CALL US AT: (877) 838.BABY


Archive for the ‘TTC’ tag

In the “IVF Oscars”, the Nominee for Best Supporting Role is…

By David Kreiner MD

February 2nd, 2016 at 6:54 pm

 

image courtesy of wpclipart.com


Many husbands complain that they feel left out of the whole IVF process as all the attention and care is apparently directed towards the woman.

If anything they may feel that at best they can show up for the retrieval at which time they are expected to donate their sperm on demand. If you should fail at this then all the money, time, hope and efforts were wasted all because you choked when you could not even perform this one “simple” step.

I have not witnessed the terror and horrors of war but I have seen the devastation resulting from an IVF cycle failed as a result of a husband’s inability to collect a specimen. Relationships often do not survive in the wake of such a disappointment. Talk about performing under pressure, there is more at stake in the collection room than pitching in the World Series.

Husbands and male partners view IVF from a different perspective than their wives. They are not the ones being injected with hormones; commuting to the physician’s office frequently over a two week span for blood tests and vaginal ultrasounds and undergoing a transvaginal needle aspiration procedure. At least women are involved in the entire process, speak with and see the IVF staff regularly, understand what they are doing, and are deeply invested emotionally and physically in this experience.

So what is a husband to do?

 

Get Involved

Those couples that appear to deal best with the stress of IVF are ones that do it together. Many husbands learn to give their wives the injections. It helps involve them in the efforts and give them some degree of control over the process. They can relate better to what their wives are doing and take pride that they are contributing towards the common goal of achieving the baby.

When possible, husbands should accompany their wives to the doctor visits. They can interact with the staff, get questions answered and obtain a better understanding of what is going on. This not only makes women feel like their husbands are supportive but is helpful in getting accurate information and directions. Both of these things are so important that in a husband’s absence I would recommend that a surrogate such as a friend, sister, or mother be there if he cannot be. Support from him and others helps diminish the level of stress and especially if it comes from the husband helps to solidify their relationship.

Husbands should accompany their wives to the embryo transfer. This can be a highly emotional procedure. Your embryo/s is being placed in the womb and at least in that moment many women feel as if they are pregnant. Life may be starting here and it is wonderful for a husband to share this moment with his wife. Perhaps he may keep the Petri dish as a keepsake as the “baby’s first crib”.  It is an experience a couple is not likely to forget as their first time together as a family.

With regards to the pressure of performing to provide the specimen at the time of the retrieval, I would recommend that a husband freeze a specimen collected on a previous day when he does not have the intense pressure of having to produce at that moment or else. Having the insurance of a back-up frozen specimen takes much of the pressure off at the time of retrieval making it that much easier to produce a fresh specimen. There are strategies that can be planned for special circumstances including arranging for assistance from your wife and using collection condoms so that the specimen can be collected during intercourse. Depending on the program these alternatives may be available.

* * * * * * * * * * *  * * * * * * * *

Do you agree that the man should be more involved or would you prefer not to be? Why or why not?

no comments

IVF in a Snow Storm: 10 Survival Tips

By Tracey Minella

January 25th, 2016 at 6:16 pm

 

credit: T. Minella

 

So what do you do when….on top of the regular stress of an IVF cycle… there’s a blizzard of record-breaking proportions on the day of your retrieval or transfer? Or on the day of your IUI?

 

Suddenly, there are two feet down and no sign of it stopping.  It’ll take forever to dig out the car. Hey, where is the car?

 

“Are you kidding? Seriously?”

 

If you were lucky enough not to have had your treatment impacted by the weekend’s blizzard, here are some tips to keep in mind as you face the remainder of the snow season. The 11th tip: Breathe.

 

Here are 10 Tips for surviving your retrieval/transfer/IUI in a blizzard:

 

  1. Touch base with the RE’s office, during regular hours if possible. Otherwise, do not hesitate to call the nurse on call or service. Be sure you understand your instructions, follow the instructions, and know what number you should call in an emergency or if there is a delay in getting to your procedure.

 

  1. Be that person who actually has their general storm preparedness kit together so all you need to focus on is your treatment preparedness plan. Water, food, batteries, cash, gas, charge your cell phone, etc. Have a casserole-type meal in the freezer, too, for when you come home from your procedure.

