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Archive for April, 2011

I’m Less of a Man Because I Can’t Get My Wife Pregnant

By Tracey Minella

April 29th, 2011 at 12:00 am


I  can’t resist a challenge, so when RESOLVE asked infertility bloggers to help bust some popular myths during National Infertility Awareness Week in April, I stepped up. And since this issue of the ECF News is focused on the guys because its Father’s Day this month, I’ve decided to share a less edgy version of that post.

I’m busting that myth about a guy’s manliness being based on his ability to get his wife pregnant. Harsh language ahead, but you guys can take it, right?

First of all, a guy can have eleventy two million sperm, all shaped like Hercules, but if his troops encounter cervical mucus from hell, tubes tighter than his formerly favorite briefs, or a hostile womb…none of which would be his “fault”…she’s not getting pregnant. 

But men don’t see things that way. Men think they’re losers if they “shoot blanks”. Where the heck does this thinking come from? The locker room? Cowboy movies? When are you going to realize that size doesn’t matter, guys…at least when it comes to sperm count?

There’s only one type of guy we infertiles talk about… our soul mate. Wanna know why? Because if you’re not our soul mate, you’re the loser ex who bailed at the first signs of infertility…or even before that over something even less important. So what if your sperm can’t get us pregnant.

The measure of a man’s worth is not determined by the size of his sperm count or by whether he’s hung like a bear or a raisin. It’s much deeper than that. Stop feeling like you are less of a man.

You are more of a man because you’re still here beside me telling me we’re gonna get through this together, and because you’re not afraid to show me your pain and disappointment at the setbacks.

You are more of a man because you scraped me off the floor after that HSG and you learned to do the injections despite every fiber of your being wanting to run and hide.

You’re more of a man because you held my hand at all the surgeries, retrievals, transfers, and miscarriages and always made sure I had plenty of hot hospital blankets.

You’re more of a man because you can handle yourself and a plastic cup.

You’re more of a man because you show me every day that you’ll do whatever it takes to make us a family… even if it means accepting another man’s cup.  Even if it means releasing your own dream of someday seeing yourself in your son’s eyes.

There’s an abundance of sperm in the world. It only costs a couple hundred bucks per vial. But there’s only one you. And you’re priceless.

Sperm may make you a father, but it takes what you’ve got to be a daddy. And don’t you forget it.

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Ladies: If you could tell your partner one thing to reassure him, what would it be?

Guys: How does your wife make you feel about male factor issues?

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Happy National Infertility Awareness Week

By Tracey Minella

April 27th, 2011 at 4:34 pm


Well, there’s an oxymoron for you. Nothing should begin with the word “happy” and include the word “infertility”, if you ask me. And yes, I know…you didn’t ask me. But having been an IVF patient and a medical assistant in Dr. Kreiner’s practice, and now the primary writer of ECF’s blog, The Fertility Daily, http://www.eastcoastfertility.com/about/ecfblog, I have a unique perspective on infertility-related things. And if you know me from the blog, you already know I like to share.

Starting with the fact that for the infertility patient, every single minute of every freakin day is    Infertility Awareness Day.  So, giving us just a week is kind of insulting. Don’t you think?

So, how do we mark this week? Even Hallmark doesn’t have a card for this occasion…yet. And it certainly doesn’t seem like a celebration is in order, right? No one’s boss is sending flowers or candy. If the boss even knows.

Which brings me to the next conundrum about this week: How do we call attention to “our week” when so many of us haven’t even told our closest friends and family that we’re suffering from infertility yet?

In fact, many patients understandably go to incredible lengths just to keep the boss and co-workers in the dark, for reasons ranging from unfounded but real embarrassment to the fear of losing their jobs…and insurance benefits…upon discovery of their “secret”.

No one can understand the intensity and rawness of the range of emotions of an infertility patient … unless they are an infertility patient. Not your mother, your doctor, your best friend, or even your spouse. It’s something only you can feel the true depths of.  And calling attention to this week may not make you feel better. But it is necessary. Why?

Over the years, raising awareness of infertility has ever so slowly resulted in increased insurance coverage and benefits, and more grant programs to defer some of the costs of treatment. In addition, it has enabled IVF offices to reach out and offer opportunities to the community for discounted or free treatments, such as East Coast Fertility’s current contest.

