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The nation’s largest fertility network expands its footprint. IntegraMed Fertility^®  has announced that Reproductive Science Center of New Jersey (RSC-NJ) has joined their Attain Fertility® Network.  As an affiliate member of the network, RSC-NJ now offers the Attain® IVF Programs, to RSC-NJ’s patients which can increase their patients’ chance of having a baby while saving them up to 40% off the cost of their IVF treatment plan.

RSC-NJ has three fertility treatment centers located in Eatontown, Toms River, and Lawrenceville that combine a commitment to sensitive care with a state-of-the-art program to treat male infertility and female infertility. As a leading provider of advanced reproductive technologies, RSC-NJ established the first successful egg donor program in central New Jersey.  They provide comprehensive care and all of the latest infertility treatments, ranging from in vitro fertilization and artificial insemination to drug therapies and tubal ligation reversal. The onsite embryology lab provides a wide range of services, including semen analysis, sperm and embryo cryopreservation, preimplantation genetic diagnosis (PGD), and intracytoplasmic sperm injection (ICSI).

RSC-NJ’s specialists, Dr. William Ziegler and Dr. Jessica Salas Mann, were recently recognized as 2013’s “Top Docs” for their commitment to excellence in reproductive medicine and infertility by NJ Top Docs, New Jersey’s Total Healthcare Resource.

“While providing the very finest, most accessible reproductive medicine to our patients is imperative, we believe that the most important quality a facility can offer is genuine concern and understanding for our patients’ emotional needs through this stressful time. Now as an affiliate of the Attain Fertility Network we are able to help reduce that stress further by giving our IVF patients access to a program that helps them commit to their treatment plan while controlling costs,” said Dr. William Ziegler, DO, FACOG, Medical Director of RSC-NJ.

“We are very happy to welcome RSC-NJ into the Attain Fertility Network. They have helped so many people realize their dreams of becoming successful and happy parents. We feel that by providing them access to our full-service marketing services and turn-key Attain IVF Programs, physicians and staff at RSC-NJ will be able to focus on what they do best: provide superior patient care and clinical outcomes,” said Doug Weiss, SVP, Sales and Marketing of IntegraMed Fertility.

With the addition of RSC-NJ, the Attain Fertility Network now comprises 39 centers in 152 locations across 34 states and the District of Columbia. One in four IVF procedures in the U.S. each year is performed by a physician in the Attain Fertility Network.

Marcia Clark is the Managing Partner of Shameless Promotions, LLC, a full service Public Relations and Communications firm based in the Lower Hudson Valley of New York. Shameless Promotions provides public relations services to the Attain Fertility Centers division of IntegraMed America, Inc.

Many women experience fibroids, benign growths of the uterine muscle. Fibroids can affect fertility, pregnancy, and childbirth. At times, they can even cause pain and bleeding. Today, we explore what to expect with fibroid removal in our Attain Fertility video series.  

Fibroids Explained

The Benefits of Fibroid Removal

Recovery Time After Fibroid Removal

Robotic-Assisted Laparoscopy

Meet Dr. Susan Willman

Dr. Susan Willman is a leading reproductive endocrinology and infertility specialist at the Reproductive Science Center of the San Francisco Bay Area.

The New SART numbers are here! The New SART numbers are here! 

Each year the Society of Assisted Reproduction Technologies (SART) publishes the success rates of over 375 infertility clinics in the United States. Just a few months ago the 2011 data were released on SART’s website. Why 2011 when it’s now 2013, you ask? The most recent numbers are always 2 years behind due to the time it takes to gather the information as well as the 9 months it takes to grow a baby!

The reports are exciting to look at for both the doctors and patients alike. For doctors, it is a time when we can see how we are doing compared to the rest of the country. Patients can also use the information to compare clinics’ success rates and get an idea of their chances of pregnancy based upon their age. The report is publicly available and free for everyone to see.

There is a lot of information jam packed onto one page. Although it may seem confusing at first, really its just a few simple parameters looked at in different ways. I’ll walk you through step by step.

The first two sections give you the option to search the information throughout the past several years and give the basic breakdown of the types of patients and procedures encountered at the fertility clinics.

