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Fertile Food Friday– Red Meat

By Tracey Minella

July 12th, 2013 at 10:24 pm


recipe and photo courtesy of

Fertile Food Friday– Red Meat

Welcome back to Long Island IVF’s “Fertile Food Fridays”*! This is our third week of focusing on foods that can potentially boost male or female fertility. If you missed them, be sure to check out our first two featured foods…avocados and blueberries…covered the past two Fridays.

Next up to the plate…Red Meat.

Step outside at dinnertime most summer evenings and you can smell something good on the neighbor’s grill. And chances are it’s some kind of red meat.

Red meat is a great source of iron. Iron deficiency is common in women of bearing age and also can contribute to ovulatory infertility. In fact, a large study found that “women who consumed iron supplements had a significantly lower risk of ovulatory infertility than women who did not use iron supplements” . More precisely, they had a 40% less risk of ovulatory infertility than those who did not use supplements.

If you are trying to conceive, and suspect you may be iron deficient, ask your doctor to check your iron level. This is done with a simple CBC blood test to see if your red blood cell count is adequate. Red blood cells deliver oxygen to all the cells and tissues of your body, including your ovaries and uterus**. If your red blood cell count is too low, you may be anemic, and may be instructed to take iron supplements or make dietary changes. Never take any supplements without your doctor’s approval since too much iron can be harmful.

Symptoms of anemia** may include:

mild to severe fatigue
• chronic headaches
• dizziness
• brittle or weak nails
• decreased appetite
• low blood pressure

According to the Mayo Clinic, some iron-rich foods include red meat, leafy green vegetables like spinach, beans, eggs, dried fruit, and other items. In addition, eating foods rich in Vitamin C, like peppers, helps your body absorb iron.

So this week’s recipe is a winner because it provides iron from steak and spinach, plus Vitamin C from the peppers to help you absorb the iron. Give yourself a break from those boring old burgers and try this amazing Stuffed Flank Steak, courtesy of Kelly over at Primally-Inspired. <<<Get the recipe here. And while you are over there, check out Kelly’s other great recipes for those with a primal palette. Or here it is below:


4 or more servings


1 ½ – 2 lb flank or skirt steak

2 – 4 T olive or coconut oil

4 – 6 oz mushrooms, sliced thin

1 shallot, diced

2 cloves garlic, minced

5 – 6 pieces prosciutto

2 roasted red peppers (from a jar or make your own), cut into thin strips

1 bunch of fresh spinach

1/3 cup blue cheese crumbles (omit if you cannot eat dairy)

salt and pepper, to taste

½ tsp smoked paprika

kitchen twine


Preheat oven to 350.

Starting with the long side of your flank steak, cut it in half carefully, but don’t cut all the way through to the other end (butterfly it). You want to cut it and open it like a book. Once it’s cut and open like a book, place a piece of plastic or parchment over it and pound it to uniform thickness – about ¼ of an inch thick.

In the largest skillet you have (must fit the rolled up steak), pour 1 – 2 T oil in the pan over medium low heat. Add your shallot, garlic, and mushrooms and cook for 5 minutes. Season them with salt and pepper.

Add the mushroom mixture to the flank steak, leaving 2 to 3 inches of open space on one of the long ends.

Add the red peppers on top of the mushrooms. Then add the prosciutto slices all over the red peppers. Then add your spinach all over the prosciutto. Next sprinkle the blue cheese all over the spinach.

Starting with the long end (not the end that you left 2-3 inches of space), roll up carefully.

Now tie kitchen twine around your roll about every 2 inches. Salt and pepper and sprinkle the smoked paprika all over the outside of the roll.

Pour 1- 2 T oil back in the skillet and turn the heat to medium high.

Sear your roll on all sides until browned – it takes about a minute each side.

Transfer your skillet to the oven and cook for 20 minutes (for medium).

After the 20 minutes is up, take it out and tent your steak with aluminum foil. Let rest for 10 minutes. For steak done more than medium: cook in the oven for 30 minutes, tent steak and let rest for 10 minutes.

To serve: cut off the twine and slice in ½ – 1 inch slices and enjoy!


Once you make it, come back and tell me how great it was!

*Disclaimer:Any recipe we offer is only meant for those who aren’t sensitive or allergic to the ingredients. Recipes are shared simply for fun only and nothing contained herein constitutes medical advice or a guarantee that eating any particular food will have any affect on your fertility.

