This post is written by Shelley Leech, Dr. Kubik’s new OI Coordinator.

My job at Reproductive Health Specialists is to coordinate OI cycles, educate patients, and help patients understand testing and medication throughout their cycle. I have been a medical assistant for 17 years, working for a family practice office for 10 years and an Ob/Gyn office for seven years.

In my first experience I had working with an infertility patient, my thoughts were that we were interfering with nature and that we should let it take its course. I felt like we were playing God. I learned soon afterward how long it had been for this couple to try and conceive and had no luck. I asked myself how I would feel if the shoe was on the other foot. I now have the feeling that I am more like an angel sent to help, rather than someone playing God. 

I can’t explain the feeling we as infertility specialists get when we can tell a patient they are going to have a baby after they have been trying to get pregnant for so long. It is so fulfilling to me to know that I have been an active part of the process in helping someone to conceive. It is truly a miracle, the “Miracle of Life.” I am here at RHS to help make your dreams come true and help make your little miracle.

Shelley is from Leechburg, Pennsylvania, where she has lived for 32 years. She is married with two children.

Recently we have had a few requests from our patients asking for more information on acupuncture and its benefits.  In return, we have contacted several acupuncturists and they have readily agreed to write for our blog periodically.

 Our first post is written by Maureen Tighe, ND, L.Ac. at Trillium Natural Medicine in Pittsburgh.

Acupuncture is a therapy that not only compliments western medicine’s approach to infertility, but also offers a unique approach for improving outcomes with couples trying to conceive and have a healthy pregnancy.  

Reproductive endocrinology (RE) and western medicine excel in their ability to diagnose obstacles with fertility such as fallopian tube obstruction, hypothyroidism, premature ovarian failure and luteal phase defect. Ruling out these possibilities or diagnosing them is imperative in order to determine the best course of action for each couple. Success rates with IVF and IUI are much higher than they were twenty years ago; therefore, RE offers many couples a much greater chance of conceiving.

Acupuncture gently nourishes or tonifies aspects of health that relate to women’s health: menstruation, fertility, pregnancy and menopause. Most often women have patterns of disharmony involving the yin organs: the liver, spleen or kidney, as well as qi (spiritual energy) and blood. With the insertion of fine, sterile needles along the surface of the body, movement of qi and blood is stimulated, allowing communication among organ systems. This restores normal physiology of organs and glands that relate to fertility. 

A convenient side effect of acupuncture is the release of endorphins, which promotes a sense of calm and well-being.  Many women opt to do acupuncture in conjunction with IUIs or IVFs in order to improve the efficacy. It is a proactive investment in one’s health that results in not only being more fertile, but also improving the health of the mom, the pregnancy and the baby.

At Trillium Natural Medicine, our utmost care is given to ensure the most thorough and effective treatment plan for addressing each individual’s or couple’s needs. We offer an empowered approach towards enhancing fertility and improving RE procedure outcomes.

Maureen Tighe, N.D., L.Ac.

Trillium Natural Medicine, LLC

3043 West Liberty Avenue

Pittsburgh, PA 15216
412-571-9355

 Not being able to conceive a baby can be one of the most difficult and stressful things a couple may ever have to face. However, science continues to make great advances in treating infertility. Older women who had a very slim chance of getting pregnant before now have scientific advancements on their side.

For example, one of the latest celebrities to announce her pregnancy with the help of infertility treatments is Celine Dion. She announced that she is pregnant with twins after years of trying to expand her family. Her pregnancy is the result of her sixth in vitro fertilization (IVF) attempt. At 42, she should be a model of hope for those who have come to rely on infertility treatments as they become older.

Also, it is interesting to note that Celine Dion used acupuncture techniques to bolster her pregnancy chances. Combining different treatment options can be successful, which is why RHS encourages a holistic approach to infertility treatment.

Learning as much as possible about different treatment options can bring a sense of hope and empowerment to people struggling with infertility:

Ovulation Induction (OI) – where fertility drugs are given to a woman in order to regulate, stimulate or increase ovulation. They typically work to stimulate or mimic two hormones responsible for ovulation: follicle-stimulating hormone (FSH) and luteinizing hormone (LH). 

