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Archive for the ‘Donor Sperm’ tag

Infertility Podcast Series: Journey to the Crib: Chapter 23: Nominated for Best Supporting Role Is…

By David Kreiner MD

August 23rd, 2012 at 8:51 pm

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twenty-Three: Nominated for Best Supporting Role Is… You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=122 

Nominated for Best Supporting Role Is… 

Superficially, the role of the male partner in IVF is to produce a semen specimen… at least in those cases not utilizing sperm from a donor. This is not trivial and in fact when the partner is unsuccessful the cycle is lost. For this reason, I recommend freezing a specimen before the retrieval that is available as back up. 

However, the male’s role can and should be much more than producing a specimen on the day of retrieval.  Those couples that appear to deal best with the stress of IVF are ones that do it together.  

Many men learn to give their partners injections.  It helps involve them in the efforts and give them some degree of power over the process. They can relate better to what their partners are doing and take pride in contributing towards the common goal of achieving a baby.  The more involved a partner is the more support that is felt by the patient which is not only good for her emotionally but also helps in getting accurate information and directions from the office. It also helps to solidify their relationship.  

My recommendation is for partners to be as involved as possible.  In their absence a surrogate such as a friend, sister, or mother is far better than dealing with the office visits and procedures alone. 

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Was this helpful in answering your questions about the partner’s role in IVF?

 LAST CALL TO ENTER!!! 3 DAYS LEFT!!!!

Are you aware that Long Island IVF is giving away a free basic Micro-IVF cycle, valued at $3,900.00? Check out the contest here: http://bit.ly/LHbmQR

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

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The Importance of a Soul Mate in IVF

By Tracey Minella

August 3rd, 2012 at 8:13 am

courtesy of Rosen Georgeiev/ FreeDigitalPhotos.net

I should begin by applauding the single ladies doing IVF. I didn’t do IVF without a partner by my side, but had the circumstances required it, my desire to have a baby would have put me on the IVF road myself as well. I imagine you all having amazing strength simply for undertaking the challenge of single parenting, never mind the lengths you’re going to to make it happen.

But IVF with a partner is obviously very different. It must be… simply by nature of there being a relationship involved.

There’s the issue of blame. There shouldn’t be. But there often is. If one of the pair has the diagnosis, there’s often guilt to deal with. That’s never good for a relationship.

Sometimes, there are the issues of donation and third parties. Donor eggs, donor sperm, donor embryos. Or the need for a gestational carrier or surrogate. More complicated stuff.

There are almost always financial issues unless you are lucky enough to have generous insurance coverage. If your jobs don’t offer infertility insurance, or your employers aren’t supportive of your situation, there can be stress at work…which spills over into the home.

Then there’s the stress of watching other couples have it all. The baby you can’t have without the treatment. The house or vacation you can’t afford because of the treatment. Why you?

Infertility is isolating. It’s just the two of you. It’s like living long-term in that moment of your vows where you said “for better or for worse; in sickness and in health” but never thought the bad stuff would really happen to you.

For me, the lows were so low at times that I didn’t always appreciate my husband’s support while we were going through it. I was too consumed by the details, too worried about failing, too focused on the goal. Not focused enough on the guy at the end of that long needle each night. The one who quietly absorbed the brunt of my hormonal outbursts. The one who held me when the bottom fell out of the world. The one who never questioned my need to try again. And again.

There’s no doubt that infertility is one of the toughest tests of a marriage. Most couples that make it through successfully are surely stronger for it. I feel that most couples who come to the end of their journey together…whether it ends with a biological baby, an adopted baby, or a decision to remain child-free…proudly wear an invisible badge of marital courage.

But I feel for those whose marriages crumble from the strain of infertility. Would they have survived if not for those stresses? Would they have been one of those happy couples who skate through life escaping all real adversity? Or were they doomed anyway, and infertility just happened to be the blow to expose their already weak foundations? It’s hard to say.

Looking back, I wish I’d been better at stopping the world from spinning and re-connecting with my partner along the way. Try to do that. You are the only two who understand what you are going through and what is on the line. What you have to lose…what you have to gain. Don’t lose sight of each other when simply going through the motions of your treatment. Show your gratitude.

