Archive for the ‘Fertility’ tag
By David Kreiner MD
March 28th, 2017 at 1:04 pm
Working in the field of In Vitro Fertilization (IVF) for over thirty years, I am in awe of the powerful potential our technology offers. Today Pre-Implantation Genetic Screening (PGS) is routinely offered to fertility patients undergoing IVF to test the chromosomes of embryos that a patient has created prior to Embryo Transfer. If PGS shows a normal complement of chromosomes then a single embryo transferred has an approximate 50% chance of resulting in a pregnancy with a less than 10% chance of miscarriage. As gender can be identified by this process, selection based on gender is available.
Many question the ethics of any manipulation of embryos including selecting the embryo for transfer based on gender. Although I am not fond of those equating family balancing with genetic engineering, I do share their concern of clinical tampering with the DNA of embryos.
Technology in IVF is reaching the point where DNA may be snipped, removed and/or implanted. Clinically, one can foresee where diseases and serious health conditions may be cured or prevented by such pre-embryo manipulations. Though I am tempted to cure or eliminate disease and serious health conditions, I worry that when we snip to cure we may unknowingly create some new malady– perhaps of a nature we have not previously envisioned.
The Brave New World of Aldous Huxley may be upon us but whether you view this world as positive in its ability to give man the power to eliminate disease or negative because you fear that man in his limited knowledge is apt to cause unforeseen damage is based on your own individual perspective and it is society’s duty to control in a responsible way the utilization of this new technology.
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Do you see the power to eliminate disease by snipping, removing or implanting DNA as a positive or negative? Why?
By Tracey Minella
March 23rd, 2017 at 1:10 pm
Are you the “all happy for the official start of spring” type? Or a crank who can’t adjust to losing that hour of sleep? (There’s no correct answer!)
Worn down by winter and overwhelmed by infertility’s challenges? You’re not alone. But spring is here now…at least on the calendar if not by the forecast. It’s time to change things up a bit.
The most frustrating thing about infertility is the lack of control over everything– your dreams, your life, and your body. The longer you live in this frustrated state, the greater the chance you’ll feel stressed or depressed. Your “fuse” gets shorter and the littlest thing that upsets your routine can…understandably…throw you off. Even that single hour lost may have affected your routine and added to your exhaustion and crankiness for days!
Why not turn it all back around to your benefit?
Start with a small block of time. Make a change for the better and take back some control this spring. Just a bit.
Imagine committing to even one small change in your day…one that you choose. One that you want. One that you… control.
No need to be drastic or crazy or set a lofty goal you can’t reach (which will defeat the purpose here). Pick something do-able and fun that is just for you. If it happens to have an added fertility-boosting benefit, that’s even better. But the main goal is that you feel better, either physically or emotionally, or both. And that you feel more in control of your life.
Here are a few examples of little things you can consider:
- Drink more water. You’ll feel and look better and the health benefits are countless.
- Make a “To Do” list before bed. You’ll sleep better knowing your next day is planned out and you haven’t forgotten something. Then, spend 15 minutes on your most important task first thing in the morning if you can, so you start off on a positive, less stressed note.
- Exercise…even for just 10 minutes each day. Even a walk to clear your mind will help. If that seems like root canal, just pick something fun that makes you move. Anything.
- Keep a daily gratitude journal. List 3 things you have to be thankful for. It will keep you grounded in positivity and give you an outlet for your feelings.
- Sleep more. Take a power nap at lunchtime of you’re feeling tired or treat yourself to an early turn-in at bedtime. Even 30 minutes would feel indulgent. Trust me.
- Meditate. It could be in a fertile yoga class or just grabbing 15 minutes of quiet, uninterrupted “you” time on your den floor– or outside if it ever warms up again. Why not come to Long Island IVF’s upcoming free fertility yoga event during National Infertility Awareness Week in April? Register here.
Of course, if you’re really feeling overwhelmed, you might consider a group or individual therapy session with Bina Benisch, M.S., R.N., our counselor who specializes in helping those suffering from infertility.
