April’s Journey to Fertility: Week Thirty Four

April is a CNY Fertility Center patient and has been on her journey to fertility for approximately two and a half years. April will share candid stories and a unique perspective on the fertility challenges many women and couples face. CNY Fertility Center has locations in Syracuse, Albany and Rochester, NY.

Week 34: Empowerment
When I recently searched for synonyms for the word control, I found the following terms: manage, organize, run, have power over, be in command of, direct, cope, supervise. Immediately, I realize I feel most at ease when I am effectively coping with life’s daily challenges, managing my workload efficiently and keeping organized. Although I may not admit I like to be in control, I like to be in control! (I am sure my husband is nodding his head as he reads this.)

Since navigating through fertility treatment can leave me feeling as if very little is within my control, finding ways to feel personally empowered is important. In order to establish and maintain that feeling, I ask questions – many, many questions when I am with the doctor or acupuncturist, empowering myself at the fertility center.

Achieving that sense of satisfaction and empowerment can sometimes be a creative and engaging process, too. For example, I try to be inventive and diligent at work. Having my own classes allows for me to use my management and creativity skills, empowering myself at work.  Exercising empowers me by invigorating my spirit and energy.  We are currently remodeling everything from the floors to the closet in our office, making me feel empowered at home. Even though there is one specific area in which we feel out of control, we certainly can feel empowered to take charge of other aspects of our lives.

Many couples feel frustrated, alone and out of control during fertility treatment, but learning communication and coping strategies helps both members of a couple feel empowered and in charge. Kristen Magnacca will be offering her Love and Infertility workshop this coming Saturday at the CNY Syracuse location. My husband and I have attended three of her workshops. We always leave knowing there will be an end to this journey and that our marriage is able to survive this challenge. I would encourage you to attend this workshop. Whether you are attending one of Kristen’s workshops for the first time or as a refresher, you will leave with coping strategies and a refreshed outlook. For those of you who are shy and have yet to attend a workshop, do not worry. Kristen will make you feel comfortable and does an excellent job of meeting each individual’s and couple’s needs. Not to mention, Kristen has been through the challenges of infertility herself and has made it to the other side. Her stories and strategies are relevant and effective.

Whatever you do to empower yourself, my intention for you is that you achieve a sense of control and satisfaction.

Peace and blessings,
April all Year Read more

Words of Support and Encouragement Week of January 25, 2010

This week I would like to start looking ahead to some of the support opportunities available to you.  Each location will be holding the monthly Circle of Hope support group where we will discuss the book of the month: Love & Infertility by Kristen Magnacca.  At the support group sessions we will also be creating vision boards.  If you are not familiar with what a vision board is, take a look at this article from last November: Vision Boards

If you are in the Syracuse area, part two of Dr. Rob’s Love & Infertility Workshop with Kristen Magnacca will be held this Saturday, January 30, 2110.  For information on that session: Love & Infertility

There are many other events happening in February at all three locations, especially some wonderful couple based activities right around Valentine’s Day!

Take a look at the calendars and register soon, as space is limited for most events!

CNY Fertility Calendar

CNY Healing Arts Calendar

Remember that what you do to care for your physical, spiritual, and emotional health is just as important as any medication or procedure.

Take care, and I hope to see you at one of these great events!

Lisa

Lstack@cnyfertility.com

315-744-8073

Contacts to Address Your Billing Questions

If you have any questions or concerns with your bill, please e-mail or call the Patient Accounting Representative that handles your specific insurance carrier. We are here to help make this process easier for you, please don’t hesitate to contact us.

