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Archive for the ‘Dr. David Kreiner’ tag

Dr. Kreiner Hosts Talk on Fertility Preservation and Reproductive Options for the LGBT Community

By Tracey Minella

November 1st, 2015 at 1:24 pm

Dr. David Kreiner, reproductive endocrinologist and co-founder of Long Island IVF, is excited to be presenting an interactive lecture and Q&A session on Fertility Preservation and Reproductive Options for the LGBT Community at the 20th Annual Long Island LGBT Conference.

The conference will be held at the Charles B. Wang Center at Stony Brook University in Stony Brook, New York, on Tuesday, November 17th, from 8:30 am- 2:00 pm. The conference is sponsored by the LGBT Network and any questions or registration should be directed to them. Admission is free to SBU students and is available for $20-30 for other age groups.

Dr. Kreiner will introduce the medical options available to assist LGBT family-building with special emphasis on the importance on advance planning for fertility preservation. Topics will include:  donor sperm insemination, in vitro fertilization, reciprocal IVF, use of gestational carriers, and also fertility preservation in the transgender community. The social, legal, financial, and medical issues will be discussed.

Reproductive options for lesbian couples will also be discussed. The limitations and the workup for women wishing to donate eggs and/or carry a pregnancy will be covered. The legal, medical and financial issues involved with surrogacy and gestational carriers for gay male couples will also be addressed. In addition, the fertility preservation options available to transgender people prior to transitioning will be covered. If you are…or love…a member of the LGBT community, you won’t want to miss this information–packed seminar.

Long Island IVF has been a supportive provider of assisted reproductive family-building services for the LGBT community for decades. We recognize that your needs and rights to parenthood are universal, but that the approach to your care and particular fertility obstacles is unique. Our staff, some of whom are members of the LGBT community themselves, is sensitive to your needs and eager to help you build your family.

If you would like to attend Dr. Kreiner’s lecture, please register by contacting the LGBT Network. http://bit.ly/1N77BrP

 

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Do you have any questions you would like Dr. Kreiner to address either before or at the lecture? If so, please comment below.

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The Man’s Role in IVF

By David Kreiner MD

January 24th, 2015 at 8:13 am

 

credit: imagery majestic/ freedigitalphotos.net


Many husbands complain that they feel left out of the whole IVF process as all the attention and care is apparently directed towards the woman. If anything they may feel that at best they can show up for the retrieval at which time they are expected to donate their sperm on demand. If you should fail at this then all the money, time, hope and efforts were wasted all because you choked when you could not even perform this one “simple” step.

I have not witnessed the terror and horrors of war but I have seen the devastation resulting from an IVF cycle failed as a result of a husband’s inability to collect a specimen. Relationships often do not survive in the wake of such a disappointment. Talk about performing under pressure, there is more at stake in the collection room than pitching in the World Series.

Husbands and male partners view IVF from a different perspective than their wives. They are not the ones being injected with hormones; commuting to the physician’s office frequently over a two week span for blood tests and vaginal ultrasounds and undergoing a transvaginal needle aspiration procedure. At least women are involved in the entire process, speak with and see the IVF staff regularly and understand what they are doing and are deeply invested emotionally and physically in this experience. So what is a husband to do?

 

Get Involved

Those couples that appear to deal best with the stress of IVF are ones that do it together.

Many husbands learn to give their wives the injections. It helps involve them in the efforts and give them some degree of control over the process. They can relate better to what their wives are doing and take pride that they are contributing towards the common goal of achieving the baby.

When possible, husbands should accompany their wives to the doctor visits. They can interact with the staff, get questions answered and obtain a better understanding of what is going on. This not only makes women feel like their husbands are supportive but is helpful in getting accurate information and directions. Both of these things are so important that in a husband’s absence I would recommend that a surrogate such as a friend, sister, or mother be there if he cannot be. Support from him and others help diminish the level of stress and especially if it comes from the husband helps to solidify their relationship.

Husbands should accompany their wives to the embryo transfer. This can be a highly emotional procedure. Your embryo/s is being placed in the womb and at least in that moment many women feel as if they are pregnant. Life may be starting here and it is wonderful for a husband to share this moment with his wife. Perhaps he may keep the Petri dish as a keepsake as the “baby’s first crib”.  It is an experience a couple is not likely to forget as their first time together as a family.

