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Archive for the ‘clomid’ tag

Reflecting on the Contribution of Clomid® Chemist, Frank Palopoli

By David Kreiner MD

August 18th, 2016 at 9:50 am

 

image credit: nenetus/freedigitalphotos.net


I was cooling off in my community pool and a former patient recognized me and proudly  showed off her 13 year old daughter…”just Clomid® right?”, I asked, a trite too brash.  “Yes, and insemination after a couple of failed attempts,” she replied.

I sometimes assume if a patient doesn’t have to do IVF to conceive that they have not sufficiently suffered the infertility rites of passage.  Shame on me…for someone facing the challenge of conceiving, the pain can be most severe and if solved with fertility pills—Clomid®–then it is just as miraculous a cure as the newer technologic marvel of IVF.

I have experienced in my 31 years as a reproductive endocrinologist specializing in fertility several hundred such successes and babies born from this highly successful fertility pill that was developed by a team in the 1950’s led by Frank Palopoli who died last week at the age of 94.

Clomiphene®, the generic form of the estrogen receptor inhibitor that came on the market in 1967, works by blocking the negative feedback of estrogen resulting in an increase of pituitary hormones, FSH and LH which in turn stimulates the ovaries to ovulate.

Clomid® may be used by itself or augmented with injections of LH and/or FSH as well as HCG used as a trigger for ovulation when the ovarian follicles stimulated by Clomid® have reached maturity.  The pills are usually taken in the beginning of the cycle for five days and the response carefully monitored with serum estradiol and LH levels as well as follicular ultrasounds.

As tens of millions of babies have been born since Mr. Palopoli developed Clomid® we in the field and those who have reaped the rewards of this medication owe him a tremendous debt of gratitude.

* * ** * * *** *

Did Clomid® play a part in your fertility journey?

 

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Is Clomid Right for You?

By David Kreiner MD

May 22nd, 2015 at 12:27 pm

 

Photo: imagery magestic/ freedigitalphotos.net


It has become commonplace for women who have been frustrated with repeated unsuccessful attempts to conceive naturally on their own to see their gynecologist who often times will try clomid therapy on them.

Clomid, the traditional brand name for clomiphene citrate, is a competitive inhibitor of estrogen. It stimulates the pituitary gland to produce follicle stimulating hormone (FSH) which in turn will stimulate the ovaries to mature follicle(s) containing eggs. Estrogen normally has a negative effect on the pituitary: Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.

Infertility patients — those under 35 having one year of unprotected intercourse without a resulting pregnancy and those over 35 having six months without pregnancy — have a two to five percent pregnancy rate each month trying on their own without treatment.

Clomid therapy increases a couple’s fertility by increasing the number of eggs matured in a cycle and by producing a healthier egg and follicle. The pregnancy rate with clomid therapy alone is approximately ten percent per cycle and 12 -15 percent when combined with intrauterine insemination (IUI). Women who are unable to ovulate on their own experience a 20 percent pregnancy rate per cycle with clomid, the equivalent to that of a fertile couple trying on their own.

Clomid and Your Cervical Mucus

Women who are likely to conceive with clomid usually do so in the first three months of therapy, with very few conceiving after six months. As clomid has an anti-estrogen effect, the cervical mucus and endometrial lining may be adversely affected.

Cervical mucus is normally produced just prior to ovulation and may be noticed as a stringy egg white-like discharge unique to the middle of a woman’s cycle just prior to and during ovulation. It provides the perfect environment for the sperm to swim through to gain access to a woman’s reproductive tract and find her egg. Unfortunately, clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb. IUI overcomes this issue through bypassing the cervical barrier and depositing the sperm directly into the uterus.

However, when the uterine lining or endometrium is affected by the anti-estrogenic properties of clomid, an egg may be fertilized but implantation is unsuccessful due to the lack of secretory gland development in the uterus. The lining does not thicken as it normally would during the cycle. Attempts to overcome this problem with estrogen therapy are rarely successful.

Side Effects

Many women who take clomid experience no side effects. Others have complained of headache, mood changes, spots in front of their eyes, blurry vision, hot flashes and occasional cyst development (which normally resolves on its own). Most of these effects last no longer than the five or seven days that you take the clomid and have no permanent side effect. The incidence of twins is eight to ten percent with a one percent risk of triplet development.