Blue Cross Blue Shield:
Sharon Curtis             
scurtis@cnyfertility.com
315-701-1660 ext.3073

April Thompson
athompson@cnyfertility.com
315-439-6239

MVP:
Cheryl Davison
cdavison@cnyfertility.com
315-701-1660 ext.3076

Pomco:
Chelsea Abbott
cabbott@cnyfertility.com
315-701-1660 ext. 4841

United Healthcare and The Empire Plan:
Kim Egenhofer       
kegenhofer@cnyfertility.com
315-701-1660 ext.3074

Aetna, Cigna, CDPHP, GHI, RMSCO, Tricare and all other Insurance Carriers:
Lesley Cook
lcook@cnyfertility.com
315-701-1660 ext. 4840

Patients with no Insurance – Self Pay:
Cheryl Davison
cdavison@cnyfertility.com
315-701-1660 ext.3076

Embryo and Sperm Storage:
Debbie D’Agostino   
ddagostino@cnyfertility.com
315-701-1660 ext. 3075

Accounts in Collection

Last names that beginning with A-M:
Andrea Ennis             
aennis@cnyfertility.com
315-701-1660 ext. 4842

Last names beginning with N-Z:
Debbie D’Agostino
ddagostino@cnyfertility.com
315-701-1660 ext. 3075

CNY Fertility Center Donor Portal

Our Donor database is website protected, please contact Kari Gardner for your own personal and customized login information. You will need this login whether to begin your journey toward becoming a donor with CNY Fertility Center. We are here to help make this experience as easy as possible so don’t hesitate to contact us.

You can phone the Syracuse Office by calling toll free 800.539.9870 or email Kari at kgardner@cnyfertility.com.

*For those individuals looking to become a donor we are now offering a $50 cash incentive for donors that complete an application, and are accepted into the program.

Once you have your login information please click here to enter our Donor Portal.

Solo Mothers

IVF in single women with donor eggs and donor sperm

CNY Fertility Center has locations in Syracuse, NY Albany, NY and Rochester, NY. Fertility treatments are affordable and include low cost IVF (In Vitro Fertilization). Our caring and experienced staff provides confidential treatments for heterosexual couples, same sex couples and  unmarried individuals who are looking to conceive. CNY Fertility Center offers donor eggs, donor sperm and donor embryos. In this article we will explore the options for solo mothers using donor eggs and sperm IVF to create their family.

There is virtually no method for trying to conceive which has not been explored in this day of increasingly progressive options. There can be many different match ups between the sources of the sperm and eggs, thanks to the structure of the IVF technique. It seems that where there is a will, there is a way.

Over the past 20 years, the new class of “solo mothers” has emerged. This is an example of the strength of the drive for reproduction, despite seemingly overwhelming odds. One study focused on 11 single Israeli women who required both eggs and sperm from anonymous sources. These women’s biological clocks had indeed run out, as their average age was 46. Prior to treatment, these women were intensively interviewed regarding issues of older parenting and the living adjustments that would have to be made.

In most countries, it is only financially stable women with college educations who choose to become mothers in this fashion. In pro-baby Israel, the national health care system actually encourages this further, as it provides infertility treatment for producing up to two children up to the maternal age of 51, without regard to marital status. Out of the small Israeli study group, three women had not attended college.  Upon follow-up, socio-emotional development and mother-child relationships seemed satisfactory. All the women reported the highest possible levels of satisfaction with parenthood.

Several of these women were working full time; however, they were depending on extended families and day care facilities during those hours. Interestingly, the lack of a genetic bond did not seem to be a concern for the women: The gestational bond seemed quite strong and was distinguished from adoptive situations. This information may be of help to others considering egg donations.

It is known that IVF can produce multiple births, and this may carry some health risks for the children. In the small Israeli study, one set of twins had suboptimal health after a premature birth.  Certainly this risk is an important one to remember, if a single parent. The amount of work and time involved may be greater than “normal,” if circumstances such as this arise. Replacement of single embryos is a consideration for women in this situation. And that might mean an increase in the number of attempts to have a child; therefore, it might increase IVF cost.

Methods of low cost IVF can be applied in the pursuit of conception for the single woman. Egg donors may have low gonadotropin stimulation for fresh cycle therapy. Egg banks using frozen eggs are also now a realistic option to pursue. This is because the splitting of batches of donated eggs among two or more recipients lowers the cost of IVF.

There is debate on what to tell the child. Concerns have been raised about the previous secrecy involved and much increased openness with the children has been advocated. This and other related topics are covered in a recent book by Angela Best Boss and Evelina Sterling. It is of note that the writers provide a professional counseling service at www.myfertilityplan.com.   Also we recommend the referenced article published in Women’s Health on a related topic.