In honor of National Infertility Awareness Week, ECF is kicking off a contest where five winners (one each day of NIAW 4/25-4/29) will each receive a copy of Jodi Picoult’s new infertility-themed bestseller, Sing Him Home, plus a spa finder gift card! And that’s not all…each of the five winners will be eligible to win the grand prize of a FREE MICRO-IVF CYCLE. Complete rules are posted on the ECF facebook page, ECF website, The Fertility Daily blog and ECF’s face of fertility forum. It’s our way of showing how much our patients mean.

Raising awareness has also helped patients find blogs and support groups to help them through this journey, so please consider “liking” ECF on facebook, or at least bookmarking the blog.

And just as National Infertility Awareness Week will come and go, so too will this journey you are on. Even if it seems never-ending at times. It will end.

And because we raise infertility awareness, the technology gets better every day, and your chances for a happy ending get better daily, too.

Well, look at that…a sentence with the words “happy” and “infertility” in it. Things are looking up.

            

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Submitting Your Essay Soon? Or Must I Give You Detention?

By Tracey Minella

April 27th, 2011 at 1:05 am


It isn’t easy to write about your infertility journey. To dig down really deep and face those powerful pent-up emotions you may be suppressing. But I promise that after the tears and the ink dry, you will be glad you did..especially since it could bring you the baby of your dreams.

Not only will you have a journal entry to save and look back on someday when this journey is behind you, you’ll have an entry for ECF’s NIAW contest.  Five of you will hit the spa with your new books and have a chance at the one Free Micro-IVF cycle grand prize.

So here are two “prompts” …a term writers use for a helpful nudge…to get your mind thinking, your creative juices flowing, and those emotions spilling onto the page. After all, there’s a $3,900 Micro-IVF cycle on the line here (not to mention the other great prizes):

I haven’t “come out-of-the-closet” with my infertility secret because…and here’s how living with the secret affects my life…

OR

The first person I told about my infertility was…and here’s how I did it and how I’ve felt ever since…

You can do this! The stories received so far have been heartfelt masterpieces, each one both sadder and yet more beautiful than the others. Each spoken from the heart. Let yours speak for you. What are you waiting for?

To enter the contest, go to the Monday April 25th post for details and enter your essay in the comment section of that post or enter on our ECF facebook page by clicking on the Note or Event. Last day to enter is this Friday! Won’t you kick yourself on Monday if you forget to enter?

* * * * * * *

So, in honor of NIAW, I ask: For those who have “come out” about their infertility, do you regret the decision? How has being “out” affected your life and your relationships?

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My IVF Doc Can Take Your IVF Doc (With One Hand Behind His Back!)

By Tracey Minella and David Kreiner MD

April 26th, 2011 at 1:42 am


“Nyeh, Nyeh. My RE is better than your RE!”

“Is not!”

“Is TOO!”

“No way!”

“YES WAY!”

Well, the words may be more polished than the childish playground bullies use…or in some heated cases, maybe not… but the sentiment is the same. Some of us adore our RE’s. Others are indifferent, cautiously saving the kudos for when their pee stick evidence is in. And the unlucky ones have freakin horror stories to share from choosing the doc who graduated in the bottom of the class.

My RE graduated in the top of his class and learned beside the doctors who pioneered IVF in America. A real science geek. And it turns out that he can even string a few sentences together in a coherent fashion, having authored Journey to the Crib.

So, I dug out an old blog post he wrote last June to give all those who are coming here for the NIAW contest (or from ICLW) a glimpse into the funny, poignant family man, Dr. Kreiner really is, not the stiff academic his credentials would lead you to imagine.

So before I leave you with his words, I have one parting shot for anyone who thinks their RE is better: “You wanna step outside?!”

Dr. David Kreiner of East Coast Fertility and The Miracle on Old Country Road:

I was feeling depressed the other day.  It seemed that we had insurmountable computer issues, staff morale was down and my family was acting rebellious.  My kids were arguing with each other, with me and I found myself mindlessly walking out of my office down Old Country Road.

I came to a busy intersection and just stood there as cars sped by me.  Honestly, at that moment in time I was thinking, why am I here?  Why put up with all the hard work at the office trying to make the practice viable despite the pressures of the recession?  Insurance companies were denying claims and when they were paying claims, it was at lower reimbursements that threatened to not compensate for our expenses.  The government was planning to lower reimbursements even more.  Patients, also experiencing financial difficulties were either asking for more breaks in the fees or not paying.  I have to admit I gave thought to giving it all up as the pain and aggravations were not worth the efforts.