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Do you know your iron level? Have any recipes high in iron-rich foods that you’d like to share? If so, please share it here. And if you try this one, let us know what you thought.




Photo credit: Primally-inspired

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Fertile Food Friday- Avocado

By Tracey Minella

June 28th, 2013 at 3:29 pm


image courtesy of flikr

Did you know that some foods can potentially boost male and female fertility? Want to learn more? Check out Long Island IVF’s “Fertile Food Friday” posts. We’ll have some fun facts and a recipe or video for each food we focus on… for those who aren’t sensitive or allergic to the ingredients, of course.

The first fertile food will be avocado.

As you can see from the photo, avocados hail from what the Aztecs nicknamed Āhuacatl , short for āhuacacuahuitl, which means “testicle tree”.*

Avocados are thick-skinned, dark green/black, pear-shaped, bumpy fruits (about the size of your palm) with soft, pale yellow flesh and a large pit. They are rich in folate and Vitamin E, and are an excellent monounsaturated (good) fat which may benefit the reproductive health of both men and women and also help lower inflammation and insulin resistance (which could be particularly beneficial to many PCOS patients).

In fact, a recent study out of Harvard’s School of Public Health on the effects of dietary fats on IVF outcomes found that those who consumed the highest intake of monounsaturated (good) fats were 3.4 times more likely to have a baby after IVF than those who consumed the lowest amount. Lead researcher, Professor Jorge Chavarro, was quoted by the Daily Mail** as saying, “”The best kinds of food to eat are avocados, which have a lot of monounsaturated fat…” In addition, the women with the highest levels of monounsaturated fat consumption had higher live birth rates. Further, the women who ate mostly saturated (bad) fats had lower egg quality.

Ready for an avocado recipe recommendation?

image courtesy of Mister GC/

Perhaps the most popular use for avocados is in Guacamole, a Mexican dip often used for chips and nachos. It is the quintessential party food and a staple at many summer gatherings. But you may need to skip out on its partner…the Margarita… if you’re trying to conceive.

Chef Rick Bayless, author of Frontera: Margaritas, Guacamoles and Snacks and other cookbooks, is famous for guacamole, and often demonstrates his technique in short videos. His guacamole begins with avocados, salt, fresh white onion, fresh lime juice, and cilantro, but the remaining ingredients vary. Additions may include fresh or canned hot chiles, tomatoes or tomatillos, and crispy, crumbled bacon. Check out this video demonstration or one of his cookbooks (available on amazon) to learn how to make fresh guacamole in about 5 minutes. Add chips and a cold drink and you’re ready to go!

Don’t forget that you can also add avocado chunks to salads. And if you don’t care for the taste but still want the health benefits, I will share one of my biggest culinary secrets…you can add it to meatloaf. Cream it into the meat mixture. I promise no one will know.

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Did you make this guacamole? Have another avocado recipe to share? Please share. Let’s help each other feed ourselves fertile.




Guacamole photo credit: Grant Cohrane

Avocado Tree photo credit: Alpha/avlxyz





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Infertility and Twisted Thoughts

By Tracey Minella

June 7th, 2013 at 9:52 pm


image courtesy of freedigital

Do you ever wonder if other infertile women think the way you do? I’m talking about those really crazy, twisted thoughts we sometimes feel. The ones we don’t speak out loud.

You know the ones.

The thoughts that would prompt a knowing nod (or howls of laughter) from other infertiles…and condemnation from the rest of society. 

On your lowest days, could you relate to any of these scenarios (tongue-in-cheek, of course!):

·         Tell me you haven’t imagined peeling the stick figure families off those minivans? Would you spare the pets or just leave the couple standing alone?

·         Do you always call out to the mother when you see a kid’s “binky” go missing in a public place? Or do you sometimes let the inattentive mom learn a lesson?

·         Ever bought a sort of ugly baby outfit…or a Diaper genie… for a baby or shower gift because the thought of 235+ dirty diapers crammed into the nursery corner would bring you a shred of comfort during an unbearably painful event?

·         Have you ever been in such a bad mood that, instead of mustering a smile, you actually kind of “stared down” a baby when its mom wasn’t looking…and it cried? And you didn’t feel guilty?

·         Ever want to (or actually) “unfriend” someone on Facebook for posting too many pregnancy updates, maternity photos, or baby pictures?