All journeys end. Most end happily, though not always the way we imagine happiness will be when we started. Then you get to look back on it years later and laugh at things you never thought you would. And realize you’d never have gotten though it all without your soul mate.

Happy 27th Anniversary to mine.

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What’s the one moment on your journey that you realized you were/were not with your soul mate? What would you tell your soul mate to thank him/her?

 

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Dr. Kreiner’s Letter to the Editor of Newsday

By David Kreiner, MD

July 12th, 2012 at 3:29 pm

credit: wpclipart.com

 

Long Island IVF’s co-founder, Dr. David Kreiner responds to the assertion that in-vitro fertilization, or IVF as it’s known, is a treatment of “last resort”. Here is his letter to the Editor of Newsday published on July 8, 2012:

“ Adrian Peracchio wrote an interesting account of in vitro fertilization, a technology that is now 34 years old ["The future is now," Opinion, July 1]. As stated in the article, IVF is a procedure that was born in a hailstorm of controversy and remains today accountable for 3 percent of all births in the developed nations.

A reason for IVF’s rise in popularity is a tremendous improvement in success rates. As reported in the June 28 issue of the New England Journal of Medicine, live birthrates with IVF approximate natural conception in fertile couples. Also, IVF reaches success rates as high as 80.7 percent for couples using donor eggs after three cycles.

Peracchio points out that the cost of IVF, as much as $15,000 in many centers, is often not covered by health insurance, and that IVF was intended as a “last resort” treatment.

This is a misunderstanding of IVF as an alternative only after the failure of less aggressive treatments — such as inseminations with fertility drugs. Insurance providers cover the drug treatment, which is ironically more expensive. Fertility drug treatments can lead to multiple pregnancies and premature deliveries. According to the Centers for Disease Control and Prevention, we could save $1.1 billion a year if single embryo transfers with IVF were performed instead.

It is a shame that the technology developed by Robert G. Edwards for which he was awarded the Nobel Prize for Medicine remains available only to a minority of couples and is still not recognized by insurance companies.”

Dr. David Kreiner, Plainview

Editor’s note: The writer is the co-founder of Long Island IVF, an infertility care center.

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We’d love your thoughts here on the blog.

But if you’d like to respond to this article on Newsday.com and reply to the thread of unsympathetic comments, the link to the letter is here: http://bit.ly/NcuEwn (I’m guessing a stress-busting vent session will result for anyone willling to take up the cause!)

 

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

By David Kreiner MD

July 5th, 2012 at 9:39 am

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.  You can access the podcast here: http://podcast.eastcoastfertility.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, 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. 

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

Are you aware that Long Island IVF is giving away a free basic Micro-IVF cycle, valued at $3,900.00? Check out the contest here: http://bit.ly/LHbmQR 

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

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Figuring out YOUR Odds of a Live Birth With IVF

By David Kreiner MD, and Tracey Minella

July 2nd, 2012 at 8:35 am

 

 

Statistics can be confusing. And when you’re on fertility meds and your hormones are raging, it can be hard to think clearly. So grab a cup of coffee and your thinking cap because you’re going to be interested in this post from Dr. Kreiner.

It’s about a recent study published in the New England Journal of Medicine that finally sheds light on a woman’s odds of having a live birth from IVF. The study examined data from SART (Society for Assisted Reproductive Technology), the primary organization that collects data, sets the guidelines, and helps maintain the standards for the practice of assisted reproductive technologies.

Dr. Kreiner reports:

NEJM Study Uses SART Data to Determine Cumulative Birth Rates for Individual Patients with In Vitro Fertilization

A new study published in the New England Journal of Medicine links data from the SART Clinic Outcome Reporting System to individual women who underwent cycles from 2004 to 2009.  In this way a cumulative live birth rate over the course of all their cycles could be determined.