Suddenly, a white Audi convertible came to a screeching stop right next to me.  It was one of my patients in the passenger seat sporting a very pregnant belly and apparently blowing through what I assumed was a labor pain.  Her husband spoke.  “Dr. Kreiner, Lara went into labor early this morning and we are on our way to the hospital to have the baby…can you come with us?”  Speechless and shocked, I let myself into the cramped backseat and tried to comprehend what was happening as Lara’s husband took off.

We pulled into the emergency room five minutes later.  Lara and I were taken to the labor floor while her husband dealt with the paperwork at the desk.  Nurses barked orders, the doctor was called, and Lara started screaming during her pains and in this laboring frenzy I was awakened from my funk.  It has been awhile since I was involved in a delivery but this baby was not waiting for the doctor and I got back into obstetrical mode, checking the baby’s position and heart rate and getting the anesthesiologist to administer the epidural.  Lara’s husband was now at her side assisting her with her breathing.

“Push Lara, push”, I yelled as I saw the baby’s head crowning.  She and her husband acted as if they had trained all pregnancy for this moment, working together as a team, his arm around her shoulders, breathing with her and supporting her back as she pushed.

Well, the doctor got there just before the baby was delivering.  I stood on the side watching this miraculous event…Lara and her husband together pushing the baby out of the same womb that I had implanted nine months earlier.  I remembered the image of showing Lara and her husband the photograph of the embryo and then watching on ultrasound as I injected the drop of media and air bubble containing the microscopic embryo into her uterus.  I thought how sweet life was and I smiled.

Moments later, Lara put baby Adam to breast, her husband a proud new father was beaming as he gave out chocolate cigars to the doctor and nurses and then came to me with tears in his eyes and said, “Thank you, so much Dr. Kreiner.  We could never have done this without you.  This will be my first Father’s Day and I couldn’t be happier.”

What can I say?  It was as if my problems never existed.  I thought the only thing missing for me was to be with my family and appreciate what I have.  And what my wife and I have is truly amazing.  We have my two lovely daughters and two sons, one with a fantastic girlfriend who he just moved in with and another son who has the best wife and most gorgeous three children one can ever wish for.  Playing with them, having brunch and dinner with the family I love, I enjoyed a very Happy Father’s Day.

* * * * * *

How important is it to you to actually like your fertility doctor on a personal level instead of just a professional level? Should you put up with a good doctor with a lousy bedside manner…or are you entitled to more?

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Will You and Your Computer Get Lucky & Win a Free Micro-IVF?

By Tracey Minella

April 25th, 2011 at 12:00 am


First, Happy National Infertility Awareness Week (NIAW) and if you’re here from ICLW, or stopping by from anywhere else…WELCOME TO OUR BLOG AND PLEASE ENTER OUR CONTEST!

Contest Rules are in this post!!!

At East Coast Fertility, we love building families…and it shows. How many other fertility practices can boast that several of their medical and support staff were also previously infertility patients of their practice?! I’m just one of them! We totally “get it” when it comes to the emotional roller coaster you’re on.

So, in celebration of NIAW, we want to honor infertile women everywhere by holding an online essay contest and giving away some great prizes to the winners. The essay must be about your infertility journey and what winning a free Micro-IVF cycle would mean to you.

One winner will be chosen for each day of NIAW (Monday 4/25 through Friday 4/29/11). Each of those five (5) winners will receive these two great prizes: a copy of Jodi Picoult’s new book, Sing You Home, and a Spa Finder gift card, which is redeemable in many locations across the country. The Five winners will be announced right here on TheFertiltiyDaily blog next Monday, May 2, 2011. Winners will have 30 days from May 2, 2011 to claim their prizes or will forfeit their prizes, including the chance to win the micro-IVF cycle, and a replacement winner will be chosen in their place. (Replacement winners will have 10 days to claim prizes from date of the announcment of their win in this blog or will forfeit their prizes.)

But that’s not all! Each of the five (5) winners, along with the winners of two more contests to be held in June and August, will also be eligible to win the one (1) Grand Prize of a FREE MICRO-IVF CYCLE, VALUED AT $3,900.00!!!! The winner of the Grand Prize will be announced on Labor Day!

