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Archive for the ‘PCOS’ Category

September is PCOS Awareness Month

By David Kreiner MD

September 1st, 2017 at 9:05 am

, via Wikimedia Commons”]

By Anne Mousse (Own work) [CC0

Polycystic Ovarian Syndrome, or “PCOS”,  is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin her blood sugar levels rise, triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles, preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Ovarian Hyperstimulation syndrome, or OHSS.

Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk, it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.

The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

* * * * * * ** *

Do you suffer from PCOS? Do you have any advice to share for other “cysters”?

 

Photo credit:

By Anne Mousse (Own work) [CC0], via Wikimedia Commons

https://commons.wikimedia.org/wiki/File%3AEchographie_pelvienne%2C_aplio_toshiba_ssa_700_5_2004_03_detail.jpg

 

 

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PCOS Awareness

By David Kreiner, MD

September 2nd, 2016 at 11:12 am

 

LIIVF Melville staff wearing teal


Teal ribbons in September signify PCOS Awareness Month.

PCOS (formally known as Polycystic Ovary Syndrome) is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin her blood sugar levels rise, triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles, preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Ovarian Hyperstimulation syndrome, or OHSS.

Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.

The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

* * * * * * ** *

Do you suffer from PCOS? Do you have any advice to share for other “cysters”?

 

 

no comments

September is PCOS Awareness Month

By David Kreiner MD

September 1st, 2015 at 6:09 pm

 

Teal ribbons in September signify PCOS Awareness Month.

PCOS (formally known as Polycystic Ovary Syndrome)  is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin her blood sugar levels rise, triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles, preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Ovarian Hyperstimulation syndrome, or OHSS.

Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.

The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

* * * * * * ** *

Do you suffer from PCOS? Do you have any advice to share for other “cysters”?

 

 

no comments

5 Popular Misconceptions Regarding Polycystic Ovary Syndrome (PCOS)

By Dr. Joseph Pena

June 22nd, 2015 at 11:23 am

 

via WikipediaCommons pubdomain”]

By Schomynv [CCo


Myth #1 – “If I have irregular periods, I have PCOS”.

Women with irregular menstrual periods are often unaware of the reason for their menstrual irregularity.  Many women are placed on hormonal contraceptives (i.e. birth control pills) by their gynecologist to regulate their menstrual periods and prevent an overgrowth of the lining of the uterus that may lead to cancer if left unchecked.  Some women are told they have PCOS as this is the most common etiology for irregular menstrual periods (4-7% of women of reproductive age, ~60-85% of anovulatory women), while others are not given a specific reason for their irregular menstrual periods.

While there is no universally accepted definition for PCOS, there are a few expert groups which have generated diagnostic criteria.  The Rotterdam Consensus Criteria (2006) requires two of the three signs/symptoms of PCOS (hyperandrogenism, irregular menstrual periods, polycystic-appearing ovaries on pelvic ultrasound) to be present for the diagnosis to be made.  The Androgen Excess Society (2006) requires hyperandrogenism plus one of the other two signs/symptoms (irregular menstrual periods, polycystic-appearing ovaries on pelvic ultrasound).  The hyperandrogenism criteria may be satisfied by either the presence of hirsutism (excessive hair growth) or elevated androgen levels, such as testosterone.  However, both criteria recommend excluding other possible causes of these signs and symptoms.  The differential diagnosis of someone with irregular menstrual periods and/or hirsutism is listed in the table below.