If you related to any of the above scenarios…or have your own list…it doesn’t make you a bad person. It makes you human. Occasional jealous or angry thoughts are common when you’re infertile.

But if the ache of empty arms or the depression and frustration of infertility is significantly interfering with your ability to get through your daily responsibilities, you may need a little help coping. Consider an infertility support group led by peers or professionals.

Anyone interested in Long Island IVF’s professionally-run support groups and counseling sessions should contact Bina Benisch, M.S., R.N. at Bina counsels both women and men in separate support groups as they navigate their infertility journeys. All are welcome to join, even if you are not yet a Long Island IVF patient. You can read more about Long Island IVF’s Mind-Body Program and counseling services here.

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Did you ever think any of the above thoughts? Or do you have others to share? Have you tried Bina’s support groups, and if so, what did you think?

Photo Credit: Stuart Miles and


How Far Would You…Literally… Go To Have a Baby?

By Tracey Minella

January 31st, 2013 at 9:04 pm

image courtesy of Ambro/freedigital

If you ask an infertile couple what they’d be willing to do to have a baby, they’d probably say “Anything”. What would they be willing to spend? “Every last dime”. What would they sacrifice? “Whatever they need to”.

How far would they be willing to go to have a baby? “The ends of the earth”.

No, I don’t mean that philosophically. I mean it literally.

How far would you be willing to physically travel on your infertility journey?

If you live in a very rural or remote area, you have no choice but to travel extensively just to get to the nearest infertility clinic. Maybe it’s an hour or two in each direction. Many days per week, when cycling. And that’s just to access the nearest reproductive endocrinologist, not necessarily the best one.

Did location factor in to your decision for an R.E.? Did you choose the closest? Are you willing to travel farther for a clinic with the best reputation and success rates? If so, how far would you be willing to go? An hour? Two?

And on a related note, would you… or have you…relocated to another state to pursue IVF?

If the state you live in is not one of the 15 states that mandates some level of infertility coverage, and you do not have private medical insurance for infertility treatment, would you move to a state that does in order to pursue treatment? Here is a list of the states which do mandate some level of infertility coverage:

This list, provided by RESOLVE, is an invaluable asset for anyone willing to consider relocating, especially due to a job transfer or new employment opportunity. There are many variables, conditions, limitations, and exclusions on the coverage. Some states cover diagnostic testing only, others will allow certain treatments but exclude IVF, and some cover IVF but limit the number of cycles. Massachusetts has a very generous mandate which would certainly tempt infertile couples to consider relocating under the right circumstances. But it’s important to do your research since, even in Massachusetts, employers who self-insure are exempt.

Long Island IVF has treated patients who have traveled here from distant states and other countries, attracted by success rates and/or programs like our Micro-IVF and Donor Egg programs.

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Would you…or have you… traveled far, or even relocated to another state to pursue your dream of having a baby?


Photo credit:



The Infertile Woman’s New Year’s Resolution

By Tracey Minella

January 1st, 2013 at 12:36 pm

credit; Simon Howden/

1. Have a Baby in 2010, 2011, 2012, 2013.

That’s it. Same old resolution. Can you even remember when it wasn’t the resolution?

I don’t know what’s more frustrating: Making the same resolution of having a baby or listening to others making their insignificant resolutions to lose the last 5 pounds of their baby weight. Could anything be more important than having a baby?

The frustration about listening to the resolutions of others…many of which are destined to fail due to a lack of real commitment… is that in most cases the resolutions could succeed if the maker wanted it badly enough. The powers to lose weight, quit smoking, or make more money… while not easy… are more often than not within the control of the person who says they want it.

For women who are infertile and unable to conceive without medical intervention, having a baby is not in their ultimate control. Sure they can get in good shape, eat well, take vitamins, and even update their dental health to maximize their chances. Then, if they can afford it, they can find a great Reproductive Endocrinologist, follow the prescribed protocol and… hope to get pregnant.

They can only hope.

Getting pregnant is not in their hands. It’s not a choice they can just make. The lack of control over the situation is maddening. And it’s even harder for those who need IVF and can’t afford it. It makes the goal flat out unattainable… unless a creative, alternative financing solution is found.

Yet we still make that same resolution because the hope of it coming true is what gets us out of bed each morning. So what can we do differently in 2013?

Perhaps we can start with a better mindset. And by that, I don’t mean forcing some bubbly optimism about the New Year if you’re not feeling it. I mean being realistic and balanced about it all. I mean taking the famous quote to heart about having the serenity to accept what you can’t change, the courage to change what you can, and the wisdom to know the difference. To calm the chaos a bit.

