Natural Conception after Adoption and Assisted Reproduction Treatment

Today at work I was putting together a presentation on “What is correlation?” (I know, my work is full of excitement and such geekery 😎 ), and I came across an interesting example of ‘illusory correlation’ from the infertility world that I thought I would share with you all.  I was about using it as an example in my presentation.

Have you ever heard someone say

“Adoption increases the chance of an infertile couple getting pregnant naturally?”

Many people have heard or say this, and many can tell you a story of someone they know/know of that this happened to.  The rationale behind this can be hypothesised as:

Once the pressure is off and the couple is less anxious, it will happen naturally.

But how true is that?

Apparently it turns out there is NO empirical evidence to support such a hypothesis.  Research (from Resolve) has shown that the percentage of women who become pregnant without adopting is no different to the percentage of women who become pregnant without adopting.  What this means is that, while a small percentage of people who were having difficulty getting pregnant do not get pregnant after adopting a child, these are likely the same people who would have gotten pregnant after having difficulty, even without the adoption.  It has nothing to do with the adoption.

So why do so many people believe this myth?  Because many people can tell you of a story of someone they know that this happened to.  But the thing is, most people can only tell you ONE story.  And they don’t tell you all the stories they know about the infertile couples that adopted a child and didn’t get pregnant naturally afterward.  The examples of where it did happen are salient to them, perhaps because they remember thinking to themselves “This couple is going to have two babies within a few months of age of each other!”  What happens when something is salient – or when it produces a vivid memory – is that people tend to overemphasize the likelihood of its occurrence.  And they give it a lot of attention.

This is known as vividness bias.

The vividness bias is supported by what’s often referred to as an illusory correlation – the impression that two variables are related when in fact they are not.  In this example, because of one or two very salient or vivid examples, many people believe that there is a relationship between adoption and getting pregnant, when in reality, there is not.

(Extracted from: Intentional Interruption: Breaking Down Learning Barriers to Transform By Steven Katz and Lisa Ain Dack)

Similar to the case made for getting pregnant naturally after adoption, you may have heard a similar argument for couples who stop assisted reproduction and get pregnant naturally afterwards.  There is research that was published in 2012 that found that 17% of women who became pregnant, and gave birth, from IVF treatment, became pregnant again naturally (NB….within 6 years!).  For those women who were unsuccessful with IVF, 24% became pregnant naturally after stopping infertility treatment.

Other recent research has found that 16% of infertile women conceive naturally after stopping treatment (within 13 years!).  And by the way, let us not forget that a fertile couple’s chance of conception is 20-24% for every menstrual cycle!  So that 16% statistic still SUCKS.  In addition, the original cause of a woman’s infertility made a difference as to the chance of achieving a successful natural pregnancy after IVF – if the infertility was due to uterine, cervical or ovarian problems, endometriosis or infertility in their male partners, the women had a significantly greater chance of achieving a successful natural pregnancy after stopping IVF.  However in comparison, if the couple’s infertility was ‘unexplained’ or the problem was with tubal pathology, her chances of a natural pregnancy decreased 😦

So there are many illusory correlations out there in the infertility world.  And now you know how to respond to people that say to you:

“ohhh you will get pregnant naturally after adopting/stopping treatment, that happened to my friend/friend of friend”

you can reply

“……the evidence is contrary, my dear, and you are suffering from vividness bias”

It’s a whole lot politer, and factual, than – “F*#$ you”.

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reblog – Let’s Break The Internet With Infertility Awareness! —

I totally missed Day 5 of the Bloggers Unite Conference – bad Dani!!! I was exhausted driving back from DC yesterday (I know, excuses excuses!!) :-s

Day 5’s topic is about #StartAsking for insurance coverage.  As I have the best insurance coverage, I think, in the whole of the US (I have a worldwide insurance policy) I can talk about the benefits that everyone should have available to them – I have coverage for infertility diagnosis and infertility treatments (IUI, IVF, ICSI etc), including medication – I even have coverage for Genetic testing.  There is no $$$ limit, but I can only have 6 life time IUIs and IVFs. It’s quite amazing really!  So I have already used up half my life time allowance.  I still have to pay the 10% copay…but it is no comparison to those couples who have to pay the full amount.  Infertility is stressful enough as it is without the added financial burden and bills to track and pay.  It makes me mad that infertility treatment is seen to be ‘an option’ like cosmetic surgery is ‘an option’.  You can read more about this at missconceptioncoach.com below

