Archive for December, 2013
By Tracey Minella
December 29th, 2013 at 11:47 pm
Tagged with baby wishes, Biological Clock, coping with infertility, Fertility, infertile on New Years, infertile on the holidays, Infertility, infertility help, infertility information, Infertility Support, Infertility Treatment, IUI, IVF, IVF Long island, Long Island IVF, male infertility, Miscarriage, stress of infertility, Tracey Minella, Trying to Conceive, TTC, unhappy holidays
And so we move on toward yet another new year. Another supposed-to-be Happy New Year.
But holidays aren’t happy when you’re trying to conceive. They just aren’t. And sticking the word “happy” on them only adds to the stress. Isn’t it enough to have to face another year without a baby? Now you have to be “happy” too?
Father Time’s clock on New Year’s Eve is not welcome to many infertiles. How many of us have morphed into hermit couples over time? There is actually a pattern to it.
One year, you’re typical party-goers hoisting champagne at some big, loud gathering and confidently proclaiming to all within earshot “This year is the year we’re having a baby!”
Time passes. It’s New Year’s again. The crowd you’re celebrating with dwindles to a few close friends or family and the scene is more low-key. You trade in the bubbly for an alcohol-free toast because you’re doing everything you can to make that baby wish come true. You no longer say out loud that “This is the year”. You are still hopeful, but uneasiness dampens your party spirit.
More time passes. It’s just the two of you now. You don’t want to be out with others. Maybe you’ve suffered losses or are frustrated by financial roadblocks to necessary fertility treatment. You’re depressed and are simply too exhausted to pretend you’re happy…especially when surrounded by people who don’t understand your totally understandable depression. You’re tired of saying “This will be the year” only to find another year goes by and you’re making the same wish over and over. You’re hope is dangerously depleted and you officially loathe New Year’s with all its shallow celebratory nonsense. Prolonged infertility has stolen your happiness.
It’s okay. It really is okay not to be happy on New Year’s.
But it is not okay to lose hope. You need to keep hope alive. Nourish whatever bit is left. Breathe life back into it. Even if there is only a glimmer remaining. Find a way. Because your dream needs hope…and more…in order to come true. Depending on your circumstances, it may also need some combination of action, money and/or a miracle to come true.
So, from someone who ushered in about a decade of consecutive frustrating infertile New Year’s here’s some advice on how to make the best of a tough night.
· Don’t think of yourselves as alone. Remind yourself of why you chose and love this person and reconnect. Realize the power couple you are. You’ve been blessed with each other to get through this journey and, hard as it is, it’s making you stronger. When you finally do have a child, you will be ready for anything life throws your way. Take the night to make a written plan for 2014. What is the next step going to be? What do you need to get there? And how will you get it? Real steps. In writing. Make the plan.
· Acknowledge the elephant in the room…the baby that is not here yet. Instead of focusing on what’s missing, why not play a game? Similar to the movie “The Odd Life of Timothy Green”, you and your partner can brainstorm on the character traits you imagine your future baby will have. Boy or girl? Good at soccer or music? Quiet or loud? And so on. Positive visualization can do wonders.
· Offer to babysit. For those up to it emotionally (and it’s okay not to be), consider offering to babysit for a friend’s baby overnight. You get a real taste of parenting and you get to help out a friend who may want to go out. When you have your own baby, maybe they’ll return the favor!
· Have a Plan. If you are venturing out into the fertile, celebratory world you need a plan. If you’re with people who know you are trying, tell them up front that the topic is off limits tonight. If not, try to have a planned response ready for any possible nosy comments so you are not caught off guard. Have a secret “signal” with your partner that means “It’s time to leave…NOW!” Preparation is the best defense.
Wherever you are, kiss at the stroke of midnight. It’s the best way to enter the New Year. And it’s bound to fill your heart with hope.
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What are your plans and tips for New Year’s Eve?