What kind of big impact could these small changes make for you? How about committing to one of them…or some other change that works for you? Let’s see what a difference a small change that you control can make in your life in 30 days.
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What is your “take control” action plan for spring?
By David Kreiner MD
March 1st, 2017 at 12:20 pm
I don’t have to tell you that endometriosis can be a very painful illness and that it can cause infertility. It is often a reproductive lifelong struggle in which tissue that normally lines the uterus migrates or implants into other parts of the body, most often in the pelvic lining and ovaries. This leads to pain and swelling and often times difficulty conceiving.
If you have endometriosis, you are not alone. Five to ten percent of all women have it. Though many of these women are not infertile, among patients who have infertility, about 30 percent have endometriosis.
Endometriosis can grow like a weed in a garden, irritating the local lining of the pelvic cavity and attaching itself to the ovaries and bowels. Scar tissue often forms where it grows, which can exacerbate the pain and increase the likelihood of infertility. The only way to be sure a woman has endometriosis is to perform a surgical procedure called laparoscopy which allows your physician to look inside the abdominal cavity with a narrow tubular scope. He may be suspicious that you have endometriosis based on your history of very painful menstrual cycles, painful intercourse, etc., or based on your physical examination or ultrasound findings. On an ultrasound, a cyst of endometriosis has a characteristic homogenous appearance showing echoes in the cyst that distinguish it from a normal ovarian follicle. Unlike the corpus luteum (ovulated follicle), its edges are round as opposed to collapsed and irregular in the corpus luteum and the cyst persists after a menses where corpora lutea will resolve each month.
Women with any stage of endometriosis (mild, moderate, or severe) can have severe lower abdominal and pelvic pain – or they might have no pain or symptoms whatsoever. Patients with mild endometriosis will not have a cyst and will have no physical findings on exam or ultrasound. It is thought that infertility caused by mild disease may be chemical in nature perhaps affecting sperm motility, fertilization, embryo development or even implantation perhaps mediated through an autoimmune response.
Moderate and severe endometriosis are, on the other hand, associated with ovarian cysts of endometriosis which contain old blood which turns brown and has the appearance of chocolate. These endometriomata (so called “chocolate cysts”) cause pelvic scarring and distortion of pelvic anatomy. The tubes can become damaged or blocked and the ovaries may become adherent to the uterus, bowel or pelvic side wall. Any of these anatomic distortions can result in infertility. In some cases the tissue including the eggs in the ovaries can be damaged, resulting in diminished ovarian reserve and reduced egg quantity and quality.
The treatment for endometriosis associated with infertility needs to be individualized for each woman. Surgery often provides temporary relief and can improve fertility but rarely is successful in permanently eliminating the endometriosis which typically returns one to two years after resection.
There are no easy answers, and treatment decisions depend on factors such as the severity of the disease and its location in the pelvis, the woman’s age, length of infertility, and the presence of pain or other symptoms.
Treatment for Mild Endometriosis
Medical (drug) treatment can suppress endometriosis and relieve the associated pain in many women. Surgical removal of lesions by laparoscopy might also reduce the pain temporarily.
However, several well-controlled studies have shown that neither medical nor surgical treatment for mild endometriosis will improve pregnancy rates for infertile women as compared to expectant management (no treatment). For treatment of infertility associated with mild to moderate endometriosis, ovulation induction with intrauterine insemination (IUI) has a reasonable chance to result in pregnancy if no other infertility factors are present. If this is not effective after about three – six cycles (maximum), then I would recommend proceeding with in vitro fertilization (IVF).
Treatment for Severe Endometriosis
Several studies have shown that medical treatment for severe endometriosis does not improve pregnancy rates for infertile women. Some studies have shown that surgical treatment of severe endometriosis does improve the chances for pregnancy as compared to no treatment. However, the pregnancy rates remain low after surgery, perhaps no better than two percent per month.
Some physicians advocate medical suppression with a GnRH-agonist such as Lupron for up to six months after surgery for severe endometriosis before attempting conception. Although at least one published study found this to improve pregnancy rates as compared to surgery alone, other studies have shown it to be of no benefit. The older a patient is, the more problematic post surgical treatment with Lupron will be as it delays a woman’s attempt to conceive until she is even older and less fertile due to aging.
