New face of infertility – women under the age of 35

USA Today writes that TTC may well be the new OMG for life as a young woman with motherhood on her mind.

TTC, in Internet-speak, means “trying to conceive.” Being labeled “infertile” or discovering a partner’s infertility is changing the life plans of many in their late 20s and early 30s.

“I wanted to have three children by now,” says Lindsay Coser, 28, of St. Peters, Mo. “It’s been very devastating because this is out of my control.”

She and her husband, Nicholas Coser, 27, stopped using birth control when they got engaged in February 2010. They were married seven months later and began trying to conceive. She saw a specialist a year ago and is now seeing another.

Coser’s generation is living a different experience of infertility than the stereotypical over-35 career woman who married late. More specialists are seeing younger women, impatient to start families; often they haven’t been trying a year before seeking treatment, considered standard practice under 35. They search the Internet for information, provide emotional support online and are outspoken about their disappointment as they put a new face on a topic once considered taboo.

“The older woman is sort of a myth, even though that’s the public perception. Infertility affects women and men at all ages,” says Barbara Collura, executive director of RESOLVE: The National Infertility Association, a non-profit advocacy group. It wants to alert women in their 20s to start thinking about having kids – often not on the minds of twentysomethings, who may still be in college or grad school, unemployed, not yet partnered or not emotionally ready to become parents.

Start planning in your 20s

“The best time to have a baby is up to age 32,” says reproductive endocrinologist Pasquale Patrizio, director of the Yale Fertility Center in New Haven, Conn. “After 32, fertility starts to decline and it becomes steeper very quickly up to age of 40, when it declines very rapidly.”

“The time to start planning your motherhood is … in your 20s,” says Brigitte Mueller, 43, of Los Angeles, who wrote, produced and directed a documentary airing on PBS in September called My Future Baby: Breakthroughs in Modern Fertility. It features the Fertility Clock, an age chart she co-developed with a fertility specialist to help women estimate their chances to conceive.

Mueller watched two of her sisters have trouble getting pregnant; she has frozen four eggs for possible future use.

Kids weren’t on Candice Nigro’s mind at 22, says Nigro, 29, of Middletown, N.J. “I just thought when I was ready, it would just happen. We figured we’d try a couple of months and we’d have a baby.”

Seeing couples earlier

Nigro says she and her husband, Michael Nigro, also 29, have been married almost four years. They started trying to conceive in 2009 and found that both had conditions impairing conception. Their second attempt at in vitro fertilization, or IVF, succeeded. Their triplet daughters, Michaela, Emma and Hailey, were born Feb. 1.

Erica and Jeff Bode, ages 30 and 31, of Grand Rapids, Mich., had their son Jack, 4, through artificial insemination, also called intrauterine insemination (IUI). Married almost nine years, they tried four IUIs and three IVF procedures since Jack’s birth. She miscarried once. “Our picture-perfect family was to have four kids by 30,” she says. “We thought we’d be done” by now.

The latest federal data from 2006-08 suggest that among childless married women ages 15-29, 15% report fertility problems; for ages 30-34, it’s 14%.

The chance of pregnancy for someone with no known fertility problems is about one in four or five each month, says Owen Davis, associate director of the IVF program at New York-Presbyterian Hospital/Weill Cornell Medical Center. There is a 50% chance of getting pregnant in three months; about 75% in six months; and 90% in a year.

“It used to be couples would come in after trying two to four years. I’m definitely seeing a majority of couples after only five months of trying, and both are fairly young,” says Marc Goldstein, director of that facility’s program for men and co-author of the 2010 book A Baby at Last!

Younger women want to act, not wait, says psychologist Jean Twenge of San Diego State University, author of the new book The Impatient Woman’s Guide to Getting Pregnant.

The infertility toll isn’t just medical and financial. It’s also emotional, experts say.

“Every month, it’s a roller coaster of emotions,” says Jennifer Hampshire, 30, of Keego Harbor, Mich., who has been diagnosed with endometriosis. She and her husband have had four failed IUIs.

“People say to me, ‘You’re still young,’ but I’m already past my point of being super fertile,” she says. “It’s a very insensitive thing to say to someone going through infertility, especially for us who are younger. I don’t feel like time is on my side.”

