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Archive for the ‘Planning and Trying’ Category

Long Island IVF “Coming Out Infertile” Day Workshop

By Tracey Minella

November 13th, 2017 at 8:46 am

If you’re suffering in silence, you’ve got a date with us tonight.

Are you dreading the winter holiday season that’s only a week away? More silent suffering with your secret struggle of trying to start or build your own family? All those nagging questions about when are you finally going to have that baby? Being surrounded with nieces and nephews and their wish lists? Surprise pregnancy announcements at almost every gathering? Ugh.

Well, Long Island IVF can help. We’re proud to sponsor the third annual “Coming Out Infertile” Day on November 13, 2017 with a “Tired of the Secret?” special workshop for those suffering in silence from infertility. All are welcome and its free. No need to be a patient. If you haven’t registered yet, there is still time to come down.

Coming Out Infertile Day was conceived to encourage those suffering from infertility to “come out” to their families, friends, and/or employers if they feel ready to do so… and to help them with the tools they need to do so. And most importantly, to come out in a way that feels right for them.

Infertility is a devastating disease that affects 1 out of every 8 couples. In addition to the pain and fear that comes with this diagnosis, many couples feel the unwarranted stigma of shame and guilt. Consequently, they keep their infertility a secret—even from their family and closest friends.

They are often afraid…or don’t know how… to tell their families and friends (or their employers) that they are having trouble getting or staying pregnant and need treatment. So they suffer in silence. Often for many months or years.

The holiday season, with its focus on children and families, is a particularly hard time for infertile folks who are easy targets for nagging personal questions about baby-making plans. So, a week before the emotional onslaught is the perfect time to offer help “coming out”. You can come out today or plan to come out on Thanksgiving or some other time during the holiday season that feels right.

Coming Out Infertile Day…seven months after National Infertility Awareness Week in April and right before the stress of the holidays…is a timely public reminder of the pain of infertility and a chance for those suffering to come out and get support.

Long Island IVF is offering “Tired of the Secret?”—a free Coming-Out Infertile Workshop on November 13, 2017 from 6:30-8:30 pm at its offices at 8 Corporate Center Drive, Melville, New York. Led by our own Mind-Body medicine expert and psychologist, Bina Benisch, MS, RN, who specializes in counseling infertility patients, attendees will be given the support they need to come out infertile in a manner that’s right for them. Are you ready to tell just your parents? Or your best friend? The whole family? Need to know how to break it to your boss? We can help. The workshop is free but pre-registration is requested, so register here.

It’s time to end the stigma of infertility. It’s time to unburden yourself from the added weight of this secret and get the support you need. It’s time to #comeoutinfertile.

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What is holding you back from coming out infertile?

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Remembering 9/11 Sixteen Years Later

By Tracey Minella

September 11th, 2017 at 6:43 am

Credit: Pixabay/Ronile

 

I don’t think anything is more appropriate on this anniversary than to remember that day, so I’m sharing this classic.

 

You’ll always remember where you were that fateful day. And so will I.

 

I was working as a medical assistant for Long Island IVF. I was also a patient of Dr. Kreiner’s…and about 9 weeks pregnant with my son. Could life be any happier on a blindingly clear, crisp September morning?

 

It started out as a typical day, with the usual morning rush. Lots of busy women…many trying to get their blood and sono done so they cold hurry off to work. A few rushing to catch a train to the city. Men dropping off specimens on their way to the office. Some trying to catch a train to the city.

 

A train to the city.

 

By the time news of the second plane crash hit, most of the morning’s patients had already been seen and were gone. Disbelief was quickly followed by panic as we and the rest of the nation scrambled to figure out if our friends and family who worked in NYC were ok.  And what about our patients?

 

Doesn’t “So-and-So” work downtown? Isn’t “Mr. X” a trader on Wall Street? We spent the morning pouring over the employer info in the patients’ charts, making calls on jammed phone lines, and accounting for everyone’s whereabouts.  We went through the motions of the day on auto-pilot, glued to a 13” black and white TV in the nurse’s station, watching the horror unfold.

 

What kind of world was I bringing this baby into?

 

But just as there were stories of heroism, good deeds, and miracles amid the atrocity of the attacks, there was something positive that day in the Long Island IVF office.