OKAY. In addition to the above, here’s the rest of the rules:

1.  You must be 18 or over to enter.

2.  You must enter online (no mail-in or handwritten entries).

3.  You can enter with your real name or a user name.

 

4.  You may enter your essay by posting it on only ONE of these ECF sites:

     www.thefertilitydaily.com blog as a reply/comment to THIS POST only!

OR

     www.faceoffertility.com forum

OR

    East Coast Fertility’s local business Facebook page.

DO NOT POST YOUR ESSAY ON ALL THREE SITES. CHOOSE ONLY ONE.

5.  You may enter only one essay, and it will be eligible to win each day of the contest, so enter early for best chances. It can be poignant or humorous, but must be truthful. Make us laugh or cry with you. Just speak from your heart. DO NOT INCLUDE ANY VIDEO OR PHOTOS OR IMAGES WITH YOUR ENTRY!

6.  All entries meeting the criteria herein will be considered. However, if you want to really want to noticed, get your friends and family to “LIKE” your entry post! Winners of all prizes, including the Grand Prize Free Micro-IVF cycle ($3,900.00 value) will be decided by a panel of ECF physicians and staff and the judges’ decisions are final.

7.  The book and spa finder gift card winners can either pick up their prizes or ECF will mail them. Failure to provide ECF with an address for mailing within 30 days of notification of winning will result in forfeiture of the prizes and ECF will have the right to award it to another entrant.

8. Winner of the Grand Prize Micro-IVF cycle must undergo the Micro-IVF procedure on or before December 31, 2011, unless ECF, in its sole discretion grants an extension of time to the winner in writing.   If the winner is or subsequently becomes pregnant at or after the announcement of the winning entry and prior to undergoing the Micro-IVF prize, she will forfeit the prize and ECF may award it to another eligible entrant.

9.  The Grand Prize is NOT transferable and may not be redeemed for cash value or for a credit against any other services rendered, past or future.

10. The Free Micro-IVF cycle is valued at $3,900.00 and is the basic Micro-IVF cycle offered by ECF. It covers the monitoring services of the ECF physicians and nurses for the duration of the cycle. It does not include the anesthesiologist, if needed, donor gametes, if needed, medications, cryopreservation, if applicable, required lab and screening tests, or other procedures, including but not limited to discretionary embryology services such as ICSI, assisted hatching, embryo glue, co-culture or other surgical or diagnostic procedures beyond the scope of the basic Micro-IVF program, if needed. It does not include any travel, lodging, food, or other such expenses.

11. The ECF physician retains the right, based on a review of the winner’s particular medical condition and other related factors, to determine at any time from the initial visit through retrieval and/or transfer, that Micro-IVF is either not medically advisable to commence or, if already commenced, then not medically advisable to continue, in the winner’s case. The denial or cancellation of the Micro-IVF is in the sole discretion of the ECF physician, as the patient’s safety and compliance with screening guidelines are of utmost concern. In such a case, the winner understands that ECF is under no obligation to provide winner with any substitute prize, or monetary or any other compensation for time, out-of-pocket costs or disbursements or damages of any kind whatsoever.

12. The grand prize winner must undergo all pre-requisite testing and screening, including physical and psychological testing, which is standard procedure for IVF patients in the ordinary course of ECF’s practice, prior to commencing the Micro-IVF cycle. It is possible that some (if not all) of this screening may be done through the winner’s hometown OBGYN, but as noted previously, it is the financial responsibility of the winner to undergo said testing.

13.The grand prize winner must represent in writing at the time of the initial office visit to discuss commencing the free Micro-IVF cycle, that she does not currently have medical insurance coverage for IVF on any medical plan whether through herself, her partner or spouse, or her parent, or that if she does, the IVF allowance has been exhausted.

14. ECF is not responsible for any technical difficulties or malfunctions with respect to any of the three online sites on which essay contest entries can be submitted whether or not same are in the ultimate control of ECF. It is the responsibility of the entrant to properly and successfully post an entry on one of the available sites in a timely manner. Entries will be accepted beginning 12:01 am EST on Monday April 25, 2011 and end at 11:59 pm on Friday, April 29, 2011. In addition, ECF reserves the right to tweak and/or modify the rules of the contest up until the prizes are awarded.

