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Archive for November, 2010

You Can Have a Baby

By admin

November 28th, 2010 at 12:00 am

You Can Have a Baby!

Thursday, December 2nd, 2010 will be one of the most important nights of your life. If you have plans, cancel them. Attend this mind-blowing, information-packed, life-changing seminar!

Do you want a baby? Or perhaps another one? Have you had multiple failed cycles of IUI, IVF, or even donor-egg transfers?

Are you ready to open your heart and mind to learn about something that was successfully used to help couples get pregnant long before your great-great-great grandparents were even a twinkle in their parent’s eye?  Way before the time of IUI or IVF or donor-egg transfer?

Mike Berkley, licensed acupuncturist and board certified herbalist has been treating infertility for thirteen years.  He has lectured nationally to gynecologists, reproductive endocrinologists, acupuncturists and patients alike on the subject of complementary medicine and infertility. 

Mike has created new acupuncture and herbal medicine protocols that are showing promising results.  He has helped hundreds of ‘failed’ cases have babies!

In fact, Mike was the very first acupuncturist in the United States to devote a complementary medicine wellness center to the treatment and care of those trying to start or grow their families.

You are invited to attend this lecture and learn about ALL of your option. You are invited to learn how your odds of having a baby can sky-rocket with the right help! 

Please be sure to bring your partner and a friend who may benefit from this ground-breaking knowledge.

Where: The Berkley Center at East Coast Fertility

1074 Old Country Road, Plainview, New York

When: Thursday, December 2nd, 2010 – 7:00pm to 8:30pm

The ball is in your court. Are you going to play to win or just sit in the stands and watch others score?

I have devoted my life to helping couples become pregnant; will you grant me the privilege to help you?

TO REGISTER…mikeberkley@berkleycenter.com

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Thanksgiving in The Fertility World

By Dr. David Kreiner

November 24th, 2010 at 7:43 am

My mother always told me that when you do good deeds for others it pays off with interest.  Well, I never invested in annuities but helping couples with their struggles to build their families for the past 25 years now pays back with scores of pictures and thank you greeting cards on holidays like Christmas and Thanksgiving.

Some of these kids have even graduated college now and I suspect will be hoping to start a family of their own.  I believe that growing up in an environment where their parents’ love and sacrifice for them was so great that the concept of the family has an even greater meaning to them.

Unfortunately, as those of us in the field know all too well, building one’s family can come at a great expense and with much heartache.  Today, as it was 30 years ago, if you have a medical problem preventing you from getting pregnant, it is still unusual to have the insurance coverage to pay for it.  Success with fertility treatments, in particular IVF, is better than 50% per cycle today, far superior than what it was years ago.  Even so, many cannot take advantage of IVF due to the costs. 

As a result of my mother’s teachings, I try to create paths for my patients to afford IVF.  We utilize income based grants, research studies and discounts for single embryo transfer and minimal stimulation IVF or MicroIVF.  We even instituted a guarantee program for those who would like insurance in case IVF is not successful.

My wish is that any couple or woman who wants to start a family is not denied for financial or medical reasons.  With our innovative programs we are almost there making more and more people’s dreams of building their family a reality.

On this Thanksgiving, I would like to give thanks for my family and for all those who have helped enrich my life by letting me into their lives and allowing me to assist them with their family building.  Let us pray that with each passing Thanksgiving this circle of thanks continues to grow and we can make that many more families a reality.

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Managing Our Food, Infertilty and Anger

By Pamela Madsen

November 23rd, 2010 at 7:32 am

A few weeks ago – my best friend and fellow fertility blogger – Lisa Rosenthal wrote a great true confession blog entry called  "Angry Infertile Woman (me), Baby Showers and Bathrooms".

Lisa has always been good at "feeling her feelings".  Perhaps it is because she is has practiced yoga for years – she has learned to be still enough to let them in. I really don’t know how she mastered the fine art of staying still enough to really feel her emotions – but not everyone is so good at feeling their feelings.  For me – learning to truly feel my emotions has been a journey.  You see – it is not always comfortable to really be alone with our own stuff.

Do you really want to feel how angry you are at your body for not conceiving? Do you really, really want to allow the grief and sorrow to rack through your being at the first sign of blood when you prayed that you wouldn’t be seeing red for nine months? It’s hard to be alone with that kind of pain. In the end – we are alone aren’t we?  No one can really comfort us – not really.  And to really acknowledge that can feel terrifying.