 

A patient learned that, despite the chaos unfolding around her, it was indeed going to be her insemination day. When it’s your day, it’s your day. Not even an act of war will intervene. And 9/11 was to be her only day. One insemination. That afternoon. Amid the sadness and silence and sobs of the patient and everyone in the office.

 

And we came to learn a couple weeks later, that on the day the Twin Towers and the lives of so many innocent people were lost, we had participated in one ironically beautiful beginning. That patient got pregnant and had…twins.

 

Usually, it’s the patient who is thankful to the doctor and staff. But I will always be grateful to that patient for giving us one little happy something…well, actually two…to remember from that fateful day. And for being a sign to me that the world would go on, that we’d keep making babies, and that maybe it was going to be all right.

 

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How to Support an Infertile Man on Father’s Day

By Tracey Minella

June 17th, 2017 at 9:06 am

 

image: tminella


Infertile “dads-in-waiting” are no different when it comes to being infertile on Father’s Day than infertile wannabe moms are on Mother’s Day.

They want a baby.

A daddy’s little girl around whose little finger to be proverbially wrapped. A “mini-me” son to hang out with.

But society doesn’t seem to see his pain… because he is quiet. Maybe even to his wife or partner.

Women are more likely to chat with their sisters or closest girlfriends about their infertility—they cry on each other’s shoulders and talk about treatment—but men just don’t really do that. They don’t open up like that. Women talk. But guys’ group conversations tend to gravitate towards sports or politics—not how they injected their wife with a two-inch needle last night or held her as she cried over another negative pregnancy test.

Many men think they have to be the strong one– because if she sees him crumble, she may unravel herself. How unfair is that? Yet that’s how it is for so many guys and it’s completely understandable, and yes, a bit sexist, how they are willing to take all the pain on their shoulders if it’d shelter her.

Imagine that pressure to be strong and not cry? Imagine the totally unfounded but very real guilt he may feel if the diagnosis is male factor infertility? Or the stress he’s under if they can’t afford infertility treatment because his insurance or his salary doesn’t cover it? Or how he’s keeping the secret and hoping the guys don’t find out and rag on him about specimen collection or awkwardly joke about how they can help get her pregnant.

And don’t think for a minute he’s not aware of the children of other men at the gathering. Especially on Father’s Day. Kids playing catch with their dads. Dads showing pictures from the dance recital.

If his relationship with his own father is a good one, it may help to spend some one-on-one together on Father’s Day focusing on his role as the son. Maybe reflect on what kind of father he plans to be when the time comes for him—what he loved about his dad’s parenting style and what he might do differently.

Most importantly, let him do what he wants. See or be with who he wants and be sure to run interference for him with difficult people when you can. If he wants to be around the nieces or nephews, indulge his wish even if you feel differently. Or be alone together—or let him do his own thing–if that’s what he needs for that day.

And don’t ask him about starting a family. Just don’t. Ever. Especially on Father’s Day.

There is no substitution for a baby on Father’s Day, but you can give him hope for one next year. And if you think he’d benefit from talking it out with a caring infertility specialist, Long Island IVF offers group and individual counseling. Some couples have found a special connection to others who understand what they are going through and have even remained friends after their infertility journeys have resolved.

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What are your plans for Father’s Day?

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Long Island IVF Joins Lobbying Efforts for Mandated IVF Coverage in New York State

By Daniel Kenigsberg,MD

June 7th, 2017 at 10:10 am

 

Dr. Daniel Kenigsberg, Co-Founder Long Island IVF

 

I am lobbying for passage of Senate Bill S3248, a bill sponsored by Sen. Diane Savino of Staten Island, N.Y. which would mandate In-Vitro Fertilization (“IVF”) coverage in New York State –just as it is in neighboring states including Massachusetts, New Jersey, and Connecticut.

Our patients and other New Yorkers struggling with the significant emotional and financial burdens of infertility are under the impression that they live in a progressive state, but little do most know how poorly served they are by existing New York law.

Currently, the law mandates coverage for “correctable” medical conditions causing Infertility–but specifically EXCLUDES coverage for IVF. This has resulted in much emotional and financial cost spent on inferior or inappropriate treatments which ARE covered when, for over 50% of infertile couples, IVF was the best or only treatment.