Photo credit: Danilo Rizzuti
By Bina Benisch, MS, RN
December 27th, 2013 at 3:02 pm
Tagged with Bina Benisch, coping with infertility, Fertility, fertility and mind body medicine, Health, holistic infertility, Infertility, infertility help, infertility information, Infertility Support, infertility support group, Infertility Treatment, IUI, IVF, IVF Long island, LI-IVF, Long Island IVF, male infertility, male infertility support, Mind Body program, Miscarriage, pregnancy loss and stress, stress of infertility, stress response and fertility, Trying to Conceive, TTC
Since many may still be reeling from the emotions and stress of the holidays, it’s a good time to remind you of Long Island IVF’s many supportive counselors on staff, and to call your attention to the Mind Body Program and its benefits.
Bina Benisch is a Registered Professional Nurse and a psychotherapist with an M.S. in Mental Health Counseling. She did her Mind Body Medicine training at the Benson-Henry Institute for Mind Body Medicine, Harvard Medical School.
Bina is the support group coordinator, patient advocate, and stress management psychotherapist for Long Island IVF, working with both female and male patients. Her groups are wildly popular, and she always has room for more.
Bina explains the Long Island IVF Mind Body Program and its benefits for those couples trying to conceive:
Life changes. You’ve had your intentions, your hopes, and your dreams of where life would take you. What you may not have envisioned is suddenly being a member of the population that struggles with infertility. Being diagnosed with infertility – for any reason – “unexplained,” male factor, or female factor, can feel like a lonely, isolating experience for many reasons. The fact is that most women never expected to be in this position, and this is often one of the most stressful times in a woman’s life. Feelings of anxiety, depression, isolation, and anger can be overwhelming during infertility. Often, anger masks the feelings of loss experienced month after month of trying to conceive without success. Infertility impacts on one’s marriage, self-esteem, sexual relationship, family, friends, job, and financial security.
Our Mind Body Program provides a space where you can relax, a place where you are free to express whatever it is you are feeling … a sacred circle of connection and support. I have been told by women who have participated in the Mind Body Support Group that they experience a huge relief by connecting with other women who really “get it,” who understand these unique feelings. During the sessions, I take part of the time to teach Mind Body methods to elicit the relaxation response (emotional and physiological relaxation). In this way, you can learn to practice these methods on your own on a daily basis.
In our Mind Body support group, patients experience the opportunity to share information, feelings, or their own personal stories. You may be surprised to see how your support can help others or you may be relieved to hear others experiencing the same type of thoughts and feelings as you experience. Often, the supportive nature of this group, and the connection that develops between members, fosters a healing process.
Feelings of isolation, anger, and stress are slowly relieved. Our Mind Body program focuses on symptom reduction and developing a sense of control over one’s life by utilizing Mind Body strategies and interventions which elicit the relaxation response. The relaxation response is actually a physical state that counteracts the stress response. You can think of it as the physiological opposite of the body’s stress response. We cannot be stressed and relaxed at the same time.
Therefore when a person elicits the relaxation response, the body’s stress response is halted, stress hormones diminish. It is important to understand fertility holistically. Your mind and body work together, not separately. Therefore your thoughts have a direct effect on your physiology. When you are experiencing stress, your brain releases stress hormones. These stress hormones function in many ways. One of the stress hormones, cortisol, has been documented to interfere with the release of the reproductive hormones, GnRH (gonadatropin releasing hormone), LH (luteinizing hormone), FSH (follicle stimulating hormone), estrogen, and progesterone. In fact, severe enough stress can completely inhibit the reproductive system. Cortisol levels have also been linked to very early pregnancy loss. For this reason, it has been found extremely helpful when treating infertility, to include mind body strategies which help to alleviate the stress responses which may inhibit fertility.