It’s not that you may not cry, vent or throw a vase.  You may – but then you may move those really uncomfortable feelings away as soon as possible – telling yourself and others – that "I am fine – really. It’s okay" – when it’s really not.

So many of us – going through life (not just infertility) look for ways to dull the pain – or the intensity of any emotion. We want to avoid feeling the full intensity of what ever it is that we are going through. It can just feel like too much – so we eat – or over exercise – we may throw our venom at unsuspecting co-workers- or use drugs.  Many of us engage in addictive behavior to dull our senses – and distract ourselves from what is truly going on in our lives. What would happen if we didn’t? How would that change us?

I attended a workshop a few years ago – and we were asked to do this anger exercise.  It was quite cliche’ – we were suppose to hit pillows and scream. We were suppose to "feel our anger".  I ran from the room.  It felt like way too much for me.  I found simply listening to all of that rage being expressed in the room overwhelming – let alone confronting my own head on.

I escaped to the kitchen – and made tea to calm myself.  Why couldn’t I face my anger – I wondered while I absently ate a bag of organic cookies.  I remember waiting for the session to be over – and walking back to the empty workshop space strewn with pillows.  I picked one up and threw it down.  You know what? That felt pretty good. So I did it again – and then I added punching the pillows – and kicking them.  I added my voice and started to scream! I was primal!  I must have gone at it for fifteen minutes.  I actually allowed myself to be alone with my anger and really feel it instead of eating it.

And guess what? I didn’t die.  I didn’t take my anger out on my friends, family or co-workers.  I didn’t eat my anger. I had an experience of simply being in my anger. It was new for me.  I don’t know if you have ever just sat alone with your emotions – really let them. But afterward, I felt amazing.  I had really touched some places deep inside myself and I didn’t die! I could handle it – and just knowing that was amazing.

If you haven’t encouraged yourself to really stay with your feelings instead of pushing them under the carpet or into a pizza -  you might want to try it on.

It might take some courage – after all – who wants to feel all of those hard feelings.  But what you might find out if you do – is that it’s okay.  You don’t need to run from them.  You will make it through whatever it is in your life – and by truly feeling it – you are allowing yourself to heal instead of burying your life under excess weight, or other types of self destruction.

So what do you think? Does this make any sense to you at all? Or do I simply need to go eat a cookie?

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The Top Five Ways That Acupuncture Can Support Your Infertility Treatment

By Mike Berkley

November 22nd, 2010 at 12:00 am

Acupuncture, the traditional Chinese medicine technique that uses hair-thin needles to treat pain, allergies and nausea is showing promise as a treatment for female infertility. Researchers from New York Weill Cornell Medical Center reviewed existing studies and found that acupuncture helps to:

1.     Reduce stress hormones that interfere with ovulation

2.     Normalize hormones that regulate ovulation so an egg can be released

3.     Increase blood flow to the uterus, improving the chances of a fertilized               egg implanting

4.     Improve ovulation cycles in women with polycystic ovarian syndrome               (PCOS)

 5.    Improve pregnancy rates in women undergoing in vitro fertilization (IVF)

The Berkley Center for Reproductive Wellness has been successfully treating infertility for thirteen years with acupuncture, herbal medicine, nutrition, and massage. And is exciting to now have offices in Plainview – at East Coast Fertility.  To learn more please click here.  or call 516-204-7149.

Mike Berkley, Licensed Acupuncturist and Board Certified Herbalist; Fellow, American Board of Oriental Reproductive Medicine.Founder and Director, The Berkley Center for Reproductive Wellness Specializing in the care and treatment of infertility – naturally.

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IVF: The Chances of Success

By Dr. David Kreiner

November 19th, 2010 at 10:44 am

What everyone wants to know when they decide to look into invitro ferilization (IVF) as a treatment option is "what is my chance for success?"  It’s a complicated question and the answer varies from  patient to patient. But let me try to break down a little bit for you.

In 2002 about 28% of cycles in the United States in which women underwent IVF and embryo transfer with their own eggs resulted in the live birth of at least one infant. This rate has been improving slowly but steadily over the years.  Patients should be aware, however, that some clinics define "success" as any positive pregnancy test or any pregnancy, even if miscarried or ectopic. These "successes" are irrelevant to patients desiring a baby. To put these figures into perspective, studies have shown that the rate of pregnancy in couples with proven fertility in the past is only about 20% per cycle. Therefore, although a figure of 28% may sound low, it is greater than the chance that a fertile couple will conceive in any given cycle.

