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Who Will Carry the Baby in LGBT Family-Building? (Part Two): For Lesbians

By Tracey Minella

February 28th, 2018 at 12:25 pm


image: shutterstock

At Long Island IVF, we take pride in building families for the LGBT community. And the first question in LGBT family-building is the same whether you are a single gay man, a gay couple, a lesbian couple, or a single lesbian: Who will carry the baby?

Don’t jump to the seemingly obvious conclusion that a single woman or a lesbian couple necessarily has a uterus—or two—that would be suitable for carrying a pregnancy. Things are not always that simple. That’s why if the idea of having a baby now or someday is something you’re considering, it might be wise to see a reproductive endocrinologist for a baseline fertility evaluation now to catch any “red flags” that could compromise your fertility.

One (or both females) may have uterine or other medical issues that either prohibit her or them from carrying a pregnancy or would make attempting to do so unsafe or unadvisable. In addition, there may be non-medical factors that make a woman an uninterested, unwilling, or otherwise a poor candidate for baby-carrying. When that happens, a gestational carrier would be needed to carry the baby for the intended parent(s). That’s assuming there are healthy eggs.

In addition to a uterus in which to carry the pregnancy, the single woman or lesbian couple needs to produce healthy eggs. Again, it may be easy to assume that a woman—or especially two women—would have that requirement covered. And they generally do. But if premature ovarian failure, poor egg-quality, or another medical condition precludes the use of the intended parent’s eggs, an egg donor may be required.

In the vast majority of cases, a lesbian couple will not need a gestational carrier to overcome uterine issues. And, depending on their age, most lesbian couples won’t need an egg donor. The availability of two female reproductive systems instead of one basically gives lesbian couples a second chance at overcoming many fertility obstacles one might face. But there is one thing all lesbians do need for family-building.

Lesbians have the obvious need for donor sperm. Fortunately, obtaining that missing biological piece is far easier and cheaper for them than obtaining donor eggs is for their gay male friends. Pre-screened donor sperm is readily available and relatively inexpensive. A single woman or lesbian couple generally selects an anonymous donor after reviewing the profiles of available sperm donors. Frozen specimens from the sperm donor would be shipped to the reproductive endocrinologist’s lab so they may be thawed and used at the time they are needed for conception.

Although sperm donation from a known individual or friend is possible, that option comes with additional complexities related to medical pre-screening, a mandated quarantine period and re-testing period as well as psycho-social and legal considerations, which need to be considered. These additional elements may complicate as well as add time to the process.

In many cases, where no tubal or other fertility issues have been identified, the partner wishing to carry the pregnancy –or the partner who wants to carry a pregnancy first–would be monitored for ovulation and, at that time, inseminated with the donor sperm through an intrauterine insemination (“IUI”).

Here’s how an intrauterine insemination (“IUI”) works: The woman who wants to carry the baby is carefully monitored through blood work and ultrasounds to determine when she is ready to ovulate and her insemination is scheduled to coincide with ovulation. She can do a natural cycle, without added hormones, or she can do a medicated cycle in which oral or injectable hormones are added to the protocol. For the IUI, the donor’s specimen is thawed and deposited into the woman’s uterus via a thin, flexible catheter during a fast and simple office visit at the time of ovulation.

Through careful monitoring and minimal or no ovarian stimulation, the risk of a high-order multiple pregnancy in IUI can generally be reduced but not eliminated. Since the egg(s) remain inside the woman’s body in IUI and are therefore capable of being ovulated (rather than being retrieved from the body as in IVF), there may be a greater chance for multiple eggs becoming fertilized and multiple pregnancies implanting with an IUI than there is in the more-controlled IVF procedure.

