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#StartAsking About National Infertility Awareness Week 2016

By Tracey Minella

April 25th, 2016 at 1:16 pm

 

National Infertility Awareness Week (NIAW) kicked off yesterday with this year’s theme being #StartAsking, according to Resolve, the National Infertility Association.

The sobering stats show that 1 in 8 couples suffer from infertility. Despite those significant numbers, a social stigma persists that often forces affected couples to suffer in silence. That has to change.

NIAW is an annual tradition, with a calendar of events, activities, ideas and suggestions on how to raise awareness of infertility in the hope of removing the stigma, enacting legislation to mandate better coverage for infertility/adoption services, encouraging people to “come out” of the infertility closet, and getting people the financial and emotional support they need to battle infertility.

Long Island IVF is presenting an informative FREE Symposium: “Improving IVF Success with Acupuncture”. It is jam packed with eight (8) experts, and is scheduled right after NIAW—on May 12th from 6:30-8:30 pm in our Melville office.

Long Island IVF is the only fertility practice in the region that has a reproductive endocrinologist who is also a certified acupuncturist. Co-founder, David Kreiner, MD went back to the classroom after 30 years of family-building to study and now offer this affordable, complementary therapy in an effort to potentially boost IVF success rates. Register today.

Don’t miss this exciting lineup of experts:

  • Western Medicine Approach to Infertility
    David Kreiner, MD, Reproductive Endocrinologist and NYS Certified Medical Acupuncturist
  • Acupuncture Diagnosis and How Treatment is Individualized
    James Shinol, Licensed Acupuncturist
  • Fertility Enhancement with Diminished Ovarian Reserve – Improving Ovarian Stimulation
    XinJuan Yang, PhD, MD (China), Licensed Acupuncturist
  • Fertility and Diet
    Roberta Siegelson, Licensed Acupuncturist
  • PCOS and Acupuncture
    Christine Bauer, DC, Licensed Acupuncturist
  • Enhancing Uterine Receptivity
    Ping Zhu, PhD, MD (China), Licensed Acupuncturist
  • Acupuncture to Minimize Risk of Miscarriage
    Mike Berkley, Licensed Acupuncturist
  • Japanese Acupuncture
    James Vitale, Licensed Acupuncturist

 

We look forward to seeing you there!

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What are you doing to “start talking” about infertility this week?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

 

 

 

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Long Island IVF and LGBT Network Alliance

By Tracey Minella

April 7th, 2016 at 4:25 am

 

image courtesy of LGBT Network


Long Island IVF is proud to partner with the Long Island LGBT Network as the exclusive family planning service for the LGBT Network community.

On April 7, 2016, Long Island IVF physicians, Dr. David Kreiner, Dr. Steven Brenner, and Dr. Satu Kuokkanen presented a check in the sum of $17,000 to LGBT Network’s Jonathan Chenkin, Development Officer for Corporate and Business Relations and Robert Vitelli, COO – Director of Development. This donation will fund and support our mutual educational and outreach efforts here on Long Island.

Long Island IVF has been building families in the LGBT community for decades and has long practiced its belief that every person is entitle to become a parent. Not only are some staff members also members of the LGBT community, but our entire staff has been trained to be sensitive to our LGBT patients. Your needs and treatment are unique and your comfort is important to us.

Long Island IVF will again sponsor the Family Services Pavilion at the Long Island Pridefest on June 11, 2016. Be sure to come by and meet our team. Some of our patients and their little miracles often drop in, and they love to share their LIIVF family-building experience with others just starting their journeys.

If you’d like to schedule an initial consultation with one of our physicians, please call 877-838-BABY today. With six offices across Long Island and Brooklyn, there is sure to be one convenient to you.

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Will we see you at Pridefest?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

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Reminiscing on Doctor’s Day

By David Kreiner MD

March 30th, 2016 at 12:54 pm

I once had a dream that my lab would be staffed by the most skilled embryologists I could find and that my physician partners would be the recognized experts in the field.

Throughout my career, I have met some of the world’s best specialists in Reproductive Endocrinology and IVF from my time at the Jones Institute and in my 24 years of practice since I left Norfolk to found Long Island IVF with Dr. Dan Kenigsberg. Together, in 1988, we developed the first successful IVF program onLong Island.