 

  1. Pack a bag. (It’ll be good practice for when you are pregnant and ready to deliver.) Have copies of any important paperwork, insurance form, phone numbers for family and the doctor’s office, your cell phone, eyeglasses, and the comfy clothes you plan to wear to and from the procedure. If you’re able to bring a camera or camcorder, get that stuff ready and charged in advance.

 

  1. Know where you are going and know at least one alternate route to get there in case roads are closed. Have the address ready to input in a GPS. Better yet, use an app like Google Maps or Mapquest to print out at least two different routes to your destination. And put them in your packed bag. Then, gas up the car.

 

  1. Have emergency phone numbers ready in case you are stranded at home or on the road so you can call your local police department or fire department for help…especially if you’ve taken a timed hCG injection for IVF. Though there is a small window of flexibility, your retrieval timing is critical so that the eggs are retrieved before they are ovulated. Explain the situation and your need to get to the hospital or clinic immediately. (When I ran this scenario by my local precinct, they said they’d likely dispatch an ambulance.) After all, they are here to protect and serve.

 

  1. Line up help in advance…reliable neighbors or a service…for plowing or shoveling the driveway and have them arrive well before you need to leave for the hospital or clinic.

 

  1. Call your local village or town offices to explain your medical situation and beg them to have your road plowed early and often on the day in question.

 

  1. Borrow an SUV from a friend, or, if you just aren’t a confident bad weather driver, ask them to drive you to the hospital or clinic.

 

  1. Consider staying in a hotel very near the hospital or clinic if you live far away.

 

  1. If you have young children at home already, have a babysitting plan (with a back-up) ready in the event of an unexpected illness or weather-related school closing on your big day.

 

 

So what do you do if you didn’t plan in advance of the blizzard?

 

First, stay calm and call the doctor’s office. Follow their instructions. Then plan how to get there safely and quickly. Remember, a woman with swollen ovaries full of follicles on the verge of ovulation should not be shoveling snow nor doing anything super strenuous or potentially dangerous. If others can’t get your car out, call a friend, neighbor, reliable taxi, or emergency services to get you to the hospital or clinic.

 

When it all works out fine and you can take a sigh of relief, be sure to commit this story to memory. Hopefully, the tale of the blizzard you faced in order to have your child can be held over his or her head for years to come…especially during those teenage years!

 

* * ** * * * * * * *

 

Did you ever have a blizzard or other “natural disaster” that threatened your treatment? Do you have any tips to add or advice or a story to share

no comments

The Male Biologic Drive to Parent

By David Kreiner MD

July 7th, 2015 at 3:01 pm

Photo credit: Valentina, proud wife and mom of Devin and Danny

Fatherhood comes in many different varieties that as a reproductive endocrinologist specializing in family building I see on a regular basis.  Whether the man is involved in a traditional heterosexual relationship or is attempting to build a family with his male partner or by himself, man… like woman… feels a biologic drive to parent.  As such, although adoption is a wonderful way to create a family, surrogacy and egg donation is appealing to male-only prospective parents because it affords them the opportunity to have a biological connection to their baby.

 

There are two types of surrogates: traditional and gestational.  A traditional surrogate supplies her own eggs and carries the baby to term.  Gestational carriers do not supply their own eggs and therefore a separate egg donor is utilized.  Unlike donated sperm, donated eggs require the in vitro fertilization (“IVF”) process involving hormonal stimulation of the female egg donor, monitoring during the 2 weeks of stimulation, and transvaginal egg retrieval which is performed under anesthesia.  Typically, the intended male father supplies the sperm and the fertilized eggs or embryos are placed into the uterus of the gestational surrogate.  Surrogates carry the pregnancy to term then surrender the baby and their parental rights to the father or male couple.  The process involves the use of assisted reproduction attorneys, and/or a donor/surrogacy agency. The entire process including IVF with egg donation, surrogacy, and obstetrical care has a cost that can be insurmountable for many men desiring to start a family, estimated to cost between $125-150,000.