If the lesbian partner (or the single woman) who wants to carry the pregnancy doesn’t become pregnant after a few IUI cycles, she might want to consider undergoing in vitro fertilization (“IVF”) — or in the case of a lesbian couple they might decide that the other partner will carry the pregnancy instead. In the event neither partner is willing or able to conceive or maintain a pregnancy for health or other reasons, the lesbian couple or single woman would still have the option of using donor eggs and/or a gestational carrier as mentioned above.

Here’s how IVF typically works for lesbians: The woman whose eggs are being used to create the baby will receive hormonal injections, blood work, and ultrasound monitoring over a period of weeks that is designed for her to produce multiple egg-containing follicles rather than the one egg she would generally produce naturally each month. When the time is right based on close monitoring, the eggs are retrieved by the reproductive endocrinologist transvaginally–using a needle aspiration procedure–and combined with the donor sperm in the hope that fertilization occurs. If it does, generally one or two embryos will later be transferred back into the woman’s uterus in the hope of a pregnancy implanting and developing. In IVF, the hope is to produce many more eggs than in IUI because they are being retrieved instead of ovulated. The excess embryos can be frozen for future use. Sometimes, enough eggs can be retrieved in a single IVF cycle to create a couple’s entire family—which can be built over time through successive pregnancies.

Sometimes, one partner in a lesbian couple will become pregnant first and then the other will follow. Sometimes only one partner may want to carry all of the couple’s pregnancies. Other times, both may attempt pregnancy at the same time.

But there is another exciting family-building option for lesbian couples that is rapidly gaining popularity: reciprocal IVF.

Because reciprocal IVF involves one of the women in a lesbian couple undergoing IVF, it is a more expensive treatment option than a relatively simple IUI cycle, but it’s increasingly popular because it allows both partners to be involved in the creation, pregnancy, and birth of the baby.

This is how reciprocal IVF works: One partner undergoes a typical IVF cycle, including routine hormonal injections, blood work, ultrasound monitoring, and the egg retrieval. Those eggs would be fertilized using donor sperm. Now, here is the twist: After fertilization, instead of the resulting embryos being transferred into the partner the eggs were retrieved from, they get transferred into the uterus of the other partner. If the embryo implants and a pregnancy occurs, one partner is the genetic mother of the baby growing inside the uterus of the other partner who gets to carry the pregnancy and experience childbirth!

If you are interested in LGBT family-building, Long Island IVF has decades of experience helping the community become parents.  Please contact us today for more information or to schedule an initial consultation.

We are proud to partner with the LGBT Network to provide information, education, support, and access to the most advanced traditional and holistic assisted reproductive technologies. All while understanding, respecting, and being sensitive to the unique needs of the LGBT community.

This year, Long Island IVF is celebrating a milestone–our 30th anniversary. If you are ready for parenthood, we would love the opportunity to assist you with your own milestone. Please follow us on Facebook or Twitter for info on our upcoming free events.

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Will You Conceive in the Year of the Dog?

By Tracey Minella

February 17th, 2018 at 7:22 pm

image courtesy of 9comeback at

The celebration of Chinese New Year has begun. Out with the Year of the Rooster. Welcome the Year of the Dog. You don’t have to be Chinese to appreciate the richness of that culture’s traditions and the mystique of the Chinese methods of enhancing fertility.

In addition to being a pioneer in cutting-edge Western medicine and assisted reproductive technologies like IVF, Long Island IVF offers fertility acupuncture to its interested patients. This inexpensive, complementary holistic therapy is a hallmark of ancient Traditional Chinese Medicine (“TCM”) and is administered by our own Dr. David Kreiner–Long Island’s first reproductive endocrinologist who is also a certified acupuncturist.

Want to learn more about how fertility acupuncture might influence your ability to conceive? Register here for our free upcoming Fertility Acupuncture Seminar on March 29, 2018 at the Long Island IVF Melville office.

The Chinese zodiac consists of a cycle of 12 years, with each year being named for a different animal, and supposedly bestowing upon those born in that year certain characteristics which are similar to the traits of the featured animal.

