Dr. Spencer Richlin Explains Why an Obstetrician Cares About Fertility Screening
Part of my job at Reproductive Medicine Associates of Connecticut (RMACT) is outreach to local Obstetricians/Gynecologists (OB/Gyn). The most pleasant way that is done is that I accompany one of our board certified reproductive endocrinologists (Dr's Mark Leondires, Spencer Richlin, Joshua Hurwitz, Cynthia Murdock and Shaun Williams) to a lunch at the office of an OB/Gyn.
Yesterday, it was Dr. Richlin and myself. I hadn't seen him in a while. I didn't forget how smart he is, really, I didn't. Listening to him explain the difference between PGD (pre-genetic diagnosis) and CCS (Comprehensive Chromosonal Screening) though, reminded me again how smart he is.
Be very clear, when you have two physicians talking about medical issues, as a lay person, I tend to get a bit lost. Less so these days then years ago. Also, they are kind and explain some of it as they go. Sometimes, like yesterday, they get so excited that the conversation just spirals away from me. It was fascinating listening to these men and women talk in such an animated way about their chosen fields of medicine and noticing where they intersect.
Why does an Obstetrician Care About CCS?
Why should an OB/Gyn care about CCS? Simple answer. One that I understood easily. Less pregnancy loss because there are almost no chromosomal abnormalities in the tested embryos (not zero, but less than 2% error rate). Given that almost 25% of all pregnancies result in miscarriage, that's important for an OB/Gyn to know. Pregnancy loss is hardest on the parents to be, without a doubt. I know. I had two of them. Pregnancy loss is also very challenging for a doctor's office to handle. There is the medical piece of it, which is often very straight forward, but not always. There is also the emotional piece of it, which is far less straight forward and needs to be handled on a patient by patient basis. There is often a lot of grief around a miscarriage even more potent when infertility was a struggle first. Our doctors and medical staff grieve with us when there's a loss.
Another reason that an OB/Gyn should care about CCS? Single pregnancies. When an embryo that has been found to be healthy is transferred back, the chances of pregnancy are much higher (and the risk of miscarriage much lower) and therefore allows for less embryos to be transferred back. Twin pregnancies frequently result in healthy babies and healthy moms. Often, though, there are more complications for both the babies and the mothers, even in a twin pregnancy. Certainly when we start to talk about higher order multiples (pregnancies of 3 or more), there will almost certainly be complications and probable compromises in the health and well being of the babies and the mother. An OB/Gyn would much prefer to see patients who are pregnant with one baby; they know that there is a much greater chance of a healthy baby and mom and much less chance of complications.
I got all this yesterday, again, while having the honor of hearing these physicians speak to one another. Yet another reason that I love my job! Fascinating conversations about women's health and family building, with doctors that really care. What's not to love?
CT Fertility Specialist Dr. Spencer Richlin Wins "Top Doc" Award
Yes, we are proud! This time, it's fertility specialist Dr. Spencer Richlin who has won the award. It means a lot to him because it's awarded by his peers. We are lucky and privilaged to have 5 award-winning, board-certified reproductive endocrinologists at RMACT. Drs. Leondires, Richlin, Hurwitz, Murdock and Williams are all hard working, dedicated professionals who have up to the date medical expertise as well as compassion and understanding of what men and women struggling with infertility go through.
Yes, we are proud. Wouldn't you be?
Reproductive Endocrinologist Dr. Spencer Richlin Recognized by Peers
For the second consecutive year, Dr. Spencer Richlin, Surgical Director and Fertility Specialist with Reproductive Medicine Associates of Connecticut (RMACT), has been honored by his peers by being rated a “Top Doc.” Castle Connolly’s 2013 list of Fairfield County’s Top Doctors of will appear in the January/February issues of Fairfield Living, Greenwich, New Canaan-Darien, Westport and Stamford magazines, all of which are published by Moffley Media and are on stands now.
“I feel privileged to be in the reproductive endocrinology field during a time when so many new advances are making it possible to help patients realize their dreams of a family,” says Dr. Richlin, who is the Division Chief of Reproductive Endocrinology and Fertility at Norwalk Hospital along with his responsibilities at RMACT. “And to have this work recognized by my peers through this award is simply amazing.”