Limit Your Clomid Cycles

Yet another deterrent to clomid use was a study performed years ago that suggested that women who used clomid for more than twelve cycles developed an increased incidence of ovarian tumors. It is therefore recommended by the American Society of Reproductive Medicine as well as the manufacturer of clomiphene that clomid be used for no more than six months after which it is recommended by both groups that patients proceed with treatment including gonadotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization.

Success rates

For patients who fail to ovulate, clomid is successful in achieving a pregnancy in nearly 70 percent of cases. All other patients average close to a 50 percent pregnancy rate if they attempt six cycles with clomid, especially when they combine it with IUI. After six months, the success is less than five percent per month.

In vitro fertilization (IVF) is a successful alternative therapy when other pelvic factors such as tubal disease, tubal ligation, adhesions or scar tissue and endometriosis exist or there is a deficient number, volume or motility of sperm. Success rates with IVF are age, exam and history dependent.

Young patients sometimes choose a minimal stimulation IVF or MicroIVF as an alternative to clomid/IUI cycles as a more successful and cost effective option as many of these patients experience a 40 percent pregnancy rate per retrieval at a cost today of about $3,900.

Today, with all these options available to patients, a woman desiring to build her family will usually succeed in becoming a mom.

* * * * * * ** * *

Did you start out with Clomid? Did you have success with it or did you move on to IVF?

 

photo credit: imagery majestic http://www.freedigitalphotos.net/images/Couplespartners_g216-Young_Romantic_Couple_p75136.html

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TTC? Everything You Ever Wanted to Know About Clomid

By David Kreiner MD

December 7th, 2014 at 5:23 pm

credit: taoty/ freedigitalphotos.net

It has become commonplace for women who have been frustrated with repeated unsuccessful attempts to conceive naturally on their own to see their gynecologist who often times will try clomid therapy on them. Clomid, the traditional brand name for clomiphene citrate, is a competitive inhibitor of estrogen. It stimulates the pituitary gland to produce follicle stimulating hormone (FSH) which in turn will stimulate the ovaries to mature follicle(s) containing eggs. Estrogen normally has a negative effect on the pituitary: Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.

Infertility patients — those under 35 having one year and of unprotected intercourse without a resulting pregnancy and those over 35 having six months without pregnancy — have a two to five percent pregnancy rate each month trying on their own without treatment. Clomid therapy increases a couple’s fertility by increasing the number of eggs matured in a cycle and by producing a healthier egg and follicle. The pregnancy rate with clomid therapy alone is approximately ten percent per cycle and 12 -15 percent when combined with intrauterine insemination (IUI). Women who are unable to ovulate on their own experience a 20 percent pregnancy rate per cycle with clomid, the equivalent to that of a fertile couple trying on their own.

Clomid and Your Cervical Mucus

Women who are likely to conceive with clomid usually do so in the first three months of therapy, with very few conceiving after six months. As clomid has an anti-estrogen effect, the cervical mucus and endometrial lining may be adversely affected.

Cervical mucus is normally produced just prior to ovulation and may be noticed as a stringy egg white like discharge unique to the middle of a woman’s cycle just prior to and during ovulation. It provides the perfect environment for the sperm to swim through to gain access to a woman’s reproductive tract and find her egg. Unfortunately, clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb. IUI overcomes this issue through bypassing the cervical barrier and depositing the sperm directly into the uterus.

However, when the uterine lining or endometrium is affected by the anti-estrogic properties of clomid, an egg may be fertilized but implantation is unsuccessful due to the lack of secretory gland development in the uterus. The lining does not thicken as it normally would during the cycle. Attempts to overcome this problem with estrogen therapy are rarely successful.

Side Effects

Many women who take clomid experience no side effects. Others have complained of headache, mood changes, spots in front of their eyes, blurry vision, hot flashes and occasional cyst development (which normally resolves on its own). Most of these effects last no longer than the five or seven days that you take the clomid and have no permanent side effect. The incidence of twins is eight to ten percent with a one percent risk of triplet development.

Limit Your Clomid Cycles

Yet another deterrent to clomid use was a study performed years ago that suggested that women who used clomid for more than twelve cycles developed an increased incidence of ovarian tumors. It is therefore recommended by the American Society of Reproductive Medicine as well as the manufacturer of clomiphene that clomid be used for no more than six months after which it is recommended by both groups that patients proceed with treatment including gonadotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization.