 

There have been a few ways some men have successfully cut this expense.  First of all, the fee agencies charge to supply the donated eggs and the surrogates ranges from $10,000-$40,000 independent of the fee the reproductive attorney charges or the cost of psychological screening.  Some IVF programs will supply these services at a much lower cost.  In addition, these IVF programs have relationships with lesbian partners who may be interested in becoming surrogates after they have completed their own families.  Also, some income-based grants exist for male couples in need of surrogates.

 

Whatever your situation, Long Island IVF has the history, the means, the skills, and the desire to assist you in your family building journey.  We can assist you in finding the best agencies/donors/surrogates, reproductive attorneys and counselors to insure that you have the greatest chance of achieving your goal for the family of your dreams.

* * * * * ** * * * * * * * * * * * * * * * * * * * * * **

How important is it to you to have a biological child and what is the greatest obstacle to you’re facing/faced in achieving that dream?

no comments

How to Survive the Two Week Wait for Your Pregnancy Result

By Bina Benisch, MS, RN

May 1st, 2015 at 8:54 pm

photo: peter kratochvil/ publicdomainimages.com

 

It seems interminable.

 

You’ve finally made it through your IVF stimulation. You’ve survived your injections and all those early morning monitoring visits…not to mention being poked and prodded for blood and vaginal ultrasounds. You’ve undergone your retrieval procedure, sweated out the fertilization results, and here it is – the day of your embryo transfer.  Or, if you’re doing IUI, you’ve made it through your insemination.

 

What a relief!  You can finally relax…. NOT so fast!

 

The next 10-14 days can seem like an eternity when you’re waiting for your pregnancy result.

 

Your emotions may ride that roller coaster … slow ascending hope, with glimmers of joy at the prospect that this time you actually may be pregnant … only to be violently interrupted by thunderous pangs of fear that this may not have worked, and then falling into despair.

 

How do you regulate your feelings and create a sense of balance so that you’re not held hostage by every emotion and negative thought that grips you?  Here is your mission for the next 10-14 days, should you choose to accept it:

 

  • Create a list of leisure activities that you and your partner have always enjoyed doing, and set a plan into action.  Yes, there are jobs and responsibilities, but schedule some “special” time together for these activities… whether it’s watching movies together, outdoor activities, date nights, music, or working together on a project that embodies a sense of satisfaction.  Not only does this help keep your relationship close – which in itself is emotionally enriching – but it may distract your attention and maintain some perspective on your life so that you are not feverishly focused on your fertility status.

 

  • Talk to your partner about your feelings.  There are no pat solutions which will stop your anxiety. However, making room for all feelings – even the darker ones – and knowing you will get through it as you ride this wave, will relieve the stress of suppressing these feelings. This will also keep the lines of communication open between you and your partner.

 

  • Restructure your thoughts! This is not to advise Pollyanna or positive thinking.  Let’s face it, the last thing you need is to be told to “be positive” or “relax.” It’s extremely difficult to feel “positive” when you’re struggling with infertility.  However, take a moment to look at the thoughts you are telling yourself – the thoughts that are causing your fear and anxiety to escalate: “I know I’m not pregnant.”  “It probably didn’t work this time.” “What if it doesn’t work this time?” “What if I never become pregnant?”   These thoughts and statements are not etched in truth, and are only fear-based. Better thoughts… which may be equally true, but are not fear based…are: “I could very well be pregnant.” “The possibility that I will become pregnant is just as much a reality.”  Don’t fear that allowing yourself to entertain these hopeful thoughts will cause greater disappointment from a negative result. You will be disappointed or devastated either way, whether you’ve been fearful, anxious, and negative, or you’ve had the perspective that you may very well become pregnant.  Here is a mental framework that is absolutely realistic, true, and can go a long way to helping you maintain peace of mind:  “I am doing everything in my power to become pregnant, and therefore, I can emotionally let go for now, and leave this in the hands of (God, the universe, my doctors).”

 

  • Selectively avoid situations that you know will trigger your fear or anxiety.   Learn to say “NO”.  People will forgive you for not attending a family function, social event, or any situation where you find pregnant people, or people with babies, or people who will ask you when you are going to have children.  YOU come first at this time in your life. YOUR emotional health takes precedence.