For most new patients the middle section is where they will want to focus. These are the success rates for women undergoing fresh IVF cycles using their own eggs separated by age groups. Although it is tempting to look at the “percentage of cycles resulting in pregnancies” as the most important number, really it is the “percentage of cycles resulting in live births” that is the most meaningful. This is the number that best reflects the success rate you can expect to take home a baby.

SART further breaks down IVF success rates by looking at different stages of an IVF cycle. Once an IVF cycle starts, not all patients will make it to egg retrieval (the percentage of cancellations shown further down reflects these patients). Likewise, not all patients undergoing egg retrieval will have embryos to transfer. The percentage of retrievals and transfers resulting in live births only looks at those patients making it to those specific stages.

Elective single embryo transfer is when a woman who has more than one embryo to choose to place back only chooses one in order to decrease the chance of twins (or triplets). Higher numbers usually indicate a more successful clinic because they can maintain their success while having the confidence of putting only one embryo back. Likewise, a more successful clinic will tend to have a lower number of embryos transferred. This is also reflected in the implantation rate: the chance that each individual embryo transferred has of becoming a pregnancy. Obviously, the higher the number the better.

The twin and triplet rates are self-explanatory. If you look through the years you will notice that triplet rates have dropped dramatically! This is fantastic because triplet pregnancies are at high risk for complications. Twin pregnancies are also high risk and are now one of the main areas of improvement we are working on. (This will, no doubt, be a topic of many more blogs!)

The next section is much simpler and shows the success rate of women who have, again, used their own eggs. However, these eggs were frozen during a previous cycle and thawed for transfer during a new IVF cycle. Higher birth rates with lower number of embryos transferred indicate a successful freezing program.

Finally, the last section looks at the success rate of fresh and frozen IVF cycles for women who have used donor eggs from another woman. Although these cycles are not categorized at by age, most egg donors are less than 35 years old and, generally, have the highest success rate. Again, a higher birth rate with fewer embryos transferred is better. Since donors often come from around the country and are similar from clinic to clinic, many people consider these numbers the most indicative of a program’s overall quality.

Although making SART outcome comparisons between clinics is difficult because of large differences between patient populations, I always give my patients the SART web address so they can get an overall picture of what to expect for a single cycle success. Remember, these numbers give averages for all patients and your success rates may differ based on other factors. Nevertheless, this is a great place to start on your journey for IVF.

Dr. Evan Rosenbluth is a board-eligible Reproductive Endocrinologist at the Reproductive Science Center of the Bay area. After completing his training at Tulane University, Dr. Rosenbluth performed extensive award-winning research studying genes that affect endometrial gland formation as well as non-invasive methods for determining embryo implantation potential. His areas of interest are minimally invasive, fertility-sparing surgery (including robotics), elective single embryo transfer, fertility treatment for people with disabilities, and developing biopsy-free methods for selecting healthy embryos. 

Answer: Recurrent miscarriages are a deeply felt loss. When we feel so sad or even discouraged, it is hard to hear even the waiter who happily exclaimed “Happy Mother’s Day” as you walked into a restaurant. After all, everywhere you look on Mother’s Day, there seem to be smiling, happy faces. To take care of yourself this Mother’s Day, plan ahead. Here are some suggestions to help you this Mother’s Day and during other difficult times throughout the year.

-Don’t put yourself in painful situations such as going out to a Mother’s Day brunch or attending Mother’s Day dedications at church. It’s not that you shouldn’t do those things for the rest of your life, but kindly declining may be the best way to protect your heart from difficult situations as you maneuver through this phase.

- Don’t spend Mother’s Day hosting a pity party by yourself. It’s a wasted day that you’ll never get back. Instead, plan an enjoyable day together with your partner. It is important to work as a couple during these difficult days. Consider tuning out the holiday emphasis entirely and make it an opportunity for a fun day together. See that movie you’ve wanted to see together or create a special meal together.

- Do plan an escape and make it your very own tradition. Go for a hike, to a movie, or the beach. Try a new exercise class at the gym, or pick out some new flowers from the nursery and spend the afternoon in the garden. Whatever it is, pick an activity where the focus is not on Mother’s Day but on something that you enjoy, something rejuvenating, and something that positively lifts your spirits naturally, away from the standard Mother’s Day reminders.