Unfortunately, the infertility in women with severe endometriosis is often resistant to treatment with ovarian stimulation plus IUI as the pelvic anatomy is very distorted. These women will often require IVF in order to conceive.
As endometriosis is a progressive destructive disorder that will lead to diminished ovarian reserve if left unchecked, it is vital to undergo a regular fertility screen annually and to consider moving up your plans to start a family before your ovaries become too egg depleted. When ready to conceive, I recommend that you proceed aggressively to the most effective and efficient therapy possible.
Women with endometriosis and infertility are unfortunately in a race to get pregnant before the endometriosis destroys too much ovarian tissue and achieving a pregnancy with their own eggs becomes impossible. However, if you are proactive and do not significantly delay in aggressively proceeding with your family building, then I have every expectation that you will be successful in your efforts to become a mom.
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Do you suffer from endometriosis? How has it impacted your fertility journey? Do you have any advice for others who are suffering?
Photo credit: Ryan McGuire at http://www.gratisography.com/
February 28th, 2017 at 9:27 am
Tagged with acupuncture, acupuncture for fertility, David Kreiner MD, Fertility, fertility acupuncture, Fertility Acupuncture seminar, Infertility, IVF and acupuncture, Long Island IVF, Trying to Conceive
If there was something holistic—an ancient, trusted treatment—that might improve your chances of success with IVF would you want to learn more about it?
What if this exclusive, yet very affordable, natural therapy might even help if you’ve had prior unsuccessful IVF cycles? And what if this complementary therapy cost less than $200 per IVF cycle? Are you ready to learn more… even see a live demo of the treatment?
With so much riding on the outcome of an IVF cycle—emotionally and financially—many patients are looking closely at ways to “customize” their traditional IVF cycle. Depending on a patient’s particular case, customized “add-on” treatments might include such things as ICSI, PGS/PGD, and other cutting-edge Western medicine offerings.
Now, there is something from the East that shows promise, too… Acupuncture for fertility.
Long Island IVF is the first infertility practice with a Reproductive Endocrinologist who is also a Traditional Chinese Medicine (TCM) practitioner and a NYS certified medical acupuncturist.
Motivated by a desire to find complementary holistic approaches to enhance today’s best Western medical technologies, Long Island IVF co-founder and REI, Dr. David Kreiner, went back to school to study TCM after over 30 years of making babies.
Dr. Kreiner is now applying that acupuncture training in the IVF procedure room, both pre- and post-IVF transfer–exclusively to ALL interested Long Island IVF patients. IVF patients… especially those for whom Western medicine alone has not yet produced a baby…may benefit from adding this ancient therapy.
Long Island IVF’s Acupuncture Program is hosting a free seminar with Dr. Kreiner and a special guest–local acupuncturist James Vitale, M.S.,L.Ac–to discuss topics related to improving IVF success with acupuncture. You can also see a live demonstration of fertility acupuncture.
Don’t miss this special FREE program on Thursday, March 9, 2017 from 6:30 pm-8:30 pm at our Melville office at 8 Corporate Center Drive, Melville, New York. Seating is limited, so pre-registration is required. Register here now: http://bit.ly/2kBnYV7
We look forward to seeing you there. Please contact Lindsay Montello, Patient Services, at 631-752-0606 or LMontello@liivf.com with any questions.
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Are you coming to the Acupuncture Seminar?
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Long Island IVF-WINNER: Best in Vitro Fertility Practice 2015 and 2016 and 2017!
It is with humble yet excited hearts that we announce that Long Island IVF was voted the Best In Vitro Fertility Practice in the Best Of Long Island 2015 and 2016 and 2017 contest…three years in a row!
The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so thankful to every one of you who took the time to vote. From the moms juggling LIIVF babies… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.
We love what we’ve gotten to do every day for almost 30 years…build families. If you are having trouble conceiving, please call us. Many of our nurses and staff were also our patients, so we really do understand what you’re going through. And we’d like to help. 631-752-0606.