 

  • Nurture yourself. Whatever that means for you. Massage, Reiki, reading, movies, shopping, yoga (not hot yoga), — what do you find to be a relaxing, self-nurturing activity?

 

  • Remember proper breathing. Slow, deep breathing will cause a physiological reversal of the body’s stress response.  This will reduce anxiety and stress.  Learn to practice breath work every day.

 

In essence, have compassion for yourself.  Talk about your feelings with your partner.  If you find it difficult to restructure your thoughts, practice the mantra that you have done everything in your power, and now it’s time to let go.  This takes practice, but you can do it if you take on this mission for self-balance, peace of mind, and equilibrium.

 

http://www.publicdomainpictures.net/view-image.php?image=14919&picture=your-are-late

 

 

no comments

Happy National Infertility Awareness Week #NIAW

By Tracey Minella

April 20th, 2015 at 10:55 am

 

 

Well, it’s the biggest week of the year in the infertile world… National Infertility Awareness Week. NIAW, for short.

I confess I hate saying “Happy” before “National Infertility Awareness Week”. Those suffering know there’s nothing “happy” about it. Not a club anyone wants to belong to. No reason to buy balloons or a cake.

But celebrate we will. We must. Because we are celebrating you.

We celebrate you for your strength and resolve in the face of what may be the greatest challenge of your life so far. In overcoming great emotional, physical, and financial stress. We recognize that no matter what pain and losses you’ve faced to date, you find the strength to get out of bed each day and continue to fight for your dream of a family.

This week, Long Island IVF has both educational and fun events to celebrate you, distract you,  and to help spread infertility awareness. All events are from 7:00pm-9:00pm at the Melville office and will offer light refreshments.

 

Here is the lineup of FREE events:

 

Donor Egg Recipient Seminar (Tuesday):

Learn everything you need to know about the Donor Egg process. Learn why some women can benefit from donor eggs, how egg donors are thoroughly screened, how the process works, the competitive success rates of our program, and so much more. Meet the Donor Egg Team and hear a testimonial from one of our many successful and happy moms. Light refreshments.

 

Fertile Yoga Night (Wednesday):

Yoga with a Baby Goal! Created for both newbies and yoga devotes, this is your chance to participate in a yoga session specifically geared to potentially enhance your fertility. Bring your mat or a towel (and yoga pants or gym wear) and experience mediation, breathing and stretching designed to reduce stress, lessen muscle tension and increase blood flow to the pelvis. You’ll be guided by Lisa Pineda, an instructor experienced in yoga for fertility who will leave you relaxed and wanting more. Light refreshments.

 

Alternative Medicine and Holistic Approaches to Enhancing Fertility Night (Thursday):

This interactive evening will highlight Mind-Body and holistic medicine practices including meditation techniques, breath work, Reiki, massage therapy and a live demonstration of fertility-focused acupuncture. LIIVF’s own Dr. David Kreiner will discuss acupuncture and Bina Benisch, MS RN and other affiliated local practitioners will lead the other discussions/demos. Additionally, Rachel Liberatore, LMT, from Nu Touch Therapy will be providing free chair massages. Jim Vitale of Suffolk County Acupuncture will give a live demo of fertility-focused acupuncture, too. Don’t miss this chance to learn how to help yourself reduce stress and improve your own fertility. Light refreshments, including Dr. Kreiner’s special secret fertility friendly trail mix!!!

 

 

Again, all events are FREE, but pre-registration is required. If you’ve been trying to conceive without success, please RSVP immediately to reserve your spot by contacting our Patient Services Coordinator, Lindsay Montello at 631-386-5509 or lmontello@liivf.com. You do not have to be a Long Island IVF patient to attend. Feel free to bring your partner or a friend.

Please come out to one or all of these events. Please help us raise awareness of infertility this week by sharing this post. Someone you know is suffering. You can help.

Did I mention the secret trail mix?

* * * * * * * * * * * * * * * ** * * **

Will we see you at one of these events? Can you guess what’s in the secret trail mix?

 

no comments

Additional Extended Evening Office Hours at Long Island IVF

By Tracey Minella

February 23rd, 2015 at 11:23 am

 

Did you know that Long Island IVF offered evening office hours? Well not only have we offered extended hours in all of our offices for ages, we’ve added even more!

