PHYSICIAN PROFILE

HEALTHCIRCLE

AMH TESTING

FERTILITY MEDS SAFETY

FERTILITY 101 VIDEOS

Using Acupuncture to enhance your fertility treatment plan

AMH levels and how it might impact your decision of when to start a family

David Schmidt, MD addresses this subject in-depth. It's a must read!

Claudio Benadiva, MD has been awarded "Best Doctor in America"

every year since 2001

Educational videos featuring our doctors with answers to some of the

most commonly asked questions

How do you spot a complicated syndrome? Follow the clues.Polycystic Ovary Syndrome: What it is, and what your doctor can do about it.It’s a fairly common syndrome. In fact, 5-10% of women have it. And, it can contribute to infertility. But here’s the thing … not everyone has the same symptoms. So, to determine whether you have Polycystic Ovary Syndrome (or PCOS), your doctor has to follow the clues to look for a combination of problems.

Volume 1 Issue 3 Autumn 2016

(cont. inside)

YOU NEED TWO OF THE THREE

To be diagnosed with PCOS, you need to exhibit two of the following three symptoms:

1) A chronic lack of ovulation (anovulation)

2) A chronically high level of the hormone testosterone (hyperandrogenism)

3) Multiple small cysts on your ovaries (polycystic)

So, how can your doctor determine whether you have PCOS?

UNCOVERING DIFFERENT CONDITIONS REQUIRES DIFFERENT METHODS

To determine whether you have “two of the three,” your doctor will need to do a variety of things. First, you’ll need to have a physical exam and go over your menstrual history with your doctor. You’ll also need to have a transvaginal ultrasound. And, you’ll need to have some blood work done. These three diagnostic methods will help determine whether you have the conditions that add up to PCOS.

Even though not everyone has the same symptoms, there are some commonalities among women who are diagnosed with PCOS. For example, women with PCOS typically report having irregular menstrual periods. They may skip a period, or go a long time between periods. Other commons signs include being obese, having increased hair growth, or having problems with excessive acne.

Ultrasounds typically reveal that women with PCOS have enlarged ovaries with a number of small cysts. High levels of blood sugar, cholesterol and testosterone (the “male hormone”) are also commonly found in the blood tests of women with PCOS.

ARE THERE RISKS TO HAVING PCOS?

Absolutely. Besides making it difficult to get pregnant, there are health risks associated with irregular ovulation.

Studies reveal that over 50% of women with PCOS will

develop diabetes (or pre-diabetes) before they’re 40. Women

with PCOS are at greater risk for developing high blood

pressure, having increased levels of “bad” cholesterol (LDL)

and lower levels of “good” cholesterol (HDL), as well as having

a heart attack. Women with PCOS are also at risk for sleep

apnea, anxiety and depression.

The hormonal irregularities associated with PCOS can also

put patients at increased risk for developing endometrial

cancer (the endometrium is the lining of the womb). When

menstruation and ovulation are irregular, women still

produce the hormone estrogen. But, they do not produce

progesterone, the hormone that causes the endometrium

to “shed” each month creating a woman’s period. Without

progesterone, over time the lining of the

womb can become too thick, causing

heavy or irregular bleeding. If the lining

grows too much, the patient can

develop endometrial hyperplasia,

or eventually, cancer.

If you’re diagnosed with

PCOS, talk with your

doctor about steps you can

take to reduce your chances

of developing long-term health

problems. For example: If you eat

right, exercise more, reduce your

weight and quit smoking, you can give

your body a better chance of developing

a more regular ovulation pattern.

CAN YOU BE TREATED FOR INFERTILITY IF YOU HAVE PCOS?

You can. In fact, our physicians will offer you a variety

of treatments that will maximize your chances of getting

pregnant. In addition to the lifestyle changes mentioned above,

our specialists might recommend oral medications that induce

ovulation, or fertility medicines that are taken by injection.

In Vitro Fertilization (IVF) may be the best option for you.

Whatever form your treatment takes, you can be assured that

we will “follow the clues,” work with you, explore all the

options, monitor you carefully, and give you the best chance

of realizing your dream.

Studies reveal that over 50% of women

with PCOS will develop diabetes (or

pre-diabetes) before they’re 40.

Polycystic Ovary Syndrome(cont. from page 1)

Autumn 2016

Considering acupuncture to enhance your fertility

treatment plan?

An ancient Chinese medicine treatment, acupuncture relies

on the strategic (and painless!) placement of tiny needles to stimulate certain key “energy points” believed to regulate spiritual, mental, emotional and physical balance. And, for many women, both pre and post embryo transfer acupuncture have been shown to help with fertility in many ways.

