Sugar and Health
There's been a lot of talk about sugar and health this week at Reproductive Medicine Associates of Connecticut (RMACT), as we talk about weight, and healthful lifestyle choices, and all the discussion topics related to PCOS: Polycystic Ovarian Syndrome.
Recognizing PCOS Symptoms
PCOS is characterized by a variety of symptoms that can make it very difficult to become pregnant. Symptoms include, but are not limited to and do not always include: hirstuism (hair growth on face and other places); ability to gain weight easily and not lose it easily; irregular or non-existent menstrual cycles; insulin resistance; and/or small non-malignant cysts in your ovaries.
What Is PCOS?
This blog is not here to explain what PCOS is and what it isn't. Click here and you will get all the information you need about the clinical assessment of PCOS, how to treat it and more.
This blog is about chocolate cake. And fried foods. And white flour. If you've ever had a weight issue, you will probably understand.
By weight issue, I mean if you ever wanted to lose a pound or two, or thirty pounds, or if you ever needed to gain ten pounds. By weight issue, I also mean that you may have had problems sticking to a diet or eating in a way that you decided you would--instead finding that you have gone off the diet in ways that you had decided that you wouldn't. Weight issue might also mean that you have found that you have gained or lost weight without meaning to and without having a good idea of how it happened.
Pretty much covers all of us, no? If you are an exception, wow. Write and tell us, cause I want to know how you do it!
Finally, though, to the point of this blog. It appears that I owe a chocolate cake my apology.
LOL. I know. Sounds ridiculous, doesn't it?
PCOS and Weight
In all my conversations this week about PCOS and weight and all, it turns out it's not so ridiculous.
So here goes, my formal apology:
I apologize to you, gorgeous-looking cake, with your alluring sweetness and tempting flavor. Turning my back on you was not meant to be disrespectful to you; it was from an intention to be respectful to myself. While you are not evil, nor do you mean to do damage, you are an unhealthy choice for me. Perhaps some people can eat you without damaging side effects; I am not one of those people. I would feel the effects of you for days, in terms of craving and I do not want that for myself.
So my apology for my cold shoulder. I did deliberately turn my back to you so as not to be tempted to eat you. I'm happy there were people who could eat and enjoy you. Perhaps it lessened the impact of my snub.
While I'm at it, I may as well apologize to all the fried foods that I won't be eating and white flour products that I will be avoiding. Sorry!
Those of you reading my blog today, read this with a smile. I'm not really crazy, just a little bit.
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About IVF (in vitro fertilization)
Here at Reproductive Medicine Associates of Connecticut (RMACT), we have a wealth of experience. One of the reasons that I appreciate that so very much is that we can look at different ways to explain things. Our clinical staff, including our board certified reproductive endocrinologists, physicians assistant, specially trained fertility nurses, patient navigators, medical assistants, financial team and more; they all have a specific way of seeing the fertility treatment process and protocols.
Why is that important? Why does that matter? Because sometimes it is helpful to hear a different perspective. Sometimes hearing the same information from just a slightly different point of view, variation on language, a metaphor that makes more sense to you, can bring you to understanding that you can feel all the way to your toes.
So, something new for this blog, PathtoFertility; an ongoing series by our wonderful, talented team at RMACT. Below, find the information that we have on our website regarding IVF.
Next Monday, on Medical Monday, we will have a more step by step description of IVF (in vitro fertilization) from one of our talented fertility nurses. Don’t worry, I will remind you that it’s coming.
You will love it. It’s well written, with a sense of humor, which can be quite a relief in the middle of the seriousness of fertility treatment.
Something to look forward to~ Lisa Rosenthal
During the in vitro fertilization (IVF) process, eggs are removed from the woman’s body and combined with sperm in the laboratory to create embryos, which are then transferred into the woman’s uterus. Nearly 60% of IVF procedures in the United States are performed on women 35 and older.
Before undergoing IVF in Connecticut, you will be prescribed several medications to stimulate the development of multiple ovarian follicles containing eggs to be fertilized. We closely monitor this process using blood tests and ultrasound. Once the eggs have matured, they are retrieved through a simple procedure under ultrasound guidance. We then expose the retrieved eggs to sperm and transfer a limited number of the resulting embryos back into your uterus.