Artificial Insemination – is a process in which the sperm is placed inside the uterus through medical intervention instead of sexual intercourse. Doctors can treat the sperm in a laboratory setting before placing it inside the uterus, increasing the chances of the sperm successfully fertilizing the egg.

In Vitro Fertilization (IVF) – is a method that fertilizes an egg in a laboratory setting and then places it inside a woman’s uterus. This can be done with either donor sperm or eggs or with sperm and eggs from the infertile couple, depending upon the specific cause or causes of infertility. IVF is typically suggested when a woman’s fallopian tubes are blocked, but is also recommended in cases like unexplained infertility, cervical problems, male infertility and certain ovulation disorders.

Lifestyle changes – if medical intervention is not desired, simple lifestyle changes may also be done to treat infertility. Increasing the frequency of intercourse, eating a healthier diet and getting regular exercise are all things that may increase the chances of conception. In addition, appropriately timing sexual intercourse by tracking ovulation can increase the odds of pregnancy.

Other helpful changes for stress reduction include acupuncture and yoga.

Sleep might be a fairly important factor to consider when trying to conceive. Not getting enough of it can throw your body out of whack enough to make conception more difficult.

The physicians here at RHS encourage their patients to try to get plenty of rest. They understand that procedures like in vitro fertilization (IVF) can cause a considerate amount of stress that might have an effect on a woman’s ability to conceive. When you are trying to conceive, the excitement about getting pregnant – or the worry that you won’t – can certainly keep you tossing and turning all night!

Getting a good night’s sleep helps to keep your circadian rhythm running smooth. Your circadian rhythm is your internal clock, the one that helps to control every system in your body. The rhythm also helps to determine when you ovulate. If your body lacks sleep, it wants to protect itself, so it boosts the immune system and performs other activities that take its attention away from conceiving.

While it’s not clear exactly how much sleep deprivation might compromise fertility, it is apparent that chronic stress and obesity can lower a woman’s chances of getting pregnant. These conditions can all be made worse by sleep loss. 

What can you do to improve your sleep and your odds of conceiving?

·        Put yourself on a regular sleep schedule – go to bed and get up at the same time every day. Also, establishing a nightly routine before bed will help you relax and clear your mind.

·        Get moving – moderate exercise will reduce stress.  Working out makes falling and staying asleep easier. If you have trouble sleeping, avoid evening workouts.

·        Lose weight if your BMI (Body Mass Index) is >35 – being overweight can have a direct effect on your quality of sleep. It can lower your chances of pregnancy; not to mention other serious health problems, including heart disease, stroke and diabetes. 

In regards to sleep and conception, one thing is for certain: a good night’s sleep will not hurt your odds, it just might help. 

How will the New Health Care Bill affect coverage for Infertility treatments?

In terms of covering infertility treatments or in-vitro fertilization, none of that is made mandatory under the new bill for insurance companies.  In other words, there is no change.  However, one benefit is that insurance companies cannot deny coverage to couples who suffer from infertility because it was deemed a pre-existing condition. 

The Right Amount of Exercise

Too little exercise isn’t good for your health, but women have long been told that too much isn’t good for their fertility. Just how much exercise is the right amount in order to conceive?

Research suggests that moderate exercise can boost some women’s chances of getting and staying pregnant. Exercise can lessen the likelihood of high blood pressure and glucose metabolism problems that often interfere with fertility. Exercise can also make it less likely that complications such as preeclampsia and musculoskeletal aches and pains will occur during pregnancy.

How Exercise Can Help

Diabetes rates are rising at an alarming pace and women who have diabetes can experience problems getting or staying pregnant. Gestational diabetes mellitus (GDM) is the single most common medical complication of pregnancy. Moderate aerobic exercise, such as brisk walking, could be one of the most effective means of prevention. There is scientific evidence that exercise’s positive effect on body weight, body chemistry, and insulin resistance lowers diabetes risk. 

Exercise is now part of more and more physicians’ prescriptions for those suffering from high blood pressure. It has also been proven that moderate exercise can help women suffering from endometriosis. Being physically active can be a powerful antidote to physical and emotional pain. There is no question that exercise benefits a woman’s overall health.

