Archive for November, 2016
By Tracey Minella
November 26th, 2016 at 8:49 pm
Is it common for those born through IVF to grow up to grieve their “sibling embryos” that were not born…either because they were never transferred or because they failed to survive the transfer or at some point thereafter?
As an IVF mom, an article I read about a woman who grieves her lost embryo siblings really got me thinking. The woman complained that no one understands her overwhelming grief… including her own parents… and that there are no appropriate support groups for IVF children who feel like she does. Will my IVF children feel this way someday? Is there anything I can do to prevent that from happening?
I wonder how many IVF children suffer from this grief and guilt. If given a name, would we call it “Survivor Embryo Syndrome”? Does it occur more often in only children born through IVF…children who may be longing for a sibling? Or is it extremely rare and that’s why support groups don’t seem to exist?
There are countless grown women and men who were conceived long ago through this miracle technology and could possibly be struggling with such feelings.
These adults were conceived before today’s recommended single or double embryo transfers…probably back when four embryo transfers were the norm. Imagine being the only one out of four embryos that survived? Wouldn’t it seem natural to often wonder “Why only me?”
Then again, sometimes all four embryos survived. In past decades, selective embryo reduction was often used in high order multiple pregnancies. A difficult and personal decision (and a controversial topic not without its own risks) selective reduction may be used to reduce the number of a high order multiple pregnancy, from quadruplets to twins or from triplets to a singleton, for example. It’s hard to imagine the conflicted feelings some of the surviving children of such cases might experience.
Why am I here and they are not?
Hopefully, IVF parents who may understandably be blinded to the plight of their lost embryos by their extreme thankfulness for the one that did survive will be mindful that their miracle may grow up with some survivor guilt issues.
If my own IVF daughter shares these feelings with me someday, I will certainly acknowledge them and help her process them in the same way we’ve always discussed how she came into this world. Age-appropriate information shared in many open discussions that always focus on our determination to have a baby and how very much we loved her even before she was born.
I’d tell her that it was fate that she was the one we were meant to have at that given time, even if it’s sad that so many other embryos with the potential for life did not come to be. I’d tell her there is a reason she is here and to live her life to the fullest, use her talents, be happy, be charitable, and do good things. And if she still needed more help than I could give her, I’d encourage her to talk with a professional counselor with experience in infertility-related issues, such as Long Island IVF’s Mind-Body Program specialist, Bina Benisch, MS, RN.
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What do you think about this survivor guilt issue? How would you comfort your IVF child or what would you do to prevent them from feeling any guilt over being survivors?
November 21st, 2016 at 8:32 am
A diagnosis of breast cancer is one of the most challenging health issues a person could face. This diagnosis is even more devastating to the woman who desires to have children the future. Treatments for the breast cancer may have harmful effects on the woman’s ability to conceive by adversely affecting the health of her eggs. In addition the hormonal treatments frequently used to help an individual conceive have the potential to worsen the breast cancer.
There is often turmoil surrounding the diagnosis of breast cancer. The individual, her family and physicians are appropriately focused on getting rapid effective treatment and survival. The issue of fertility may not be thought of until a chemotherapeutic plan is just about to start or has already been initiated.
Since there are fertility preserving options for the individuals facing breast cancer treatment, these options should be considered. If time allows eggs or embryos may be frozen for future use. The use of such procedures depends on many factors, primarily, will such treatment have a negative effect on the woman’s disease. If in the patient’s and oncologist’s judgment fertility preservation is an option it should occur rapidly to allow for the timely treatment of the breast cancer.
The key is for the oncologist and patient to be aware and discuss the potential for fertility conservation treatment prior to the start of chemotherapy. This opportunity for discussion may be lost in the unrest that surrounds the diagnosis. Breast cancer awareness month, October, 2016, creates a platform to raise these issues and help both individuals and health care providers come more cognizant of available treatments and the importance of timing these treatments to maximize future fertility.
By Tracey Minella
November 18th, 2016 at 11:30 am
Tagged with Best In Vitro Fertility Practice on Long Island, Best Infertility Practice on Long Island, Best of Long Island, Best of Long Island Winner, BOLI Best In Vitro Fertility Practice 2016, Fertility, Infertility, Long Island IVF
Even though the presidential election is over, there is still plenty of voting to do!