15. The five (5) daily winners will be announced on TheFertilityDaily blog (www.thefertilitydaily.com) on Monday, May 2, 2011.

 

Phew!! Glad all the required legal stuff is over!

So, now that you know what the contest is about, start sending in those essays! The last time we gave away a free Micro-IVF, well, I can’t say the result, but I’m smiling as I’m typing (wink wink!). Will you be next?

If you’re entering on this blog, just post your essay as a comment below this post. Good luck everyone!

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Do IVF Patients Skip the Amnio?

By Tracey Minella

April 22nd, 2011 at 12:00 am


The hardest decision most IVF patients make is whether to have an amnio to check for chromosomal abnormalities in their fetus. There’s a slight miscarriage risk from the procedure, which involves inserting a rather large needle through the abdomen and into the uterus to draw out some amniotic fluid for testing.

When I got pregnant with my daughter, I had just turned 35. It was my sixth fresh IVF cycle. I’d lost a twin pregnancy on IVF#3. I lost an ovary and tube on that cycle, too. I agonized over what to do about the amnio now.

I worked for my RE and was surrounded daily by doctors and nurses who had all the faith in the world in the safety of amnios. “Don’t worry. The risk of a miscarriage is so slim. It’s only around 1-2%”, they said reassuringly.

I hormonally snapped back. “But you also said no patient, in the entire friggin history of the practice, ever had an ovarian torsion from severe IVF hyperstimulation and its resulting multiple pregnancy…yet I defied those odds, too!” They couldn’t argue with that.

I’m that one person out a thousand.

So, after much debate and soul-searching…and a highly-detailed ultrasound designed to check the fetus for a list of “physical markers” for Down’s syndrome and other so-called abnormalities… I opted out of the amnio. My daughter was fine.

Fast forward four years and one more IVF. Pregnant with my son. Still working for the RE. More pressure to have the amnio now that I was just 39. I caved. Was there a tiny bit less worry/more faith here since I had a live baby at home this time? If so, isn’t that twisted?

Well, it was the nightmare from hell. Clearly the worst amnio ever performed in history. Ever. My landscaper would have done a better job. Dr. Dumbass had to repeat it. As in stab me twice. The eleventy-seven foot needle, in his incapable hands, felt like I’d been impaled on an iron fence post. Tears fell freely. Cramping began. And all I could think was…

I’m that one person out of a thousand.

I was left alone with my tortured thoughts for a weekend of cramping and crying in bed. Why couldn’t I have been the type who could definitively answer the inevitable question: “Well, would you do anything based on the results?” I didn’t know what I’d do, but I knew I wanted to know.

I also remember selfishly thinking I paid my dues to have my girl and we were finally a happy family after so many years of losses and pain. How can I saddle her with a handicapped sibling to care for after we’re gone? Would it be better to have just one healthy child? But as difficult as it was to think that thought, I could not wrap my head around the idea of acting on it.

I worried. If I lose the pregnancy because I chose this procedure, how can I live with that? Why couldn’t I have just trusted that it’d be okay?

What had I done?!

Eventually, the cramps subsided and the miscarriage scare passed. The pregnancy progressed with its gestational diabetes, pre-term labor, bed rest and early delivery. Just like my other pregnancy. A happy ending*. With an asterisk. A footnote.

*My son has autism. The footnote in my life.

Yes, life is challenging, but the bond between my children is beautiful. She nurtures him. He learns from and models her. Every social gain he makes is because of her guidance, love, and patience. I’m embarrassed to have once thought having a disabled child would have unduly burdened my healthy child. It is his condition that has contributed to making her the mature, sensitive young lady she has grown to be. He is not typical; he is so much more. I’d have died for him the instant he took his first breath.

If infertility itself has taught us anything it’s that there are no guarantees in life. Each cycle is a roll of the dice. Pregnant or not pregnant.

Each pregnancy is a roll of the dice, too. Singleton or multiple, autism, a birth defect, stillborn, miscarriage, ectopic, or a healthy baby.

Sadly, disabilities happen before, during, and after birth.

But happily, the reality of living with a disabled child is so much better than I imagined it’d be when I was thinking in abstract terms, before the baby was in my arms. When the baby isn’t there yet, all you have to face is fear of the unknown. Once the baby arrives, you see all its goodness and the disability…if noticeable at all…is put in its proper perspective.

