Dr. Hershlag shared his views with HealthDay News and WebMD.  Please follow the links to learn more about the study.

Very early in the pregnancy, doctors cannot tell where a pregnancy may be because it is too small to be seen on ultrasound. Sometimes a pregnancy may grow outside of the uterus, most commonly in the fallopian tube, which can be very dangerous. These pregnancies, which are called ectopic pregnancies, can lead to potentially life-threatening bleeding if it grows in and ruptures the fallopian tube.  Symptoms women may have include pain and bleeding, but such symptoms can also accompany miscarriages or normal pregnancies. When a woman has symptoms early in pregnancy, she is often followed with blood hormone levels and ultrasounds for a period until the doctor can diagnose whether she has a normal pregnancy, miscarriage or ectopic pregnancy.

Over the past few years, I have been working with a team to develop a test to diagnose ectopic pregnancy before it can cause serious damage to the woman and before it is visible on ultrasound. Although the test we’ve developed needs to be studied further before it could be used clinically, in preliminary studies it was 99% accurate at differentiating ectopic from normal pregnancies. We are hopeful that one day we will have a blood test which will let women know if they have a normal or abnormal pregnancy very early on. Such a test could bring great relief to women with pain or bleeding early in the pregnancy, if the results are that it is a normal pregnancy, or could allow for immediate treatment if the pregnancy isn’t normal. Knowing the diagnosis days or weeks earlier would not only be safer, but would provide piece of mind.

When a woman has tried so hard to become pregnant, the first trimester can be a both an exciting and scary time. As a fertility doctor seeing so many women go through this period of uncertainly, it is very satisfying to be a part of a project that could improve the experience of these women.

For more information on this study check out the following articles from The Telegraph (U.K.) and Pregnancy and Baby.

On the occasion of Breast Cancer Awareness Month, we would like to wish all of our patients who have survived breast cancer, and those who are currently battling breast cancer, a smooth recovery and a long, healthy life.  We’d also like to illuminate some very exciting breakthroughs to help future generations live without the worry of genetic breast cancer. 

Genetic breast cancer is transferred through the abnormal BRCA gene, which is responsible for 5-10% of all breast cancer cases under the age of 50.  Through a process known as PGD, or Preimplantation Genetic Diagnosis, we are now able to identify the abnormal BRCA gene in your embryos and transfer to patients only embryos that do not possess the gene. Our specially trained embryologists will remove a cell (or cells) from each viable embryo (embryo biopsy). The genetics lab will determine which embryos do not have the abnormal BRCA gene and only healthy embryos will be transferred into the uterus. 

Women who carry the abnormal gene are at an increased risk of breast cancer.  Breast surgeons recommend that women with the abnormal BRCA gene should have a prophylactic double mastectomy.  IVF with PGD offers an alternative for your daughters and even sons.  Instead of having to go through the painful decision and process of having a double mastectomy and breast reconstruction, PGD will allow you to rid your child of the BRCA gene before birth. 

More about the BRCA Gene:

•     The BRCA gene is especially common in Ashkenazi Jews (2.5%)

•     BRCA-1 is associated with lifetime risk:

-  1^st Breast Cancer, 50-85%

-  2^nd Breast Cancer, 40-60%

-  Risk of ovarian cancer ranges from 20-45%

-  BRCA-2 gene associated with similar risk

•     It should be noted that male breast cancer occurs in more than 6% of cases

•     We recommend that those with the BRCA gene mutation come in for a consultation to discuss having In-Vitro Fertilization (IVF) with PGD. 

 To determine whether you should consider genetic testing for BRCA1 and BRCA2 mutations please click on the following link and scroll down to Q&A #6 http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA 

A fascinating development in reproductive technology, PGD now provides an important tool to combat genetic misfortune.  PGD may give you a peace of mind, knowing that you can provide your children with a future for that is free of genetic breast cancer and that you can spare them from the struggles you had to face.

Learn more about Dr. Rosenfeld here.

David Rosenfeld, MD- Founder and Chief of the Center for Human Reproduction

It’s no surprise I ended up working in the field of Human Reproduction. Having been on an infertility journey myself, I was drawn there. The special feeling I had inside after having been through the ordeal never left me. I wanted to help those with the anguish, depression, failure and feelings of worthlessness that I too once experienced.

These heartaches run deep, they hurt so badly. To compound these feelings of despair, you have to ‘buckle up’ and smile when you hear from your friend or sister in law or cousin when they revel in the delight of a newly diagnosed pregnancy. It seems to pervade your life. Everyone you know is pregnant except you.

I’ll never forget the devastating feeling of being in the bathroom and crying because once again, another month gone by and I got my period. It’s an indescribable feeling that hurts so much it’s nearly unbearable– and though my husband was supportive, I never really felt that he understood this feeling of hopelessness.