- Do spoil someone deserving. It truly is greater to give than to receive. Serving others will leave you little time to focus on yourself while giving you a sense of purpose. So instead of going to Mother’s Day brunch, plan to cook a nice lunch for someone you admire (your mother, mother-in-law, or another special person in your life)

- Do acknowledge your miscarriages. Talking about your loss is another important part of grieving.

- Do count your blessings. Literally count your blessings by listing them on a sheet of paper. You will realize that you are showered with goodness day after day. Think about family, friends, and faith and how your life is enriched by each one of these. Remember that there is always something for which to be thankful.

Whatever combination of coping strategies you chose…please do remember to be kind and loving to yourself on Mother’s Day.

Dr. Ariadna Cymet Lanski is a clinical psychologist who offers psychological services to meet the unique needs of individuals and couples coping with fertility challenges at the Fertility Centers of Illinois. She leads FCI’s Women’s Support Group, provides consultation during various stages of fertility treatment and conducts egg donor assessments. Dr. Cymet Lanski’s clinical practice specializes in reproductive health issues -from preconception, pregnancy, and postpartum adjustment to parenthood.  Dr. Cymet Lanski helps patients to manage stress and feel empowered about their choices. Dr. Cymet Lanski is a graduate of the Universida De Las Mareicas (BA in Psychology) and Illinois School of Professional Psychology (M.A., Psy.D. in clinical psychology). She completed her doctoral internship at Illinois Masonic Behavioral Health, and received post-internship training at Swedish Covenant Hospital, and postdoctoral training at Chicago’s Institute for Psychoanalysis.

Answer: Having a miscarriage is a significant loss and a devastating experience. Hopes and dreams of a baby are snatched away so suddenly. One moment there was a baby growing inside of you, and the next one the baby is gone. And as with any loss, you must grieve. In your case, this Mother’s Day might be particularly painful as it also marks the first anniversary of your loss (the first year after a loss is particularly painful and difficult). Will next year or the year after be better? Probably “ it usually does get better. You will never forget, but it will be easier to deal with someday. And don’t forget you’re still a mother too, even if your baby isn’t here with you.

Here are some ways that you can cope when Mother’s Day rolls around.

1. Spend time talking with your partner about your loss and what the baby meant to both of you. There is great healing when a couple can talk together about their baby. Also, talking about your loss is another way of allowing yourself to “feel” like you are a mother. Validation is an important part of the grieving process.

2. If you have not named your baby who was lost to miscarriage, Mother’s Day is a great day to think about doing this. There is healing in giving your child a name. You or your partner might not be ready to do this, or you might not see a reason to name a miscarried child. But sometimes we need to hear words other than “it”, “tissue”, or “fetus”. There is something very special when a mother can call her child by name. And you can keep the name in your heart forever.

3. Mother’s Day is not a day to mask your feelings. Give yourself permission to do what feels best for you to do. Take some time for yourself today, cry if you have to, and consider doing something to honor your baby. For example, write a letter to your baby, or plant a flower. This symbolizes that you will never forget the baby that was lost.  You might want to plan for a balloon release on Mother’s Day, giving your baby permission to “be away” while you remain the baby’s mother.

Use any and all combinations to cope on Mother’s Day after you have had a miscarriage. My thoughts are with you and all of the other mothers out there who are going through this right now.

Dr. Ariadna Cymet Lanski is a clinical psychologist who offers psychological services to meet the unique needs of individuals and couples coping with fertility challenges at the Fertility Centers of Illinois. She leads FCI’s Women’s Support Group, provides consultation during various stages of fertility treatment and conducts egg donor assessments. Dr. Cymet Lanski’s clinical practice specializes in reproductive health issues -from preconception, pregnancy, and postpartum adjustment to parenthood.  Dr. Cymet Lanski helps patients to manage stress and feel empowered about their choices. Dr. Cymet Lanski is a graduate of the Universida De Las Mareicas (BA in Psychology) and Illinois School of Professional Psychology (M.A., Psy.D. in clinical psychology). She completed her doctoral internship at Illinois Masonic Behavioral Health, and received post-internship training at Swedish Covenant Hospital, and postdoctoral training at Chicago’s Institute for Psychoanalysis.

