How do they work?
Gonadotropins are natural hormones that trigger the ovaries to make eggs. They are generally safe to use, but do require experience and careful monitoring.

In a natural menstrual cycle without any medications, a woman produces one or two follicles, which are fluid filled sacs that contain an egg. The growth of the eggs and their release from the follicles are influenced by the secretion of two hormones from the pituitary gland: Follicle Stimulating Hormone (FSH); and Luteinizing Hormone (LH), both known as gonadotropins.

When a woman becomes menopausal, her pituitary gland secretes large amounts of these hormones in an attempt to stimulate the ovaries, which no longer function. Gonadotropins (other than Follistim and Gonal F) are manufactured by extracting FSH and LH from the urine of post-menopausal women. Menopur contains both FSH and LH, while Bravelle contains only FSH.

For a woman going through infertility treatments, these extracts must be injected and cannot be taken orally, because they would be digested by the stomach.

Recently, gonadotropins (Gonal-F, Follistim) have been manufactured in the laboratory using recombinant technology, which allows a pure form of FSH to be produced. This is not a human tissue or urinary by-product, it is a recombinant FSH. Since it is more pure, it may be self-injected, using a small needle just under the skin.

We are looking for patients (age 34-42) to participate in the 2007-2008 Genesis/Ferring Study - Echogenicity and Progesterone Concentrations:

This study is for patients undergoing IVF. It entails undergoing a regular IVF cycle in the office, and does not involve extra visits. We may provide all medications needed for the IVF cycle. The cost of the IVF cycle is $4,000 if you do not have insurance coverage.

A hydrosalpinx is a condition in which one or both fallopian tubes are blocked and filled with a clear fluid.  To detect whether a patient has hydrosalpinx, a specialist may perform an ultrasound, HSG (Hystersalpingogram), or a laparoscopic surgery.  At CNY Fertility Center, most hydrosalpinx are discovered through an HSG, during which a special dye is injected into the uterus and fallopian tubes, and then viewed through a fluoroscope (similar to an x-ray machine). If the fluid spills out of the fallopian tubes, they are not blocked. If the fluid remains, then the patient has a hydrosalpinx.

Hydrosalpinx can be the result of endometriosis, previous pelvic infections, or can be due to a developmental abnormality. Some patients have recurrent abdominal pain, whereas others experience no symptoms at all.

If both fallopian tubes have hydrosalpinx, then the sperm cannot reach the egg in the fallopian tube, and conception is thus prevented. The best option for women with two hydrosalpinx is IVF (invitro fertilization), because fallopian tubes are not necessary for the process. Some studies indicate that the fluid in a hydrosalpinx decreases conception by about 50%, and increases miscarriage, when undergoing IVF. Therefore, your specialist may recommend that your tubes (with hydrosalpinx) be removed through laparoscopic surgery done in the office to enhance your success. Women who have one hydrosalpinx and one open tube can also benefit from removing the hydrosalpinx, and will increase their chances of conceiving on their own.

Spring is coming! Really it is, but for us New Englanders it doesn't really feel that way at this moment. March 21^st is the first day of spring and we're counting down the days.

Spring offers a time of renewal. Within the renewal we need to focus on our mind, body and soul.  Going through the process of creating a child with the assistance of reproductive technology is traumatic, life altering and relationship challenging.  

I'd like to offer two powerful exercises that you can focus on for March that will help harness the power and energy of change during the equinox.   (Definition from Wikipedia:  equinox in astronomy is that moment in time (not a whole day) when the center of the Sun can be observed to be directly above the Earth's equator, occurring around March 20 and September 23 each year).
 

Lamenting Time (excerpt from Love and Infertility: Survival Strategies for Balancing Infertility, Marriage and Life)

This technique is perfect for controlling fear and mental chatter, giving you a chance to balance your emotions throughout the day. The goal of this strategy is to give you permission to feel what you need to feel, but at an appropriate time.  Allowing yourself

to feel helps your body purge itself of negative and toxic emotions.

Part I. The List
You'll need a piece of paper, a notepad, or a stack of little pieces of paper. (I recommend those little colored sticky-notes.) Keep this paper and a pen or pencil nearby throughout the day.

Whenever a stray thought pops into your head, quickly write it down on your notepad or on a separate sheet of paper. Repeat this step during the day, stopping, jotting the thought down, and then moving forward with whatever task you have at hand.

Part II. Schedule Lamenting Time

At the end of each day, after compiling your list of stray, distracting thoughts, set aside fifteen minutes when you know you won't be disturbed.

Now review your list, allowing yourself to feel the emotions that each thought brings up for you. Focusing on that thought alone, permit yourself to experience the excitement, grief, sadness, or disappointment-whatever the emotion. Then move on to the next "thought" on your list or in your pile of notes. Move through your list until you've addressed each "thought." Feel the release of tension and the toxic "obsessing." You should feel lighter, less distracted, and better able to focus on what tomorrow will bring. For me, performing this exercise is like giving myself the gift of freedom and the permission to feel without guilt. I encourage you to give yourself the gift of fifteen minutes during the day to think, purge, and release all the harmful energy that is stored with negative emotions.

