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Archive for the ‘ECF’ tag

Gratitude and the Poetic Patient

By Tracey Minella and Anonymous Poet

November 3rd, 2011 at 9:07 am

East Coast Fertility loves contests. We do big ones, small ones, and everything in between. We’ve got our weekly NWW (Nearly Wordless Wednesday)  photo caption contests and we recently gave away a free micro-IVF cycle!

And there’s more contests coming!

First, if you haven’t entered our fast, fun photo caption contest this week, please click on yesterday’s post and enter. Or enter on Facebook.

Next, read this poem below if you’d like a hint about what the next ECF contest theme will be! It’ll be announced real soon…so check back daily!

This poem is a patient’s note of gratitude. Not only did she take the time to express her thanks, but she did so in the form of a poem. And she wrote it so that it will inspire others to believe that they, too, will get their little miracles if they continue to dream big dreams:

It’s not a dream, it’s Fertility

This isn’t a dream it really does come true
A family you can have even if the odds are so against you.
You just have to be able to take deep breath and say
I need some help and thank your lucky stars it’s out there today.


Once upon a time I was lost and alone
Never did I think I’d have a family of my own.
The doctors explained all about IVF
And off to East Coast we went they are known to be the best.


At first it’s confusing a new world you enter in
But once you take that first step it’s easy to begin.
You do what you need and you hold hands and pray,
I am here to have a child it’s going to happen today.


You focus and they focus and you start to believe
That yes it’s going to happen at East Coast you will conceive.
As you walk through their doors at East Coast you start to feel
That your miracle will come true it is very real.


You get top notch care and they assist in everyway
You can call and someone will answer 24 hours each day.
They work 7 days and they work hard they do,
Success is the only thing they want and it’s all about "you."

 
Now time has gone by two kids depend on me,
And one day I’ll tell them about East Coast Fertility
I just embrace everyday and hold a special place in my heart
At East Coast Fertility is where my dreams did start.


I look at two kids and they stare back at me.
Life is a miracle and so is East Coast Fertility.

We welcome your input at East Coast Fertility, whether it’s a question, a suggestion, a note, a comment on the blog…or a poem.

* * * * * * * * * *

Please let us know what you like about us, or the blog. And tell us what more we could do, or what else you’d like to see. Any specific topics you want covered?

Photo credit: http://www.publicdomainpictures.net/view-image.php?image=15690&picture=daydreaming

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Nearly Wordless Wednesday Photo Caption Contest

By Tracey Minella

November 2nd, 2011 at 9:09 am

East Coast Fertility’s weekly photo caption contest continues with a timely weather-related photo from the yard of our friend, Amy Demma.

(When she’s not building snowmen with her family, Amy is a reproductive rights attorney with an office in the Hamptons. She enjoys helping infertile folks with the legal end of donor and surrogacy matters.)

I can’t even imagine what I’d think if I was a kid who woke up to this snowy scene on Halloween morning. Can you? If so, tell us your caption and the best one wins a Starbucks gift card.

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

You can enter here or on East Coast Fertility’s Facebook page.

Either provide your email address with your entry or check back to see if you won and we’ll tell you how to email us so we can mail you your gift card.

Plus, if you “LIKE” us on Facebook at https://www.facebook.com/ecfertility#!/ecfertility, we can send you the prize as a Starbuck’s Card e-gift right through Facebook, so you could be sipping your winnings as early as on the day we choose the winner! (And as much as we’d love you to like us on Facebook, it is absolutely not required to either enter or win our contests!)

Also, if you have a photo that you have the rights to and you’d like to submit it for a future NWW caption contest, email it with your contact information to tracey@eastcoastfertility.com and if we use it, you’ll get a free Starbucks card just for submitting it!

Enter today!

Oh, and last week’s contest winner, is Lili McDonald. You can see her entry on our facebook page at:  https://www.facebook.com/ecfertility.

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IVF: The Chances of Success

By Dr. David Kreiner

November 19th, 2010 at 10:44 am

What everyone wants to know when they decide to look into invitro ferilization (IVF) as a treatment option is "what is my chance for success?"  It’s a complicated question and the answer varies from  patient to patient. But let me try to break down a little bit for you.

In 2002 about 28% of cycles in the United States in which women underwent IVF and embryo transfer with their own eggs resulted in the live birth of at least one infant. This rate has been improving slowly but steadily over the years.  Patients should be aware, however, that some clinics define "success" as any positive pregnancy test or any pregnancy, even if miscarried or ectopic. These "successes" are irrelevant to patients desiring a baby. To put these figures into perspective, studies have shown that the rate of pregnancy in couples with proven fertility in the past is only about 20% per cycle. Therefore, although a figure of 28% may sound low, it is greater than the chance that a fertile couple will conceive in any given cycle.

