The Art of ART

April 4, 2006 - Tuesday
7:50 PM to (EST)
Guest Speakers: Rafat Abbasi, MD
Columbia Fertility Associates

Categories
Egg Donation • Egg Freezing • Fertility • Infertility Drugs • PCOS • Pregnancy

	Cat joined
	melissa3 joined
	deb_capone joined
	blissfinder joined
	Dr_Abbasi joined
	tamany joined
Dr_Abbasi	Yes . The topic tonight is to emphasize the proactive approach for women.
	mellyis1 joined
deb_capone	good evneing mellyis.
Dr_Abbasi	Women should be made aware of all the options out there regarding egg and embryo freezing.
deb_capone	Why do you think that is so important?
	mellyis1 left
Cat	For a woman over forty do you donor egg is worth a try?
Dr_Abbasi	Women tend to del;ay childbearing for different reasons. they do not realize that time is passing by and there is a finite reproductive span and soon it will be toolate.
Dr_Abbasi	Cat, it depends upon the FSH level and the quality of her eggs.
Cat	I tried to have children for 20 years and had a stillborn baby. What about donor eggs?
Dr_Abbasi	Cat, donor egg is a good option.
Cat	Where are the best places to have it done? Name a few if you can. Dr. Gordon, Dr. Masher ?
Dr_Abbasi	There are several centers including ours that have a great success with donor eggs
Cat	Do you have donors avaliable immediately?
Dr_Abbasi	yes.
tamany	Are there any diet suggestions that you would make for women with PCOS?
Dr_Abbasi	Yes. Control the carbohydrate content of the diet.
	alexandria07 joined
tamany	Are diets like South Beach helpful or hurtful, I should say that I am a normal weight PCOSer and ovulate regularly
Dr_Abbasi	Tamany, any diet that is carb restricted will work.
	blissfinder left
tamany	thanks
Dr_Abbasi	Your'e welcome
Cat	Why did your network of doctors dis ban?
Dr_Abbasi	Cat, I do not understand the question/
melissa3	are women with PCOS good candidates for IVF?
	tamany left
Dr_Abbasi	Melissa3. Yes they may be if all other treatments like ovulation induction have failed.
	tamany joined
	blissfinder joined
Cat	What percent of egg donors have success at your practice?
Dr_Abbasi	Cat, our donor egg success rate is 60%.
deb_capone	Welcome , Alexandria 07
	leanne joined
melissa3	do you have a better chance if they transfer blastocyst embryo?
deb_capone	We are talking with Dr. Rabat Abbasi, from Columbia Fertility Assoc. about preserving fertility options. Feel free to join in...
Dr_Abbasi	Melissa, a blastocyst has a higher chance of implantation.
	leanne left
	yassi joined
	qpnmwzni joined
deb_capone	good evening yassi and qpnmwzni. we are glad to have you aboard.
Cat	When is it impossible for a female to become pregnant in terms of age?
tamany	what about caffeine -- do moderate amounts hamper fertility
deb_capone	Dr. Abbasi is with us tonight talking about preserving fertility options...especially as it relates to egg and embryo freezing.
Dr_Abbasi	Cat, that is dependent upon many factors but in general before age 40.
Dr_Abbasi	Tamany, Caffeine in smalll amounts is not harmful. Like the equivalent of 1 cup of coffee.
melissa3	how many days do you think a women should have off after the transfer?
Dr_Abbasi	There is no fixed time period. Generally the day if transfer is enough.
	alexandria07 left
Cat	I don't think well of freezing eggs myself. They disintegrate.
blissfinder	Can other people chime in with opinions on things, or just the doctor? not sure what the protocol is here.
	Symharmony joined
	alexandria07 joined
Dr_Abbasi	Cat, egg freezing is only for younger women or those who have to undergo Cancer treatment.
deb_capone	blissfinder, you are welcome to chime in.....this is all about you guys!
deb_capone	Good to see you symharmony!
	honeybumblebee joined
Symharmony	Thanks
deb_capone	good evening honeybumblebee!
	alexandria07 left
honeybumblebee	GOODEVENING, HOW IS EVERYONE ?
Cat	Does an egg donor work usually on the first try? Too expesnsive to do too many tires!!!
blissfinder	Melissa3, the days off question is a difficult one. I ended up taking off the full two weeks, because I didn't want to be stressed and I could not concentrate on work. It's a very individual decision.
Dr_Abbasi	Cat, yes it does but there are shared risk donor programs like ours available also/
	alexandria07 joined
honeybumblebee	ANYBODY FAMILIAR WITH POLYCYSTIC OVARIAN SYNDROME
Dr_Abbasi	Yes
	jblewin joined
	Ana_Gonzalez joined
deb_capone	What is your question honeybumblebee?
jblewin	I'm jenn lewin. I'd like to know if doing IVF now will have an effect on future pregnancies.
	kingzlee joined
	Ana_Gonzalez left
tamany	That is a great question
blissfinder	Dr. Abbasi, do you recommend that a couple that has been through four IVF's, two with their own egg/sperm and doing PGD, and two donor egg IVF's (one fresh, one frozen), who has not gotten pregnant discontinue treatment? This is after five miscarriages.
Dr_Abbasi	Jenn, there is no evidence of any adverse effect on future pregnancies.
deb_capone	Also, The AFA is publishing an issue of inFocus on PCOS this spring. If you are a 'no barriers' member of the AFA you will get it in the mail. If you aren't a member...join now: www.theafa.org