 

Infertility treatment can be stressful. And while some appointments and blood tests simply need to be done in the early morning hours, there are times when an evening appointment is feasible and might be more convenient. Especially for those who work full-time or who might be taking off certain mornings for less flexible monitoring appointments.

 

We’re pleased to announce that in an effort to be even more accessible to her patients, Dr. Satu Kuokkanen will be available on Wednesday evenings in the Lake Success office, starting in March.

 

The hours, nights, and doctors covering these evening appointments vary for each office so check with your doctor or LIIVF office for the specifics. Or if you are a new patient, contact the office you’re interested in for more information.

 

 

 

* * * * * * * * * * * * * * * ** * * * * * * * *

Is the availability of evening doctor appointments an important factor in your decision to choose a reproductive endocrinologist?

no comments

To Single Embryo Transfer (or Not to)?: That is the Question

By Tracey Minella

February 11th, 2015 at 12:24 pm

 

Credit: stockimages/ freedigitalphotos.net


One of the hardest parts of undergoing in vitro fertilization is the difficult decision of how many embryos to transfer back…because each embryo transferred has the potential to implant and develop into a baby.

In the 1980s when IVF was new and success rates were understandably low, it was common to transfer as many as 6 embryos back. Even then, many women did not conceive. Others conceived multiple pregnancies. Still others conceived only one.

Happily, today the technology has been dramatically fine-tuned, resulting in much higher IVF success rates and, because fewer embryos are being transferred, fewer multiple pregnancies.

Some women can’t or don’t want to have a multiple pregnancy and are interested in a program that virtually eliminates the risk of more than a singleton pregnancy. Some of their reasons include possible health risks for the mother or babies, concerns over the higher costs of raising multiples, or the fear of being placed on bed rest and its potential financial impact.

On the other hand, because IVF can be expensive and often not covered by insurance, and because the couples attempting it may have already been trying to conceive for a long time with and without medical assistance and expense, it’s tempting to want to “put all your eggs in one basket”. These couples want to transfer a higher number of embryos back to maximize their chance of conceiving in that one cycle or because they can’t afford to do more cycles. Many couples think of the possibility of twins as a bonus. Two-for-one. Instant family. Dream come true.

But if the financial burden was lessened, and the odds of a live birth from transferring one embryo were nearly comparable to the odds for transferring more, would that make a difference to you? Would you opt for the statistically safer singleton pregnancy vs. the statistically riskier multiple pregnancy? Would you really prefer a multiple pregnancy or would you rather have a succession of singleton pregnancies, the way you originally planned before infertility entered your life?

Deep, emotionally-charged decision. No right answer. Just the right answer for you.

Some good news that may affect your decision is 20-year study of 92,000 patients from Denmark, Norway, Sweden, and Finland, recently published in the on-line Oxford Journal, Human Reproduction, on January 21, 2015. The Nordic study found that the health of children born from IVF has significantly improved and that the risks of pre-term or severely pre-term births have declined dramatically…and it’s primarily due to transferring just one embryo. In addition, the stillborn and infant death rate for singletons and twins born through IVF has declined. http://bit.ly/1Ejgg1o

For those interested, Long Island IVF has a well-established Elective Single Embryo Transfer Program with success rates comparable to traditional IVF in select patients. If you elect to transfer one embryo in your fresh cycle you get free cryopreservation of your embryos and free storage for six months or until a live birth occurs. As an additional incentive to motivate patients to make safer choices, we offer patients transferring a single embryo during their fresh stimulation cycle up to three frozen embryo transfers, within a year of their retrieval or until a live birth occurs, for the price of one. For more details and information on whether SET may be right for you, visit http://www.longislandivf.com/single_embryo_transfer.cfm or ask your LIIVF physician.

* * * * * * ** * * * * *

What did/would you consider when deciding how many embryos to transfer? Is the elective SET program something you did/would consider? Why or why not?

 

 

no comments

Too Fat for Fertility Treatment?