In a perfect world, the tens of thousands of women and men suffering from infertility who consult reproductive specialists every year would know that their medical treatment would be covered by their health insurance. Infertility is, after all, considered a disease as stated by the World Health Organization. Yet the establishment of an “Essential […]

keep reading more here…via Day 5 – #niaw, Bloggers Unite Conference – Let’s Break The Internet With Infertility Awareness! —

Why can’t we make a baby? #NIAW

Why?  Why me?  Why can’t I make a baby like all my other friends and family? I have so many questions about why after almost 2.5 years of trying to conceive and failing miserably, month after month.  What have I done to cause this?  Why won’t my body just get pregnant? What am I doing wrong?

It’s human nature to want to know why things happen.  But these are the type of questions that run through my head round and round, continuously ever since we decided to grow our family.  I have yet to answer any of these questions.  It is exhausting.

Chris and I are 1 in 8 couples of child bearing age in the US that struggle with the disease that is infertility.  We tried the good old fashioned way – sex – for 11 months before we went to seek specialist help from a reproductive endocrinologist doctor after we discovered that Chris’s testosterone levels were “below normal”.  It turned out for us that testosterone levels do not actually matter that much when it comes to fertility.  Chris actually had super sperm, and lots of them!  But it did lead us to start the typical tests for diagnosing infertility.

We thanked our lucky stars that all our test results came back normal – there was nothing seriously wrong with either of us.  In fact, we passed all our tests with flying colours, we were top of the class!  But this put us into the category that 20% of infertile couples are diagnosed with – unexplained infertility.  This meant that the doctors could not tell us why we hadn’t been successful so far in trying to conceive the way they teach you at school.  We were about to embark on a journey that was going to take us beyond what they taught us at school – we were going to try to get pregnant with medical assistance.  We were heading into the world of the unknown.  We knew little to nothing about infertility.

At first it was difficult to explain to our friends and family why we were seeking treatment, because there was nothing ‘technically’ wrong with us.  The infertility was inexplicable!  It was embarrassing, it was awkward to explain.  So this is why I started this blog, to help us get over this difficulty in explaining what we were doing and why, as well as helping to explain our feelings about our disease in general.

Unexplained infertility in someways has been a good thing – there is always hope that this treatment will work.  But ultimately it is difficult to accept that there is just no known reason that this isn’t working for us.  In some cases, going through medically assisted treatment for infertility can reveal the explanation of a couple’s infertility.  But in our case, after 3 IUIs (Artificial Insemination) and 3 cycles of IVF (In-Vitro Fertilisation), 1 suspected ectopic pregnancy,  and over $90k of medical bills we are none the wiser as to why we do not have a baby in our arms yet.

Conception is a wondrous act of nature, but it is also an incredibly complex process  – there have to be many stars in line for a healthy baby to be born.  For something that is the very basis of our human race’s existence, we still know very little about the disease that prevents us from growing our families.  It’s incredible, right?

I am currently in the dreaded two week wait of our third (and final) IVF cycle.  If this cycle fails, apart from being devastated, I do not know how we will ever be able to move forward without knowing why this has happened, why medical treatment didn’t work for us.  Our infertility will never leave us.

For National Infertility Awareness Week (NIAW), the national non-profit infertility organisation Resolve is promoting this year’s theme #StartAsking.  The theme is about promoting the questions that we want to be answered, whether this is asking for our Employers to provide insurance coverage, asking for legislation that supports family building options or asking our friends and family to support us.  For me, the one question I have and want to raise more awareness about is to:

 #StartAsking for more targeted research on unexplained infertility.

Perhaps if we can understand more about how or why some couples are infertile, then better focused medical interventions can be developed to defeat infertility.

I want answers!!!! But we won’t ever get answers if we don’t talk about infertility and unexplained infertility.  It shouldn’t be a secret.  We can do this by speaking openly about infertility, by getting organisations like Resolve to help raise our community’s voice and build awareness.

If you would like to know more about infertility, please visit Resolve.org.