February 8th, 2017 at 10:05 am
Tagged with Best in Vitro Fertility Practice Long island, Best of Long Island, Best of Long Island 2017 Winner, BOLI winner 2017, Fertility, Infertility, Infertility Treatment, Long Island best in vitro fertility practice 2017, Long Island IVF, Trying to Conceive
For the third consecutive year, we humbly and excitedly announce that Long Island IVF was again voted the “Best In Vitro Fertility Practice” on Long Island in the Best Of Long Island 2017 contest. We won the same wonderful honor in 2015 and 2016 as well.
We recently received word that we won again… and it’s thanks to all of you! Literally. Your votes made this possible.
The doctors, nurses, embryologists, and the rest of the Long Island IVF staff are so proud of this honor and so genuinely thankful to each and every one of you who took the time to cast a vote in our favor. From the moms juggling LIIVF toddlers… to the dads coaching LIIVF teens…to the parents sending LIIVF adults off to college or down the aisles… to the LIIVF patients still on their journeys to parenthood who are confident in the care they’re receiving…we thank you all.
We love what we get to do every day…build families. And that’s all the thanks we really need. But your endorsement of us to your friends, families, and the public (by voting for us) means so much and will enable us to help even more infertile couples fulfill their dreams of building a family.
By voting for us in this public contest—and leaving positive reviews on MD review sites about your experiences with our doctors– you help other couples decide to trust us with their care, too. So thanks for doing that.
As we usher in 2017…our 29th year…we will continue to offer our unique blend of cutting-edge medical technologies and holistic, personal support… wrapped in the comfort of a private, non-hospital setting.
Thanks again, everyone.
By Tracey Minella
January 18th, 2017 at 11:35 am
What if the idea of “doin’ it” just ain’t doin’ it for you?
Like a winter storm, battling infertility can beat a couple down over time. Hot on the heels of navigating the winter holidays without children and facing another New Year’s without the baby, is the coming pressure of Valentine’s Day and all its sexy hype.
Who needs a night of chocolates, flowers, satin sheets, and lacy lingerie when all you really want is a night of Dominoes® home delivery, spit-up soaked sweats, and colicky midnight feedings?
So how do you keep the passion in lovemaking even when baby-making is challenging?
Long Island IVF’s own psychologist and infertility specialist Bina Benisch, M.S., R.N. is hosting a workshop specifically designed to help infertile couples navigate the challenges of feeling sexual and loving and keeping their passion alive while battling infertility.
The free workshop will be held on Thursday night, January 26, 2017 at 6:30 pm at the Long Island IVF office at 8 Corporate Center Dr., Melville, New York.
All are welcome to attend—no need to be a patient of our practice. Can’t get your partner to come with you? Bring a friend or come alone. Pre-registration is required so secure your spot and sign up here now.
Let us help you dig out of the depression of scheduled sex, negativity, self-criticism, and fear and rekindle the romance and spontaneity that’s buried under that pile of negative pee sticks.
You love your partner and you are in this together. Let us help you reconnect…because reducing stress and rekindling romance can only help in the end.
Is that Dominoes® at the door?
We hope to see you there! Register today.
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Are you coming to the workshop? Do you have any specific questions or topics you’d like addressed at the workshop?
By Tracey Minella
January 16th, 2017 at 6:01 pm
As Americans celebrate the late, great Dr. Martin Luther King, Jr., we usually remember his most famous quotation from his 1963 speech for racial equality.
“I Have a Dream…”
Those trying to conceive a baby live by these same words. They are the mantra of the suffering, infertile woman.
To be clear, infertility is not on the same “life-and-death” level as the civil rights movement. Yet there is no mistaking the parallels that do exist between the passion MLK Jr. felt for his cause and the passion infertile women feel for their quest for motherhood.
When you are infertile, you are ever-aware of a different unfairness and inequality in the world. How fertile couples take their fertility for granted. How others have what you’ve been denied. You suffer unimaginable pain and despair at what is effectively a denial of your right to the pursuit of happiness. And you passionately dream your dream…of a day when you will hold a baby in your arms.