With regards to the pressure of performing to provide the specimen at the time of the retrieval, I would recommend that a husband freeze a specimen collected on a previous day when he does not have the intense pressure of having to produce at that moment or else. Having the insurance of a back-up frozen specimen takes much of the pressure off at the time of retrieval making it that much easier to produce a fresh specimen. There are strategies that can be planned for special circumstances including arranging for assistance from your wife and using collection condoms so that the specimen can be collected during intercourse. Depending on the program these alternatives may be available.

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If you did IVF, was your partner involved? How did it go? Any funny or sweet stories to share?

If your partner wasn’t involved, are you happy about that decision, and if so, why was it the right decision for you?

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Fibroids and Fertility

By David Kreiner MD

December 13th, 2013 at 9:13 am

 

 

 

Fertility is dependent upon so many things!

We must have healthy gametes (eggs and sperm) capable of fertilizing and implanting in a uterus with a normal endometrial lining unimpeded by any uterine or endometrial pathology. The sperm need be in sufficient number and capable of swimming up through a cervix which is not inflamed and provides a mucous medium that promotes sperm motility. The eggs need to ovulate and be picked up by normal healthy fimbriated ends (finger like projections) of the fallopian tubes. The tubes need to be covered with normal micro hairs called cilia that help transport the egg one third of the way down the tube where one of the sperm will fertilize it.

The united egg and sperm (the “conceptus”) then needs to undergo cell division, growth and development as it traverses the tube and makes its way to the uterine cavity by the embryo’s fifth day of life at which point it is a blastocyst. The blastocyst hatches out of its shell (“zona pellucidum”) and implants into the endometrial lining requiring adequate blood flow.

And you wonder why getting pregnant is so hard?

All too often patients, in some groups as many as 30% of women, are told that they have fibroids that may be contributing to their infertility. Fibroids or leiomyomata are non malignant smooth muscle tumors of the uterus. They can vary in number, size and location in the uterus including; the outside facing the pelvic cavity (subserosal), the inside facing the uterine cavity (submucosal) and in between inside the uterine wall (intramural). Fortunately, most fibroids have minimal or no effect on fertility and may be ignored.

The subserosal myoma will rarely cause fertility issues. If it were distorting the tubo- ovarian anatomy so that eggs could not get picked up by the fimbria then it can cause infertility. Otherwise, the subserosal fibroid does not cause problems conceiving.

Occasionally, an intramural myoma may obstruct adequate blood flow to the endometrial lining. The likelihood of this being significant increases with the number and size of the fibroids. The more space occupied by the fibroids, the greater the likelihood of intruding on blood vessels traveling to the endometrium. Diminished blood flow to the uterine lining can prevent implantation or increase the risk of miscarriage. Surgery may be recommended when it is feared that the number and size of fibroids is great enough to have such an impact.
However, it is the submucosal myoma, inside the uterine cavity, that can irritate the endometrium and have the greatest effect on the implanting embryo.

To determine if your fertility is being hindered by these growths you may have a hydrosonogram. A hydrosonogram is a procedure where your doctor or a radiologist injects water through your cervix while performing a transvaginal ultrasound of your uterus. On the ultrasound, the water shows up as black against a white endometrial border. A defect in the smooth edges of the uterine cavity caused by an endometrial polyp or fibroid may be easily seen.

Submucosal as well as intramural myomata can also cause abnormal vaginal bleeding and occasionally cramping. Intramural myomata will usually cause heavy but regular menses that can create fairly severe anemias. Submucosal myomata can cause bleeding throughout the cycle.

Though these submucosal fibroids are almost always benign they need to be removed to allow implantation. A submucosal myoma may be removed by hysteroscopy through cutting, chopping or vaporizing the tissue. A hysteroscopy is performed vaginally, while a patient is asleep under anesthesia. A scope is placed through the cervix into the uterus in order to look inside the uterine cavity. This procedure can be performed as an outpatient in an ambulatory or office based surgery unit. The risk of bleeding, infection or injury to the uterus or pelvic organs is small.