If you would like to help, you can contribute by fundraising or donating for Resolve.  Or just comment below with your questions and thoughts to join in the discussion!

wishniaw.png

I always say it’s never over ’til the fat lady sings….predicting a successful pregnancy outcome

fat_lady_singing

I always say it’s never over ’til the fat lady sings.  But that doesn’t mean I can’t see that fat lady getting ready to get on stage…I can also hear her warming up, running through a few scales too.

So, my suspicions were pretty much confirmed about why I didn’t get my results yesterday.  My results were not good.  And let me point out here that these are not my words, but the words of my nurse.

My hCG levels last Weds were 49 –  just a bit lower about where they should be, but were not overly worrisome…

My results from Tues this week, however, were 126.  They went up!!!! But those of you who are familiar with hCG levels and where they should be by now will know this is not a great number.  hCG levels should double every 2 to 3 days.  What does this mean?  Well my doctor wants me to keep taking my progesterone and estrogen, just in case – there is always a small chance this pregnancy is still viable!! But I have to go in for another beta test on Friday to double check that this pregnancy is, in fact, over.

I can safely say I am no longer feeling cautiously optimistic….I am feeling pessimistic as hell and sad.  If you would like to hold onto hope for us, I gratefully take your strength and thank you for helping to hold us up, but quite frankly when the nurse tells you it is not good, it’s not good.  I understand she is preparing us for the worst.

BUT!!!!! I decided to do a bit of research on what all this really means, what are MY chances?  You know I had to do it, as one of my colleagues told me today – GTS!  (Google That S#*% !!!).  OK, I’m going to get a bit technical here….hang in there if you have in interest in hCG levels (the beautiful pregnancy hormone!!)….


I found a very useful study* that looked at the predictive values of hCG levels for a viable pregnancy 13 days after a 3 day Embryo Transfer (I took my first beta test 14 days after my 3 day Embryo transfer).  My result of 49, according to their model, gives me the following chances of outcome: 45% successful singleton pregnancy, 31% miscarriage, 13% bio-chemical pregnancy, 9% ectopic pregnancy, 3% successful multiples pregnancy.  Well I am glad they didn’t tell me what my hCG levels were last week!

According to these researchers’ analysis, they decided that the cut-off level for predicting a viable pregnancy was an hCG level is 76 IU/I (80% sensitivity)….although this is considerably higher than some other researchers have reported (for example other studies have found the cut off at a similar sensitivity to be: 42 mIU/ml (Qasim et al., 1996); 55 IU/l (Bjercke et al., 1999); and 50 IU/l (Sugantha et al., 2000)).

Wow guys, 76 seems to be a whole lot higher than the others….so do they have credibility in their research?  Well from what I can ‘statistically understand’ and in understanding their research design, it looks solid; their sample size is excellent, some of the best I have seen in articles about artificial reproductive technologies….but I am not a medical professional, so I am totally relying on my knowledge of stats and may be there is something ‘medically awry’ that I cannot see.

If I use any of these models, and consider my hCG level of 49 from last week, these researchers would have told me my chances of a viable pregnancy were always going to be low.

However, there was one interesting point that came out from this study that caught my eye:

In subjects with unexplained infertility, ICSI may result in lower than expected HCG levels (Gold et al., 2000)….The explanation for this was not clear.  Although the early embryo cleavage is delayed in ICSI-derived embryos and the fragmentation of embryos is increased the implantation potential is comparable with IVF-derived embryos.

Even though my numbers have not multiplied nicely….in the back of my mind I am holding onto this slither of hope….holding on that we are the ones in that 5% extreme quantile who defy the norm, and it is because we are unexplained and our embryo was ‘ICSI-ed‘ that my hCG numbers are much lower.