MLK Jr.’s peaceful protesting of the injustices of segregation and racial inequality ultimately changed a nation. But for the infertile woman, there is no protest that can make that dream of motherhood come true. Sure, we can and must demand the government do more to help infertile women… such continually advocating for legislation mandating more comprehensive medical insurance for infertility treatment. But ultimately, your plight is based on individual circumstance, not oppression by others. New legislation may help financially, but it alone won’t guarantee you get pregnant. So how do you deal with the frustration over the situation? How do you keep your dream alive?
Dr. King…a spiritual man and motivational speaker…gave us more than that one famous quote. Here’s another one, which speaks to the heart of the infertile woman:
“Faith is taking the first step, even when you don’t see the whole staircase.”
So when you remember the courage of this great man, think about becoming an advocate for political change that will advance the cause for infertile women. Keep the faith.
And never give up on your dream.
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How do you keep your dream alive? What’s the biggest obstacle?
By Tracey Minella
December 29th, 2016 at 11:38 am
And so we move on toward yet another new year. Another supposed-to-be Happy New Year.
Holidays aren’t happy when you’re trying to conceive. They just aren’t. And sticking the word “happy” on them only adds to the stress. Isn’t it enough to have to face another year without a baby? Now you have to be “happy” too?
The passing of time is unsettling and the countdown to midnight on New Year’s Eve can be panic-inducing in a way that’s hard to describe. It’s like the world sees a regular clock and infertiles see a biological one. Clocks and other reminders of the passage of time are not welcome to many infertiles. How many of us have morphed into hermit couples over time? There is actually a pattern to it.
One year, you’re typical party-goers hoisting champagne at some big, loud gathering and confidently proclaiming to all within earshot “This year is the year we’re having a baby!”
Time passes. It’s New Year’s Eve again. The crowd you’re celebrating with has dwindled to a few close friends or family and the scene is more low-key. You trade in the bubbly for an alcohol-free toast because you’re doing everything you can to make that baby wish come true and maybe, just maybe, you’re even pregnant right now. You no longer say out loud that “This is the year”. You’re still hopeful, but uneasiness dampens your party spirit.
More time passes. It’s just the two of you now. You don’t want to be out with others. Maybe you’ve suffered losses or are frustrated by financial roadblocks to necessary fertility treatment. You’re depressed and are simply too exhausted to pretend you’re happy…especially when surrounded by people who don’t understand your totally understandable depression. You’re tired of saying “This will be the year” only to find another year goes by and you’re making the same wish over and over. Maybe you’re kicking yourself over all the years you did say it out loud or are just consumed with the thought that if you don’t get pregnant by March, you won’t have a baby in 2017 at all. Time is twisting your mind and manipulating each moment. You’re hope is dangerously depleted and you officially loathe New Year’s with all its shallow celebratory nonsense. Prolonged infertility has stolen your happiness.
It’s okay. It really is okay not to be happy on New Year’s. There are plenty of people who are down or are fearful of what lies ahead.
But it is not okay to lose hope. You need to keep hope alive. Nourish whatever bit is left. Breathe life back into it. Even if there is only a glimmer remaining. Find a way. Because your dream needs hope…and more…in order to come true. Depending on your circumstances, it may also need some combination of action, money and/or a miracle to come true.
So, from someone who ushered in about a decade of consecutive frustrating infertile New Year’s here’s some advice on how to make the best of a tough night.
- Don’t think of yourselves as alone. Remind yourself of why you chose and love this person and reconnect. Realize the power couple you are. You’ve been blessed with each other to get through this journey and, hard as it is, it’s making you stronger. When you finally do have a child, you will be ready for anything life throws your way. Take the night to make a written plan for 2017. What is the next step going to be? What do you need to get there? And how will you get it? Real steps. In writing. Make the plan.
