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Archive for the ‘David Kreiner MD’ tag

A Long Island IVF Symposium: How Acupuncture May Enhance Fertility and Impact IVF Success

By Tracey Minella

November 3rd, 2017 at 4:27 pm

Acupuncture has been practiced in Traditional Chinese Medicine for ages, but its potential impact as a complementary fertility treatment to Western Medicine’s cutting-edge in vitro fertilization (“IVF”) is relatively new and exciting in comparison. And it’s available at Long Island IVF.

Would you like to know more about how this holistic treatment might be the missing piece in your pathway to parenthood?

This very affordable, natural therapy might even help if you’ve had prior unsuccessful IVF cycles. Fertility acupuncture only costs about $200 per IVF cycle at Long Island IVF. And the acupuncture needles are so tiny, thin, and painless that any brave IVF veteran could easily handle it.

With so much riding on the outcome of an IVF cycle—emotionally and financially—many patients look for ways to “customize” their traditional IVF cycle. Some customized “add-on” treatments might include such things as ICSI, PGS/PGD, and other cutting-edge Western medicine offerings. Now, there’s acupuncture.

Long Island IVF is the first infertility practice with a Reproductive Endocrinologist who is also a Traditional Chinese Medicine (TCM) practitioner and a NYS certified medical acupuncturist.

Motivated by a desire to find complementary holistic approaches to enhance today’s best Western medical technologies, Long Island IVF co-founder and REI, Dr. David Kreiner, went back to school to study TCM after over 30 years of making babies.

Dr. Kreiner is now applying that acupuncture training in the IVF procedure room, both pre- and post-IVF transfer–exclusively to ALL interested Long Island IVF patients.

Come down and learn more about it.

Long Island IVF’s Acupuncture Program is hosting a free symposium with Dr. Kreiner and a few special guest speakers who are all experts in the field of acupuncture to discuss topics related to improving IVF success with acupuncture, including:

  • David Kreiner, MD, certified Medical Acupuncturist – Epigenetics, Acupuncture and IVF
  • James Shinol, MSOM, L.Ac., LMT – Fertility Benefits of Traditional Chinese Medicine
  • XiuJuan Yang, PhD, MD (China) - TCM Treatment for Diminished Ovarian Reserve
  • James Vitale, M.S., L.Ac – FAQs about Acupuncture and TCM

Don’t miss this special FREE program on Thursday, November 9, 2017 from 6:30 pm-8:30 pm at our Melville office at 8 Corporate Center Drive, Melville, New York. Seating is limited, so pre-registration is required. Register here.

We look forward to seeing you there. Please contact us at 631-752-0606 with any questions.

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Are you coming to the Acupuncture Symposium?

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“Unsung hero to LGBT community” Dr. Howard W. Jones Jr., the Father of Fertility

By David Kreiner, MD

August 23rd, 2017 at 11:04 am

 

Dr.David Kreiner with Drs. Georgeanna Jones and Howard W. Jones, Jr.


You may already know that Dr. Howard W. Jones, Jr. was the doctor responsible for the birth of America’s first in vitro fertilization “IVF” baby in 1981. IVF and its related technology is the therapy used most often in LGBT family-building.

But you probably didn’t know that the “Father of Fertility” also did ground-breaking work in another medical area that would impact the lives of those in the LGBT community? Work that might raise some eyebrows today, but was positively unfathomable in the 1960s. Let me tell you more about my fascinating mentor.

I first met Howard W. Jones Jr, when I was 29 years old while still an obstetrics and gynecology resident in 1984.  It is now two years since his passing at the age of 104 and his legacy lives on growing greater with each passing year.

He interviewed me back then for a fellowship position in Reproductive Endocrinology/Infertility and IVF at the Jones Institute in Norfolk, Va., the first successful IVF center in the Western Hemisphere.  I was in awe of this 74-year-old statesman of the Infertility world.  He was after all famous in the field even before America’s first IVF baby, Elizabeth Carr, was delivered on Dec. 28, 1981 — that first IVF success that Howard W. Jones Jr. and his wife Georgeanna were responsible for in the United States.

I have aspired to live my life and career as the mentor and man I knew as “Dr. Howard” had taught me.  As such, I have been active in the fertility world of the LGBT community, building your families for decades. In addition, my “LGBT Family Building New York” Facebook page is an endeavor I have undertaken to increase awareness. I also enjoy the partnership between Long Island IVF and the LGBT Network on Long Island which serves to improve access to and increase awareness of quality family-building treatment options for the LGBT community.