Until Friday…………. :-s

*Pokkeus, P., Hiilesmaa, V. & Tiitinen, A. (2002) Serum HCG 12 days after embryo transfer in predicting pregnancy outcome. Human Reproduction 17(7):1901-1905. Available at: http://humrep.oxfordjournals.org/content/17/7/1901.full

How to get the most out of your doctor

It took me about 24hrs after it was confirmed that I am pregnant to realise I do not know how to be pregnant.  This might seem very weird considering we have been talking about this moment for more than two years now.  Once we started trying to conceive I just of buried my head in the sand.  I didn’t want to jinx our chances by buying a book about it, and I started to avoid all pregnancy related websites and apps after 6 months of failing to succeed in our quest to make a baby.  I know the basics, like smoking is a big no-no, drugs are dangerous, avoid raw meat and reduce caffeine, but really, that is the limits of my knowledge.  So yesterday we went to the book store and bought two books on pregnancy.  One was the standard text book “Great expectations: Your all in one resource for pregnancy”, and the second was “Expecting Better”, beautifully demonstrated in this picture by Sushi:

Sushi, my book keeper

Sushi, my book keeper

This second book interested me because I have always wondered whether Japanese women stop eating sushi, or French women stop eating brie when they are pregnant.  Really?  I don’t think so.  I hope that this book will enlighten me to what the conventional wisdom really means.  But when I started reading the first chapter I didn’t need to go much further with it to be completely satisfied with my purchase.  Why?  Well the author, Emily Oster, is not so different from me, she was not happy with what her doctor was telling her.  I realised that my experience with my fertility clinic’s doctors and the feeling I had that there was a poor lack of communication.  All of this was because I was not asking the right questions.  I didn’t know I needed to ask them.  And this is silly because all along I had the key questions in the back of my mind…I use them everyday at work!!!

In my job I help leaders make decisions every day…I do this by presenting the evidence, the facts – for and against a decision – I do some analysis on the data that supports the decision, I try to be unbiased and objective in my analysis, and then I present a recommendation to the leader on the best course of action.  The leader doesn’t always go with my recommendation, but I have presented them with the facts and figures to make their own mind up.  Sometimes I feel a bit hurt, but then I remember, I am not the one taking the risk.  So when it comes to our healthcare and doctors, WE are the decision makers.  We need to be presented with the arguments for and against, and be told what the supporting evidence is.  WE are unique in many different ways and the decisions we make will be unique, blanket guidelines are not always appropriate for everyone.

I think a good example of this is when we were told we should do ‘ICSI’ because of our unexplained infertility.  We didn’t ask the questions:  What are the pros of ICSI?  What are the cons of ICSI?  What are the improved success rates with people like us? (i.e. what’s the supporting evidence/data?)   We were not armed to make a decision, we just went with what the doctor said, and in the back of my mind I felt like I had not been given a chance to make a decision.  I did actually do a lot of this research myself, but it would have been better if my doctor would have told me – after all I am not the medical professional, I just have the fortunate ability to interpret statistics from studies and experiments.  So although I was finally happy with the decision to do ICSI after my research, something inside me was niggling about our doctor’s communication.

Another example is when it came to our embryo transfer.  We were told that it is the standard practice at the clinic to transfer 2 embryos on day 3, unless there were over 6 fertilised embryos then maybe we would be a candidate for waiting to Day 5 to transfer 2 blastocysts.  We did not ask the questions: what are the pros of us waiting to Day 5? What are the cons of us waiting to Day 5?  What are our personal chance of success with 4 fertilised embryos compared to if we had had 6? (i.e. what’s the supporting evidence/data?).  Again, I did a lot of this research myself.

I could go on with other opportunities throughout our infertility treatment where I could have asked these three simple questions that would have revealed the knowledge I needed to feel like I was in control of making a decision.  We rely on doctors to make the decisions for us…and most of the time I am happy with that fact, but there were times that I felt like we should hold that responsibility for a decision.  When it comes to my pregnancy I want to be able to ask these questions to my doctors and nurses so I can take the responsibility for making some of the big decisions such as prenatal testing or birthing plans.

Emily Oster suggests reading the book “Our medical mind: How to decide what is right for you” by Jerome Groopman and Pamela Hartzband.  I think I might try it, and I’ll let you know how it goes.  Has anyone read this one?

In the meantime my friends, next time you are in a consult with your doctor, remember these three simple questions to help you make the best decision, for you, and get the most out of your doctor….

  • What are the pros (for me)?
  • What are the cons (for me)?
  • What is the evidence/what are the chances (for me in particular)?

