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Archive for March, 2017

Long Island IVF Celebrates National Doctor’s Day

By Tracey Minella

March 30th, 2017 at 8:48 pm

 

L-R Drs. Brenner, Pena, Kenigsberg, Kreiner


You’ve trusted them with more than just your medical care. You’ve trusted them with your future…with your dreams of having a family. They are your Long Island IVF doctors. And we celebrate them today on National Doctor’s Day. (Camera shy today are Drs. Zinger and Droesch!)

For almost 30 years, the doctors at Long Island IVF have been helping Long Islanders become parents through advanced assisted reproductive technologies like IUI and IVF. We were responsible for such milestones as Long Island’s first IVF baby, its first Donor Egg baby, and its first IVF baby from a cryopreserved embryo. We are often the first practice in the region to offer the newest technologies and treatments in family-building.

Whether you came to one of our doctors through a trusted recommendation from family or friends whose families we helped to build, or you found us through conducting your own research into Long Island IVF’s history, we are so glad you chose our doctors.

There is a beautiful transition that often happens between a patient and her doctor. What starts out as a queasy mix of hopefulness and fear at an initial consultation—where you lay your story and feelings there at the feet of an expert who is still a stranger—often develops into a partnership in care that leads to that sought-after pregnancy. Not always unfortunately, and that is devastating to both the patient and the doctor. The journey may be short for some, longer for others, and stressful for all.

Your doctors pour over your case and feel enormous responsibility to help you succeed because they know how much is on the line. They don’t really exhale until you are sent back to your ObGyn for pregnancy care with a healthy sono photo in your hand.

And nothing makes them happier than when they get to meet your little ones at the annual LIIVF family reunion– or any time you want to drop in for a visit.

If there is a special doctor at Long Island IVF that has touched your life, feel free to give a “shout-out” right here in the comments to let them know how much they mean to you. It will make their day! (Hey Dr. Kreiner, if you’re listening—thanks for the two miracles!)

Now it’s YOUR turn…

Shout out begins now!

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Who is your favorite LIIVF doctor?

 

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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015- 2016- 2017

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 and 2016 and 2017 contest…three years in a row!

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 29 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. 631-752-0606.

 

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To Snip or Not to Snip…DNA Discoveries Making Science Fiction Fact

By David Kreiner MD

March 28th, 2017 at 1:04 pm

 

image purchased at shutterstock


Working in the field of In Vitro Fertilization (IVF) for over thirty years, I am in awe of the powerful potential our technology offers. Today Pre-Implantation Genetic Screening (PGS) is routinely offered to fertility patients undergoing IVF to test the chromosomes of embryos that a patient has created prior to Embryo Transfer.  If PGS shows a normal complement of chromosomes then a single embryo transferred has an approximate 50% chance of resulting in a pregnancy with a less than 10% chance of miscarriage.  As gender can be identified by this process, selection based on gender is available.

Many question the ethics of any manipulation of embryos including selecting the embryo for transfer based on gender.  Although I am not fond of those equating family balancing with genetic engineering, I do share their concern of clinical tampering with the DNA of embryos.

Technology in IVF is reaching the point where DNA may be snipped, removed and/or implanted.  Clinically, one can foresee where diseases and serious health conditions may be cured or prevented by such pre-embryo manipulations.  Though I am tempted to cure or eliminate disease and serious health conditions, I worry that when we snip to cure we may unknowingly create some new malady– perhaps of a nature we have not previously envisioned.

The Brave New World of Aldous Huxley may be upon us but whether you view this world as positive in its ability to give man the power to eliminate disease or negative because you fear that man in his limited knowledge is apt to cause unforeseen damage is based on your own individual perspective and it is society’s duty to control in a responsible way the utilization of this new technology.

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Do you see the power to eliminate disease by snipping, removing or implanting DNA as a positive or negative? Why?

