Dare to Fail

Thomas Edison failed 1,000 times before he created the first successful light bulb
 

My avid blog readers will recall a post from June 2015, entitled “Transplant-astic””, which was about the first successful uterine transplant in Sweden (October 2014).  On February 24, 2016, The Cleveland Clinic attempted to replicate Sweden’s success; a uterine organ transplant was performed by Dr. Andreas G. Tzakis and her team on 26 year old Lindsey, the organ recipient.  The surgical team was initially positive about the transplant, which they hoped would be the first of ten successful uterine transplants.  Unfortunately, a simple fungal infection to Lindsey’s immunosuppressed system resulted in post-surgical blood loss and subsequent transplant failure.

Shortly after Lindsey’s media debut, which was greeted with initial excitement at the prospect of success, she began experiencing tachycardia (increased heart rate), dizziness, and decreased blood pressure.  She was brought back to the Cleveland Clinic where it was determined that she required emergency surgery to remove the uterus.  Apparently, candidiasis, a Candida albicans infection, had developed at the attachment site of the transplanted uterus.  According to the Centers for Disease Control and Prevention, Candida albicans is the most common of the 20+ species of candida yeasts which can infect humans.  Candida yeasts typically reside on mucous membranes and skin without causing infection, however proliferation of the fungus can create organ specific symptoms.  For example, overgrowth in the vagina results in a yeast infection, overgrowth in the mouth/throat results in oropharyngeal candidiasis (thrush), and overgrowth in the bloodstream is referred to as invasive candidiasis.  In Lindsey’s case, the infection resulted in blood loss and the other aforementioned symptoms.  Fortunately, Lindsey is in good medical condition, however she will not be an appropriate candidate for a repeat surgery in the near future.

I chose to highlight this medical milestone in today’s blog.  And yes, I refer to it as a “milestone” despite the fact that others might prefer to call it a “failure.”  The reason I have chosen to do so is because medical research follows the same principal as the one taught to many children learning to tie their shoelaces for the first time.  Namely, “If you don’t succeed at first, try, try again.”  Many successful medical advancements come on the heels of previous unsuccessful attempts.  Confucius has aptly stated, “Our greatest glory is not in never failing but in rising every time we fail.”  Similarly, Thomas Edison, inventor of the light bulb, failed 1,000 times before he finally succeeded.  When asked how it felt to fail 1,000 times, Edison responded, “I didn’t fail 1,000 times.  The light bulb was an invention with 1,000 steps.”  On that note, I give much credit to the Cleveland Clinic, who is already planning for future transplants with modified protocol to decrease the chance of future similar occurrences.  In addition, I applaud Lindsey for boldly going where no American woman has gone before.  May all her hopes and dreams regarding family planning come to fruition in a safe and satisfying manner.

Twin-finity and Beyond

 

Mary-Kate and Ashley Olsen set a Twin Trend

No, you are not making it up, and yes, it definitely seems like more and more sets of twins are being born than you recall in the past.  In fact, the CDC has revealed that the incidence of twin births continues to rise.  In 2013, 33.7 twins births occurred per thousand births, and in 2014, 33.9 occurred per thousand births.  This means 135,336 sets of twins were born in 2014 (statistics for 2015 are not yet available).  Approximately 75% of twin pregnancies are non-identical twins, which means that the two fetuses developed from two separately fertilized eggs.  In addition, the average age of first time mothers is also on the rise.  In 2013, the average age of first time mothers was 26 years old; in 2014, the average was 26.3.  Simultaneously, teen births are declining, probably due to increased education and availability to contraceptive medications and devices.

Some might presume that the connection between older mothers and increased incidence of twins can be attributed to increased fertility treatment.  However, an even stronger connection is hormonally mediated.  A Dutch study (printed in Human Reproduction) revealed that older women have higher amounts of FSH, follicle stimulating hormone.  This hormone is responsible for the development of healthy, viable eggs which can subsequently be fertilized.  The study included women who were undergoing intrauterine insemination.  Development of multiple follicles occurred in 105 of the approximate 500 study participants, and these women contained higher concentrations of FSH compared to the women who developed single follicles.

Apparently, the pituitary gland, which secretes FSH, steps up its game in the eleventh hour to perform its grand finale, so to speak.  Scientifically speaking, this gland produces greater amounts of FSH between the ages of 38 and 48 to help the few remaining viable eggs develop.  In regards to this phenomenon, Dr. Cornelius Lambalk, one of the study’s head researchers, remarked, “Advancing female age is associated with declining fertility due to decreasing numbers and quality of oocytes.  But at the same time there is a distinct increase in dizygotic [non-identical] twin rates – a seemingly paradoxical phenomenon that has not been entirely explained, until now.”

If you have recently given birth to twins, or even a single baby, chances are that you may benefit from pelvic floor physical therapy.  Pelvic floor physical therapy can help treat symptoms associated with recent pregnancy and delivery, including urinary incontinence due to muscle weakness, diastasis recti, and cesarean section or episiotomy related scar tightness, to name a few.  If you or someone you know recently gave birth, please encourage them to consult with a pelvic floor physical therapy clinic, such as Revitalize Physical Therapy, to learn more about how this treatment can expedite the healing process.  Congratulations, and I look forward to the opportunity to help you.