Success varies with many factors. The age of the woman is the most important factor, when women are using their own eggs. Success rates decline as women age, and success rates drop off even more dramatically after about age 37. Part of this decline is due to a lower chance of getting pregnant from ART, and part is due to a higher risk of miscarriage with increasing age, especially over age 40. There is, however, no evidence that the risk of birth defects or chromosome abnormalities (such as Down’s syndrome) is any different with ART than with natural conception.

Success rates vary with the number of embryos transferred. However, transferring more embryos at one time not only increases the chance of success with that transfer, but will also increase the risk of a multiple pregnancy, which are much more complicated than a singleton pregnancy. The impact of the number of embryos that are transferred on success rates also varies with the age of the woman.

Pregnancy complications, such as premature birth and low birth weight, tend to be higher with ART pregnancies, primarily because of the much higher rate of multiple pregnancies. Nationally, in 2002-2003 about 30% of ART deliveries were twin deliveries, versus 1-2% of spontaneous pregnancies. The risk of pregnancy containing triplets or more was 6% in 2003.

As women get older, the likelihood of a successful response to ovarian stimulation and progression to egg retrieval decreases. These cycles in older women that have progressed to egg retrieval are also slightly less likely to reach transfer.  The percentage of cycles that progress from transfer to pregnancy significantly decreases as women get older.  As women get older, cycles that have progressed to pregnancy are less likely to result in a live birth because the risk for miscarriage is greater.  This age related decrease in success accelerates after age 35 and even more so after age 40.  Overall, 37% of cycles started in 2003 among women younger than 35 resulted in live births. This percentage decreased to 30% among women 35–37 years of age, 20% among women 38–40, 11% among women 41–42, and 4% among women older than 42.  The proportion of cycles that resulted in singleton live births is even lower for each age group.

The success rates vary in different programs in part because of quality, skill and experience but also based on the above factors of age, number of embryos transferred and patient population.  Patients may also differ by diagnosis and intrinsic fertility which may relate to the number of eggs a patient may be able to stimulate reflected by baseline FSH and antral follicle count as well as the genetics of their gametes.  These differences make it impossible to compare programs.

Another factor often overlooked when considering one’s odds of conceiving and having a healthy baby from an IVF procedure is the success with cryopreserved embryos.

Thus, a program which may have a lower success rate with a fresh transfer but much higher success with a frozen embryo transfer will result in a better chance of conceiving with only a single IVF stimulation and retrieval.  Success with frozen embryos transferred in a subsequent cycle also allows the program to transfer fewer embryos in the fresh cycle minimizing the risk of a riskier multiple pregnancy.  It may be more revealing to examine a program’s success with a combination of the fresh embryo transfer and frozen embryo transfers resulting from a single IVF stimulation and transfer.  For example, at East Coast Fertility, the combined number of fresh and frozen embryo transfers that resulted in pregnancies for women under 35.from January 1, 2002 to December 2008 was 396.  The number of retrievals during that time was 821.  The success rate combining the fresh and frozen pregnancies divided by the number of retrievals was 61%.  The high frozen embryo transfer pregnancy rate allowed us to transfer fewer embryos so that there were 0 triplets from fresh transfers during this time.

What can I do to increase my odds?

Patients often ask if there are any additional procedures we can do in the lab that may improve the odds of conception.  Assisted hatching is the oldest and most commonly added procedure aimed at improving an embryo’s ability to implant.  Embryos must break out or hatch from their shell that has enclosed them since fertilization prior to implanting into the uterine lining.  This can be performed mechanically, chemically and most recently by utilizing a laser microscopically aimed at the zona pellucidum, the shell surrounding the embryo.  Assisted hatching appears to benefit patients who are older than 38 years of age and those with thick zonae.

Recently a protein additive called “Embryo glue” was shown to improve implantation rates in some patients whose embryos were transferred in media containing “Embryo glue”.  Time will tell if the adhesive effect of this supplement is truly increasing success rates and warrants wide scale use in IVF programs.

Embryo co culture is the growth of developing embryos is the same Petri dish as another cell line.  Programs utilize either the woman’s endometrial cells obtained from a previous endometrial biopsy or granulosa cells obtained at the time of the egg retrieval from the same follicles aspirated as the eggs.  Growth factors produced by these endometrial and granulosa cell lines diffuse to the developing embryo and are thought to aid in the growth and development of the embryo.  It appears to help patients who have had previous IVF failures and poor embryo development.

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