Moffley Media’s list is compiled by the renowned healthcare research firm Castle Connelly Medical Ltd., which conducts a rigorous, peer-reviewed assessment of local doctors by their peers.
Dr. Richlin is board certified in both Reproductive Endocrinology and Obstetrics and Gynecology. He is a member of the American College of Obstetrics and Gynecology and of the American Society for Reproductive Medicine. He has published several articles and co-wrote with his RMACT partner, Dr. Mark Leondires, the fertility chapters in a new textbook titled Avoiding Common Obstetrics and Gynecology Errors, published by Lippincott, Williams & Wilkins.
Dr. Richlin received his undergraduate degree in psychology from the University of California at Berkeley, and his medical degree from the University of Southern California Keck School of Medicine. He completed two internships, one in Emergency Medicine and one in Obstetrics and Gynecology. Dr. Richlin served his residency at Stamford Hospital in Stamford Connecticut from 1995-1999, where he was named Berlex Best Teaching Resident. He then completed his subspecialty fellowship in reproductive endocrinology and infertility at Emory University School of Medicine in Atlanta, Georgia.
Within the reproductive endocrinology field, Dr. Richlin’s main interests are reproductive surgery, in vitro fertilization (IVF), donor egg pregnancies and a cutting edge technology called Comprehensive Chromosome Screening (CCS), which safely evaluates biopsied embryos prior to transfer. Dr. Richlin takes a personal interest in his patients, and finds fertility preservation for cancer patients especially rewarding.
About Reproductive Medicine Associates of Connecticut (RMACT)
RMACT specializes in the treatment of infertility, including assisted reproductive technologies (ART) such as intrauterine insemination (IUI), in-vitro fertilization (IVF), and Comprehensive Chromosomal Screening (CCS). RMACT, Fairfield County’s largest fertility clinic and egg donation center, is one of 11 leading In Vitro Fertilization (IVF) centers nationwide chosen by In Vitro Sciences to participate in its Centers of Excellence program. RMACT has offices in Norwalk, Danbury and Stamford, and affiliate New York fertility clinics serving Putnam and Dutchess counties. RMACT also offers infertility treatment financing and support services through RMACT Integrated Fertility & Wellness Center, such as nutrition counseling, massage therapy, psychological counseling, acupuncture and yoga.
The RMACT team of Board-Certified Reproductive Endocrinologists includes Drs. Mark P. Leondires, Spencer S. Richlin, Joshua M. Hurwitz and Cynthia M. Murdock. All physicians are members of the American Society for Reproductive Medicine (ASRM), the Society for Assisted Reproductive Technology (SART) and the Fairfield County and Connecticut Medical Societies. RMACT’s IVF laboratory is accredited by the College of American Pathologists (CAP), and CLIA; other accreditations include the Accreditation Association for Ambulatory Health Care (AAAHC) and the American Institute for Ultrasound in Medicine (AIUM). For more information visit http://www.RMACT.com or find us on Facebook.
Read below what the medical director of Reproductive Medicine Associates of Connecticut (RMACT) and the team of board certified reproductive endocrinologists in the program have to say about frequently asked questions.
"Infertility can be confusing, and people frequently ask questions because they want to know if they should seek help from a fertility specialist," says Dr. Mark Leondires, Medical Director. "The questions and answers below are intended to give some basic knowledge. Many couples put off seeing a fertility specialist when they are having trouble getting pregnant, but they are typically reassured after being diagnosed and starting a treatment plan."
What is infertility?
Infertility is a disease or condition of the reproductive system often diagnosed after a couple has had one year of unprotected, well-timed intercourse, or if the woman has been unable to carry a pregnancy that results in a live birth.
Is infertility a "women's problem"?
Infertility is a medical problem. Approximately 35% of infertility is due to a female factor and 35% is due to a male factor. In the balance of cases, infertility results from problems in both partners or the cause of the infertility cannot be explained.
