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Archive for the ‘Donor Sperm’ tag

Fertility-Saving Options for Breast Cancer Patients

By Tracey Minella

October 2nd, 2012 at 8:11 pm


October is Breast Cancer Awareness Month.

The movement to remind women to get mammograms is in full swing.  Pink… the color for breast cancer awareness… is everywhere. It is no longer taboo to talk about breasts! Silicone bracelets proclaiming “Save the Tatas” and “I Love Boobies” have been spotted on the wrists of young and old alike.

Society’s newfound comfort with the word “breast” …and its slang…is evidence of how far breast cancer awareness has come. And it offers hope that the infertility awareness campaign will someday join breast cancer in terms of public awareness, funding, and support. If we can openly talk openly about breasts, can ovaries be far behind?

When you’re trying to conceive and you can’t, and then you go to a fertility specialist for help, and it still doesn’t happen, some women might think their life is over. That nothing could be worse. That no one has it harder than they do. Some may even feel that there’s no reason to go on if they can’t have a baby.

That probably sounds melodramatic to anyone who hasn’t faced down infertility… who hasn’t faced the possibility that the most maternal of our instincts, desires, and needs could be denied. But while the infertile woman is absolutely justified in feeling the whole range of emotions that accompany her diagnosis, things could actually be worse.

“What could possibly be worse than being infertile?” you ask.

You could have breast cancer.

It wasn’t all that long ago that a breast cancer diagnosis, with its accompanying chemotherapy and/or radiation, meant the end of a woman’s dream of having a biological child. The focus…and rightly so…was on saving her life. Not her breast. And certainly not her fertility.

Today there are more options for women. Now, women may have the chance to freeze their eggs or embryos prior to undergoing chemo or radiation or prior to surgically removing their ovaries. By doing that, women may be able to preserve their fertility for a future time when their breast cancer…or any cancer… crisis is behind them.

Although some breast cancer survivors do not undergo chemotherapy or radiation and, accordingly don’t compromise their fertility, many women do need these more aggressive cancer treatments. Thanks to egg and embryo freezing now, and IVF and embryo transfers later, more breast cancer survivors will be able to enjoy the post-cancer miracle of giving birth to a biological child.

Hopefully most oncologists and primary care doctors would refer young, newly-diagnosed cancer patients who have yet to start or complete their families to a reproductive endocrinologist for a consultation prior to chemotherapy or radiation or oophorectomy if time permits. If not, it’s an omission that can’t be remedied later.

Even if the referral is recommended, can a newly-diagnosed cancer patient even wrap her head around saving her fertility when she fears for her life? And if so, does her particular cancer allow her the time to explore this option? And what about teens whose health care is effectively still in the hands of their parents? Will the parents even think about their “baby’s” future fertility in the chaos of living through a parent’s worst nightmare?

It’s up to all of us to help spread the word about fertility-saving options so no woman who beats cancer has to find out afterward that she can’t become pregnant using her own eggs. So, file this information away and hope you never need to use it:

If any female you know (except post-menopausal women)…even a teen… is ever diagnosed with breast cancer, tell her or her spouse or parent to consider consulting  a reproductive endocrinologist before having chemotherapy or radiation or before removing her ovaries, if her cancer treatment protocol can accommodate the delay. You just might save her fertility. Of course, any post-menopausal woman diagnosed with breast cancer and any woman who did not pursue fertility preservation efforts prior to undergoing chemotherapy and/or radiation could explore conceiving with donor eggs or embryos after her treatment ends.

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Do you know of anyone who preserved her fertility prior to cancer treatment? Would you be able to share this information with someone diagnosed with cancer?

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Choosing an Egg Donor or Sperm Donor

By Dr. David Kreiner and Tracey Minella

October 1st, 2012 at 8:28 pm

photo credit: jscreationzs/

No one grows up thinking about making this kind of a decision when they get older. We grow up thinking, no—assuming—we’ll get pregnant the old fashioned way. And even if we do entertain the thought that we might need some medical assistance, we likely figure a little Clomid will do the trick. Certainly nothing as emotionally charged as the decision to use donor eggs or donor sperm.

A couple years ago, I came upon a fellow attorney who’d been an egg donor back in law school. She was outwardly beautiful, and obviously intelligent. And a nanosecond after I thought about how generous she’d been I thought how lucky the recipients were to have her genetic traits in their children.

But that got me thinking about what my own “trait shopping” experience would have been like if I’d gone down that path to parenthood. Would I have tried to meticulously match the donor to my own traits, or my husband’s? Maybe I’d try to weed out an undesirable family trait…on his side, of course! What would I consider as the most important factors? Good health, first. But then what? Education? Athletics? A particular look or ethnicity?

Jeez, I can’t even decide between two options for dinner! 