Via Digtriad

 

From donor to recipient – two amazing stories

The link between a donor and her recipient is a special and unique one. Here a donor and recipient share their stories. (identities have been kept anonymous).

The donor writes:

Hello special soul

Firstly I would like to wish you all the best. I know that between Wednesday and Friday you should be receiving the conceived embryo. I’m sure you are excited and at the same time also pretty nervous. You are in good hands and I believe you would get the same loving treatment from Nurture and the Doctors at the Clinic as I have.

Having been your donor was one of the most interesting experiences of my life. I have never felt so close and loving towards a complete stranger.  

My body has gone through a lot of change since I started going on the contraception and hormone injections. My emotions were up and down and it was fascinating to see how easy I could cry to things like a song on American Idols… completely hormonal!

On my first scan last week I was told that my ovaries where super eager and had produced over 12+ eggs in each ovary. I need to warn you that you have an over achiever baby coming your way by looking at my ovaries. For this reason my retrieval was also moved up by two days.  By Monday I felt extremely bloated and even had to decline my daily run because it was so uncomfortable. I spent most of my morning talking to my eggs and making sure that they understand what was going to happen. I was very calm and believe that they were as ready as I was. Waking up after the procedure I was a bit confused and not sure where I was or what was going on. A rush of relief came over me and for no particular reason I cried. I wasn’t sad but more overwhelmed about what had happened and what was going to happen to you in the next couple of days. 

I believe you will be a wonderful mom and I pray blessings over your pregnancy. I send you my honest love, care, harmony and happiness.

xM 

 

The recipient writes:

Dear Donor

In the exciting process of selecting a donor I read a lot of profiles. I liked some, I refused others, and when I saw your photo I felt maternal, and a sense of love came over me. I felt in a strange way that you could be my baby because of our similarities – the shape of your lips and face, your eyes and even our haircuts! Kim suggested you, and I “knew” that you were my donor.

Some months ago I wrote to Kim telling her that I thought you were my destiny donor.

When I met Melany, she was so emotional. When I asked her if we look similar, she looked at her notebook and said: “ I can’t believe it, you could be sisters!” That was like music in my ears and in my soul.

I feel a great immense love towards you because I can’t believe that a stranger could give me the most important thing in my life. You are so generous, and you complete me.

I had a philosophy professor who said: “I think life is more than the fact to born and to die… at my old age I believe life is the great opportunity to give love.” That sentence is written in my mind and my heart, and since then, I try to give love to my family, my friends, my clients and everyone I meet.

You are the best example of giving, and I have no more words to tell you how grateful I am. I hope my son/daughter/sons/daughters will have your same generous heart.

 Thank you

M

Egg donation does not affect fertility, says Reuters Health

Donating eggs does not appear to hurt a woman’s chances of becoming pregnant in the years after the procedure, a small study from Belgium found.
Few other studies have looked at the effects of egg-harvesting procedures on the future reproductive health of women who donate eggs.

Some experts question whether hormonally stimulating the ovaries — which makes them produce extra eggs — and removing those eggs from a healthy, young woman could later increase her chance of infertility, but others contend there are no serious long-term risks.

“Egg donation has been offered to patients in Belgium since the 1980s. We were not surprised by the good reproductive outcomes in ex-egg donors,” Dr. Dominic Stoop, medical director at the Center for Reproductive Medicine in Brussels, Belgium and lead author of the study, wrote in an email to Reuters Health.

The researchers gave a telephone questionnaire to 194 women who had donated eggs at the Belgian center between 1999 and 2010. The surveys were conducted an average of four to five years after those procedures.

At the time of donation, women averaged 30 years old.

Sixty past egg donors reported trying to get pregnant since the procedure. Of those, 57 women conceived without help. The other three women required fertility treatment, though two of them sought treatment because of their partner’s infertility.

Sixteen percent of donors had changes in their menstrual cycle after donation. However, none of the women reporting these changes had fertility problems.

“Menstrual pattern could be disrupted temporarily by hormonal changes due to ovarian stimulation, much like how menstrual changes also appear after stopping an oral contraceptive,” said Stoop, whose study is published in Fertility and Sterility.

“In the short term, egg donation appears to have no effect on fertility,” said Dr. Orhan Bukulmez, an infertility specialist at University of Texas Southwestern Medical Center in Dallas who wasn’t involved in the new research. But longer-term studies of egg donors are needed, he told Reuters Health.