The time to start working out, wherever you are in your baby-planning agenda, is now. The desire to conceive and have a healthy child should be the perfect motivation to start a healthier lifestyle!

Diet and Fertility

Maintaining a proper diet is essential when trying to conceive. Meals should be healthy and balanced, containing foods from every food group.

Organic foods, whole wheat, fruits and vegetables all help increase a woman’s chance of becoming pregnant. Protein sources, such as meat and poultry, help maintain healthy levels of iron. Low iron levels at the onset of pregnancy increase the risk of developing postpartum anemia. 

Calcium is another positive factor in boosting fertility. Dairy foods, such as milk, yogurt and cheese are good sources of calcium.  Fat-free dairy products contain the same amount of calcium as whole milk products, but have significantly fewer calories and lower levels of saturated fat. Broccoli, kale and oranges are all high in calcium. 

When choosing fruits and veggies, the brighter the color, the more nutrients the food contains. Peas, broccoli and pumpkin are excellent sources of fiber and vitamins.  Blueberries and red peppers are a good source of antioxidants. Eating foods with folic acid is also very important during pregnancy.  Oranges and lemons are excellent food sources of folic acid.

For more information and tips, please refer to our Healthy Lifestyle section on the website.

Donor Egg

Sometimes fertility issues make it impossible to achieve pregnancy without the help of an egg donor. As a result of a variety of medical conditions, a woman/couple may seek an egg donor to allow the birth of a child through in vitro fertilization (IVF).  

An egg donor can either be anonymous or a directed/known donor to the recipient patient. If a directed or known donor is selected, a legal agreement between the recipient and egg donor is required. If an anonymous egg donor is being used, no legal contract is required. The anonymous donor is required to sign a consent which includes a waiver and release, forever relinquishing any rights to any child or children born.

Our donors at RHS are between the ages of 21 and 32 and are recruited from the Western PA and Pittsburgh areas. All donors are screened for substance abuse and communicable diseases such as HIV and hepatitis. A complete medical/genetic history is obtained to gather information about the donor’s personal and family health history. Also, a written psychological evaluation, along with multiple counseling sessions, helps us to determine if an individual is an appropriate egg donor. Egg donors are screened according to FDA requirements for eligibility.

RHS strives to meet the varied needs and desires of our intended parents. The coordinators put a significant amount of time and effort into finding what we feel makes a close match. Once egg donors become available, the recipient will be notified and profiles will be sent for review. The recipient patient will have approximately two weeks to confirm.

Once the egg donor had been chosen, the intended parent(s) will begin planning the IVF cycle with a nurse coordinator.

Donor Sperm

Many couples experiencing male factor infertility may choose to undergo donor insemination (DI) in order to achieve pregnancy. During DI, the physician or nurse places donor sperm into the female’s reproductive tract near the time of ovulation. Donor insemination has become one of the most effective methods for couples with severe male factor infertility to experience pregnancy and childbirth. Patients may also choose this treatment in the absence of a male partner.

In order to decide whether to undergo donor insemination, couples need to know the cause(s) of infertility. At RHS, patients who are interested in DI undergo a thorough evaluation prior to initiating treatment. Donor insemination may be indicated if there are significantly abnormal semen characteristics and if the female appears to be fertile after a series of tests.

All sperm must be frozen and stored until adequately screened. The American Society for Reproductive Medicine (ASRM) recommends that all sperm be frozen for at least six months prior to insemination. Here are some donor sperm cryobanks that have been approved by RHS:

            California Cryobank, Inc.

            11915 La Grange Avenue

            Los Angeles, CA  90025

            (800) 977-3761

            Fairfax Cryobank

            3015 Williams Drive,    Suite 110

            Fairfax, VA  22031

            (800) 338-8407          

            Cryobiology, Inc. Sperm Bank

            4830-D Knightsbridge Blvd.

            Columbus, OH  43214

            (800) 359-4375

Don’t panic! The financial counselors at RHS are always here to provide you with information and options for financing your infertility journey. 

Yes, treating infertility can be costly. RHS does participate with several insurance plans, but infertility is often excluded from health insurance coverage. Because we know that your finances should be the least of your worries, and since we require pre-payment for all services, we meet with each couple individually to determine their best financial route right from the start. We determine what level of insurance coverage exists, and if no coverage exists, these couples are considered “self-payers.”     

