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Archive for May, 2015

Is Clomid Right for You?

By David Kreiner MD

May 22nd, 2015 at 12:27 pm

 

Photo: imagery magestic/ freedigitalphotos.net


It has become commonplace for women who have been frustrated with repeated unsuccessful attempts to conceive naturally on their own to see their gynecologist who often times will try clomid therapy on them.

Clomid, the traditional brand name for clomiphene citrate, is a competitive inhibitor of estrogen. It stimulates the pituitary gland to produce follicle stimulating hormone (FSH) which in turn will stimulate the ovaries to mature follicle(s) containing eggs. Estrogen normally has a negative effect on the pituitary: Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.

Infertility patients — those under 35 having one year of unprotected intercourse without a resulting pregnancy and those over 35 having six months without pregnancy — have a two to five percent pregnancy rate each month trying on their own without treatment.

Clomid therapy increases a couple’s fertility by increasing the number of eggs matured in a cycle and by producing a healthier egg and follicle. The pregnancy rate with clomid therapy alone is approximately ten percent per cycle and 12 -15 percent when combined with intrauterine insemination (IUI). Women who are unable to ovulate on their own experience a 20 percent pregnancy rate per cycle with clomid, the equivalent to that of a fertile couple trying on their own.

Clomid and Your Cervical Mucus

Women who are likely to conceive with clomid usually do so in the first three months of therapy, with very few conceiving after six months. As clomid has an anti-estrogen effect, the cervical mucus and endometrial lining may be adversely affected.

Cervical mucus is normally produced just prior to ovulation and may be noticed as a stringy egg white-like discharge unique to the middle of a woman’s cycle just prior to and during ovulation. It provides the perfect environment for the sperm to swim through to gain access to a woman’s reproductive tract and find her egg. Unfortunately, clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb. IUI overcomes this issue through bypassing the cervical barrier and depositing the sperm directly into the uterus.

However, when the uterine lining or endometrium is affected by the anti-estrogenic properties of clomid, an egg may be fertilized but implantation is unsuccessful due to the lack of secretory gland development in the uterus. The lining does not thicken as it normally would during the cycle. Attempts to overcome this problem with estrogen therapy are rarely successful.

Side Effects

Many women who take clomid experience no side effects. Others have complained of headache, mood changes, spots in front of their eyes, blurry vision, hot flashes and occasional cyst development (which normally resolves on its own). Most of these effects last no longer than the five or seven days that you take the clomid and have no permanent side effect. The incidence of twins is eight to ten percent with a one percent risk of triplet development.

Limit Your Clomid Cycles

Yet another deterrent to clomid use was a study performed years ago that suggested that women who used clomid for more than twelve cycles developed an increased incidence of ovarian tumors. It is therefore recommended by the American Society of Reproductive Medicine as well as the manufacturer of clomiphene that clomid be used for no more than six months after which it is recommended by both groups that patients proceed with treatment including gonadotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization.

Success rates

For patients who fail to ovulate, clomid is successful in achieving a pregnancy in nearly 70 percent of cases. All other patients average close to a 50 percent pregnancy rate if they attempt six cycles with clomid, especially when they combine it with IUI. After six months, the success is less than five percent per month.

In vitro fertilization (IVF) is a successful alternative therapy when other pelvic factors such as tubal disease, tubal ligation, adhesions or scar tissue and endometriosis exist or there is a deficient number, volume or motility of sperm. Success rates with IVF are age, exam and history dependent.

Young patients sometimes choose a minimal stimulation IVF or MicroIVF as an alternative to clomid/IUI cycles as a more successful and cost effective option as many of these patients experience a 40 percent pregnancy rate per retrieval at a cost today of about $3,900.

Today, with all these options available to patients, a woman desiring to build her family will usually succeed in becoming a mom.

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Did you start out with Clomid? Did you have success with it or did you move on to IVF?

 

photo credit: imagery majestic http://www.freedigitalphotos.net/images/Couplespartners_g216-Young_Romantic_Couple_p75136.html

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Win a Free IVF Cycle Door Prize at Long Island IVF Event: Final 3 Day Promo!

By Tracey Minella

May 19th, 2015 at 3:21 pm

Forget the Memorial Day weekend grocery list! Step away from the barbeque.

You’ve got a more urgent matter to address before the weekend festivities begin.

Are you listening?

I’m making you an offer you can’t refuse. Seriously. You can’t.

Picture this: Only $25 for a chance to win a Free IVF cycle door prize worth approximately $10,000 plus a guaranteed fabulous night out at the Great South Bay Brewery on Thursday June 4th filled with music, food, craft beer sampling, brewery tours, souvenir glasses, and a silent auction.