I am most excited to announce that we have assembled since the merger of Long Island IVF and East Coast Fertility such a “Dream Team”. Three of our embryologists have been directors of very successful IVF labs. The other embryologists by virtue of their experience, advanced degrees, and skills could start a successful IVF lab of their own. Instead, we have assembled under the leadership of Dr. Glenn Moodie arguably the strongest embryology team in the nation.

Likewise, Drs. Joseph Pena, Michael Zinger and myself have joined nationally recognized, Castle Connolly’s “Best Doctors in America”, Drs. Dan Kenigsberg and Steven Brenner, as well as Drs. Kathleen Droesch and Satu Kuokkanen.

This “Dream Team” of Reproductive Endocrinologists and embryologists in our first three months together produced remarkably successful IVF as good as anywhere in the country. 

For women under 35, during our first three months as a combined program, October 1, 2011 through December 31, 2011, Long Island IVF achieved 35 clinical pregnancies in 53 fresh transfers (66.0%).  For women 35-37, 18/30 (60.0%), 38-40, 20/37 (54.1%) and for women 41 and 42, 8 of 28 (28.6%) achieved clinical pregnancies.

Additionally, the East Coast Fertility MicroIVF program featuring minimal stimulation and a cost of $3900 achieved 5 pregnancies in 8 women under 38 yrs of age.

It is apparent that the whole of the combined Long Island IVF is greater than the sum of its independent parts of the two merging practices (East Coast Fertility + Long Island IVF).

There is perhaps no more rewarding work than to help build families for those who would otherwise never be able to do so but for our efforts. Working as part of the Long Island IVF “Dream Team” is that much more enjoyable knowing that we can give our patients their very best chance to realize their own dreams of creating their families.

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

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Stop April Fool’s Day Pregnancy Jokes

By Tracey Minella

March 30th, 2016 at 6:45 am

 

image credit: nenetus/freedigitalphotos.net


Even a holiday as insignificant as April Fool’s Day has become a minefield for the infertile.

What should be a harmless day of dodging innocent pranks always turns ugly with the inevitable April Fool’s Day prank post: “I’m pregnant”.

Just. Stop. Now.

It’s not only soooooo last year (and the year before that… and the year before that) but it’s not even believable or funny anymore. In fact, it never was. It’s simply hurtful to those who can’t have children. And we are not oversensitive. Infertility is no joke. It’s a disease. Would you joke about having cancer? Of course not.

So how about you think before typing that lame joke this year? Think about all the infertile couples who suffer every day of the year as their newsfeeds are bombarded by countless legit pregnancy announcements, baby pictures, and other kid-related posts.

Give us a break. Better yet, post something that is actually laugh-out-loud funny. Lord knows, we could use a momentary diversion from the pain with a rare and honest belly laugh.

Don’t be the Fool this April 1st.

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Are you bothered by April Fool’s Day pregnancy pranks? How do you respond?

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Egg Donation at Easter

By Tracey Minella

March 24th, 2016 at 4:40 pm

 

image credit: tiramisustudio and freedigitalphotos.net


What better time of year than Easter to talk about eggs?

No, not the colored ones that young children in starched knickers and tulle dresses egg-citedly gather up in egg hunts. We’re talking about the millions of eggs each woman is born with–the ones that some infertile women need donated from fertile women in order to have a baby.

Whether you are a young mother who has finished your own family-building, or you are a young woman putting off family-building while you pursue your education or career aspirations… or you’re just a young healthy woman with a warm heart!…egg donation is a priceless gift you can give to someone longing for a baby.

In addition to how good it may make your heart feel to help another woman to become a mother, your giving spirit is rewarded with generous financial compensation. And repeat donors may qualify to have some of the eggs from their donor cycle frozen for their own future use.

If you’d like an egg donor application or more information on how you can become an egg donor and receive $8,000 for each cycle you donate, please call Long Island IVF’s Donor Egg Program Coordinator, Victoria Loveland, MS, RN at (877)838-BABY. Many of our egg donors enjoy the experience so much that they return to donate again and again.

In this season of rebirth and renewal, won’t you consider egg donation?

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Would you consider becoming an egg donor? Why or why not?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

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Social Media and the IVF Experience

By Tracey Minella

March 20th, 2016 at 10:11 pm

 

image courtesy of bplanet/ freedigitalphotos.net


Snapchat® your IVF retrieval day story? Instagram® your embryo’s first picture*? Live tweet your transfer on Twitter®?