These treatments are available on site at the Center with Helen BetGivargis for both women and men undergoing treatment. Helen has the unique experience of having had 15 years experience as an IVF embryologist before becoming a certified acupuncturist and she has trained with numerous fertility experts in the field of acupuncture, Chinese medicine, and functional medicine approaches to fertility.

Acupuncture Director of the IVF Laboratory and a lead physician,

Dr. Benadiva is among very few physicians who are

certified by the American Board of Bioanalysis as a high

complexity laboratory director and board certified in a

specialty, making him uniquely suited to integrate both

clinical and laboratory protocols in an IVF program. In

addition to numerous awards and recognitions, he has

also been awarded “Best Doctor in America” every year

since 2001. He continues to lecture nationally and

internationally, with a special interest in ovulation

induction for IVF, PGD, and methods for prevention

of ovarian hyperstimulation syndrome.

As a native Spanish speaker, Dr. Benadiva welcomes

the opportunity to care for those for whom English is

not their native language.

“Our wide range of services and focus on clinical

excellence let us treat couples worldwide. In our

specialty, the world becomes very small and

distance is no longer a barrier to good care.”

Meet Dr. Claudio Benadiva

An estimated

36% of U.S. adults use some form of

complementary and alternative medicine.

So what makes our nurses special? The best way to find out is to listen to what our patients have to say: “We are so blessed that you were a part of our journey to parenthood and helped us make our miracles come true!”

Our nurses are truly dedicated and compassionate professionals who understand the stresses of infertility treatment and the importance of emotional support, a helping hand, and being available to our patients for follow-up and discussion.

OUR NURSES

♥♥ ♥ ♥♥ ♥♥

Autumn 2016

Sharing Our Patients’Love“Thank you doesn’t begin to cover the emotions and gratitude that I feel.” “ Your team combined everything I

needed and made my dreams come true.”

We are proud to have contributed to the births of over 12,000 babies! Thanks to all our patients; for your notes and especially your photographs!

Women are born with their lifetime supply of eggs, and these gradually decrease in both quality and quantity with age. Anti-Mullerian Hormone, or AMH is a hormone that generally is a good indicator of ovarian reserve. Ovarian reserve is the term used to describe the number of good quality eggs left within a woman’s ovaries.

AMH levels are determined through a simple blood test, and unlike other hormones, levels do not vary significantly through the menstrual cycle. Women with diminished ovarian reserve can have diminished fertility and an increased risk of miscarriage. If you have a low number, it’s important to know early on so you can make decisions on when to start having a family and when to access assisted reproductive technology if required.

The Center is offering free AMH testing at our Free Fertility event, Saturday, October 29th from 10-2. More information and sign-up is available on our website at uconnfertility.com

Have you seen our new educational

videos?Our YouTube channel is full

of videos with answers to some of the most commonly asked

fertility questions.

�� ��101

Andrea J. DiLuigi, MD

"HSG & Sonohysterography"

Lawerence Engmann, MD

"What is the AMH Test?"

John C. Nulsen, MD

"Is IVF Safe for Moms & Kids?"

Ami Chokshi

"What Happens at the First Visit?"

Why Test For

AMH Levels?

Are Fertility Medications Safe?

Featuring Dr. David Schmidt

Fertility treatment typically involves a good amount of medications. What are they and are they safe? Dr. Schmidt addresses these questions.

What fertility medications are commonly used in fertility treatment?

There are several medications we can use that are very safe. The most common come in a pill form such as clomid or letrozole. The pill form medications work by different mechanisms but they basically work indirectly and help stimulate the ovary more efficiently and more effectively to recruit follicles.

The other types we use are injectable gonatropins which are protein hormones that are normally secreted from the brain to stimulate the ovary to recruit eggs or follicles. We use these in a controlled fashion to directly stimulate the woman’s ovaries safely with careful monitoring so we can recruit multiple follicles for certain types of fertility treatments.

What are some of the potential side effects of fertility medications?

The medications are very safe, have been well studied, and have not been shown to increase any risks of ovarian or breast cancer. One of the potential side affects of gonadtropins is an overstimulation of the ovaries so they do require a specialist to monitor the growth and development of these follicles. This typically consists of ultrasounds so we can measure the size and the number of follicles. This allows us to stimulate the ovaries safely and effectively and optimize chances of success.

☞

Read more on our Facebook page @uconnfertility

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Being Jewish and InfertileVery simply, Judaism revolves around children. The first words spoken to a couple is the first Jewish mitzvah: have kids. But in

fact, Sarah, one of the Hebrew bible’s most important matriarchs, was infertile for much of her life.

Infertility is not just a Jewish problem. Infertility crosses all ethnicities, all religions. But Jewish beliefs and practices can place an extra strain on the couple facing infertility.