Although some researchers argue that the extra hormones women are given before the procedure and possible trauma to the ovaries during it could lead to early menopause in egg donors, studies haven’t found reasons to be concerned so far.

Egg donation is a well-established form of fertility treatment. In the United States, roughly 12 percent of all treatment cycles in 2009 used donor eggs, according to the Centers for Disease Control and Prevention.

Future research is needed to also consider possible fertility risks for women who have their eggs harvested and frozen for their own future personal use, according to Stoop.

Originally explored as a way for women undergoing cancer treatment to preserve their fertility, the American Society for Reproductive Medicine still considers that type of egg freezing experimental.

Bukulmez cautioned that the results of the current study cannot be generalized to include women seeking to freeze their own eggs.

Egg donors are a very select group of patients that are chosen for their healthy ovaries, according to Bukulmez. “They may not be representative of the fertile female population as a whole,” he said.

Via Reuters

A hi (and high) five to donation

Egg donation is legal, ethical and regulated in South Africa

Egg donors are healthy, young – between the ages of 21 and 34 years old – women who voluntarily undergoes hormonal and medical treatment so that their eggs can be given to people who have no other hope of conceiving a child.

It is a great act of kindness – as anyone who has ever benefitted from receiving such a donation would tell you – but what exactly inspires young women to do this?

For Kim (not her real name), a 23-year old undergraduate university student from South Africa, the motivating factor was seeing advertisements online and realising just how many couples out there struggle to conceive. “Women have over 300 000 eggs, eggs which would go to waste with each monthly cycles anyway,” she says. “Why not donate some to a couple who desperately want a family? I feel it is the best give you can give, a gift of life.”

In South Africa, egg donation is 100% legal, ethical and strictly regulated by The Policy Committee of the South African Society of Reproductive Science and Surgery. Unlike in many other countries, donors in South Africa remain anonymous, with only her medical history, education, and description of physical features, characteristics, her interests, etc. being revealed to prospective donor egg recipients. She never meets or makes contact with the recipients and the prospective recipients only get to photographs of her as a baby and a toddler. The child’s birth certificate will record only the names of the recipient parents. This also allows the recipient parents to one day choose whether or not to reveal the origins of their child’s conception.

In South Africa, egg donors receive some money for their time and effort. However, the amount paid has been carefully assessed and determined to ensure that donors are not exploited in anyway. The money paid essentially covers the incidentals that the donor will incur, such as getting to and from the clinic during her participation in the donor programme. Although the money can certainly make a difference – especially in the life of a student – it is definitely not the motivating factor, and egg donors donate out of sheer kindness and to make a genuine difference in someone else’s life.

This is exactly what has prompted Kim to donate that first time. She has already donated four times and says she would do it again in a heartbeat. She says: “I cannot describe to anyone what an amazing, heart warming feeling overcomes me when I hear that a [egg donor recipient] couple is pregnant, or when I hear that their precious bundle of joy has been born.”

Scientists can stop menopause with ovary transplants

Women may soon be able to forgo the menopause after scientists hailed a major breakthrough in the success of transplanted ovaries, reports The Daily Mail.

It comes after the cases of three ladies who all conceived naturally and gave birth to seven babies after receiving ovary transplants. Medical experts believe the technology could be as significant as the pill was in giving woman the choice about when to have children.

Stinne Holm Bergholdt, who was left infertile after suffering bone cancer, has pioneered a groundbreaking ovarian transplant treatment, which enabled her to give birth to three babies and could be used to stop the menopause.

Before the chemotherapy, however, she had one of her ovaries taken out and transplanted back in afterwards.

Holm Bergholt, a Danish doctor, told The Sunday Times: ‘Seven years back, I had just finished chemotherapy and my body was very weak. ‘Now I have three children and I am living a normal life. It’s amazing.’

One of the women had her tissue frozen and inserted back into her at a later date, while the other two received ovaries extracted from an identical twin to prevent

The results showed that transplanted ovaries could remain effective for at least seven years and raise the possibility of being able to stop the menopause and allow women to delay motherhood.

Sherman Silber, one of the lead scientists and a member of the Infertility Centre of St Louis, Missouri, said: ‘It is possible to remove a small piece of ovarian tissue, freeze it, and when the woman reaches menopause around the age of 51, we could transplant that tissue back and she might not ever have to go through menopause.’