 

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Spring Into Action Ideas for Infertility Warriors

By Tracey Minella

March 23rd, 2017 at 1:10 pm

 

credit: Gratisography-Ryan McGuire


Are you the “all happy for the official start of spring” type? Or a crank who can’t adjust to losing that hour of sleep? (There’s no correct answer!)

Worn down by winter and overwhelmed by infertility’s challenges? You’re not alone. But spring is here now…at least on the calendar if not by the forecast. It’s time to change things up a bit.

The most frustrating thing about infertility is the lack of control over everything– your dreams, your life, and your body. The longer you live in this frustrated state, the greater the chance you’ll feel stressed or depressed. Your “fuse” gets shorter and the littlest thing that upsets your routine can…understandably…throw you off. Even that single hour lost may have affected your routine and added to your exhaustion and crankiness for days!

Why not turn it all back around to your benefit?

Start with a small block of time. Make a change for the better and take back some control this spring. Just a bit.

Imagine committing to even one small change in your day…one that you choose. One that you want. One that you… control.

No need to be drastic or crazy or set a lofty goal you can’t reach (which will defeat the purpose here). Pick something do-able and fun that is just for you. If it happens to have an added fertility-boosting benefit, that’s even better. But the main goal is that you feel better, either physically or emotionally, or both. And that you feel more in control of your life.

Here are a few examples of little things you can consider:

  • Drink more water. You’ll feel and look better and the health benefits are countless.
  • Make a “To Do” list before bed. You’ll sleep better knowing your next day is planned out and you haven’t forgotten something. Then, spend 15 minutes on your most important task first thing in the morning if you can, so you start off on a positive, less stressed note.
  • Exercise…even for just 10 minutes each day. Even a walk to clear your mind will help. If that seems like root canal, just pick something fun that makes you move. Anything.
  • Keep a daily gratitude journal. List 3 things you have to be thankful for. It will keep you grounded in positivity and give you an outlet for your feelings.
  • Sleep more. Take a power nap at lunchtime of you’re feeling tired or treat yourself to an early turn-in at bedtime. Even 30 minutes would feel indulgent. Trust me.
  • Meditate. It could be in a fertile yoga class or just grabbing 15 minutes of quiet, uninterrupted “you” time on your den floor– or outside if it ever warms up again. Why not come to Long Island IVF’s upcoming free fertility yoga event during National Infertility Awareness Week in April? Register here.

Of course, if you’re really feeling overwhelmed, you might consider a group or individual therapy session with Bina Benisch, M.S., R.N., our counselor who specializes in helping those suffering from infertility.

What kind of big impact could these small changes make for you? How about committing to one of them…or some other change that works for you? Let’s see what a difference a small change that you control can make in your life in 30 days.

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What is your “take control” action plan for spring?

 

 

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Long Island IVF’s Dr. Zinger is now in Lake Success and Brooklyn

By Tracey Minella

March 22nd, 2017 at 12:27 pm

We are happy to announce that Dr. Michael Zinger has joined Dr. Daniel Kenigsberg and Dr. Steven Brenner in seeing patients at Long Island IVF’s Lake Success location. Dr. Zinger will continue seeing patients in our Brooklyn office as well.

Dr. Zinger has been with Long Island IVF since 2008 as the reproductive endocrinologist who anchors our Brooklyn facility. He enjoys a loyal patient following and has just branched out a bit eastward to reach even more patients closer to where they live and work.

Uniquely-qualified with dual board certifications in Reproductive Endocrinology and Infertility as well as OBGYN, Dr. Zinger appreciates the difficulty frustrated patients face when choosing an infertility specialist as well as the trust it takes for OBGYNs to refer patients out to him for advanced infertility care.

Consistently ranked by his peers as a “SuperDoc” in the New York Times and selected for the Patient’s Choice and Compassionate Doctor awards on vitals.com, Dr. Zinger makes quality, compassionate patient care a priority. He’s one reason the public voted Long Island IVF the “Best In Vitro Fertility Practice” for three straight years– 2015, 2016, and 2017.