Journaling with a Twist!

Writing your Love Story  (excerpt from Love and Infertility: Survival Strategies for Balancing Infertility, Marriage and Life)

Each individual in a couple interprets the baby-creating experience differently, and because of these differences, it can be easy to "lose that loving feeling".  From my experience, it is critical to have direct access to why we're with the partner we're with, what made us fall head-over-heels in love with that person, and why we committed ourselves to a life with that person.  One day when Mark and I were at odds and the "ugly-marriage" bug began to bite, I interpreted his behavior as unloving, cold, and disinterested. Instead of following the temptation to go for his jugular, I realized that I needed to remind myself why I was in love with this person.  That night, in my journal, I wrote down our love story.  My anger at Mark softened and I became more rational about the argument we'd had.  From then on, whenever things got tense or our lovemaking became too mechanical, I would reread our history.  By doing that, I connected to the "loving feelings" and was able to address my feelings in a controlled manner.

*Open your journal to a fresh page.  In the upper right-hand corner, write the date that you met your partner.  Not today's date, but the date your relationship began, the date you first met this person who you now may be viewing as a sperm or egg making machine.

*Begin to fill the page with the sights, sounds, smells, and feelings of that meeting.

*When you're finished, write down five reasons why you fell in love with him or her.

*As you and your partner continue in your quest to have a baby and create your family, refer to your love story again and again. Trust me, this really works.  Your documentation of your meeting, and its significance to you, is the key to accessing those loving feelings again. 

Lamenting Time and Writing Your Love Story can provide you with a sense of control and power over a situation that can make you feel totally out of control and uncertain.  These strategies can help to quiet your negative mental chatter and reconnect you with the positive energy of your true self. 

One of my favorite spring quotes is from Sarah Ban Breathnach, which addresses the undercurrent of these two strategies; expectations.

"Expect to be kind to yourself and feel what needs to be felt. Expect your relationship to be protected through this dry season and it will be. Expect to have hope rekindled. Expect your prayers to be answered in wondrous ways. The dry seasons in life do not last. The spring rains will come again."

-Sarah Ban Breathnach

 
Kristen Magnacca is a speaker, life coach and the author of "Girlfriend to Girlfriend: A Fertility Companion" and "Love and Infertility: Survival Strategies for Balancing Infertility, Marriage and Life".  Please feel free to visit her website www.kristenmagnacca.com

Tom & Willow's Story
We wanted to thank you for all of the help and support you gave us during our infertility treatments. Our son, Jaxson Thomas, was born on 04/09/07, weighing in at 6lbs, 2oz. He is truly our miracle, thanks to the CNY Fertility family and Dr. Kiltz. This has been a long 7 year road, with one disappointment after another. We had a miscarriage about 7 years ago and could not get pregnant after that. We tried everything possible - IVF, injectables, standing on our heads. If someone told us that we had to eat a certain food to guarantee a pregnancy, we would have done it! Just when we were giving up hope, we decided to see Dr. Kiltz as a last effort. I cannot say enough good things about Dr. Kiltz. He is a fantastic doctor with great bed side manner. I work with physicians all day and wish they were as personable...and funny as Dr. Kiltz is. The best part was that he treated us like we were his first patients, and spent as much time with us as we needed. That is a great quality to have, especially when you are dealing with patients who cannot or may not ever have the one thing they have been dreaming of:  a baby boy or girl. To make a long story short, too late, I know, my wife was put on a miracle drug called glucophage. After three months and three IUI cycles, our son Jaxson was conceived. I am still on cloud 9 every time I look at him. If it had not been for Dr. Kiltz discovering polycystic ovaries, we would not have our bundle of joy.    He is the best thing that has happened to us! We cannot thank Dr. Kiltz and all of the nursing staff enough for the continuous support throughout this process. You will always have a special place in our hearts. Thank you again for our little miracle!

Corri & John's Story
Arabella, our happy, active little red-head, is nearly 5 months old. Her typical day involves an early morning wake up, lots of breast milk, and a tour through a cavalcade of toys that squeak, click, or sing. If Mom is working (part-time), she spends her mornings with "Gramama," who we persuaded to trade her sunny Florida home for Syracuse winters--all for the pleasure of engaging with our dynamic little girl!  Of course, Gramama is onto something--the experience of bringing our little gem into the world, of preparing her for its joys and challenges, and, most, the privilege of knowing her as she becomes herself.  My husband and I learned of Dr. Kiltz from a friend.  We had heard that CNY Fertility Center is visited by practitioners around the country as a model for how to run an incredibly effective and compassionate medical practice.  But this does not begin to describe our experience.  Not only did we feel that we were part of a community that made any health issue manageable.  We felt that every staff member somehow "got it," the intrinsic value of bringing a child, every child, into the world.  We couldn't be happier with this philosophy and its outcome.