All mind body methods ultimately cause the breathing to become deeper and slower. This causes stress responses such as heart rate, metabolic rate, and blood pressure to decrease. The way in which you are taught to elicit the relaxation response is through methods such as: breath focus, guided visual imagery, muscle relaxation and learned mindfulness, and meditation. Awareness of the mind body connection allows us to use our minds to make changes in our physiology. This holistic treatment – combining bio-medical science with mind body medicine deals with the treatment of the whole individual rather than looking only at the physical aspect. The fact is, body and mind work together.
Let’s not forget the men. Men often feel uncertain about the ‘right’ way to support their partners, and don’t realize how they themselves are affected. We now offer our “Just For Guys Group.” In sharing how infertility affects the men, their relationships, and each man’s deepest sense of self, these men gain insight, and experience support during what can be an isolating and difficult time.
We invite and encourage you to take advantage of this unique area of support provided by The Mind Body Program at Long Island IVF.
photos credit: David Castillo Dominici
By Tracey Minella
December 23rd, 2013 at 9:55 am
Tagged with coping with infertility, Fertility, Health, infertile at Christmas, infertile for the holidays, Infertility, infertility information, Infertility Support, Infertility Treatment, IUI, IVF, LI-IVF, Long Island IVF, male infertility, pregnancy, stress of infertility, Trying to Conceive, TTC, virgin birth, virgin birth and IVF
What better season to contemplate the idea of a virgin birth? Or miracles?
The Medical Daily reported this week that virgin births made up 0.5% of births, according to a survey out of the University of North Carolina at Chapel Hill.
Of the 7,870 respondents, having a median age of 19.3 years at the time of giving birth, 45 reported having given birth despite never having had sex. And without the use of assisted reproductive technology, like IVF. It’s noteworthy that about one third of those claiming virgin births had previously signed chastity pledges. As for the plausibility of this phenomenon, the lead researcher stated there are “no medically-validated reports of virgin births in humans, or other mammals” to her knowledge.” http://bit.ly/1c16LXS
As an infertile woman, there are two striking takeaways from this story. And they are not the debate about miracles vs. science. Or the apparent need to improve sexual education. Or even the cultural pressures on young girls to remain virgins until marriage.
Need a hint? It was that simple statement tucked in the middle of it all: “And without the use of IVF.”
The first thing that came to mind was the idea that someone…a virgin, to be precise…could actually use IVF to have a baby. Technically, a virgin birth. Imagine that!
But the other epiphany is now my message of hope to all of you non-virgins still on your infertility journeys…juggling things like partners, temperature charts, syringes, and annoying relatives this holiday season:
IVF is today’s miracle. Every day, it creates babies for women who medical science has determined cannot otherwise have children. We call them “miracle babies”.
In this season of hope, may you find the strength to cope with the added stress of the holidays and continue to believe in your dream. Miracles do happen every day.
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Do you believe in miracles?
Photo credit; Stuart Miles http://www.freedigitalphotos.net/images/agree-terms.php?id=100144418
By David Kreiner MD
December 20th, 2013 at 11:07 am
Tagged with coping with infertility, David Kreiner MD, Fertility, fertility instructions, Fertility Medications, HCG shot, Infertility, infertility help, infertility information, Infertility Support, Infertility Treatment, IUI, IVF, IVF Long island, LI-IVF, Long Island IVF, male infertility, mind-body, Miscarriage, Reproductive Endocrinologist, retrievals, stress and fertility, stress of infertility, transfers, Trying to Conceive, TTC
“Scuza,scuza , Signore e signori we are experiencing technical difficulties…”
While I sit uncomfortably detained aboard an Al Italia jet on the tarmac at the Sicilian airport waiting for the mechanics to determine if they can repair the mechanical troubles, my mind drifts to the plight my patients experience while they go through their fertility treatments.
Frustrated, with no control over my situation I reflected upon what it must feel like for my patients who must place their trust in people more experienced than them who routinely deal with those issues that are so significantly impacting them.
Like my pilots and their support staff, the fertility doctors, nurses and their staff have dealt with problems identical to or extremely similar to the ones my patients face on a daily basis. As such I felt that I should trust that the pilots and maintenance staff would only proceed with the flight once they were assured the problem was satisfactorily repaired and that the plane was safe.