Success rates

For patients who fail to ovulate, clomid is successful in achieving a pregnancy in nearly 70 percent of cases. All other patients average close to a 50 percent pregnancy rate if they attempt six cycles with clomid, especially when they combine it with IUI. After six months, the success is less than five percent per month.

In vitro fertilization (IVF) is a successful alternative therapy when other pelvic factors such as tubal disease, tubal ligation, adhesions or scar tissue and endometriosis exist or there is a deficient number, volume or motility of sperm. Success rates with IVF are age, exam and history dependent. The average pregnancy rate with a single fresh IVF cycle is greater than 50 percent. For women under 35, the pregnancy rate for women after a single stimulation and retrieval is greater than 70 percent with a greater than 60 percent live birth rate at Long Island IVF.

Young patients sometimes choose a minimal stimulation IVF or MicroIVF as an alternative to clomid/IUI cycles as a more successful and cost effective option as many of these patients experience a 40 percent pregnancy rate per retrieval at a cost today of about $3,900.

Today, with all these options available to patients, a woman desiring to build her family will usually succeed in becoming a mom.

* * * * * * * * * * *

Do you have any other questions for Dr. Kreiner about Clomid?

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Negative Pregnancy Test Again! Now What?!

By David Kreiner MD

November 30th, 2014 at 9:51 am

 

credit: davidcastillodominici/ freedigitlaphotos.net


Women confronted with a negative result from a pregnancy test are always disappointed, sometimes devastated. Many admit to becoming depressed and finding it hard to associate with people and go places where there are pregnant women or babies, making social situations extremely uncomfortable. A negative test is a reminder of all those feelings of emptiness, sadness and grief over the void infertility creates.

We don’t have control over these feelings and emotions. They affect our whole being and, unchecked, will continue until they have caused a complete state of depression. This article can arm you with a strategy to fight the potentially damaging effects that infertility threatens to do to you and your life.

First, upon seeing or hearing that gut-wrenching news, breathe.
Meditation — by controlling and focusing on your breathing — can help you gain control of your emotions and calm your body, slow down your heart rate and let you focus rationally on the issues. It’s best to have your partner or a special someone by your side who can help you to calm down and regain control.

Second, put this trauma into perspective.
It doesn’t always help to hear that someone else is suffering worse — whether it’s earthquake or cancer victims — but knowledge that fertile couples only conceive 20% of the time every month means that you are in good company with plenty of future moms and dads.

Third, seek help from a specialist, a reproductive endocrinologist (RE).
An RE has seven years of post-graduate training with much of it spent helping patients with the same problem you have. An RE will seek to establish a diagnosis and offer you an option of treatments. He will work with you to develop a plan to support your therapy based on your diagnosis, age, years of infertility, motivation, as well your financial and emotional means. If you are already under an RE’s care, the third step becomes developing a plan with your RE or evaluating your current plan.

Understand your odds of success per cycle are important for your treatment regimen. You want to establish why a past cycle may not have worked. It is the RE’s job to offer recommendations either for continuing the present course of therapy — explaining the odds of success, cost and risks — or for alternative more aggressive and successful treatments (again offering his opinion regarding the success, costs and risks of the other therapies).

Therapies may be surgical, such as laparoscopy or hysteroscopy to remove endometriosis, scar tissue, repair fallopian tubes or remove fibroids. They may be medical, such as using ovulation inducing agents like clomid or gonadotropin injections. They may include intrauterine insemination (IUI) with or without medications. They also may include minimal stimulation IVF or full-stimulated IVF. Age, duration of infertility, your diagnosis, ovarian condition, and financial and emotional means play a large role in determining this plan that the RE must make with your input.

There may be further diagnostic tests that may prove value in ascertaining your diagnosis and facilitate your treatment. These include a hysteroscopy or hydrosonogram to evaluate the uterine cavity, as well as the HSG (hysterosalpingogram) to evaluate the patency of the fallopian tubes as well as the uterine cavity.