Resection of the submucosal myoma can be difficult especially when the fibroid is large and can sometimes take longer than is safe to be performed in a single procedure. It is not uncommon that when the fibroid is large, it will take multiple procedures in order to remove the fibroid in its entirety. It will be necessary to repeat the hydrosonogram after the fibroid resection to make sure the cavity is satisfactory for implantation.

The good news is, when no other causes of infertility are found, removal of a submucosal fibroid is often successful in allowing conception to occur naturally or at least with assisted reproduction.

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Anyone have a fibroid story to share?

Photo credit: public domain: http://en.wikipedia.org/wiki/File:Fibroids.jpg

 

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Infertility Podcast Series: Journey to the Crib: Chapter 22: Cryopreservation of Embryos

By David Kreiner MD

July 8th, 2013 at 8:58 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-Two: Cryopreservation of Embryos. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=119

Cryopreservation of Embryos

In 1985, my mentors, Drs. Howard W. Jones Jr and his wife Georgeanna Seegar Jones, the two pioneers of In Vitro Fertilization (IVF) in the Western Hemisphere, proposed the potential benefits of cryopreserving embryos for future transfers.  They predicted that doing so would increase the overall success rate of IVF and make the procedure safer, more efficient and cost effective. 

 

One fresh IVF cycle might yield enough embryos so that in addition to performing a fresh embryo transfer in the same cycle as the stimulation and retrieval that additional embryos may be preserved for use in future cycles.  This helps to limit the exposure to certain risks confronted in a fresh cycle such as the use of injectable stimulation hormones, the egg retrieval and general anesthesia.  It also allows patients to minimize their risk for a multiple pregnancy since embryos can be divided for multiple transfers.

 

At Long Island IVF, we are realizing the Jones’ dream of safer, more efficient and cost- effective IVF, as well as increasing the overall success of IVF. 

 

Today, an estimated 25% of all assisted reproductive technology babies worldwide are now born after freezing.  Studies performed in Sweden revealed that babies born after being frozen had at least as good obstetric outcome and malformation rates as with fresh IVF.  Slow freezing of embryos has been utilized for 25 years and data concerning infant outcome appear reassuring relative to fresh IVF. 

 

I personally have pushed to promote the concept of removing the financial pressure to put all your eggs in one basket by eliminating the cost of cryopreservation and storage for those patients transferring a single embryo.  Furthermore, such a patient may go through three frozen embryo transfers to conceive for the price of one at our program.  We truly believe we are practicing the most successful, safe and cost effective IVF utilizing cryopreservation.

 

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Was this helpful in answering your questions about cryopreservation of embryos?

Please share your thoughts about this podcast here. And ask any questions, whih Dr. Kreiner will answer.

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

By David Kreiner MD

June 10th, 2013 at 9:46 pm

 

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

Micro-IVF

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

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

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

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

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

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

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

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A Heart-Stopping Tale: The Old Friend, A Fertility Doc, and The Subway Series

By David Kreiner MD

May 31st, 2013 at 9:05 pm

 

image courtesy of freedigital photos.net

“How do I feel?…The Mets won!” he exclaimed. And with those words exuding from his mouth, Marty’s whole face smiled from ear-to-ear.  “How do I feel?…Weak, but I don’t think I need a fertility doctor.”

Marty was on a roll, his joking relaxed me…his light-hearted mood and focus on his love for the Mets gladdened my heart as I was slowly realizing that Marty was back.

This 76 year-old semi-crippled athlete who loved to play tennis despite his obvious orthopedic infirmities of late struggled to walk, much less compete athletically, but clearly competitive sport was a great love of his.

This is how I knew Marty was back as he joked about his Mets winning the Subway Series.

His wife was now by his side, grasping for rational thought clouded by the sight of seeing her life’s soul mate lying apparently helpless on the floor, having just returned from a temporary state of cardiorespiratory arrest.  She was shaking, yet uncertain about Marty’s fate.

Karina, Dr. Karina I learned… our hero… was a 40-something gastroenterologist who initiated chest compressions moments before I arrived to the lobby of the restaurant but seconds after Marty was seen clutching at his chest, collapsing to the ground. He stopped breathing… his heart stopped beating…and he turned blue.