By David Kreiner MD

January 2nd, 2015 at 9:01 am

credit: Ohmega1982/ freedigitalphotos.net

The most shocking thing I’ve experienced in my 30+ year career in Reproductive Endocrinology has been the consistent “resistance” among specialists to treat women with obesity. This “resistance” has felt at times to both me and many patients to be more like a prejudice. I have heard other REI specialists say that it is harder for women to conceive until they shed their excess weight. “Come back to my office when you have lost 20, 30 or more pounds,” is a typical remark heard by many at their REI’s office. “It’s not healthy to be pregnant at your weight and you risk your health and the health of the baby.” Closing the door to fertility treatment is what most women in this condition experience.

An article in Medical News Today, “Obese Women Undergoing Infertility Treatment Advised Not To Attempt Rapid Weight Loss”, once suggested that weight loss just prior to conception may have adverse effects on the pregnancy, either by disrupting normal physiology or by releasing environmental pollutants stored in the fat. The article pointed out what is obvious to many who share the lifelong struggle to maintain a reasonable Body Mass Index (BMI): Weight loss is difficult to achieve. Few people adhere to lifestyle intervention and diets which may have no benefit in improving pregnancy in subfertile obese women.

The bias in the field is so strong that when I submitted a research paper demonstrating equivalent IVF pregnancy rates for women with excessive BMIs greater than 35 to the ASRM for presentation, it was rejected based on the notion that there was clear evidence to the contrary. Here’s the point I was trying to prove: IVF care must be customized to optimize the potential for this group.

Women with high BMI need a higher dose of medication. Those with PCOS benefit from treatment with Metformin. Their ultrasounds and retrievals need to be performed by the most experienced personnel. Often their follicles will be larger than in women of lower weight. Strategies to retrieve follicles in high BMI women include using a suture in the cervix to manipulate the uterus and an abdominal hand to push the ovaries into view.

Most importantly, a two-stage embryo transfer with the cervical suture can insure in utero placement of the transfer catheter and embryos without contamination caused by inadvertent touching of the catheter to the vaginal wall before insertion through the cervical canal. Visualization of the cervix is facilitated by pulling on the cervical suture, straightening the canal and allowing for easier passage of the catheter. The technique calls for placement of one catheter into the cervix through which a separate catheter, loaded with the patient’s embryo, is inserted.

Using this strategy, IVF with high BMI patients is extremely successful. With regard to the health of the high BMI woman and her fetus, it’s critical to counsel patients just as it is when dealing with women who live with diabetes or any other chronic situation that adds risk.

We refuse to share in the prejudice that is nearly universal in this field. It’s horrible and hypocritical to refuse these patients treatment. Clearly, with close attention to the needs of this population, their success is like any others.

Women who have time and motivation to lose significant weight prior to fertility therapy are encouraged to do so and I try to support their efforts. Unfortunately, many have tried and are unable to significantly reduce prior to conception.

What right do we have to deny these women the right to build their families?

It can be hard to deal with obesity and even more so when combined with infertility. If you are feeling sad or depressed, it may help to talk to a counselor or to others who have the condition. I advise you to ask your doctor about support groups and for treatment that can help you including fertility treatment. Long Island IVF has a complete Mind-Body program with counselors for men and women suffering from infertility and we welcome those who are not yet our patients. See http://www.longislandivf.com/mind_body.cfm

Remember, though this condition can be annoying, aggravating and even depressing, seek an REI who is interested in supporting you and helping you build your family and reject those who simply tell you to return after you have lost sufficient weight.

* * * * * * ** * * ** **

Have you been turned away from an RE because you’re overweight or obese? Do you think that’s fair?

 

Photo credit: Ohmega 1982 http://www.freedigitalphotos.net/images/agree-terms.php?id=10073481

 

 

 

4 comments

Infertile Again on New Year’s Eve

By Tracey A. Minella

December 31st, 2014 at 2:17 pm

 

credit: stuart miles/ freedigitalphotos.net


I know exactly what you want to do with that noise maker.

No one would blame you either.

When you’re battling infertility, the last thing most people want to do is party. Unless you’re determined to forget reality for a few hours, who wants to spend money we don’t have dressing up for some rip-off celebration where you’re crowded into a ballroom full of strangers, with bad food, bargain booze, and loud tacky music while fertile friends complain about what the babysitter is costing them?