Complementary therapies offer additional success potential by improving the health and wellness of an individual and, therefore, her fertility as well. These therapies — acupuncture, massage, nutrition, psychological mind and body programs, hypnotherapy –
have been associated with improved pregnancy rates seen when used as an adjunct to assisted reproductive technologies.

A negative pregnancy test can throw you off balance, out of your routine and depress you. Use my plan here to take control and not just improve your mood and life but increase the likelihood that your next test will be a positive one.

* * * * * * * *

What have you done to get through the disappointment?

 

photo credit: http://www.freedigitalphotos.net/images/CouplesPartners_g216-Depressed_Young_Couple_p104407.html

 

 

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Is Clomid for You?

By David Kreiner MD

January 16th, 2014 at 6:51 pm

 

 

It has become commonplace for women who have been frustrated with repeated unsuccessful attempts to conceive naturally on their own to see their gynecologist who often times will try clomid therapy on them.

Clomid, the traditional brand name for clomiphene citrate, is a competitive inhibitor of estrogen. It stimulates the pituitary gland to produce follicle stimulating hormone (FSH) which in turn will stimulate the ovaries to mature follicle(s) containing eggs. Estrogen normally has a negative effect on the pituitary: Clomid blocks estrogen and leads to pituitary FSH production and ovarian stimulation.

Infertility patients — those under 35 having one year of unprotected intercourse without a resulting pregnancy and those over 35 having six months without pregnancy — have a two to five percent pregnancy rate each month trying on their own without treatment.

Clomid therapy increases a couple’s fertility by increasing the number of eggs matured in a cycle and by producing a healthier egg and follicle. The pregnancy rate with clomid therapy alone is approximately ten percent per cycle and 12 -15 percent when combined with intrauterine insemination (IUI). Women who are unable to ovulate on their own experience a 20 percent pregnancy rate per cycle with clomid, the equivalent to that of a fertile couple trying on their own.

Clomid and Your Cervical Mucus

Women who are likely to conceive with clomid usually do so in the first three months of therapy, with very few conceiving after six months. As clomid has an anti-estrogen effect, the cervical mucus and endometrial lining may be adversely affected.

Cervical mucus is normally produced just prior to ovulation and may be noticed as a stringy egg white-like discharge unique to the middle of a woman’s cycle just prior to and during ovulation. It provides the perfect environment for the sperm to swim through to gain access to a woman’s reproductive tract and find her egg. Unfortunately, clomid may thin out her cervical mucus, preventing the sperm’s entrance into her womb. IUI overcomes this issue through bypassing the cervical barrier and depositing the sperm directly into the uterus.

However, when the uterine lining or endometrium is affected by the anti-estrogenic properties of clomid, an egg may be fertilized but implantation is unsuccessful due to the lack of secretory gland development in the uterus. The lining does not thicken as it normally would during the cycle. Attempts to overcome this problem with estrogen therapy are rarely successful.

Side Effects

Many women who take clomid experience no side effects. Others have complained of headache, mood changes, spots in front of their eyes, blurry vision, hot flashes and occasional cyst development (which normally resolves on its own). Most of these effects last no longer than the five or seven days that you take the clomid and have no permanent side effect. The incidence of twins is eight to ten percent with a one percent risk of triplet development.

Limit Your Clomid Cycles

Yet another deterrent to clomid use was a study performed years ago that suggested that women who used clomid for more than twelve cycles developed an increased incidence of ovarian tumors. It is therefore recommended by the American Society of Reproductive Medicine as well as the manufacturer of clomiphene that clomid be used for no more than six months after which it is recommended by both groups that patients proceed with treatment including gonadotropins (injectable hormones containing FSH and LH) to stimulate the ovaries in combination with intrauterine insemination or in vitro fertilization.

Success rates

For patients who fail to ovulate, clomid is successful in achieving a pregnancy in nearly 70 percent of cases. All other patients average close to a 50 percent pregnancy rate if they attempt six cycles with clomid, especially when they combine it with IUI. After six months, the success is less than five percent per month.

In vitro fertilization (IVF) is a successful alternative therapy when other pelvic factors such as tubal disease, tubal ligation, adhesions or scar tissue and endometriosis exist or there is a deficient number, volume or motility of sperm. Success rates with IVF are age, exam and history dependent. The average pregnancy rate with a single fresh IVF cycle is greater than 50 percent. For women under 35, the pregnancy rate for women after a single stimulation and retrieval is greater than 70 percent with a greater than 60 percent live birth rate at Long Island IVF.