For self-payers, two popular options are available at RHS beyond the traditional out-of-pocket payment (cash, check, credit card): 

1. Discounted Loan

RHS has streamlined the loan process to make IVF an affordable option. We partner with Dollar Bank to offer our patients a significant discount on loans.

1. Cost Sharing

IVF Cost Sharing is an innovative program offered by RHS which allows eligible patients to reduce out-of-pocket costs by purchasing a series of three IVF sessions in advance.

By purchasing three cycles at one time, patients pay less than they would for three individual cycles at the traditional fee-for-service rate. Please contact any RHS financial counselor to obtain the current costs for the IVF Cost Sharing Program.

RHS is always open to discussing payment options with concerned IVF candidates. If you would like any additional information on the payment options mentioned or would like to request an appointment with one of our financial counselors, please call us at 412-731-8000 or 800-318-3144.

As we all know we had an incredible snowstorm this past week. We got hit with about 18 inches in less than 12 hours.  Because RHS sees patients 7 days a week (every day but Christmas day and New Years Day) patients were scheduled for Saturday morning.  What a nightmare!  Dr. Kubik, who was on call over the weekend, got a call at 5:30 from Bernadette our embryologist, the one person who is in fact more critical than the physician, because she is the one that has to prepare the embryos for transfer.  Trees were down, roads were blocked and there was no way for her to get to RHS.  Electricity was out for the other embryologist so there was no way to get in contact with her.  Back up plans were immediately made.  Our weekend receptionist is none other than Dr. Kubik’s soon to be 80-year-old mom, Norma.  Dr. Kubik called her at 6 am (no answer) - because she was on her way to the office!! Her roads were snowy but plowed.  Everything was plowed EXCEPT the road leading to our office and our parking lot.  Undaunted, Norma drives her car (a Jeep) up the unplowed road, parks about 50 feet from the door, uses (according to her) a handbag on either side for balance, trudges through the 18 inches of snow, hauls the back door open, makes a pot of coffee and gets to work.   Of the 8 people scheduled to work, 5 people made it so a big thanks to each of them.

By the time everyone was ready to leave (and after some calls to our landlord about plowing the parking lot), the snowplows had arrived.  Thank goodness, because in the meantime, we got 3 more inches of snow and the plows had to dig each of the staff out one by one.

We had one patient that actually made it into the office, what a trooper! The embryologist did end up making it in to tend to the embryos and RHS was back to a normal routine by Sunday morning.

Everyone made it home safe and sound.

Ahhh, Valentine’s Day.  It’s considered the most romantic day of the year, but if you and your significant other are dealing with infertility, it may be harder to get in the mood.  Let cupid’s arrow strike and turn this Valentine’s Day into a day of hope, health and happiness.

Here are a few suggestions for you and your loved one on Valentine’s Day (or any other day for that matter) on ways to keep your relationship healthy:

1.      Schedule a non-fertility date.  On this date, neither of you are allowed to talk about children, infertility, medical treatments or anything to do with what you’re going through.  Consider going to dinner and a movie; or, cook a dinner for two and decorate the room with heart-shaped candles.

2.      Bring spontaneity back into sex.  What about making reservations at a hotel for this Valentine’s Day? But remember not to discuss fertility before, during or after!  The key to this is to make it so spontaneous and fun that you banish the work that sex has become.  A simple “I Love You” with a kiss can set the mood.

3.      Communicate the positive.  Try putting limits on the time you talk about infertility so that it does not overtake all of your communication.  Reassure your partner that you are both in it together.  Tell your loved one how you feel about them and why you want to have a child together.

4.      Keep a sense of humor.  No matter how tough things get, being able to find something humorous about the situation helps to relieve tension.  Laughing together is good for the health of your relationship. 

5.      Consider getting professional insight.  Even if you think your relationship will weather the infertility storm, it’s still a good idea to consider talking to a couples therapist or joining a support group for people going through infertility treatments. 

For more information:

·         RESOLVE – www.resolve.org

·         American Society for Reproductive Medicine - www.asrm.org