Success varies with many factors. The age of the woman is the most important factor, when women are using their own eggs. Success rates decline as women age, and success rates drop off even more dramatically after about age 37. Part of this decline is due to a lower chance of getting pregnant from ART, and part is due to a higher risk of miscarriage with increasing age, especially over age 40. There is, however, no evidence that the risk of birth defects or chromosome abnormalities (such as Down’s syndrome) is any different with ART than with natural conception.

Success rates vary with the number of embryos transferred. However, transferring more embryos at one time not only increases the chance of success with that transfer, but will also increase the risk of a multiple pregnancy, which are much more complicated than a singleton pregnancy. The impact of the number of embryos that are transferred on success rates also varies with the age of the woman.

Pregnancy complications, such as premature birth and low birth weight, tend to be higher with ART pregnancies, primarily because of the much higher rate of multiple pregnancies. Nationally, in 2002-2003 about 30% of ART deliveries were twin deliveries, versus 1-2% of spontaneous pregnancies. The risk of pregnancy containing triplets or more was 6% in 2003.

As women get older, the likelihood of a successful response to ovarian stimulation and progression to egg retrieval decreases. These cycles in older women that have progressed to egg retrieval are also slightly less likely to reach transfer.  The percentage of cycles that progress from transfer to pregnancy significantly decreases as women get older.  As women get older, cycles that have progressed to pregnancy are less likely to result in a live birth because the risk for miscarriage is greater.  This age related decrease in success accelerates after age 35 and even more so after age 40.  Overall, 37% of cycles started in 2003 among women younger than 35 resulted in live births. This percentage decreased to 30% among women 35–37 years of age, 20% among women 38–40, 11% among women 41–42, and 4% among women older than 42.  The proportion of cycles that resulted in singleton live births is even lower for each age group.

The success rates vary in different programs in part because of quality, skill and experience but also based on the above factors of age, number of embryos transferred and patient population.  Patients may also differ by diagnosis and intrinsic fertility which may relate to the number of eggs a patient may be able to stimulate reflected by baseline FSH and antral follicle count as well as the genetics of their gametes.  These differences make it impossible to compare programs.

Another factor often overlooked when considering one’s odds of conceiving and having a healthy baby from an IVF procedure is the success with cryopreserved embryos.

Thus, a program which may have a lower success rate with a fresh transfer but much higher success with a frozen embryo transfer will result in a better chance of conceiving with only a single IVF stimulation and retrieval.  Success with frozen embryos transferred in a subsequent cycle also allows the program to transfer fewer embryos in the fresh cycle minimizing the risk of a riskier multiple pregnancy.  It may be more revealing to examine a program’s success with a combination of the fresh embryo transfer and frozen embryo transfers resulting from a single IVF stimulation and transfer.  For example, at East Coast Fertility, the combined number of fresh and frozen embryo transfers that resulted in pregnancies for women under 35.from January 1, 2002 to December 2008 was 396.  The number of retrievals during that time was 821.  The success rate combining the fresh and frozen pregnancies divided by the number of retrievals was 61%.  The high frozen embryo transfer pregnancy rate allowed us to transfer fewer embryos so that there were 0 triplets from fresh transfers during this time.

What can I do to increase my odds?

Patients often ask if there are any additional procedures we can do in the lab that may improve the odds of conception.  Assisted hatching is the oldest and most commonly added procedure aimed at improving an embryo’s ability to implant.  Embryos must break out or hatch from their shell that has enclosed them since fertilization prior to implanting into the uterine lining.  This can be performed mechanically, chemically and most recently by utilizing a laser microscopically aimed at the zona pellucidum, the shell surrounding the embryo.  Assisted hatching appears to benefit patients who are older than 38 years of age and those with thick zonae.

Recently a protein additive called “Embryo glue” was shown to improve implantation rates in some patients whose embryos were transferred in media containing “Embryo glue”.  Time will tell if the adhesive effect of this supplement is truly increasing success rates and warrants wide scale use in IVF programs.

Embryo co culture is the growth of developing embryos is the same Petri dish as another cell line.  Programs utilize either the woman’s endometrial cells obtained from a previous endometrial biopsy or granulosa cells obtained at the time of the egg retrieval from the same follicles aspirated as the eggs.  Growth factors produced by these endometrial and granulosa cell lines diffuse to the developing embryo and are thought to aid in the growth and development of the embryo.  It appears to help patients who have had previous IVF failures and poor embryo development.