Young patients sometimes choose a minimal stimulation IVF or MicroIVF as an alternative to clomid/IUI cycles as a more successful and cost effective option as many of these patients experience a 40 percent pregnancy rate per retrieval at a cost today of about $3,900.

Today, with all these options available to patients, a woman desiring to build her family will usually succeed in becoming a mom.

* * * * * * ** * *

Did you start out with Clomid? Did you have success with it or did you move on to IVF?

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Infertility and National Prematurity Awareness Month

By Tracey Minella

November 19th, 2013 at 10:53 am

 

photo credit: praisaeng/freedigitalphotos.net

Infertility is a disease. Its course often follows a common progression. It often starts with the abandonment of what turns out to have been unnecessary birth control. It then progresses through a repeated series of monthly disappointments until charts, thermometers, and the “chore-mentality” move into the bedroom. ObGyn intervention becomes an RE referral. A battery of tests and invasive procedures follow. Sometimes there’s Clomid. Maybe even ovulation induction with IUIs. Possibly, there’s IVF.

It’s no wonder that most infertility patients are so caught up in the all-consuming grind of simply trying to get pregnant, that they don’t think past getting that positive pregnancy test. They don’t think that…after all that time and sacrifice…something could threaten that hard-earned pregnancy.

It’s National Prematurity Awareness Month. And there is no better time to focus on what you can do to reduce your chances of having a premature baby than before you become pregnant.

It’s not always known why babies are born prematurely, but according to the Mayo Clinic*, some risk factors can include:

  • Pregnancy with twins, triplets or other multiples
  • Problems with the uterus, cervix or placenta
  • Smoking cigarettes, drinking alcohol or using illicit drugs
  • Poor nutrition
  • Some infections, particularly of the amniotic fluid and lower genital tract
  • Some chronic conditions, such as high blood pressure and diabetes
  • Being underweight or overweight before pregnancy.

 

According to the CDC**, some of the symptoms or warning signs of pre-term labor include:

  • Contractions (the abdomen tightens like a fist) every 10 minutes or more often.
  • Change in vaginal discharge (leaking fluid or bleeding from the vagina).
  • Pelvic pressure—the feeling that the baby is pushing down.
  • Low, dull backache.
  • Cramps that feel like a menstrual period.

If you are doing IVF, one of the things you may want to consider to reduce your chances of prematurity is having a single embryo transfer (“SET”), if your doctor feels you are a good candidate. Doing so virtually eliminates your chance of a multiple pregnancy. In addition to the safety considerations for mother and baby, SET at Long Island IVF offers financial incentives, including free cryopreservation and reduced rates for subsequent frozen embryo transfers. Click here for more information about Long Island IVF’s Single Embryo Transfer Program. http://bit.ly/WpzCvv

As an IVF mom of two preemies myself, let me acknowledge that very often, babies arrive early for reasons beyond our control. Sadly, the outcomes are not always happy. But knowledge is power, so control what you can, watch for the signs, and listen to that little voice if you feel something is amiss. And remember that the vast majority of these hard-earned pregnancies do turn out just fine.

*http://mayocl.in/HWaNGz

** http://1.usa.gov/IdCytZ

* * * * * * * * * * * * * * * * *

Do you worry about prematurity? If so, would you consider SET to reduce the chance of a multiple pregnancy?

Photo credit: http://www.freedigitalphotos.net/images/agree-terms.php?id=100141619 /praisaeng

 

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Favorite Infertility Injection Stories

By Tracey Minella

July 2nd, 2013 at 9:51 pm

 

image courtesy of sakhorn 38/freedigitalphotos.net

The hardest part of the initiation into the “Infertility Injectables Sorority” is… well… the injectables. Once you’ve moved on from popping Clomid, there’s no other way to nudge your ovaries into high gear without facing a needle…or…”about facing” a needle, to be more accurate.

You’ve got your little needles. And then you’ve got your big guns. Determining who the injector will be is as easy as… seeing who doesn’t pass out at injection-teaching. Seriously, more often than not, one partner injects the other. But some women inject themselves. It’s good to be prepared to do that, because life is never predicable, right? Overtime, traffic, surprise visitors, flat tires, poorly-timed wedding receptions…all conspire to de-rail the planned “window of injectability”.

