Archive for August, 2016
By Tracey A. Minella
August 28th, 2016 at 7:28 am
And just like that, she was gone.
How is it that the six year infertility journey dragged so slowly and these 18 years flew by so fast?
Infertility never left me completely. It impacted my parenting experience in ways I couldn’t have imagined. In those first few weeks, I never left the couch. I literally held her all day long—asleep or awake—trying to process that she really was here at last.
Yes, I was THAT mom. Totally and unapologetically over-protective. I was the last mom to let her stay all night at a sleepover. The one who grilled the hosts about teenage brothers, the house alarm system, the escape route in case of fire, dog bite history, hunting rifles in the house, well, you get it. I wore the “Seatbelt Nazi” title with pride when reluctantly allowing my precious cargo into the cars of other parents. I promise I wasn’t crazy—just ever mindful of the gift she was and always fearful of losing this dream come true.
Life after infertility isn’t always “happily ever after”-even with a princess in your arms. Like all good fairy tales, there’s also villains and drama, but a mom who slayed the infertility dragon can face anything. There were good times and challenging ones, milestones and accomplishments. We were just a happy, regular family. We hosted endless kid’s gatherings, mother-daughter tea parties, huge Halloween parties, Christmas cookie baking days, and super unique birthday parties. I was the Girl Scout leader, class mom, and all around volunteer. Countless memories were captured on camera in pictures I already look longingly back on just two weeks after she’s gone away.
“Let her fly!”
I hate that expression. Not only because she’s not a bird, but because she’s my girl and she’s 6.5 hours away and I miss her. I’m so happy for her and so proud of her, but her life—as wonderful as it promises to be—is diverging from mine, and it’s hard to let go even if that’s the natural order of things and even though she’s at the perfect school for her and is adjusting well. I recently read a great description somewhere about the feeling of loss after college drop-off…that it’s not a tragedy or a death, but it’s not nothing either.
It’s definitely not nothing.
I’ve noticed parallels between the infertility years and the college send-off experience in the concepts of time, loss, emotions, and hope.
Time drags when you’re trying to conceive and also crawls when you’re staring down a calendar awaiting parents’ weekend at college or trying to fill the hours you spent each day for the last 18 years being needed for food, clothes, hugs, or rides by that now missing child. Still two flips of the calendar to go before I see that sweet face again.
There’s the emptiness that washes over you during each loss or failed attempt to conceive and each fearful thought– that you don’t even want to whisper to the universe– that you’re not sure if you will ever have a baby. And then there’s the emptiness when life takes your child far away, even if it’s on to bigger and better things for them because it changes the role you suffered so long to earn and that you’ve cherished from the moment she took her first breath. Now, there’s a life being made without you in it, with friends you don’t know and experiences you’re not sharing. And it’s all good for her, yet it still hurts as you learn to step back to a daily life without that child, or perhaps any child, in it.
A wave of second-guessing hits a mom facing college drop-off as she uneasily asks herself, “Was I a good enough mom?”, remembering those promises to be “the best mother ever” that she made in those long-ago bargains with God or the universe. She reflects on those times she wasn’t perfect, yearning for a do-over. With misplaced guilt, she hopes her child will forgive any missteps that derailed the plan to deliver a childhood so magical that Disney would have to up its game just to keep up. She hopes her now grown child will reflect on her childhood as being maybe not perfect, but perfect for her.
Today I’ll confess that part of me is jealous of those of you whose miracles haven’t arrived yet because I know the 18 years of pure joy, love, and wonder that is likely on its way to you if you stay the course. And for those making childhood memories now, I have only two words of advice…don’t blink. Those old people I once gave imaginary eye-rolls to were right about the speed of time. I’m so thankful and honored for every minute of this blessing so far.
