Volume 2 Issue 2 Summer 2017

PHYSICIAN PROFILE

LGBTQ

MEN’S HEALTH

MEET A PATIENT

FERTILITY 101 VIDEOS

Mary Casey Jacob, Ph.D. is a psychologist at the Center. She focuses

specifically on guiding patients through the fertility treatment process

June is Gay Pride Month! Information about third party fertility options

IUI, IVF, and Acupuncture. Elements of a successful pregnancy

Educational videos featuring our staff with answers to some of the most

commonly asked questions

Why adopting a healthy lifestyle is so important for menWhen One Beats Two

THE ADVANTAGES OF SINGLE EMBRYO TRANSFER

1

(Cover story begins inside)

Sometimes, we encounter patients who seek to transfer

back more embryos than is clinically recommended as

part their fertility treatment. Typically, these are patients

who believe transferring back more than one embryo will

increase their chance of success or wish to have more than

one child, or and want to “get it done all at once.”

Although some patients may be suitable candidates for the

implantation of more than one embryo through Assisted

Reproductive Technology (ART), for many women, there

can be serious potential risks — to both the mother and the

infants — that must be considered. These risks, together

with improved techniques for growing and selecting the

best quality embryos, have led most fertility centers to

recommend Elective Single Embryo Transfer, or eSET, for

the majority of their patients.

WHAT IS eSET?

As the name implies, Elective Single Embryo

Transfer is a procedure in which one embryo is

selected from the number of embryos

available and placed in the uterus.

The embryos that are not selected

may be set aside for future use or

preservation.

The American Society for Reproductive Medicine (ASRM) advises eSET for women 37 or younger with eggs or embryos of good quality. The ASRM guidelines were developed to assist physicians in making sound clinical decisions in caring for their

patients. While each situation is different, the Center

for Advanced Reproductive Services is a leader in using

single embryo transfer to maximize the chances of a

successful live birth for its patients, while transferring as

few embryos as possible. In fact, our results have shown

that pregnancy rates with SET are as good as those

resulting from the transfer of more than one embryo.

WHAT ARE RISKS OF MULTIPLE BIRTHS?

Multiple births increase the risk of premature birth and low

birth weight. These factors can adversely affect the survival

and well being of newborns. Babies born prematurely often

require lengthy and expensive specialized care and can have

life-long issues with disabilities and developmental delays.

A Caesarean section is more likely necessary for a woman

who is trying to carry multiple embryos to term. C-sections

generally require a longer recovery time, incur greater

hospital costs, and may increase the mother’s

risk of hemorrhage during and after delivery.

Some mothers who become pregnant with

“multiples” find that one or more fetuses cannot

survive to term, or even to premature birth. This

may require medical intervention to perform

what’s called a “fetal reduction.”

Often, women over 35 years of age are at

increased risk for pregnancy complications — high

blood pressure, gestational diabetes and others.

Carrying multiple fetuses can add to these risks,

which, in some cases, can be life threatening.

When ONE Beats Two

IS eSET RIGHTFOR ME? As noted earlier, eSET is generally recommended for women 37 and

younger with “good quality” eggs or embryos. Each patient’s situation is different, however, and there are a number of things that should be taken into account before important decisions are made. For example:

• Multiple births increase health risks for mom and babies, i.e., premature birth and low birth weight.• Breastfeeding can be more challenging for mothers with “multiples.”• Finding affordable childcare options can be more difficult for families with “multiples.”• Having “multiples” can place extra demands on your support network and your lifestyle.• Your (or your partner’s) employer may not provide adequate benefits or flexibility to help you care for “multiples.”

As always, it’s best to consult with your physicians to make the best, most informed decision for your circumstances.In each case, our goal is to provide you with the greatest chance to start or add to your family by having a successful, healthy live birth.

(cover story)

Meet Mary Casey Jacob, Ph.D.

For those experiencing

infertility, treatment can

often seem a daunting

task. For those with

religious considerations,

it can sometimes seem

overwhelming.

At the Center we look to accommodate all faith-based individuals and families. We are experienced with the requirements of the Orthodox Jewish population, among others. When an individual going through IVF treatment has Orthodox halachic issues, we at the Center are sensitive and accommodating to those needs. For example, making sure that a supervisor is present throughout procedures as required. Following specific guidelines in the lab as relates to all tissues, including oocytes, sperm and embryos. And involving our patients’ families as they wish.

As a Jewish physician, Dr. Claudio Benadiva, one of our lead reproductive endocrinologists, is particularly sensitive to this community’s needs. He is a member of the Beth El temple in West Hartford, CT, and is a fluent Hebrew speaker. Fertility in the Jewish community is very much a family experience, and our family is here for yours.

BEING JEWISH AND INFERTILE

Dr. Jacob is a psychologist at the Center whose work is specifically focused on guiding patients through the fertility treatment process. Her experience and knowledge of the process can help people better understand and prepare for the

emotional and ethical issues that can be encountered along the way.