How long should we try before we see a doctor?
In general, if you are less than 35 years old and have been trying for more than one year you should schedule an appointment with a fertility specialist. If you are greater than 35 years old we would like to see you after at least six months of timed, unprotected intercourse. However, if you have a reason to suspect you may have a problem getting pregnant such as a history of pelvic inflammatory disease, painful periods, miscarriage, irregular menstrual cycles, or if your partner has a low sperm count, you should seek help sooner. Many couples have a hard time admitting that there may be an infertility problem, but be reassured there are often many things we can do to help.
What is a Fertility Specialist?
A fertility specialist, or Reproductive Endocrinologist, is a medical doctor who has been specially trained in the complex issues that can contribute to infertility. In addition to being trained as an Obstetrician/Gynecologist which requires a four-year residency a fertility specialist must complete an additional two to three year fellowship in reproductive endocrinology. This fellowship training is highly specialized to focus on the diagnosis and treatment of infertility and female endocrinology.. A physician can become Board Certified in Reproductive Endocrinology by successfully completing the fellowship as well as written and oral examinations.
Currently in the Unites States, there are only about 1,000 Board Certified Reproductive Endocrinologists. Specifically for infertility related to males, Urologists with a sub-specialty in Andrology are the most qualified experts as they have often completed two-year fellowships and passed exams to become Board Certified in Andrology.
At what time of the month is a woman fertile?
The most fertile time of a woman's cycle is just before or the of day ovulation. Ovulation usually occurs two weeks before a period starts, so it is necessary to count backwards from the anticipated start of the next period in order to find the most fertile time. Take the number of days in the usual cycle (from the beginning of one period to the beginning of the next) and subtract 14. For example, a woman with a 32-day period would likely ovulate around day 18 (32-14=18), while a woman with a 28-day cycle would ovulate around day 14 (28-14=14). We recommend every other day intercourse around the day of ovulation. That would mean days 12, 14 and 16 for women with 28 days cycles.
It is best to have intercourse before ovulation rather than afterwards, so a woman who ovulates on day 14 would have a good chance of conceiving if she has intercourse on either day 13 or 14. For women with irregular cycles you can extend the period of having sexual relations to every other day from day 11 to 18 ( 11-13-15-17). In order to better understand what day you ovulate take your average menstrual cycle length (for example 32 days) and subtract 14 and that will give you that day you ovulate around (that would be about day 18). Therefore you would have relations days 15-17&19 to cover all your bases.
Alternatively, women with irregular cycles may want to use an ovulation predictor kit, which can be purchased over the counter at most local pharmacies. This involves testing your urine around the time of ovulation using a detector stick, which give you a visual reading. Additionally, there are electronic monitors which detect ovulation by tracking two hormones (estrogen and luteinizing hormone) starting with urine testing on day one of your menstrual cycle. The methods that utilize urine predictor sticks or urine ovulation detector machines are usually highly sensitive, accurate, and reliable.
How can a woman tell if she ovulates?
The simple, inexpensive way of finding out the approximate time of your ovulation is to take your basal temperature (that is, your body temperature at rest) every morning and record it on a chart. You can buy a Basal Body Thermometer at your local drug store. Save all your charts so you can review them with your doctor. Three or four months of charting should be adequate. If your temperature goes up after the middle of your menstrual month you likely do ovulate. In general you ovulate about two days prior to the temperature rise.
How often should we have intercourse?
It is a good idea to have intercourse every other day around the time you ovulate. Remember, every woman is different, and may not ovulate exactly on "Day 14." And, just because you ovulated on "Day 14" this month, doesn't mean you will next month. It is preferable to have intercourse every other day rather than every day so that sufficient sperm will be available. To increase your chances of the egg becoming fertilized, do not douche or use lubricants immediately before having intercourse.
What fertility testing should our fertility doctor perform?
Your doctor will likely do the following:
- Blood tests to check reproductive hormone levels in the woman; estradiol (E2), progesterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid hormone, prolactin, and possibly male hormone levels.
