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Archive for the ‘egg freezing’ Category

Important Infertility Insurance Coverage Issues for the LGBT Community in New York

By Tracey Minella

June 22nd, 2017 at 8:31 am

From Stonewall to date, the LGBT community has always had to fight for rights equal to those of the heterosexual community, often in an atmosphere of “us against them”. Persistence has always paid off…eventually. As we’ve seen from winning battles on openly serving in the military with the repeal of “Don’t ask. Don’t tell” and the legalization of same-sex marriage (#LoveWins), we can move mountains as a community united.

 

The latest major gay rights fight involves insurance coverage for infertility treatment in New York.

 

The subject of mandated infertility insurance coverage in New York State has been in the news lately, but before addressing an important pending bill that could positively impact the infertility insurance rights of all New Yorkers– heterosexual and non-heterosexual– we must examine and understand the existing obstacles to LGBT infertility treatment coverage.

 

Currently, New York State has a mandate which requires coverage for infertility treatments. It’s one of only 15 states to do so, which sounds promising, but it’s not. With so many existing definitions, restrictions, qualifications, and loopholes, the mandate in its current form does very little to benefit New York’s infertile heterosexual couples– and does even less for non-heterosexual couples or single women who need advanced reproductive technologies in order to start their families.

 

Some of the major problems with the current New York State infertility coverage mandate include:

 

  • It does not cover in vitro fertilization (“IVF”), but only applies to intrauterine inseminations (“IUIs) and other low-level/less successful infertility treatments, which are also riskier in terms of causing a multiple pregnancy (twins, triplets, etc.);
  • Small group employers can opt out of having to provide this coverage;
  • Insurance carriers may impose certain restrictions and rules that impact the employees’ ability to access the benefits.

 

Some insurance carriers that do offer IVF require both heterosexual and non-heterosexual couples to undergo 6-12 unsuccessful IUI cycles before moving on to IVF treatment (6 IUIs if the woman is over 35, or 12 IUIs if under 35, though some require less).

 

In addition to the above multiple-failed-IUIs prerequisite for IVF coverage, the employee must satisfy the insurance carrier’s definition of “infertility”. “Insurance companies define ‘infertility’ as the inability to conceive after one year of frequent, unprotected heterosexual intercourse, or six months if patient is over the age of 35″.

 

Applying this definition to heterosexual couples merely costs them 6-12 months of time before moving onto IVF treatment—provided they can somehow prove they’re doing it often enough and without protection. And while up to a year of time wasted really is a big deal to all infertile folks, the impact on non-heterosexuals and single women is far worse.

 

When applying this definition to a same-sex couple or a single woman, they not only lose valuable time, but they also lose money that a heterosexual couple would not. Because for same-sex couples or single women to meet the current definition of “infertility”, they would have to undergo six or 12 months of IUI with donor sperm treatments — in many cases, at their own expense –just to prove their infertility so that they could qualify for covered infertility treatments.

 

This issue was thrust into public view when two lesbian couples in New Jersey filed a federal lawsuit alleging that the language of the New Jersey insurance mandate “discriminates based on sex and sexual orientation”.

 

There is also disparity among insurance companies with respect to requiring authorizations for IUIs, requiring IUIs with donor sperm prior to approving infertility treatment, and coverage for the cost of donor sperm or thawing the sperm. In addition, companies offer different levels of coverage, which may be dependent upon copayments, deductibles and other restrictions on certain services like embryo cryopreservation, embryo storage, Pre-implantation Genetic Diagnosis or Pre-implantation Genetic Screening (“PGD” or “PGS”) of embryos, and more. To further complicate matters, even within the same insurance company, there are different individual plans that are chosen by the employer which provide different benefits coverage and different qualifications or benefits structure.

 

That’s why Long Island IVF assigns each patient a personal financial counselor to help guide them through the complicated insurance process to maximize any benefits to which they may be entitled.

 

Despite the obstacles that currently exist, there is good news to report and even more promising change on the horizon.