So the days and the months and the years went by– my life became like clockwork, analyzing the countless temperature charts (this was before the days of IVF). Sex became a chore rather than a pleasure. The clinic visits, the testing, the pills, the temperatures, the hunger for information…….

My story ends on a happy note, though bittersweet. I kept at it. We adopted a wonderful baby boy only to succumb to another devastating loss when the birth mother changed her mind. Three months after this life changing incident, lo and behold, I was pregnant with twins!!!

Therein, lies the ecstasy. I had a relatively uneventful pregnancy though emotionally charged. It was perhaps the most memorable experience of my life. I now have not only my 26 year old identical girls but also a ’surprise’ 22 year old boy. Be it a prayer, luck or God’s will, I consider myself blessed.

I urge everybody to pursue their goals because there is an answer for everyone. Work through the pain, keep yourselves busy and persevere. That being said, when we get the news of a birth from our patients it brings a joyful tear to my eye. The best part of my job is seeing our patients realize their dreams.

Source: Mandalay Vision’s The Kids are All Right

By: Dr. Avner Hershlag

In this comedy, which opened in theaters last weekend, a lesbian couple, Nic and Jules (Annette Bening and Julianne Moore), live with their teenage children, Joni and Laser (Mia Wasikowska and Josh Hutcherson), in LA. As Joni prepares for college, her younger brother pesters her for a big favor—help him find their biological father. Against her better judgment, she makes a call to the sperm bank; the bank, in turn, calls Paul (Mark Ruffalo) and asks him if he’s willing to meet his daughter. He agrees, and a complicated new chapter begins for the family.

The movie’s message is that these teenage kids, raised by two mothers, are going to be all right. Is that true?

A recent study by Catrell & Bos, published in Pediatrics, looked at 78 offspring born to 154 lesbian mothers who conceived through donor inseminations.

They found that 17-year-old children of lesbian mothers:

• Were rated significantly higher in social, academic, and total competence than typical American children, as compared with Achenbach’s normative sample of American youth.
• Had significantly fewer social problems, and less rule-breaking, aggressive, and externalizing problem behavior than age-matched children.
• There were no differences among adolescent offspring conceived by known, as-yet-unknown, and permanently unknown donors, or between offspring whose mothers were still together and offspring whose mothers had separated.

Why?

• The mothers’ “commitment even before their offspring were born to be fully engaged in the process of parenting.” During pregnancy, the mothers took classes and formed support groups to learn about raising a child.
• “They were actively involved in the education of their children and aspired to remain close to them, however unique their interests, orientations, and preferences may be.”
• The mothers were keenly aware of the prospect of discrimination, so they “took a lot of time educating people who came into contact with their families — obstetricians, pediatricians, teachers, administrators. They were always working on diversity programs and anti-bullying programs.”
• The lower levels of externalizing problems may be explained by disciplinary styles. The mothers used verbal limit setting, and studies have shown they use less corporal punishment and less power assertion than heterosexual fathers.
• “Growing up in households with less power assertion and more parental involvement has been shown to be associated with healthier psychological adjustment.”

In an accompanying editorial, Joseph Hagan MD, of the U of Vermont, writes:

“Our experience tells of the resilience of children who are loved and know that love. Our learning tells us of the boundless ability of children to respond to that love despite the absence of a traditional parenting relationship.”

So, the kids are all right?

You bet they are!

For decades, the Surgeon General has advised quitting smoking.  Beyond the well-publicized diseases and health risks caused by smoking and second-hand smoke, smoking contributes to fertility issues.  Cigarette smokers are known to be more likely to have several fertility issues as compared to non-smokers, regardless of which partner smokes.  Both female and male smokers have lower fertility levels, taking longer to conceive, and children of mothers who smoked have an increased risk of fertility issues as adults.

On the female side, ovarian reserve (egg quantity) and egg quality are compromised in women who smoke.  Smoking also reduces the chance of success with IVF, and smokers have increased rates of miscarriage with IVF pregnancies.

And on the male side, compared to non-smokers, smokers tend to have lower sperm counts, reduced amounts of semen, impaired motility of sperm, and a higher percentage of abnormally-shaped sperm.  Smoking can also affect the blood vessels that supply the penis, causing erection problems.

Besides the obvious health benefits of quitting smoking, quitting smoking will increase your ability to conceive and your likelihood of success with IVF.  It is thought to take at least three months for improvement to be maximized in relation to fertility after stopping smoking.

To help you get started…

Center for Tobacco Control (North Shore-Long Island Jewish Health System)

(516) 466-1980

Fax: 516-466-1954

TobaccoCenter@nshs.edu

www.northshorelij.com/stopsmoking

New York State Smokers’ Quitline

1-866-NY-QUITS (1-866-697-8487)

www.nysmokefree.com