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The Key to Treat Infertility

By Dr. Eli Rybak

November 18th, 2010 at 1:12 am

Patients and practitioners alike, when confronting the challenges of infertility, perceive the uniquely existential aspect of this ordeal.  Indeed, most individuals and couples contending with infertility are otherwise “healthy”.  Many have vibrant careers, close-knit family and friends, and various volunteer or community service obligations. Yet, they and their physicians understand that without successful resolution of their infertility, the patient remains with an unfulfilled void in their life-long mission, destiny and dreams. 

I have been pondering such thoughts over the past several weeks.  In Jewish tradition, the Five Books of Moses are divided throughout the year, and a portion is read aloud in the Synagogue every Sabbath.  The cycle begins and ends each year at Simchat Torah, the conclusion of the High Holiday Season in October.  And every year in November and December, the segments from the middle of Genesis are reviewed – and with that, comes the piercing drama and recurrent cry of the Matriarchs – most of whom struggled with infertility.

After decades of childlessness, Sarah encouraged Abraham to bear a child through, effectively, a surrogate – their maidservant, Hagar.  It was only through an explicitly recorded Divine promise and intervention that Sarah herself subsequently underwent a reversal of her menopause and gave birth at age 90 to Isaac. (Oh, and she lived to see Isaac reach age 37 – I digress, but 2 important points come to mind: First, I believe that our society must develop far more effective workplace policies to enable women to better balance family and career during their peak reproductive years.  I always feel pained when I counsel a 40+ year-old patient who is not prepared to consider egg donation, and I discuss the success rates of IVF in patients over 40, as well as the risks of miscarriage etc.  At good centers like East Coast Fertility, IVF has an over 60% success rate per retrieval for women under age 35; however, such success is age-related, and does not apply to “older” reproductive-age women using their own eggs. Second, for “older” women who do choose to use donor eggs, many face unfair societal skepticism – “will that woman be alive when that child graduates college?”  I feel that such speculation is unwarranted and unfair.  Women in their 40s and 50s are leading productive, happy, healthy, and increasingly long lives.  Let’s leave a person’s longevity in the Almighty’s hands.)

Back to ancient times, Rebecca and Isaac suffered for 20 years until their prayers were answered and Rebecca delivered twin boys, Esau and Jacob.  And, most famous, is Rachel’s anguished cry to Jacob (Genesis 30:1), “Give me children, if not, I am dead.”  Biblical commentators query as to the prevalence of infertility among the righteous matriarchs.  One famous answer suggests that G-d craves the prayers of the virtuous.  Indeed, infertility is a tremendous test of one’s inner strength, and regardless of a person’s spiritual beliefs, prayer never hurts.  And, ultimately, I personally believe in the Talmudic Dictum that the key to the womb remains (alongside the key to rain, for example) with the Almighty.  As much as we have learned – and continue to learn on a daily basis regarding egg and embryo quality, fertilization, and endometrial receptivity (my colleague Dr. Zapantis and I have, ourselves, performed and published laboratory research regarding the latter), there is still so much that science cannot answer.

Nevertheless, in the 30-plus years since the birth of the very first IVF baby in 1978, assisted reproductive technology has enabled amazing new treatments for couples and individuals enduring the age-old scourge of infertility.  Many vibrant centers like ours offer the full range of diagnostics, treatment and assisted reproduction including IUI, IVF, ICSI, PGD, egg donation, egg and/or embryo freezing – and the list, thankfully, goes on.  What many centers, however, do not offer, is a “key” to unlock the financial barriers to many of these expensive, often uninsured procedures.  It is a pity and a tragedy.  In 2010, G-d and science have enabled enormous strides in treating infertility.  At East Coast Fertility, I am proud of our efforts to help patients unlock some of the financial barriers.  I welcome you: please inquire about our IVF grants as well as our successful and unique Micro-IVF and elective Single Embryo Transfer (SET) programs. We take our pledge seriously, to make IVF safe and affordable

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Fertility Drugs – What You Should Know

By Dr. Joseph Pena

November 17th, 2010 at 8:08 am

“Fertility drugs” can refer to any number of medications used for fertility treatment.  The two most common of these are the oral medication clomiphene citrate (Clomid) and the injectable gonadotropins (e.g. Gonal F, Follistim, Bravelle, Menopur, Repronex, etc.).  Some side effects and complications are common to both, while others may be unique to each group.  A review of the side effects, risks, and complications of both groups is listed below.