However, I figured that if we were to be delayed for takeoff that I could take out my iPad and make myself more comfortable during the wait. Immediately, I heard from the flight attendant, in angry Italian, scolding me to turn off my electronics. Actually, I did not understand but several other passengers quickly added in English to shut off my iPad. Did I not hear the prior instruction to turn off the electronics?
I did not understand the reasoning behind this as we were obviously delayed for takeoff. I was frustrated with my lack of control and understanding. I would have felt more comfortable if I understood what was going on and even better if I were able to participate in the process in some way.
I am sure that my patients must also have this great desire to understand and obtain some control. I believe that many do… often by gaining more knowledge on the subject through the Internet, our orientation sessions, and directly through questioning the doctors and nurses.
The fact was for me I had no knowledge of our problem with the plane and was therefore utterly helpless other than to offer my complete cooperation. My patients on the other hand do have opportunities to attain some control and an ability to assist on their own behalf achieving their goal of a pregnancy.
What can patients do to improve their success?
Listening carefully to instructions and following them religiously such as obtaining and administering medications, regarding dosages and times is essential. It is important to their ultimate success if they arrive to monitoring visits, retrievals and transfers at stated times. Patients’ responses to medications vary over time and are considered when their doctors interpret their hormone levels. The egg matures over the course of time passed from the hCG shot but if this time is extended too long a patient may ovulate before the retrieval is performed and the egg is lost.
How else can patients improve their outcome?
Studies have shown that stress reduction through support groups, mind body programs, massage and especially acupuncture improve success rates essentially by improving a body’s ability to respond in a healthy fashion to the fertility process.
As my reflections on the unique ability of my patients to impact their fertility were now complete and committed to paper (my iPad safely turned off and stowed away), over an hour later we finally pulled away from the gate and safely took flight. One hour later we landed in Rome, excited to move on to the next leg of our trip. I thought as I reflected on my successful journey how I wished for my patients to be as successful in theirs.
Yet as we are about to deplane, I hear “Signore e signori I am very sorry…” the pilot announced that the bus transportation to the gate had not yet arrived and it would be another short while.
“I apologize for the inconvenience”. Yes, this is very familiar.
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How does your infertility journey make you feel out of control or like a traveller in a foreign land?
By Tracey Minella
December 15th, 2013 at 8:09 pm
Tagged with baby dreams, coping with infertility, dream of motherhood, Early Embryo Viability Assessment Testing, Eeva, Eeva Study, Fertility, Health, Infertility, infertility help, infertility information, Infertility Support, Infertility Treatment, IUI, IVF, IVF Long island, LI-IVF, Long Island IVF, Miscarriage, motherhood, SET, Single Embryo Transfer, stress of infertility, Trying to Conceive, TTC
There are women who have babies with ease…they pick the month they’d like the baby to be born, conceive effortlessly, and often enjoy care-free pregnancies and deliveries. Others have unplanned pregnancies and sometimes complain or give up the baby. And some women choose to never have children at all.
And then there is us. The infertile ones.
We began our quest as innocent planners of big families and summertime babies. And as the journey wore on we somehow morphed into women who’d settle for just one healthy baby born on any day of the year. We altered the dream to our reality. And we prayed it would come true.
For many of us with access to quality reproductive medical care, the dream will come true. The statistics for IVF success are rapidly rising as technology improves daily. Single embryo transfers (SETs), already popular at Long Island IVF, are helping to reduce risky multiple pregnancies. And Early Embryo Viability Assessment (EEVA) Testing, which is part of a clinical trial at Long Island IVF, is helping embryologists choose the embryos most likely to result in a pregnancy.
But what about those who don’t have access for financial or other reasons? What about their dreams? If faced with no other options, these women resolve to live child-free. Many end their infertility journeys after having suffered devastating losses or repeated disappointments and are emotionally, physically, and financially exhausted. For most of them, living child-free may not really be a choice, but rather, the only option available.