It’s true. In Vitro Fertilization (IVF) is boldly going where social media has never gone before. Farther than just sharing the positive pregnancy test on Facebook®. And celebrities are leading the way.

Celebrities have often shared their infertility stories on social media after-the-fact, either during or after the resulting pregnancy. Chrissy Teigen caused a stir in the “twitterverse” when she recently came out during her pregnancy about doing IVF (and selecting a girl embryo to transfer) while shooting the Sports Illustrated® swimsuit issue. And there are countless others who speak out later.

But “real-time” social media updating has entered the IVF scene. One example is the Snapchat® retrieval day story of E!News host, Maria Menounos, as reported by intouchweekly.com., so check it out. The star was also quoted on her reported previous egg-freezing experience and shares her thoughts on the cutting edge fertility-preservation technology.

The benefits of “real-time” social sharing are many:

  • It’s your Coming Out Infertile Day. With one click, you can indirectly “come out” about your infertility struggles to your family and friends on social media.**
  • Remove the stigma and increase awareness of infertility and emotional support by putting a real face to infertility.
  • Embrace the Coolness Factor. We all know the drawbacks, but what makes IVF family-building unique in a good way? Being able to document in photos and videos the literal creation of your baby…and share it all live… is exhilarating, emotional, and, yes even cool. Not everyone can do it, so in a twisted sense, it is a privilege. (And these photos and videos are priceless keepsakes to share with your eventual children, too.)

But there’s an obvious down-side to real-time social sharing. Unforeseen and unfortunate developments sometimes happen that you may not be prepared to experience… much less share on the spot… such as fewer eggs retrieved than hoped for, poor fertilization, or a negative pregnancy test. Once you share the start of the story, you create an expectation for the ending. And while it’s often happy, there can be no guarantees.

Maybe these real-time infertility stories are the inevitable and natural answer to the never-ending flood of pregnancy posts and baby pictures on social media. What do you think?

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Would you/did you share your treatment in real-time on social media? If so, how? Would you/did you share your experience after-the-fact?

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*Many fertility practices, including Long Island IVF, do not provide embryo photos.

**Long Island IVF, sponsor of Coming Out Infertile Day, invites you to visit the Coming Out Infertile Day Facebook page for a helpful graphic and easy instructions to help you come out any day and start getting the support you need.

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

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Too Fat for Fertility Treatment?

By David Kreiner, MD

March 11th, 2016 at 12:39 pm

 

image credit: OhMega1982 at freedigitalphotos.net


The most shocking thing I’ve experienced in my 30+ year career in Reproductive Endocrinology has been the consistent “resistance” among specialists to treat women with obesity. This “resistance” has felt at times to both me and many patients to be more like a prejudice. I have heard other REI specialists say that it is harder for women to conceive until they shed their excess weight. “Come back to my office when you have lost 20, 30 or more pounds,” is a typical remark heard by many at their REI’s office. “It’s not healthy to be pregnant at your weight and you risk your health and the health of the baby.” Closing the door to fertility treatment is what most women in this condition experience.

An article in Medical News Today, “Obese Women Undergoing Infertility Treatment Advised Not To Attempt Rapid Weight Loss”, once suggested that weight loss just prior to conception may have adverse effects on the pregnancy, either by disrupting normal physiology or by releasing environmental pollutants stored in the fat. The article pointed out what is obvious to many who share the lifelong struggle to maintain a reasonable Body Mass Index (BMI): Weight loss is difficult to achieve. Few people adhere to lifestyle intervention and diets which may have no benefit in improving pregnancy in subfertile obese women.

The bias in the field is so strong that when I submitted a research paper demonstrating equivalent IVF pregnancy rates for women with excessive BMIs greater than 35 to the ASRM for presentation, it was rejected based on the notion that there was clear evidence to the contrary. Here’s the point I was trying to prove: IVF care must be customized to optimize the potential for this group.

Women with high BMI need a higher dose of medication. Those with PCOS benefit from treatment with Metformin. Their ultrasounds and retrievals need to be performed by the most experienced personnel. Often their follicles will be larger than in women of lower weight. Strategies to retrieve follicles in high BMI women include using a suture in the cervix to manipulate the uterus and an abdominal hand to push the ovaries into view.