In Vitro Fertilization at RMA Connecticut Recognized for Scientific Excellence
The fertility doctors at RMACT are all board certified in Obstetrics & Gynecology and Reproductive Endocrinology. They are members of the American Society for Reproductive Medicine (ASRM), a voluntary, non-profit organization devoted to advancing knowledge and expertise in reproductive medicine and biology. They are also members of the Society for Assisted Reproductive Technology (SART), an organization of assisted reproductive technology providers affiliated with ASRM that has collected data and published annual reports of pregnancy success rates for fertility clinics in the U.S. and Canada since 1989.
In addition, RMACT is fully accredited by both the Accreditation Association for Ambulatory Health Care (AAAHC) and the American Institute of Ultrasound in Medicine (AIUM).
Our Reproductive Endocrinology and Infertility Laboratory meets the highest standards and is certified by the College of American Pathologists (CAP) and the Clinical Laboratory Improvement Act (CLIA) for the State of Connecticut. As a result of its expertise and experience, RMACT is one of just 11 leading In Vitro Fertilization (IVF) centers nationwide chosen by In Vitro Sciences to participate in its Centers of Excellence program.
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TGIF - Infertility and Gratitude
TGIF. Thank God it’s Friday. Watching TV last night, it was TGIT. Thank God it’s Thursday.
I kind of love it. Of course it can be teased out to TGIW, TGIT. Thank God it’s Wednesday. Thank God it’s Tuesday.
Anyone want to go for Thank God it’s Monday. LOL.
I actually do love Mondays. A bright, fresh beginning to the week, where anything and everything is possible. Lists are brand new and not overwhelming. Intentions are set and feel inspiring not plodding.
There are all sorts of days like that with understanding infertility too, right?
Some days feel like it’s all going right. Some days it feels like a perfect storm. And everything in between.
What if we had a TGIT, TGIT, TGIW, TGIT, TGIF, TGIS, TGIS2? It’s a revolutionary concept! Let’s face it; it’s all ready hit network television. It’s not a revolutionary concept. It’s not even a new concept. It’s just a really difficult concept in the middle of a tornado.
Yet another metaphor for infertility. Tornado.
Let’s get back to TGIT. What do I love about Thursdays? What specifically did I love about yesterday?
A Gratitude List and A Request
Here’s my short list.
- I woke up. If the Dalai Lama can appreciate it, so can I.
- It was a glorious day, cool and sweet at the same time.
- I was with my family.
- It was my sister’s birthday.
- There were berries for breakfast.
- There was chai tea in the cupboard.
- There was a hike in the woods.
- I heard about my mother giving birth 55 years ago, no medication or epidural. Go mom!
- My dog isn’t sick anymore.
- I heard from a lot of you lovelies out there, sending me love. So appreciated. Oh, so very appreciated. My Jen and Jenn, special call out to you both.
There it is folks. My gratitude list for yesterday.
Wonder what I will put on my list for today?
I think I will start with writing to you. One of my joys every day.
Thank you for reading.
Could you do something for me today please?
Could you send me just one thing that you are grateful for?
If you cannot think of anything, please know that’s ok. In the midst of huge pain and sorrow, fear and anger, sometimes gratitude is elusive, twisting away just as your reach for it. I know that. I know that in the midst of trying so hard for our babies that it can feel almost impossible to hold onto hope. I promise that I will find an extra thing to feel grateful for today, for all of you out there who can’t. Let me know that too.
Use this email address, knowing that it’s secure. Comes only to me. Won’t be shared with anyone else: FertileYoga@gmail.com
I could use a little inspiration today. Still, I have a little inspiration to share too. If you can’t reach across the span and find gratitude, email me. I’ll put something extra on my list for you.
Don’t just think about it. Email me.
Have a lovely TGIF. And so on.
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PCOS Awareness Year-Round
September is PCOS Awareness Month. Ah, but if PCOS would disappear for the other eleven months. What would it be like to only have to deal with this disorder for one month a year?
We will never know. PCOS is a lifelong condition. The news that can make you smile about it is that there is much you can take into your own hands. While not every symptom and aspect of this disorder is treatable through diet and exercise, many absolutely are. This is a powerful statement. You can treat this disorder with many simple tools that are at your disposal every day.