Dr. Howard was the ultimate medical scientist who did not have a social agenda or prejudice… only an inclination to help all those whom he was capable of helping and if there was not an established way to do so, he worked tirelessly to pave the way.

In the 1960′s– before the general public was aware of what transgender was– Dr. Howard opened the first gender reassignment surgery clinic in the U.S.  For him, this was a way he could utilize his skills learned from performing work on children with ambiguous genitalia to helping those whose gender identities differed from their appearances.

When Dr. Howard established the first successful IVF program west of the Atlantic he did not limit the technology to the married heterosexual couple.  It was his vision that if an individual or couple was in need and desired to start a family that he could offer the latest advances in medicine to assist them.

Remarkably, Dr. Howard was 70 years old when he succeeded with America’s first IVF success.  Rather than accept the retirement his former employer, Johns Hopkins University, had imposed on him due to age, Dr. Howard embarked on arguably the most significant project of his life…IVF.

As I just begin to enter the twilight years of my professional career I look at the accomplishments of my mentor and realize that there is still much good to accomplish.  For me, among other things that means continuing my commitment to making available family building to those in the LGBT community and in so doing perpetuating the legacy of groundbreaking reproductive assistance that was started by the “Father of Fertility”, Dr. Howard W. Jones. Jr.

I encourage all members of the LGBT community who long for a family of their own to meet me and some of the medical staff of Long Island IVF and reproductive attorney, Amy Demma, at our upcoming free event “Building Families in the LGBT Community”, held in conjunction with the LGBT Network at the Center at Bay Shore at 34 Park Avenue, Bay Shore, NY 11706 on October 26, 2017. Register here now.

 

 

 

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Remembering My Mentor, Dr. Howard W. Jones, Jr.

By David Kreiner, MD

August 4th, 2017 at 6:14 pm

 

I first met Howard W. Jones Jr, when I was 29 years old while still an obstetrics and gynecology resident in 1984.  It is now two years since his passing at the age of 104 and his legacy lives on ever greater with each passing year.

He interviewed me back then for a fellowship position in Reproductive Endocrinology/Infertility and IVF at the Jones Institute in Norfolk, Va., the first successful IVF center in the Western Hemisphere.  I was in awe of this 74-year-old statesman of the IVF/Infertility world.  He was after all famous in the field even before Elizabeth Carr was delivered on Dec. 28, 1981, that first IVF success that Howard W. Jones Jr. and his wife Georgeanna were responsible for in the United States.

In the 1950′s, it was HWJ Jr. who biopsied the cervical cancer of Henrietta Lacks who was made famous from the book and movie, “The Immortal Life of Henrietta Lacks”.  These cells from his biopsy were later utilized in nearly all scientific experiments for the next several decades.

In the 1960′s HWJ Jr. opened the first gender reassignment surgery clinic in the U.S. as well as performing pioneering work on ambiguous genitalia.

In 1965, he and Robert Edwards, the Nobel Prize winner for the world’s first successful IVF birth of Louise Brown, fertilized the first human egg.

In 1975, at the age of 65, Howard W. Jones Jr. was forced to retire from Johns Hopkins.  Ultimately, in 1978, Dr. Howard and Georgeanna retired to Norfolk, VA where he planned to work part-time as Emeritus Professor at the local medical school.  All this changed when Robert Edwards succeeded in creating the first successful IVF that resulted in Louise Brown.

Local journalists, aware of Dr. Jones’s reputation and past work with Prof. Edwards interviewed Howard.  At the conclusion of the interview the journalist asked Dr. Jones what it would take to perform IVF in Norfolk to which he simply replied “money”. The next day a former patient pledged that money and within 2 years the first successful IVF program west of the Atlantic was up and running and quickly became arguably the world’s most successful IVF program.

In his final decades Dr. Howard dedicated himself to promoting IVF as a successful medical treatment for those otherwise unable to conceive and to exploring bioethics in the field of reproduction.  Howard Jones never retired as he loved his work and recognized purpose and the satisfaction of achieving his life’s goals in his endeavors.

At a speech he gave during a celebration of his 100th birthday in a huge gathering of hundreds of professionals in the field, he quoted a professor of his at Amherst College from 80 years earlier, Robert Frost.  These seven lines, he said, exemplify, for him, the way to live:

My object in living is to unite 
My avocation and my vocation 
As my two eyes make one in sight. 
Only where love and need are one, 
And the work is play for mortal stakes,
Is the deed ever really done 
For Heaven and the future’s sakes.

I have aspired to live my life and career as Dr. Howard had taught me. When I am asked what I do for a living I smile and ramble on about feeling privileged to do what I love…helping those in need build families. By doing so I truly feel my endeavors perpetuate Dr. Howard’s standard of making a significant impact on the future of humanity.