Most importantly, a two-stage embryo transfer with the cervical suture can insure in utero placement of the transfer catheter and embryos without contamination caused by inadvertent touching of the catheter to the vaginal wall before insertion through the cervical canal. Visualization of the cervix is facilitated by pulling on the cervical suture, straightening the canal and allowing for easier passage of the catheter. The technique calls for placement of one catheter into the cervix through which a separate catheter, loaded with the patient’s embryo, is inserted.

Using this strategy, IVF with high BMI patients is extremely successful. With regard to the health of the high BMI woman and her fetus, it’s critical to counsel patients just as it is when dealing with women who live with diabetes or any other chronic situation that adds risk.

We refuse to share in the prejudice that is nearly universal in this field. It’s horrible and hypocritical to refuse these patients treatment. Clearly, with close attention to the needs of this population, their success is like any others.

Women who have time and motivation to lose significant weight prior to fertility therapy are encouraged to do so and I try to support their efforts. Unfortunately, many have tried and are unable to significantly reduce prior to conception.

What right do we have to deny these women the right to build their families?

It can be hard to deal with obesity and even more so when combined with infertility. If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition. I advise you to ask your doctor about support groups and for treatment that can help you including fertility treatment. Long Island IVF has a complete Mind-Body program with counselors for men and women suffering from infertility and we welcome those who are not yet our patients. See http://www.longislandivf.com/mind_body.cfm

Remember, though this condition can be annoying, aggravating and even depressing, seek an REI who is interested in supporting you and helping you build your family and reject those who simply tell you to return after you have lost sufficient weight.

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Have you been turned away from an RE because you’re overweight or obese? Do you think that’s fair?

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Photo credit: Ohmega 1982 at freedigitalphotos.net  http://www.freedigitalphotos.net/images/Other_health_and_bea_g278-Female_Hand_Touching_Stomach_Fat_p86222.html

 

Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

 

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

 

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

 

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

 

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Improving IVF Success With Acupuncture

By David Kreiner MD

March 3rd, 2016 at 11:08 am

image credit: Praisaeng/ Freedigitalphotos.net

I have been studying and practicing fertility treatment since 1985.  Over the past 31 years, I’ve witnessed first-hand the enormously improved success we have been able to achieve with advancements in in-vitro fertilization (“IVF”).  Every day now, people we previously thought could never be helped to conceive are having babies as a result of today’s state-of-the-art IVF technology.  However, successful as we have been, there are those who remain unhelped and still in need despite modern technology and medicine.  For those, I went back to school to study Traditional Chinese Medicine (“TCM”) and acupuncture.

 

TCM has been successfully used for nearly all health problems since before recorded history.  In fact, approximately 2400 years ago the ancient Chinese medical text, Yellow Emperor’s Canon of Internal Medicine, was written dealing with the relationships among the internal organs and with the concepts of yin and yang as applied to medicine.  In TCM, the yin and yang principle proposes that the bodily organs are interdependent and support each other in harmony.  Disease is defined as a loss of this state of balance within and among the organs.  Treatment with TCM is based on the restoration of the body’s natural harmony and rebalancing of all the organs.

 

Applying TCM to conventional Western medical diagnosis mixes different worlds without a common language.  The science of TCM is based on the flow of Qi (the body’s life energy) that connect the organs through channels and runs throughout the body.  Deficiencies and stagnations of this Qi arising from the different organs result in patterns of symptomatology– including the inability to conceive.  Treatment is individualized based on the unique patterns that are evident in each patient.  These symptoms and patterns are elucidated upon taking the patient’s history and performing a physical examination.

 

Integrating TCM with state-of-the-art Western medicine involves focusing on these patterns and  connections that help us filter each patient’s story and emerge with a clear map of how to use all the tools of medicine… including the most effective TCM and high-tech Western medicine.

 

Though the West was first introduced to acupuncture and TCM when President Nixon visited China, it was not until 2002 that the American Society for Reproductive Medicine (“ASRM”) took notice when a published article in Fertility and Sterility showed that pre- and post- transfer acupuncture increased pregnancy rates.

 

The Manheimer review published in Human Reproduction in June 2013 showed statistically improved success when acupuncture was used as adjunctive therapy in IVF programs that had lower pregnancy rates.  Recently, Dr. Shahar Lev-Ari from Tel Aviv University Sackler School of Medicine reported when combining IUI with TCM treatments, 65.5% of a test group of 29 women between ages 30 and 45 (average 39.4) were able to conceive, compared with 39.4% of the control group of 94 women between ages 28 and 46 (average 37.1) who received no herbal or acupuncture therapy.  The TCM treatment included weekly acupuncture and Chinese herbs.