Differential Diagnosis of Polycystic Ovary Syndrome (PCOS)
—  Thyroid disease (hypothyroidism, hyperthyroidism)—  Prolactin/Pituitary disorders

—  Nonclassical congenital adrenal hyperplasia (Nonclassical CAH)

—  Androgen-secreting tumor (ovary, adrenal gland)

—  Exogenous androgens

—  Primary hypothalamic amenorrhea (stress-related, exercise-related, eating disorders, low body weight)

—  Central nervous system tumors/disorders

—  Primary ovarian failure

—  Cushing syndrome

—  Insulin-receptor defects

 

The proper evaluation of a woman with irregular menstrual periods and confirmation of PCOS is important because this affects treatment (e.g. combined hormonal contraceptives for PCOS, thyroid hormone replacement for hypothyroidism, corticosteroid replacement for nonclassical congenital adrenal hyperplasia, surgery for androgen-secreting tumor, etc.), as well as determining future fertility treatment (e.g. clomiphene citrate for PCOS, dopamine agonist for hyperprolactinemia, in vitro fertilization using donor oocytes for ovarian failure, etc.).  Thus, it is important for women to ask their physicians for a diagnosis for their irregular menstrual cycles.

 

Myth #2 – “Regular menstrual periods means I’m ovulating”.

The menstrual bleeding that occurs in a woman with inconsistent or absent ovulation is more likely due to breakthrough bleeding rather than post-ovulation withdrawal bleeding.  Thus, vaginal bleeding cannot be assumed to be an indication of ovulation in these women.

In addition, while many women and some clinicians use a history of regular menstrual cycles as a predictor of normal ovulatory function, ~40% of normally-menstruating women who exhibit hirsutism (excessive hair growth) are, actually, not ovulating and may be classified as having PCOS or other diagnosis associated with hyperandrogenism.

 

Myth #3 – PCOS is an ovarian cystic problem.

PCOS is an endocrine disorder of androgen excess with defined diagnostic criteria as noted above in Myth #1.  The determination of “the polycystic ovary (PCO)” (in contrast to the syndrome, PCOS) is defined in the table below.

Determination of polycystic appearing ovary (PCO)
—  In one or both ovaries, either:—  >12 follicles measuring 2-9mm in diameter

—  Increased ovarian volume > 10 cm3

—  If there is a follicle > 10mm in diameter, scan should be repeated at a time of ovarian quiescence in order to calculate volume/area

—  Presence of one PCO is sufficient for diagnosis

 

From the table above, it can be seen that PCO does not refer to and is very different from clinical ovarian cysts, both physiologic (e.g. corpus luteum) and pathologic (e.g. endometrioma, dermoid tumor), which tend to be larger in size.

The characteristic PCO emerges when a state of anovulation (lack of ovulatory cycles) persists for any length of time.  ~75% of anovulatory women will have PCO.  Since there are many causes of anovulation, there are many causes of PCO (e.g. PCOS, congenital adrenal hyperplasia, hyperprolactinemia, hyperandrogenism, type 2 diabetes mellitus, eating disorders, etc.).   PCO is the result of a problem with the normal functioning of the ovaries, and not necessarily from a specific individual cause.

Last but not least, PCO is not necessarily a pathologic abnormality.  Up to 25% of women who menstruate and ovulate normally will demonstrate PCO on ultrasound.

 

Myth #4 – “PCOS does not occur in thin or normal-weight women, or in women without excessive hair growth”.

While obesity and hirsutism (excessive hair growth) are relatively common in women with PCOS, with a prevalence of 20-60% and 30-80%, respectively, there are many women with PCOS with neither feature.  Again, referring to the diagnostic criteria for PCOS (see above in Myth #1), the presence of obesity is not necessary.  Hirsutism is just one manifestation of hyperandrogenism.  The other is biochemical, such as elevated androgen levels in the blood.  Certain ethnic backgrounds (e.g. Asians) may genetically not manifest hirsutism despite elevated androgen levels.  Thus, being thin or of normal weight and showing no signs of excessive hair growth does not necessarily eliminate PCOS as a diagnostic possibility.  Other common (but not necessarily required) features of PCOS are listed in the table below.