I have countless crazy injectable stories from 3 IUIs and 7 fresh IVFs. I will save my self-injecting IM to the thigh story for another time. But I’ll share this favorite one now.

As a pre-requisite to acceptance into an intended P.A. program, I was taking an evening college biology course during an IVF cycle and… wouldn’t ya know it…it fell smack in my “injectability window”. So, I figured I’d better tell the professor what I was doing. Never know when slinking off to the bathroom with syringes and vials of white powder every night might raise an eyebrow.

Then, Lupron gave way to the big guns…the IM injections. More explaining to do. Foggy windows in the parking lot where my husband the designated injector met me for the nightly ritual. We were like spies with synchronized watches in the pre cell phone days.

Finally… the final. Yeah, sorry but that’s the night of my hCG shot and I am NOT doing that precisely-timed, majorly-important shot in the backseat. I’ll need a make-up exam, please.

The professor was very understanding. I got an A- from him, missing the A by a mere nano fraction of a point. I lost my passionate but good-natured argument for a rounding up to compensate for points lost for “Lupron brain”. On top of all that, I did not get pregnant that cycle.

Fast forward about two years to me working part time as a hospital phlebotomist (another pre-requisite: 500 hours of actual patient care experience). One afternoon, I walked into a patient’s room, with my cheery greeting preceding me. As I rounded the edge of the curtain, he was sitting in the bed. I wonder if he recognizes me.

I moved to his bedside, checked his wristband, and laid out my blood-drawing tools. As I wrapped the tourniquet around his arm, I looked up with a smile and our eyes met. At that moment, I knew our minds met as well.

“Bet you’re wishing you gave me that “A” right about now, huh?” I whispered.

* * * * * * * * * ** * ** *

What’s your favorite injection story?

 

Photo credit: sakhorn38 and  http://www.freedigitalphotos.net/images/agree-terms.php?id=100163051

 

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Infertility Podcast Series: Journey to the Crib: Chapter 16 Micro-IVF

By David Kreiner MD

June 10th, 2013 at 9:46 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Sixteen: Micro-IVF. You, the listener, are invited to ask questions and make comments.  Dr. Kreiner will answer them. You can access the podcast here: http://podcast.longislandivf.com/?p=101

Micro-IVF

Micro-IVF, also known as Mini-IVF, is a minimal stimulation IVF that differs from routine IVF only in the ovarian stimulation hormones that are used.  We typically stimulate with clomid 100mg for the first five days followed by 75 units of FSH hormones for two days.  We monitor, retrieve the eggs, fertilize the eggs in the lab and perform the embryo transfer in the same exact way as we do with all other IVF patients. 

In 2006, a friend and colleague of mine, Suheil Muasher, who completed the Jones Institute fellowship two years before me, introduced the idea of Micro-IVF to me.  My initial reaction was not unlike most other reproductive endocrinologists who question “Why offer an IVF alternative that has a lower success rate?”  Well, as they say, the proof is in the pudding. And it doesn’t hurt that the pudding costs less with ingredients that have less of an effect on the body.

Since October 2011, when East Coast Fertility merged with Long Island IVF, we have had a better than 50% pregnancy rate for our patients under 35 years of age utilizing Micro-IVF.  That the cost is $3900 and the exposure to fertility drugs is minimal makes this an astounding success rate.

Furthermore, our patients who transfer just one embryo with the fresh transfer qualify for the Long Island IVF Single Embryo Transfer program and as a result are entitled to cryopreserving and storing up to one year any excess embryos for free. 

With such great results, I recommend Micro-IVF as a safer and superior alternative to FSH/IUI and sometimes even Clomid/IUI cycles especially in our younger age patients.

* * * * * * **  * * * *

Was this helpful in answering your questions about Micro-IVF?

Please share your thoughts about this podcast here. And ask Dr. Kreiner any questions.

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Oscar’s Relationship with Infertility

By Tracey Minella

February 25th, 2013 at 8:12 pm

image courtesy of free digital photos.net

Last night was the 85th Annual Academy Awards celebration. As I watched the show, a small part of me…the cynic…couldn’t help but shake my head at the ridiculous amount of money entertainers make for what they do. (Was I the only one secretly wondering how many IVF cycles could have been funded by that gown Jennifer Lawrence tripped over?) But then, they only make it because we’re willing to pay it to see them. In fact, America loves Hollywood so much that millions of us watch not only their movies, but also shows where they give awards to each other!