It's about choice. While you did not choose PCOS, it is a disorder in which your choices make a very big difference.
Melissa Kelleher, LCSW, from RMACT's team on PCOS, shares her thoughts about responding rather than reacting to the news that you have or may have PCOS. Below that, Eloise Downs, RN, tells us of a few favorite and reliable websites to investigate for help and support.
Read on to hear what a few of our RMACT PCOS members have to say about it. ~Lisa Rosenthal
Coping Techniques for PCOS Diagnosis
When you are first diagnosed with PCOS (polycystic ovarian syndrome), it can be overwhelming. Fortunately, there are ways that you can deal with it and feel that you are able to take some control back. PCOS will not go away completely but by developing some coping techniques it will become more manageable and you will get to a point where it is not a constant source of stress. Here are a few tips:
- Be an ACTIVE participant in your treatment
- Remember that it takes time for medical treatments to work
- Utilize coping strategies that will reduce your feelings of stress. Explore different ways until you find one (or a few) that work best. Here are a few examples:
- write in a journal
- start a blog
- speak to family or friends
- learn and utilize relaxation techniques
- visit message boards/websites to connect with others with PCOS
- join a peer support group
- do things that will help improve your self-esteem
- eat healthy foods
- set up an exercise plan
- do something special for yourself that makes you feel good
- if necessary, seek individual counseling to help deal with feelings related to PCOS
- and then, one day…
- Be an inspiration to others with PCOS!
~Melissa Kelleher, LCSW
PCOS Support Resources
Eloise Downs, our wonderful Registered Nurse on the PCOS team, has this to add for PCOS support:
The following are a few of my favorite resources for patients, parents or anyone suspecting that they may have PCOS:
www.Pcosnutrition.com – great PCOS nutrition website.
www.managingpcos.org.au - an Australian website. The group behind this website developed and documented evidence-based guidelines for PCOS; we heard the leading physician speak at the NIH conference.
www.youngwomenshealth.org/pcosinfo.html - good resource for teens with PCOS to see a well rounded view of this very common endocrine disorder.
PCOS is best treated as early as possible, when symptoms first appear. Please let us know if we can help you in any way, including answering questions right here on PathtoFertility.
Lisa Rosenthal's Google+
Remembering Each of My Miscarriages
Dates mean remembering. Even when our cognitive brains don’t remember an important anniversary, our hearts do the remembering. Feeling sad and looking to see why.
Birthday? Anniversary of a death? A loss of a relationship? Our feelings show us the way, remind us that there is a cycle. A year brings reminders as well as relief.
I remember each of my miscarriages. They were a long time ago. Loss and grief are not resolved by time, I’ve found that out the hard way. I am generally a happy person, I enjoy my life. My days are filled with fulfilling activities and purpose. The world invites me to notice and so I do. Birds, flowers, clouds, dewdrops. The big things in my life are foundationally correct, happy and secure. There is joy and there is contentment. The little things in life, I take notice of; every single day.
I am not a morbid person. I am not a pessimist. I am not one who wallows in self-pity. (Okay, I have my moments.) Still, autumn is a hard season for me. I love it. Perfect weather, not too hot or too cool yet. Lingering sun, colors and sweet moments. It could be my favorite season of all.
Except it holds memories that become reactivated, that cloud even sunny days. At least some days. Every fall is tinged with sadness that I fight valiantly against. Every fall I remember that a baby was to have been born in mid-September. I remember that there was another baby conceived in early October, also never born.
Those babies are my company on a walk sometimes. Present in how the sun hits the stems of the Black-eyed Susans. I struggle with the dilemma of pushing away these thoughts and honoring these little lives that never came to be. Do I just let myself feel how I feel? Do I look at the beauty and know that it reflects out how my babies might have lived their lives?
There are certain awarenesses that I cannot push away. How old these babies would now be. How tall they might have become. What their sense of humor might have been like. These questions and thoughts come unbidden, unasked for, when I see a person who might have looked like them. Or when I see a first star in the earlier evening sky.