FEATURES OF POLYCYSTIC OVARY SYNDROME

PREVALENCE

CLINICAL
     Hirsutism (excessive hair growth) 30-80% (depends on ethnicity)
     Acne 15-20%
     Androgenic alopecia 5-10%
     Obesity 20-60%
     Anovulation 90-100% (depending on definition)
     Oligo/amenorrhea (irregular/absent menses) 50-70%
OVARIAN
     Polycystic appearing ovaries 70-80%
BIOCHEMICAL
     ­ LH/FSH 35-95%
     ­ free testosterone 60-80%
     ­ total testosterone 30-50%
     ­ DHEAS 25-70%
METABOLIC
     hyperinsulinemia 25-60%

 

 

Myth #5 – “Irregular menstrual periods due to PCOS is only a problem when trying to conceive.”

Obesity, irregular menstrual periods, and elevated insulin levels are common features of PCOS and significant risk factors for the development of an overgrowth of the lining of the uterus (endometrial hyperplasia), which may lead to cancer, if left unchecked.  It is not surprising then that women with PCOS are at an increased lifetime risk for developing endometrial hyperplasia and cancer of the lining of the uterus.  Thus, it is essential for a woman with PCOS who is currently not interested in conceiving, to discuss with her gynecologist the best option for her to decrease her risk for developing endometrial hyperplasia/cancer.   Options that might be considered include the use of [low-dose combined] hormonal contraceptives (e.g. the pill, transdermal patch, vaginal ring), progesterone-only pill, progestin IUD, and/or withdrawing with progesterone at regular intervals.

Women with PCOS are also thought to be at increased lifetime risk for developing type 2 diabetes mellitus and cardiovascular disease (abnormal cholesterol and other lipids, high blood pressure).  Regular screening for pre-diabetes or diabetes (with a 2-hour glucose tolerance test or fasting glucose level), body mass index, fasting lipid profile, and metabolic syndrome risk factors is essential to possibly help improve mortality and morbidity in such individuals.  Early intervention with lifestyle modification (diet, exercise, weight loss) and pharmacological treatment if needed (e.g. insulin-sensitizing agents, statins) may help to accomplish this.

Thus, PCOS is more than simply a problem of infertility.  It is a condition which should be discussed with one’s physician (gynecologist, primary physician, endocrinologist) even when one is not actively trying to conceive.

 

By Schomynv (Own work) [CC0], via Wikimedia Commons

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September is PCOS Awareness Month

By David Kreiner MD

September 12th, 2014 at 2:30 pm

 

credit: anankkml and free digital photos.net


PCOS is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin her blood sugar levels rise, triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles, preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Ovarian Hyperstimulation syndrome, or OHSS.

Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.

The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

* * * * * * ** *

Do you suffer from PCOS? Do you have any advice to share for other “cysters”?

 

 

no comments

Nutrition, BMI, and Infertility

By Tracey Minella

March 28th, 2014 at 5:38 am

 

credit: surachaifreedigitalphotos.net


The practice of eating well while you’re pregnant is pretty common.  Most women know that, in addition to taking prenatal vitamins, eating the right foods during pregnancy can have a positive impact on their baby’s development. Even women who didn’t have stellar eating habits before conceiving often make healthier choices once they learn they are eating for two.

But did you know that proper nutrition and reaching a healthy weight for your height (also known as having a healthy body mass index, or “BMI”) prior to conceiving may help boost your chances of conception, whether naturally or through assisted reproductive technologies like IVF?

According to the American Society for Reproductive Medicine*, a BMI outside the normal range of 19-24 can impact the fertility of men and women. Obesity can contribute to low sperm count and motility in men and can cause irregular ovulation and irregular cycles in women. Underweight women may also experience irregular cycles or stop having periods altogether. In addition, there are several conditions that can impact achieving or maintaining a pregnancy… including PCOS, thyroid disease, gestational diabetes, and preeclampsia… which are often obesity-related.