The free IVF cycle door prize is transferable, so those who need it should bring down all their friends and family to help increase their odds. Don’t need the IVF cycle yourself? You probably know someone who does. Just love beer? Perfect. This night is for you, too. So be a hero while raising money to help infertile couples build their families.

Can you even wrap your head around the idea of all you’re getting for only $25? You can’t even go to the movies for that!

The catch, you ask?

YOU HAVE TO ACT FAST. As in tomorrow, Thursday, or Friday.

In what can only be categorized as a moment of heartfelt compassion…or extreme patriotism… or complete insanity…the organizers of Long Island’s Brew for the Family event have decided to offer a FINAL pre-Memorial Day promotion in an effort to be sure everyone who would love the chance to win the Free IVF cycle door prize could afford a ticket.

So from tomorrow (May 20) through midnight on Friday May 22, 2015, you can purchase a regular $55 ticket for only $25!!!! Crazy, right??! Sure, it’s a bargain at $55, but why not take advantage at this steal of a price?!

Purchase your tickets right here:

http://www.eventbrite.com/e/long-island-brew-for-the-family-hosted-by-long-island-ivf-tickets-15203780918

So what’s it going to be? Crying in your beer this weekend because you didn’t take advantage of this amazing opportunity…or raising a glass to hope and possibility?

Don’t miss this chance.

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Are you going to go to Long Island Brew for the Family?

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Long Island IVF Doctors Are Recognized as “Super Doctors” Again!

By admin

May 15th, 2015 at 10:39 am

 

 

Dr. Pena


Did you catch the big news? New York Times Magazine named this year’s “Super Docs” list on Sunday and you might just recognize a name or two!

Long Island IVF doctors, Dr. Joseph Pena and Dr. Michael Zinger, were named as New York “Super Doctors” in the field of Reproductive Endocrinology, securing two of only about a dozen spots on the elite list, which only includes two doctors on Long Island, and the remaining in the NYC area.

What makes this exciting and humbling is that “Super Docs” honorees are chosen by their peers. You can’t buy your way onto the list through paid advertising, or get on it by generating the most “likes” in a social media campaign (but feel free to come over and “like” us on Facebook anyway at http://www.facebook.com/longislandivf!) It is doctors recognizing other doctors’ talent and ability.

Dr. Zinger

We know of many other top notch doctors…both on the Long Island IVF team and in other fields who are not included on the Super Doctors list… and are humbled by this recognition. Thanks to all the physicians who voted for Drs. Pena and Zinger for this honor.

And of course, we’d like to thank our wonderful patients, who so often sing the praises of their LIIVF doctors… because it’s possible many of the doctors who nominate our physicians for these honors may have first heard about them from you! You are the reason we all love what we do every day.

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Have you ever told another doctor about your LIIVF experience or recommended your LIIVF doctor?

 

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Getting Real About Mother’s Day Blues

By Tracey Minella

May 9th, 2015 at 2:05 pm

photo: davidcastillodominici/ freedigitalphotos.net


I want to help and inspire you this Sunday. To mend the raw and broken heart that simply is infertility. To distract you from the emptiness that is Mother’s Day. And from the pain of losses suffered and prayers still unanswered.

But the words don’t come.

I lived it, too, for very many years. The memories are crystal clear. And still the words won’t come to make the worst day of the year any easier. So I’m going to ramble and share some thoughts from the heart.

This journey you’re on, that consumes your life and sucks you dry, will end someday. Yes, it will… even though it feels like it’s been this way forever and that it never will end.  But it has to, if you take the time to think about it. And for many it will end with a family. One built in the way you hoped, or in another way that through your evolution on your journey you will have come to accept. And it will feel like it was meant to be and the heavens will literally feel like they opened up and shone down on you just like in the movies.

But you won’t get these years back. I call the infertility years, “the hole”. It’s nearly a decade that I let some form of family-building consume me. When I look back, it’s an effort to remember the good times because I simply couldn’t allow myself to be happy or force myself to have fun. I let infertility rob me of more than it already had. It stole a decade of my life. Don’t let it do that to you. Trust that you’ll be a parent someday. Believe it. Because if it comes true, which it often does, you will have been able to find some happiness during the waiting years. And if it doesn’t come true, you are no worse off.

Celebrate your own mom on Mother’s Day because she won’t be here forever. Trust me, I know. I lost my mom before I got pregnant and could make her a grandmother. Same with my dad. Put the focus on her on Sunday. If it’s too hard, then see her today. Don’t get so lost in your own desire to be a mom that you forget to somehow celebrate the woman who is your mother.

