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Archive for January, 2016

IVF in a Snow Storm: 10 Survival Tips

By Tracey Minella

January 25th, 2016 at 6:16 pm

 

credit: T. Minella

 

So what do you do when….on top of the regular stress of an IVF cycle… there’s a blizzard of record-breaking proportions on the day of your retrieval or transfer? Or on the day of your IUI?

 

Suddenly, there are two feet down and no sign of it stopping.  It’ll take forever to dig out the car. Hey, where is the car?

 

“Are you kidding? Seriously?”

 

If you were lucky enough not to have had your treatment impacted by the weekend’s blizzard, here are some tips to keep in mind as you face the remainder of the snow season. The 11th tip: Breathe.

 

Here are 10 Tips for surviving your retrieval/transfer/IUI in a blizzard:

 

  1. Touch base with the RE’s office, during regular hours if possible. Otherwise, do not hesitate to call the nurse on call or service. Be sure you understand your instructions, follow the instructions, and know what number you should call in an emergency or if there is a delay in getting to your procedure.

 

  1. Be that person who actually has their general storm preparedness kit together so all you need to focus on is your treatment preparedness plan. Water, food, batteries, cash, gas, charge your cell phone, etc. Have a casserole-type meal in the freezer, too, for when you come home from your procedure.

 

  1. Pack a bag. (It’ll be good practice for when you are pregnant and ready to deliver.) Have copies of any important paperwork, insurance form, phone numbers for family and the doctor’s office, your cell phone, eyeglasses, and the comfy clothes you plan to wear to and from the procedure. If you’re able to bring a camera or camcorder, get that stuff ready and charged in advance.

 

  1. Know where you are going and know at least one alternate route to get there in case roads are closed. Have the address ready to input in a GPS. Better yet, use an app like Google Maps or Mapquest to print out at least two different routes to your destination. And put them in your packed bag. Then, gas up the car.

 

  1. Have emergency phone numbers ready in case you are stranded at home or on the road so you can call your local police department or fire department for help…especially if you’ve taken a timed hCG injection for IVF. Though there is a small window of flexibility, your retrieval timing is critical so that the eggs are retrieved before they are ovulated. Explain the situation and your need to get to the hospital or clinic immediately. (When I ran this scenario by my local precinct, they said they’d likely dispatch an ambulance.) After all, they are here to protect and serve.

 

  1. Line up help in advance…reliable neighbors or a service…for plowing or shoveling the driveway and have them arrive well before you need to leave for the hospital or clinic.

 

  1. Call your local village or town offices to explain your medical situation and beg them to have your road plowed early and often on the day in question.

 

  1. Borrow an SUV from a friend, or, if you just aren’t a confident bad weather driver, ask them to drive you to the hospital or clinic.

 

  1. Consider staying in a hotel very near the hospital or clinic if you live far away.

 

  1. If you have young children at home already, have a babysitting plan (with a back-up) ready in the event of an unexpected illness or weather-related school closing on your big day.

 

 

So what do you do if you didn’t plan in advance of the blizzard?

 

First, stay calm and call the doctor’s office. Follow their instructions. Then plan how to get there safely and quickly. Remember, a woman with swollen ovaries full of follicles on the verge of ovulation should not be shoveling snow nor doing anything super strenuous or potentially dangerous. If others can’t get your car out, call a friend, neighbor, reliable taxi, or emergency services to get you to the hospital or clinic.

 

When it all works out fine and you can take a sigh of relief, be sure to commit this story to memory. Hopefully, the tale of the blizzard you faced in order to have your child can be held over his or her head for years to come…especially during those teenage years!

 

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Did you ever have a blizzard or other “natural disaster” that threatened your treatment? Do you have any tips to add or advice or a story to share

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IVF and Comprehensive Chromosomal Screening (CCS) a/k/a Pre-embryo Genetic Screening (PGS)

By David Kreiner MD

January 20th, 2016 at 1:55 pm

 

credit T. Minella

In 1985, when I started my fellowship training at the Jones Institute, IVF technology was so new that we numbered each baby that was born as a result of IVF and it was still in double digits. People came to us for IVF from all over the world because our success rate was the best — at that time, just 15 percent.

The technology of IVF was so inefficient then, it was routine to transfer six embryos at a time. That’s what it typically took to create a singleton pregnancy. Sometimes the result was multiples. My experience with multiple pregnancies in those early years opened my eyes and heart to the additional struggles that accompanied patients’ tremendous joy at finally being pregnant.

With the discoveries and improvements in both clinical and laboratory procedures and techniques in the early 2000’s, success rates for IVF boomed… allowing for the transfer of a much more limited number of embryos that depended on patient age and embryo quality. Ultimately, the goal was Single Embryo Transfer (SET), the transfer of one high quality embryo to eliminate the additional risks associated with multiple pregnancies.

The challenge has been that, despite the transfer of an embryo that appeared of highest quality, one could not tell by simply looking under the microscope that the embryo was genetically normal. Abnormal embryos were not just less likely to implant, but if they did, would miscarry or result in an abnormal fetus.

Technology to test embryos with CCS to determine if they were chromosomally normal before transferring them into the uterus has been available for over 10 years but previously the test was often inconclusive, occasionally inaccurate, and potentially hazardous to the embryos. In addition, the test cost between $5000 and $7000. Today, CCS (also known as PGS) has improved to the point that it is nearly 100% accurate and rarely inconclusive or damaging to embryos and the cost is generally not significantly more than $3000, depending on the number of embryos tested.