Side effects, risks, and complications of clomiphene citrate (CC) may include the following:

·         Menopausal symptoms are not uncommon such as:

o   Hot flashes (~10%)

o   Irritability

o   Headaches (1.3%)

·         Abdominal distension, bloating, pain, or soreness (5.5%)

·         Ovarian cyst formation – not uncommon and temporary, resolving within in 1-2 menstrual cycles

·         Thickened cervical mucus

o   If present, it can be treated by bypassing the cervix with use of intrauterine insemination (IUI)

·         Breast discomfort (2%)

·         Nausea and vomiting (2%)

·         Visual disturbances (1.5%), such as blurring, spots or flashes, double vision, intolerance to light, decreased visual sharpness, loss of peripheral vision, and distortion of space

o   If present, should be cautious about driving a car or operating dangerous machinery

o   Notify your doctor immediately who may modify your treatment and/or recommend a complete evaluation by an eye specialist

o   Symptoms usually disappear within a few days of discontinuing the medication

·         Multiple pregnancy

o   5-8% risk of multiple pregnancy with use of CC (mostly twins, 1% risk of triplets), compared to baseline of 1-2% in the general population

·         Ovarian hyperstimulation syndrome

o   If present, usually mild (enlarged ovaries and abdominal discomfort)

o   Rarely, may be severe.  Potential complications may include

§  Massive ovarian enlargement, progressive weight gain, severe abdominal pain, nausea and vomiting, fluid in abdominal cavity, decreased urine output

·         Miscarriage risk?

o   Some studies have noted a slightly higher miscarriage rate.  However, it is not clear if this is due to an effect of the medication or related to preexisting conditions such as age or polycystic ovary syndrome (PCOS), which are found more often in women who take CC.

o   Other studies have not shown an increased risk of miscarriage.

o   No evidence that CC treatment increases overall risk of birth defects

·         Ovarian cancer?

o   No causal relationship between ovulation inducing drugs and ovarian cancer has been established

Thus, while the use of clomiphene citrate is generally safe and the benefits far outweigh the risks/side effects for a majority of women undergoing fertility treatment, it is important that while taking any of these medications, it should be done under the close supervision of a physician who is experienced in managing such treatment cycles.  And if one has any questions or concerns while taking any of these medications, it is best to consult one’s physician.  You can learn more about clomiphene citrate at:  http://www.eastcoastfertility.com/index.php?id=blogsingle&tx_ttnews[tt_news]=41&cHash=f6fa864a75e9c0f6e8982478ab2256db

Side effects, risk, and complications of gonadotropins may include the following:

·         Ovarian hyperstimulation syndrome (OHSS)

o   OHSS occurs when the ovaries respond too well to the medication and produce too many eggs.  The ovaries rapidly swell to several times their size and leak fluid into the abdominal cavity.

o   If present, usually mild (10-30% of IVF cycles, less likely in intrauterine insemination (IUI) cycles) resulting in some discomfort (abdominal and pelvic bloating and discomfort) but almost always resolves without complications

o   Severe OHSS occurs ~1% of IVF cycles, increased in younger women, women with PCOS, and women who conceive.  Potential complications include:

§  Abdominal and chest fluid collections, blood clots, kidney problems, ovarian twisting

§  May occasionally require draining of fluid from the abdomen (paracentesis) to help alleviate symptoms (e.g. difficulty breathing, abdominal pain due to distention, decreased urine output)

§  May require hospitalization for close monitoring, but the condition is usually transient lasting about 1-2 weeks

o   The key is prevention.  A couple of options that may be considered in patients deemed to be at significant risk for OHSS (increased number of ovarian follicles on ultrasound, increased serum estradiol levels, PCOS) to decrease risk of manifesting severe OHSS include:

§  Cancelling IVF cycle (withholding hCG) and prevent ovulation

§  Cancelling embryo transfer with cryopreservation of the embryos for frozen embryo transfer in a subsequent menstrual cycle, in order to prevent conception during current cycle

·         Multiple pregnancy

o   Up to 20% risk of multiple pregnancy with use of gonadotropins in IUI cycles (majority are twins, but up 5% risk of triplets or greater), compared to baseline of 1-2% in the general population

o   Associated with increased risk of pregnancy loss, premature delivery, handicap due to the consequences of very premature delivery, pregnancy-induced hypertension, hemorrhage, and other maternal complications