 

As a result of New York Governor Cuomo’s mandate to New York State insurance companies, they may no longer exclude same-sex prospective parents or single prospective parents from infertility coverage. While this is a victory, the sticking point for true reform and open access to appropriate infertility coverage for both heterosexual and non-heterosexual patients requires a redefinition of “infertility” and direct access to IVF.

 

There have already been noticeable changes in policies and the provision of coverage for IUIs with donor sperm in same-sex couples, presumably collectively-driven by Gov. Cuomo’s mandate, along with the New Jersey lawsuit, and forward-thinking, large-scale employers like Facebook and Google now offering high-end infertility insurance coverage for egg-freezing services. But the bottom line is that until a patient meets the “infertility” definition, they still have to self-pay.

 

That’s why we need the definition of ‘infertility’ to change. And we need access to IVF, which is the more successful treatment in terms of a singleton birth outcome.

 

And it is within our grasp right now.

 

As this article is being written, a bill that would revolutionize the infertility insurance law in New York for the benefit of heterosexuals, same-sex couples, and single women is awaiting consideration by the Senate after having passed in the Assembly this week.

 

The Senate Bill S.3148A known as the “Fair Access to Fertility Treatment Act”, or (“FAFTA”), if enacted, would not only mandate coverage for IVF treatment, but it would change the application of the definition of “infertility” to:

 

“a disease or condition characterized by the incapacity to impregnate another person or to conceive, as diagnosed or determined (I) by a physician licensed to practice medicine in this state, or (II) by the failure to establish a clinical pregnancy after 12 months of regular, unprotected sexual intercourse in the case of a female 35 years of age or older.”

 

According to Long Island IVF co-founder and reproductive endocrinologist, Dr. Daniel Kenigsberg, who has been advocating for the passage of the FAFTA bill, “the current mandate’s specific exclusion of coverage for IVF has resulted in much emotional and financial cost spent on inferior or inappropriate treatments which ARE covered by the mandate when, for over 50% of infertile couples, IVF was the best or only treatment.” He further notes that “IVF is far safer in terms of reducing multiple pregnancy risk than less successful and often inferior treatments like ovulation induction and intrauterine insemination (IUI). There has been waste and needless sacrifice for insured couples denied IVF.”

 

It is time for both the heterosexual and the LGBT communities to get active and push our respective representatives to pass this legislation. You can find your local senator here or can access their phone number here. Armed with Senate Bill number S. 3148A, a simple phone call expressing your support of the bill may make all the difference. It takes less than one minute to help support this latest gay rights fight for fair access to appropriate infertility treatment and insurance coverage. Do it now.

 

There has never been a better time for non-heterosexuals to fulfill their dream of parenthood. If you would like more information on the many available LGBT family-building options, we encourage you to join Long Island IVF and our partner, The LGBT Network, on June 29, 2017 for a special free seminar entitled “Building Families in the LGBT Community”. Pre-register here.

 

This progressive legislation not only opens the door to IVF access for all, but it changes the definition of infertility to one that encompasses everyone, regardless of sex or sexual orientation. Instead of “us against them” it’s “one for all”. Its passage would put everybody suffering from the disease of infertility one giant step closer to our common dream of parenthood– and maybe, just maybe, a step closer to us all being one united community.

 

 

 

 

 

 

 

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“New Beginnings through Donor Egg” Seminar at Long Island IVF

By Tracey Minella

April 14th, 2017 at 9:15 am

Right on the heels of National Infertility Awareness Week (April 23-29) is a seminar especially for women who think they might need an egg donor to build their family. It’s called “New Beginnings through Donor Egg”.

Have you ever met a woman who became a mom through egg donation? Wouldn’t it be helpful to hear about her experience and ask her questions in person knowing she once shared the same concerns you may have about the process?

Well, you won’t want to miss this seminar! The donor egg recipient mom who is coming can’t wait to tell you all about her experience. Like many women who turn to donor egg, she suffered through disappointment and loss before finally considering and then deciding to use an egg donor to build her family. Her story is fascinating and her heart is big.