Children born in the Year of the Dog are said to be loyal above all else. They are also honest, popular, give good and helpful advice, but can be worried and anxious, too. Of course, having a healthy baby any day of any year is likely all that really matters to most.

A Chinese co-worker enlightened me years ago about some Chinese New Year’s traditions, and since many involve luck and good fortune, it’s no wonder people—especially those experiencing infertility– might want to get in on the celebrations, which last a couple weeks.

On New Year’s Eve, the Chinese often celebrate by eating dumplings called “jiaozi”, which translates literally to “sleep together and have sons” according to They also sweep out the house from top to bottom with a broom and give it a good cleaning. It symbolizes the sweeping away of all the bad luck of the past year so the good luck can enter.

On New Year’s Day, celebrants wear something red. It’s the color of good luck and symbolic of wealth. Elders often give children red envelopes with money inside on Chinese New Year. (And wouldn’t you know—there’s an app for that.) Maybe you can break out a red envelope, start a new tradition, and get your relatives to contribute to the IVF fund.

Tradition dictates that you put away the knives…this is good advice for hormonal women anyway. Using knives and scissors at this time symbolizes the “cutting off” of the good luck and is an omen of bad luck in the year to come. Finger foods today.

My point is that you don’t have to be Chinese to embrace some of the Chinese culture and have some fun. Wear red. Try your hand at jiaozi from an internet recipe—or order Chinese take-out and help a local business start its year of good fortune! Surround yourself with the richness of red and gold. Sweep out that old bad luck and embrace the new year that waits.

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Do you celebrate Chinese New Year or follow any other cultural traditions with fertility-related traditions? Would you like to learn about fertility acupuncture?


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“Unsung hero to LGBT community” Dr. Howard W. Jones Jr., the Father of Fertility

By David Kreiner, MD

August 23rd, 2017 at 11:04 am


Dr.David Kreiner with Drs. Georgeanna Jones and Howard W. Jones, Jr.

You may already know that Dr. Howard W. Jones, Jr. was the doctor responsible for the birth of America’s first in vitro fertilization “IVF” baby in 1981. IVF and its related technology is the therapy used most often in LGBT family-building.

But you probably didn’t know that the “Father of Fertility” also did ground-breaking work in another medical area that would impact the lives of those in the LGBT community? Work that might raise some eyebrows today, but was positively unfathomable in the 1960s. Let me tell you more about my fascinating mentor.

I first met Howard W. Jones Jr, when I was 29 years old while still an obstetrics and gynecology resident in 1984.  It is now two years since his passing at the age of 104 and his legacy lives on growing greater with each passing year.

He interviewed me back then for a fellowship position in Reproductive Endocrinology/Infertility and IVF at the Jones Institute in Norfolk, Va., the first successful IVF center in the Western Hemisphere.  I was in awe of this 74-year-old statesman of the Infertility world.  He was after all famous in the field even before America’s first IVF baby, Elizabeth Carr, was delivered on Dec. 28, 1981 — that first IVF success that Howard W. Jones Jr. and his wife Georgeanna were responsible for in the United States.

I have aspired to live my life and career as the mentor and man I knew as “Dr. Howard” had taught me.  As such, I have been active in the fertility world of the LGBT community, building your families for decades. In addition, my “LGBT Family Building New York” Facebook page is an endeavor I have undertaken to increase awareness. I also enjoy the partnership between Long Island IVF and the LGBT Network on Long Island which serves to improve access to and increase awareness of quality family-building treatment options for the LGBT community.

Dr. Howard was the ultimate medical scientist who did not have a social agenda or prejudice… only an inclination to help all those whom he was capable of helping and if there was not an established way to do so, he worked tirelessly to pave the way.

In the 1960’s– before the general public was aware of what transgender was– Dr. Howard opened the first gender reassignment surgery clinic in the U.S.  For him, this was a way he could utilize his skills learned from performing work on children with ambiguous genitalia to helping those whose gender identities differed from their appearances.