- Complete semen analysis on the male partner
- Hysterosalpingogram (HSG), an x-ray exam to evaluate if the woman's fallopian tubes are open
- Ultrasound to confirm the normal appearance of your uterus and ovaries in the woman
What about smoking and drinking alcohol and caffeine?
There is evidence linking reproductive impairment with exposure to alcohol, tobacco, and caffeine.
Alcohol and tobacco use have been demonstrated to affect the reproductive capacities of both men and women, and tobacco is an especially potent reproductive toxin that negatively effects female fertility by damaging eggs. In men there is a direct effect on sperm quantity, quality, and reproductive function. In general we ask that women consume less than 150 mg of caffeine per day which is equivalent to two small 8 oz cups per day. Remember sodas and tea also contain caffeine. In addition, it is wise to be in the best physical shape possible while you attempt to conceive and, of course, to ensure a healthy pregnancy and baby.
Are hot tubs really bad for a man?
Yes. High temperatures can damage sperm. That is why the scrotum is located outside the body - to act as a kind of "refrigerator" to keep the sperm cool. So, it is a good idea to avoid hot tubs, saunas, and steam rooms when men are trying to help in the pregnancy pathway.
What else can we do?
Learn as much as you can about infertility.
- Get and read good, reliable information (not just from popular magazines) from your doctor, library, or trusted friends or family.
- RESOLVE (http://www.resolve.org/) and the American Fertility Association (AFA - www.theafa.org) has over 60 fact sheets on different topics related to infertility, and support groups in many areas.
- Also visit the ASRM (http://www.asrm.com/), SART (http://www.sart.org/), ACOG (www.acog.org) and CDC (http://www.cdc.gov/) web sites for more information.
Dr. Spencer Richlin is Surgical Director and a fertility specialist in reproductive endocrinology at Reproductive Medicine Associates of Connecticut (RMACT). In addition, he is Division Chief of Reproductive Endocrinology at Norwalk Hospital. Dr. Richlin is Board Certified in both Reproductive Endocrinology, Obstetrics and Gynecology.
1. What drew you to the field of infertility?
The field is evolving so quickly. IVF is such an amazing tool to help people buil their families. As a medical discipline, it is so interesting and futuristic.
2. What are the things that you would like to see evolve in treatment of infertility?
I want to see the pregnancy rates with IVF increase even more. We are at a cross roads now where embryo biopsy/CCS can increase pregnancy rates significantly for couples. One day, all embryos before transfer will be analyzed to help us choose the most fit embryos for transfer.
3. What appeals to you most about being a doctor?
Besides helping our patients, I like the scientific content of the reproductive health field.
4. What is the one thing that you would like your patients to know about going through treatment?
I want to see them have a good journey with us and get pregnant. I just want our patients to succeed and start or continue family building.
5. Tell us something you would like every patient to know about you.
What makes me most happy is to see our patients succeed
6. What kind of things do you like to do in your spare time?
Spend time with my wife
Play baseball with my son and watch his games
Hang out with my daughters and help them bake
Travel and be on vacation
7. If you could travel anywhere in the world in the next month or so, where would you like to go?
I'd go to Hawaii and sit on the hot beach and do absolutely nothing
8. Who is your favorite author?
Greg Mortenson, Author of Three Cups of Tea
9. Favorite genre of movie?
10. If your schedule allowed for an unexpected few hours free, what would you do with them?
Relax at home with family or go clothes shopping
11. If you could sit down for lunch with two people, living or not, who would they be?
My Uncle Hugh, who was a great guy, passed away 15 years ago. I would have wanted him to meet my wife and family and have him see what I am doing now. Warren Buffet would be my other choice of an interesting person to spend time with.
12. What is your favorite ethnic food?
Indian and Mexican are my two favorites
Dr. Spencer Richlin
Dr. Spencer Richlin is Surgical Director and a fertility specialist in reproductive endocrinology at Reproductive Medicine Associates of Connecticut (RMACT). In addition, he is Division Chief of Reproductive Endocrinology at Norwalk Hospital. Dr. Richlin is Board Certified in both Reproductive Endocrinology, Obstetrics and Gynecology.