Through education and counseling, Dr. Jacob offers insight into what people might experience when going through treatment: What effects the medications might have. What emotions might emerge. What partners can expect, and how they can support each other along the way. Her approach to mind-body cognitive-behavioral counseling is part of the holistic treatment plan that the Center is proud to offer.

Dr. Jacob’s range of work also includes specific treatments for situations patients might experience during the process such as needle phobias, help with smoking cessation, and ideas for working together to make decisions along the way.

Dr. Jacob received her Ph.D. in psychology from the University of North Carolina at Chapel Hill and then completed a Health Psychology Internship at Veterans Administration Medical Center in West Haven, CT. She is a Professor in the Departments of Psychiatry and Obstetrics and Gynecology at the UConn School of Medicine.

Meet Mary Casey Jacob, Ph.D.

✌

Summer 2017

Sharing Our Patients’Love“Gracias por estar con nosotros en

cada paso del camino mientras nos embarcamos en este viaje extraordinario. Esperamos que sepas cuánto valoramos la orientación y el cuidado que recibimos de todo el personal. Ahora cada día es una continuación de ese viaje maravilloso para nuestra familia.”

“We can’t stop smiling and being thankful for our new miracle.

We will be taking a long awaited trip soon to introduce her to our extended families. There will be a lot of people who will be thanking you and your expert team for bringing this joy to our lives.”

We love our patients! We are proud to be the team they’ve chosen to help them through their fertility journey. Seeing families of all types continue to grow and thrive is the biggest benefit of the work we do, so we love when they share family updates with us.

At the Center, we employ secret weapons in helping our patients navigate the insurance obstacles that may present themselves during the testing and treatment phases. And those secret weapons are our financial counselors.

Our counselors work with patients to review benefit coverage, obtain any prior authorizations needed, appeal claim denials, help patients communicate with their insurance companies, and identify any out of pocket financial responsibilities that might be associated with their treatment.

Connecticut is a mandated state so insurance companies must cover infertility treatments, and in January of 2016, the state lifted age restrictions on that coverage. However, each insurance plan is different and working with one of our counselors can help you optimize your plan, as well as seek additional funding if needed.

In addition to reviewing existing coverage, our counselors provide patients with information about foundations that offer grant money to support IVF treatments, such as Nest Egg Foundation. They will also look at other options that might be available to help offset the cost of treatment, such as discounted medication programs, and possible financing options.

At the Center, we strongly believe in developing partnerships with our patients. By working together we can help alleviate the stress that financial and insurance aspects can have on a patient’s health and infertility treatment.

Visit our Video Library to see Christine Guarda, Lead Patient Service Representative talk about the role of our financial counselors.

We’d like to wish all in the LGBTQ community a joyful Pride

Month. Here at the Center, we know that the fertility options and

issues facing gay and lesbian individuals and couples are different

from others wishing to become parents. There are legal, financial

and ethical obstacles that need special attention and knowledge to

overcome. Various medical procedures also have benefits and risks

that need to be understood. That’s why we offer the very best in

comprehensive and personalized care.

Fertility options for third party reproduction have grown over the

years. Gay and lesbian individuals and couples now have choices that

include genetically related children, in addition to adoption. Females,

depending on their health and age, can use advanced technologies

such as sperm donation with Intrauterine Insemination (IUI), IVF,

shared conception, egg donation, and egg or embryo freezing to

achieve a pregnancy. Males, depending on their sperm quality and

surrogacy options, can use technologies like artificial insemination,

IVF, egg donation, and gestational carriers.

All of these techniques have been used extensively here at the Center,

and our experts can help patients determine what is best for their

particular situation. In addition to the range of advanced medical

technologies we offer, we can also guarantee the highest level of

skill and expertise in successfully using them. We are experts in the

field of reproductive endocrinology and infertility and are nationally

recognized for our success, compassion, and commitment.

JUNE IS GAY PRIDE MONTH

Choosing a quality Center is paramount to having successful outcomes. Not all Centers provide the same infertility treatments, offer the same approach or have the same results. Important criteria used to evaluate a Center’s success include its:

• experience level or volume

• live birth rate, and• triplet or higher

birth rate

We’re pleased that the 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. With over 12,000 babies born since our inception, 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.