Memories of Fertile Hopes and Joys
I remember when the leaves start to change, what my dreams were all those years ago. I remember myself, as a younger person, so happy to be expecting these lovelies. The fertile hopes and dreams. I feel the pain less and the echo of the joy much more now.
I honor these babies that never arrived on the earth. I honor myself as that younger person, full of pain and sorrow. I remember that I am that person still. That time has continued to spiral around, cycle around so that we are experiencing autumn once more.
I honor you, going through your losses and experiencing your pain.
I honor your strength.
Your ability to continue.
As I honor my own ability to continue.
May we all feel peace, shanti.
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Fertility Specialist Explains PCOS (Polycystic Ovarian Syndrome)
Nurse Practitioner Monica Moore, MSN, RN, Shares Her Own Story
I promised you another blog explaining PCOS (Polycystic Ovarian Syndrome) and who better than Nurse Practitioner Monica Moore, MSN, RN, to explain. As always, Monica goes a step further than a comprehensive description of the syndrome; she shares her own experience with us. And as always, she gives hope. Thanks, Monica, for a great blog!
PCOS, polycystic ovarian syndrome, is a common, but confusing endocrine condition. It is characterized by menstrual cycle irregularity, absent (anovulation) or infrequent ovulation, and an excess of androgens (male hormones) that cause acne, unwanted facial hair growth and hair thinning. It also predisposes the people who have it to diabetes, high cholesterol, and other risks. Although PCOS can’t be “cured”, it can be managed by making some simple lifestyle changes.
PCOS and Insulin Resistance
As stated above, PCOS is very common: about 5-10% of women who are reproductive age have it. What is now known is that PCOS is a condition caused by insulin resistance. Insulin resistance can lead to abnormally high levels of circulating blood glucose (sugar) which can lead to serious health problems such as type 2 diabetes, elevated cholesterol and high blood pressure.
I, like many other patients with PCOS, saw multiple practitioners to treat my symptoms. I saw a dermatologist for my skin, a GYN due to missed periods and had laser hair removal. When I wanted to attempt pregnancy, I saw a reproductive endocrinologist who did a vaginal ultrasound and showed me the multiple tiny cysts on my ovaries which are characteristic of PCOS. After I was given this diagnosis, I was initially disheartened. I didn’t want to be told that I would have to deal with this disease for the rest of my life. I then realized that it was actually a relief to have a reason for the symptoms that I was experiencing, and I set about reading as much as I could about PCOS.
Fast-forward 10 years, when I decided to become a fertility nurse. I now know, and try to explain to patients who have PCOS, that I would much rather have this diagnosis than many other infertility diagnoses. One reason is that it is well-known that anovulation is one of the easiest infertility factors to treat. Many patients with PCOS get pregnant with minimal fertility treatments. In addition, most of the infertility factors, such as blocked fallopian tubes, fibroids or endometriosis, cannot be improved by lifestyle changes. I have found that this can cause a sense of helplessness and frustration in the patients given these diagnoses. The negative consequences of PCOS, on the other hand, can be somewhat lessened by employing certain, reasonable strategies, enabling patients to be proactive in their own care.
PCOS and Weight: Opportunities and Challenges
Approximately 70% of people with PCOS are overweight and the condition itself makes losing weight even harder than it already is. One reason is that the hormones which regulate hunger and fullness are imbalanced. Someone with PCOS might still feel hungry after a regular-sized meal, for example. Also, people with PCOS crave carbohydrates, usually simple carbs such as bread and sweets, which signal the pancreas to release high levels of insulin and the cycle perpetuates itself.
On a positive note, studies show that even a modest weight loss can effectively lower the risks of the serious medical conditions and can alleviate some of the PCOS-related symptoms listed earlier. A weight loss of just 5% will go a long way towards restoring ovulation and menstrual cycle regularity. For those who are not attempting pregnancy, going on certain birth control pills can help to control excess androgens, which may help acne resolve and prevent new body hair from growing. They will not, though, get rid of existing body hair, but many people have success using lasers or electrolysis for this. Some patients require medication to increase their body’s sensitivity to insulin. One medication is called metformin (or glucophage) and is only prescribed if you have insulin or sugar problems--it is not a wonder drug that makes PCOS go away. There is now a natural insulin-sensitizing agent available, called Pregnitude®, that seems promising. Recent studies suggest that it can improve insulin resistance just as well as metformin, but without the side effects.