She broke the bread into two fragments, and gave them to the children, who ate with avidity. “She has kept none for herself,” grumbled the sergeant. “Because she is not hungry,” said a soldier. “Because she is a mother,” said the sergeant. – Victor Hugo

The other day I ran into another one of those patients that always makes me smile when I see her. She brought me up to date on what was happening in her life. It was a story of debilitating pain and multiple surgeries to try and relieve the pain. Instead of relief she developed a tumor in the area that required more surgery. In the end she was still in just as much pain and on chronic medications for it. I expressed my heartfelt sympathy for what she has had to go through. She smiled and said she’s fine and that she is almost off of the pain medications because she is planning to come to see me soon to try to have another baby. She was coming off of the medications not because she didn’t have pain, she was coming off of the medication because she wanted to have another baby. I looked into her eyes “ and her smile and realized I am a better person for knowing her.

Mother’s day is upon us. It is not that welcome of a holiday for many of my patients. Gifts passed out at church or given by a well meaning spouse do little to fill the void of yearning that brings them to my office. We hear stories about the great love, sacrifice and courage that mothers have for their children, but little is said about the incredible love, sacrifice and courage of my mothers-to-be.

It takes incredible courage to acknowledge that there is even a problem. We all want to believe that we are in control of our lives and to acknowledge that there is a fertility problem is to internalize a lack of control over this incredibly sensitive part of their lives.

It takes courage to seek medical attention. No one likes to see doctors (I’m over a year late for my colonoscopy), and the trip to the fertility doctor is a particularly difficult journey.

It takes courage to undergo procedures that are not comfortable and are in an area where discomfort is particularly unwanted.

It takes courage to face the possibility of disappointment. Studies have shown that when a woman experiencing infertility has a period, indicating that once again she is not pregnant, she experiences the same degree of grief as if her brother or sister had just died. Most of us will go through that only once or twice in our lifetime. Imagine going through that every month for years. Then imagine going through a specific procedure to get pregnant and having it not work.

It takes courage to hope that it will work the first time and proceed , and even greater courage to experience a failed attempt and then turn around and have the courage to hope again.

These women undergo great sacrifices.

They sacrifice the intimacy of what was supposed to be a wonderful and intensely personal experience with their partner for a doctor’s office.

They sacrifice time on often repetitive visits for monitoring and procedures.

They sacrifice financial resources as they struggle to have something that everyone around them seems to receive without thought and sometimes with disdain.

They sacrifice personal comfort, sometimes thinking that if they experience pain, they will be more worthy of the gain they so desperately seek.

Why? Why do they do this? They do this for the same reason the mother gives her bread and goes without. They do it for love. The only difference is that they do it for a deep abiding love for a child that they have not yet held, a voice they have not yet heard, a smile they have not yet seen, and a touch they have not yet felt.

My smiling patient had experienced infertility for 10 months when she came to see me. It was clear that each passing month was difficult. She had endometriosis and her husband had a sperm problem. We unfortunately discovered that her biological clock was more advanced than it should have been. When two months of inseminations failed, she went immediately to IVF. She required high doses of medication to produce 9 eggs but only made 4 embryos. One of them would be her beautiful baby boy.

Sixteen months after delivery, she was back for a brother or sister. She did IVF again. Similar story with a positive pregnancy test but then the pregnancy hormone dropped, leaving her with what is called a biochemical pregnancy. The pain from her medical condition had reached a peak and she had to stop infertility treatment to pursue that. She returned two years later after many surgeries and no relief in her pain with the intent to continue but could not. She returns now two years later having experienced a tumor where her pain surgeries had been and having had an additional 7 biochemical pregnancies and she still wears a smile. She is the epitome of the courage, sacrifice, and love that characterizes mothers in general and the mothers-to-be that I have the privilege of associating with every day.

To the mothers and mothers-to-be everywhere, Happy Mother’s Day.

Drew V. Moffitt, M.D., FACOG, is the co-medical director of the Arizona Reproductive Medicine Specialists (ARMS), the director of the Division of Reproductive Endocrinology and Infertility at Good Samaritan Regional Medical Center and an assistant professor at the University of Arizona. He is now president of ARMS and director of the Division of Reproductive Medicine and infertility for the residency program at Good Samaritan Regional Medical Center. Dr. Moffitt has significant clinical experience in assisted reproductive technologies and reproductive surgery.