This month, the blog will feature posts that will help you focus on the balance of the above quote. To help you realize and accept what you can’t change, while giving you the courage to change the things you can. Real steps to help you release the negative and move you forward on the road to fulfilling that New Year’s resolution of having a baby. Empowering stuff.

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Do you have a specific plan to fulfill your New Year’s resolution this year?

Photo credit:

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The “Dream Team”

By David Kreiner MD

March 26th, 2012 at 10:23 pm

I once had a dream that my lab would be staffed by the most skilled embryologists I could find and that my physician partners would be the recognized experts in the field. 

Throughout my career, I have met some of the world’s best specialists in Reproductive Endocrinology and IVF from my time at the Jones Institute and in my 24 years of practice since I left Norfolk to found Long Island IVF with Dr. Dan Kenigsberg. Together, in 1988, we developed the first successful IVF program onLong Island. 

I am most excited to announce that we have assembled since the merger of Long Island IVF and East Coast Fertility such a “Dream Team”. Three of our embryologists have been directors of very successful IVF labs. The other embryologists by virtue of their experience, advanced degrees, and skills could start a successful IVF lab of their own. Instead, we have assembled under the leadership of Dr. Glenn Moodie arguably the strongest embryology team in the nation. 

Likewise, Drs. Joseph Pena, Michael Zinger and myself have joined nationally recognized, Castle Connolly’s “Best Doctors in America”, Drs. Dan Kenigsberg and Steven Brenner, as well as Drs. Kathleen Droesch and Satu Kuokkanen. 

This “Dream Team” of Reproductive Endocrinologists and embryologists in our first three months together produced remarkably successful IVF as good as anywhere in the country.  

For women under 35, during our first three months as a combined program, October 1, 2011 through December 31, 2011, Long Island IVF achieved 35 clinical pregnancies in 53 fresh transfers (66.0%).  For women 35-37, 18/30 (60.0%), 38-40, 20/37 (54.1%) and for women 41 and 42, 8 of 28 (28.6%) achieved clinical pregnancies. 

Additionally, the East Coast Fertility MicroIVF program featuring minimal stimulation and a cost of $3900 achieved 5 pregnancies in 8 women under 38 yrs of age. 

It is apparent that the whole of the combined Long Island IVF is greater than the sum of its independent parts of the two merging practices (East Coast Fertility + Long Island IVF). 

There is perhaps no more rewarding work than to help build families for those who would otherwise never be able to do so but for our efforts. Working as part of the Long Island IVF “Dream Team” is that much more enjoyable knowing that we can give our patients their very best chance to realize their own dreams of creating their families.


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Miracle on Old Country Road

By David Kreiner MD

December 22nd, 2011 at 11:09 pm

In this season of miracles, I decided to pull out my very favorite old post of Dr. Kreiner’s, edited for the current holiday. Any infertility patient fortunate enough to conceive will be jealous of this patient’s luck.

Here’s Dr. Kreiner’s story:

I was feeling depressed the other day.  It seemed that we had insurmountable computer issues, staff morale was down and my family was acting rebellious.  My kids were arguing with each other, with me and I found myself mindlessly walking out of my office down Old Country Road.

I came to a busy intersection and just stood there as cars sped by me.  Honestly, at that moment in time I was thinking, why am I here?  Why put up with all the hard work at the office trying to make the practice viable despite the pressures of the recession?  Insurance companies were denying claims and when they were paying claims, it was at lower reimbursements that threatened to not compensate for our expenses.  The government was planning to lower reimbursements even more.  Patients, also experiencing financial difficulties were either asking for more breaks in the fees or not paying.  I have to admit I gave thought to giving it all up as the pain and aggravations were not worth the efforts.

Suddenly, a white Audi convertible came to a screeching stop right next to me.  It was one of my patients in the passenger seat sporting a very pregnant belly and apparently blowing through what I assumed was a labor pain.  Her husband spoke.  “Dr. Kreiner, Lara went into labor early this morning and we are on our way to the hospital to have the baby…can you come with us?”  Speechless and shocked, I let myself into the cramped backseat and tried to comprehend what was happening as Lara’s husband took off.