Incorporating CCS/PGS into IVF will increase the ability for a patient to achieve a live birth of a normal healthy baby while minimizing the risk for a miscarriage and to do so in fewer embryo transfers since only normal healthy embryos need be transferred. It is envisioned that the additional cost of PGS will be offset by virtue of going through fewer frozen embryo transfers .

These 30 years, I have seen a number of game changers in IVF.  CCS/PGS may be among the most significant.

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Would you consider using CCS/PGD?

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Infertility and Powerball Dreams

By Tracey Minella

January 12th, 2016 at 3:19 pm

 

Photo credit: Mister GC/ freedigitalphotos.net


If I had $100 for every infertile woman or couple out there who is dreaming that the Powerball win could fund their fertility treatment, well… I’d be almost as rich as the eventual lucky winner.

Imagine what you’d do with that record-crushing fortune. You could aggressively pursue your fertility treatment, including some options that might currently be out of your financial reach. You could pursue adoption, or maybe surrogacy. Even do it all simultaneously! Imagine not having the financial stress on top of the stress of trying to conceive.

If I couldn’t claim the big prize, here’s what I’d like to say to the billionaire Powerball Winner:

You’ve just won more money than one person could spend in a lifetime and I’m sure you want to do some good in this world. After you have taken care of yourself and your friends and family, and are considering how to spend and invest the rest, please think of the infertile people who need your help and start a charitable foundation to help them become parents.

Yachts, trips, mansions, sports teams…they are all great fun and smart investments of time and money. But answering prayers and creating life? That’s truly priceless stuff. And fate has granted you the extraordinary means to do just that. Look at your parents. Look at your children. That kind of love is at stake. Please use your power to grow it.

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What would you do if you won? How would it affect your infertility journey and your future plans?

 

 

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Long Island IVF WINS– AGAIN!! Best of Long Island 2016: Best In Vitro Fertility Practice!

By Tracey Minella

January 10th, 2016 at 8:32 am

We are beyond excited to announce that… for the second consecutive year… Long Island IVF was voted the Best In-Vitro Fertility Practice in the Best Of Long Island 2016 contest.

And it’s all because of YOU!

To be the best infertility practice on Long Island means that you’ve trusted us not only with your care…but with your biggest dream. And that we came through for you in a way that compelled you to recommend us to others by voting.

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so humbled by this honor and so thankful to each and every one of you who took the time to cast a vote in our favor. From the moms juggling LIIVF toddlers… 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 get to do every day…build families. And that’s all the thanks we really need. However, when you recommend us to your friends and families and endorse us to the public by voting for us, you enable us to help even more infertile couples fulfill their dreams of building a family. And we’re thankful for that as well.

As we’ve done for almost 28 years, we offer patients our unique blend of cutting-edge medical technologies and holistic, personal support… wrapped in the comfort of a private, non-hospital setting. Because we believe all people have the right to pursue their dream of parenthood, we have long-offered family-building treatments specially designed for the LGBT community’s unique needs. We also offer grants and other programs to help make treatment options more affordable. https://www.longislandivf.com/ivf_grants.cfm

Thanks again for your vote and for trusting us with your care.

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Treating International Fertility Patients

By David Kreiner MD

January 7th, 2016 at 12:43 pm

 

Credit: WpClipart.com (public domain photo)


My wife says I don’t show my emotions enough.  Perhaps this is a flaw in my character. However, as a reproductive endocrinologist whether it is in the midst of surgery or under the gun of treating a patient from far-away lands like Sicily or Mongolia…keeping my cool has its benefits.

With international travel very much in the news lately, it made me think of my experiences treating international patients for infertility. And the added stress and honor that comes with being chosen for the job.

The patient from Taormina, Italy had already gone through gonadotropin/IUI cycles without success in Italy.  The wife barely spoke English. She was very nervous, not just because of her fertility challenge, but being so far from home and not being able to communicate well added greatly to her angst.  For me, a patient’s anxiety level is something that I am very sensitive to, and it could raise my own stress level…which it did.  However, add to that the fact that this couple left their home, lives and jobs to come all the way here for an IVF attempt that– if it failed– would require yet another transatlantic flight and additional weeks away from their normal lives.

I suppose distance plays into the potential stress factor since another patient– from Mongolia– who came to me at Long Island IVF was travelling, according to my astute Long Island sense of geography…from the opposite end of the world.  Yes, even for an unemotional seasoned infertility specialist like myself, I have to admit my heart pounds a little stronger in these situations.

Like for all my patients, I prefer to oversee their care personally and if possible perform their procedures even though I have complete confidence in the exceptional abilities of my partners.  I think patients like to see their own doctors that they have bonded with and trusted during the preceding weeks and months.

The intervening 10-14 days of nail biting time is rough for patient and doctor alike.  Fortunately, my Mongolian patient had the most beautiful baby from her first attempt and my patients from Taormina who I have become very friendly with, now have two of the most gorgeous children from two separate embryo transfers three years apart.

I guess sometimes I do let my emotions get the best of me…when I look at the baby pictures remembering all that I have been through with my patients including when I injected the embryos that we all saw as a drop of fluid in the uterus on the ultrasound machine…I still get choked up.

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Have you travelled out of state or the country (or would you ever consider it) for medical care? If so, why, and how far would you be willing to go? Do you have any fears of travelling related to contracting infection or disease?

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