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Long Island IVF Fertility Acupuncture Seminar: What’s the Point?

By Tracey Minella

June 20th, 2017 at 7:35 am

So much about infertility is out of your control. In fact, next to the paralyzing fear and constant worry that you might never become parents, the lack of control over your body’s ability to reproduce when– and as often as– you want is probably the most maddening part of infertility.

So, when it comes to treatment options, it’s common to think a bit too aggressively and want things that deep down you know aren’t considered safe—like transferring back 8 embryos at once—just because you hope it’ll increase the odds of getting pregnant. Desperation can do that to you, especially if your journey is taking a long time.

Fortunately, there is a better and safer option. It’s fertility acupuncture. And it is available at Long Island IVF. Acupuncture is holistic—an ancient, trusted treatment—that might improve your chances of success with IVF. So, shouldn’t you learn more about it?

It gets better: This exclusive, yet very affordable, natural therapy might even help if you’ve had prior unsuccessful IVF cycles. And fertility acupuncture costs less than $200 per IVF cycle. Are you ready to learn more from the doctor who performs it and other local experts?

With so much riding on the outcome of an IVF cycle—emotionally and financially—many patients are looking closely at ways to “customize” their traditional IVF cycle. Depending on a patient’s particular case, customized “add-on” treatments might include such things as ICSI, PGS/PGD, and other cutting-edge Western medicine offerings.

Now, there is something from the East that shows promise, too… Acupuncture for fertility.

Long Island IVF is the first infertility practice with a Reproductive Endocrinologist who is also a Traditional Chinese Medicine (TCM) practitioner and a NYS certified medical acupuncturist.

Motivated by a desire to find complementary holistic approaches to enhance today’s best Western medical technologies, Long Island IVF co-founder and REI, Dr. David Kreiner, went back to school to study TCM after over 30 years of making babies.

Dr. Kreiner is now applying that acupuncture training in the IVF procedure room, both pre- and post-IVF transfer–exclusively to ALL interested Long Island IVF patients. IVF patients… especially those for whom Western medicine alone has not yet produced a baby…may benefit from adding this ancient therapy. Could this be the missing piece?

Long Island IVF’s Acupuncture Program is hosting a free seminar with Dr. Kreiner and a special guest–local acupuncturist James Vitale, M.S., LAc. — to discuss topics related to improving IVF success with acupuncture. You may also see a live demonstration of fertility acupuncture.

Don’t miss this special FREE program on Thursday, June 22, 2017 from 6:30 pm-8:30 pm at our Melville office at 8 Corporate Center Drive, Melville, New York. Seating is limited, so pre-registration is required. Register here now: http://bit.ly/2pt8c0K

We look forward to seeing you there. Please contact Lindsay Montello, Patient Services, at 631-752-0606 or LMontello@liivf.com with any questions.

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Are you coming to the Acupuncture Seminar?

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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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Listen Up! National Infertility Awareness Week Events are coming to Long Island IVF

By Tracey Minella

April 4th, 2017 at 6:28 am

It’s that time of the year again. That time when we have the attention of the rest of the world…a/k/a the fertile folks…and get a chance to school their basically clueless selves about the daily and often debilitating struggles of the fertility-challenged.

It’s not their fault they are fertile. Or clueless. But that doesn’t make them or their remarks any less irritable all year long. So the theme for this year’s National Infertility Awareness Week (“NIAW”)–“Listen Up!”—is really appropriate! NIAW runs from April 23-29, 2017. Let’s take advantage of the chance to make them listen up.

Each year, before, during, and after NIAW, Long Island IVF offers some events to help those struggling with infertility and to raise awareness of infertility. All events are presented in our Melville office and are free and open to the public—no need to be a patient of ours. They are designed to help support you physically and emotionally no matter where you are on your journey to parenthood. Did I mention they are FREE?

Some events give you a mental and physical leg up, so to speak—like our “Yoga for Fertility Night” on April 26th with Lisa Pineda! Learn and do the poses designed to help your body become more receptive to pregnancy through stress reduction, increased blood flow to the uterus, and more. Register here for free. Spots go fast. This was wildly popular last time we offered it!

Similarly, our “Acupuncture for Fertility Symposium” on April 27th, offers a live demo of fertility acupuncture—a holistic and ancient therapy offered at Long Island IVF by our own Dr. David Kreiner, the area’s first and only known reproductive endocrinologist who is also a certified and practicing medical acupuncturist. Learn from a panel of experts how some patients may improve their chances of IVF success by using this complementary therapy—even if they tried IVF unsuccessfully in the past. Register here for free.