Rev 10-22-09

References:

Best-Boss, Angie and Sterling, Evelina. Having Your Baby through Egg Donation  2005.

Kirkamn M.  Egg and embryo donation and the meaning of motherhood.  Women’s Health 2003; 38: 1-18.

Landau R et al. Older single mothers and IVF with sperm and egg donation. Fertil Steril 2008; 90: 576-583

Embryo Transfer – Day 3 versus Day 5

CNY Fertility Center has locations in Syracuse, NY Albany, NY and Rochester, NY. CNY Fertility offers affordable fertility treatments including low cost IVF (In Vitro Fertilization). Patients often have questions about the day that their embryos will be transferred back to their uterus following their IVF procedure. This article is a quick summary of the history and advantages of both Day 3 and Day 5 embryo transfers.

Until about 10 years ago, all embryos were routinely placed in the uterus on day 3 of the cycle. Embryos are then at the 6-8 cell stage.

(8 celled embryo – Day 3)

Culture methods then emerged which allowed healthy embryos to continue developing to day 5, the blastocyst stage which has several attractive features.  Most importantly it allows some of the embryos which are doomed to failure due to internal defects to fall by the wayside as they arrest and do not continue to develop. Thus the more hardy embryos are self selecting and the rate of implantation of each embryo is higher.  Culturing embryos out to the blastocyst stage reduced the number of embryos that were transferred back as well, reducing the incidence of multiple gestations.

(Blastocyst stage embryo – Day 5)

Initially it seemed as this was applied in IVF practice, that the ability to choose the more robust embryos by self selection in this manner would raise pregnancy rates. In a common scenario, the choice if a patient had 5 embryos available for transfer, all about equal in quality on inspection under the microscope, the option would be to replace 3 embryos on day 3 or two on day 5. It was hoped that the day 5 embryo transfer would yield higher results for the IVF patient. This has not turned out to be the case. It is however true that the number of triplets is reduced by use of the day 5 strategy, which is an important option to consider when the risk of multiples is paramount.

IUI with Clomiphene, a First Line Treatment for Infertility

This information is provided for couples who may just be starting out in fertility treatments and are trying to conceive using IUI with clomiphene. CNY Fertility Centers provide infertility services including low cost IVF (In Vitro Fertilization) for couples who are starting or continuing their families in Albany, New York, Rochester New York and Syracuse, NY. In addition to our local services we work with patients from across the country and world offering affordable IVF and fertility treatments.

Unexplained infertility is when a couple can’t conceive although the woman is ovulating, and her fallopian tubes, uterus and partner’s semen results come back normal after testing. Some of the women have had endometriosis diagnosed and treated, thus are not truly unexplained, but do fit into this category in terms of an approach for treatment.

Clomiphene is inexpensive, and acts in women who already ovulate to stimulate production of several eggs during a treatment cycle. Clomiphene causes the brain to misinterpret blood estrogen levels. This induces the pituitary gland to produce a surge of the follicle stimulating hormone or FSH. The result is the production of more than usual numbers of follicles, each with one egg.  Intrauterine insemination (IUI) places more sperm into the uterus and then the fallopian tubes than could ever reach through intercourse. Thus more bullets are shooting at more targets.

The combined use of clomiphene and IUI has been shown to nearly double the results compared to using clomiphene alone to improve pregnancy likelihood (Guzick, 1998). The master student of IUI, Dr Richard Dickey and colleagues in 2002 compiled a large series in New Orleans and reported almost 10% success per cycle.

The distinguished Boston IVF group in a study led by Dr. Alan Penzias recently confirmed a cycle success rate of 11.5% (Dovey, 2008) from over 4000 cycles of treatment. The patients were ovulatory and some of the men had low sperm counts.  The success of treatments cumulatively over up to four cycles, was successful in 24% of patients under age 35. Age specific pregnancy rates per cycle ranges from 12% under age 35 to 4% over age 40. Corresponding decreases in overall success were seen according to age. Only one patient was successful (1.8%) of the 55 women treated over 43 years of age.