When Dr. Howard established the first successful IVF program west of the Atlantic he did not limit the technology to the married heterosexual couple.  It was his vision that if an individual or couple was in need and desired to start a family that he could offer the latest advances in medicine to assist them.

Remarkably, Dr. Howard was 70 years old when he succeeded with America’s first IVF success.  Rather than accept the retirement his former employer, Johns Hopkins University, had imposed on him due to age, Dr. Howard embarked on arguably the most significant project of his life…IVF.

As I just begin to enter the twilight years of my professional career I look at the accomplishments of my mentor and realize that there is still much good to accomplish.  For me, among other things that means continuing my commitment to making available family building to those in the LGBT community and in so doing perpetuating the legacy of groundbreaking reproductive assistance that was started by the “Father of Fertility”, Dr. Howard W. Jones. Jr.

I encourage all members of the LGBT community who long for a family of their own to meet me and some of the medical staff of Long Island IVF and reproductive attorney, Amy Demma, at our upcoming free event “Building Families in the LGBT Community”, held in conjunction with the LGBT Network at the Center at Bay Shore at 34 Park Avenue, Bay Shore, NY 11706 on October 26, 2017. Register here now.




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Happy Birthday to the World’s First Test Tube Baby!

By Tracey Minella

July 25th, 2017 at 9:04 am




Happy Birthday to you. Happy Birthday to you. Happy birthday, dear Louise Brown. Happy Birthday to you. Are ya one, are ya two, are ya three…?


Do you remember where you were when you heard about the birth of the World’s first “test tube” baby? Probably not. But I do.


I was just learning about reproduction as a young teen, reading the newspaper in my parents’ brown, gold, orange and white classic 70’s kitchen, when I learned the sensational, seemingly sci-fi news. I remember thinking it was cool. Dad was intrigued. Mom was mortified.


Little did I know then how important that day in history would be in my own life. And how that very technology would be the answer to my own dream of becoming a mother some twenty plus years later.


Let’s celebrate Louise Brown’s birthday with a Q&A to honor the woman whose birth led us to our life’s work… and for some of us… to our own children.


So here are the questions:

  1. In what country was the World’s first IVF Baby, Louise Brown, born?
  2. Give the last names of Louise Brown’s mother’s two IVF doctors?
  3. In what year was Louise born?
  4. Was she an only child?
  5. Was Louise’s first child conceived naturally or through IVF?
  6. Louise is not the first IVF baby to have her own baby, but Louise is related to the first IVF baby to have her own baby. What is the woman’s name and what is their relationship?
  7. Who was America’s first IVF baby?


So…any smarty pants IVF historians out there? Let’s see what you’ve got!

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Long Island IVF Joins Lobbying Efforts for Mandated IVF Coverage in New York State

By Daniel Kenigsberg,MD

June 7th, 2017 at 10:10 am


Dr. Daniel Kenigsberg, Co-Founder Long Island IVF


I am lobbying for passage of Senate Bill S3248, a bill sponsored by Sen. Diane Savino of Staten Island, N.Y. which would mandate In-Vitro Fertilization (“IVF”) coverage in New York State –just as it is in neighboring states including Massachusetts, New Jersey, and Connecticut.

Our patients and other New Yorkers struggling with the significant emotional and financial burdens of infertility are under the impression that they live in a progressive state, but little do most know how poorly served they are by existing New York law.

Currently, the law mandates coverage for “correctable” medical conditions causing Infertility–but specifically EXCLUDES coverage for IVF. This has resulted in much emotional and financial cost spent on inferior or inappropriate treatments which ARE covered when, for over 50% of infertile couples, IVF was the best or only treatment.

IVF is far safer in terms of reducing multiple pregnancy risk than less successful and often inferior treatments like ovulation induction and intrauterine insemination (IUI). There has been waste and needless sacrifice for insured couples denied IVF.

