Mark P. Trolice, M.D., Director of Fertility CARE: The IVF Center, went live on Reddit for an Ask Me Anything chat—a live, interactive interview where subscribers could ask any question they wanted.
Dr. Trolice participated in the AMA session to answer questions that people may otherwise be too embarrassed to ask. He also wanted to give people the opportunity to ask common questions they have about fertility.
What Exactly is a Reddit AMA?
An AMA (r/IAmA) is a subreddit for question-and-answer interactive interviews (short for “Ask Me Anything”). The AMA interview session takes place at a certain time on a specific day. The individual who hosts the AMA answers questions from anyone who asks.
AMA interviewees have ranged from high-profile celebrities to everyday people in specific lines of work to regular people with extraordinary life experiences to share. Founded in May 2009, the subreddit has emerged as one of Reddit’s most popular communities.
[Hi! I’m Dr. Mark Trolice, infertility and reproductive endocrinology specialist and the director of Fertility CARE: The IVF Center in Florida. AMA!]
What Advice Did Dr. Trolice Provide?
Below are a few of the questions and answers Dr. Trolice covered in his AMA.
Question: Can women have fertility testing without trying to conceive actively?
Dr. Trolice’s answer:
Thank you so much for your comments. Fertility testing for women is limited to ovulation, which can be performed by using an over-the-counter ovulation predictor kit. A hysterosalpingogram (HSG) can also be employed to determine if the fallopian tubes are open. Ovarian age testing has not been shown to affect natural fertility.
Polycystic Ovary Syndrome (PCOS) is a complicated disease with reproductive and metabolic consequences, including high blood pressure, diabetes, and increased waist measurement. Once health is optimized, then ovulation induction is the first step. Ultimately, you may consider In Vitro Fertilization (IVF). Success rates depend on age, body mass index, and any other factors. We are sending prayers to you to make the right decision. Please visit PCOSchallenge.org for more information.
Question: What is the consensus on marijuana use and male fertility?
Marijuana has been shown to have negative effects on both male and female fertility, so we recommend discontinuation. It has been shown to affect sperm motility and fertilization.
Question: Are twin/multiple pregnancy rates still higher for IVF? Is it the norm now to implant 1 embryo at a time?
Great question! Our society has increasingly gone to a single embryo transfer to reduce the complications of a multiple pregnancy. In our program, all women below age 38 usually receive a single embryo, as do all women who have had chromosome testing resulting in a normal embryo.
With single embryo transfer, the twin pregnancy rate is approximately 1 to 2%. With IUI (intrauterine insemination), the twin pregnancy rate is typically less than 5%. The risk of high order multiple pregnancy is typically from IUI because there is no control over the number of embryos that can be implanted inside the uterus, unlike with IVF. Thank you!
Question: How do you decide when a woman is too old to conceive a child?
Very difficult question! Ovarian aging can be explained by quality and quantity. Both of these factors decline as women age. After age 30, fertility begins and continues to decline slowly but more rapidly in the late 30s and early 40s. Success rates above 40 are challenging, and miscarriages increase. Above age 42, and most clinics will discuss the alternative option of egg donation. As a pregnancy carrier, we will offer egg donation to a woman up until age 55. Men also have a decline in their fertility, beginning at around age 40, and also increase the risk of miscarriage. Hope this helps!
Question: What are the effects of Hashimoto’s disease on fertility?
Great question! Thyroid dysfunction, particularly with thyroid antibodies as with Hashimoto’s, has been shown to decrease pregnancy rates and increased risk of miscarriage. Fortunately, with medication to control the thyroid hormone, outcomes are improved. Thank you!
To view Dr. Trolice’s entire AMA discussion, please click here.