The researchers reviewed data from 246,740 women, with 471,208 cycles and 140,859 live births, found that live-birth rates declined with increasing maternal age and increasing cycle number when patients’ own oocytes were used, but live-birth rates remained high in donor egg cycles. See Luke et al, Cumulative Birth Rates with Linked Assisted Reproductive Technology Cycles, N Engl J Med 2012; 366:2483-2491 June 28, 2012. http://www.nejm.org/doi/full/10.1056/NEJMoa1110238

By the third cycle, the conservative (patients who underwent fewer than three cycles were assumed not to get pregnant) and optimal estimates of live-birth rates (patients with fewer than three cycles were assumed to have a live birth) with autologous oocytes had declined from 63.3% and 74.6%, respectively, for women younger than 31 years of age to 18.6% and 27.8% for those 41 or 42 years of age and to 6.6% and 11.3% for those 43 years of age or older. When donor oocytes were used, the rates were higher than 60% and 80%, respectively, for all ages. Rates were higher with blastocyst embryos (day of transfer, 5 or 6) than with cleavage embryos (day of transfer, 2 or 3).

At the third cycle, the conservative and optimal estimates of cumulative live-birth rates were, respectively, 42.7% and 65.3% for transfer of cleavage embryos and 52.4% and 80.7% for transfer of blastocyst embryos when fresh autologous oocytes were used.

The study looks for the first time at a “cumulative live birth rate” for each patient going through three embryo transfers. They provide a range based on those patients who did not proceed with subsequent cycles assuming no pregnancy for lower end and live birth in upper end. They do not go into number of embryos transferred or multiple pregnancies.  This provides the best data we have available to answer the question of what the odds are that a patient will experience a successful live birth with IVF.  Understanding that the data is now a little dated and represents a national average, my expectation is that on the average we should see even somewhat better success.

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What did you think of the study? Any questions? Ask Dr. Kreiner right here.

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Your Wildest Dreams Can Come True

By Tracey Minella

June 28th, 2012 at 9:00 am

Some ladies have crushes on their RE. Do you ever dream about your IVF doctor?

Ever fantasize that he comes to you in the wee hours of the morning, a hulking presence walking through the misty fog just past dawn? You feel the excitement in the thick air as he moves toward you with hurried anticipation. He meets your gaze and whispers “Let’s make a baby…”

Phew, is it getting hot in here or is it just me?

Well, for one lucky woman, this dream will come true on September 4, 2012! That woman would be the winner of Long Island IVF’s “Extreme Family-Building Makeover” Contest. She will receive a Free basic Micro-IVF cycle, valued at 3,900.00! And if she happens to come from the Long Island or Brooklyn area, she may get the good news by a personal visit from one of our doctors on the day after Labor Day!

The annual contest launched during National Infertility Awareness Week in April and runs through August 26, 2012. You can enter by essay or video. Please see full rules here:

http://blog.longislandivf.com/2012/win-a-free-basic-micro-ivf-cycle-in-long-island-ivfs-extreme-family-building-makeover-contest/

You can also get to the rules via Long Island IVF’s Facebook Page at: http://www.facebook.com/longislandivf and clicking on the “Contest” tab.

 In addition to the awesome Grand Prize of a Free basic Micro-IVF cycle, there are early incentive prizes awarded each month of the contest, so get those entries in, ladies.

A prior Micro-IVF winner tucks her baby boy in each night in Georgia. Will you be next?

 

 

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Infertile Men are Fathers, Too

By Tracey Minella

June 17th, 2012 at 8:56 am

If you are a man who wants to be a father, but infertility is standing in the way, I don’t have to tell you how tough it is getting through today. If male factor infertility is all or part of the problem, there’s often an added level of misplaced guilt as well. And if you’ve lost your own dad along the way, the day is even worse.

I could tell you to take care of yourself today, but you’re probably more concerned about your wife or partner. How she wants the baby, the card and the homemade clay presents that Father’s Day is supposed to be about.

If you’re seeing your own dad… and siblings with children will be there… there can be guilt about not making grandchildren yet and the sense of urgency to do so while he’s still alive. But you will manage, despite the ache in your heart, to smile for your dad today and to play a little catch with those nephews.