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.

Further, not covering IVF treatment has a disproportionate effect on women (name one male treatment not covered by medical insurance). In Massachusetts, 5% of births result from IVF. In New York, it’s 1.5%. That is how dramatic the current arcane New York law hurts the population it is supposed to protect.

You can help right this wrong. And it won’t take more than 5 minutes of your time.

Call, write and email your state senator. You can find your senator here. Please note that mine is John Flanagan of Smithtown, Senate Majority Leader.

Also, contact Senator Savino of Staten Island because it is her bill to push and prioritize (or not). You can contact her here.

If you are currently suffering from infertility, it can be an overwhelmingly difficult time, but if you have a moment to reach out to your senator and Senator Savino, and any other local representatives, the combined effect of all of our voices can make a big difference. Or if your infertility journey has already been resolved, please reach out as well for the benefit of all that are now– and will someday be– following in your footsteps. And please share this with your family and friends so they may do the same. Thank you.

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4 Tricks Infertiles Can Use to Avoid Being Grilled at BBQs All Summer Long

By Tracey Minella

May 30th, 2017 at 7:37 am

 

Image: gratisography/Ryan McGuire


After a long winter– and some still chilly temps and wet days in New York—the kick-off to summer is finally here. Barbecue season is upon us and the charcoal is waiting for fresh meat…

Don’t be the meat.

The first picnics are here and that means you may be thrust into big group social situations again, after a long winter of hibernating. Maybe not this weekend, but maybe next. Or the one after that.

Are you ready? Do you need to up your defense?

Here are 4 tips to help you dodge the naggers before they can ask “When are you guys going to have a baby?”:

Drink heavily. I don’t mean alcohol (necessarily). But if you have a drink in your hand or a glass to your mouth, it can discourage conversation. Plus, you can down the contents and excuse yourself for a refill at the first hint of unpleasant conversation. Or if the nagger really oversteps, and you happen to slip and accidentally spill it down their dress, well, that’s really a diversion.

Stuff your face. You don’t have to eat non-stop, but (like the drinking tip) keeping something in your hand or on a plate that you can pop into your mouth when a nagger approaches could be key. You can’t be expected to answer an inappropriate… or any…question with your mouth full.

Have a Plan B… and sensible shoes. If a nagger is in the kitchen where you’re helping out, grab a tray of hors d’oeuvres and make a hasty exit to the yard. Or reverse. Or seek refuge in the bathroom for a bit.

Use children as shields. Normally, the kind of people who butt into your sex life aren’t the ones who play with the 87 kids at the party. Sure, being with other peoples’ kids can hurt, but it may still be better to jump into their game than face a nagger. No one can expect you to provide intimate details while you’re jumping rope or pitching a whiffle ball. And those whiffle balls can have unpredictable paths, too…

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Do you have any other tips to add on how to avoid or diffuse the nagger problem?

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Some Confessions of a NIAW Hater

By Tracey Minella

April 30th, 2017 at 9:28 am

 

image courtesy of RESOLVE


I hate infertility. I hate that people are so clueless… and their words and actions are so hurtful …that we have to raise their awareness of our pain and educate them about this disease that affects 1 in 8. And I hate that NIAW is just a week long.

Then, in many ways, life just goes back “normal”. To the unacceptable normal. Starting now.

Sure, last week we certainly raised awareness in the community. We hosted a couple of NIAW events including a wildly popular and fun night of Yoga for Fertility on Wednesday followed by  an Acupuncture for Fertility Symposium on Thursday where a small group gathered in an intimate setting with Dr. Kreiner and James Vitale, LAc, to learn about and discuss fertility-focused acupuncture.

We bonded with patients from our own practice, as well as those from other practices, and they bonded with each other. We welcomed prospective patients, their parents and friends, and interested strangers. We empowered them with therapies and activities they can use to take back some control over their fertility. They were thankful and such a pleasure to get to know. In short, we did some good. As did other infertility practices and organizations around the country.

But, now NIAW is over. And it’s kind of quiet.

How do we keep the momentum of NIAW going? How do we make sure the topic of infertility doesn’t get swept under the rug until next April?