To help you get to your nutritional peak and optimum fertility BMI, Long Island IVF offers nutrition counseling and safe, effective weight loss planning. If you are overweight, we can help you reach a healthy weight in a quick but safe way through the Take Shape for Life/Medifast program. In addition to medically- supervised weight loss, clients in the program learn lifestyle and behavior changes that support maintaining their weight loss success and improved health. If you are underweight, we offer nutritional counseling and life style change suggestions as well. If interested in either of these programs, please contact Mary Ann Vuolo, RN in the Melville office.

If you’d like to learn how fun eating fertility-friendly foods can be, join Long Island IVF for “Fun in the Fertile Kitchen”, a live cooking demonstration and multi-course dinner event on April 24, 2014, in celebration of National Infertility Awareness Awareness Week. For more details on this exciting, limited seating event, please see our website, our Facebook, or the previous blog post. To RSVP, contact our patient advocate, Bina Benisch at binabenisch@gmail.com

* * * * * *** * **

Do you struggle with maintaining a healthy BMI? What tips have you tried, or foods have you eaten, to improve your BMI or overall nutrition?

 

*https://www.asrm.org/Weight_and_Fertility_factsheet/

 

 

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Long Island IVF Celebrates National Infertility Awareness Week with a Fun Fertile Cooking Event!

By Tracey Minella

March 26th, 2014 at 11:00 am

 

Move over, Emeril! Long Island IVF is “kickin’ it up a notch” for National Infertility Awareness Week this year with an offer you can’t refuse.

If you’ve been trying to conceive without success and could use a fun night out with other women in the same boat, this invitation is for you. And you do not even have to be a Long Island IVF patient to attend.

Be our guest for an evening of fun in the fertility kitchen with chef-lecturer, Patricia Bove at the quaint Long Island Cooking Café and Tea Room, 454 Main Street, Islip, New York, on Thursday, April 24, 2014 at 7:00 pm.

Experience the thrill of a live cooking demonstration while learning how you may improve your chances of conceiving. Savor the intoxicating aromas and treat your taste buds to a gourmet, sit-down, multi-course dinner of fertility-friendly foods. Kick back and let a professional chef entertain and serve you! You’ll walk away from this fabulous feast knowing how to optimize your chances of conceiving and take back some control over your fertility.

Did you know that what you eat…or don’t eat…can affect your fertility? Are you aware that science has proven that both men and women can improve their reproductive health by eating certain foods? Well, Long Island IVF is raising awareness of infertility in a fun and novel way this NIAW with an event designed to entertain as well as educate.

Understandably, an event like this is bound to fill up quickly. Seating is limited and pre-registration is required. Please RSVP immediately to reserve your spot by contacting our patient advocate, Bina Benisch at 516-398-5248 or binabenisch@gmail.com.  Please do not call the Long Island IVF office or Chef Bove directly. Don’t delay, call today.

* * * * * * * * * *

Do you know any… or have some favorite… fertile foods? Will we see YOU at this fun event???

 

 

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September is PCOS Awareness Month

By David Kreiner, MD

September 19th, 2013 at 8:10 pm

image courtesy of arztsamui/free digital photos.com

 

PCOS is the most common hormonal disorder of reproductive age women, occurring in over 7% of women at some point in their lifetime.  It usually develops during the teen years.  Treatment can assist women attempting to conceive, help control the symptoms and prevent long term health problems.

The most common cause of PCOS is glucose intolerance resulting in abnormally high insulin levels.  If a woman does not respond normally to insulin her blood sugar levels rise, triggering the body to produce more insulin.  The insulin stimulates your ovaries to produce male sex hormones called androgens.  Testosterone is a common androgen and is often elevated in women with PCOS.  These androgens block the development and maturation of a woman’s ovarian follicles, preventing ovulation resulting in irregular menses and infertility.  Androgens may also trigger development of acne and extra facial and body hair.  It will increase lipids in the blood.  The elevated blood sugar from insulin resistance can develop into diabetes.

Symptoms may vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility.

Ovaries develop numerous small follicles that look like cysts hence the name polycystic ovary syndrome.  These cysts themselves are not harmful but in response to fertility treatment can result in a condition known as Ovarian Hyperstimulation syndrome, or OHSS.

Hyperstimulation syndrome involves ovarian swelling, fluid accumulating in the belly and occasionally around the lungs.  A woman with Hyperstimulation syndrome may become dehydrated increasing her risk of developing blood clots.  Becoming pregnant adds to the stimulation and exacerbates the condition leading many specialists to cancel cycles in which a woman is at high risk of developing Hyperstimulation.  They may also prescribe aspirin to prevent clot formation.

These cysts may lead to many eggs maturing in response to fertility treatment also placing patients at a high risk of developing a high order multiple pregnancy.  Due to this unique risk it may be advantageous to avoid aggressive stimulation of the ovaries unless the eggs are removed as part of an in vitro fertilization procedure.

A diagnosis of PCOS may be made by history and physical examination including an ultrasound of the ovaries.  A glucose tolerance test is most useful to determine the presence of glucose intolerance and diabetes.  Hormone assays will also be helpful in making a differential diagnosis.

Treatment starts with regular exercise and a diet including healthy foods with a controlled carbohydrate intake.  This can help lower blood pressure and cholesterol and reduce the risk of diabetes.  It can also help you lose weight if you need to.

Quitting smoking will help reduce androgen levels and reduce the risk for heart disease.  Birth control pills help regulate periods and reduce excess facial hair and acne.  Laser hair removal has also been used successfully to reduce excess hair.

A diabetes medicine called metformin can help control insulin and blood sugar levels.  This can help lower androgen levels, regulate menstrual cycles and improve fertility.  Fertility medications, in particular clomiphene are often needed in addition to metformin to get a woman to ovulate and will assist many women to conceive.

The use of gonadotropin hormone injections without egg removal as performed as part of an IVF procedure may result in Hyperstimulation syndrome and/or multiple pregnancies and therefore one must be extremely cautious in its use.  In vitro fertilization has been very successful and offers a means for a woman with PCOS to conceive without a significant risk for developing a multiple pregnancy especially when associated with a single embryo transfer.   Since IVF is much more successful than insemination or intercourse with gonadotropin stimulation, IVF will reduce the number of potential exposures a patient must have to Hyperstimulation syndrome before conceiving.

It can be hard to deal with having PCOS.  If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition.  Ask your doctor about support groups and for treatment that can help you with your symptoms.  Remember, PCOS can be annoying, aggravating even depressing but it is fortunately a very treatable disorder.

* * * * * * ** *

Do you suffer from PCOS? Do you have any advice to share for other “cysters”?

 

photo credit: artzsamui/http://www.freedigitalphotos.net/images/agree-terms.php?id=100156295

 

 

no comments

Fertile Food Friday- Avocado

By Tracey Minella

June 28th, 2013 at 3:29 pm

 

image courtesy of flikr

Did you know that some foods can potentially boost male and female fertility? Want to learn more? Check out Long Island IVF’s “Fertile Food Friday” posts. We’ll have some fun facts and a recipe or video for each food we focus on… for those who aren’t sensitive or allergic to the ingredients, of course.

The first fertile food will be avocado.

As you can see from the photo, avocados hail from what the Aztecs nicknamed Āhuacatl , short for āhuacacuahuitl, which means “testicle tree”.*

Avocados are thick-skinned, dark green/black, pear-shaped, bumpy fruits (about the size of your palm) with soft, pale yellow flesh and a large pit. They are rich in folate and Vitamin E, and are an excellent monounsaturated (good) fat which may benefit the reproductive health of both men and women and also help lower inflammation and insulin resistance (which could be particularly beneficial to many PCOS patients).

In fact, a recent study out of Harvard’s School of Public Health on the effects of dietary fats on IVF outcomes found that those who consumed the highest intake of monounsaturated (good) fats were 3.4 times more likely to have a baby after IVF than those who consumed the lowest amount. Lead researcher, Professor Jorge Chavarro, was quoted by the Daily Mail** as saying, “”The best kinds of food to eat are avocados, which have a lot of monounsaturated fat…” In addition, the women with the highest levels of monounsaturated fat consumption had higher live birth rates. Further, the women who ate mostly saturated (bad) fats had lower egg quality.

Ready for an avocado recipe recommendation?

image courtesy of Mister GC/freedigitalphotos.net

Perhaps the most popular use for avocados is in Guacamole, a Mexican dip often used for chips and nachos. It is the quintessential party food and a staple at many summer gatherings. But you may need to skip out on its partner…the Margarita… if you’re trying to conceive.

Chef Rick Bayless, author of Frontera: Margaritas, Guacamoles and Snacks and other cookbooks, is famous for guacamole, and often demonstrates his technique in short videos. His guacamole begins with avocados, salt, fresh white onion, fresh lime juice, and cilantro, but the remaining ingredients vary. Additions may include fresh or canned hot chiles, tomatoes or tomatillos, and crispy, crumbled bacon. Check out this video demonstration http://youtu.be/vZ7HtsGrpvc or one of his cookbooks (available on amazon) to learn how to make fresh guacamole in about 5 minutes. Add chips and a cold drink and you’re ready to go!

Don’t forget that you can also add avocado chunks to salads. And if you don’t care for the taste but still want the health benefits, I will share one of my biggest culinary secrets…you can add it to meatloaf. Cream it into the meat mixture. I promise no one will know.

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Did you make this guacamole? Have another avocado recipe to share? Please share. Let’s help each other feed ourselves fertile.

 

* Merriam-Webster.com

** http://www.dailymail.co.uk/health/article-2168494/Avocado-diet-triples-chance-success-couples-undergoing-IVF.html

Guacamole photo credit: Grant Cohrane http://www.freedigitalphotos.net/images/search.php?search=guacamole&cat=

Avocado Tree photo credit: Alpha/avlxyz  http://www.flickr.com/photos/avlxyz/375423476/

 

 

 

 

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Long Island IVF’s National Infertility Awareness Week Events

By Tracey Minella

April 15th, 2013 at 3:47 pm

 

Long Island IVF is pleased to offer an exciting series of seminars for National Infertility Awareness Week 2013. The five (5) seminars in our “Evenings of Education” series will be packed with information on many areas of interest to those trying to conceive. Each event will be led by a different expert at Long Island IVF.

All seminars, which will run for approximately two hours, will take place at our beautiful, centrally-located Melville offices at 8 Corporate Center Drive, Suite 101, Melville, New York and start at 6:30 pm. (Please note the one exception is “The Complete IVF Donor Egg Program” which starts at 7:00 pm). Refreshments will be served at all events. Pre-registration is encouraged.

These seminars are designed to answer all the questions you may have no matter where you are along your journey to parenthood. Maybe you know… or suspect… that you’re suffering from PCOS and worry about its impact on your fertility. Or maybe you’ve been trying to conceive and have been unable to get pregnant, or have suffered from recurrent miscarriages, and think it might be time to move on to an infertility specialist. Maybe you need help dealing with the stress of infertility itself, as well as the financial stress it can bring. Maybe you’re considering getting a second opinion or are questioning the whether the fit is right with your current reproductive endocrinologist.

Take the next step. Come to one…or all…of our seminars. Get a feel for the personal touch we bring to infertility treatment and see what makes our program different from those hospital-based programs that treat you like a number.

Long Island IVF …celebrating our 25th anniversary this year…is the first successful IVF program on Long Island. We brought Long Island its first IVF baby, its first FET baby, and its first donor egg baby. Come meet us during National Infertility Awareness Week. We’ll be looking forward to seeing you.