On Tuesday, May 2, 2017, at 7:00 pm, Long Island IVF will host a free event “New Beginnings through Donor Egg” that could potentially change the course of your family-building journey. Our caring doctors and staff…and that happy donor recipient mom… will go over everything you could ever need to know about egg donation.

Women whose eggs have been compromised by advanced age, premature ovarian failure, failed IVF treatment, cancer, or poor egg quality should consider donor egg therapy. Long Island IVF offers many ways to build a family through the donor egg program. Gay men wanting biological children also need the help of an egg donor.

Admittedly, conceiving with donor eggs is rarely the first choice, but often is an acceptable alternative after weighing many personal, physical, emotional, psychological, and financial considerations. Decades of happy moms agree that using donor eggs was the best decision they ever made and many wish they’d come around to the idea sooner.

Maybe you’re not yet ready to act on the information you’ll receive. No problem. We’re just here to offer information and emotional support. So, why not attend the seminar and learn about Egg Donation as an opportunity to create your family? It’s right before the often-dreaded Mother’s Day and a perfect time to get educated and empowered about this powerful family-building option.

Victoria Loveland, RN & Donor Egg Nursing Coordinator, Aviva Zigelman, LCSW & Donor Egg Program Director, and Long Island IVF partner and reproductive endocrinologist Steven Brenner, MD will all be there to answer your questions. You can even speak to them privately if you’re more comfortable.

Long Island IVF offers several different egg donation options, including:

  • Sole Recipient Fresh Egg Donation,
  • Shared Recipient Fresh Egg Donation, and
  • Frozen Egg Donation.

Each option offers its own unique benefits, costs, and other considerations. We have young, healthy, pre-screened, anonymous egg donors representing multiple ethnicities ready to help build your family. Or you can use a known donor if you prefer.

Register here for “New Beginnings through Donor Egg”. Walk-ins are always welcome, too. Bring a friend or partner. Take that first step, even if you’re hesitant. We look forward to seeing you and answering your questions about the exciting option of egg donation. This seminar is generally intimate, low-key and not overly-crowded.

Location: Long Island IVF 8 Corporate Center Drive, Suite 101, Melville, NY

Date: Tuesday May 2, 2017

Time: 7:00 pm- 9:30 pm

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Will you be there? If you’d like to attend but can’t, please call anyway and ask for Vicky Loveland, so we can make other arrangements to help you.

 

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Balancing Breast Cancer and Fertility Preservation

By Steven Brenner MD

October 9th, 2016 at 5:22 pm

 

Dr. Steven Brenner


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.

Long Island IVF offers women facing cancer the fertility preservation options of elective embryo- or egg-freezing prior to undergoing chemotherapy. This enables the woman to safeguard some of her eggs from the adverse effects of chemotherapy by retrieving and freezing them before she begins her cancer treatment. Her frozen eggs or embryos will be there for her use in family-building once her cancer battle is behind her. For more information, please contact our office at 877-838-BABY.

 

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Would you consider fertility preservation or mention the option to a friend facing a cancer diagnosis?

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When Should I Freeze My Eggs?

By Dr. Michael Zinger

August 4th, 2016 at 3:43 pm

 

image credit: stockimages/freedigitalphotos.net


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.

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8 Things to #StartAsking and #KEEPAsking after #NIAW

By Tracey Minella

April 30th, 2016 at 4:43 pm

 

image courtesy of Resolve, the National Infertility Association


Honestly, my first reaction to this year’s NAIW #StartAsking theme wasn’t positive. It just didn’t sit right with me for some nagging reason I couldn’t put my finger on. So, it was hard to sit down and write a post using it. It made me have to really think about some serious and difficult things. Stuff I usually keep locked away. Some days, I just don’t have the strength to think too hard.

Start Asking.

Start Asking why? Start asking how? Start asking for something?

Start asking…what, exactly?