Further, not covering IVF treatment has a disproportionate effect on women (name one male treatment not covered by medical insurance). In Massachusetts, 5% of births result from IVF. In New York, it’s 1.5%. That is how dramatic the current arcane New York law hurts the population it is supposed to protect.

You can help right this wrong. And it won’t take more than 5 minutes of your time.

Call, write and email your state senator. You can find your senator here. Please note that mine is John Flanagan of Smithtown, Senate Majority Leader.

Also, contact Senator Savino of Staten Island because it is her bill to push and prioritize (or not). You can contact her here.

If you are currently suffering from infertility, it can be an overwhelmingly difficult time, but if you have a moment to reach out to your senator and Senator Savino, and any other local representatives, the combined effect of all of our voices can make a big difference. Or if your infertility journey has already been resolved, please reach out as well for the benefit of all that are now– and will someday be– following in your footsteps. And please share this with your family and friends so they may do the same. Thank you.

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Teacher Appreciation Day: When Will it be YOUR Turn to be the Parent?

By admin

May 9th, 2017 at 3:27 pm



We know it’s a tough job to be a teacher…especially when you are struggling with infertility. To spend all day, each day surrounded by little faces—playing a big part in not just in educating these children entrusted to your care, but also in raising them. It’s not a job you can turn off when the final bell rings. You keep thinking about them 24/7. Just like infertility.

When will it be your turn to be the parent at the parent teacher conference?

Well, maybe we can help you get that family started.

Did you know that Long Island IVF is a designated Center of Excellence for the Empire Plan, the insurance provider for many local Teachers as well as other NY State and Local Government Employees? That’s great news for Long Island’s insured teachers and others who want to take advantage of the substantial financial benefits that come with choosing a COE provider for your fertility care and have those services provided on Long Island.

Even those who aren’t able to take advantage of the Empire Plan’s COE benefits can confidently trust Long Island IVF with their fertility care. Our doctors are consistently voted Top Docs and Super Doctors by their peers. We brought Long Island its first IVF baby and many other firsts in the field.

In addition to the assurance of working with a program that has achieved high quality measures, our COE designated program affords our Empire Plan patients an additional financial advantage — once treatment is approved by the Empire Plan, you receive full benefits with no co-payments or co-insurance requirements for the services covered by their insurance plan.

Now is the perfect time to start planning for infertility treatment this summer—especially for teachers! Free from the stress of a teacher’s rigid schedule, the summer months offer the flexibility to do IVF (or IUI) in a more relaxed frame of mind.

If you are not already a Long Island IVF patient and would like to jump start your family-building plans, call us today. With six offices across Long Island and Brooklyn, there is sure to one that’s conveniently located near you.

We look forward to welcoming brand new patients as well as patients transferring from other practices for insurance reasons. Let’s start building that family together this summer. School is almost out. Sounds like the perfect time for a personal project.

Call our New Patient Coordinator at 877-838-BABY to schedule your initial consultation today.

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Are you a teacher or government employee who may need help conceiving—or do you know of someone else who does? Please share. You never know if that great teacher who your child loves is secretly longing for a baby of her own.


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Spring Into Action Ideas for Infertility Warriors

By Tracey Minella

March 23rd, 2017 at 1:10 pm


credit: Gratisography-Ryan McGuire

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?



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Infertility, Lucky Charms, and St. Patrick’s Day

By Tracey Minella

March 11th, 2017 at 10:32 pm


image: wpclipart


Let’s raise a glass to one of the few holidays that’s not focused on children!


Other than spotting those little scouts at a local parade, St. Patrick’s Day—or night—is a time where a good part of the country…legit Irish or wannabes…gets downright hammered. (Not that we advocate that or anything…wink, wink.)


So what are you going to do?