Long Island IVF is excited to announce that– thanks to your support–we have again been nominated “Best In Vitro Fertility Practice” in the Best of Long Island (“BOLI”) 2017 Contest. This year’s nomination comes after our practice WON the contest for the past two consecutive years!
Thank you to all of our patients and their families for nominating us in this public opinion-based contest again. Word-of-mouth recommendations have always been the cornerstone of our practice and we appreciate you taking a moment to cast a vote in our favor. Now that nominations are done, voting for a winner is underway.
Can we count on your votes to help us continue our reign for the upcoming year?
The voting period to determine the one ultimate winner in the “Best In Vitro Fertility Practice” is underway now and runs until December 15 and voters may cast one vote per day, per category, per IP address.
For those interested in voting for any of the many businesses or service providers who have been nominated, you may do so at: http://bestof.longislandpress.com/voting-open/ Find us under the Health & Wellness category, under “In-Vitro Fertility Practice”.
Again, thanks for nominating us. We love what we do… and love who we do it for!
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So how did YOU come to hear of Long Island IVF?
Was it a recommendation from friends or family? Your gynecologist? A print or radio ad? The internet? Research into our success rates and innovative programs? Something else? What brought you into the practice?
By Tracey Minella
November 8th, 2016 at 5:33 pm
Tagged with Coming Out Infertile Day, Election Day, Election day and infertility, Fertility, Infertility, infertility and politics, Infertility legislation, IVF for Vets, Long Island IVF, resolve, The Reveal, Trying to Conceive
Today, what feels like the longest, most controversial, and unprecedented presidential election campaign will finally come to an end. Sadly, and on a level not seen before, families and friendships have been broken over this election and we are all watching and holding our collective breath for the results as well as the potential aftermath.
But this post is not to persuade anyone on whom to choose. We each have issues that are important to us and, for some, the choice today may come down to which candidate supports our most important issue.
This post is to reflect on how the infertility community affects political change and public awareness of infertility.
Behind the scenes—and often center stage—countless people fight continuously for the rights of the infertility community. Some advocates are infertile right now; others may have already resolved their infertility but want to help those suffering today—and tomorrow. Some want to see certain groups, such as military veterans, get medical coverage for assisted reproductive technology. While others just want mandated infertility and adoption coverage for all.
There’s a lot going on in the political and infertile world—some front-burner and other back-burner movements.
A couple of months ago, after years of advocacy, the commonly-called #IVF4Vets bill, also known as MilCon-VA, was finally passed, removing the VA-bar on IVF treatment for veterans. This change is the first step toward providing IVF to military veterans who are infertile as a result of their military service. Unfortunately, it’s often one step forward and two steps back when it comes to gaining political ground. At practically the same time, what’s been coined the proposed Harris Embryo Amendment entered the picture. It’s also been called “the worst piece of federal legislation ever introduced”*.
The Harris Embryo Amendment would be a real threat to federally-funded IVF. In a nutshell, it would prohibit the federal funding of any IVF treatments in a federal government facility in which there is a possibility that any resulting viable embryo could be discarded or destroyed. Since excess embryos are not only commonplace in IVF, but generally an unavoidable result of the treatment, the mandated transfer of all fresh embryos would actually, in most cases, be detrimental, since the current standard practice is generally transferring only one or two embryos per cycle. In addition, the survival and use of all embryos thawed after cryopreservation cannot be guaranteed. So, the proposed amendment may threaten federally-funded IVF and cryopreservation as it now exists.
There have been other political initiatives in recent years on behalf of the infertile, including but not limited to the Family Act and the Adoption Tax Credit Refundability Act. As assisted reproductive technology continues to advance and the demand for these services grows, we can expect to continue to advocate both for and against new legislation.
So, after this election—and maybe just a short break from the politics—consider becoming more involved in infertility-related advocacy and legislation. The first and best step would be to reach out the RESOLVE: The National Infertility Association—the group that fights tirelessly for the rights of the infertile community. (Thanks, RESOLVE!) You can check out the political initiatives here.
And if you are overcome with infertility-related sadness and stress as the holiday season is approaching, please let us help you.