I don’t think the dream of motherhood ever dies. Certainly not for women who wanted it badly enough to endure the sacrifices and demands of repeated IUIs and IVFs. The journey may end, but the longing remains. Even if the woman stops talking about it. Even if she says she’s okay with living child-free. That’s just self-preservation talking.
This week that theory was validated as a 64 year old woman gave birth after a 41 year infertility journey. She got married six years before the first IVF baby was even born. She tried IVF only once, in 1988, without success and thereafter gave up treatment…for 23 years. But the dream hadn’t died. She went back for another IVF procedure and is finally a mother at 64. Her daughter is named Durga, which means “invincible”. For the full story, clickhttp://bit.ly/INs6ua
This story is offered not to spark debate on how old is too old to become a mother, but as testament to the unwavering power of the dream of motherhood and the miracles capable from modern reproductive medical technology.
What may feel like the impossible dream today may be the invincible dream tomorrow. Dare to dream it.
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photo credit: David Castillo Dominici/free digital photos.net
By David Kreiner MD
December 13th, 2013 at 9:13 am
Tagged with blastocyst, Dr. David Kreiner, endometrial lining and fibroids, endometrial polyp, Fibroids, fibroids and fertility, fibroids and implantation, fibroids and infertility, hydrosonogram, hysteroscopy, Infertility, infertility information, Infertility Treatment, intramural myoma, IVF, leiomyomata, Long Island IVF, Miscarriage, pregnancy, subserosal myoma, Trying to Conceive, uterine tumors
Fertility is dependent upon so many things!
We must have healthy gametes (eggs and sperm) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. The sperm need be in sufficient number and capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.
The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.
And you wonder why getting pregnant is so hard?
All too often patients, in some groups as many as 30% of women, are told that they have fibroids that may be contributing to their infertility. Fibroids or leiomyomata are non malignant smooth muscle tumors of the uterus. They can vary in number, size and location in the uterus including; the outside facing the pelvic cavity (subserosal), the inside facing the uterine cavity (submucosal) and in between inside the uterine wall (intramural). Fortunately, most fibroids have minimal or no effect on fertility and may be ignored.
The subserosal myoma will rarely cause fertility issues. If it were distorting the tubo- ovarian anatomy so that eggs could not get picked up by the fimbria then it can cause infertility. Otherwise, the subserosal fibroid does not cause problems conceiving.
Occasionally, an intramural myoma may obstruct adequate blood flow to the endometrial lining. The likelihood of this being significant increases with the number and size of the fibroids. The more space occupied by the fibroids, the greater the likelihood of intruding on blood vessels traveling to the endometrium. Diminished blood flow to the uterine lining can prevent implantation or increase the risk of miscarriage. Surgery may be recommended when it is feared that the number and size of fibroids is great enough to have such an impact.
However, it is the submucosal myoma, inside the uterine cavity, that can irritate the endometrium and have the greatest effect on the implanting embryo.
To determine if your fertility is being hindered by these growths you may have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.
Submucosal as well as intramural myomata can also cause abnormal vaginal bleeding and occasionally cramping. Intramural myomata will usually cause heavy but regular menses that can create fairly severe anemias. Submucosal myomata can cause bleeding throughout the cycle.
Though these submucosal fibroids are almost always benign they need to be removed to allow implantation. A submucosal myoma may be removed by hysteroscopy through cutting, chopping or vaporizing the tissue. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus or pelvic organs is small.
Resection of the submucosal myoma can be difficult especially when the fibroid is large and can sometimes take longer than is safe to be performed in a single procedure. It is not uncommon that when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.
The good news is, when no other causes of infertility are found, removal of a submucosal fibroid is often successful in allowing conception to occur naturally or at least with assisted reproduction.
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Anyone have a fibroid story to share?