If you’re a cycling infertility patient, you’ll likely resist the urge to drown your TTC sorrows in a pint of green beer, sacrificing the party for the benefit of the potential life you’re trying to create. Hey, there’s no shame in being sober on St. Patrick’s Day! Be the responsible designated driver–it’s great training for all the parental responsibility and sacrifice that might be just over the rainbow for you.


So what about all that “luck o’ the Irish” stuff? As a half-Irish lass myself, and one who did my share of IVFs before having success, I thought it was a farce—a scam. C’mon, if I was really lucky, I wouldn’t have needed IVF to conceive. And, might I add, I’d have had a pot o’ gold to finance it all. But, nooo.


Do YOU believe in lucky charms for fertility?


There are more symbols associated with good luck and fertility than you can shake a shillelagh at! There are frogs, acorns, and of course, eggs. You can buy statues and jewelry of these and other symbols. I once bought a cheap pewter Chinese fertility symbol on a thin black leather necklace. Couldn’t hurt, right? Today, there are many fertility jewelry sites that make beautiful handmade items if you’re open about the struggle.


I also had a lucky charm. It was a gift from a casual friend from work who was moving out of state and knew of my infertility secret. She gave me a pretty mirrored compact with a little cameo angel on top…for luck. I had it with me when I finally had my IVF success. After my angel was born, I tucked it away, figuring I’d give it to my girl one day and tell her its special story.


But a few years later, I had a co-worker who was TTC and was moving to Florida. I thought of my lucky compact and everything suddenly became clear. I told her the story and gave it to her on the following condition: She was to use it as long as she needed it and then pass it along to someone else who was TTC, with the same instructions.


This travelling compact is touching lives and spreading love and luck throughout our sisterhood.


Now that’s worth doing a jig over.


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Have you given or received a lucky charm? What is it and what is the story behind it?


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March is Endometriosis Awareness Month

By David Kreiner MD

March 1st, 2017 at 12:20 pm


photo: Ryan McGuire/

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



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Fertility Acupuncture Seminar at Long Island IVF

By Tracey Minella

October 21st, 2016 at 12:42 pm


David Kreiner, MD and James Vitale, LAc

If you’ve done IVF without success or are thinking about doing IVF and would like to maximize your chances of conceiving, you’ll want to come to Long Island IVF’s Fertility Acupuncture Seminar on November 3, 2016 at 6:30-8:30 pm in our Melville office.

Dr. Kreiner will go over how this ancient therapy, when combined with in vitro fertilization (IVF), may boost pregnancy rates in some cases. Many patients are interested in this holistic therapy and are pleased to learn it costs less than $200 to add it to their IVF cycle.

Dr. Kreiner is the only reproductive endocrinologist in the region who is also a certified acupuncturist and this combined Western and Eastern medicine therapy is available to all Long Island IVF patients, not only his patients.

Come hear Dr. Kreiner tell of how he went back to school after three decades of building families on Long Island to learn TCM and acupuncture in an effort to offer couples—especially those for whom Western medicine alone has not yet produced a baby– every chance of conceiving through a blend of the best Western and Eastern medicine therapies.

Dr. Kreiner is now applying that acupuncture training in the IVF procedure room, both pre- and post-IVF transfer.

Why not see a live demonstration of fertility acupuncture for yourself in a relaxed and casual setting and learn more about how this exclusive, yet very affordable, natural therapy might help increase your chances of conceiving? Dr. Kreiner is very friendly and approachable, as is his special guest, James Vitale, LAc.  Consider stopping by at the end of your workday to find out if this could be the missing piece to your fertility puzzle.

Register to attend this intimate discussion on Thursday, November 3, 2016 at 6:30 pm at our Melville office at 8 Corporate Center Drive, Melville, New York. The seminar is free, but seating is limited, so pre-registration is required.

We look forward to seeing you there. Please contact Lindsay Montello, Patient Services, at 631-752-0606 or with any questions.

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Can we tell Dr. Kreiner you’ll be there?



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