Improve Your Chances of Conception
Whether you need medication or not, here are some simple things that you can do to improve the quality of your health and improve the chances of conceiving:
1) Consult a Nutritionist. Meet with a nutritionist who specializes in PCOS or insulin-resistance, or attend a nutrition seminar. People with PCOS need to eat differently than others, since their hunger signals don’t work properly. There are easy ways to improve your diet, such as eating small meals frequently, and assuring that each meal contains a healthy mix of carbohydrates, proteins, and “good” fat component. A nutritionist will help you plan your meals and read labels to find healthy food choices.
2) Exercise. Don’t be daunted by the need to exercise for long periods of time every day. Even short, frequent sessions of exercise can be helpful. Try to incorporate activity in your daily life, such as walking to a colleague’s desk instead of sending an e-mail or walking outside with a pet instead of just letting it outside into your backyard. Some researchers suggest that the amount of inactivity daily is just as important as the amount of activity, so trying to move around often can help. Find an activity that you like and is fun, such as dance classes or a dance video that you can do at home. Try to make “appointments” to exercise, such as a class you pay for, or plan on meeting a friend at the gym.
3) Manage Stress. There are many ways to manage stress. Your body responds to stress by releasing a cascade of hormones. One of these is cortisol, which can lead to abdominal fat. The other is epinephrine, which triggers the liver to release glucose into the bloodstream to be used for emergencies. When there is no emergency, this glucose remains and prompts the pancreas to release insulin. Join a support group. Try to incorporate some form of a mind-body approach in your every day life. For some people, that can be yoga, acupuncture, acupressure, journaling, Reiki or just meditating on your own. Even adopting a sense of mindfulness can help, such as really noticing your food or reflecting on how beautiful a sunny day feels or a fall day smells.
4) Get more sleep! Lack of sleep can increase the signals for hunger and increase your appetite. The National Center for Health Statistics found that obesity was much more common in people who got less than 6 hours of sleep per night. There are some resources available, such as your local hospital’s Sleep Clinic, which can assist you in obtaining good-quality sleep.
5) Pursue comprehensive care. Comprehensive care for PCOS is paramount. This condition is multi-faceted and may require the participation of multiple health-care providers, such as your OB/GYN, dermatologist, reproductive endocrinologist and internist, but this can also lead to fragmented care in which one physician is not aware of what the other is doing. At RMACT, we have a PCOS clinic for this reason. Our team of clinicians, nurses and a nutritionist work closely with other providers to provide continuity of care and narrow any ‘gaps’.
Most importantly, realize that the diagnosis of PCOS is surmountable. Small, manageable steps can make a big difference!
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Fertility Treatment Options for Women
When you look at Reproductive Medicine Associates of Connecticut (RMACT) as a medical practice, there are other pieces, beside our RMACT website, that need to be seen to see the whole picture. Two very important other pieces include GayParentstoBe and SingleMomstoBe. We have created these websites as places specific to those communities and their individual needs and desires to make sure that they are being served and supported as is appropriate and necessary.
We know that PathtoFertility has a readership that includes members of many different communities, including the LGBTQ and SingleMomstoBe. So to ensure that all members of our community are being served here as well, we will be posting material from the other RMACT websites occasionally as well.
Where better to start than with RMACT’s Medical Director, Dr. Mark Leondires? Dr. Leondires speaks eloquently, professionally and compassionately about how to become parents as a lesbian couple.
Enjoy~ Lisa Rosenthal
Lesbian Family Planning Options
Congratulations on making the decision to become parents as a lesbian couple! As a lesbian couple, where do you start?
The first question to ask is: do you want to proceed with a genetically linked child or adoption?
If you decide to move forward with a genetically linked child, there are some different family building options a lesbian couple can proceed with.
Option 1- Artificial Insemination
Artificial insemination (AI) is a process that is used to place sperm into a woman’s reproductive tract using means other than sexual intercourse. The procedure involves concentrating semen into a small volume and placing it into the uterus (intrauterine insemination, or IUI) or the cervix (intracervical insemination, or ICI).