We pulled into the emergency room five minutes later.  Lara and I were taken to the labor floor while her husband dealt with the paperwork at the desk.  Nurse’s barked orders, the doctor was called, and Lara started screaming during her pains and in this laboring frenzy I was awakened from my funk.  It has been awhile since I was involved in a delivery but this baby was not waiting for the doctor and I got back into obstetrical mode, checking the baby’s position and heart rate and getting the anesthesiologist to administer the epidural.  Lara’s husband was now at her side assisting her with her breathing.

“Push Lara, push”, I yelled as I saw the baby’s head crowning.  She and her husband acted as if they had trained all pregnancy for this moment, working together as a team, his arm around her shoulders, breathing with her and supporting her back as she pushed.

Well, the doctor got there just before the baby was delivering.  I stood on the side watching this miraculous event…Lara and her husband together pushing the baby out of the same womb that I had implanted nine months earlier.  I remembered the image of showing Lara and her husband the photograph of the embryo and then watching on ultrasound as I injected the drop of media and air bubble containing the microscopic embryo into her uterus.  I thought how sweet life was and I smiled.

Moments later, Lara put baby Adam to breast, her husband a proud new father was beaming as he gave out chocolate cigars to the doctor and nurses and then came to me with tears in his eyes and said, “thank you, so much Dr. Kreiner.  We could never have done this without you.”

What can I say?  It was as if my problems never existed.  I thought the only thing missing for me was to be with my family and appreciate what I have.  And what my wife and I have is truly amazing.  We have my two lovely daughters and two sons, one a newlywed with a fantastic wife and another son who has the best wife and most gorgeous three children one can ever wish for.  Playing with them, having brunch and dinner with the family I love, I enjoyed a very Happy Hanukkah.

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How do you feel about having to leave your fertility doctor once you get pregnant to go back to your OB/GYN? Do you wish your RE could deliver the baby?

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Cryopreservation: A Look into the IVF Freezer

By Tracey Minella and David Kreiner MD

December 13th, 2011 at 2:41 pm

Remember the Good Humor man? You’d hear that sound from blocks away and bolt out the door barefoot, shrieking “STAAAPPP!” arms flailing, and being joined by the rest of the block like rats to the Pied Piper.

Remember the way the white square door with the chunky silver hinge on the back swung open and all that cold, smoky fog billowed out into the humid air?

Remember the frozen magic inside?

Well, Long Island IVF and East Coast Fertility have magic freezers, too. Full of dreams. Full of potential. Full of embryos that may one day turn out to be rugrats running after the ice cream man.

In fact, Long Island IVF’s freezer once held the frozen embryo that turned out to be Long Island’s first cryo baby! Let’s revisit an earlier post by Dr. Kreiner which lets us take a peek inside the freezer of Long Island’s first successful cryopreservation program:

In 1985, my mentors, Drs. Howard W. Jones Jr. and his wife Georgeanna Seegar Jones, the two pioneers of in-vitro fertilization in the USA and the entire western hemisphere, proposed the potential benefits of cryopreserving or freezing embryos following an IVF cycle. They predicted that cryopreserving embryos for future transfers would increase the overall success rate of IVF and make the procedure more efficient and cost effective. They also suggested that it would reduce the overall risks of IVF. For example, one fresh IVF cycle might yield many embryos which can be used in future frozen embryo transfer cycles, if necessary. This helps to limit the exposure to certain risks confronted only in a fresh IVF cycle such as the use of injectable stimulation hormones, the egg retrieval operation, and general anesthesia.

At East Coast Fertility, we are realizing the Jones’ dream of safer, more efficient and cost effective IVF. By utilizing the ability to cryopreserve embryos in 2007, 61.5% (118/192) of patients under 35 were successful in having a live birth as a result of only one egg stimulation and retrieval cycle! In addition, because of our outstanding Embryology Laboratory, we are usually able to transfer as few as 1 or 2 high quality embryos per cycle and avoid risky triplet pregnancies. In fact, since 2002, the only triplet pregnancies we have experienced have resulted from the successful implantation of two embryos, one of which goes on to split into identical twins (this is rare!). By cryopreserving embryos in certain high-risk circumstances, we are able to vastly reduce the risk of ovarian hyperstimulation syndrome requiring hospitalization. At East Coast Fertility, safety of our patients comes first. Fortunately, our success with frozen embryo transfers is equivalent to that of fresh embryo transfers, so that pregnancy rates are not compromised in the name of safety, nor are the babies.