Irritable Bowel Syndrome and Trying to Conceive

I have Irritable Bowel Syndrome (IBS).  It is a relatively common disorder of the gut.  The weird thing about IBS is that no one really quite knows what causes it exactly.  Symptoms are variable depending on the nature of the IBS.  For me, I suffer from abdominal pain and diarrheoa.  I’ve had it since I was a late teen.  But I don’t really remember when it truly started, but it got worse at university.  There is no cure for IBS, only treatment of the symptoms.  Approximately 1 in 5 people will suffer from IBS in their lives, some may never realise they have it.  Symptoms vary on scale and nature and is slightly more common in women than men.

I am writing about IBS because last night as I boarded the plane for my transatlantic flight and experienced an awkward situation.  As I sat down the family next to me asked if I could switch seats with their son (about 13yrs old) so they could all sit next to each other.  Sure I said, no problem, I don’t mind moving a row back!  But then they pointed to the dreaded in centre seat.  I had specifically booked an aisle seat because I go to the toilet a lot.  And as this was a red eye flight I would not do well sitting here, I would have asked the person next to me to move at least 10 times so I could go to the toilet.  I looked at the boy, realised he was 13 and thought he would be perfectly fine there, plus one of his parents could always sit on their own if they were worried about him.  So I politely declined to switch seats and told them of my predicament to be near the toilet.  But then the mother told me she couldn’t swap because she had a fear of flying.  Yes I felt guilty, but I was very willing to swap with anyone in an aisle seat.  Eventually a nice lady the other side of the plane volunteered to sit in the boys seat so I could sit in her aisle seat.  But it just reminded me of the hidden side of IBS, even though I told the family my reasoning, they seemed pretty pissed at me.  They didn’t understand.  I know of people with IBS who have disabled toilet keys because when it is bad, it is very bad!!  I don’t have this extreme requirement, but IBS is a hidden disability.

I self manage my symptoms.  I know that stress makes it worse, and eating certain foods such as potatoes and pineapple can give me killer cramps and half a night on the toilet.  I have simply learned to avoid certain foods or when I have a craving, give in and just expect it and manage it when it happens,  I prefer it that way rather than take drugs.  I tried a lot of things at university to relieve the symptoms, but ultimately cutting out the stress seemed to work the best.

In order to diagnose IBS the doctor will put you through a series of tests to rule out something more serious, like Chron’s disease, cancer of the ovaries or coeliac disease.  These are tested usually with blood and stool tests.  For me, the doctor said that there was a possibility of having endometriosis, which can only be detected through a laporoscopy.  But before doing this invasive procedure she wanted me to try an exclusion diet to see if there were certain foods that increased the symptoms.  After several weeks of hunger, cravings and a very large shopping bill, we figured that IBS was likely.  So I never had a laporoscopy to rule out endometriosis.  My current Reproductive Endocrinologist has suggested there is a chance I do have endo, but a laporoscopy can do more harm than good to my fertility if it is just a little bit of endo.  I find it strange that I have no definite diagnosis whether I have one, the other or both conditions.

As I get further into my two week wait and I get pains even a couple of days after IUI, I wonder are they IBS pains?  Or are they related to the IUI and the progesterone? What has IBS got to do with infertility?  Well I didn’t think there was much of a linkage, but as always google shows you something interesting.  There were two interesting conclusions that came out of my, albeit brief, search, in general the research is pretty thin on the ground.

There is no evidence to suggest IBS causes infertility.  A couple of sites discuss this and conclude that there is no evidence of a linkage.

IBS increases risk of miscarriage and ectopic pregnancy.  A research study* looked at 100 000 women who became pregnant during the period 1990 to 2008.  Of these 100 000 women 6% suffered a miscarriage, which is considered to be the ‘normal’ statistic.  Of these 100 000 women, 26 000 women were diagnosed with IBS.  Of these women diagnosed with IBS, 7.5% lost their babies.  That is a significant difference, increasing the risk of miscarriage for women with IBS by 30%.  It should be noted that IBS is linked with other disorders which are also potentially linked to miscarriage, for example chronic fatigue syndrome and fibromyalgia, therefore it is not wholly conclusive evidence.  The authors wanted to stress that the chance of miscarriage was still small, and that they wanted to highlight the need for more research into IBS and fertility.  I have not been able to find anything more up to date than this report from 2012.  Maybe they are still researching it…maybe no one carried it forward. But I think it definitely deserves some more attention.