First off, we have two more important events this week— basically extending the NIAW into two weeks instead of one– giving you some extra support as the dreaded Mother’s Day and Father’s Day holidays approach.

We have a seminar called New Beginnings Through Donor Egg” on May 2 for those who’d like more information on conceiving through donor egg and who want to hear from a successful donor egg mom. We also have a ground-breaking workshop called “Tired of the Secret?” on May 4 for those who want to explore the option of coming out of the infertility closet, but need to work through some issues with our infertility specialist and counselor, Bina Benisch, M.S., R.N. Both events are free and open to the public, but preregistration is required and seats are limited.

Another way to keep infertility in the spotlight is to move on swiftly and loudly to the next thing that keeps infertility in the news. Maybe that means joining thousands of infertility advocates by going to Washington D.C. for Advocacy Day on May 18, 2017.

Or maybe it means participating in the New York City Walk of Hope on May 20, 2017 to raise infertility awareness. The “Baby Hope” team asked us to spread the word in case anyone else wants to join or donate to her team for the walk. It’s just a mile…you can do it!

Let’s keep the conversations about infertility going…

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Will you be there?

 

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No More April Fool’s Day Pregnancy Jokes

By Tracey Minella

April 1st, 2017 at 1:58 pm

 

image: wpclipart

Even a holiday as insignificant as April Fool’s Day has become a minefield for the infertile.

What should be a harmless day of dodging innocent pranks always turns ugly with the inevitable April Fool’s Day prank post: “I’m pregnant”.

Just. Stop. Now.

It’s not only soooooo last year (and the year before that… and the year before that) but it’s not even believable or funny anymore. In fact, it never was. It’s simply hurtful to those who can’t have children. And we are not oversensitive. Infertility is no joke. It’s a disease. Would you joke about having cancer? Of course not.

So how about you think before typing that lame joke this year? Think about all the infertile couples who suffer every day of the year as their newsfeeds are bombarded by countless legit pregnancy announcements, baby pictures, and other kid-related posts.

Give us a break. Better yet, post something that is actually laugh-out-loud funny. God/Goodness knows, we could use a momentary diversion from the pain with a rare and honest belly laugh.

Don’t be the Fool on April 1st.

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Are you bothered by April Fool’s Day pregnancy pranks? How do you respond?

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The 12 Pains of Christmas and Infertility

By Tracey Minella

December 5th, 2016 at 9:36 am

 

image credit: james barker/free digital photos.net

There’s a funny Christmas song that parodies “The Twelve Days of Christmas” called “The 12 Pains of Christmas”, by Bob Rivers. It starts out calm and as the verses go on repetitively, the frustration escalates. My favorite parts are the lines about rigging up the lights (“One goes out, they ALL GO OUT!”), facing my in-laws (“She’s a witch, I hate her!”) and sending Christmas cards (“I don’t even KNOW half these people!”).

But when you’re suffering from infertility, the holiday season is particularly hard and just about everything having to do with it is frustrating. It’s hard to be festive at office parties when that water you’re drinking is sure to prompt smirks or comments about the pregnancy your co-workers think you must be hiding. Maybe you don’t feel like decorating a tree or attending a cookie swap. The idea of facing the toy stores for the kids in your life’s wish list is simply daunting.

And don’t get me started on the cards. The photo cards. The perfect little baby photo cards. The deluge of pictures of families that flood the mailbox. Every. Single. Day. It hurts to receive them. And it hurts to have to send your own out without a baby photo on it—again.

And it hurts to feel guilt and sadness over feeling how you’re feeling.

So in a small attempt at levity, I propose the following song—an anthem if you will—“The 12 Pains of Christmas with Infertility”, set to the same tune as The 12 Days of Christmas:

Here goes:

The first pain of Christmas with Infertility is…

1-    Hiding Your Infertility;

2-    Pregnancy announcements;

3-    Nosy in-laws’ questions;

4-    Specimen collection;

5-    FIVE GRAND IN MEDS!!!

6-    Facing Toys R Us®;

7-    Booze-free office parties;

8-    One line on the pee stick;

9-    Photo cards with babies;

10- Daily injections;

11- Hiding blood work bruises;

12- Aunt Flo comes to visit.