I can’t imagine what a difficult, yet also exciting, experience choosing a sperm or egg donor must be. Oh, the possibilities…

Long Island IVF’s Dr. David Kreiner offers valuable insight into this choice:

Patients selecting donors whether for eggs or sperm often spend endless hours choosing the “best match”. On an episode of the T.V. show “Brothers and Sisters”, a couple was beyond themselves trying to decide and at one point, out of desperation toyed with the idea of choosing by posting the possible donors on a dart board and letting the dart decide.

People verbalize concern about both a physical and behavioral match. Patients assume that the child will resemble the donor. The likelihood that the child physically looks like the donor varies. The inheritance from a behavioral standpoint including personality and intelligence, drive and aspirations is less clear. There is a significant contribution that the environment plays and to the extent which factor will dominate, nature vs. nurture is not known.

I don’t have the answer to this question; it’s one I, myself, have spent much time considering. I’m one of five children and I have four children of my own and, so far, three grandchildren. Though the environment and the genetics of my siblings and my children does not appear to be so different, each of us has developed unique characteristics and personalities; some more so than others.

I think the nature vs. nurture question is like a Jackson Pollack painting. When you raise a child, different colors of nature and nurture are tossed randomly up in the air and what we call “life” dresses the canvas below. Sometimes the painting it creates is breathtakingly beautiful and other times, well… you wish you could throw out the old and start with a fresh canvas.

Now, if you are a conscientious parent, then you are most careful about how and what colors of nurture you toss. With nature however, there is no control over what features are inherited.

So, I tell my patients who are screening donors and are so concerned that their donor has a particular color hair, eye color or even personality type, that they are putting too much faith in just one can of paint that they get to choose to toss up in the air. People with blue eyes and blonde hair have other colors from ancestors that randomly did not appear on their body. But their gametes contain them and these cans of paint could potentially have more impact on the canvas than the blue eyes and blonde hair that the recipient is hoping for.

I prefer a recipient be concerned that the donor is healthy with good odds for successful conception and a generally appropriate match of physical and behavioral characteristics.

Then I pray for G-d’s blessing.

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What would your top considerations be in choosing a donor?


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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/

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



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 and reply to the thread of unsympathetic comments, the link to the letter is here: (I’m guessing a stress-busting vent session will result for anyone willling to take up the cause!)


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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.

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:

You can also get to the rules via Long Island IVF’s Facebook Page at: 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:


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

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Ethical, Moral and Legal IVF Factors

By David Kreiner MD, Tracey Minella

May 29th, 2012 at 9:35 pm


If you think that all fertility patients look like your average young urban professional neighbors with the SUV, think again. They are as diverse as the general population.

Actually, anyone can be infertile. There could be a reality show called “The Real Infertile Housewives of Long Island”. When the door swings open and a potential new patient walks in, infertility doctors never know what they’re gonna get. Often, it’s a so-called “traditional” married couple using their own eggs and sperm or those of a donor. It could also be an equally welcome gay couple or single woman using donor eggs and or sperm. But often enough… it’s not. And sometimes, it’s downright ugly and complicated.

Must he treat them? Should he treat them? Often, the legal system muddies the waters.

Dr. Kreiner of Long Island IVF gives us a glimpse of what it’s like to be on his side of the desk at a new patient appointment. Here’s a post he wrote prior to New York’s  legalization of same sex marriages:

Those of us who work in the infertility field are often presented with situations that make us ponder whether we should assist in endeavors that make us feel a bit, well, uncomfortable. I suppose it’s common to have these experiences in our field as family building is a cornerstone of our society. But manipulating a family affects not just the people directly involved, but all of us.

There are the straightforward illegal and unethical cases: The married woman who presents with a proposal to conceive with a man other than her husband (without the husband’s consent) or the married man “donating” his sperm to a “friend” other than his wife (without his wife’s knowledge). These are the easy ones that don’t even make me pause.

I come across more difficult questions, however, that require much more intense contemplation and research. On a daily basis, the way most of us professionals try to deal with ethical and legal dilemmas is to resort to an evaluation of the “yuk factor.” It’s an internal cliff notes version of societal morality and law that many of us professionals rely on to make daily decisions when we can’t read the whole book on an issue. Sure, there’s a potential downside of going down the slippery “yuk” slope, but when was the last time the approach “if you’d be ashamed to see it on the front page of the New York Times, then don’t do it” led you down the wrong path?