·         Ectopic (tubal) pregnancies

o   Slightly increased risk from the 1-2% rate in the general population

o   Important for close monitoring in the early part of pregnancy to confirm that the pregnancy is located in the uterus

·         Adnexal torsion (ovarian twisting)

o   The enlarged, stimulated ovary can twist on itself, cutting off its own blood supply in < 1% of cycles

o   May require surgery to untwist or remove the ovary

·         Ovarian cancer?

o   Link between use of gonadotropins and the development of ovarian cancer is unknown and is the subject of ongoing research

Thus, while the use of the injectable gonadotropins is generally safe and the benefits outweigh the risks/side effects for many women undergoing fertility treatment, it is important that while taking any of these medications, it should be done under the close supervision of a physician who specializes in managing such treatment cycles.  And if one has any questions or concerns while taking any of these medications, it is best to consult one’s physician.

References:

-Clinical Gynecologic Endocrinology & Infertility.  Speroff.

-ASRM Patient’s Fact Sheet: Side Effects of Gonadotropins

 -ASRM Practice Committee: Use of clomiphene citrate in women
-Clinical Gynecologic Endocrinology & Infertility.  Speroff.
-WebMD: Infertility & Reproduction Health Center

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Week 3: Changing our Subconscious Thinking to Improve Mind, Body & Fertility

By Joanne Verkuilen | Founder, Circle + Bloom

November 16th, 2010 at 7:20 am


“Everything we think and everything we choose to do alters our brain and fundamentally changes who we are.” – Richard Restak, M.D., author of Mozart’s Brain and the Fighter Pilot

Welcome to Week 3 of our “How Einstein Would Get Pregnant” series, a fun and educational way to shine a light on the role of the mind over our bodies and ultimately our fertility.

Last week we gained a better understanding of our subconscious and how it can impact your health and well being. This week, I would like to share with you an amazing story about a group of people who changed their subconscious thoughts and also give you easy to follow steps to begin to take more control of your subconscious thoughts.

First lets do a quick recap of what the heck our subconscious has to do with our fertility? If we believe in the mind-body connection (hopefully we’ve convinced you of this already!) then any negative thoughts – influenced by our subconscious – will have a subsequent reaction on a physical basis within our bodies.

I also want to mention that there should be no judgment against our negative thoughts – we all have them! I would go as far to argue that it would be consider abnormal to NOT have negative thoughts from time to time.  But we have an opportunity to turn them around through a reprogramming of our subconscious.

Let me share with you an example of where a group of people had a change in their subconscious thoughts which lead to unbelievable results. Hotel cleaning professionals participated in a study over the course of 8 – 10 weeks.  The people participating did no active exercising outside of their jobs and as a group were considered out of shape. The cleaning professionals were broken into two groups. The first group was told that by virtue of their jobs, they essentially exercised all day long – that they were “exercisers.” The second group was told nothing. At the end of the study, the group that was told they were getting a great workout while the did their jobs lost weight, and were more fit. There was no other change other than their subconscious making a change from “I do not exercise” to “I exercise all day”. The group that was not told anything did not experience weight loss or improved health.

Two groups working side by side, two very different results.

How was this possible? They started to think of themselves as “exercisers” – their thoughts grew more positive about their actions every moment and how it was positively influencing their bodies, and their bodies followed suit. Their bodies literally changed by virtue of changing their thoughts about their jobs and how their physical activity was impacting their health in a dramatic and positive way.
In the book Mozart’s Brain and the Fighter Pilot: Unleashing Your Brain’s Potential, Richard Restak, M.D. talks about how we can turn our feelings and emotions into an advantage.  He used a similar example we used last week regarding seeing a red car drive down the street – and your reaction to that seemingly neutral event if you had been a serious accident with a red car and the physical response your body would have.

He talks specifically about that part of your brain that stores and remembers emotions – otherwise known as the amygdala.  The amygdala becomes stimulated as old emotions and memory react to seeing the car and subconsciously reacting on a physical level with increased heart rate, sweaty palms and that sinking feeling in your stomach.

He says that “fortunately, the influence of the amygdala can be moderated in most instances by the consciousness. We can internally talk it out and adopt a positive attitude about the experience: “I’ve never had a prior accident and there’s no reason to expect another. I should be glad I survived and get on with my life.”