In an effort to increase public awareness of infertility before the special stress of the winter holiday season hits those who are suffering in silence, Long Island IVF is sponsoring the second annual Coming Out Infertile Day with “The Reveal: A Coming Out Infertile Workshop” on November 17th from 6:30-8:00 pm at our Melville office.
This free workshop will be led by our own Mind-Body Medicine expert and psychologist, Bina Benisch, MS, RN, who specializes in counseling infertility patients and will focus on helping infertile people work through the obstacles that may be preventing them from coming out to their family and friends. The focus is to help those who would like to “come out” to do so in a way that’s right for them, so they can get the support they need. All are welcome. Pre- registration is required here. Like our Facebook page or Coming Out Infertile Day page for information on how to join the social media movement on Nov 17 to come out infertile with one easy graphic and one click-again for those who are ready to do so.
Now, go ahead and vote!
*Barbara Collura, RESOLVE
By David Kreiner MD
November 7th, 2016 at 7:45 am
The theme for the 2016 ASRM (American Society for Reproductive Medicine) conference in Salt Lake City, Utah was “Scaling New Heights in Fertility”. As one whose life on Long Island sheltered me from views of snow-capped mountain tops, the perspective of the attendees appeared to climb higher and perhaps to possibilities never previously conceived.
I summarize here 4 Hot Fertility Questions that were debated and discussed in the conference:
1) Should PGS screening be routine for all IVF patients?
2) Should all IVF transfers be restricted to blastocysts only?
3) Should we freeze all embryos and transfer in an unstimulated cycle?
4) What is the best treatment for the patient with diminished ovarian reserve?
Should PGS screening be routine for all IVF patients?
The theoretical benefit of Pre-Implantation Genetic Screening, or“PGS”, testing is that it allows one to select a single “tested normal” embryo in the presence of multiple embryos which is more likely to implant and less likely to miscarry. Absent testing the chromosome number of the embryos, to insure a similar chance of conception one might transfer two embryos– increasing the likelihood that twins would result in a pregnancy at greater risk for prematurity and complications affecting the health of the babies. Most miscarriages are the result of abnormal chromosomes and if the embryos had normal chromosomes then there should be less of a chance the pregnancy would result in miscarriage.
The argument against routine PGS testing is based mainly on the fact that the test is not 100% accurate or predictive of either normalcy or abnormalcy in addition to not obtaining a result in some cases. It is argued that the error rate is only 1% but there is a phenomenon called mosaicism where an embryo may have more than one cell line. It is not rare that an embryo which has an abnormal cell line in addition to a normal one can, during development, shed the abnormal cells and evolve normally. However, PGS testing may pick up only the abnormal cell or detect both normal and abnormal and then there is the question of what to do with the mosaic embryos since there is no current way to predict whether these embryos will ultimately be normal.
Another argument against routine PGS testing is that most abnormal embryos never implant anyway and that perhaps the reduction in miscarriages with PGS is not as great as predicted. Still another argument that holds true for younger patients in particular is that the pregnancy rate for a single blastocyst transfer is nearly as high without PGS testing and that one can achieve equal success without the risk of discarding potentially normal embryos.
Should all IVF transfers be restricted to blastocysts only?
In addition to improving the ability to select the best embryo, the proposed advantages of a blastocyst transfer (typically 5-6 days old) versus a cleaved embryo transfer (usually 3 days old) include the following:
- an embryo transferred 5-6 days after ovulation is closer to the natural physiologic state
- there are thought to be fewer uterine contractions 5-6 days post ovulation than 3 days;
- blastocysts have a larger diameter and are thought to be less likely to be pushed into the fallopian tubes—which may lead to a lower ectopic pregnancy rate;
- there is a shorter time to implantation and therefore less opportunity for a deleterious event to occur to an embryo in the uterus.
However, there are some patients, in particular older or those with more fragile embryos, which have been shown to fail to conceive on multiple occasions after a blast transfer but successfully get pregnant and deliver healthy babies after transfer of cleaved embryos. Furthermore, there is evidence that in some of these cases embryos that may have been destined to otherwise result in a normal pregnancy may fail to develop to blast in the laboratory.
Should we freeze all embryos and transfer in an unstimulated cycle?