- Acknowledge the elephant in the room…the baby that is not here yet. Instead of focusing on what’s missing, why not play a game? Similar to the movie “The Odd Life of Timothy Green”, you and your partner can brainstorm on the character traits you imagine your future baby will have. Boy or girl? Good at soccer or music? Quiet or loud? And so on. Positive visualization can do wonders. If you write it all down, safeguard it to look back on someday.
- Offer to babysit. For those up to it emotionally (and it’s okay not to be), consider offering to babysit for a friend’s baby or children overnight. You get a real taste of parenting and you get to help out a friend who may want to go out. When you have your own baby, maybe they’ll return the favor!
- Have a plan for an outing. If you are venturing out into the fertile, celebratory world you need a plan. If you’re with people who know you are trying, tell them up front that the topic is off limits tonight. If not, try to have a planned response ready for any possible nosy comments so you are not caught off guard. Have a secret “signal” with your partner that means “It’s time to leave…NOW!” Preparation is the best defense.
Wherever you are, kiss at the stroke of midnight. It’s the best way to enter the New Year. And it’s bound to fill your heart with hope.
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What are your plans and tips for New Year’s Eve?
By Tracey Minella
December 24th, 2016 at 9:37 pm
I was never very patient and infertility only made that worse.
At the risk of sounding like a spoiled child, I wanted what I wanted—a baby. And I wanted it, well, now. Actually, more like yesterday.
Why should I have to wait? I already did all those things I planned to do before starting a family. School. Career. Marriage. Wild newlywed life. Travel. House. Got off birth control and onto prenatal vitamins. Ditched the booze, briefs, fast food, hot tubs–basically all the fun stuff.
The pre-parenthood bucket list has been checked off. Hello, Universe? Let’s go already.
The winter holidays always make the impatience worse. Not my year to buy a Baby’s First Christmas ornament. Not my turn to drop a wailing infant into the lap of a creepy mall Santa. Not my moment to see two lines on the stick.
Just not my time. Again.
There’s the two week wait. Waiting on lines in stores. Waiting in the doctor’s office. Waiting for the ball to drop on another New Year’s without the baby. Again.
I’m sorry you have to wait. And I’m sorry your wait is longer than you expected—longer than you ever imagined. I know how hard it is to wait because my own wait took several years.
But I also know how worth the wait it can– and hopefully will–be once it’s finally over.
Wishing you peace and patience during once of the hardest weeks of waiting for your dreams to come true.
By Tracey Minella
December 17th, 2016 at 1:32 pm
Time flies when you’re having fun—or not. Ever notice how fast did your #1 holiday wish list item morphed from a bicycle into an IVF cycle?
With a price tag to challenge most budgets, IVF can be hard on a partner’s wallet. So if no one checked that item off your list this year, maybe thinking outside the box is in order.
1. Fertility Grants and Creative/Discounted IVF Payment Packages.
Long Island IVF offers many different payment options, bundle plans, IVF grants, DOH grants and exclusive Jade Foundation grant programs, and IVF share refund programs to help their patients with the financial end of their fertility journey. Like a guidance counselor helps a student, the staff is trained to guide you through the maze of available options when planning to finance your family-building plan. You may have more options than you realize. Check it out.
2. Free/Discounted IVF Opportunities.
As you may expect, these opportunities are hard to come by, but they are out there. Some contests allow winners to choose their own fertility clinic for treatment. We pass this information along as we find it, so it pays to follow our blog and like us on Facebook.
3. On-line Fertility Treatment Fundraiser.
If you are not keeping your infertility secret, this option is great for those with the right mix of friends and families…or faith in the kindness of strangers. Of course, some people you approach may be uncomfortable with the idea, so prepare yourself for the critics, too. But others are probably so happy to have a chance to help you. GoFundMe* crowd-funding accounts are wildly popular now among those hoping to raise funds for infertility treatment. In fact, some couples request contributions to these fertility treatment accounts in lieu of registering for traditional wedding or shower gifts.
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Have these suggestions been helpful? Do you have any suggestions to add? Have you tried or will you consider any of these tips?
*Disclaimer: Long Island IVF does not endorse this or any other fundraising site, and are providing this link for informational purposes only.