The study verified findings by others who found that 90% of success is found in three or four cycles. Those who are not pregnant by then should move to gonadotropin and IUI or IVF therapy.

At RBA in Atlanta, Dr Massey and colleagues found that the addition of a chemical called PAF to the sperm wash dramatically improved success rates (Roudebush 2004) to nearly double those without it. This is a reasonably simple method which more clinicians might use.

Those who are concerned with cost effective treatment for infertility continue to believe that clomiphene and IUI are a good treatment for younger patients who are trying to conceive, and fit the criteria outlined.

More information may be found on line and though membership in the patient advocacy group at www.resolve.com

For further information on infertility topics see   www.myfertileground.com

For individual infertility advice by expert patient advocates, see www.myfertilityplan.com

Selected References

Dovey S et al Fertil Steril 2008:90:2281-86

Guzick, DS et al Fertil Steril 1998;70:207-13

Dickey RP et al Fertil Steril 2002;78:1088-95

Roudebush WE et al Fertil Steril 2004;82:52-56

Low Cost IVF in the United States

CNY Fertility Center, founded and directed by Dr. Robert J. Kiltz, with offices across New York State, offers low cost fertility/infertility treatment that include IVF, ICSI, PGD, Cryopreservation, Donor Eggs, and much more. Although fertility treatments are offered worldwide, wide variations are noted in different countries in regard to quality and availability. Medical tourism is becoming a popular means for consumers to find state-of-the-art medical care around the globe. We have integrated both Eastern and Western medicine to provide our clients with a holistic approach to their reproductive care. It is our goal at CNY Fertility Center to become the center of choice both across the United States and to our friends abroad.

Our mission is to provide comprehensive reproductive services in a compassionate, honest and friendly environment at a low cost to our clients. In 2010, Dr. Kiltz has created financial plans to minimize the stress on our clients on their journey to build their family. We offer multiple cycle discounts as well as IVF refund programs. Couples interested in donor eggs will also find that we offer exceptional rates in comparison to many other programs and we as well offer both multiple cycle discounts and refund programs for couples/recipients who are interested in pursuing donor eggs.

As our centers grow to offer services across the United States and around the world, we will strive to meet your needs. We understand the inconvenience of leaving your home for medical care and we will assist you in any way we can to make your stay in New York as comfortable and as convenient as possible. We will provide you with continuous support throughout your journey. Our staff is here for you and it would be our pleasure and our honor to help you build your family.

If you are interested in exceptional, quality care, in a warm environment, at a low cost, please visit our website at www.cnyfertility.com. If you have questions regarding any aspect of the services offered at CNY Fertility Center, please do not hesitate to contact us at (518) 690-0700. Our staff is available 24 hours per day, 7 days a week, to answer any of your questions. We look forward to working with you.

Justine Taylor, RN, BSN
Nurse Manager and IVF Coordinator
jtaylor@cnyfertility.com

A New You Instead of a New Year’s Resolution!

With the hubbub of the holidays past I was curious as to how many of us make a New Year’s Resolution and my Google search revealed about 70% of people do. The article goes on to share that within a few weeks of the New Year an overwhelming majority of people leave their resolutions behind.  Hmmm… I have to admit that I was part of the overwhelming majority prior to my shift.  The shift was from making “resolutions” which seem so final to me; to creating a “Dream’s List”.

What resolutions means to me is that I’m going to resolve,  “not to do something” or “change a behavior” that is deemed negative. The eradication of a bad behavior just feels plain wrong to me.  I’ll tell you why. Good vs. bad doesn’t help us to vibrate at our highest potential; it creates the judgment of the duality rather than the acceptance and acknowledge of the duality. The shift was to something new and came in the form of  a “Dream’s Listing and Goal Setting.” Creating goals for the year with the positive in mind shifts the focus off the bad behavior, to that of instilling a habit that is for the highest good. For example, my first goal is directly correlated with the four-letter “F” word.  FEAR! The fear that I am discussing is presented as worry.  Worry for my children’s safety, worry for the completion of deadlines, worry for the smoothness of a schedule. I found myself being critical of my “worrying” and focusing on the worry instead of the dual side of worry, trust and faith. My first goal for 2010 was to Trust in the Process to help me with this goal I say  “Trust & Faith Is My Way.”