Board-Certified Reproductive Endocrinologist: Infertility Specialist – Connecticut & New York
Prior to joining RMA, Dr. Richlin served on the faculty of Loma Linda University School of Medicine, in California, as a Clinical Assistant Professor of Gynecology and Obstetrics. He is a member of both the American College of Obstetrics and Gynecology and of the American Society for Reproductive Medicine.
Dr. Richlin has published numerous abstracts, articles and book chapters, and is the lead author of the IVF section in Danforth’s Obstetrics and Gynecology, 9th Edition. He coauthored with Dr Leondires the “Infertility” chapter in the text “Avoiding Common Errors in Obstetrics and Gynecology. This is due out in 2011.
Dr Richlin received his undergraduate degree in psychology from The University of California at Berkeley, and his medical degree from the University of Southern California’s School of Medicine. He completed two internships, in Emergency Medicine and Obstetrics. Dr. Richlin served his residency at The Stamford Hospital in Stamford Connecticut from 1995-1999, where he was named Berlex Best Teaching Resident.
He then completed his subspecialty fellowship in reproductive endocrinology and fertility at Emory University’s School of Medicine in Georgia. Then he carried out research projects in in vitro fertilization and intrauterine lesions such as fibroids and polyps. There he wrote book chapters on abnormal uterine bleeding and endometrial ablation.
Editor's side note- Look for a personal interview with Dr. Richlin next week where you can learn more about why he chose to go into the field of fertility treatment as well as what he likes to do when he is not practicing medicine.
Reproductive Medicine Associates of CT (RMACT) is full of announcements this morning.
Coming up tomorrow on this blog we have an interview with Dr. Cynthia Murdock of RMACT, sharing the more personal side of herself. What she enjoys doing, why she decided on reproductive medicine, how she likes to spend her time off and more. Read tomorrow to get to know this board certified reproductive endocrinologist as a real person.
This coming Saturday, Carolyn Gundell MS, and Dr. Spencer Richlin, RMACT’s Surgical Director, will be presenting an interactive seminar as part of our fall series. Open to the public, the seminar will be held in our learning center in Norwalk.
Fertile Nutrition: Tools for Success
A discussion on how to increase your chances of pregnancy and optimizing your health prior to pregnancy with nutrition and lifestyle choices. Led by Carolyn Gundell and Spencer Richlin, MD.
Seminars are $10 per person or $15 per couple
RSVP to Cori at 203-750-7492
Dr. Spencer Richlin is a busy man these days! He will be speaking next Tuesday at TLC (Total Learning Center in Norwalk CT). Very exciting panel discussing the patient being treated in an integrative manner. The details are as follows:
On Fertile Ground:
Holistic & Traditional Approaches to Infertility
Figures vary, but as many as 40% of infertility cases have been described as 'unexplained' which means that following thorough investigations, doctors can find no specific or identifiable medical problem at the root cause. Clearly even today, it's still a bit of a mystery why pregnancy may or may not occur.
On Fertile Ground is a panel discussion which looks deeper at some possible causes - lifestyle factors, nutritional imbalances, even emotional elements and offers ways in which couples may be able to overcome their fertility challenges by taking responsibility for themselves, rather than handing it all over to the doctors.
Our panel represents Western, Eastern and Integrated approaches to fertility - offering a strong potential for success in promoting fertility.
Joel Evans, MD: founder and director of The Center For Women's Health, nationally recognized wellness expert, educator, author and physician specializing in nutrition, mind/body medicine and spirituality.
Spencer Richlin, MD: Surgical Director and a specialist in reproductive endocrinology at Reproductive Medicine Associates of Connecticut.
Vicki Kobliner, MS RD: a RegisteredDietitian with extensive experience in using dietary modification, appropriate supplementation and functional lab testing to achieve optimal wellness.
Elaine M. Malin, MTCM, L.Ac.: a licensed acupuncturist and a Diplomat of Oriental Medicine, treating physical and emotional issues in adults, children and infants.