Right on the heels of NIAW is the most dreaded day of the year for many infertile ladies: Mother’s Day (followed by the also-awful Father’s Day for the guys). These two days are difficult for all of us, but they’re particularly hard on those who have been on their infertility journey a long time and have exhausted many available family-building options or those suffering in silence and stressing over keeping the secret.

Right before Mother’s Day we are offering our “New Beginnings through Donor Egg Seminar” on May 2nd. Donor Egg is not usually the first step for people seeking to build a family and many people have suffered a long time, through disappointment and loss, before opening up to the possibility of building their family with donor egg. If you find yourself open to exploring a program that many women later confess they wish they considered sooner, please join us to learn more from our supportive and compassionate donor egg team of doctors and nurses. Hear from one of our many successful donor egg recipient moms and ask your questions. Register here for free.

 

Also before Mother’s Day is our “Tired of the Secret Workshop” on May 4th. In an effort to help those couples who want or need to come out of the infertility closet and tell their family and friends or employers—but don’t know how to do it—we are bringing back this popular workshop from Coming Out Infertile Day last November. Led by our Mind-Body Program and infertility specialist, Bina Benisch, MS, RN, couples or individuals who want to “come out” are given counsel and guidance to work through the issues that are blocking them, as well as suggestions on how to navigate that important conversation so they can unburden themselves and get the support they need from their loved ones. Register here for free.

If you or anyone you know is struggling with infertility please join us at any or all of these events for free, so we can support you on your journey. If your personal journey is resolved, please share the information so friends who are suffering in silence may see it and benefit.

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Which event(s) seem interesting to you? Are there any other events you’d like to see offered?

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

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 and 2017 contest…three years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 29 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

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Long Island IVF Celebrates National Doctor’s Day

By Tracey Minella

March 30th, 2017 at 8:48 pm

 

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


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

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

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

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

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

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

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

Now it’s YOUR turn…

Shout out begins now!

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Who is your favorite LIIVF doctor?

 

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

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 and 2017 contest…three years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day more than 29 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

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

By David Kreiner MD

March 14th, 2017 at 1:04 pm

 

image purchased at shutterstock


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

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

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

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

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

 

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Long Island IVF Free Seminar and Live Demo: Improving IVF Success with Acupuncture

By admin

February 28th, 2017 at 9:27 am

If there was something holistic—an ancient, trusted treatment—that might improve your chances of success with IVF would you want to learn more about it?

What if this exclusive, yet very affordable, natural therapy might even help if you’ve had prior unsuccessful IVF cycles? And what if this complementary therapy cost less than $200 per IVF cycle? Are you ready to learn more… even see a live demo of the treatment?

With so much riding on the outcome of an IVF cycle—emotionally and financially—many patients are looking closely at ways to “customize” their traditional IVF cycle. Depending on a patient’s particular case, customized “add-on” treatments might include such things as ICSI, PGS/PGD, and other cutting-edge Western medicine offerings.

Now, there is something from the East that shows promise, too… Acupuncture for fertility.

Long Island IVF is the first infertility practice with a Reproductive Endocrinologist who is also a Traditional Chinese Medicine (TCM) practitioner and a NYS certified medical acupuncturist.

Motivated by a desire to find complementary holistic approaches to enhance today’s best Western medical technologies, Long Island IVF co-founder and REI, Dr. David Kreiner, went back to school to study TCM after over 30 years of making babies.

Dr. Kreiner is now applying that acupuncture training in the IVF procedure room, both pre- and post-IVF transfer–exclusively to ALL interested Long Island IVF patients. IVF patients… especially those for whom Western medicine alone has not yet produced a baby…may benefit from adding this ancient therapy.

Long Island IVF’s Acupuncture Program is hosting a free seminar with Dr. Kreiner and a special guest–local acupuncturist James Vitale, M.S.,L.Ac–to discuss topics related to improving IVF success with acupuncture. You can also see a live demonstration of fertility acupuncture.

Don’t miss this special FREE program on Thursday, March 9, 2017 from 6:30 pm-8:30 pm at our Melville office at 8 Corporate Center Drive, Melville, New York. Seating is limited, so pre-registration is required. Register here now: http://bit.ly/2kBnYV7

We look forward to seeing you there. Please contact Lindsay Montello, Patient Services, at 631-752-0606 or LMontello@liivf.com with any questions.

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Are you coming to the Acupuncture Seminar?

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

It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 and 2017 contest…three years in a row!

The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.

We love what we’ve gotten to do every day for almost 30 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.

 

 

 

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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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