Yet, I still have difficulty understanding what’s ethically and/or legally right in some situations. The go-ahead is clear to me if an unmarried man and woman present as a couple, each using their own gametes, and both sign consent acknowledging their rights and responsibilities to the future child. Less obvious is the case of the unmarried lesbian couple who present with only one partner participating biologically. They live as a couple, but the law doesn’t necessarily recognize the partner who isn’t participating biologically as having parental rights. Should they be signing as a couple for use of donor sperm to create a baby and, if so, what –if any– are the ramifications? Is this situation different if the unmarried-yet-cohabiting partner who is not participating is a male? Does the unmarried lesbian partner have the right to adopt the baby? Does this change if the partner is a transsexual?

It would seem to me that if the couple decides that they will have a baby together, despite the fact that only one is contributing biologically, that there should be parity recognized legally based on the emotional and financial contributions the other partner makes, especially if she were willing to adopt the child and legally take on parental rights. For me the “yuk” factor becomes the legal system if that unmarried partner who is unable to contribute biologically is unable to retain parental rights in a split.

So now I’m off to the clinic to see what murky issues the day will present.

Every day is different.

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Do you think there are situations where a doctor can, should, or must refuse treatment? If so, when?

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Long Island IVF’s “Every Baby’s Beautiful Pageant Parade”-MOVED TO RAINDATE!!

By Tracey Minella

May 21st, 2012 at 1:58 pm


At Long Island IVF, we love reunions. We love seeing the most recent batch of our beautiful babies every year at this time. But we’re not fond of the rain…


We wish we could have a reunion with ALL of our babies at once. But when you think of the sheer volume of children …many young adults now… conceived since we brought Long Island its first IVF baby shortly after our founding in 1988, well we’d need a super big place! And the Nassau Coliseum is probably taken!

So, since every baby’s beautiful at Long Island IVF, we decided it’d be fun to hold our first “Every Baby’s Beautiful Pageant Parade” for the boys and girls born through IVF in 2011. That is, of course, as long as it doesn’t rain on our parade! None of the Toddlers and Tiaras competitive nonsense here! Just a fun little stroll…or roll…down the red carpet! Every baby’s a winner!

Please come down with your little miracles and show off! This is what it’s all about…celebrating the life of your little miracle and your dream come true.

And be sure to check in on the Long Island Facebook page at before you head on over on Wednesday if the weather looks bad. Updated information will be there if it gets postponed again. And while you’re at it, why not just “LIKE” our Facebook page if you haven’t already?!

Here’s the scoop:

What: LIIVF’s “Every Baby’s Beautiful” Luncheon and Pageant
Where: Syosset-Woodbury Community Park, Area “B,” Jericho Turnpike, Woodbury, NY 11797 (Across from the Fox Hollow Inn)
When: Tuesday, May 22,  Wednesday, May 23, noon to 2 p.m.

All family members of LIIVF babies born in 2011 are welcome at the reunion and pageant parade.

For more information or to RSVP, contact: Lindsay Montello at lmontello(at)liivf(dot)com or 516-939-BABY (2229).

Hope to see you all there!

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Spending a Beautiful Weekend at the Fertility Clinic

By Tracey Minella

May 20th, 2012 at 12:13 am


Finally, the warm weather has arrived. The bulky sweaters have been shed (we won’t mention winter’s added pounds that need to go with them!)

And where are you on this sunny Sunday morning?

Stuck in the R.E.’s office being, well…stuck.

Stuck with a sono wand. Stuck with a needle. Stuck listening to the cries of another woman’s child as she sits in the waiting room trying to complete her family.

Well, how can we put a positive spin on this?

First, tell yourself that there is nothing… nothing… more important to be doing than what you are doing right now. Seriously, creating a baby trumps a barbeque any day. Tap into the hope that is around you. The promise of potential success. Embrace it.

Then, remind yourself that while it’s unfair that you have to go through all of this to have a child (when others can flirt and get pregnant), that you are luckier than those who need the same treatment but either have no insurance coverage or cannot afford it. Yes, it’s a small consolation, and it’s still a huge financial sacrifice, but it’s an opportunity that some don’t have. If you try to look at it that way, it may take some of the sting off.

Now, plan to make the most of the remainder of the day. Get out and do something in the sun. Vitamin D from the sun can even give your fertility a boost! Maybe do some planting or gardening. Some people love growing things and getting in touch with nature. (Plus digging is a great stress release!)

Maybe something more relaxing is more your speed? Read a book outside, walk on the beach. Get those toes in the sand. Consider a pampering pedicure. Go wild with a toe ring. Even something as small as that can give you a boost.

The point is to take some time for yourself. Do some positive visualization. Maybe even enter our Extreme Family-Building Makeover Contest and try to win the Grand Prize of a free micro-IVF cycle valued at $3,900.00! See entry details on the April 23, 2012 blog post! 

And remember…there are worse places to be spending a few hours on a Sunday afternoon…you could be stuck at a baby shower.

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What do you do on the weekends during treatment? Any rewards? Any tips on how to get through weekends at the doctor’s office?

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