Should I start asking Why me? Truth be told, that was the first thing that came to mind. But there is no point in asking that question. So what is worth asking?

Then it dawned on me. We need to start asking for whatever it is we need in order to get through this journey (or to see that those who follow us can get through it). It’s that simple. And that difficult.

That means asking for help, for understanding, for respect, for answers, for kindness, for prayers, for coverage, and for action.

Start asking yourself what you need. And who can fill that need?

  1. Help: It’s hard to ask for financial help but if it’s the only barrier to treatment, you may have to ask. Loans, gifts, online fundraising sites are some ways to finance fertility treatment. Most IVF practices offer grants as well. Ask for help.
  2. Understanding: No one will truly get it unless they’ve battled infertility themselves. But they need to try to understand why it’s too hard for you to handle things like baby showers, egg hunts, and gender reveal parties for a couple’s 5th baby. Tell them you’re happy for them, but it hurts too much to participate right now. Ask them to understand.
  3. Respect: Everyone has advice on how you should be handling your infertility journey. Regardless of their personal (and usually uneducated) opinions, they need to respect the decisions you’re making…whether that involves IUI,  IVF, egg donation, donor sperm, surrogacy, egg freezing, pre-implantation genetic screening, adoption, or choosing to live child-free. Ask them to respect your right to make your own decisions.
  4. Answers: There is no such thing as a stupid question, at least when it comes to infertility treatment. So much is on the line that you owe it to yourself to understand the often complicated and ever-changing world of assisted reproductive technology. Understand what is happening to your body during any given treatment or procedure, including the medications you’re taking, how to take them, and any possible side-effects.  Knowledge is power. Ask questions if you don’t understand something.
  5. Kindness: Similar to respect, you deserve to be treated kindly. People can be mean…on purpose or innocently. “Why can’t you give me grandchildren?” “He just looks at me and I get pregnant”. “You can have one of mine.” “I’ll get her pregnant for you”. “Be thankful you have one.” Protect your heart. Ask people to stop saying hurtful things like that.
  6. Prayers: For the religious, infertility (especially a long journey filled with losses) can sometimes be a test of one’s faith. Don’t feel guilty asking why this is happening to you or questioning why your prayers are not being answered. If your faith is a source of comfort and strength to you and also to those you know, ask for their prayers or good thoughts on your behalf.
  7. Coverage: As you no doubt know, the biggest barrier to infertility treatment is often lack of health insurance coverage. Most policies offer little to no coverage for fertility treatments like IVF. The only hope for change lies in advocating for new legislation mandating better infertility coverage. Ask your elected representatives to create or support legislation mandating IVF coverage.
  8. Action: Start asking is a good start. It’s a catchy theme for NIAW. It’s good to raise awareness. One week per year. But that’s not enough. We need infertility action not just infertility awareness. The week is over. Tomorrow we risk being forgotten until next April (or at least until we resurrect Coming Out Infertile Day in November). And those baby shower invites will still flood the mailbox. Those nagging personal questions will not abate. And those uncovered infertility costs will still prevent many from accessing the treatments they need to become parents. Ask yourself and others to take action for real change.

I guess my issue with the theme this year, or maybe every year, is just a frustration over the slow pace of change. And the poor collective memory of the public. Tomorrow will not only start a new week, but a new month. A new “awareness” cause to push. By Friday, will anyone still be aware of infertility? Will they still be ASKING? We don’t need to just #StartAsking. We need to #KEEPAsking.

Let’s show our appreciation for –and join–all the tireless infertility advocates who support the infertile folks of today through activism, advocacy, blogging, and more. To the extent you can, join the fight. Consider participating in Advocacy Day . Don’t just start asking. Keep asking. Then keep acting until real change happens. Until we have babies for all.

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What did you #StartAsking? What will you #KeepAsking?

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

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 contest…two 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 28 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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Egg Donation at Easter

By Tracey Minella

March 24th, 2016 at 4:40 pm

 

image credit: tiramisustudio and freedigitalphotos.net


What better time of year than Easter to talk about eggs?