What he is referring to are essentially intentions or affirmations. Ways we can “talk” to our mind and take greater control over our emotions and reactions to situations. This leads to a more healthy and positive attitude towards life in general.

Restak goes on to say that when we are feeling down or have distressing emotional responses, it doesn’t help much to try to seek the “why” behind those negative feelings. He says that the best philosophy is to “put a happy face on it and smile, smile, smile.” Easier said than done, I know!

On a personal note, until recently I did not understand the idea of using affirmations. It seemed a little too “self-help-y” to me. But I tried an experiment. While exercising on my elliptical machine and hating every minute, I decided to begin to repeat the words “I love this. I love exercising. I love how my body feels when I exercise.” I repeated these words over and over again. There has been a dramatic change in my life since then…I have since become much more happy about the prospect of exercise, spend much more time exercising and love how I feel while I am exercising. I get it now! I reprogrammed my subconscious negative reaction to exercise with a much more positive feeling about it.

Here are some simple ideas to get you started:
1. Feel the emotion. It has been said that emotions are held in the body. Remembering a time that you have been nervous – that you could literally feel that in your body by those butterflies in your stomach. Or if you are down or depressed, maybe it’s a feeling of being weighted, tired, and lethargic. Become more aware of the physical sensation of your emotions as this will help you become conscious of them as well.
2. Try not to analyze it. As Restak states, trying to find the reason why you feel the way you do is like trying to find a non-existence buried treasure. Accept your feelings as they are. Keep them there and let your body experience them. Learn from it.
3. Talk to your subconscious. Like I did with my experiment on exercising on the elliptical, I didn’t try to analyze or berate myself (you’re so lazy!). I just started talking. Out loud and silently – over and over again. In the context of fertility and becoming pregnant, you could have a whole host of affirmations and intentions that you say every single day to begin to reprogram this downward spiral of despair. We have created this daily intentions chart as a PDF to help you get started.

Do you want to learn more about Circle + Bloom? Visit here http://www.circlebloom.com

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Bringing Eastern Medicine to The Fertility Patient

By Dr. David Kreiner

November 15th, 2010 at 7:08 am

How might it work?

It has been proposed by many that acupuncture could positively impact the results of In vitro Fertilization – IVF.  The mechanisms proposed for this effect are several.

Acupuncture affects the levels of pituitary and ovarian hormones as demonstrated in several studies. Other studies show that it may help improve blood flow to the uterus which might improve implantation.

Another explanation attractive to me is that acupuncture may "relax" the uterus at the time of embryo transfer. Several studies have demonstrated uterine contractions and that these contractions can expel transferred IVF embryos. If these contractions were reduced by acupuncture then that could improve IVF pregnancy rates.

Reducing stress and improving the general health and wellness of an individual undergoing IVF was scientifically demonstrated to improve our IVF success rates.  If acupuncture is able to achieve some reduction in stress and/or some improvement in patient wellness than statistically it should improve the likelihood of achieving a pregnancy.

There are claims that acupuncture will help patients respond better to stimulation medication, get more eggs, even healthier eggs, and get higher pregnancy rates. Many women with diminished ovarian reserve and a high FSH level or history of miscarriages have been promised that acupuncture can cure these problems. The challenge has been to objectively prove these claims with scientific studies.

Thus far, there have been a few studies examining the use of acupuncture as an adjunctive therapy to IVF.  A relatively new study, published in 2008, combined the results of many of these smaller studies, concluding that one additional live birth would be obtained for every 10 IVF embryo transfers performed when acupuncture was added to the therapeutic regimen.

Acupuncture and IVF Studies

Study 1

The first published study, which received a great deal of attention, was conducted by Paulus and published in Fertility and Sterility.

The study looked at 160 women aged 21 to 43.  In this study, IVF patients received acupuncture 25 minutes before and 25 minutes after the embryo transfer. No patients received acupuncture before or during treatment with fertility medications.

The acupuncture points chosen for the study were supposed to result in:

  • Better blood perfusion and "energy" in the uterus
  • Sedation of the patient
  • "Stabilization" of the endocrine system

IVF patients who had acupuncture had a 42% pregnancy rate. IVF patients who did not have acupuncture had a 26% rate.