Want a bit of a distraction? Do this project: Fill a mason jar with memories of your mom. Colorful tiny strips of paper with stories and traditions and qualities that you admire about her. And give it to her. What a priceless gift. Not feeling that? Then make one for yourself (or start a journal) with a list of all your plans and the qualities you hope to have as a mom. Baby names, nursery colors, favorite movies and books you’ll share. Activities you’ll encourage. Traditions you’ll start or continue. Add tidbits about this journey you’re on and how you’re feeling. These are therapeutic projects.

Follow your heart Sunday and do what you need to do to get through the day. Avoid places with children if that’s too hard to bear. Stay up late tonight and sleep extra late (cut that day in half!). Treat yourself in some way.

And listen to that heart as well. It’s telling you more than the grief and fear and frustration is letting you hear. There’s a voice whispering deep inside that makes you get out of bed each and every day, including tomorrow.

If you listen…really listen…it’s telling you that you are a mom-in-waiting. Hear it.

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What are you doing to get through the day? What/who are you dreading most?

 

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Long Island “Brew For the Family” Event- June 4, 2015

Would winning a FREE IVF Cycle door prize help you or a loved one build a family?

Join us on Thursday, June 4th, 2015 from 7:30-10PM at the Long Island Brew for the Family event hosted in partnership with the Tinina Q. Cade Foundation.

We have come together to spread the message that infertility can be overcome! Enjoy a night out and forget the stress of infertility as we sample craft beers at one of Long Island’s premier microbreweries, The Great South Bay Brewery. The evening will include a sampling of 6 beers, guided brewery tours with a master brewer, great food, music, and a silent auction.

Each admission ticket will include one entry into the drawing for a FREE IVF CYCLE* door prize. Be sure to invite your family and friends for even more chances to win, as the prize is transferrable.

To purchase tickets and learn more about this event please visit: www.librewforthefamily.eventbrite.com.

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

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 contest.

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

We love what we’ve gotten to do every day more than 27 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help.

 

 

Photo credit:  http://www.freedigitalphotos.net/images/Gestures_g185-Depressed_Woman_Sitting_On_Floor__p99322.html

 

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Long Island IVF Celebrates Nurse Appreciation Week!

By Tracey Minella

May 6th, 2015 at 3:56 pm

You’ve yelled at them. Cried on their shoulders. Squeezed their hands. Lent them your sore and weary veins. And celebrated (or will celebrate) your success with them.

They are your Long Island IVF Nurses. And they are the embodiment of all that National Nurses Appreciation Week is meant to celebrate.

They’ve been right there in the trenches with you on the most important journey you may ever take. They’re the link between you and your doctor. Maybe the link between you and your sanity at times, too.

They know your name and your history. Taught you how to do injections. Ordered your meds. Wiped your tears. They’re your biggest fan and are ready with a hug of support or congratulations. They’ve got your back.

If there is a special nurse at Long Island IVF (or anywhere) that has touched your life, please drop her a note, give her a call, or just give her a “shout-out” right here in the comments to let her know how much she means to you. It will make her day!

As a 7 time IVF patient from the “dark ages” of the 90’s, my personal shout out goes to my own LIIVF nurses: Joey, Maryann, Sue and Vicky (pre-donor egg coordinator days!)

Joey, you rode the ups and downs like they were your own and you always knew how to make me laugh, even when I was dying.

Maryann, your Katie stories and special humor were always day-brighteners. Your perfect mix of realism and optimism kept me grounded and hopeful.

Sue, no one…and I mean no one… could ever be more organized and on the ball than you. Thanks for giving me the peace of mind of knowing that every single minor detail of all my IVF cycle stuff was in order on your watch.

Vicky, I’ve never met anyone who oozes comfort, calm, and hope like you. Having you as a nurse was like wrapping all the stress of IVF in some fluffy, happy, insulating cloud. It’s no wonder you moved on to Donor Egg Coordinator.

My other nurses, Denise, Patty, and Dotty retired or moved on, but are all special to me.

Now it’s YOUR turn…

Shout out begins now!

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Who is your favorite LIIVF nurse?

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Long Island “Brew For the Family” Event- June 4, 2015

Would winning a FREE IVF Cycle door prize help you or a loved one build a family?

Join us on Thursday, June 4th, 2015 from 7:30-10PM at the Long Island Brew for the Family event hosted in partnership with the Tinina Q. Cade Foundation.