Thinking back to the heat of our fertility journey, the worry had almost eradicated my faith and trust in the process.  The worry about the appropriate elevations of my hormone levels, the worry about the specimen, the worry about “missing the opportunity to create a baby” was what was in the forefront.  Worry a.k.a. Fear. Sir Isaac Newton’s Third’s Law of Motion is “To every action there is an equal and opposite reaction.” I am asking you to think about the opposite reaction to the negative and release the tone of resolutions of what you “should” be doing and make a shift yourself.

~~~~
Dr. Rob will be beginning the 2nd Part of the Love and Infertility Workshop Series at the end of the month in Syracuse on Saturday, January 30, 2010.  The intention of Part Two will be  to focus on Your Dream’s List and create new habits of thinking and approaching your current life situation with a focus on Gratitude.  Please RSVP Kristen@cnyfertility.com. To see more information on this event click here.

Dr. Massey Offers Consultations in Rochester Office

CNY Fertility Center is excited to announce that Dr. Joe Massey will be scheduling fertility consultations for patients interested in Intrauterine Insemination (IUI), In Vitro Fertilization (IVF), donor eggs, reproductive surgeries, and follow up talks in our Rochester office on Tuesdays. To schedule an appointment with Dr. Massey call our Rochester center at 585.244.1280.

Dr. Massey joined our staff in 2009 and has over 30 years of experience in IVF.  He is a native of Macon, Georgia attended college and medical school at Emory University in Atlanta. After completing training and two years in the US Navy, his private medical practice began in general ob/gyn with an emphasis on infertility, back home in Atlanta. Soon after IVF was established in Norfolk, he and his colleague Dr Hilton Kort began to realize that IVF was emerging from clinical experiment to clinical reality for patients in the US. Massey’s first step was to visit Monash University in Melbourne for a prolonged tutorial in IVF methods. During his visit the group was to achieve the first donor egg success. Inspired by this accomplishment and the improving success rates achieved in leading centers, the two doctors then established Reproductive Biology Associates, or RBA.

RBA established the first IVF success in Georgia in 1983. In those days many new clinics failed to achieve pregnancies at all. This early success was followed by thousands of others over the years at what was to become the largest clinic in the South. Dr Massey stressed from the beginning that professionals involved in IVF should strive to assist in making improvements in the methods. The clinic achieved a series of major breakthroughs under the guidance of a succession of innovative lab directors including Jacques Cohen PhD who helped achieve early success in embryo freezing. The world’s first micromanipulation-related pregnancy was reported at RBA, demonstrating a pre-ICSI method of introducing sperm. Further micromanipulation trials by the team led to the first publication of assisted hatching to help embryos implant. The first successful randomized trial of co-culture was reported and was recognized with the overall first prize for research by the American Fertility Society in that year. When ICSI was improved and began to allow men with low sperm quality to achieve success with IVF, RBA logged the first US pregnancy. This led to national press coverage.

At RBA in Atlanta, egg freezing trials were long and difficult. Over 100 eggs were thawed before finally three babies were born, again a first in the US and once more leading to national attention. Egg freezing advances by others have ensued and finally egg banks are a reality. This approach offers major cost savings as Dr Massey had predicted but been unable to achieve using the methods of slow freezing then available.

Dr Massey has now turned his interest to improving access to IVF for large numbers of people. He was the clinical chief investigator in a new method to improve IUI. Dr Massey has been following the possibilities of natural cycle in vitro maturation for 4 years. He has attended courses and meetings on the subject and he has written the protocol for a study. This study is the first large scale US prospective randomized trial which is designed to determine the cost effectiveness of the treatment.

Dr Massey feels strongly that assisted reproduction should now be available in the US to a broad spectrum of the population, not only those lucky enough to have proper insurance or the means to cover the costs.