And you may have to endure the insensitive and hurtful comments…sometimes directly targeted at your manhood… by ignorant brothers or in-laws. You know the ones. I won’t repeat them. But you’ll laugh it off to keep the peace and pretend it’s the barbeque smoke stinging your eyes.

Today I want you to know that you are a dad. You’re a father “in-the-making”.

Good dads are selfless. They put everyone else’s needs before their own. They take care of their wives and their parents. They often hide their pain. Without realizing it, some practice their “dad skills” on nieces and nephews. They get stronger by facing and overcoming adversity. Their commitment to their wife deepens by battling this challenge together.

All this crap you are going through… this journey… has either given you or fine-tuned all the traits you need to be a great dad someday.

So, Happy Father’s Day to a great dad-to-be. And I hope that next year will be the year of the baby to complete the deal.

To our patients who have already become fathers, Happy Father’s Day. Enjoy those miracles… and their homemade clay presents!

Happy Father’s Day to the wonderful doctor dads of Long Island IVF…great men and loving fathers/grandfathers who use their gifts every day to help build our families.

And finally, Happy Father’s Day to my husband Adam, not just for being the wonderful father I knew he’d be, but for hanging in there during the many years of our own 7 fresh IVF cycles journey to parenthood.

If winning a free Micro-IVF cycle (valued at $3,900.00) would assist you on your infertility journey, please enter Long Island IVF’s “Extreme Family-Building Makeover” Contest. Details are on the April 23, 2012 blog post or click here: http://blog.longislandivf.com/2012/win-a-free-basic-micro-ivf-cycle-in-long-island-ivfs-extreme-family-building-makeover-contest/

 

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Tell us how you get through days like this. Did anyone say something hurtful? How did you respond?

Photo credit: http://www.wpclipart.com/holiday/fathers_day/index.html

 

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Infertility Podcast Series: Journey to the Crib: Chapter 13 Sperm Meets Egg- Why Doesn’t It Work Every Time?

By David Kreiner MD

June 14th, 2012 at 6:17 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Thirteen: Sperm Meets Egg-Why Doesn’t It Work Every Time? You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.eastcoastfertility.com/?p=92 

Sperm Meets Egg- Why Doesn’t It Work Every Time? 

We live in a society where people grow up with certain entitlements. 

We expect to complete a transatlantic flight within 6 hours without delay.  While 30,000 feet up in the air we get upset if our internet momentarily goes on the blink.  When normally menstruating women having regular intercourse cannot get pregnant it turns their lives upside down.  After all, we plan our lives, our careers and our families and there often is not time allowed for such difficulties. 

When the source of the trouble is the Man, the impact on his ego, his mood and the couple’s relationship can be quite dramatic.  Men have a problem that contributes to the difficulty conceiving in 50-60% of cases.  Most of these cases can be picked up by a simple semen analysis.  

Unfortunately, even when the semen analysis screen is normal about 10% of the time when routine in vitro fertilization is attempted, the partner’s eggs fail to fertilize.  This is why we recommend that we perform ICSI, intracytoplasmic sperm injection, in cases of unexplained infertility, on half the eggs.  That allows us to test the fertilizability of the eggs and treat those with deficient fertilization in the same cycle. 

There are numerous causes of male infertility discussed in the chapter.  Some are amenable to hormonal treatment, some could benefit from surgery, and nearly all may be overcome with IVF using ICSI. Other supplements, herbal medicine, and adjunctive therapy are mentioned. 

Recently, it has been found that in cases of severe male infertility, though pregnancies may be achieved with ICSI, in those cases there appears to be a higher incidence of miscarriages and congenital anomalies and other problems in some babies born to such couples. 

Still… for those couples who otherwise would never have previously been able to conceive without IVF… IVF with ICSI offers a significant possibility for them to build their own healthy families using their own eggs and sperm. 

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Was this helpful in answering your questions about why it doesn’t work every time sperm meets egg? 

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

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Infertility Podcast Series: Journey to the Crib: Chapter 12 What Do You Know About Your Fertility?