Prior to joining Long Island IVF, Dr. Zinger spent six years heading the IVF program at Edwards Hospital. A prolific author of medical textbook chapters and medical journal articles, as well as a presenter at numerous national and international medical meetings, Dr. Zinger was also the recipient of The Endocrine Society’s prestigious Senior Fellow’s Award for outstanding research. His complete bio can be viewed here.

If you are looking for a trustworthy and experienced infertility specialist in the Lake Success or Brooklyn area, you can book an appointment with Dr. Zinger by calling (718) 375-6400 for Brooklyn or (516) 358-6363 for Lake Success.

Long Island IVF has multiple offices throughout Long Island as well as in Brooklyn for your convenience.

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Infertility, Lucky Charms, and St. Patrick’s Day

By Tracey Minella

March 11th, 2017 at 10:32 pm

 

image: wpclipart


 

Let’s raise a glass to one of the few holidays that’s not focused on children!

 

Other than spotting those little scouts at a local parade, St. Patrick’s Day—or night—is a time where a good part of the country…legit Irish or wannabes…gets downright hammered. (Not that we advocate that or anything…wink, wink.)

 

So what are you going to do?

 

If you’re a cycling infertility patient, you’ll likely resist the urge to drown your TTC sorrows in a pint of green beer, sacrificing the party for the benefit of the potential life you’re trying to create. Hey, there’s no shame in being sober on St. Patrick’s Day! Be the responsible designated driver–it’s great training for all the parental responsibility and sacrifice that might be just over the rainbow for you.

 

So what about all that “luck o’ the Irish” stuff? As a half-Irish lass myself, and one who did my share of IVFs before having success, I thought it was a farce—a scam. C’mon, if I was really lucky, I wouldn’t have needed IVF to conceive. And, might I add, I’d have had a pot o’ gold to finance it all. But, nooo.

 

Do YOU believe in lucky charms for fertility?

 

There are more symbols associated with good luck and fertility than you can shake a shillelagh at! There are frogs, acorns, and of course, eggs. You can buy statues and jewelry of these and other symbols. I once bought a cheap pewter Chinese fertility symbol on a thin black leather necklace. Couldn’t hurt, right? Today, there are many fertility jewelry sites that make beautiful handmade items if you’re open about the struggle.

 

I also had a lucky charm. It was a gift from a casual friend from work who was moving out of state and knew of my infertility secret. She gave me a pretty mirrored compact with a little cameo angel on top…for luck. I had it with me when I finally had my IVF success. After my angel was born, I tucked it away, figuring I’d give it to my girl one day and tell her its special story.

 

But a few years later, I had a co-worker who was TTC and was moving to Florida. I thought of my lucky compact and everything suddenly became clear. I told her the story and gave it to her on the following condition: She was to use it as long as she needed it and then pass it along to someone else who was TTC, with the same instructions.

 

This travelling compact is touching lives and spreading love and luck throughout our sisterhood.

 

Now that’s worth doing a jig over.

 

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Have you given or received a lucky charm? What is it and what is the story behind it?

 

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March is Endometriosis Awareness Month

By David Kreiner MD

March 1st, 2017 at 12:20 pm

 

photo: Ryan McGuire/gratisography.com


I don’t have to tell you that endometriosis can be a very painful illness and that it can cause infertility. It is often a reproductive lifelong struggle in which tissue that normally lines the uterus migrates or implants into other parts of the body, most often in the pelvic lining and ovaries. This leads to pain and swelling and often times difficulty conceiving.

If you have endometriosis, you are not alone. Five to ten percent of all women have it. Though many of these women are not infertile, among patients who have infertility, about 30 percent have endometriosis.