Photo by Stephanie Himel-Nelson.

By Dr. Marcus Jurema

Stress, especially chronic stress, is likely to play a negative role in fertility. When a couple tries to conceive, lack of sleep or stress at work or home may decrease the chances of having effective intercourse (at the time of ovulation), decreasing the chances of pregnancy. If this goes on for a prolonged period of time, couples begin to worry about being infertile, which in turn leads to more stress.

A woman’s reproductive system is quite advanced but it is tied to her brain via hormones in a relatively pre-historic way. In other words, if the female brain translates any external stimulus as “stressful” it goes into survival mode and secretion of reproductive hormones takes a back seat. Having said that, it is impossible to know if someone’s fertility is actually being hindered by stress unless clear signs are noticeable, like significant menstrual cycle abnormalities.

Stress is a very broad term because it comes in different flavors and has a variable effect on people. Stress is any stimulus that can cause mental or physical tension. However, two different people may respond to the same stimulus very differently depending on the intensity, circumstances and prior experiences.

When it comes to maximizing conception potential, human nature requires the female body to be in a relaxed, as opposed to a stressed-out, state. Take, for example, a common situation where a woman training for a marathon with intense aerobic exercise (here considered to be the stress factor) may notice her menstrual cycles becoming abnormal or infrequent. This is a sign of the brain interfering with the hormones that produce ovulation in an effort to prevent reproduction. Why? Because the intense running could be a result of survival tactics to escape a wild animal, for all the brain knows!

Emotional stress can be as powerful as physical stress when it comes to ovulation. For example, a young woman with regular menstrual cycles leaves home to go away to college. She may start to experience irregular menstrual cycles due to the stress of the new environment. Similarly, women making career changes or leaving home to explore a different culture or society in a foreign country may also experience similar menstrual disturbances.

Can stress reduction help you get pregnant?
Reducing stress may improve the ability of a couple to conceive, especially when trying to get pregnant naturally. Stressful factors may snowball from a simple problem to something that eventually becomes bigger and may start keeping us awake at night. Lack of sleep is a type of stress that causes circadian rhythm disturbances, which in turn can deregulate many of the hormones involved in reproduction. In addition, stress increases secretion of other non-reproductive hormones such as cortisol and prolactin, which can also affect fertility issues. Thankfully, for the most part, our body is able to adjust to some of these issues but chronic exposure to stress may lead to long-term problems.

Because avoiding stress is nearly impossible, managing it is the key. We all process stress differently and it has unpredictable effects on our biological functions. We must somehow channel this negative energy. There are several techniques designed to do this, including:

• Exercising in moderation
• Yoga
• Acupuncture
• Massage
• Talk therapy

To reduce stress, first make sure you are getting a good night’s sleep. Everyone is different, so try to find something that works for you.

Dr. Marcus Jurema, fertility specialist at IVF New Jersey Fertility Center, received his medical degree from Stanford University School of Medicine and completed residency at The New York-Presbyterian Hospital, Weill Medical College of Cornell University, NY, NY. In 2003, he completed a fellowship in reproductive endocrinology and infertility at The Johns Hopkins Medical Institutions. After his fellowship, Dr. Jurema accepted an academic position at the Brown University Medical School as a Clinical Assistant Professor of Obstetrics and Gynecology, Division of Reproductive Medicine and Infertility of The Women and Infants’ Hospital of Rhode Island and became the Director of the Fertility Preservation Program and co-director of the Donor Egg Program. Areas of interest include the In Vitro Maturation (IVM) of Oocytes Program, a new technology allowing eggs to mature outside of the woman’s body, oocyte (egg) freezing, reproductive tract abnormalities, and improving IVF outcome for women with a low egg reserve.