Here is the Seminar Schedule:

Tuesday, April 16, 2013 at 7:00 p.m.: “The Complete IVF Donor Egg Program”  

Kicking off NIAW early is the first of five seminars in our “Evenings of Education Series”. Presented by a panel of Long Island IVF doctors and staff (Donor Egg Program Director, Dr. Steven Brenner, Donor Egg Clinical Nurse Coordinator, Vicky Loveland, R.N., and Aviva Zigelman, LCSW) this educational seminar, including a slide show, will discuss why a woman may need donor eggs to conceive. The psychological aspects of being an egg donor or recipient will also be discussed. The entire donor egg program and its various processes will be reviewed, including what sets Long Island IVF’s donor egg program apart from others. The discussion will feature a previously successful recipient who used the donor egg program, as a guest speaker. There is no waiting list for egg donors at Long Island IVF. To register for this FREE seminar, Email: victorial@longislandivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

 

Monday, April 22, 2013 at 6:30 p.m.: “Trying to Conceive: The Complete Fertility Workup”   The second of five seminars in our NIAW “Evenings of Education” Series. Presented by Long Island IVF’s Dr. David Kreiner, this educational seminar will help interested people determine when it’s time to see a Reproductive Endocrinologist for assistance in conceiving. Dr. Kreiner will also explain the tests and procedures they may expect as part of a complete fertility evaluation and the full range of available treatment options to maximize the chances for conception. Dr. Kreiner will hold a Q&A session afterwards where attendees may ask him public, or private, questions. Pick the brain of Long Island’s IVF “pioneer” reproductive endocrinologist at the practice that brought Long Island its first IVF baby, first FET baby, and first donor egg baby. Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Tuesday, April 23, 2013 6:30 pm: “The Mind-Body Program: Use Your Mind to Help You Conceive” Presented by Long Island IVF’s Bina Benisch, R.N., this third seminar in our series will explain how stress hormones, anxiety, and depression physiologically affect the body and how it is crucial to break this cycle to increase your chance to conceive. Relaxation strategies of the Mind-Body program are taught in small, intimate group settings and include breath work, meditation, progressive muscle relaxation, focused mindfulness, and more. Once learned, you can use these coping strategies daily at home. Meet Bina and see if becoming part of this sacred circle of support is right for you.  Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Wednesday, April 24, 2013 6:30 pm: “Conceiving With PCOS” Presented by Long Island IVF’s Dr. Michael Zinger, this educational seminar, the fourth in our NIAW “Evenings of Education” series will address the most common hormonal disorders of reproductive age women: Polycystic Ovary Syndrome. PCOS symptoms vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility. The most common cause of PCOS is glucose intolerance. Dr. Zinger will discuss the treatment options for PCOS which can not only assist women attempting to conceive, but can help control their symptoms and may prevent long-term health problems. If you are one of the 7% of all women who suffer from this hormonal disorder, you won’t want to miss this seminar. Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Thursday, April 25, 2013 6:30 pm: “Fertility and Financial Options” Presented by Long Island IVF’s financial counselor, Chris Graffeo, this educational seminar, the fifth in our NIAW “Evenings of Education” series, will help you navigate the maze of health insurance and infertility treatment. You’ll learn how to find out what, if any, insurance benefits you may have for fertility treatment and how to find a participating reproductive endocrinologist. Chris will also discuss how to apply for Department of Health (DOH) IVF grants, how an IVF Refund Program works, and how a case rate plan can help make fertility treatment more affordable to self-pay patients. If the financial aspect of fertility care has you confused, this night is for you.  Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

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Which of these do YOU plan to attend? If there is a topic you’d like covered that you’re not sure fits in to one of the planned discussions, please comment below, or email lmontello@liivf.com with your question and we will forward it to one of the doctors. Or just come to one of the seminars and ask the doctor privately.

 

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