*Increased Risk of Miscarriage and Ectopic Pregnancy Among Women With Irritable Bowel Syndrome, Khashan, Ali S. et al. Clinical Gastroenterology and Hepatology , Volume 10 , Issue 8 , 902 – 909

Work in Progress…ARTApp

I successfully completed another module in my Data Science course! Woohoo!! Eight modules down, one to go. Now I have one week off of study, then onto the home straight.  I can’t wait to finish it.

Part of my final project was to develop an online web App; I decided to develop an App that uses the data provided by the CDC on Assisted Reproductive Technology and presents the data in more user friendly way.  I bit off more than I could chew for this project because the data the CDC provides is a bit messy and required some cleaning up in order that I could manipulate it easily.  Now I have ‘cleaned’ the data, I need to spend a bit more time making the visualisation useful.  I got 100% for my project so I passed with flying colours, but I have a lot more to do before I share it with a wider online community.  You can have a sneak preview!

You can see my ARTapp here.  It was supposed to look a bit more like this…

Screen shot of my ARTApp

Screen shot of my ARTApp so far

My idea is that someone can select a state they are interested in, it shows all the fertility clinics in that given state, then the user can select a fertility statistic they are interested in comparing their clinic against the state wide average.  There is also a map of the states that shows the statistic average for each state. This is just a prototype for now, I will keep working at it and include all data available from CDC, not just data for fresh embryos.  Also add in some more interactive charts for looking at ART data over time.

Now, wouldn’t it be good to know what the IUI stats are like too?

View the latest U.S. Fertility Clinic Data

What is the probability of IUI success?

Our Doctor told us that we have a 20% chance of success with our IUI treatment (Letrozole Day 3-7, Ovidrel trigger 36 hours before IUI procedure and progesterone suppositories (50mg) for two weeks after IUI).  After three rounds, that would be a cumulative chance of success of 60%.  But this probability is a calculated estimate based on many factors that our doctor knows about us.  For example, if you were diagnosed with unexplained infertility the probabilities of success are lower than if you have been diagnosed with an ovulation related dysfunction.  Age, number of years trying to conceive and sperm quality are all examples of other factors that will influence your probability of success.

Success rates for IUI?

Success rates for IUI?

There are many predictive models out there to determine likelihood of success of IUI.  Each model seems to be slightly different, but in general they tend to range between 9-23% success for unexplained infertility, and the important factors that determine this success also seem to vary from model to model.  This is probably the real reason why that if you were to google ‘the probability of IUI success’, you won’t find much of a straight or clear answer.

Why do I care?  The difference between 10% (a one in ten chance) compared to 20% (a one in five chance), is psychologically different and I’d like to prepare myself for these seemingly different odds!  I trust my doctor, but I want to know more about why it’s 20%.

I spent several hours trying to find something useful that explained the most recent stats.  But the website with the most useful statistics explaining the different probabilities is www.advancedfertility.com.  However, the website is confusing, statistics are hidden away in text paragraphs that require reading several times, multiple hyperlinks to different pages that break up ease of understanding, how recent is this information and it is not always clear where their statistics have come from.

If you google ‘the probability of IVF success’ there is a plethora of useful information and supporting data (because the govt mandates the data is collected by clinics), also there is a really good resource, Society for Assisted Reproductive Technologies (http://www.sart.org/) who summaries the most recent data at the clinic level and the national level.  They even have a patient level ‘Predict my success’ interactive tool.

So, I herby call for greater transparency and clarity on IUI success rates, similar to what can be found online for IVF success rates.  I’m not looking for exactness, just more openness.

If you know of good resources to help understand success rates of IUI, please comment below and share!

Half way through the two week wait and feeling low…

So this is it…the half way point in the 2 week wait (AKA the 2WW).  I am feeling a little low.  It is probably as a result of a mix of things – first of all, being stuck inside all weekend behind a computer, second of all, I am impatient being in the middle of the 2WW, thirdly I am fed up with the progesterone suppositories leaking everywhere.  Is there a chance that my feelings are related to hormones and medications?  Maybe, I can’t tell.

diesel worried

Diesel don’t look so worried, it’s gonna be OK

My lowness hasn’t been helped that I had two course projects due this evening.  Both were programming assignments….the first project I developed a web app that uses the CDC’s most recent data on Assisted Reproductive Technologies (Here is some info on it).  I was unable to fully deploy the app online before the deadline. It worked perfectly yesterday on my computer and all day today I have bee trying to figure out why it won’t go live. Sooooooo frustrating.  Hopefully my graders will see my code and be generous.