I confirmed there was no heartbeat nor respirations, as Dr. Karina continued chest compressions.  I looked at Marty and thought about all the fuss he had made over the years regarding road safety in our community…his involvement in tennis and the men’s club, as well attempts to bring others into the fold.

I respected Marty as a role model who I wished to emulate 19 years hence.  He was active, athletic, and responsible for the welfare of the community.

I was determined to breathe life back into this man who in my eyes had plenty more tennis matches to play, Mets games to cheer for, and kids to warn to slow down their cars.  With the will of God I exhaled my life’s breath, filling Marty’s lungs not once but twice.  In response to Dr. Karina’s chest compressions and my breaths, Marty started to perk up with a strong pulse.  His palms were now sweaty and his eyes were beginning to focus.

I dared to ask him, “Marty, do you know who I am”?

“Of course,” Marty said.  “You are the fertility doctor and the one who creates life”.

Later that evening, reflecting on the events at the restaurant, I finally felt that maybe there is some truth that Dr. Karina and I acted as agents of God and indeed did recreate life in the lobby of the restaurant that evening.

Photo credit: Victor Habbick/ http://www.freedigitalphotos.net/images/agree-terms.php?id=100100670

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Long Island IVF’s 25th Anniversary Reunion Recap

By Tracey Minella

May 17th, 2013 at 9:14 pm

 

The only thing more perfect than the beautiful spring weather for Long Island IVF’s 25th Anniversary reunion party yesterday was the smiles on the faces of all of our babies and their grateful parents!

Every spring, Long Island IVF celebrates the births of our most recent IVF arrivals with a picnic for that year’s newborns and their parents. But this year…for our big anniversary…we opened it up to all 5,000+ couples whose families we’ve helped build over the past quarter century! Please “like” us on Facebook and check out some more reunion pictures there.

For those who don’t know, Long Island IVF was the practice to bring Long Island its first IVF baby, first FET/cryo baby, and first donor egg baby. The same doctors who co-founded Long Island IVF twenty-five years ago are still partners today.

We cherish every little life we’ve helped create, from the college grads to those being conceived today. But it was especially exciting to reunite with some of our oldest babies, now all grown-up, including the second baby born to Long Island IVF’s program, Alyssa.

Alyssa is the beautiful 24 year-old blonde in the picture with Dr. Kreiner. She and her mother came (her 21 year-old younger brother couldn’t make it) and they were instant “celebrities” as word spread throughout the crowd that Baby #2 was “in the house”. They each addressed the crowd, recalling how important Long Island IVF was in their lives, in a very emotional moment of the day that really helped bring home the magnitude of what Long Island IVF has meant to so many couples for 25 years and counting.

Other beautiful older babies were there. Some reiterated the same sentiment as they spoke about their lives…lives that would not have been possible without Long Island IVF. It was a humbling and gratifying experience for the whole Long Island IVF staff. As always, the fresh crop of adorable newborns and toddlers, decked out in their finest, were a joy to meet and gush over!

Everyone at Long Island IVF would like to thank all of the parents and children who came out to celebrate this very important milestone with us…and all those who were there in spirit, but were not able to come.

You and your families are beautiful. You all inspire us each day to do the work we love…building families. Thank you from the bottom of our hearts for allowing us the privilege of building yours.

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Were you at the party? Please share your thoughts and feel free to upload a photo on our Facebook page.

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Long Island IVF’s National Infertility Awareness Week Events

By Tracey Minella

April 15th, 2013 at 3:47 pm

 

Long Island IVF is pleased to offer an exciting series of seminars for National Infertility Awareness Week 2013. The five (5) seminars in our “Evenings of Education” series will be packed with information on many areas of interest to those trying to conceive. Each event will be led by a different expert at Long Island IVF.

All seminars, which will run for approximately two hours, will take place at our beautiful, centrally-located Melville offices at 8 Corporate Center Drive, Suite 101, Melville, New York and start at 6:30 pm. (Please note the one exception is “The Complete IVF Donor Egg Program” which starts at 7:00 pm). Refreshments will be served at all events. Pre-registration is encouraged.