No, not the colored ones that young children in starched knickers and tulle dresses egg-citedly gather up in egg hunts. We’re talking about the millions of eggs each woman is born with–the ones that some infertile women need donated from fertile women in order to have a baby.

Whether you are a young mother who has finished your own family-building, or you are a young woman putting off family-building while you pursue your education or career aspirations… or you’re just a young healthy woman with a warm heart!…egg donation is a priceless gift you can give to someone longing for a baby.

In addition to how good it may make your heart feel to help another woman to become a mother, your giving spirit is rewarded with generous financial compensation. And repeat donors may qualify to have some of the eggs from their donor cycle frozen for their own future use.

If you’d like an egg donor application or more information on how you can become an egg donor and receive $8,000 for each cycle you donate, please call Long Island IVF’s Donor Egg Program Coordinator, Victoria Loveland, MS, RN at (877)838-BABY. Many of our egg donors enjoy the experience so much that they return to donate again and again.

In this season of rebirth and renewal, won’t you consider egg donation?

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Would you consider becoming an egg donor? Why or why not?

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

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 contest…two 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 28 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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Social Media and the IVF Experience

By Tracey Minella

March 20th, 2016 at 10:11 pm

 

image courtesy of bplanet/ freedigitalphotos.net


Snapchat® your IVF retrieval day story? Instagram® your embryo’s first picture*? Live tweet your transfer on Twitter®?

It’s true. In Vitro Fertilization (IVF) is boldly going where social media has never gone before. Farther than just sharing the positive pregnancy test on Facebook®. And celebrities are leading the way.

Celebrities have often shared their infertility stories on social media after-the-fact, either during or after the resulting pregnancy. Chrissy Teigen caused a stir in the “twitterverse” when she recently came out during her pregnancy about doing IVF (and selecting a girl embryo to transfer) while shooting the Sports Illustrated® swimsuit issue. And there are countless others who speak out later.

But “real-time” social media updating has entered the IVF scene. One example is the Snapchat® retrieval day story of E!News host, Maria Menounos, as reported by intouchweekly.com., so check it out. The star was also quoted on her reported previous egg-freezing experience and shares her thoughts on the cutting edge fertility-preservation technology.

The benefits of “real-time” social sharing are many:

  • It’s your Coming Out Infertile Day. With one click, you can indirectly “come out” about your infertility struggles to your family and friends on social media.**
  • Remove the stigma and increase awareness of infertility and emotional support by putting a real face to infertility.
  • Embrace the Coolness Factor. We all know the drawbacks, but what makes IVF family-building unique in a good way? Being able to document in photos and videos the literal creation of your baby…and share it all live… is exhilarating, emotional, and, yes even cool. Not everyone can do it, so in a twisted sense, it is a privilege. (And these photos and videos are priceless keepsakes to share with your eventual children, too.)

But there’s an obvious down-side to real-time social sharing. Unforeseen and unfortunate developments sometimes happen that you may not be prepared to experience… much less share on the spot… such as fewer eggs retrieved than hoped for, poor fertilization, or a negative pregnancy test. Once you share the start of the story, you create an expectation for the ending. And while it’s often happy, there can be no guarantees.

Maybe these real-time infertility stories are the inevitable and natural answer to the never-ending flood of pregnancy posts and baby pictures on social media. What do you think?

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Would you/did you share your treatment in real-time on social media? If so, how? Would you/did you share your experience after-the-fact?

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*Many fertility practices, including Long Island IVF, do not provide embryo photos.

**Long Island IVF, sponsor of Coming Out Infertile Day, invites you to visit the Coming Out Infertile Day Facebook page for a helpful graphic and easy instructions to help you come out any day and start getting the support you need.

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

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 contest…two 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 28 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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Start the New Year with an Annual Fertility Screening

By David Kreiner MD

December 13th, 2015 at 12:31 pm

Photo Credit: George Hodan/ publicdomainphotos.net


As the year winds down and you reflect on the past, and make resolution for the future, it pays to consider an annual fertility screening.