Tuesday, Oct. 26th
112 Main Street
Next up, is Dr. Joshua Hurwitz. We are delighted to announce that American Registry, a leader in recognizing excellence, has awarded our very own Dr. Joshua Hurtwitz with its prestigious One of 2009's "Most Compassionate Doctors" Award.
Dr. Hurwitz's patients have expressed their esteemed opinion of his bedside manner and have identified him as one of America's Most Compassionate Doctors. Only a handful of physicians receive such complimentary reviews nationally. In fact, of the nation's 720,000 active physicians, less than 3% were awarded this honor in 2009.
Dr. Hurwitz will be presenting at the following of RMACT’s fall seminar series:
Saturday October 30th 11:00 AM – 12:30 PM
The Science of Dieting, Weight and the Fertility Connection
This seminar will discuss which meal plans work best, dieting fads and myths, and how body composition can affect fertility, pregnancy, and long term health for both mother and baby. Led by Carolyn Gundell and Joshua Hurwitz, MD.
Look to reading more about Dr. Mark Leondires (Medical Director of RMACT) in just a few weeks. Or better yet, watch and listen to him speak about how to optimize an IVF cycle. A subject that could help you enhance your chances of pregnancy and just a click away. Dr. Leondires has been a leader in supporting men and women on their path to their fertility and quest to create their families
Wednesday is the day of the week that we have our medical pieces on PathtoFertility. The line up for the next several weeks is exciting in that several challenging topics are being tackled. Some of these subjects are not talked about very much and are difficult for patients to bring up with their fertility doctors or other medical care individuals. Although they are not talked about easily or openly, they are certainly on many of our mind’s and can often weigh heavily on our hearts as well. Please read these educational and informative blogs for a clear and comprehensive explanation and understanding of some tough subjects.
The first this Wednesday, is from Dr. Cynthia Murdock, of Reproductive Medicine Associates of CT. Dr. Murdock has been with the practice for over two years and has office hours in all three of RMACT’s offices (Norwalk, Danbury and Greenwich). Dr. Murdock writes about one of the most alarming things that can happen after a positive pregnancy test. Bleeding or staining in the first trimester of pregnancy is scary; Dr. Murdock explains what it can mean, what it generally doesn’t mean and what to do. Anyone, whether after an IVF (in vitro fertilization) or IUI (intrauterine) cycle or having become pregnant on one’s own, knows just how heart stopping it is to see any blood at all after a positive pregnancy test. It’s very reassuring to have a Board Certified Reproductive Endocrinologist tackle this upsetting subject and separate out the truly worrisome from the ordinary. Read this Wednesday to hear exactly what she has to say.
Next Wednesday is a thought provoking blog written by Jane Elisofon, MSW. Jane is one of the two mental health professionals who work with Reproductive Medicine Associates of CT. (Dr. Lisa Tuttle works in our Norwalk office.) Jane sees and counsels couples and individuals; evaluates donor situations; facilitates support groups, and on occasion writes wonderful blogs. This particular blog is on how a woman’s feelings about a previous abortion in one’s life may continue to affect her through her life, and particularly as she enters infertility treatment. If you are one of the many women who experienced an abortion, then you know just how conflicting the feelings can be around this subject. Jane’s blog is non-judgmental and compassionate while giving solid support and useful advice on how to manage such a difficult subject.
Dr. Spencer Richlin (Surgical Director of Reproductive Medicine Associates of CT) will be up the Wednesday after that, writing about fertility preservation. He writes about patients who have been helped by pre-counseling after getting a diagnosis of cancer. While the diagnosis of cancer and subsequent treatment is devastating enough, to a woman of reproductive years that has either not started or not completed their family, it can feel even more hopeless. How reassuring to read Dr. Richlin’s blog and find out about the procedures that can be done prior to cancer treatment to enable a woman to become pregnant and have a child after treatment.
Thank you to all three of these Reproductive Medicine Associates of CT professionals for taking on uncomfortable, challenging subjects so that infertility patients can breathe a sign of relief, understand what their options are and know that you are not alone on this path to fertility.