In order to begin artificial insemination, you need to see your primary care physician. Be sure to be up-to-date on all health care maintenance, including Pap smear, and mammogram if recommended. It is important to track your cycle each month as you must also have a regular menstrual cycle to complete a natural cycle insemination with success. This cycle tracking is how insemination is timed. Some OB/GYNs will require a basic fertility evaluation, including a hysterosalpingogram and documentation of ovulation.
A HYSTEROSALPINGOGRAM (HSG) is a short X-ray procedure used to evaluate the status of a woman’s fallopian tubes, the two structures that carry eggs from the ovaries to the uterus. It is also used to make sure that the uterine cavity has a normal shape and size and to identify uterine malformations, adhesions, polyps or fibroids. These types of problems may cause painful menstrual periods or repeated miscarriages. It is possible that they may be damaged from a known/unknown infection or previous surgery.
Documentation of ovulation can be done by testing your blood for the presence of high levels of progesterone which is a hormone required for pregnancy and secreted by the ovary.
For women over 35 the completion of a basic fertility workup should be considered to evaluate their reproductive age. Here are some tests given:
- When a woman is undergoing a fertility work-up, Menstrual Cycle Day 3 is the day she has blood work done to check the levels of three important substances: follicle stimulating hormone (FSH) and estradiol (E2).
- FSH is secreted by the pituitary (a gland in the brain) throughout the menstrual cycle, but on day 3 it should be low indicating good fertility.
- Estradiol (E2) is a complimentary hormone which is secreted by the ovary and correlates proper time of the FSH test.
- Anti-Mullerian Hormone (AMH) may also be tested. This blood test is now able to tell women, more easily than ever before, about their potential to become pregnant. The AMH test is used to measure ovarian reserve, the quality and quantity of your eggs. This result helps doctors determine your chances of becoming pregnant now and in the future. This can be done at any point in the menstrual cycle.
To complete the process, you are required to meet with a board- certified Reproductive Endocrinologist. At this meeting with a fertility specialist, you will discuss donor insemination. A known donor can be a family member or friend, but requires careful consideration and consultation with an attorney to protect parental rights and to be sure that all adults are invested in the emotional development the child to be. An anonymous donorcan be found through a sperm bank. As the name implies, parents do not know the donor, including his name or medical history. However, recipients can choose a sperm donor based on basic characteristics such as family history, race, academic achievements, looks and other factors. This is considered by many the safest way to choose a donor as these donors have been screened for infectious diseases, genetic risk factors, and been counseled on their release of parental rights.
Many sperm banks offer a known sperm donor option. This is a sperm donor who is willing to be known to the parents and child, who has been screened by the sperm bank. Sperm is shipped to your physician frozen and is thawed the day of insemination.
After a donor is chosen, you can then proceed into natural cycle insemination or, if recommended by your physician, superovulation and insemination. The focus of this treatment path is to properly time and deliver sperm into the female reproductive tract. Superovulation therapy uses medication to release more than one egg in a month to increase the chances for pregnancy. This can dramatically increase a woman’s per cycle chance of pregnancy. Ovulation medicine is used to induce ovulation. Then, at the appropriate time, the sperm are introduced into the vagina, cervix (intracervical insemination), or uterus (intrauterine insemination). These procedures are very low risk, take about 5-10 minutes and are done in the office
Option 2 - IVF with One Person’s Egg and Uterus
In-vitro fertilization (IVF) is a process that involves stimulating ovaries to develop multiple eggs. This is achieved with injectable medications.To move forward with IVF you should see a board certified Reproductive Endocrinologist. She/he will complete a panel of pre-pregnancy screening tests, genetic tests, and infectious disease tests. The goal of IVF is to produce a large number of growing follicles, then to retrieve the eggs from inside the follicles through a short surgical procedure performed in the office. The eggs are then inseminated with designated donor sperm in the laboratory in order to create embryos that can then be transferred to the endometrial cavity (the uterus) of the recipient. To complete IVF using one person’s egg and uterus, the same screening listed above is required to continue with the process. A uterine assessment with a saline sonogram is also required to investigate the health of the implantation site.