Some critics claimed that improvement was due to the placebo effect. To examine this Paulus presented a placebo-controlled study at the annual meeting of the European Society for Human Reproduction and Embryology. Two hundred patients with good embryo quality were randomized to receive either real or faked acupuncture for 25 minutes before and after ET. There were clinical pregnancies in 43% of the real and 37% of the faked acupuncture patients. Statistical analysis of the results was not significant but there was the trend towards improved success with the acupuncture.

Study 2

The study was conducted on 300 couples and was randomized to one of three groups on the day of egg retrieval. After randomization, 27 patients were excluded for various reasons. Of the remaining 273 patients, 87 were allocated to no acupuncture (control group), 95 to acupuncture on the day of embryo transfer, and 91 to receive acupuncture on the day of ET and again 2 days later.

There was no difference between the three groups in the number of eggs retrieved or the number of embryos available to transfer to the uterus.

The ongoing pregnancy rate was higher in both of the acupuncture groups compared to the control group. The ongoing pregnancy rate in the group which received acupuncture once was 36%, in the group that received acupuncture twice, the rate was 33% and in the group that did not receive acupuncture at all it was 22%.

Study 3

In this third acupuncture study, a total of 225 infertile patients were included: 116 women were randomized into group I (the acupuncture group), and 109 women were randomized into group II (the no acupuncture group). The physician who performed the embryo transfer was not aware of which couples were in which group. On the day of embryo transfer, the patients in the study group received acupuncture.  At the same time, a special Chinese medical drug (the seed of Caryophyllaceae) was placed on the patient’s ear. The seeds remained in place for 2 days and were pressed twice daily for 10 minutes. Three days after the embryo transfer, the patients received a second acupuncture treatment. In addition, the same ear points were pressed at the opposite ear twice daily. The seeds were removed after 2 days.

The control group received a faked acupuncture. As in the treatment group, patients received the phony acupuncture treatment for 30 minutes. This placebo treatment was repeated three days after the embryo transfer. Equal numbers of needles were applied to the study and control groups. The placebo acupuncture treatment was designed not to influence fertility.

Both groups were similar in terms of age, weight, duration of infertility, cause of infertility, and number of previous IVF attempts. No differences were found in the specifics of the ovarian stimulation, the number of eggs retrieved, the fertilization rate, or the number of embryos transferred.

The real acupuncture group had an implantation rate per embryo of 14.2% whereas the faked acupuncture group’s implantation rate was only 5.9%. The ongoing pregnancy rate was 28.4% in the real acupuncture group compared to 13.8% in the control group.

Study 4

This next acupuncture and in vitro fertilization study subjected the patients to three acupuncture treatment sessions. The first took place before the egg retrieval on the 9th day of ovarian stimulation, and the second and third acupuncture treatments were performed immediately before and after the embryo transfer. Women were randomly allocated to receive treatment with either real therapeutic acupuncture or with faked acupuncture.

Of the 228 subjects randomized, 15% were unable to complete the treatment protocol because their IVF cycle was cancelled prior to the embryo transfer. No difference in the grading of embryos was found between groups. The pregnancy rate, defined by a positive fetal heart beat, was 31% in the acupuncture group and 23% in the control group.

I am very proud that  The Berkeley Center For Reproductive Wellness at East Coast Fertility has opened it’s doors at East Coast Fertility. It’s our hope to support you in every way to build your family.

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Join The Team At East Coast Fertility For A Special Event: The Path To Parenthood

By East Coast Fertility

November 12th, 2010 at 10:12 am

Please Join East Coast Fertility For a Special Evening of Education and Support!

We will be discussing:

What’s New in Infertility Treatment 

The Importance of Getting The Support You Need

How To Finance Infertility Treatment

How Holistic Medicine Can Support Your Fertility Treatment

Our panel of experts will include Dr. David Kreiner, Founder of East Coast Fertility,  Rosa Fernandez, B.S.N., RN, Nurse Coordinator, John Moschella,MS, ELD, Lab Director, Bina Benisch, R.N., M.S., Support Group Coordinator, Maryanne Abramowitz, Billing Administrator, and Mike Berkley Director of The Berkley Center for Reproductive Medicine at East Coast Fertility

The panel will be moderated by Pamela Madsen, The Founder of The American Fertility Association

When: November 18, 2010

Time:   6:30 to 8:00 pm

Where: East Coast Fertility
            Plainview Office
            245 Newtown Road
            Plainview, NY  11803
            Click here for directions

RSVP Please to Lindsay, lmontello@eastcoastfertility.com or call 516 939 2229

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