The findings, to be published in the medical journal Reproductive Biomedicine Online, have led to plans to offer British women the option of freezing parts of their ovaries in the twenties.

Gedis Grudzinskas, a consultant gynaecologist in London, said: ‘Women will have so much choice about when and how to have children, independent of their age and the so-called biological clocks ticking away at various rates in their ovaries.

Read more: http://www.dailymail.co.uk/health/article-2120102/Fertility-breakthrough-Scientists-halt-menopause-ovary-transplants.html#ixzz1qQUrYAJG

“I’m glad I’m just glad that I could help pave the way a little” – one donor’s story

Candace Whitehead is one of Nurture’s most loved recipient as she’s been so vocal in sharing her story, and encouraging others to donate too. Here she tells her donor story, which first appeared on iafrica.

I have been asked so many times since I started all of this: “Why donate your eggs?”

I don’t have one specific answer – I have dozens of reasons, and you’ll probably get a different answer every day. Mostly I’ll say it’s because I want to do something spectacular for somebody else. I want to give somebody else a chance at having a family. I can think of dozens of reasons why I do donate – and not a single reason why I shouldn’t.

I’m young – just 24 – single, although not a Bridget-Jones-cry-into-my-wine kind of single (well, not often at least). Do I see children in my future? I hope there will be. But my family is – without a doubt – the most important thing to me. I get family.

Egg donation, in a nutshell, involves harvesting a number of healthy, ripe eggs from a donor before fertilising them and transferring them to the mother – where, all fingers and toes crossed, they hang around for nine months.

My journey to Nurture – the egg donation who has facilitated my first two donations – started almost a year before the first time I donated. I had a boyfriend who had donated sperm before we started dating, and I was inspired. I started investigating egg donation agencies but it was Nurture that “clicked” with me. Founded in 2008 by Tertia Albertyn (a recovering infertile) and Melany Bartok (herself a past donor), Nurture has become one of the top agencies in South Africa. I was in good hands, though I didn’t really know it yet.

When I finally got my act together, filled out my entire medical history and committed to Nurture, the process was almost entirely smooth-sailing for me. Firstly, I met with two of the Nurture women – Melany and my donor liaison Lee, who became my apparent stand-in sister – for a coffee date at Cavendish. We went through the process, they explained the risks and the procedure, and double-checked that I was keen to sign up. After meeting with them, I was extra keen.

From there, I scheduled a psychological evaluation at the Cape Fertility Clinic – who would be performing the egg retrieval. Every donor is required to have an hour-long meeting with a psychologist to ensure that they understand the process – but my meeting became a wonderful chat with the psychologist Leanne, who thankfully decided I wasn’t entirely crazy and signed me off.

I also had an initial appointment with Dr Le Roux – the doctor that performed my first retrieval. This appointment was, in my mind, quite daunting – but I shouldn’t have worried. A quick internal check-up to make sure everything’s okay inside and another chat about the procedure, and I was packed off to the pathologists to be tested and cleared for HIV, syphilis and hepatitis. Obviously, if you are HIV positive or have hepatitis, you cannot donate – and so these blood tests are compulsory. This physical examination is repeated every time you donate – so if you donate four times, you’ll be examined and tested four times.

After you’ve got the all-clear, the next step is to synch your menstrual cycle with your recipient’s and then start the daily fertility injections. All donors are placed on a short, light course of a medication that stimulates follicule growth – in my case, Gonal-F, which stimulates the ovaries to produce more eggs. I know that the daily injections put off a lot of women – and honestly, they were probably the worst part. But you’d be surprised how quickly you get used to them! During this time, you have a further two or three scans with the doctor to make sure everything is a-okay. Near the end of your fertility injections, you’re also given a shot of Cetrotide – a medication to ensure you don’t spontaneously ovulate – before being given two “trigger” shots to ripen the eggs 36 and 24 hours before you donate.

The first time I donated, I was fortunate in that I responded beautifully to all the medication –– Dr Le Roux was always so pleased with my scans and I realised I was quite proud of myself. Strange, seeing as women are “supposed” to ovulate, but hey, I like being good at things. The second time, I was a bit of a “slow starter” – which goes to show: It’ll never be the same every woman, every time.