For every one of you who has sent your miracle off into the world, congratulations on surviving what may have been one of the hardest losses you’ve faced since trying to conceive them. Believe it will get easier, as those who managed this transition before us promise. Trust that they know the depths of your love for them, your pride in them, and your gratitude for being the one chosen to parent them. And as we’ve done since the journey to conceive them began, look forward with hope to the blessings the future will bring.
* * * * * * * * * **
By David Kreiner MD
August 18th, 2016 at 9:50 am
I was cooling off in my community pool and a former patient recognized me and proudly showed off her 13 year old daughter…”just Clomid® right?”, I asked, a trite too brash. “Yes, and insemination after a couple of failed attempts,” she replied.
I sometimes assume if a patient doesn’t have to do IVF to conceive that they have not sufficiently suffered the infertility rites of passage. Shame on me…for someone facing the challenge of conceiving, the pain can be most severe and if solved with fertility pills—Clomid®–then it is just as miraculous a cure as the newer technologic marvel of IVF.
I have experienced in my 31 years as a reproductive endocrinologist specializing in fertility several hundred such successes and babies born from this highly successful fertility pill that was developed by a team in the 1950’s led by Frank Palopoli who died last week at the age of 94.
Clomiphene®, the generic form of the estrogen receptor inhibitor that came on the market in 1967, works by blocking the negative feedback of estrogen resulting in an increase of pituitary hormones, FSH and LH which in turn stimulates the ovaries to ovulate.
Clomid® may be used by itself or augmented with injections of LH and/or FSH as well as HCG used as a trigger for ovulation when the ovarian follicles stimulated by Clomid® have reached maturity. The pills are usually taken in the beginning of the cycle for five days and the response carefully monitored with serum estradiol and LH levels as well as follicular ultrasounds.
As tens of millions of babies have been born since Mr. Palopoli developed Clomid® we in the field and those who have reaped the rewards of this medication owe him a tremendous debt of gratitude.
* * ** * * *** *
Did Clomid® play a part in your fertility journey?
By Tracey Minella
August 12th, 2016 at 5:51 pm
These days are pretty emotional around the office as the Long Island IVF babies of a few of the current and former staff are going off to college and military academies!!! Imagine that. We’ve been making IVF babies so long here—since 1988– that a bunch of our babies are flying the coop all at once! It seems we were all just pregnant together, nearly 18 years ago. (Good luck Tori, Eric, and Nicolette!)
Maybe yours are leaving, too?
Or maybe they’re starting kindergarten. Or you just brought them home from the hospital. Or maybe you’re pregnant at last and waiting with baited breath for the big arrival. Or you’re currently in treatment and hopeful during the two week wait.
All those moments seem like just yesterday…*sigh*
Consider sharing your Long Island IVF baby moments! After all, we’re all family.
Please join us as we share these milestones on social media. Whether you’re a Facebook fan, or love to Tweet, or are heavily into Instagram, we’d love it if you’re comfortable sharing your posts and pics on our social media accounts– so just tag us if you’d like to share your pride and joy.
These photos and shared experiences give hope to current and prospective patients that they will have their miracles and their lifetimes of shareable moments, too. Too often, we see the babies shortly after birth and then life gets in the way. We’d love to see our your babies more often, especially when they are celebrating milestones.
* * * * * * * ** * *** *
What’s your little miracle up to?
By David Kreiner MD
August 11th, 2016 at 1:41 am
What treatment might Olympic athletes and fertility-challenged women have in common?
Evidence of Cupping on many competing in the Olympics, especially the swimmers, has made quite a splash…but what is cupping and why the purplish circular marks on the skin?
Cupping is a form of traditional medicine found in many cultures throughout the world. This treatment involves placing cups containing a negative pressure which exerts suction onto the skin that if left on long enough breaks small blood vessels or capillaries resulting in a bruise in the affected area. This sounds painful, but it isn’t.
Cupping is a popular form of Traditional Chinese Medicine (TCM) that works to unblock “Qi”, a form of life energy. Once unblocked, the energy can flow smoothly throughout the meridians or pathways in the body.