Today, as reported in the Daily Science: “The results are good news as an increasing number of children, estimated to be 25% of assisted reproductive technology (ART) babies worldwide, are now born after freezing or vitrification” (a process similar to freezing that prevents the formation of ice crystals).

The study, led by Dr Ulla-Britt Wennerholm, an obstetrician at the Institute for Clinical Sciences, Sahlgrenska Academy (Goteborg, Sweden), reviewed the evidence from 21 controlled studies that reported on prenatal or child outcomes after freezing or vitrification.

She found that embryos that had been frozen shortly after they started to divide (early stage cleavage embryos) had a better, or at least as good, obstetric outcome (measured as preterm birth and low birth weight) as children born from fresh cycles of IVF (in vitro fertilization) or ICSI (intracytoplasmic sperm injection). There were comparable malformation rates between the fresh and frozen cycles. There were limited data available for freezing of blastocysts (embryos that have developed for about five days) and for vitrification of early cleavage stage embryos, blastocysts and eggs.

Slow freezing of embryos has been used for 25 years and data concerning infant outcome seems reassuring with even higher birthweights and lower rates of preterm and low birthweights than children born after fresh IVF/ICSI. For the newly introduced technique of vitrification of blastocysts and oocytes, very limited data have been reported on obstetric and neonatal outcomes. This emphasises the urgent need for properly controlled follow-up studies of neonatal outcomes and a careful assessment of evidence currently available before these techniques are added to daily routines. In addition, long-term follow-up studies are needed for all cryopreservation techniques,’ concluded Dr Wennerholm.

The use of frozen embryos has become a common standard of care in most IVF Programs. At East Coast Fertility, [now merging with Long Island IVF], we are able to keep multiple pregnancy rates down – by only transferring one or two embryos at a time – while allowing patients to hold on to the additional embryos that they may have created during the fresh cycle. It is like creating an insurance plan for patients. We developed a unique financial incentive program using the technology of cryopreservation to encourage patients to transfer only one healthy embryo at a time.

In order to ensure the best outcome for mother and child – these special pricing plans take the burden off the patient to pay for the additional transfers and the cryopreservation process. We have eliminated the cost of cryopreservation, storage and embryo transfer for patients in the single embryo transfer program. Thus, patients no longer have that financial pressure to put all their eggs in one basket! We truly believe we are practicing the most successful, safe and cost effective IVF utilizing cryopreservation.

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Did you know before today that Long Island IVF is the home of Long Island’s first cryo baby?

Or that East Coast Fertility’s Director, Dr. Kreiner, and Long Island IVF’s Co-Directors, Drs. Kenigsberg and Brenner were running the show together at Long Island IVF way back then when cryo first came to Long Island…back when most of you reading this were very little kids?

Stay tuned as we bring you more interesting history about these IVF pioneers now that they’re all together again.

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Thanksgiving Infertility Patient “Open Venting” Session

By Tracey Minella

November 24th, 2011 at 12:00 am

It’s Turkey Day. And today I am giving you permission to vent. (Actually, you can vent anytime in here, but today you are formally invited to let loose if you need to, as the stressful holiday season has commenced.)

Is it early in the day and you’re checking in for your Fertility Daily “fix” before bravely facing the holiday and all the relatives and their nosy questions, unwanted advice, and insensitive comments? (C’mon, humor me!) If so, why not tell me what you’re dreading about today? Who is the big mouth that could wind up with a fork in her neck if she so much as looks at you funny?

Or is it after the festivities and you are emotionally wiped out by, well, all the relatives and their nosy questions, unwanted advice, and insensitive comments? How about sharing whatever upset you? It’ll make you feel better to vent. And besides, who doesn’t love a good fork-in-the-neck story?

Sometimes it’s hard to feel thankful. Especially when you don’t have the family you expected to have by now.

Truth be told, I had my doubts about the response we’d get for our Thankfulness Contest. I remember feeling very depressed and resentful during the holidays when I was doing my seven IVF cycles. Year after miserable year.

I was pretty bitter and completely overlooked anything good in my life…unable to focus on anything at all other than my infertility struggle. My mind was jam-packed with cycle info, drug inventories, numbers of follicles or embryos, hormone levels, and the ever present mental calculation of “if I get pregnant this cycle, the baby will be born in [insert month] and I will be [insert age]”. There was nothing else that mattered. Nothing.