Over 5 million children have been born from in vitro fertilization. IVF is considered safe for women, and one of the most successful fertility treatment options available. IVF stimulation requires injectable medication, and also a procedure known as an egg retrieval under sedation.
Option 3- Reciprocal IVF
With reciprocal in vitro fertilization, one woman donates her eggs to her partner, and her partner carries the pregnancy. For female couples this is a way that both can participate in the process of bringing a child into their home. One woman donates egg and goes through superovulation with fertility medicines to produce multiple eggs and undergoes egg retrieval. After egg retrieval eggs are combined with the designated donor sperm in the IVF laboratory. Her partner who is choosing to become pregnant, goes on medication to prepare her uterus. Then when the timing is optimal 1-2 embryos are transferred into her uterus.
For the person who carries, the same screening as above is required, along with a uterine assessment with a saline sonogram to investigate the health of the implantation site. Estradiol will be taken to thicken the lining. The carrier will also be required to take progesterone to prepare the uterine lining for the embryo transfer, the process in which an embryo is placed into the uterus during a simple painless procedure under ultrasound guidance. Progesterone is required to maintain the uterine lining in which the embryo grows and develops. The embryo transfer should occur on a set day under a controlled condition, and is a 15’ low risk, very little discomfort procedure. Success rates with reciprocal IVF vary with the age of the women. If successful, women are discharged to their OB-GYN in about six weeks.
In summary there are three routes to pregnancy for women: artificial insemination, IVF using their eggs and uterus, or IVF using their partner’s eggs and their uterus. Success rates vary based on individual circumstances. A very important part of the journey is to pick out a sperm donor. There are many choices in this regard and I recommend you meet with an experienced reproductive mental health professional to help you with this decision. This decision is a lifelong one for you and your child. Overall, success rates for woman remain very high for women under the age of 40, but age is a significant predictor for success. I recommend you work with a board certified Reproductive Endocrinologist to assure that your pathway to pregnancy is successful, safe, and time-efficient.
Good luck in your family building journey, take the time to get educated, and stay hopeful.
Dr. Mark P. Leondires, Medical Director and lead infertility doctor with Reproductive Medicine Associates of Connecticut (RMACT), is board-certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility.
Infertility Or Something Entirely Different
I just want this weekend. Simple as that.
I don’t just want this weekend.
I NEED this weekend.
A little time off from obsessing on this, that and the other thing.
Funny thing is, that it being Friday, Saturday or Sunday won’t really prevent me from obsessing because it’s still me. Yes, I bring me wherever I go.
And I’m still not that adept at turning my brain off.
Obsessed? Infertility has you wrapped around its little finger? Wondering every other moment how big your follicles are, how many there are, how your progesterone level is? Feel obsessed even if you aren’t clinically obsessed?
Is an infertility diagnosis taking up so much real estate in your brain that it’s crowding out almost everything else?
I don’t know what you’re going to do about it. I know a few things that don’t work when I’m in that state. Which I am right now, just not about fertility treatment.
Secrets About Obsession
A short list about obsession and what doesn’t work for me:
1. Chocolate. There’s actually not enough chocolate in the world to make me stop thinking this way and there’s definitely not enough chocolate in the world to make me feel more comfortable.
2. Alcohol. So momentary a release and not at all guaranteed to work for me. In the past, it has been known to actually make it worse. I have never noticed that a hangover has helped either.
3. Anger. Ah, and this is such a particularly easy and accessible one for me. I carry the possibility of this one wherever I am, able to come up at any moment. Still, it doesn’t help and leaves an even worse hangover than alcohol and chocolate combined. Invariably, when I indulge in this one, I have a whole slew of apologies to make as well. Which I rarely feel like making.
I’m stuck with what does work, even when it isn’t working. How do I turn my heart and mind away from something that I can’t fix or solve instead of obsessing?
Same old, same old.
8 Tips to Relieve the Struggle
Meditate. Even when it doesn’t work. Especially when it doesn’t work. Longer when it doesn’t work because it gives me pause.
Quiet time. Need it more when I don’t have time for it.
Looking up and out. Followed behind a car last night (very annoying, they drove way too slowly) and started to notice how their headlights danced in the trees, lighting them up momentarily. So very pretty and like a calmed down version of a concert light show. Made me smile.