Sometimes you just have to roll the dice. Especially if it’s the only game in town. I hit the jackpot with my children and am a better parent because of them. And I’m no longer that one person in a thousand.

As National Autism Awareness Month comes to its close, all I can think is…

I’m that one person in 110.

* * * * * * * * *

Has your infertility affected your position on having an amnio? How?

BE SURE TO CHECK BACK ON MONDAY FOR YOUR CHANCE TO WIN A FREE MICRO-IVF CYCLE AND OTHER GREAT PRIZES FOR NATIONAL INFERTILITY AWARENESS WEEK!!

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“Yo Mama’s So Fat…” and Other Reasons Infertile, Overweight Women Kill

By Tracey Minella and David Kreiner MD

April 21st, 2011 at 12:00 am

Maybe murder is a bit extreme, but then again…

To a woman TTC, nothing is worse than being told you can’t have a baby without medical intervention…unless you’re then told you’re too overweight to have the treatments. That can hurt even more than those terrible fat jokes.

For me, depression and overeating Oreos went hand in…well… mouth. And the longer my infertility journey took… with the sorrows of miscarriage, failed IVFs, and an ovarian torsion to drown… the bigger the gap got in the back of my hospital gowns.

In a perfect world, we’d all be a healthy weight. None of us would be infertile, or have thyroid issues or diabetes, or PCOS, or just plain-old, depression-induced obesity to fill the void where our baby is supposed to be.

But the world is not perfect.

Fortunately, there are compassionate RE’s out there who are willing to give overweight patients the respect and the treatment they deserve. They’re just not easy to find. Maybe they even felt the sting of the public’s distain for the obese on a personal level. Whatever their motivation, it’s worth the extra effort to find this kind of support on your infertility journey.

You need a doctor who is willing to potentially sacrifice the program’s IVF stats to make you a mom, because he does believe he can do it…today…not after sending you home to lose loads of weight first. Today.

Dr. Kreiner of East Coast Fertility brings this prejudice and injustice to the forefront in his thoughtful, compassionate post:

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”, 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 points 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.

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.

* * * * * *

Have you felt prejudiced along your journey because of your weight? Do you feel that obese women should have to lose weight before TTC with IVF?

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Did Infertility Make Biblical Matriarchs Bitchy?

By Tracey Minella

April 20th, 2011 at 1:21 am

Since the holy days of Jews and Christians coincide this week, I’m pondering whether G*d had a sense of humor when He proclaimed: “Be fruitful and multiply”. And then He proceeded to saddle three of the four biblical matriarchs, Sarah, Rebecca, and Rachel with serious infertility problems. Was He still mad at Eve?

I mean no disrespect here; I’m just pushing the envelope in good fun by looking at biblical history in a rough, edgy, contemporary light.

So, women have suffered from infertility from the beginning of time. I say “women” because polygamy and early surrogacy using handmaids often gave the man an alternate route to fatherhood.

Consider Abraham and Sarah. G*d promised they’d be the parents of a nation. She was beautiful, but barren. Pretty face, but an apparently dysfunctional uterus. After decades of TTC, she even offered her maid as a surrogate, who gave birth to Abraham’s son, then over time she copped an attitude with Sarah, who still had no baby of her own.

Sarah is remembered for laughing at G*d’s announcement …when she was in her eighties and Abraham was 100…that she was finally going to give birth to Abraham’s son. Was the laugh from joy at being rewarded for a lifetime of unwavering faith, or from a bitter, sarcastic woman whose faith had been either shaken or lost?

In Sarah’s defense, she’s coming off what could rightfully be seen by an eighty year old as a broken promise. And the denial of a basic, well, G*d-given right. And the frustration over being told to multiply but not being given the tools to do so. Imagine a lifetime of baby-making sex with nothing to show for it? She was likely beyond belief or fear or sadness. Beyond where anything else…even perhaps G*d’s wrath… could feel worse than not having the baby she trusted she’d have her whole life. So she laughed.

Given all that, I totally support and applaud the laugh. And most long-suffering infertile women are probably giving Sarah a “You go, girl!” high five at their laptops right now.

But, G*d delivered. The miracle of Isaac… whose name means “laughter”.