With cupping, TCM practitioners, commonly called acupuncturists, help to remove congestion and stagnation (stagnant blood and lymph) from the body and to improve the flow of “Qi” throughout the body. It also will increase the blood flow to the area upon which the cup is applied.
Musculoskeletal disorders are aided by increasing the flow of blood and “Qi” to the muscles underlying the applied cups. Hence, Michael Phelps and other Olympians have been going for cupping treatment to alleviate their sore muscles. Some TCM practitioners will also use cupping to treat breathing problems or respiratory conditions such as a cold, bronchitis or pneumonia.
Cupping may also be utilized to improve fertility in conjunction with acupuncture, moxibustion (heat applied to acupuncture point through burning herbs) and/or herbal therapy. From a TCM perspective, improving the flow of “Qi” at specific points or meridians may correct an imbalance that is preventing conception. From a Western scientific view, cupping and acupuncture cause the body to release endorphins. The endorphin system consists of chemicals that regulate the activity of a group of nerve cells in the brain that relax muscles, dull pain, and reduce panic and anxiety.
It is believed that these therapies may also trigger the release of more hormones, including serotonin. Serotonin is a brain chemical that has a calming effect resulting in a serenity that aids the fertility process. Cupping, like acupuncture, reduces inflammation which could also benefit fertility. Whether it be the challenge of an Olympic trial or a battle against infertility cupping may be a valuable addition to one’s program.
By Dr. Michael Zinger
August 4th, 2016 at 3:43 pm
Every woman is born with a limited supply of eggs. As this supply ages, the likelihood of each remaining egg to have the capability to become a baby diminishes. However, this loss of potential is not spread evenly over the years, rather it is a shallow decline that usually continues into the mid-30’s, followed by a steeper loss that typically happens from the late 30’s into the early 40’s. Over a matter of 5 years, the odds of one egg having the potential to make a baby decreases by about 80%. Of course, not every woman is typical and the age at which this transition starts can vary quite a bit.
The only way to effectively protect the potential of eggs over time is cryopreservation, also known as egg freezing. Once frozen, the capacity of the eggs to create a successful pregnancy is maintained through the years.
Gynecologists often ask me at which age to refer their single patients to me to discuss egg freezing. The answer is not simple. Certainly we do not want to put a patient through this process if it is likely that she will meet the right partner and form a family without ever using those eggs. It would have been an unnecessary medical procedure with associated expense and lost time and effort.
On the other hand, we have to weigh the risk that the steeper decline in the eggs’ potential will happen before the woman has met her future partner and completed her family. If we could predict when that decline will happen in each woman then this question would be much easier. Unfortunately, our testing is only accurate in identifying this steeper decline when it is already occurring, at which point we have already missed the opportunity to freeze high-potential eggs.
Most of my egg-freeze patients are in their mid-30’s. On average, at this point, only subtle changes in the potential of eggs have occurred, whereas within a few years, more drastic changes usually start. Therefore, this timing does make sense for most women, but not everyone.
A concern about waiting until the mid 30’s is the possibility of an earlier decrease in egg potential. While that is unusual, it tends to also be unpredictable. Factors that contribute may include a history of smoking, a history of ovarian surgery or conditions that may lead to such surgery (e.g. endometriosis), or having a mother or older sister that experienced either an earlier menopause or infertility due to loss in egg potential. Women with these factors should consider freezing eggs in their early 30’s or even late 20’s. But, most often, if an early decrease occurs, it is without any predisposing factors and with no known cause. Therefore, even without predisposing factors, cautious women, who want to minimize the risk of missing the opportunity, should also consider freezing their eggs in their early 30’s.
Of course, just as some women unpredictably have an earlier loss, some also have good potential that persists even past 40. This can be determined at an initial visit with a fertility specialist through sonogram and blood tests. So, for women who have not yet frozen eggs, even at 41 or 42 it makes sense to come in for evaluation and determine if this could still be worthwhile.