We have come together to spread the message that infertility can be overcome! Enjoy a night out and forget the stress of infertility as we sample craft beers at one of Long Island’s premier microbreweries, The Great South Bay Brewery. The evening will include a sampling of 6 beers, guided brewery tours with a master brewer, great food, music, and a silent auction.

Each admission ticket will include one entry into the drawing for a FREE IVF CYCLE* door prize. Be sure to invite your family and friends for even more chances to win, as the prize is transferrable.

To purchase tickets and learn more about this event please visit: www.librewforthefamily.eventbrite.com.

***************************************************************

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

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 contest.

We love what we’ve gotten to do every day more than 27 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help.

 

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How to Survive the Two Week Wait for Your Pregnancy Result

By Bina Benisch, MS, RN

May 1st, 2015 at 8:54 pm

photo: peter kratochvil/ publicdomainimages.com

 

It seems interminable.

 

You’ve finally made it through your IVF stimulation. You’ve survived your injections and all those early morning monitoring visits…not to mention being poked and prodded for blood and vaginal ultrasounds. You’ve undergone your retrieval procedure, sweated out the fertilization results, and here it is – the day of your embryo transfer.  Or, if you’re doing IUI, you’ve made it through your insemination.

 

What a relief!  You can finally relax…. NOT so fast!

 

The next 10-14 days can seem like an eternity when you’re waiting for your pregnancy result.

 

Your emotions may ride that roller coaster … slow ascending hope, with glimmers of joy at the prospect that this time you actually may be pregnant … only to be violently interrupted by thunderous pangs of fear that this may not have worked, and then falling into despair.

 

How do you regulate your feelings and create a sense of balance so that you’re not held hostage by every emotion and negative thought that grips you?  Here is your mission for the next 10-14 days, should you choose to accept it:

 

  • Create a list of leisure activities that you and your partner have always enjoyed doing, and set a plan into action.  Yes, there are jobs and responsibilities, but schedule some “special” time together for these activities… whether it’s watching movies together, outdoor activities, date nights, music, or working together on a project that embodies a sense of satisfaction.  Not only does this help keep your relationship close – which in itself is emotionally enriching – but it may distract your attention and maintain some perspective on your life so that you are not feverishly focused on your fertility status.

 

  • Talk to your partner about your feelings.  There are no pat solutions which will stop your anxiety. However, making room for all feelings – even the darker ones – and knowing you will get through it as you ride this wave, will relieve the stress of suppressing these feelings. This will also keep the lines of communication open between you and your partner.

 

  • Restructure your thoughts! This is not to advise Pollyanna or positive thinking.  Let’s face it, the last thing you need is to be told to “be positive” or “relax.” It’s extremely difficult to feel “positive” when you’re struggling with infertility.  However, take a moment to look at the thoughts you are telling yourself – the thoughts that are causing your fear and anxiety to escalate: “I know I’m not pregnant.”  “It probably didn’t work this time.” “What if it doesn’t work this time?” “What if I never become pregnant?”   These thoughts and statements are not etched in truth, and are only fear-based. Better thoughts… which may be equally true, but are not fear based…are: “I could very well be pregnant.” “The possibility that I will become pregnant is just as much a reality.”  Don’t fear that allowing yourself to entertain these hopeful thoughts will cause greater disappointment from a negative result. You will be disappointed or devastated either way, whether you’ve been fearful, anxious, and negative, or you’ve had the perspective that you may very well become pregnant.  Here is a mental framework that is absolutely realistic, true, and can go a long way to helping you maintain peace of mind:  “I am doing everything in my power to become pregnant, and therefore, I can emotionally let go for now, and leave this in the hands of (God, the universe, my doctors).”

 

  • Selectively avoid situations that you know will trigger your fear or anxiety.   Learn to say “NO”.  People will forgive you for not attending a family function, social event, or any situation where you find pregnant people, or people with babies, or people who will ask you when you are going to have children.  YOU come first at this time in your life. YOUR emotional health takes precedence.

 

  • Nurture yourself. Whatever that means for you. Massage, Reiki, reading, movies, shopping, yoga (not hot yoga), — what do you find to be a relaxing, self-nurturing activity?

 

  • Remember proper breathing. Slow, deep breathing will cause a physiological reversal of the body’s stress response.  This will reduce anxiety and stress.  Learn to practice breath work every day.

 

In essence, have compassion for yourself.  Talk about your feelings with your partner.  If you find it difficult to restructure your thoughts, practice the mantra that you have done everything in your power, and now it’s time to let go.  This takes practice, but you can do it if you take on this mission for self-balance, peace of mind, and equilibrium.

 

http://www.publicdomainpictures.net/view-image.php?image=14919&picture=your-are-late

 

 

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