Endometriosis can grow like a weed in a garden, irritating the local lining of the pelvic cavity and attaching itself to the ovaries and bowels. Scar tissue often forms where it grows, which can exacerbate the pain and increase the likelihood of infertility. The only way to be sure a woman has endometriosis is to perform a surgical procedure called laparoscopy which allows your physician to look inside the abdominal cavity with a narrow tubular scope. He may be suspicious that you have endometriosis based on your history of very painful menstrual cycles, painful intercourse, etc., or based on your physical examination or ultrasound findings. On an ultrasound, a cyst of endometriosis has a characteristic homogenous appearance showing echoes in the cyst that distinguish it from a normal ovarian follicle. Unlike the corpus luteum (ovulated follicle), its edges are round as opposed to collapsed and irregular in the corpus luteum and the cyst persists after a menses where corpora lutea will resolve each month.

Women with any stage of endometriosis (mild, moderate, or severe) can have severe lower abdominal and pelvic pain – or they might have no pain or symptoms whatsoever. Patients with mild endometriosis will not have a cyst and will have no physical findings on exam or ultrasound. It is thought that infertility caused by mild disease may be chemical in nature perhaps affecting sperm motility, fertilization, embryo development or even implantation perhaps mediated through an autoimmune response.

Moderate and severe endometriosis are, on the other hand, associated with ovarian cysts of endometriosis which contain old blood which turns brown and has the appearance of chocolate. These endometriomata (so called “chocolate cysts”) cause pelvic scarring and distortion of pelvic anatomy. The tubes can become damaged or blocked and the ovaries may become adherent to the uterus, bowel or pelvic side wall. Any of these anatomic distortions can result in infertility. In some cases the tissue including the eggs in the ovaries can be damaged, resulting in diminished ovarian reserve and reduced egg quantity and quality.

The treatment for endometriosis associated with infertility needs to be individualized for each woman. Surgery often provides temporary relief and can improve fertility but rarely is successful in permanently eliminating the endometriosis which typically returns one to two years after resection.

There are no easy answers, and treatment decisions depend on factors such as the severity of the disease and its location in the pelvis, the woman’s age, length of infertility, and the presence of pain or other symptoms.

Treatment for Mild Endometriosis

Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.
However, several well-controlled studies have shown that neither medical nor surgical treatment for mild endometriosis will improve pregnancy rates for infertile women as compared to expectant management (no treatment). For treatment of infertility associated with mild to moderate endometriosis, ovulation induction with intrauterine insemination (IUI) has a reasonable chance to result in pregnancy if no other infertility factors are present. If this is not effective after about three – six cycles (maximum), then I would recommend proceeding with in vitro fertilization (IVF).

Treatment for Severe Endometriosis

Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women. Some studies have shown that surgical treatment of severe endometriosis does improve the chances for pregnancy as compared to no treatment. However, the pregnancy rates remain low after surgery, perhaps no better than two percent per month.

Some physicians advocate medical suppression with a GnRH-agonist such as Lupron for up to six months after surgery for severe endometriosis before attempting conception. Although at least one published study found this to improve pregnancy rates as compared to surgery alone, other studies have shown it to be of no benefit. The older a patient is, the more problematic post surgical treatment with Lupron will be as it delays a woman’s attempt to conceive until she is even older and less fertile due to aging.

Unfortunately, the infertility in women with severe endometriosis is often resistant to treatment with ovarian stimulation plus IUI as the pelvic anatomy is very distorted. These women will often require IVF in order to conceive.

Recommendations

As endometriosis is a progressive destructive disorder that will lead to diminished ovarian reserve if left unchecked, it is vital to undergo a regular fertility screen annually and to consider moving up your plans to start a family before your ovaries become too egg depleted. When ready to conceive, I recommend that you proceed aggressively to the most effective and efficient therapy possible.

Women with endometriosis and infertility are unfortunately in a race to get pregnant before the endometriosis destroys too much ovarian tissue and achieving a pregnancy with their own eggs becomes impossible. However, if you are proactive and do not significantly delay in aggressively proceeding with your family building, then I have every expectation that you will be successful in your efforts to become a mom.

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Do you suffer from endometriosis? How has it impacted your fertility journey? Do you have any advice for others who are suffering?

 

 

Photo credit: Ryan McGuire at http://www.gratisography.com/

 

 

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