We're pleased to thank our founding sponsors: IU Medical Group, Clarian Health and Wishard Health Services.

Upcoming topics:

Early onset puberty

Selective mutism in children

Over-the-counter pain medications

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Health Quiz — Fertility folklore in weddings
Fertility rituals and superstitions abound in folklore reaching back thousands of years, and many still survive today. Many favorite wedding traditions arose from trying to appease the fertility gods and secure healthy and plentiful offspring for the new couple. Which of these wedding customs are meant to bestow the blessings of fertility on the bride and groom?

a. Flower girls
b. The wedding cake
c. Throwing rice
d. All of the above

What's the answer?

Weekly Notebook — Fertility Statistics
These figures are for American women.

• To naturally replace the population, women must have an average of 2.1 births.
• During the 1990s fertility rates fluctuated between 2.0 and 2.1 births per woman.
• In the 1950s, women had an average of 3.5 births.
• In the 1970s, women had an average of 1.8 births.
• 43% of women of childbearing age were childless in 2000.
• In 1995, there were 9.3 million women using infertility services.
• A 12-month study ending in June 2000 indicated that 31% of all births in that period were out-of-wedlock. Most of these women had one or more years of college.
• 83% of teenage births in this period were out-of-wedlock.
• In 2000, 34% of mothers with infants worked full time.
• In 1995, there were 2.1 million infertile couples.
• Also in 1995, 6.1 million women had impaired ability to have children.

Sources: The National Center for Health Statistics and the Census Bureau.