The actual donation procedure takes place around 14 days after starting the fertility injections – depending on how you respond. I have also been asked so many times “Weren’t you terrified? Aren’t you scared something will go wrong? What if you can’t have your own babies later on?” Honestly, the thing I was most scared of the whole way through? Not being able to give my recipient what she’d been dreaming of. I was never truly scared of any complications (although obviously it has to be in the back of your mind) but I had so much faith in Dr Le Roux and his team that I was more worried about not being able to bring my side to the party.

So what happens on donation day? You’re admitted sometime in the morning, and get dressed into possibly the least sexy hospital gowns of all time. You’re checked out by the anaesthetist, a nurse fusses over you, and you’re led through to the theatre. You’re then put under a “twilight anaesthetic” – enough to knock you out long enough for them to do the retrieval so you won’t feel a thing.
During the retrieval, the doctor performs an “ultrasound directed needle aspiration”. A needle is inserted through the upper portion of the vagina directly into the ovary – and the ultrasound allows the physician to guide the needle into each follicle – where the egg is sucked through and collected. This takes about 15 to 30 minutes.

Following the retrieval, you hang out in the clinic for an hour or two while you recover from the anaesthetic. The first time I donated, I was in a fair amount of pain – the second time, barely any pain. Different, every time. And yes – this is where you get paid. Nurture pays R5000 for each donation, on the day of retrieval. Following that, a delicious day of bed rest is prescribed – in my case, it meant time spent catching up on cheesy movies!

After the retrieval, the egg goes to the laboratory where it is mixed with sperm and “grown” for a few days before transfer. So far I’ve been really lucky – both of the woman I have donated to are pregnant! I’ve also signed up for a third donation – there’s nothing more amazing than that phone call or email saying “SHE’S PREGNANT!”

Do I ever think about meeting my recipient’s children? Of course I do. I’d like to see that they’re healthy – and don’t have three arms or something – and obviously I’m curious about how much they resemble me. But that’s about it. A good friend of mine was shocked that I wouldn’t want to be involved in “my” children’s life – but they aren’t my children. They never were.

As cheesy as it sounds, they always belonged to my recipient, who walked a terrifying, difficult road. I’m just glad that I could help pave the way a little, and hopefully make the rest of the way a little smoother.

Men who are overweight or obese are at greater risk of infertility

Men who are overweight or obese are at a greater risk for infertility, says a report in fox.com.

Compared with men of normal weight, overweight and obese men were more likely to have low sperm count, or not have any viable sperm, researchers in France found.

“These data strongly suggest that excess body weight affects sperm production,” the researchers wrote in their conclusion.

The findings may help explain why the global obesity epidemic has run parallel with a decrease in male fertility, said study researcher Dr. Sébastien Czernichow, who leads the nutrition department at Ambroise Paré University Hospital in Paris.

Czernichow and his colleagues gathered data from 14 previous studies, including nearly 10,000 men. The researchers looked at each participant’s sperm count and body mass index (or BMI), which is a measure of body fatness and is calculated based on weight and height. Men with a BMI of more than 25 are considered overweight, and those with a BMI of more than 30 are considered obese.

They found that among men who were normal weight, 24 percent had a low sperm count and 2.6 percent had no viable sperm. Among the overweight men, 25.6 percent had a low sperm count and 4.7 percent had no viable sperm. Of the men who were obese, 32.4 percent had a low sperm count and 6.9 percent had no viable sperm.

Previous studies looking at the relationship between body mass index and sperm counts have been mixed, with some finding no link. “We believed that this remained a controversial issue,” Czernichow told MyHealthNewsDaily.

The link might be explained by the fact that fat tissue can convert male hormones such as testosterone into the female hormone estrogen, Czernichow said. “More fat tissue, more estrogens,” he said.

There may also be other ways to explain the link as well, Czernichow said. The hormone leptin, which is produced by fat cells, might damage sperm cells or the cells that produce them. Or it could be that elevated temperatures within the scrotum, due to more fat tissue, harm sperm cells.

More work is needed for researchers to understand the effect of obesity on sperm cells, according to the study.

The analysis was limited, the authors noted, in that some previous studies of the link could not be included in their analysis because data were missing, and in that sperm count is an imperfect measurement of fertility.

The findings are published today (March 12) in the journal Archives of Internal Medicine.