I’m offering you hope and humor, strength and peace this holiday season.

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What would you add to the list?

 

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Election Day, Politics, and Infertility

By Tracey Minella

November 8th, 2016 at 5:33 pm

 

image: coward_lion/free digitalphotos.net


Today, what feels like the longest, most controversial, and unprecedented presidential election campaign will finally come to an end. Sadly, and on a level not seen before, families and friendships have been broken over this election and we are all watching and holding our collective breath for the results as well as the potential aftermath.

But this post is not to persuade anyone on whom to choose. We each have issues that are important to us and, for some, the choice today may come down to which candidate supports our most important issue.

This post is to reflect on how the infertility community affects political change and public awareness of infertility.

Behind the scenes—and often center stage—countless people fight continuously for the rights of the infertility community. Some advocates are infertile right now; others may have already resolved their infertility but want to help those suffering today—and tomorrow. Some want to see certain groups, such as military veterans, get medical coverage for assisted reproductive technology. While others just want mandated infertility and adoption coverage for all.

There’s a lot going on in the political and infertile world—some front-burner and other back-burner movements.

A couple of months ago, after years of advocacy, the commonly-called #IVF4Vets bill, also known as MilCon-VA, was finally passed, removing the VA-bar on IVF treatment for veterans. This change is the first step toward providing IVF to military veterans who are infertile as a result of their military service. Unfortunately, it’s often one step forward and two steps back when it comes to gaining political ground. At practically the same time, what’s been coined the proposed Harris Embryo Amendment entered the picture. It’s also been called “the worst piece of federal legislation ever introduced”*.

The Harris Embryo Amendment would be a real threat to federally-funded IVF. In a nutshell, it would prohibit the federal funding of any IVF treatments in a federal government facility in which there is a possibility that any resulting viable embryo could be discarded or destroyed. Since excess embryos are not only commonplace in IVF, but generally an unavoidable result of the treatment, the mandated transfer of all fresh embryos would actually, in most cases, be detrimental, since the current standard practice is generally transferring only one or two embryos per cycle. In addition, the survival and use of all embryos thawed after cryopreservation cannot be guaranteed. So, the proposed amendment may threaten federally-funded IVF and cryopreservation as it now exists.

There have been other political initiatives in recent years on behalf of the infertile, including but not limited to the Family Act and the Adoption Tax Credit Refundability Act. As assisted reproductive technology continues to advance and the demand for these services grows, we can expect to continue to advocate both for and against new legislation.

So, after this election—and maybe just a short break from the politics—consider becoming more involved in infertility-related advocacy and legislation. The first and best step would be to reach out the RESOLVE: The National Infertility Association—the group that fights tirelessly for the rights of the infertile community. (Thanks, RESOLVE!) You can check out the political initiatives here.

And if you are overcome with infertility-related sadness and stress as the holiday season is approaching, please let us help you.

In an effort to increase public awareness of infertility before the special stress of the winter holiday season hits those who are suffering in silence, Long Island IVF is sponsoring the second annual Coming Out Infertile Day with “The Reveal: A Coming Out Infertile Workshop” on November 17th from 6:30-8:00 pm at our Melville office.

This free workshop will be led by our own Mind-Body Medicine expert and psychologist, Bina Benisch, MS, RN, who specializes in counseling infertility patients and will focus on helping infertile people work through the obstacles that may be preventing them from coming out to their family and friends. The focus is to help those who would like to “come out” to do so in a way that’s right for them, so they can get the support they need. All are welcome. Pre- registration is required here. Like our Facebook page or Coming Out Infertile Day page for information on how to join the social media movement on Nov 17 to come out infertile with one easy graphic and one click-again for those who are ready to do so.

Now, go ahead and vote!

*Barbara Collura, RESOLVE

 

 

 

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4 Hot Fertility Questions at ASRM 2016

By David Kreiner MD

November 7th, 2016 at 7:45 am

The theme for the 2016 ASRM (American Society for Reproductive Medicine) conference in Salt Lake City, Utah was “Scaling New Heights in Fertility”.  As one whose life on Long Island sheltered me from views of snow-capped mountain tops, the perspective of the attendees appeared to climb higher and perhaps to possibilities never previously conceived.

