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Archive for the ‘triplet pregnancy’ tag

Infertility Podcast Series: Journey to the Crib: Chapter 28: No More “Jon and Kate” Casualties

By David Kreiner, MD

August 23rd, 2013 at 5:12 pm


Welcome to the Journey to the Crib Podcast.  We will have a blog discussion each week with each chapter.  This podcast covers Chapter Twenty-Eight: No More “Jon and Kate” Casualties. You, the listener, are invited to ask questions and make comments.  You can access the podcast here:

No More “Jon and Kate” Casualties


A few years ago when I wrote this chapter, the Jon and Kate makes eight story was still hot in the press.  It brought to the national limelight the potentially tragic risk of the high order multiple pregnancy for women undergoing fertility therapy.  It is one I was all too familiar with from my early days in the field, during the mid-1980’s when the success with IVF was poor and we consequently ran into occasional high order multiple pregnancies with transfer of four or more embryos or with the alternative gonadotropin injection treatment with intrauterine insemination (IUI).


Today, IVF is an efficient process that, combined with the ability to cryopreserve excess embryos, allows us to avoid almost all high order multiple pregnancies.  In fact the IVF triplet pregnancy rate for Long Island IVF docs has been under 1% for several years now.  There has not been a quadruplet pregnancy in over 20 years.  Such a claim cannot be made for gonadotropin injection/IUI therapy where as many eggs that ovulate may implant.


You may ask then why would we provide a service that is both less successful and more risky and was the reason Jon and Kate made eight.


Not surprisingly, the impetus for this unfortunate treatment choice is financial.  Insurance companies, looking to minimize their cost, refuse to cover fertility treatment unless they are forced to do so.  In New York State, there is a law that requires insurance companies based in NY State that cover companies with over 50 employees that is not an HMO to cover IUI.  The insurance companies battled in Albany to prevent a mandate to cover IVF as has been passed in New Jersey, Massachusetts and Illinois among a few others.  As a result, many patients are covered for IUI but not IVF.  This short-sighted policy ignores the costs that the insurance companies, and ultimately society, incurs as a result of high order multiple pregnancies, hospital and long-term care for the babies.


The answer is simple.  Encourage patients to practice safer, more effective fertility.  This can be accomplished with insurance coverage for IVF, wider use of minimal stimulation IVF especially the younger patients who have had great success with it and minimizing the number of embryos transferred. 


At Long Island IVF we encourage single embryo transfer by eliminating the cost of cryopreservation and embryo storage for one year for patients who transfer one fresh embryo.  In addition, we offer those patients up to three frozen embryo transfers for the price of one within a year of their retrieval or until they have a live birth.


It is my sincere wish that the government can step in to enforce a policy that will never again allow for the possibility of another Jon and Kate debacle.


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Was this helpful in answering your questions about multiple pregnancies, IVF, IUI, and Micro-IVF?

Please share your thoughts about this podcast here. And ask any questions and Dr. Kreiner will answer them.

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Journey On: My Journey, My Advice

By Tracey Minella

January 3rd, 2013 at 2:38 pm

credit: tung photo/

I want to share my story today because I want to inspire you to go on when you think you can’t possibly do so any longer. I hope you will listen even though I personally know… and will always remember…how much it hurts to hear of someone else’s IVF success.

Fifteen years ago today,  my infertility journey took a turn down a new path. My daughter was born. Allow me to follow that with a big fat “Finally!”

She arrived six weeks early amid chaos in a delivery room crowded with NICU team members. I’d spent a week before Christmas in the hospital trying to stave off early labor and to get the hang of insulin injections for gestational diabetes. But there was no putting her off any longer. I won’t lie to you: my life truly began that day.

Nothing on the road to motherhood was easy for me, including the pregnancy itself. Some people are lucky to have IVF success right off the bat, but not me. But here’s one of the life lessons I learned from what felt like the world’s longest infertility journey ever: The longer the wait, the happier the ending.

The happiest “happy endings” come after struggle and loss. They come from a place of profound gratitude. From a place where hope barely hangs on. They often come after the heart-wrenching ups and downs of “No you can’t have it”…“Wait for it”… “It’s possible”…“It’s negative, again”…“Ok, we can do this”…” “See the heartbeats?”… “No, I’m so sorry”… “Let’s try this”… “Good news”… “You’re being admitted”…“There’s been a complication”…

But they do come:

“Congratulations. It’s a girl.”

If you’ve suffered long, may you find some consolation in the idea that you may be building a happier ending.

I usually share my story for new readers in January and June, on the anniversaries of the day I became a mother and the day I started working at Long Island IVF.

Oddly enough, I started working as a medical assistant at Long Island IVF on the day of my first pregnancy test after my 6th fresh IVF cycle. What the heck were we all thinking? It was a big gamble for the doctors… hiring not only a patient, but a very challenging one nearly ready to crawl out on the ledge. But it was a life-changing day for me on many levels.

I made it my purpose then to help others on their journeys. There is something to be said about “misery loves company.” As I drew their blood and they’d talk of quitting, I’d share my stories of perseverance in the face of my early 1990’s IVF challenges like hyperstimulation, poor fertilization, repeated failed implantation, ovarian torsion and its removal, high order multiple pregnancy, and pregnancy loss. I’d never push them to go on, but many chose to.

I help today’s patients through blogging. I pass along the latest information about advances in the field (like the PGS/PGD study we are currently recruiting patients for), share some stories, educate and entertain, and provide a laugh or a virtual shoulder to cry on. Some of the drug names have changed…and some of the needles have gotten smaller…but the emotions and most of the experiences are the same. Happily, the success rates are much higher.

As this New Year begins with possible thoughts of stopping your own infertility journey, please remember this when you’re weighing your options: Just because it doesn’t work out for you the first, second, third, fourth, or fifth time, it doesn’t necessarily mean it isn’t meant to be. We all may need financial and emotional breaks and we each take different roads along the way. Just realize that not succeeding quickly doesn’t necessarily mean you never will. I proved many people wrong.

I hope you all find your way over the worst bumps and turns in your own infertility road, sooner rather than later. In the meantime, you can vent here. Real life and online friendships have started here. Join us this year.

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Where are you along your infertility journey? Where do you find support?



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