By David Kreiner MD

June 7th, 2012 at 3:34 pm

 

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twelve: What Do You Know About Your Fertility? You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.eastcoastfertility.com/?p=74

 What do you know about your fertility?

 Women have a biological clock.  Everyone knows that.  However, life seems to get in the way sometimes; whether it be school, career or failure to find Mr. Right.  Most people assume that if they are healthy then there should not be a problem conceiving.  Unfortunately, general health and fertility are not always related.

 Women are born with their reproductive lifetime supply of eggs.  That means the body doesn’t produce new ones.  With each menstrual cycle one egg is released and an additional thousand eggs simply are lost in the body’s natural process of selecting one for ovulation.  As a woman approaches 50, she typically runs out of her store of eggs. 

Additionally, there is the issue of the effect of aging on the eggs.  Older eggs are more likely to have chromosomal abnormalities making them unlikely to become viable embryos.  Fertilized eggs with abnormal chromosomes are the most common cause of miscarriages, running about 40% by age 40. 

Furthermore, not everyone’s ovaries/eggs age at the same rate and again it is not necessarily reflective of how old you look either.  Often very young looking women have very old acting ovaries and eggs.  You can be screened to evaluate your fertility status with an ultrasound examination of your ovaries performed by an experienced reproductive endocrinologist as well as by blood hormone screening looking at your FSH, estradiol and AntiMullerian Hormone levels. 

I urge every woman of reproductive age who has not completed her childbearing to be evaluated and make plans based on knowledge about her own fertility.  Aggressive fertility treatment might be needed depending on your age, how long you have been trying to conceive, and your fertility screening.  Women who do not have a partner should explore the possibility of freezing their eggs while the likelihood of them still being healthy is high.  Remember, fertility treatment has a high success rate that decreases significantly as time passes on the biological clock. 

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Was this helpful in answering your questions about your fertility?

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

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NWW Photo Caption Contest No.23

By Tracey Minella

June 6th, 2012 at 9:35 pm

Well, it’s NWW time! That stands for Nearly Wordless Wednesday… our weekly wacky photo caption contest where anyone anywhere can enter to win by submitting a clever caption for the photo of the week. And what infertile couple, or generally stressed out person, can’t use a fun distraction once a week? Come on and play!

Each week, the winner gets a gift card. It’s our little thank you for playing our game.

This week’s contest winner will get a Starbucks gift card. Come on and play. I love their fresh brewed iced tea. (Okay, so I’m boring!) What is your favorite thing to drink there?  Win the contest and the gift card is yours to choose your favorite!

Now, on to this week’s challenge.

But first let’s announce last week’s winner: Tiffany! Congrats!

  • Who could forget the Navy soldier arriving back from sea in a lip-lock with his lady while the baby he’s never met is dangling from under his arm! Well, we liked Tiffany’s: “All babies have been semen….But not all Seamen have been fathers!” caption for its play on fertility words.

Tiffany, please email your address and the words “NWW Contest #22-Dunkin Donuts” to Lindsay at lmontello@liivf.com to claim your gift card.

Give this photo a caption on the blog.

Best entry winner gets Starbucks on us! It’s a fast, fun and free contest open to anyone, whether infertile or not, and whether a patient of our practice or not.

Bookmark our blog or like us on Facebook and check back next week to see if you won and we’ll mail you your gift card.

Plus, if you “LIKE” us on Facebook at https://www.facebook.com/longislandivf , we may be able to send you the prize as an e-gift right through Facebook, depending on what this week’s prize is, so you could be enjoying your winnings as early as on the day we choose the winner! (And as much as we’d love you to “LIKE” us on Facebook, it is absolutely not required to either enter or win our contests! But did I mention we’d love it if you did ;-)

Enter today! Or at least before next Tuesday!

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Why not bookmark us so you remember to check back often…at least every Wednesday…so you don’t miss our NWW contests. And we also run bigger contests, too. Please feel free to suggest other fun places we could get gift cards from that you’d like to win as prizes for these fun contests or topics you’d like to see discussed on the blog. Now go enter the contest!

Photo credit: http://www.funtal.com/picdetail.php?catId=37&tid=713

 

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