Dr. Spencer Richlin, Surgical Director of Reproductive Medicine Associates of Connecticut (RMACT) and Division Chief of Reproductive Endocrinology and Fertility at Norwalk Hospital compiled this list of Do's for when trying to conceive. Whether infertility is a challenge for you or not, all of these tips are healthy and sane ideas for trying out when trying to conceive. See what you think!
1) Stay positive and confident that you can become pregnant.
2) If possible, create and utilize a support team to help you through the challenge of infertility. (Family, friends, work colleagues, support groups, mental health professionals, therapists.)
3) If you are under 35 and have been trying to conceive for a year, or you are over 35 and have been trying for 6 months, then make an appointment with a Board Certified Reproductive Endocrinologist (REI).
4) Take a prenatal vitamin with folic acid every day, starting now, to prepare for the baby that you are trying to conceive.
5) Make an appointment with your obstetrician/gynecologist (Ob/Gyn) and let him/her know that you are trying to conceive. They may offer a preconception consultation which would include information on properly timed intercourse, vitamins and more. If you do not see an Ob/Gyn regularly, get a referral from your regular physician and make an appointment to see him/her.
6) Strive to maintain good nutritional and lifestyle habits. Avoid caffeine, alcohol and sugar substitutes, as well as recreational drugs or intense exercise that raises the pulse rate over 140. Proper weight management prior to conception is critical for a safe pregnancy, as well as a healthy body.
7) Engage in at least one of the following activities to help decrease stress: 1) pleasant, gentle exercise 2) yoga 3) acupuncture 4)late night or early morning walks 5)meditation
8) Keep track of your menstrual cycle on a calendar, starting with day 1. Day 1 is the first day that you get your menstrual cycle. This will help you time sexual relations properly and will be valuable information should you need to consult an REI.
9) If there is a known inheritable family disease, ask your REI about Pre-Implantation Genetic diagnosis (PGD) to ensure that you do not pass this on to your child.
10) When searching for reliable information, start with the following internet sites. They are dependable and have information that you can count on- ASRM (American Society for Reproductive Medicine), SART (Society for Assisted Reproductive Technology), RMACT (Reproductive Medicine Associate of CT), ACOG (American Collee of Gynecologists and Obstetricians), Resolve: The National Infertility Association, INCIID (InterNational Council on Infertility Information Dissemination), Inc.,The AFA (The American Fertility Association), ATIME(A Torah Infertility Medium Exchange), Fertile Hope (a Livestrong Initiative designed to support men and women who have medical treatment that could impair fertility)
Here's what is called an "Easter Egg" in a movie. For those of us who sit through all the credits, sometimes we are treated to an extra scene or image at the very, very end.
Here's your "Easter Egg", tip number 11.
11) Make sure that you take care of all of you. Go to the dentist, make sure you are up to date on your mammograms, check ups, pap smears, dermatologists for skin check if necessary. Take care of yourself, not just your infertility.
Medical Day!! Consider this a preview for a comprehensive series on Preimplantation Genetic Diagnosis (PGD) that our own Dr. Spencer Richlin is putting together. Dr. Richlin is passionate on the subject and determined to have patients understand the big picture as well as all the intricacies that this very sophisticated technique uses.
Preimplantation Genetic Diagnosis (PGD)
Preimplantation genetic diagnosis (PGD) is an advanced laboratory procedure in which embryos are screened for genetic diseases or chromosomal problems prior to placing them in the uterus. Introduced in the 1990s, its initial purpose was to help patients avoid passing genetic diseases, such as cystic fibrosis or Tay-Sachs, to their child. It has been shown to be very effective for this purpose, and more recently, its indications have expanded. For example, it has also become a screening test for aneuploidy, which is an error in cell division resulting in an embryo with an incorrect number of chromosomes, either too many or too little.
Chromosomal abnormalities are the most common cause for miscarriage in the human population and are often a reflection of reproductive aging (otherwise known as the female "biological clock"). Couples utilizing preimplantation genetic diagnosis would have their embryos evaluated prior to embryo transfer and only the most genetically normal embryo(s) would be selected. It is a relatively complex procedure that involves manipulation of the embryo, so it is offered judiciously to patients in situations where the benefits outweigh the risks.