Photo credit: public domain: http://en.wikipedia.org/wiki/File:Fibroids.jpg
By Tracey Minella
December 8th, 2013 at 11:08 pm
Tagged with baby dreams, coping with infertility, embryo transfer, Fertility, hindsight is 20/20, holiday traditions, infertile on the holidays, Infertility, infertility help, infertility journey, infertility outcome, infertility regrets, Infertility Support, IVF, LI-IVF, Long Island IVF, male infertility, mind-body, Miscarriage, positive visualization, preparing for a baby, stress of infertility, time travel, Trying to Conceive, TTC
During my infertility journey, I always looked back. Usually with regrets or second-guessing. I’d criticize myself for decisions we made which seemed best at the time… and probably were best…even though the outcome wasn’t what we’d hoped. I questioned everything, including the timing of cycles and the numbers of embryos transferred, sometimes wishing for more and other times wishing for less. In short, I beat myself up.
Maybe you do that, too? If so, you need to stop.
Nothing is more counter-productive than being a “Monday morning quarterback”. And the cliché of hindsight being 20/20 is very true in infertility. Try to remember that every failure or setback is a lesson that you and your doctor will learn from to make different and better choices for your future treatment.
The holiday season is so difficult and each year the holiday marketing seems to start earlier and get more aggressive. Faces of children are in commercials and print ads wherever you turn. Maybe you’re receiving “wish lists” for nieces and nephews and the thought of walking into Toys R Us and faking your way through Christmas makes you ill.
Need a mental break?
Here’s a little trick I’ve used when overwhelmed or depressed and since it’s National Time Travel Day, it’s the perfect time to share it:
Escape the present and fast forward to the future for a few moments. Find a quiet place and put on some soft, relaxing music…or have total silence…whichever you prefer. Be sure you won’t be interrupted. Steal at least a half hour for yourself. Close your eyes and imagine a future point in time, maybe next holiday season. Really allow yourself to see the family you dream of, whether it’s your first baby or an addition you long for to make you feel complete.
It’s important to imagine all the details. First, picture the child. Will it be a boy, a girl, or both? Blonde or dark hair? (This is your fantasy, so let go and embrace it.) Now, take yourself through traditions you dream of starting or sharing. Will you cut down a tree? Visit someone special? Send a photo holiday card? Bake cookies? Buy a Hess truck or holiday Barbie? What are your plans? How will your life change?
Yes, this may be hard. But it can be helpful. So much of infertility is beyond our control that just making these plans in your head…or in a journal…can make them seem that much closer to coming true. At least it did for me. And if you allow yourself to see your dreams and write them down year-round as they cross your mind, your holiday “to-do” list will already be written for the year your dream does come true.
Here’s hoping that those still on their journeys will find resolution in 2014.
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What holiday tradition are you looking forward to starting or sharing?
Photo credit: Boians Cho Joo Young/http://www.freedigitalphotos.net/images/agree-terms.php?id=100208929
Infertility Podcast Series: Journey to the Crib: Chapter 34: Fertility Treatment During This Economic Downturn
By David Kreiner MD
December 5th, 2013 at 7:57 pm
Tagged with affordable IVF, Affording IVF, cost of IVF, David Kreiner MD, embryo storage fees, Fertility, Fertility treatment in bad economy, fertility treatment legislation, FET, Free IVF, frozen embryo transfers, Infertility, IVF legislation, LI-IVF, Long Island IVF, Multiple pregnancy, SET, Single Embryo Transfer, stress of infertility, transfering multiple embryos
Welcome to the Journey to the Crib Podcast. We will have a blog discussion each week with each chapter. This podcast covers the final chapter, Chapter Thirty-Four: Fertility Treatment During This Economic Downturn. You, the listener, are invited to ask questions and make comments. You can access the podcast here: http://podcast.longislandivf.com/?p=149
Fertility Treatment During This Economic Downturn
Financial hardships have increased fertility challenges for many couples attempting to build their families. In regions where patients do not have insurance coverage for their IVF procedures it is unlikely that they proceed with the treatment that is necessary for them to be able to complete their families.