Some of you may be well into treatment already, but others may just be starting out with their family-building plans…or may be putting off starting a family or adding to their family.

It may be wise to have a baseline or annual fertility screening done, just to help rule out identifiable and underlying fertility problems you may already have and are unaware of. Armed with the knowledge a screening gives you, you can make a more informed decision about how long you may want to wait before beginning or resuming your family building plan.

Dr. Kreiner explains what a fertility screening usually means:

Fertility screening starts with a blood test to check the levels of FSH (follicle stimulating hormone), estradiol and AMH (antimullerian hormone). The FSH and estradiol must be measured on the second or third day of your period. The granulosa cells of the ovarian follicles produce estradiol and AMH. The fewer the follicles there are in the ovaries the lower the AMH level. It will also mean that less estradiol is produced as well as a protein called inhibin. Both inhibin and estradiol decrease FSH production. The lower the inhibin and estradiol the higher the FSH as is seen in diminished ovarian reserve. The higher the estradiol or inhibin levels are then the lower the FSH. Estradiol may be elevated especially in the presence of an ovarian cyst even with failing ovaries that are only able to produce minimal inhibin. However, the high estradiol reduces the FSH to deceptively normal appearing levels. If not for the cyst generating excess estradiol, the FSH would be high in failing ovaries due to low inhibin production. This is why it is important to get an estradiol level at the same time as the FSH and early in the cycle when it is likely that the estradiol level is low in order to get an accurate reading of FSH.

The next step is a vaginal ultrasound to count the number of antral follicles in both ovaries. Antral follicles are a good indicator of the reserve of eggs remaining in the ovary. In general, fertility specialists like to see at least a total of eight antral follicles for the two ovaries. Between nine and twelve might be considered a borderline antral follicle count.
As you start to screen annually for your fertility, what you and your doctor are looking for is a dramatic shift in values from one year to the next.

What Does the Screen Indicate?

A positive screen showing evidence of potentially diminishing fertility is an alarm that should produce a call to action. When a woman is aware that she may be running out of time to reproduce she can take the family-planning reins and make informed decisions. The goal of fertility screening is to help you and every woman of childbearing years make the choices that can help protect and optimize your fertility.

Due to advancements in assisted reproductive technologies, younger women who may not be ready to start their families yet for social, financial or other reasons, can now freeze their eggs for future use if needed. This technology is available at Long Island IVF. If you are interested in egg-freezing for your own use or for donating to another woman, please contact our Program Coordinator, Vicky Loveland, RN in the Melville office.

Although none of these tests is in and of themselves an absolute predictor of your ability to get pregnant, when one or more come back in the abnormal range, it is highly suggestive of ovarian compromise. It deserves further scrutiny. That’s when it makes sense to have a discussion with your gynecologist or fertility specialist. Bear in mind, the “normal” range is quite broad. But when an “abnormal” flare goes off, you want to check it out.

It’s important to remember that fertility is more than your ovaries. If you have risk factors for blocked fallopian tubes such as a history of previous pelvic infection, or if your partner has potentially abnormal sperm, then other tests are in order.

Regardless of the nature or severity of the problems, today, with Assisted Reproductive Technology there is a highly effective treatment available for you.

 

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Did you put off a fertility screening… and end up regretting it? If so, what advice do you have for other women who may be doing the same thing?

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Infertility and the Wrong Path Taken

By David Kreiner MD

September 22nd, 2015 at 12:41 pm

Image credit: wpclipart.com


A day of atonement is when people reflect on the choices they’ve made and the goals they’ve set and ponder things like what mistakes or wrong decisions they may have made that have led them down a path they did not intend to take. Sometimes, mistakes may have landed patients on the path of infertility.