Sleep enough. Yes, regularly sleeping well is one of those fundamental requirements in life.
Be courageous enough to tell my friends that I’m struggling instead of telling them I’m fine. Talk about what I’m obsessing about (or not) and then ask them about them. Change the subject. Listen with my whole being instead of nodding and secretly continuing to obsess about myself.
Eat properly. It actually doesn’t help to have a stomach ache, headache, hangover or guilt on top of obsessing.
Gratitude list. Ten things every night. Even on a day which has felt just plain awful.
Trust that it will lift. Not as quickly as I would like. Not always precisely when I think I am ready. At some moment, I will realize that it’s been ten minutes without the burden of my obsession. Or a whole hour!
And so on.
My love and compassion to all of you out there struggling with an obsession.
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Fertile Hope - Gladly Holding Onto the Typical
“If I just get pregnant, then…”
Then, I will have my baby. My family.
Then the nightmare of infertility and the arduous path of fertility treatment will be over.
“If I just get pregnant, then…”
I will feel the thrill of seeing ultrasounds that reflect my baby’s existence. See a sac first. Then a fetal pole, perhaps.
“If I just get pregnant…”
Then I will see and hear my baby’s heartbeat. Know that my body is finally, FINALLY, succeeding at holding a baby gently and loving and most of all? Safely.
“If I just get pregnant…”
It will be my turn to share the news and see the delight reflected in my loved one’s eyes. Their relief that my wait is over and their hope that I have returned to them, without the shadows in my eyes. My turn to show an ultrasound image of a shadowy figure that will become my son or daughter.
“If I just get pregnant…”
The changes that my body will experience will begin, first invisible from the outside. Perhaps the nausea which could be so challenging, yet welcome because a reminder that all is well and baby is developing. The expansion will begin to hold this tiny being and I will rejoice.
“If I just get pregnant…”
I will remember the pain of infertility and be watchful for averted eyes and the pause before a friend or colleague congratulates me. I will be sensitive and compassionate about how, where, to whom and when I deliver my long awaited news so as not to hurt someone else inadvertently.
“If I just get pregnant…”
It will be my turn to be celebrated; my turn to open lovingly wrapped gifts and see the love in each stitch of the handmade knitted blankets.
“If I just get pregnant…”
I will feel the joy of my little one moving around, resettling and getting comfortable; feeling an elbow, foot or head. Experiencing my family’s love for me as I grow bigger to include this new member of our clan.
Then it will finally be my turn.
To be a mom.
To hold my baby.
To continue our family.
To extend my heart in every single possible direction.
To leave fertility shots, ultrasounds and medical procedures behind me.
To begin again.
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Ladies Night In ~ Fall 2014
Three nights a month we meet for Ladies Night In -- support, conversation, laughter, tears and more. Once a month in each of the following locations: Danbury, Norwalk, Trumbull. If you are not talking to your usual support system of friends, colleagues and family about your experiences with infertility and fertility treatment, this is a safe and confidential place to come and share what you are going through. A place to talk freely with no fear of judgment. Carrie and I would love to meet you. Tomorrow night in Norwalk, right after Fertile Yoga (5:45-6:30-no prenatal yoga). ~Lisa Rosenthal
Peer Support Group with Lisa & Carrie - Details
At this peer support group, come and meet a terrific group of women that gather monthly to share their stories, feelings, questions and laughs. Experience the relief of talking with other women who understand what you are going through. Build friendships with women who will be by your side throughout your family-building journey.
Danbury (6:00-7:30) 67 Sand Pit Rd
Tuesday Sept 9th
Tuesday Oct 7th
Tuesday Nov 11th
Norwalk (7:00-8:30) 20 Glover Ave
Thursday Sept 18th
Thursday Oct 16th
Thursday Nov 6th
Trumbull (7:00-8:30) 115 Technology Drive
Wednesday September 3rd
Wednesday Oct 22nd
Wednesday Nov 19th
To RSVP or for inquires please email Carrie at firstname.lastname@example.org. RMACT also offers a private Facebook page for our patients who can use support 24/7; email Carrie for that information as well. Ladies Night In is free of charge and a light dinner is provided.
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