Why are movies so important to infertile people? Well, they are still an affordable date for most folks. They’re a good choice for an outing when you have to socialize with those annoying friends that would otherwise talk your ear off about their children. But most importantly, movies are an escape from reality for the infertile couple. True, it’s a temporary one. But as anyone who’s walked a mile in our stirrups knows, we’ll take any escape we can get.

There are dramas that make you cry—a great release of all that pent up emotion and stress. Dramas also make us realize that others are suffering from their own burdens, which is something we may lose sight of when wallowing in our own sadness. Surely, misery loves company.

Then, there are comedies. Sometimes a great comedy is the only thing that can coax that true, long-forgotten belly-laugh out of an infertile person. Laughter really is the best medicine sometimes. (And it beats the heck out of Clomid.)

Of course, there are also animated films. These are tricky. They are usually made for a young audience and attract families, which may make viewing them anything from challenging to unbearable. But some infertile people like them…possibly viewed at home on DVD… because they think of bringing their future child to see such movies someday. I used to buy the Disney DVDs and put them away for my future child “before they went back in the vault for another 10 years”. Anyone else do that?

Then, on only two occasions I can remember, a movie will come along to deal with infertility head-on. This past year saw the release of the Disney movie, The Odd Life of Timothy Green. It was about an infertile couple at the end of their journey who, on the night they decide to give up trying to conceive, wrote down on paper scraps the qualities of the child they longed to have. Then, with heavy hearts, they buried the scraps in a box in their yard. A kick of wind, some Disney magic, and then the next morning, their son “grew” from the garden. The other film I remember starred Nicole Kidman doing IM fertility injections. Anyone remember the name of that one?

* * * * * * * * * * * * * *

What type of films do you escape with? Or do you escape another way? Did any of this year’s nominees’ or winners’ performances touch your heart?

 

Photo credit: http://www.freedigitalphotos.net/images/Movies_Theater_and_C_g202-Oscar_Su_Sfondo_Rosso_p12046.html

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Don’t Jostle Your Ovaries

By Tracey Minella

February 10th, 2013 at 12:58 pm

It takes a strong woman to go through infertility treatment. And sometimes, in our headstrong, full-speed-ahead-with-blinders-on mode, we feel we’re unstoppable. Invincible, even. But we are not.

With some areas of Long Island blanketed in over two feet of snow, there is a potential danger to infertile women in treatment… snow shoveling. You are not invincible. Do not shovel snow if you are currently in a treatment cycle, have just completed a cycle, are in the two-week waiting period for results, or are pregnant. You must be gentle to and mindful of your ovaries.

When you take injectable medications for IVF (or ovulation induction) to stimulate your ovaries to produce multiple follicles… instead of the single monthly follicle you may otherwise have produced… one of the reasons the doctors monitor you so closely with blood work and sonograms is to reduce the risk of ovarian hyper-stimulation syndrome, or “OHSS”.

When you stimulate the ovaries, they temporarily swell a bit in response, which is expected. OHSS in its mild form can be uncomfortable, but usually resolves on its own. Fortunately, severe OHSS cases are incredibly rare. But in the 1-2% of those cases, patients may experience symptoms including rapid weight gain, abdominal pain, vomiting, and shortness of breath. Pregnancy hormones can worsen OHSS. So, it is important to report any of the above symptoms to your RE as soon as possible, before or after your retrieval or transfer (or IUI). For more info on OHSS, see http://mayocl.in/Xv5NsP

Most women know not to do anything that could be harmful to a developing baby, but they don’t often realize the potential risk certain activities can pose to their stimulated, or recently retrieved, ovaries. Play it safe. Don’t jostle your ovaries.

So put the snow shovel down, ladies. And, leave the vacuum alone while you’re at it, too.

* * * * * * * * * * * **

Have you ever done anything strenuous while stimulating? Have you ever experienced OHSS?

 

Photo credit: Peter Griffin @ http://www.publicdomainpictures.net/view-image.php?image=29815&picture=shovel-snow

 

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