My second project was a little dull, statistics and investigating relationships in cars between Miles Per Gallon and transmission types (amongst other things).  I completed my report, but in the last hour before the deadline I could not get it to convert to a pdf file.  Such a simple task.  I am gutted.  I will have to re-take this module as it counts for 60% of the grade.

I will admit that I have screamed and cried at my computer several times this weekend.  I am not very good at not being in control of it!

Our cats, Sushi and Diesel, have been overly affectionate the last couple of days.  I am sure they can sense when we are down or ill.

Next week is a new week, no more snow, warmer temperatures, back to some gentle exercise, and the end of the week we are having friends over to watch rugby, eat some bad foods, and play some board games.  Something to look forward to.  With all that fun it will then be time to take the test. Which incidentally, will be the same day as our 3 year wedding anniversary – it would be a good present to ourselves if we got the big fat positive.  Monday Monday!!!

These guys help when I feel low

Sushi and Diesel being cute together, can’t help but me smile

go home cat, you're drunk
go home cat, you’re drunk – Classic Diesel

Statistics statistics – infertility and treatment – who to believe?

Did you know?? Over 1% of all infants born in the US are conceived using Assisted Reproductive Technology*.

Luckily I am an analyst by trade, so I am quite aware of the lies, damn lies and statistics.  I am quite skeptical when it comes to stats that don’t explain the data source.  A lot of websites quote stats and don’t tell you either where the data originated, how it was collected or how it was analysed.  So which stats can you believe?

I am undertaking a small project for an online course in data science – part of my project is to develop an online app.  The app can be anything I like, but it has to be an interactive tool using data.  Seeing as I have been looking at lots of statistics online about fertility treatments, I thought, why not design my own web app that allows a user to interact with all that data out there?  Hmmmm perhaps I am being ambitious.  But I have a couple of weeks to complete it – so lets see!  In the mean time, I have been doing some research on potential data sources…

The most up to date fertility treatment data I have found so far is from the Centers for Disease Control and Prevention (CDC).  (Ha! I didn’t expect to find the data here!!)  Apparently there is an Act that mandates all clinics performing Assisted Reproductive Technology to provide annual data to the CDC.  I think this data is THE most comprehensive (or certainly largest) source of data to understand the factors that contribute to a successful birth when using Assisted Reproductive Technology*.  The CDC has been collecting data since 1995.  All their data is freely available to download along with reports and interactive tables.  The most recent data released is from 2012, collected from 256 clinics with in the US.

When I was reading the CDC 2012 report that was published in 2014 I found an interesting stat that surprised me – In 2010 about 7.4 million women aged 15-44 received infertility services at some time in their lives.  That makes it about one in ten women of that age group.   If I look at all my friends and family on my facebook in that age group, that could be 12 of my friends affected somehow.  Woah.

Anyway, the data provided by the CDC gives stats on almost 98% of clinics in the US.  The link below (provided by the CDC website) takes you to an interactive tool that allows you to see the data for your fertility clinic – they probably report it on their website.  But you have to be careful when you look at the numbers and what they all mean.  I’d highly recommend reading the whole report to help understand it all.  I did not see this data before we decided which clinic to use.  To be honest the number of choices for us weren’t particularly big, but we did have a choice.

The data looks good for my project, I just need some ideas on how to make a useful app out of it.  If anyone has any suggestions on what they think would be a useful way to see the data I’d be interested to hear from you.  I’ll keep you updated on my stats research as I come across it…

Ps. Hope this post wasn’t too geeky!! I can be quite geeky sometimes.

View the latest U.S. Fertility Clinic Data

*Note. The CDC define Artificial Reproductive technology as a procedure that involves surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning then to the woman’s body or donating them to another woman.  They do NOT include treatments in which only sperm are handled (ie. IUI) or procedures in which woman takes drugs only to stimulate egg production without the intention of having eggs surgically retrieved.