These seminars are designed to answer all the questions you may have no matter where you are along your journey to parenthood. Maybe you know… or suspect… that you’re suffering from PCOS and worry about its impact on your fertility. Or maybe you’ve been trying to conceive and have been unable to get pregnant, or have suffered from recurrent miscarriages, and think it might be time to move on to an infertility specialist. Maybe you need help dealing with the stress of infertility itself, as well as the financial stress it can bring. Maybe you’re considering getting a second opinion or are questioning the whether the fit is right with your current reproductive endocrinologist.

Take the next step. Come to one…or all…of our seminars. Get a feel for the personal touch we bring to infertility treatment and see what makes our program different from those hospital-based programs that treat you like a number.

Long Island IVF …celebrating our 25th anniversary this year…is the first successful IVF program on Long Island. We brought Long Island its first IVF baby, its first FET baby, and its first donor egg baby. Come meet us during National Infertility Awareness Week. We’ll be looking forward to seeing you.

Here is the Seminar Schedule:

Tuesday, April 16, 2013 at 7:00 p.m.: “The Complete IVF Donor Egg Program”  

Kicking off NIAW early is the first of five seminars in our “Evenings of Education Series”. Presented by a panel of Long Island IVF doctors and staff (Donor Egg Program Director, Dr. Steven Brenner, Donor Egg Clinical Nurse Coordinator, Vicky Loveland, R.N., and Aviva Zigelman, LCSW) this educational seminar, including a slide show, will discuss why a woman may need donor eggs to conceive. The psychological aspects of being an egg donor or recipient will also be discussed. The entire donor egg program and its various processes will be reviewed, including what sets Long Island IVF’s donor egg program apart from others. The discussion will feature a previously successful recipient who used the donor egg program, as a guest speaker. There is no waiting list for egg donors at Long Island IVF. To register for this FREE seminar, Email: victorial@longislandivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

 

Monday, April 22, 2013 at 6:30 p.m.: “Trying to Conceive: The Complete Fertility Workup”   The second of five seminars in our NIAW “Evenings of Education” Series. Presented by Long Island IVF’s Dr. David Kreiner, this educational seminar will help interested people determine when it’s time to see a Reproductive Endocrinologist for assistance in conceiving. Dr. Kreiner will also explain the tests and procedures they may expect as part of a complete fertility evaluation and the full range of available treatment options to maximize the chances for conception. Dr. Kreiner will hold a Q&A session afterwards where attendees may ask him public, or private, questions. Pick the brain of Long Island’s IVF “pioneer” reproductive endocrinologist at the practice that brought Long Island its first IVF baby, first FET baby, and first donor egg baby. Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Tuesday, April 23, 2013 6:30 pm: “The Mind-Body Program: Use Your Mind to Help You Conceive” Presented by Long Island IVF’s Bina Benisch, R.N., this third seminar in our series will explain how stress hormones, anxiety, and depression physiologically affect the body and how it is crucial to break this cycle to increase your chance to conceive. Relaxation strategies of the Mind-Body program are taught in small, intimate group settings and include breath work, meditation, progressive muscle relaxation, focused mindfulness, and more. Once learned, you can use these coping strategies daily at home. Meet Bina and see if becoming part of this sacred circle of support is right for you.  Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Wednesday, April 24, 2013 6:30 pm: “Conceiving With PCOS” Presented by Long Island IVF’s Dr. Michael Zinger, this educational seminar, the fourth in our NIAW “Evenings of Education” series will address the most common hormonal disorders of reproductive age women: Polycystic Ovary Syndrome. PCOS symptoms vary but the most common are acne, weight gain, extra hair on the face and body, thinning of hair on the scalp, irregular periods and infertility. The most common cause of PCOS is glucose intolerance. Dr. Zinger will discuss the treatment options for PCOS which can not only assist women attempting to conceive, but can help control their symptoms and may prevent long-term health problems. If you are one of the 7% of all women who suffer from this hormonal disorder, you won’t want to miss this seminar. Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