SARTresults75%

50%

25%

0<35,

247 IVF cycles initiated

NationalAverage

56%

35-37, 95 IVF cycles initiated

NationalAverage

44%

rate of us returning newIVF patients, up to age 37, back to you

pregnant withinthe first year of

IVF treatment

Up to 60% success

Preliminary Live Birth Rate per New Patient

The Center60% The Center

50%

Source: Society for Advanced Reproductive Services (SART) 2015 Annual Report

70%

52.5%

35%

17.5%

0<35

NationalAverage

41%

35-37

NationalAverage

30%in women 35 or younger

Meets or ExceedsNational Average

by Over 25%

Elective Single Embryo Transfer (eSET) Rate

The Center68%

The Center28%

Source: Society for Advanced Reproductive Services (SART) 2015 Annual Report

1embryo

500375250125

0

248 IVF Deliveriesin this category

778 cycles initiated(patients own eggs)

204 Singleton IVF Births

82%

82% singleton births

Preliminary Primary Outcome Per Egg Retrieval

Source: Society for Advanced Reproductive Services (SART) 2015 Annual Report

As a result of expert clinical management such as eSET the

overwhelming majority of our IVF births are singleton

deliveries. This results in more healthy mom's

and babies.*Live Birth Data for This Category

<35 35-37 38-40 41-42 >43

Cycles initiated 364 173 152 51 38

Live births per egg retrieval 46.7% 35.8% 25% 22.9% 3.3%

Live births per embryo transfer 51.2% 46.6% 35.6% 8/17 1/16

�� ��

101

Check Out Our New Videos

helping you navigate insuranceobstacles

If you’ve visited our Video Library, you already know there is a wealth of educational and informational videos, created to help guide and support our patients and anyone considering fertility treatment.

Well, now there’s more! We are continually adding new and updated information, and we’ve just completed several new videos that are now available for viewing.

Visit our Video Library at www.uconnfertility.com to learn more.

Infertility and Men’s HealthMen’s Health Month is observed every June, with the purpose of heightening awareness of men’s health issues and prevention practices. Studies continually show that, for various reasons, the large majority of men refuse to go to a doctor for an illness, much less on a regular basis.

The observance of Men’s Health Month gives health care providers and families the opportunity to remind, and encourage, men to seek regular medical advice — after all, most men wouldn’t consider letting their car go a year without a visit to the mechanic, why they won’t consider the same level of care for themselves?

Because fertility and health go hand in hand, it’s a good reminder for men to look at adopting a healthy lifestyle. Maintaining an ideal weight, with a well-rounded diet and multi-vitamins may improve the quality of sperm. Regular exercise can help reduce stress, thus controlling many chronic medical conditions such as high blood pressure and diabetes, which may also improve the chances of achieving pregnancy. And of course, quitting smoking can make a significant impact on fertility.

Typically, any changes in the direction of a healthy lifestyle can take almost three months to show an improvement in sperm. So join the movement and make June a healthy month! ✌

Mosaic Embryos and PGS

Having a baby was something that Raeann Schwartz and her husband always dreamed about, but the process wasn’t easy for them. After months of trying to conceive with no results, they came to the Center looking for help.

Raeann first began her treatments with Intrauterine Insemination (IUI), then turned to IVF. As a result of the IVF treatments, she was able to get pregnant and give birth to beautiful, baby Eva.

Raeann attributes her little miracle to the Center’s advanced medical technologies and our holistic approach to treatment. She’s now a strong believer that acupuncture played a role in her ability to conceive.

“I was reading that acupuncture could increase your chances of getting pregnant, so I said ‘why not’ and took advantage of the Center’s acupuncture sessions. After each session I felt different, like it was an extra level of support for my body and my mind,” said Raeann.

At the Center, we are pleased to have Helen BetGivargis, licensed acupuncturist and former IVF embryologist offer treatments benefiting both women and men undergoing fertility treatment. Helen says, “Acupuncture supports the body’s innate healing mechanism, and some studies show that it normalizes the menstrual cycle and ovulation. Women’s bodies are wired to have children, so acupuncture encourages the body to perform its functions.”

Learn more about acupuncture and the Center’s Integrated Health programs intended to enhance fertility treatment on our website under Specialized Programs.

WHERE ARE THEY NOW?

IntrauterineInsemination (IUI)

DR. ANDREA J. DILUIGI

DR. CLAUDIO BENADIVA

❉

uconnfertil ity.com

What is a natural vs. stimulated cycle and what are the differences between them? An embryo thaw cycle is when a patient uses their previously cryopreserved embryos. Here at the Center, there are two different types of embryo thaw cycles that are utilized, natural and stimulated.

Natural is when a woman’s own hormones are being used through normal follicular development and ovulation to prepare the lining for implantation of the embryo, and stimulated uses medication, estrogen and progesterone to prepare the lining for implantation.

In this video Dr. Schmidt overviews the two cycles, and explains their differences, success rates, and how to know which will work best for you.

From Our Video LibraryFrozen Embryo: Natural vs. Stimulated Featuring Dr. David Schmidt

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

OUR STORY: 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," 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.

MONTHLY EVENTS

FIRST & THIRD Wednesdays

YOGA 5:30-6:30pm

THIRD Thursdays

RESOLVE Infertility Peer Support Group 7-9pm

We will be hosting our next Free Fertility Assessment in October. Watch the News & Events section of our website for updates.

Please check our website for more information and to register (limited space for all events!).

For the most up-to-date information, like our Facebook page and follow us on Twitter or Linkedin

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. With over 12,000 babies born since our inception, 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.

When One Beats Two