The next matriarch was Isaac’s wife, Rebecca. Again, G*d gave her looks, but messed with her fertility. Finally, after years of TTC, she got pregnant with twins. Rumor has it that the pregnancy was so tough that she sought G*d out for an explanation (again, gotta love the chutzpah!) and was told she had two nations in her womb and they’d be divided.

She gave birth to Esau and Jacob. They weren’t similar and each parent favored a different child. Storybook dysfunctional family. After Rebecca helped Jacob trick Esau out of certain entitlements upon Isaac’s death, she helped Jacob escape death at Esau’s hands by sending him far away… to her brother, Laban.

Enter the third matriarch, Rachel, daughter of Laban, and younger sister of Leah the homely old maid. Jacob met and fell in love with the beautiful Rachel (you know what’s coming, right?). When he asked to marry Rachel, Laban told Jacob he’d first have to work for him for seven years before he could marry “his daughter”.

After the seven years were up, Laban pulled a March of the Wooden Soldiers wedding scam and hid Leah under the veil and married her off to Jacob! Then, he required a promise of another seven years of labor from an enraged Jacob for Rachel’s hand.

Leah, the proverbial “fertile Myrtle”, gave six sons to Jacob, despite the fact that he hated her. His beloved Rachel could not conceive for many, many years. She offered her maid to Jacob as a surrogate, and two more sons were born. Not to be outdone, Leah offered her own maid to Jacob, who also bore him two sons. (Didn’t I see this on Oprah?)

Finally, after Leah gave Jacob a daughter, and after having 10 sons with the three other women, Rachel’s prayers were answered. She gave birth to Joseph, who was Jacob’s favorite son (hence the technicolor dream coat tale).

Joseph’s birth inspired Jacob to leave his father-in-law’s tribe, but when the whole clan fled, Rachel secretly stole her father’s priceless idols in retaliation for stealing her happiness when he married off Leah to Jacob in her place. Laban hunted them down and searched all their tents to find the idols.

Then, in a moment of sheer womanly genius, Rachel, who is hiding the idols in a menstrual cushion, sweetly tells her dad she can’t get up because she has her period! He buys it and leaves. (Love her, too!) Turns out she was actually pregnant. Unfortunately, in a moment of bravado and drama, Jacob curses “whoever” took the idols with death. Shortly thereafter, Rachel dies giving birth to their second son.

In examining these stories from the angle of the matriarchs’ infertility, I’m in awe of what they endured. Sometimes decade’s long infertility journeys, husbands having babies with other wives in their face, and the pressure of G*d telling them to populate the planet. In many ways, their lives were worse than the stuff we see on reality TV shows.

So, if you’re struggling with your faith in the face of a long infertility journey, keep in mind that women have been questioning G*d forever, that prayers do get answered (though rarely as fast as we hope), and that miracles happen even when hope seems lost. Every day.

G*d Bless your journey.

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Micro-IVF May Be Your Answer

By Tracey Minella and David Kreiner MD

April 19th, 2011 at 12:00 am


Listen up, people! East Coast Fertility is going to run a contest online next week. Daily prizes will be awarded during National Infertility Awareness Week. By the end of the week, we will announce five (5) winners.

Each of those five lucky people, along with the winners of two upcoming contests in June and August, will have a chance to win the one Grand Prize: A free basic Micro-IVF cycle. The rules and requirements will be posted on this blog and on the ECF website and on the ECF Facebook page, so be sure to bookmark the blog or website and ‘Like’ us on facebook so you don’t miss out on the fun!

Start thinking about your personal infertility journey because…come next Monday…you’re going to need to send it to us to enter the contest. You can use your name or create a user name, whichever you prefer.

So, what better time to check out what the Grand prize involves? Dr. Kreiner of East Coast Fertility explains the process and who can benefit from it:

You’ve already crossed the bridge from “We’re going to get pregnant!” to “We need help…” But this other side looks filled with more obstacles, including expensive and risky fertility medications.

How far do you have to go just to have a baby?

Micro IVF (sometimes called MiniIVF) may be your answer.

The primary point of MicroIVF: fewer fertility drugs, less cost.

Plus you get additional benefits: decreased chances of ovarian hyperstimulation syndrome and of multiple pregnancies.

Additionally, East Coast Fertility patients who choose MicroIVF can increase their savings if they also use our Single Embryo Transfer Program — embryo freezing, storage, and future frozen embryo transfers are free.