Patients who believe they are candidates for PGD should schedule a consultation with a physician separate from their new patient consultation. At that consultation, detailed information (including risks and benefits) will be reviewed and their treatment strategy will be individualized based on their situation. Considering this procedure involves an embryo biopsy, which is equivalent to surgery on the embryo on a microscopic level, there is approximately 1-3% chance that the embryo will be harmed. Having an experienced embryologist perform the biopsy minimizes this risk.
PGD has also been recently used as a tool to prescreen embryos in patients over 35 for chromosomal abnormalities in order to help the embryologist and physician choose the best embryo(s) to place into the uterus. Utilizing PGD in this context is somewhat arguable and should only be performed after extensive counseling.
So,coming soon, all the different pieces of PGD; how it's used, what it can tell us, how it's performed and when. Dr. Richlin is working on it, he wants you to understand all the different pieces.
Tomorrow is the continuation of the dialogue on infertility and egg donation
. Whether this is an option for you or not, or even if you are not trying to become pregnant, I'm interested in what you have to say. This is an issue that affects women on a very basic level and the more of us who weigh in on it; the more well balanced the conversation stays. Opinions are most welcome on the subject.
Meanwhile, I am looking forward to Fertile Yoga on Saturday as there was no class last week. I miss my students when I don't get to teach. Here are the other things that Reproductive Medicine Associates of Connecticut (RMACT) has lined up for our Summer Seminar Series:
Nutrition Tools for Fertility Success
Can supermarket sense improve fertility? Do you sometimes feel misled by food labels? Carolyn Gundell, MS, Nutritionist will lead you through the supermarket maze. We will discuss how and why certain foods are being called "fertility foods." Participants will learn about hidden sugars, healthy fats, whole grains, organic foods, and the fertility secrets to meal balancing.
Wed | June 2 6:00 PM - 7:30 PM
Sat | June 19 11:00 AM - 12:30 PM
Getting Ready for Pregnancy
Health and lifestyle changes made prior to pregnancy help to reduce complications in pregnancy and delivery, in addition to helping improve the health of the baby. Prenatal nutrition, environmental concerns and the health of both partners will be discussed. This seminar will be led by Carolyn Gundell, MS and Diana D'Amelio, RPA-C.
Wed | June 9 6:00 PM - 7:30 PM
Wed | July 21 6:00 PM - 7:30 PM
Carolyn is able to show us new things about food that often feel very mysterious. I have learnt a tremendous amount from her about balancing foods and ingredients that I have felt very confused about previously. Everyone that I know, including our RMACT doctors, have benefited enormously from her patience and wisdom. Following are several quotes from Dr. Spencer Richlin, the Surgical Director for RMACT. Dr. Richlin attended Carolyn's first "supermarket tour". He's a huge fan of Carolyn's and really makes it a point of attending her seminars as he gets so much out of it. In his own words:
"The first aisle we went down and looked at was peanut butters and jellies. While we were there looking at different brands and companies, many people were coming by quickly are buying peanut butter. They were making quick decisions and I noted that nobody was looking at the labels.
In many peanut butters we see hydrogenated oils and sugar that is not healthy for us. In addition, often when a label says "diet" it contains dietetic sugars which are poor substitutes. We have to be so careful when we look at food labels. Many times, these labels are misleading and once we read the actual ingredients, we find out that they are not healthy.
Part of the theme of the evening was for all of us to eat healthy foods and that healthy foods can potentially increase our success with reproductive treatment." Dr. Spencer Richlin
Please note, you do NOT have to be a patient of RMACT to attend any of these seminars, nor will you be given any kind of push to switch to our practice. RMACT brought Carolyn on so that our practice would be better able to offer patients the nutrition help that they need. The seminar series was added so that the reach would be broader and more help could be offered outside of our smaller community. The same is true of Fertile Yoga. All are welcome, RMACT saw that there was a need in the larger community and is trying to help fill it.
I do love working with RMACT for precisely this reason. All are welcome, hope to see you soon.