I summarize here 4 Hot Fertility Questions that were debated and discussed in the conference:

1)      Should PGS screening be routine for all IVF patients?

2)      Should all IVF transfers be restricted to blastocysts only?

3)      Should we freeze all embryos and transfer in an unstimulated cycle?

4)      What is the best treatment for the patient with diminished ovarian reserve?

Should PGS screening be routine for all IVF patients? 

The theoretical benefit of Pre-Implantation Genetic Screening, or“PGS”, testing is that it allows one to select a single “tested normal” embryo in the presence of multiple embryos which is more likely to implant and less likely to miscarry.  Absent testing the chromosome number of the embryos, to insure a similar chance of conception one might transfer two embryos– increasing the likelihood that twins would result in a pregnancy at greater risk for prematurity and complications affecting the health of the babies.  Most miscarriages are the result of abnormal chromosomes and if the embryos had normal chromosomes then there should be less of a chance the pregnancy would result in miscarriage.

The argument against routine PGS testing is based mainly on the fact that the test is not 100% accurate or predictive of either normalcy or abnormalcy in addition to not obtaining a result in some cases.  It is argued that the error rate is only 1% but there is a phenomenon called mosaicism where an embryo may have more than one cell line. It is not rare that an embryo which has an abnormal cell line in addition to a normal one can, during development, shed the abnormal cells and evolve normally.  However, PGS testing may pick up only the abnormal cell or detect both normal and abnormal and then there is the question of what to do with the mosaic embryos since there is no current way to predict whether these embryos will ultimately be normal.

Another argument against routine PGS testing is that most abnormal embryos never implant anyway and that perhaps the reduction in miscarriages with PGS is not as great as predicted.  Still another argument that holds true for younger patients in particular is that the pregnancy rate for a single blastocyst transfer is nearly as high without PGS testing and that one can achieve equal success without the risk of discarding potentially normal embryos.

Should all IVF transfers be restricted to blastocysts only?

In addition to improving the ability to select the best embryo, the proposed advantages of a blastocyst transfer (typically 5-6 days old) versus a cleaved embryo transfer (usually 3 days old) include the following:

  • an embryo transferred 5-6 days after ovulation is closer to the natural physiologic state
  • there are thought to be fewer uterine contractions 5-6 days post ovulation than 3 days;
  • blastocysts have a larger diameter and are thought to be less likely to be pushed into the fallopian tubes—which may lead to a lower ectopic pregnancy rate;
  • there is a shorter time to implantation and therefore less opportunity for a deleterious event to occur to an embryo in the uterus.

However, there are some patients, in particular older or those with more fragile embryos, which have been shown to fail to conceive on multiple occasions after a blast transfer but successfully get pregnant and deliver healthy babies after transfer of cleaved embryos.  Furthermore, there is evidence that in some of these cases embryos that may have been destined to otherwise result in a normal pregnancy may fail to develop to blast in the laboratory.

Should we freeze all embryos and transfer in an unstimulated cycle?

There is a growing consensus nationally among IVF programs that the endometrium is less receptive to embryo implantation during a stimulated cycle–especially one in which the estradiol and/or progesterone levels are high.  Although convincing patients to delay transfer to a subsequent unstimulated cycle is a challenge, growing evidence is pushing the field in this direction.

What is the best treatment for the patient with diminished ovarian reserve?

Optimal treatment of the patient with diminished ovarian reserve remains a challenge to the IVF program.  There is growing evidence that adjuvant therapy, including such things as acupuncture and Chinese herbs as well as supplements such as CoQ10 and DHEA, may improve a patient’s response to stimulation and improve pregnancy rates.  Other strategies include sensitizing follicles with estradiol and/or Growth Hormone pre-treatment and banking embryos from multiple cycles with transfer during an unstimulated cycle.  Still another strategy is milder stimulation in an attempt to improve the quality of the retrieved egg/s.

There were many heights achieved during this meeting and to this boy from Queens I was impressed not just with the science and the breathtaking vistas of the regal mountains forming a horseshoe around Salt Lake City but also with the most pleasing goodness of the people native to the city who genuinely offered their time to help make our experience a pleasant one.

 

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