I was concerned that those of you still on your journeys would be unable to look past your own own anger or sadness…your emptiness…and be able to focus on something positive that came out of your infertility journey. I totally understand that feeling. But if you can look deep inside and find something positive among the negative, please enter the contest for a chance to win a romantic dinner.

And if you’re not feeling thankful, then how about sharing right now what it is that you are feeling? Go on. Vent. You will feel better. And everyone here understands.

Photo credit:

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Washing Your Sheets May Help You Conceive

By Tracey Minella and David Kreiner MD

November 22nd, 2011 at 4:26 pm

No, not the laundry, silly. I’m talking about your sheets of cumulus cells. If you want to improve your chances for pregnancy, washing and separating these sheets of cells at the time of your IVF retrieval, and placing them in the dish with your embryos, may be just what the doctor ordered to get your pee stick to come back positive.

This revolutionary procedure is known as co-culture. Unfortunately, many IVF programs do not offer this pregnancy rate-boosting option. Fortunately for you, Long Island IVF and East Coast Fertility do offer co-culture.

Dr. David Kreiner explains the benefits of this exciting and promising weapon in the IVF arsenal:

Successful IVF is dependent on many factors.  The quality of the egg and embryo, the placement of the embryo into the uterus and the environment surrounding implantation are all paramount to the ultimate goal of creating a pregnancy that leads to a live baby.

Typically, patients present with their own gametes so the genetics and pregnancy potential of the eggs and sperm is usually predetermined when patients first present to an IVF program.  As a specialist in REI and IVF, I have dedicated my career to optimizing those other factors that we may influence.

In the late 1990’s I recorded data on all my embryo transfers including distance the catheter tip was placed into the uterine cavity, number of cells and grade of the embryos, difficulty of the transfer, use of tenaculum etc.  I presented my results at the ASRM in 2000 that highlighted the two step transfer to the middle of the uterine cavity and replaced the tenaculum with a cervical suture when needed and this radically improved pregnancy rates.

The uterine environment has been optimized through screening for anatomic issues in the uterine cavity with a hydrosonogram to identify polyps, fibroids and scar tissue that may impede implantation.  Hormonally, we have supplemented patient’s cycles with progesterone through both vaginal and parenteral (intramuscular) administration as well as estrogen that we monitor closely after embryo transfer and make adjustments when deemed helpful.

The greatest improvement in pregnancy rates for the past several years however has been due to a “Culture Revolution” in IVF that is the media environment bathing and feeding the embryos.  All these advances have had a great impact on IVF success rates to the point that 50% of retrievals will result in a pregnancy.  Unfortunately, older patients and some younger ones have yet to share in this success.

Many IVF programs have reintroduced the concept of utilizing a co-culture medium to improve the quality and implantation of embryos. Co-culture is a procedure whereby “helper” cells are grown along with the developing embryo. Today, the most popular cell lines include endometrial cells (from the endometrium, or uterine lining) and cumulus cells from women’s ovaries.  Both cell lines are derived from the patient, thereby eliminating any concerns regarding transmission of viruses. Endometrial cells are much more difficult to obtain and process, while cumulus cells are routinely removed along with the oocytes during IVF retrieval.

Cumulus cells play an important role in the maturation and development of oocytes.  After ovulation cumulus cells normally produce a chemical called Hyaluronan.   Hyaluronan is secreted by many cells of the body and is involved in regulating cell adhesion, growth and development. Recent evidence has shown that Hyaluronan is found normally in the uterus at the time of implantation.

Co-culture of cumulus cells provides an opportunity to detoxify the culture medium that the embryos are growing in and produce growth factors important for cell development.  This may explain why some human embryos can experience improved development with the use of co-culture.

Preparation of co-culture cells starts with separation of the cumulus cells from the oocytes after aspiration of the follicles. These sheets of cells are washed thoroughly and then placed in a solution that permits the sheets to separate into individual cells.  The cells are then washed again and transferred to a culture dish with medium and incubated overnight. During this time individual cells will attach to the culture dish and create junctions between adjoining cells. This communication is important for normal development. The following morning, cells are washed again and all normally fertilized oocytes (embryos) are added to the dish. Embryos are grown with the cumulus cells for a period of three days to achieve maximum benefit.

Performing co-culture of embryos has improved implantation and pregnancy rates above and beyond those seen with the IVF advances previously described. More importantly, it promises to offer advantages for those patients whose previous IVF cycles were unsuccessful.

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