 

At ASRM 2015, Dr. Paul Magarelli presented a study he performed from his program in Colorado demonstrating significantly higher pregnancy rates when acupuncture was initiated at least 6 weeks prior to embryo transfer and included pre- and post- transfer treatments.

 

How does acupuncture help fertility?  From a Western perspective, acupuncture’s successful treatment of stress is effective to improve fertility mostly by improving hormonal function.

There is evidence that acupuncture also increases blood flow to the reproductive organs and helps balance the endocrine system.

 

If we are to assume that combining TCM with modern reproductive medicine optimizes a patient’s success, then how can we best help our patients?  At Long Island IVF we work with some of the most qualified fertility acupuncturists on Long Island and, in addition, offer TCM and acupuncture on-site in the Melville office including pre- and post- transfer.

 

As a certified acupuncturist and reproductive endocrinologist with over 30 years of experience in IVF, I feel I am uniquely qualified to offer our patients the most effective fertility treatment that includes the best that Western medicine has to offer as well as TCM and acupuncture.

 

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Do you think adding acupuncture to your treatment plan could be beneficial?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

 

 

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Infertile? You’ll Need the Strength of Ten Grinches… Plus Two

By Tracey Minella

March 2nd, 2016 at 6:22 pm

photo credit: T.Minella

 

Today is Dr. Seuss’ birthday. Just hearing his name calls to mind our favorite childhood books with their catchy rhymes and quirky characters. Green Eggs and Ham. The Cat in the Hat. And countless others.

 

My personal favorite, the Grinch, was also a TV movie back in the day. I remember my parents checking the TV Guide for the Christmas TV specials. There were no TiVos, DVRs, DVDs, or even video tapes back then. If you missed a special, you had to wait until the next year to see it again. Imagine that? But it made us appreciate the magic of these childhood stories even more.

 

So what does Dr. Seuss have to do with infertility, you wonder?

 

Well, it just so happens that one of his books, Oh, the Places You’ll Go speaks directly to the infertile soul, as evidenced by  the following few excerpts:

 

“…And when you’re in a Slump,
you’re not in for much fun.
Un-slumping yourself
is not easily done.”

“You will come to a place where the streets are not marked.
Some windows are lighted. But mostly they’re darked.
A place you could sprain both your elbow and chin!
Do you dare to stay out? Do you dare to go in?
How much can you lose? How much can you win?”

 

“… And when you’re alone, there’s a very good chance
you’ll meet things that scare you right out of your pants.
There are some, down the road between hither and yon,
that can scare you so much you won’t want to go on…”

 

However, no tribute to Dr. Seuss would be complete without mentioning a fabulous book adapted from his work, similarly entitled Oh, Baby, the Places You’ll Go!  It’s specifically intended to be read to your baby in utero during your pregnancy. It is a great way for your developing baby to get used to your and your partner’s voice. Be sure to pick this one up before or right after that positive test.

 

Here’s another tip: If you can handle it emotionally, consider occasionally buying and putting away some other classic children’s books. It’s a positive step you can take in a journey that you have little control over.

 

By the time your Thing 1 and Thing 2 arrive, you could have a nice collection.

 

I’ll give you a positive send-off, with a final excerpt from Oh The Places You’ll Go:

 

So…be your name Buxbaum or Bixby or Bray
or Mordecai Ali Van Allen O’Shea,
you’re off to Great Places!
Today is your day!
Your mountain is waiting.
So…get on your way!

 

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What is your favorite Dr. Seuss book? Do you collect books or anything else while TTC?

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 AND 2016

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 contest…two years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 28 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

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March is Endometriosis Awareness Month

By David Kreiner MD

February 29th, 2016 at 11:14 pm

 

image credit: ohmega1982/freedigitalphotos.net


I don’t have to tell you that endometriosis can be a very painful illness and that it can cause infertility. It is often a reproductive lifelong struggle in which tissue that normally lines the uterus migrates or implants into other parts of the body, most often in the pelvic lining and ovaries. This leads to pain and swelling and often times difficulty conceiving.