Have HOPE even after a failed IVF cycle:

• Have hope even after abnormal lab tests
• Hope, even when IVF is not recommended
• Share hope by donating your frozen embryos to others

Dr. Mary Hinckley is a leading reproductive endocrinology and infertility specialist at the Reproductive Science Center of the San Francisco Bay Area. She has extensively published articles in peer-reviewed journals on blastocyst transfer, avoiding triplet pregnancies, monozygotic twinning, operative hysteroscopy, correction of uterine anomalies, and biochemical pathways involved in ovulation and fertilization. She serves as a member of the Society for Reproductive Endocrinologists, the Christian Medical and Dental Society and the American Society for Reproductive Medicine. Her areas of interest include laparoscopic surgery, premature ovarian failure, oocyte freezing, and recurrent pregnancy loss. Dr. Hinckley offers infertility education on YouTube.

Attain Fertility is focusing our efforts on building hope within the infertility community for National Infertility Awareness Week April 21-27, 2013.

Join us and share your thoughts on hope. 

By Dr. Estil Strawn

One of the most important things I try to explain to the overwhelming majority of my patients is this: women and men are generally not sterile or incapable of having children naturally (of course, there are some very rare exceptions). Having said that, there are some women without a functional uterus, ovaries, or fallopian tubes. There are also men that lack the appropriate anatomy to get a woman pregnant. For these individuals, having children naturally will not be possible.

In other words, I believe that the term infertility is overused. I prefer to use the term sub fertility for most of my patients. Sub fertility allows for hope. Sub fertility means that some couples will take much longer to get pregnant when compared to others.

Fertility treatments may help to improve the chances of pregnancy for sub fertile couples in a shorter time frame. At times, fertility treatments may even dramatically improve the likelihood for success, even though it still may take a couple multiple attempts to have a child. I like to inspire hope with all my patients and emphasize that with all of the options now available, including adoption and foster care, everyone should be able to have a family.

Estil Y. Strawn, Jr. M.D. is doubly board certified in Reproductive Endocrinology and Infertility and Obstetrics and Gynecology. He is the medical director of the Froedtert and Medical College of Wisconsin Reproductive Medicine Center. Dr. Strawn is also full professor with tenure at the Medical College of Wisconsin where he serves as the director of the division of Reproductive Endocrinology and Infertility in the department of Obstetrics and Gynecology. Dr. Strawn blogs monthly with Attain Fertility. Dr. Strawn has been helping patients overcome their fertility problems for 19 years, and has directed a center that is one of the largest providers of fertility services in the state of Wisconsin. This center provides some of the most advanced types of technologies in the country including pre implantation genetic diagnosis (PGD), egg freezing, egg and embryo donation, gestational carriers, as well as robotic surgery for uterine fibroids and reversal of fallopian tube sterilization.

Attain Fertility is focusing our efforts on building hope within the infertility community for National Infertility Awareness Week April 21-27, 2013.

Join us and share your thoughts on hope. 

They had hoped and prayed for this moment. It took time and patience, tears and disappointments, but mostly it took a hopeful optimism and faith that they would be here at this moment, sharing in the joy of seeing their future son or daughter for the first time, their tiny happy dancer.

It is a special privilege and gift that I can share this moment with my patients¦to see their efforts pay off, to watch with them in awe and amazement as a new life dances to its own happy rhythm.

Several months from now a new son or daughter will be born, another dancer in our world. And as we sit in awe watching ¦.the dance is just beginning¦.the arms and legs will move and the tiny heart will beat millions of times in the decades ahead, beating out a constant tempo¦.the beat, beat, beat…the amazing dance of life!

I am happy to share my amazement with you¦.and I look forward to your own special moment – when you first see your happy dancer.

Mark D. Johnson, M.D. has practiced reproductive medicine and fertility in the Phoenix valley since 2000. He came to Phoenix with an extensive professional experience in reproductive medicine. His background is unique in that he is both an experienced reproductive endocrinologist and infertility specialist and a clinical geneticist. He is Board Certified in Obstetrics and Gynecology with subspecialty Certification in Reproductive Endocrinology-Infertility and is Board Certified in the specialty of Medical Genetics. To make a consultation with Dr. Johnson at Arizona Reproductive Medicine Specialists, call (602) 281- 9032.

Attain Fertility is focusing our efforts on building hope within the infertility community for National Infertility Awareness Week April 21-27, 2013.

Join us and share your thoughts on hope.