Reproductive Endocrinology: Then and Now

Dr. Kreiner Assisted Reproductive Technologies, Causes of Infertility, Co-culture of Embryos, Cryopreservation, Embryo Glue, Endometriosis, High order Multiple Births, Infertility Information, IVF, Laboratory, Micro IVF, Physicians, Regulation of IVF, Reproductive Health, Research, Single Embryo Transfer, Treating Infertility, Tubal Disease 0 Comments

My son is starting his second year residency in obstetrics and gynecology. He, like I was 30 years ago, is turned on by reproductive medicine and enjoys performing gynecologic surgery. When I decided then to specialize in reproductive endocrinology and infertility (REI) I was looking forward to being on the frontier of fertility medicine. The details of Reproductive physiology were …

Secondary Infertility

David Kreiner, MD Assisted Reproductive Technologies, Fertility Testing, IVF, Micro IVF, Secondary Infertility, Treating Infertility 1 Comment

Sometimes my patients who have difficulty conceiving their second child feel like second class citizens in the infertility world. Unlike their infertile peers without a child they perceive that friends, family and even their doctor’s offices do not have the same sympathy and concern for them as they observe others without a child receive. I have had patients express guilt …

Minimal Stimulation IVF or MicroIVF May Be Best for Young Patients and Old

David Kreiner, MD Age Related Infertility, Assisted Reproductive Technologies, IVF, Micro IVF, PCOS, Treating Infertility 0 Comments

Minimal stimulation in vitro fertilization, also known as MicroIVF and MiniIVF is a cost effective treatment option for young women who are attempting to conceive. Although traditional full stimulation in vitro fertilization (IVF) procedures produce better pregnancy rates, minimal stimulation IVF (MS-IVF) induces ovarian follicle and egg development with less hormonal stimulation. As a result, patients going through minimal stimulation …

Do Financial Discussions Have A Place In The Fertility Consultation With The Doctor?

David Kreiner, MD Assisted Reproductive Technologies, IVF, Micro IVF, Treating Infertility 1 Comment

One of the most distressing things I face in practice is when I get negative feedback from a referring physician.  Fortunately, it happens rarely but recently I was shocked about the complaint.  Apparently, his patient was offended that I discussed the finances involved with her treatment.  Her Ob Gyn agreed with her that it was inappropriate for me to discuss …

Micro IVF May Be Your Answer

David Kreiner, MD Micro IVF 0 Comments

You’ve already crossed the bridge from “We’re going to get pregnant!” to “We need help…” But this other side looks filled with more obstacles, including expensive and risky fertility medications. How far do you have to go just to have a baby? Micro IVF (sometimes called MiniIVF) may be your answer. The primary point of MicroIVF: fewer fertility drugs, less …

Fertility Treatment During This Economic Downturn

David Kreiner, MD Making It Affordable, Micro IVF, NYS IVF Grant 1 Comment

Financial hardships have increased fertility challenges for many couples attempting to build their families. According to a new study release at the ASRM meeting in Atlanta last week, the recession has severely affected access to fertility treatment in this country. Fifty eight percent of infertile couples who chose not to pursue therapy cited cost as the primary reason. About 7 …

Is My Biological Clock Running Out?

David Kreiner, MD Age Related Infertility, Fertility Screening, FSH, IVF, Micro IVF 0 Comments

Tears start to course down the cheeks of my patient, her immediate response to the message I just conveyed to her. Minutes before, with great angst anticipating the depressing effect my words will have on her, I proceeded to explain how her FSH was slightly elevated and her antral follicle count was a disappointing 3-6 follicles. I was careful to …

Medications for IVF Treatment

David Kreiner, MD Dave Kreiner, MD, Infertility Information, IVF, Micro IVF 1 Comment

• The success of IVF largely depends on growing multiple eggs at once • Injections of the natural hormones FSH and/or LH (gonadotropins) that are normally involved in ovulation every month are used for this purpose • Additional medications are used to prevent premature ovulation • An overly vigorous ovarian response can occur, or conversely an inadequate response Medications may …

Cryopreservation of Embryos

David Kreiner, MD Assisted Reproductive Technologies, Cryopreservation, Dr. Howard and Georgeanna Jones, Infertility Information, Micro IVF, Single Embryo Transfer 0 Comments

In 1985, my mentors, Drs. Howard W. Jones Jr. and his wife Georgeanna Seegar Jones, the two pioneers of in-vitro fertilization in the USA and the entire western hemisphere, proposed the potential benefits of cryopreserving or freezing embryos following an IVF cycle. They predicted that cryopreserving embryos for future transfers would increase the overall success rate of IVF and make …