There is a growing consensus nationally among IVF programs that the endometrium is less receptive to embryo implantation during a stimulated cycle–especially one in which the estradiol and/or progesterone levels are high. Although convincing patients to delay transfer to a subsequent unstimulated cycle is a challenge, growing evidence is pushing the field in this direction.
What is the best treatment for the patient with diminished ovarian reserve?
Optimal treatment of the patient with diminished ovarian reserve remains a challenge to the IVF program. There is growing evidence that adjuvant therapy, including such things as acupuncture and Chinese herbs as well as supplements such as CoQ10 and DHEA, may improve a patient’s response to stimulation and improve pregnancy rates. Other strategies include sensitizing follicles with estradiol and/or Growth Hormone pre-treatment and banking embryos from multiple cycles with transfer during an unstimulated cycle. Still another strategy is milder stimulation in an attempt to improve the quality of the retrieved egg/s.
There were many heights achieved during this meeting and to this boy from Queens I was impressed not just with the science and the breathtaking vistas of the regal mountains forming a horseshoe around Salt Lake City but also with the most pleasing goodness of the people native to the city who genuinely offered their time to help make our experience a pleasant one.
By Tracey Minella
November 4th, 2016 at 1:30 pm
Tagged with Bina Benisch, Coming Out Infertile Day, coping with infertility, infertile on the holiday, Infertility, Infertility Support, LGBT, Long Island IVF, stigma of infertility, stress of infertility, The Reveal, Trying to Conceive
Long Island IVF is proud to sponsor the second annual “Coming Out Infertile” Day on November 17, 2016 and The Reveal: a special pre-holiday season workshop for those suffering in silence from infertility.
Infertility is a devastating disease that affects 1 out of every 8 couples. In addition to the pain and fear that comes with this diagnosis, many couples feel the unwarranted stigma of shame and guilt. Consequently, they keep their infertility a secret—even from their family and closest friends.
They are often afraid…or don’t know how… to tell their families and friends (or their employers) that they are having trouble getting or staying pregnant and need treatment. So they suffer in silence. Often for many months or years.
Coming Out Infertile Day (andThe Reveal workshop) was conceived to encourage those suffering from infertility to “come out” to their families, friends, and/or employers if they feel ready to do so… and to help them with the tools they need to do so. And most importantly, to come out in a way that feels right for them.
The holiday season, with its focus on children and families, is a particularly hard time for infertile folks who are easy targets for nagging personal questions about baby-making plans.
What we wouldn’t give to have a pregnancy test kit with two lines on it.
Coming Out Infertile Day…seven months after National Infertility Awareness Week in April and right before the stress of the winter holidays…is a timely public reminder of the pain of infertility and a chance for those suffering to come out and get support.
Long Island IVF is offering a The Reveal—a free Coming-Out Infertile Workshop on November 17, 2016 from 6:30-8 pm at its offices at 8 Corporate Center Drive, Melville, New York. Led by our own Mind-Body medicine expert and psychologist, Bina Benisch, MS, RN, who specializes in counseling infertility patients, attendees will be given the support they need to come out infertile in a manner that’s right for them. In addition to this free group counseling, attendees will receive sample scripts and template letters to customize to help them. Are you ready to tell just your parents? Or your best friend? The whole family? Need to know how to break it to your boss? We can help. All are welcome. The workshop is free but pre-registration is required, so register here: http://bit.ly/therevealCOI2016.
Sometimes a picture is worth a thousand words. So, for those ready to fully and publicly come out, Workshop attendees will be able to be part of Coming Out Infertile Day’s social media campaign where you can easily upload and share your photo with the official #Comingoutinfertile hashtag and graphic on various social media platforms by using the easy and free app, PicStitch. You do not have to be a Long Island IVF patient to participate. All are welcome and encouraged to be part of this empowering event!
Or be with us virtually!! Those unable to attend can use the #ComingOutInfertile social media PicStich app instructions coming soon. So, like our Long Island IVF Facebook page and/or the Coming Out Infertile Day page to stay on top of this movement.
It’s time to end the stigma of infertility. It’s time to unburden yourself from the added weight of this secret and get the support you need. It’s time to #comeoutinfertile. Join us in person or on social media on 11-17. Be part of the movement no matter where you are in your infertility journey.
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What is holding you back from coming out infertile? Are you ready to join the #comingoutinfertile movement?