Truth is…I never liked New Year’s Eve. I hate high heels…and am not really fond of strangers either. My well-done steak never arrives until the ball is dropping. And the group rendition of Sweet Caroline just doesn’t have the same old lure. You may have your own reasons to hate big New Year’s Eve celebrations. Reasons in addition to the obvious one…

Facing the passing of time, coupled with infertility, is a mood killer.

Here’s the best advice I’ve got: Boycott it! Yes, treat New Year’s Eve like any other night. Be a rebel and go to bed at 10. Or maybe have a romantic dinner before turning in early. Unlike many of the recent holidays, this is one where you can actually avoid family. And you can avoid the holiday itself, too…as long as you turn over the calendar the next morning. This might be best if 2014 was a particularly rough year full of losses.

Want to see people? Keep it small…with only those who truly support you…so you don’t find yourself having to fake a fun time or dodging questions about finally having a baby in 2015. A few close friends, great food and drinks, some funny board games or a good movie. Low-key.

Of course, if you do go out big time and some drunk asks if that’s a noise maker in your pocket or you’re just happy to see them, you know what to do.

* * * * * * * * ****

How do you feel about New Year’s Eve? A time to celebrate wildly? A time for quiet, casual fun? A night to hide under the covers?

What do you plan to do?

 

 

no comments

Reasons to Consider Annual Fertility Screening

By David Kreiner MD

December 19th, 2014 at 8:01 pm

 

credit: akeeris/ freedigitalphotos.net


What Is Fertility Screening?

Fertility screening starts with a blood test to check the levels of FSH (follicle stimulating hormone), estradiol and AMH (antimullerian hormone). The FSH and estradiol must be measured on the second or third day of your period. The granulosa cells of the ovarian follicles produce estradiol and AMH. The fewer the follicles there are in the ovaries the lower the AMH level. It will also mean that less estradiol is produced as well as a protein called inhibin. Both inhibin and estradiol decrease FSH production. The lower the inhibin and estradiol the higher the FSH as is seen in diminished ovarian reserve. The higher the estradiol or inhibin levels are then the lower the FSH. Estradiol may be elevated especially in the presence of an ovarian cyst even with failing ovaries that are only able to produce minimal inhibin. However, the high estradiol reduces the FSH to deceptively normal appearing levels. If not for the cyst generating excess estradiol, the FSH would be high in failing ovaries due to low inhibin production. This is why it is important to get an estradiol level at the same time as the FSH and early in the cycle when it is likely that the estradiol level is low in order to get an accurate reading of FSH.

The next step is a vaginal ultrasound to count the number of antral follicles in both ovaries. Antral follicles are a good indicator of the reserve of eggs remaining in the ovary. In general, fertility specialists like to see at least a total of eight antral follicles for the two ovaries. Between nine and twelve might be considered a borderline antral follicle count.
As you start to screen annually for your fertility, what you and your doctor are looking for is a dramatic shift in values from one year to the next.

What Does the Screen Indicate?

A positive screen showing evidence of potentially diminishing fertility is an alarm that should produce a call to action. When a woman is aware that she may be running out of time to reproduce she can take the family-planning reins and make informed decisions. The goal of fertility screening is to help you and every woman of childbearing years make the choices that can help protect and optimize your fertility.

Although none of these tests is in and of themselves an absolute predictor of your ability to get pregnant, when one or more come back in the abnormal range, it is highly suggestive of ovarian compromise. It deserves further scrutiny. That’s when it makes sense to have a discussion with your gynecologist or fertility specialist. Bear in mind, the “normal” range is quite broad. But when an “abnormal” flare goes off, you want to check it out. It’s important to remember that fertility is more than your ovaries. If you have risk factors for blocked fallopian tubes such as a history of previous pelvic infection, or if your partner has potentially abnormal sperm, then other tests are in order.

Regardless of the nature or severity of the problems, today, with Assisted Reproductive Technology and the latest Egg-freezing technology, there is a highly effective treatment available for you.

* *** ** ** ** *****


Have you had a fertility screening yet? Did you find it helpful? Do you have any questions for Dr. Kreiner?

no comments


The Fertility Daily Blog by Long Island IVF
© Copyright 2010-2012