Dr. Kreiner examines a common situation he encounters where poor decisions…or indecision…on behalf of patients and their GYNs leads them down a path they certainly did not intend…

A friend of mine was complaining to me about the trouble he got into with his homeowner’s association because he did not hide his empty garbage cans in his garage but left them behind his cars in front of his house.  It was 20 feet from the curb, he claimed, still distraught that he should have been scolded for breaking the rule.  “I didn’t know”.  That phrase, “I didn’t know” clicked in my brain as a recurrent declaration from the frustrated patients who I see every day.

My infertility practice is filled with patients who spent years of their lives all the time assuming that their fertility would be there when they were ready.  Some even mentioned their failed attempts at conceiving to their gynecologist who may have reassured them or if it were a more aggressive clinician, he may have put them on Clomid for 3 to 6 months.  Meanwhile these women got older, many over 40 not realizing that time was chipping away at their fertility.  “They didn’t know”.

A fertility screen is a good way to assess annually what is happening to your fertility independent of your age.  This is accomplished by getting day 2 or 3 FSH and estradiol levels as well as an ultrasonographic antral follicle count.  An AntiMullerian Hormone level can be checked at any point in the cycle and likewise reflect the relative number of eggs left giving some reassurance about a person’s remaining fertility.

What do I as a reproductive endocrinologist who sees the damage done by this benign neglect on a daily basis do to wake people up to the fact that fertility is a temporary state that needs to be taken advantage of when the time is right?  Today, doctors can take ovarian tissue/eggs from a child or adult to preserve her fertility prior to fertility-robbing cancer treatments.  In fact, egg freezing technology is now here for the healthy women who want to preserve their fertility. It’s become acceptable therapy with ever increasing success and lack of problems being noted. Ask your Long Island IVF doctor about egg freezing.

Patients who are not in a position to execute their reproductive rights while they are still fertile should consider egg freezing when they do not have a partner to share in conception.  With a willing and available partner, freezing embryos is another viable option.

But without question, couples who are ready to start a family, should seek assistance from a reproductive endocrinologist who specializes in helping those such as yourselves build your families.  Even when not covered by insurance, there are affordable options such as minimal stimulation IVF, grants, and studies that make the process within reach of most people in need.   So do not become another victim to “I didn’t know”.  Take action, see a reproductive endocrinologist and get on the right path to building that family of your dreams.

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Have you considered egg freezing? Do you wish you had?

 

Photo credit: http://www.wpclipart.com/travel/more_road_signs/road_signs_2/crossroads_sign.jpg

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Long Island IVF Supports PFLAG

By Tracey Minella

September 4th, 2015 at 6:15 pm

 

Dr. David Kreiner, reproductive endocrinologist and co-founder of Long Island IVF…the infertility practice responsible for bringing Long Island its first IVF baby… is excited and honored to be the guest speaker at the upcoming Long Island PFLAG chapter’s September 20th meeting in Commack. His presentation will be on “Fertility Options for Same Sex Couples”.

 

Since its inception in 1988, Long Island IVF has been committed to the belief that all people have the right to have a family. We have a proud history of supporting LGBT family-building in a way that is sensitive to the unique needs of the community. We go beyond LGBT-friendly…several of our staff members are part of the community. And our experienced psychologist, Bina Benisch, MS, RN, is also the caring and sensitive mother of an adult transgender child. So, we’ve got you covered.

 

If you are a member of the LGBT community…or a parent or loved one of a member…please come down and meet Dr. Kreiner. He will address all of your questions regarding the many fertility preservation and family-building options for the LGBT community.

 

Date: Sunday, September 20, 2015

Time: 2:00 pm

Place: Suffolk Y JCC

74 Hauppauge Rd. Commack, New York

For more information, call PFLAG at 631-462-9800

 

If you can’t wait until then to meet Dr. Kreiner, you can also attend Long Island IVF’s upcoming event, “An Evening of Holistic Approaches to Fertility”, on September 15th at our Melville office. Details are available on our website here: http://www.longislandivf.com/view_event.cfm?id=191

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Do you have any questions for Dr. Kreiner in advance of the PFLAG presentation?

 

 

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