For many, numerous issues surrounding fertility treatment need to be addressed before any testing or treatment begins. And, numerous issues continue to require halachic attention after the treatment itself concludes. Jewish law informs decisions both in and out of the laboratory or clinic: Is seeking or providing treatment a “Jewish” thing to do? Is IVF permitted? Can egg donors be used? Interestingly enough, a law was recently passed in Israel that allows women to donate their eggs for infertile couples.

At the Center, we work with numerous local resources to help individuals and couples of all religions, respecting and understanding that religion plays a prominent role in people’s decisions relating to fertility treatment.

Your 40th birthday doesn’t have to be the end of

a dream. Connecticut now has an updated insurance mandate. For policies sold or renewed after January 1, 2016, the previous age limit has been revoked, expanding coverage to women over 40. This mandate applies to health insurance plans subject to state regulation.

“If you in the past thought that door was closed to you, that door is now open,” stated Kate Weldon LeBlanc of Resolve New England. However, the law has many limitations and exemptions. Because of these variables, costs for infertility diagnosis and treatment for couples in Connecticut can be minimal or substantial. For more details go to our website for specific links to the documents addressing the insurance mandate. The only way to determine your particular coverage is to work closely with your particular insurance carrier and examine all angles of your plan. Our Insurance Program Coordinators can help you with this as well.

40+The End to the Ticking Clock

uconnfertility.com

Alison Bartolucci, Operational Lab Director, talks about the difference between a blastocyst and a day 3 embryo and why one would use one or the other during IVF.

WHAT IS A DAY 3 EMBRYO AND WHAT IS A BLASTOCYST?

A day 3 embryo is an embryo in the 3rd day of development. An embryo goes through multiple stages during its development in the lab, and an embryologist will monitor this very closely. She is looking for the number of cells, the quality, the size and the shape of the cells in order to come up with a score from which she can select the best embryos. On day 3 we like to see 8 cells that should be about the same size and shape.

A blastocyst is an embryo on day 5 of development. And so much happens between day 3 and day 5. By the time it gets to day 5 it's significantly bigger than it was on day 3 and has hundreds of cells that are nearly impossible to count. These cells have started to organize themselves into two specific types; one becomes the placenta, the other becomes the fetus.

WHAT ARE THE BENEFITS OF BLASTOCYST CULTURE AND TRANSFER?

The benefits of blastocycst culture and transfer are that we know that not all embryos will make blastocysts but the ones that do have the highest potential for becoming a baby. By leaving the embryos in culture until day 5 we are able to use that as a selection tool to select the best embryo to transfer.

IS IVF WITH BLASTOCYST TRANSFER RIGHT FOR EVERYONE?

Blastocyst culture and transfer may not be for everyone because it's a tool that we use to select embryos for transfer. If a person only has one or two embryos, there’s no need to grow them out and make a selection. In fact, we may want to transfer them earlier on day 3 to get them back into the natural environment as soon as possible.

INSIDE OUR LAB

An academic affiliate of UCONN School of Medicine

uconnfertility.com

844.HOPEIVF

FARMINGTON

2 Batterson Park Road

Farmington, CT 06032

(844) 467 3483

NEW LONDON

4 Shaws Cove

Suite 201

New London, CT 06320

(877) 860 8044

HARTFORD

50 Columbus Blvd.

Suite 2

Hartford, CT 06106

(860) 525 8283

The Center is an academic affiliate of the UCONN School of Medicine? We are a specialized program of the division of Reproductive Endocrinology and Fertility and one of

the largest and most successful IVF programs in the Northeast. We offer one of less than 40 postgraduate fellowships for Reproductive Endocrinology and Infertility (REI) in the United States. Due to our national reputation as a "Center of Excellence," acceptance to one of our fellowship positions is very competitive. Fellows also participate in ongoing clinical research. This has resulted in several first author publications and national conference presentations for our fellows. Over the past three years, the fellows have presented 18 abstracts at national meetings and have published 13 articles in peer reviewed journals. Plus, we not only have REI fellows, but also Ob/Gyn residents and medical students training here as well.

DID YOU KNOW?

MONTHLY EVENTS

FIRST & THIRD Wednesdays

YOGA 5:30-6:30pm

THIRD Thursdays

RESOLVE Infertility Peer Support

Group 7-9pm

OCTOBER 29, 2016

FREE FERTILITY EVALUATION

10–2pm at our Farmington office

Check our website at uconnfertility.com for pre-

registration information. And like our Facebook page

for the most up-to-date information.

NEW!Spring 2016

T he Center continues to demonstrate success:

Not only in the percent of live births achieved, but also in our ability to lessen the potential for pregnancies with twins, triplets or more. As the largest fertility center in the state with 1,275 IVF cycles in the last year, we continue to lead in both the region and the nation.

To learn more about our success rates and those of other programs, please visit the Society for Assisted Reproductive Technologies website (www.sart.org). Click on IVF Success. A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic.