Fertility Rankings Throughout the United States

Happy National Infertility Awareness Week! As part of the week of awareness about infertility and how to address it, the National Infertility Association along with Resolve, a nonprofit that promotes reproductive health, launched an updated index of each state’s fertility friendliness.

The ranking was based on several factors: how a state’s insurance companies address fertility, how many fertility doctors are available, how many support groups for infertility there are, etc.

Only five states—Connecticut, Illinois, Maryland, Massachusetts and New Jersey—received an “A” rating. Over half the states received a “C” grade or worse. “From my perspective, that does not bode well,” said Barbara Collura, president and CEO of Resolve. Collura hopes that by seeing how poor infertility help actually is in some states, people will be spurred to create support groups or push for new fertility facilities to be formed.

Infertility can mean three things for a woman: the inability to become pregnant, the inability to maintain a pregnancy, and the inability to carry a pregnancy to a live birth. If you think you may have problems with your fertility, visit a fertility doctor today.


Posted in Blog, Fertility Treatments, Infertility

Fertility and Same Sex Couples

Same sex couples are no less fertile than heterosexual couples.

Lesbian-couple-with-childLesbians are as capable of conceiving a child using a sperm donor, as are women who have a male partner. Homosexual men require an egg donation and a host uterus. In either case, 50% of the child’s DNA will come from the parent.

Only 50%? True, children of “conventional” families get 100% of their DNA from mom and dad, except…  for those who don’t. For women whose male partner makes little or no sperm, sperm from a donor (usually anonymous) is the only chance to conceive. Likewise, when the female heterosexual partner is devoid of eggs, either because she is older or because of early pre-menopause or menopause, eggs from a donor (anonymous or known) represent her only chance to have a child.

This has been going on for decades. And in most cases kept strictly confidential. So for all you know, some of your friends may have been conceived through sperm and/or egg donation. Some of your pregnant friends may have used donor “gametes.” Many of the older female celebrities have conceived through egg donation. This information is kept private, as it should.

So should the widespread use of sperm and egg donation by heterosexuals clear the way for same sex couples? Why not?

Prior to the development of new fertility options, both men and women struggling to have children shared one big dark space. All doors were shut. For generations, they were left there, barren.

And then came reproductive technology and started opening one door at a time. First just cracks, then wider, until it was fully open. Women considered irreversibly infertile were newly empowered: motherhood was within reach. Another door had opened for infertile men. A whole field developed, helping men with various fertility problems become fathers. And there are no guards at either door, checking for sexual orientation.

Same sex couples are as fertile.
As a reproductive endocrinologist helping build families for more than 20 years, I have been impressed by the love, commitment and stability of same sex couples.

Most heterosexual couples approach their quest for parenthood as a joint responsibility. As they should.  Female-male causes of infertility are split about 50-50. And most husbands are extremely supportive of their wives and are actively engaged in their fertility treatment. However, in many heterosexual couples there exists a large Mars/Venus polarity in prioritizing children, career and lifestyle. In many such couples, the female is frequently left alone to deal with infertility, even when the male is the problem!

Even after fertility treatment is successful, life doesn’t get any easier for women. In a two-income household, having a child, or children, does not free the new mother from working full-time. Many husbands realize the burden on their wives and actively participate in raising the children. These are, what we call – partners. And then come the “Mars” husband, maintaining that caring for the children should fall squarely on the shoulders of his wife, no matter how hard she works or how late she comes home. Those are the limited partnerships. Very limited indeed.

And about half of the couples divorce. Likely, they are more of the “limited partnership” variety, but surely not exclusively.

As for the welfare of the children of same-sex couples, a study by Catrell & Bos, published in Pediatrics, looked at 78 children born to 154 lesbian mothers who conceived through donor inseminations and found that the 17-year-old children of lesbian mothers were rated significantly higher in social, academic, and total competence than typical American children. They had significantly fewer social problems, less rule-breaking, aggressive, and externalizing problem behavior than age-matched children. The study attributed this to the mothers’ “commitment, even before their offspring were born, to be fully engaged in the process of parenting.”

Additionally, just last week the American Academy of Pediatrics (AAP) announced their support for same-sex marriage and adoption/fostering rights regardless of the sexual orientation of the parents. The AAP announced their support as it follows their belief that “children need secure and enduring relationships with committed and nurturing adults to enhance their life experiences for optimal social-emotional and cognitive development.” With the backing of scientific evidence, the AAP feels a family unit provides this to children, no matter the sexual orientation of the parents.

Same-sex couples must endure the stress of family building, coupled with the constant struggle for acceptance in a predominately heterosexual society. As patients they also have to deal with major insurance coverage as well as their own legal status and that of their children’s, already born with an inferior status in society. If we accept the 3.5% American adults identifying themselves as gay (the Williams Institute Review, April 2011; 272,493 in NYC), the same way we accept left-handedness (15%) as equals, discussion can start regarding the structure of same-sex parenting, including their legal titles.

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Genetic Test Could Help Pinpoint Menopause Start Date

Although you may have a specific plan for your life, your body may have another idea. There is currently no way to predict when you will start menopause. However, scientists are now finding the body gives more clues than originally suspected about how long you are able to have children.

There is no official age at which women start menopause. Generally, it is anywhere between 40 and 60 years old, with the average age in the United States being 51 years old. But approximately one in 100 women start menopause before age 40 and have no way of knowing that’s in their genetic makeup.

Bart Fauser, Professor of Reproductive Medicine and Gynecology at University Medical Centre in the Netherlands, says, “Women often postpone having children until their career is well established, but many find it difficult to become pregnant because of declining fertility after the age of 30. Therefore, it would be very useful for women to know well in advance the age gap in which they can expect to remain fertile. This will allow them to try to conceive naturally or to consider egg freezing or IVF treatment at a later date.”

A meta-analysis of 22 European genetic studies involving 39,000 women found about 13 gene variants that were associated with the age of natural menopause and could be used in testing. Further research is needed, but Fauser believes a genetic test for women of all ages will be available within the next five years.

Until then, women can undergo the “egg timer” test, which measures the amount of Anti-Mullerian Hormone (AMH) in a woman’s blood. Many fertility doctors believe AMH levels are a good indicator of how many fertile years a woman has left, while other doctors believe the test is unreliable.

Talk to your doctor about your medical history and desires for future children. Make a plan today to be prepared for tomorrow.

Posted in Blog, Infertility

Fertility Docs from Russia Tour Manhasset Office


Twelve physicians from six cities in Russia visit the North Shore LIJ flagship office in Manhasset to speak to doctors and staff about the practice. The visiting doctors are artificial reproductive technology specialists with extensive experience, representing a diverse background in the field, from scientific research to fertility center management in Russia. They came from six different cities: Moscow, St. Petersburg, Kazan, Ufa, Rostov-on-Don and Orenburg.

The Russian doctors include, Mr Nikolay Kornilov,  Leading Gynaecologist-Embryologist of Medical Centre “Ava-Peter”, St. Petersburg,  http://www.avapeter.com/en/about/; Mr Eduard Komlichenko,  Ph.D., Head Doctor of Almazov Federal Heart, Blood and Endocrinology Centre, St. Petersburg, http://www.almazovcentre.ru/?lang=en; Ms Nona Mishieva, Ph.D., Leading Gynaecologists of Scientific Center of Gynaecology, Obstetrics and Perinatology, Moscow,  http://www.ncagip.ru/; Mr Aydar Abubakirov, Chief of IVF Department of Scientific Center of Gynaecology, Obstetrics and Perinatology, Moscow, http://www.ncagip.ru/; Mr Andrey Ivanov, Chief of IVF Department of St. Peterburgsky Mariinsky Hospital, St Peterburg, http://mariin.ru/index.php?area=1&p=static&page=napr15&overtpl=r04; Ms Dilorom Kamilova, Ph.D.,  Head of ART department at “Mother and Child” Group of Clinics, Moscow  http://eko.mamadeti.ru/sotrudniki-eko; Ms  Alsu Nazyrova, Director of Medical Centre “Mother and Child”, Gynaecologist, Kazan, http://mamadeti.ru/content/o-klinike; Mr Firgat Bayramgulov,  Head Doctor of Republican Perinatal Centre, Ufa, http://rpcufa.ru/; Mr Ilyas Nuriev, Director of “Nuriev’s Clinic”, Fertility Endocrinologist, Kazan, http://www.nnplus.ru/en/; Ms Firaya Sabirova, Director of Kazan Branch of Medical Centre “Ava-Peter”, Fertility Endocrinologist , Kazan, http://www.avapeter.com/en/about/; Ms Karine Sagamonova, Ph.D., Director of “Rostov Centre of Human Reproduction and IVF”, Rostov-on-Don, http://www.vrt-rostov.ru/about/history/ ; and Mr Mark Shukman, Ph.D., Head Doctor of Regional Centre of Family Planning and Reproduction, Orenburg, http://www.orencpsr.ru/