Thursday, April 25, 2013 6:30 pm: “Fertility and Financial Options” Presented by Long Island IVF’s financial counselor, Chris Graffeo, this educational seminar, the fifth in our NIAW “Evenings of Education” series, will help you navigate the maze of health insurance and infertility treatment. You’ll learn how to find out what, if any, insurance benefits you may have for fertility treatment and how to find a participating reproductive endocrinologist. Chris will also discuss how to apply for Department of Health (DOH) IVF grants, how an IVF Refund Program works, and how a case rate plan can help make fertility treatment more affordable to self-pay patients. If the financial aspect of fertility care has you confused, this night is for you.  Refreshments will be served. To register for this FREE seminar or any of the others we are offering nightly this week, Email: lmontello@liivf.com or call 877-838-BABY or 631-752-0606. Location: Long Island IVF, 8 Corporate Center Dr., Suite 101, Melville, NY 11747

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Which of these do YOU plan to attend? If there is a topic you’d like covered that you’re not sure fits in to one of the planned discussions, please comment below, or email lmontello@liivf.com with your question and we will forward it to one of the doctors. Or just come to one of the seminars and ask the doctor privately.

 

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A Eulogy to Robert Edwards

By David Kreiner, MD

April 13th, 2013 at 11:34 pm

 

image courtesy of: freedigitalphotos.net/credit: Photokanok

Robert Edwards, the British scientist responsible for developing the first successful In Vitro Fertilized baby in the world in 1978, died this week.  Since then over 5 million babies have been born as a result of the IVF technology he pioneered and eventually won him the Nobel Prize in 2010.  Today, 1-4 % of all babies born in Europe, North America and Australia are the result of this assisted reproductive technology started by Professor Robert Edwards.

 

For those of us affected by infertility or who dedicate our life’s work to IVF, we owe much to this brilliant man whose perseverance in the 1960′s and 1970′s in embryologic research made it possible for us to experience the miracles we now are fortunate to know as our children and the children of our patients, friends and relatives.

 

I had the good fortune to meet Professor Edwards in the 1990′s.  He astounded me with his intelligence, his humility and his humor.  I told him about our Long Island IVF softball team that we had at the time which made him laugh hysterically.  

 

It was ironic to him that IVF which had been his research project for decades as well as a world controversy had made it to the everyday mundane status of American softball.

 

We owe much to this great man and will forever hold his memories dear to our hearts.

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What would you have said to, or asked, Robert Edwards if your paths had ever crossed?

Photo credit: freedigitalphotos.net

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Infertility Podcast Series: “Journey to the Crib”: Chapter 8 Hydrosalpinx

By David Kreiner, MD

April 1st, 2013 at 6:18 pm

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Eight: Hydrosalpinx. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=57

 

Hydrosalpinx

A hydrosalpinx is a fallopian tube that is blocked at its distal end opposite the entrance to the uterine cavity.  It is filled with inflammatory fluid most likely the end result of a pelvic infection.  This fluid can flow into the uterine cavity thereby creating a hostile environment for a potentially implanting embryo.

Aside from preventing natural conception due to an inability for the fallopian tube to pick up an ovulating egg, the hydrosalpinx may complicate an in vitro fertilization procedure by creating a uterine cavity that is unfavorable for a transferred embryo to implant.   Furthermore, the transferred embryo may be pushed into the fallopian tube by a uterine contraction and be stuck in this diseased tube where it could grow and develop into an ectopic pregnancy.   In normal tubes the embryo is swept back to the uterus by the air like projections found in the lining of healthy tubes.

Fertility surgery to open hydrosalpinges provides a 20% pregnancy rate with a very high risk to result in the development of an ectopic pregnancy.  We therefore recommend instead removal of these tubes or at least ligation where the flow of the inflammatory fluid into the cavity or travel of the embryo out of the cavity into the tube is prevented.

Salpingectomy, removal of the fallopian tube or a tubal ligation is performed by laparoscopy.  Recently, hysteroscopic procedures have been developed to create a blockage at the junction of the tube and the uterine cavity.  This is a much less invasive vaginal procedure.  There is no cutting and may sometimes be performed without anesthesia.  The tubes may take three months to completely scar to create the necessary obstruction prior to proceeding with IVF.

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Was this helpful in answering your questions about hydrosalpinx and its effects on a woman’s fertility?

 

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

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