If you have endometriosis, you are not alone. Five to ten percent of all women have it. Though many of these women are not infertile, among patients who have infertility, about 30 percent have endometriosis.

Endometriosis can grow like a weed in a garden, irritating the local lining of the pelvic cavity and attaching itself to the ovaries and bowels. Scar tissue often forms where it grows, which can exacerbate the pain and increase the likelihood of infertility. The only way to be sure a woman has endometriosis is to perform a surgical procedure called laparoscopy which allows your physician to look inside the abdominal cavity with a narrow tubular scope. He may be suspicious that you have endometriosis based on your history of very painful menstrual cycles, painful intercourse, etc., or based on your physical examination or ultrasound findings. On an ultrasound, a cyst of endometriosis has a characteristic homogenous appearance showing echoes in the cyst that distinguish it from a normal ovarian follicle. Unlike the corpus luteum (ovulated follicle), its edges are round as opposed to collapsed and irregular in the corpus luteum and the cyst persists after a menses where corpora lutea will resolve each month.

Women with any stage of endometriosis (mild, moderate, or severe) can have severe lower abdominal and pelvic pain – or they might have no pain or symptoms whatsoever. Patients with mild endometriosis will not have a cyst and will have no physical findings on exam or ultrasound. It is thought that infertility caused by mild disease may be chemical in nature perhaps affecting sperm motility, fertilization, embryo development or even implantation perhaps mediated through an autoimmune response.

Moderate and severe endometriosis are, on the other hand, associated with ovarian cysts of endometriosis which contain old blood which turns brown and has the appearance of chocolate. These endometriomata (so called “chocolate cysts”) cause pelvic scarring and distortion of pelvic anatomy. The tubes can become damaged or blocked and the ovaries may become adherent to the uterus, bowel or pelvic side wall. Any of these anatomic distortions can result in infertility. In some cases the tissue including the eggs in the ovaries can be damaged, resulting in diminished ovarian reserve and reduced egg quantity and quality.

The treatment for endometriosis associated with infertility needs to be individualized for each woman. Surgery often provides temporary relief and can improve fertility but rarely is successful in permanently eliminating the endometriosis which typically returns one to two years after resection.

There are no easy answers, and treatment decisions depend on factors such as the severity of the disease and its location in the pelvis, the woman’s age, length of infertility, and the presence of pain or other symptoms.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.
However, several well-controlled studies have shown that neither medical nor surgical treatment for mild endometriosis will improve pregnancy rates for infertile women as compared to expectant management (no treatment). For treatment of infertility associated with mild to moderate endometriosis, ovulation induction with intrauterine insemination (IUI) has a reasonable chance to result in pregnancy if no other infertility factors are present. If this is not effective after about three – six cycles (maximum), then I would recommend proceeding with in vitro fertilization (IVF).

Treatment for Severe Endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women. Some studies have shown that surgical treatment of severe endometriosis does improve the chances for pregnancy as compared to no treatment. However, the pregnancy rates remain low after surgery, perhaps no better than two percent per month.

Some physicians advocate medical suppression with a GnRH-agonist such as Lupron for up to six months after surgery for severe endometriosis before attempting conception. Although at least one published study found this to improve pregnancy rates as compared to surgery alone, other studies have shown it to be of no benefit. The older a patient is, the more problematic post surgical treatment with Lupron will be as it delays a woman’s attempt to conceive until she is even older and less fertile due to aging.

Unfortunately, the infertility in women with severe endometriosis is often resistant to treatment with ovarian stimulation plus IUI as the pelvic anatomy is very distorted. These women will often require IVF in order to conceive.

Recommendations

As endometriosis is a progressive destructive disorder that will lead to diminished ovarian reserve if left unchecked, it is vital to undergo a regular fertility screen annually and to consider moving up your plans to start a family before your ovaries become too egg depleted. When ready to conceive, I recommend that you proceed aggressively to the most effective and efficient therapy possible.

Women with endometriosis and infertility are unfortunately in a race to get pregnant before the endometriosis destroys too much ovarian tissue and achieving a pregnancy with their own eggs becomes impossible. However, if you are proactive and do not significantly delay in aggressively proceeding with your family building, then I have every expectation that you will be successful in your efforts to become a mom.

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Do you suffer from endometriosis? How has it impacted your fertility journey? Do you have any advice for others who are suffering?

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