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Archive for the ‘Embryology Lab’ tag

Infertility Podcast Series: Journey to the Crib: Chapter 4

By David Kreiner MD

March 4th, 2013 at 9:59 pm

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Four: Where Do You Go? You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://podcast.longislandivf.com/?p=34

 

Where Do You Go?

 

I try to help the reader understand the published statistics offered online by SART, the national organization of IVF programs that provides a registry of IVF programs who submit their data for audit by SART.  Rates are offered with a numerator and a denominator with the critical goal of a live baby per retrieval or transfer being the most crucial statistic.

 

The benefits and disadvantages of large programs are discussed basically offering that larger programs tend to have more experienced and often skilled personnel albeit with more waiting time for monitoring.  Some programs may provide more personalized care, some more psychological or emotional support and some offer adjunctive therapies such as acupuncture and mind body programs.

 

I emphasize the importance of the embryology lab as well as the skill of the physician performing the embryo transfer.  The technique of the transfer is described including factors that I believe may affect success rates.

 

* * * * * * **  * * * *

Please share your thoughts about this podcast here.

no comments

Infertility Podcast Series: Journey to the Crib: Chapter 4

By David Kreiner MD

April 12th, 2012 at 11:57 am

Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Four. You, the listener, are invited to ask questions and make comments.  You can access the podcast here: http://www.longislandivf.com/podcast/Chapter_4-WhereDoYouGo.mp3

 Where Do You Go?

 I try to help the reader understand the published statistics offered online by SART, the national organization of IVF programs that provides a registry of IVF programs who submit their data for audit by SART.  Rates are offered with a numerator and a denominator with the critical goal of a live baby per retrieval or transfer being the most crucial statistic.

 The benefits and disadvantages of large programs are discussed basically offering that larger programs tend to have more experienced and often skilled personnel albeit with more waiting time for monitoring.  Some programs may provide more personalized care, some more psychological or emotional support and some offer adjunctive therapies such as acupuncture and mind body programs.

 I emphasize the importance of the embryology lab as well as the skill of the physician performing the embryo transfer.  The technique of the transfer is described including factors that I believe may affect success rates.

 * * * * * * **  * * * *

Please share your thoughts about this podcast here.

no comments

Kosher IVF

By Eli Rybak, Md

October 28th, 2010 at 5:48 am

Everybody knows a thing or two about kosher food:  Meat and milk, for example, just don’t go together; although that wouldn’t stop a creative kosher food vendor from selling a kosher “cheeseburger” provided, of course, that the burger portion derives from soy, or equivalent, not meat.  Additionally, only certain kinds of meat and fish are kosher.  So, why are symbols of kosher supervision required on many food items (for example, pretzels or cookies) that appear to be “intrinsically kosher”? 

There are two important answers: One, the kosher label on the bag, box, or wrapper of food affirms that a competent supervisor ensured that the processing and packaging of the food item was done using instrumentation dedicated for kosher purposes.  Kosher food cannot be produced in the same factory or kitchen, on the same equipment, used to serve or manufacture non-kosher food.  Two, supervision aims to ensure that honest mistakes are quickly identified and rectified, and to deter foul-play.  Ideally, 24-hour-a-day supervision would be desirable.  However, owing to logistic considerations, several alternative arrangements exist; commonly, the kosher supervisor promotes kosher practice and integrity by making frequent, randomly scheduled, unannounced, and unrestricted visits to the kitchen or factory.

So, who can be a kosher supervisor?  The answer is simple: it can be any reliable individual with integrity, man or woman.  There is but one requirement: competence.  The supervisor must be versed in the relevant religious laws as well as in the relevant technology and logistics of the food production he/she is supervising.  After all, in Judaism, just one witness – male or female – is required to vouch for issues of prohibition / permissibility.  Accordingly, a woman knowledgeable in the laws of kosher food or family purity is given absolute credence to affirm that her cooking is kosher, or that she is permitted / prohibited to her husband based on her menstrual status.  The overriding concept: a competent and knowledgeable observer is needed to verify the integrity of a process involving religious prohibition.

Judaism has a well-known embrace of assisted reproduction.  The Biblical mandate to procreate and the perspective that infertility is a disease deserving of medical intervention underpin the widespread Rabbinic and communal support for A.R.T.  But there are important considerations for Orthodox patients.  And one of them is that their gametes and embryos must be supervised in the embryology laboratory – as an added layer of protection to ensure that a mix-up, albeit rare, does not occur.  Strict protocols involving acquisition, labeling, processing and storage do exist at East Coast Fertility and other large and busy A.R.T. centers to ensure that eggs, embryos, and sperm from different couples are not inadvertently confused.  Indeed, all patients require and deserve absolute reassurance that their gametes and embryos are closely guarded to avoid the rare, but devastating, repercussions when there is a mix-up.  However, akin to the laws of kosher-food supervision, many Orthodox patients will not undergo A.R.T., nor will they obtain Rabbinic permission, unless a mechanism of supervision is instituted.  And, again, the goal is not to prevent the sensationalized possibility of foul-play.  Rather, by having an observer knowledgeable in the relevant basics of Jewish law and assisted reproduction, an extra layer of protection against inadvertent error is achieved.  The stakes can be high:  many Rabbinic authorities categorically prohibit donor sperm or eggs – and inadvertent use can and will have unavoidable repercussions on the offspring.  In the spirit of the Talmudic dictum that stringencies are to be applied in matters of lineage (“Ma’aleh Assu B’Yuchsin”), many Rabbis specifically condition approval for IUI or IVF on the provision of a supervision protocol.

The embryology lab in a busy A.R.T. center is a confusing place.  Different organizations (A Time, Bonei Olam, and Machon Pu’ah) train men and women to function as supervisors protecting the “identity” of gametes in the lab.  At East Coast Fertility, patients interested in religious supervision (Hashgacha) are encouraged to contact their Rabbonim and these organizations.  East Coast Fertility works closely and cooperatively with the Rabbinic supervisor to ensure the continued attainment of the highest levels of success – both spiritually and medically!

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