Dr. Avner Hershlag leads the discussion via Skype.

Since Dr. Hershlag was in France, he joined us via Skype, and gave a presentation about the Center for Human Reproduction. After the presentation, the doctors engaged in a Q & A session, followed by a tour of the office by Dr. Tomer Singer.

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National Infertility Awareness Week

27261087_mApril 20-26 is National Infertility Awareness Week, and the theme for 2014 is “Resolve to Know More.”

If you are experiencing infertility, this may seem like a lonely and helpless time in your life. And you might be surprised to know that one in eight couples experience infertility at some point in their life. Recognizing that this is a medical condition means that there are potential treatment options — options that have improved fertility rates dramatically over the last decade.

One of the key factors is to seek out medical intervention as soon as you suspect this might be an issue. It may be a difficult conversation to have with your doctor, but the sooner you schedule an evaluation the sooner you’ll know the outlook. And the better your chances are of finding a treatment that works for you. Our team includes doctors, nurses, therapists, endocrinologists, among others who are specialists in the field of infertility and reproductive medicine.

So, in your resolve to know more, consider meeting with one of our fertility specialists to see how we can help you.

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Foods That Can Help Boost Fertility

According to doctors, there are many ways that men and women alike can improve their fertility: exercise, diet, timing intercourse with ovulation, etc. Many people underestimate just how important what they are eating is to their ability to conceive. Here are a few foods that might help your fertility improve:

In a study printed in the journal Biology of Reproduction, 117 healthy men between the ages of 21 and 35 were examined for the effect of Omega-3 fatty acids (which are good for you). Those who ate a couple handfuls of walnuts every day, a food rich in Omega-3, had improved sperm vitality, morphology and motility. Those men who hadn’t eaten the nuts had no change.

Lentils are a rich source of protein, fiber and iron. The Harvard School of Health conducted a study examining iron intake and reproductive health. They found that women who got the majority of the iron from plants, rather than meat, reduced their risk of infertility by 40 percent.

Not all fats are bad! Avocados, along with coconut oil and olive oil, provide quality fats that help women balance their hormones. Balanced hormones lead to a higher likelihood of conceiving a child as well as supporting a child in utero.

Ladies, it’s time to have your men channel Popeye. Supplemental folic acid and zinc, which spinach and kale are high in, led to increased sperm counts in men who had previously struggled with reduced fertility.

As much as you can, stick to natural foods and stay away from processed goods. Talk to your doctor if you have other questions or concerns about your diet and how it might be affecting your chances of conceiving.

Posted in Blog, Improve your Fertility, Infertility Contributing Factors, Lifestyle

Sharing Your Fertility Journey

5486175_mIf you are reading this blog, then no doubt you are at least familiar with infertility. You may even have a close, personal, albeit adversarial, relationship with it. And you may be conflicted by the thought of sharing your experience within your social network. This is especially true in our social media-hungry culture, where every tidbit of information about our personal lives is up for grabs on Facebook, Twitter, or a blog.

So what do you do when the details about your personal life are no longer about what you had for dinner, but whether you’re pregnant — or are able to become pregnant? Well, I say, go ahead and share; or not. The correct answer couldn’t be more subjective, so give some thought to the questions below and let the answer reveal itself.

First, consider how big your online social circle is. Are your Facebook ‘friends’ real friends and family, or do they include co-workers, neighbors, your dentist and your mother’s hairdresser?