In places that do provide coverage for IVF, such as Massachusetts, 5% of all babies born are as a result of IVF. Elsewhere in the U.S., IVF accounts for only 1% of births suggesting that the financial cost of IVF denies access for approximately 80% of couples in need.
The problem of the cost of IVF is compounded by the fact that patients are driven to transfer multiple embryos to limit the cost and avoid additional fees from cryopreservation, embryo storage and frozen embryo transfers. These multiple transfers increase the risks of multiple pregnancy and preterm delivery with subsequent complications to the babies from preterm birth.
We, at Long Island IVF, attempt to make IVF more accessible and safer by offering income based grants, free cryopreservation, storage and discounted frozen embryo transfers to patients electively transferring single embryos. We have also offered free IVF cycles through best video/essay contests to a few needy patients over the past few years.
It is our sincere wish and hope that a bill that is presently in front of Congress offering a tax credit to patients going through IVF is passed thereby making IVF that much more affordable to our patients in need.
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Was this helpful in answering your questions about fertility treatment during this economic downturn? Are you aware of the pending proposed Family Act, which would offer a tax credit to infertile women wishing to undergo infertility treatment (similar to the current adoption credit for those wanting to pursue adoption)? Have you urged your legislators to support this important legislation?
Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.
By David Kreiner MD
December 1st, 2013 at 8:26 am
Tagged with age-related infertilty, David Kreiner MD, Fertility, Health, implanting many embryos, Infertility, infertility information, Infertility Treatment, IVF, journey to the crib podcast, Long Island IVF, Michael Kamrava, Multiple pregnancy, Nadya Suleman, number of embryos to transfer, octomom, poor egg quality, repeated IVF failure, selective reduction, SET, Single Embryo Transfer, Trying to Conceive
Welcome to the Journey to the Crib Podcast. We will have a blog discussion each week with each chapter. This podcast covers Chapter Thirty-Two: Octomom. You, the listener, are invited to ask questions and make comments. You can access the podcast here: http://podcast.longislandivf.com/?p=146
A year ago, the Medical Board of California revoked the license of Dr. Michael Kamrava, finding he “did not exercise sound judgment” in transferring 12 embryos to Nadya Suleman, who already had six children at home. The ruling, while not surprising, was illuminating, and it’s worth reflecting on the five things we learned from Octomom:
1. Know How to Say “No”: There is a point where physicians have to make a judgment call. Pregnancies with triplets – let alone eight infants – put the mother at high risk of serious medical complications and put unborn children at risk for developmental disabilities. Physicians need to rely on their professional expertise and experience to know when to turn down a patient request no matter how vehemently it is made.
2. Beware the Patient with Tunnel Vision: Often when a patient comes to a fertility doctor, unsuccessful pregnancy attempts have made her anxious and determined. She might want to get pregnant regardless of the risks that pregnancy may present.
3. Less is More: In 1999, 35 percent of all transfers involved four or more embryos. In 2009, only 10 percent had four or more. And those high-number transfers are generally reserved for patients with significant fertility challenges. In contrast, Octomom already underwent multiple successful IVF (in vitro fertilization) procedures and had given birth to six children when she had her 12-embryo transfer.
4. Know When to Deviate: While Dr. Kamrava’s deviation from guidelines was an extreme departure, deviations do occur for specific reasons, such as repeated IVF failure, age-related infertility and poor egg quality. It is important to know when implanting several embryos is appropriate.
5. “Reduce” Risk: Dr. Kamrava complained that Octomom refused to undergo “selective reduction,” which would have reduced the number of embryos she carried to term. Here, again, is an argument for fewer transfers. Had he transferred fewer embryos, Octomom would not have had to face such a difficult decision.
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Was this helpful in answering your questions about what could have been done differently to prevent the Octomom case? How much weight do you give your doctor’s recommendation on the number of embryos to transfer?
Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.