Why go Micro?

I learned long ago that pregnancies of twins, triplets, and more can bring heartache to what should be a joyous journey for fertility patients. So the ECF team has dedicated our practice to the achievement of safe, healthy pregnancies.

IUI or IVF?

Intrauterine insemination (IUI) is often considered the first order of business for many infertility patients.

Sometimes called “artificial insemination,” the usual protocol — oral and injectable fertility medications to induce superovulation (of more than one egg in a cycle), followed by insemination via exam room procedure — is believed to be simpler and, therefore, less costly than IVF.

That’s just not true any longer.

The facts now are that success rates can be far better for IVF than for IUI, depending on the individual’s or couple’s cause of infertility. Many women undergo several IUI’s before achieving conception.

Some infertility causes — pelvic adhesions/scarring, blocked fallopian tubes, endometriosis, and severe male factor issues — will not respond to IUI but are treatable with IVF.

Even patients who would otherwise try IUI to get pregnant will find that choosing MicroIVF can result in cost savings and greater safety:

Micro IVF fee (current as of April 2011): $3900

ICSI (if required): $1000

Anesthesia (as requested): $550

IUI with hormone injections: $3500 to $4500

Is MicroIVF right for you?

Each patient’s case is considered carefully and individually. The following are conditions that might respond best to MicroIVF:

Young healthy women with PCOS or who otherwise produce many follicles

Women with pelvic adhesions or scarring, blocked fallopian tubes, or endometriosis

Couples with severe male factor infertility

MicroIVF really is a case of a little treatment going a long way! With it, you can access the world’s most successful assisted reproductive technology at far less cost.

So, will YOU win the contest?

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Should Infertile Women Dye Easter Eggs…or Their “Hare”?

By Tracey Minella

April 18th, 2011 at 12:00 am


You will always remember your first one. Gray hair, that is.

I was only 25, at a barbeque in my in-laws backyard, when my husband noticed it. I laughed it off (the way we fake laugh off the questions about when we’re going to have a baby already) and blamed it on the stress of law school and the bar exam. But I taped it to a piece of paper and saved it ever since.

Many of us are TTC during the years when we begin losing the gray hair battle. They come in faster than we can yank them out. So not only do we feel old, now we may look older, too. Just another injustice. Some of us consider dying our hair.

Like many of the habits that have been investigated for safety in pregnancy or pre-pregnancy, hair dying falls in that “gray area”. (Sorry, couldn’t resist!) Seems no government agency one wants to say that things like caffeine or hair color…or even Easter egg dyes… are definitely safe. Yet they don’t say they’re unsafe. They couch their study results or recommendations in favorite lawyer-friendly, vague terms like “doesn’t seem to” or “apparently”. So what do you do?

I recommend following your doctor’s advice and your common sense.

Most hair dyes have harsh chemicals, like ammonia. In general, the more permanent the color (vs. a temporary rinse), the greater the potential chance for harm. If your skin absorbs the chemicals, or you inhale the fumes, do you think that would be safe for a developing baby?

Surely, coming to your IVF transfer with your head wreaking of hair dye fumes would violate the no-scent rule. Maybe you want your new embryos to meet their hot, fresh red-headed mommy, but your glowing locks may be the last thing they "see" before they wither and die from the smell. Now that doesn’t mean you have to look like their Grammy on transfer day and thereafter. Why not ask your doctor and hair colorist about hennas or natural, chemical-free rinses and colorants if you don’t want to be gray?

And while you’re being extra safe about chemical hair dyes, why not consider making your own Easter egg dyes this year instead of buying those kits that are chock full of pellets of Red dye #40 and Blue dye #6, etc.?  Search online to find recipes using red onion and yellow onion peels, tea bags, and beet or blueberry juice, or spinach water, along with some vinegar, to create homemade and undeniably safe Easter Egg dyes. Or buy a natural egg dye, such as Eco-Kids Easter Egg Coloring Kit.

Or skip the egg dye experience altogether and go with plastic eggs that you can fill with candy,money or trinkets. Or gelatin "jigglers’" shaped like eggs. Or decorate real eggs with stickers and paints. What "eggcellent" ideas!

Speaking of Easter and Gray “Hare”… remember when your journey is feeling long and the goal seems out of reach, that slow and steady wins the race.

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