Answer quickly. Are you a sharer, and do you share freely? Online posts can range anywhere from, ‘I can’t wait for our 20-year reunion’ to the visceral details of what your kid just threw up at the grocery store. Where does your comfort level lie?

Where are you in your journey? People in the early stages tend to be more enthusiastic and optimistic, while someone in their second or third year of treatment might have a more balanced outlook.

Do you get comfort from the replies and inquiries you read online, or does this give you anxiety?

Consider your partner’s feelings and concerns. This could be a fine line to walk. If you are a social media butterfly, but your partner or spouse likes to keep things close to the vest, talk, specifically, about what types of news he or she is comfortable sharing. Typically, women share more about infertility issues than men, so make sure you are both on the same page about what goes on the page.

If you do decide to share your journey, think about starting a blog. This is a fail-safe way to ensure you have full ownership of the content. You manage the distribution by sharing the URL with whomever you choose. This could certainly be with the general public, but the distribution list could include only your family. It might also be just you. In this case your blog is your online journal. In general, sharing your feelings, thoughts and concerns is a valuable tool that can help you navigate any emotional journey. There’s plenty of evidence that keeping a journal can relieve stress, clarify your thoughts and feelings and give you the opportunity to know yourself better. You may find the simple act of putting your thoughts ‘on paper’ gives you a more positive outlook, whether anyone else reads them or not. One way to think about it is that you are sharing your feelings with yourself. Thoughts in your head are much different than words on a ‘page’.

On a final note, know when to take a break. If Mother’s Day is coming up and this is a day you struggle with, then by all means stay off the social networks. You can always come back in a week or so. Use the time you would normally be online to do something tactical — planting a garden is a great distraction, and May is a perfect time to be outside getting your hands dirty. Ultimately, remember that you are not walking this road alone; sharing is a good thing, even if it’s just with yourself.

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Dr. Avner Hershlag to speak on BRCA and Reproduction


The 37th Annual Clinic Day Symposium presented by the Obstetrical & Gynecological Society of Suffolk County will take place Wednesday, April 9, 2014. Dr. Hershlag will speak at 9:00 AM, stressing the importance of recognizing the urgency of fertility preservation in BRCA+ patients with and without cancer, and explain the role of PGD in BRCA+ patients.

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Ways to Improve Male Fertility

Though most of the discussions about ticking biological clocks and ways to improve fertility focus on women, men also need to be aware of the factors that can negatively impact their fertility as well as ways to boost their ability to conceive.

Stay Cool
The testes of a male are outside the body for a reason—they need to be kept cool. Cooler temperatures help the production of sperm. Do not place a laptop directly on your lap. Do not spend excessive amount of time in hot tubs or baths.

Allow for Some Space
Tight pants also negatively impact sperm production. This is partly due to poor circulation, but also due again to excess heat from being so smothered. Moderate the layers of clothing you wear and do not spend multiple hours wearing compressions shorts or bike shorts.

Have a Future Plan
It is well known that women have a shorter time in which to conceive before their fertility declines, but men’s fertility also declines with age. Not only does sperm quantity and quality go down starting in their 40s, but fathering a child at that time or later also increases the risk that the child will have mental health issues such as schizophrenia and bipolar disorder, along with childhood cancers, leukemia, and other congenital disorders. Even if you’re not ready now to have children, think about your future down the road and if being a parent is something you desire.

General Health
You already read articles or hear doctors talking about the need to exercise regularly, eat healthily, give up smoking, and monitor alcohol consumption. This is not advice to be ignored and is repeated often for a reason. Being aware of what you eat and exercising are two simple ways to vastly improve your quality of life by greatly boosting your health—and therefore the health of your sperm.

If you are interested in learning more about your fertility, contact a fertility doctor near you today.

Posted in Blog, Improve your Fertility, Infertility Contributing Factors, Quit smoking, Smoking

Dr. Avner Hershlag to be honored by UJA-Federation of New York

On April 30, 2014 the world’s largest local philanthropy, UJA Federation, will be honoring four healthcare professionals for their generous contributions to the Jewish community. One person can’t do everything, but together we can do almost anything. We want to thank each of these individuals for their passionate support and dedication to our community.

Thank you.

Dr. Avner Hershlag

Dr. Avner Hershlag


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