One child, two biological mothers

The court recognises two biological mothers after egg from one woman was removed, fertilized and placed into second woman, reports The Jerusalem Post.

Two women, who were both intrinsically involved in bringing a child into the world, were recognized on Sunday as the child’s biological mothers by the Ramat Gan Family Court, it was announced on Monday.

The couple, who now will not need to go through a long and complicated legal process to both register as the child’s mothers, received approval from the Health Ministry in 2006 for the egg of one woman to be removed, fertilized with donor sperm and placed into the second woman.

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However, while the second woman, or surrogate mother, who gave birth to the child was recognized by the Interior Ministry as the official mother, her partner – who has a genetic link to the child – was told that she would have to legally adopt the baby to also be recognized as an additional mother.

The couple refused to go through the adoption process and three years ago petitioned the court, arguing that if the donor mother had been a man and had filed a paternity suit under similar circumstances, his claim as the child’s biological parent would most likely have been accepted. The two women claimed the fact that their request was turned down due to discrimination on gender grounds.

Judge Alice Miller, who handed down the ruling on Sunday, wrote, “I think recognizing the donor mother as the mother of this child is a positive and essential step; it is also a way to solve a case that has special circumstances.

“Recognizing the genetic mother as a legal additional mother is also consistent with certain halachic [Jewish law] options,” she added, highlighting that allowing the donor mother to exercise her rights as a parent was a humanitarian and natural decision.

Na’ama Tzoref-Halevy, the couple’s lawyer who is an expert on fertility law, welcomed the ruling but warned that it was “a lonely victory.”

She explained that even though her clients were delighted by the ruling and the fact that the barrier to creating their own family had now been removed – due to a recent law aimed at protecting the rights of surrogate mothers – the Health Ministry no longer considers same-sex female couples for such surrogacy arrangements.

Tzoref-Halevy called the ministry’s interpretation of this law as “improper” and called on it to “stop discrimination against same-sex partners and apply the law equally as it does in cases of heterosexual couples.”

She said that there was a wide gap in Israel between advanced fertility technology and the laws that governed such procedures.

Attorney Irit Rosenblum, the executive director of New Family, an organization that champions the rights of Israelis to establish marriages and families outside of the traditional system, told The Jerusalem Post on Monday that she has already challenged the Health Ministry’s policy of denying such surrogacy arrangements for lesbian couples.

She said that it was all down to the definition of surrogacy, and that within the context of a same-sex couple who want to share a connection to their child, interpretation of the law in this way is not appropriate.

“The state should advance and bless any same-sex couple that finds a way to be involved genetically or practically in giving birth,” Rosenblum said.

“All efforts that enable both women to be equal parents are for the best of the child,” she said.

A spokesperson for the Health Ministry responded by saying that the egg donors law was designed to help women who had medical problems conceiving. Currently, that law does not allow for egg donation to women that do not have medical problems.

An overseas Nurture recipient shares her good news

When Tertia asked me to tell about my experience, I had two parallel internal responses: one is that I prefer not to talk about it, and keep the whole thing to myself in order to preserve my privacy. The other was that I really would like to help Tertia to help others. So we came up with the idea of this anonymous letter…

First I would to share my warm feelings to Tertia. Though we had never met and our communication was via emails and phone, from the first moment I felt that I was in a safe place of humanity, sensitivity, empathy and patience, and above all I felt that she was doing her job out of a personal mission and from a true will to help me to be a mother!

So, here is the thing: we went the whole way and did the whole process of donation in SA – egg purchase, fertilisation and implementation. Needless to say, this process is personal. Every woman and couple have their own sensitivities and any choice is a very personal issue. However, the choice of SA demands an independent set of mind and personal involvement all the way: choosing the agency and the donor, communicating with the clinic, the treatment protocol, the journey to SA, the considerably long stay, the logistics… but in the end it was worth it!

First, SA has a very high level advanced medical system. Second, it is impossible to describe the interaction, professionalism and sensitivity we were met with. As a couple, we felt through the whole way that we are in good hands – from the early stage of choosing a donor through Nurture until later even after the implementation and the monitoring of our progress when we were already back home. So… we are in the 4th month of pregnancy after the first and only attempt. I am sure that I would say the same things about our SA experience even if the outcomes were different.

Warmly recommending! Good luck…