honeybumblebee	HOW DOES IT FACTOR IN WITH FERTILITY AND GETTING PREGNANAT ?
Dr_Abbasi	The problem is that of a hormone imbalance and excess androgen production. This makes it difficult for you to ovulate.
	onecaras joined
kingzlee	Dr. would you recommend lapro, abdominal or hysteroscopic surgery for someone who was just diagnosed with a 4-5 cm submucosal fibroid that is growing inside the cavity from a "stalk" before we move onto IVF, for mild MFI (low motility, 6% kruger strict and > 22M Total Motile Count?".
Cat	blissfinder you endured a lot. My sympthay.
Dr_Abbasi	Blissfinder.It would seem thatis so but I cannot address that since I do not have all the records.,
Dr_Abbasi	Kingzlee, yes absolutely.
blissfinder	Cat, thanks. It has really been an ordeal. We have been trying for seven years. Just finished the unsuccessful frozen donor egg cycle in January. Decided to get off the roller-coaster.
	frustrated joined
tamany	Blissfinder, I am sorry that your journey has been so difficult.
jblewin	thanks. if I'm asking too many questions plese tell me! When is the right time to do IVF? We've been trying for almost a year. I've had HSG, ultrasounds, blood work, m y husband has excellent sperm stats. alls eems normal. i've been taking my temperature, using ovulation kits, etc. And I had two positive urine tests after late periods, followed immediately by negative blood tests.
Dr_Abbasi	jblewin Hard to say without all the records.
jblewin	what other factors are relevant, in your opinion?
kingzlee	Dr. is it because of the low motility? dh motility score was 58 and it said it s/b >150. results did not give a %
frustrated	For most, the first step is Clomid
jblewin	yes, but the stats are much lower for clomid than IVF, right?
Dr_Abbasi	Laparoscopy.
tamany	During an IVF cycle when should you expect to have a dominant follicle?
melissa3	when they test your HCG after the transfer 3 weeks later and it is above 12,0000 is that i sign that there can be more than one baby?
onecaras	Dr. I just turned 31 years old and we had one failed IVF cycle (no eggs were retrieved). My last FSH came back at 8 and my RE is concerned. I am just finishing my clomid challenge test, and my RE said the cutoff for IVF is 10.2. Would you reccommend a second cycle?
frustrated	I thnk it's 7-8% with Clomid, 20% with IVF
Dr_Abbasi	Kingzlee, yes it could be.
Cat	Would lap help on a 42 year old?
Dr_Abbasi	Tamany, no you should not have a dominant follicle
Dr_Abbasi	Melissa yes that is possible.
kingzlee	Dr anyt thoughts on how valid the cdc ART results are in choosing a clinic?
Dr_Abbasi	onecaras, yes definitely.
frustrated	Dr - I have had one Clomid + IUI cycle which failed. How many of these would you recommend before going on to IVF? I am turning 31 next month - normal HSG, normal sperm count, normal blood work.
Cat	What are you thoughts on choosing an egg donor program?
	catherine joined
tamany	is a FSH of 8 really that high in for a woman in in her thirties, bc mine is about the same
Dr_Abbasi	kingzlee. Like everything else it has to be evaluated. Remember the RAT results are 2 years old when published.
onecaras	why so different in answers? my RE says based on history just explained, percentages are <2% success.
Dr_Abbasi	Frustrated, about 3-6 cycles are appropriate.
Dr_Abbasi	CAt, availability of donors and success rates.
Cat	Thank you very much. I have heard good things about your kindness and skill.
Dr_Abbasi	Onecars. What percentages are you talking about?
	nansmontoya joined
	Ana_Gonzalez joined
kingzlee	any key CDC results that we should focus in on with each clinic?
	yassi left
onecaras	cycle IVF success rate
Dr_Abbasi	kingzlee Depend upon the factor for infertility.
Cat	Who has the best success rates for donor egg in Northern VA?
qpnmwzni	What is your opinion on the amount of transfers of with donor egg?
Dr_Abbasi	onecars, please explain. Ivf sucess rates for a young woman with normal FSH are hardly 2%.
honeybumblebee	DR, WHAT IS THE SUCCESS RATE OF CLOMID ASSOCIATED WITH PCOS
catherine	building on kingzlee: and if it's unknown factor?
alexandria07	thank you
	qpnmwzni left
honeybumblebee	LAST YESR I DID 4 CYCLES OF CLOMID AND NOTHING
frustrated	honeybumblebee - what is PCOS?
Dr_Abbasi	honey, About 15%.
	nansmontoya left
	nans joined
alexandria07	dr, would you be able to tell me what it means when one month you get an fsh of 17 on cd2, and then the next month you get an fsh of 5.8? What are my chances of success with ivf?
frustrated	honey - did you combine with IUI? what are you doing now?
honeybumblebee	PCOS IS POLYCYSTIC OVARIAN SYNDROME... A CONDITION WHERE THE OVARIES ARE SURROUNDED BY TINY CYST THAT PREVENT YOU FROM OVULATING
tamany	personally, I after 4 cycles of clomid I think if it is going to work, it will work in the first 2 cycles
onecaras	Dr. I have stage 3/4 endo and have had 2 laps, most recently last month with 3 endometriomas removed. RE feels my endo is destroying my eggs.
Dr_Abbasi	onecaras that is possible and you should consider IVF.
honeybumblebee	NOT OVULATING CAUSES YOU TO HAVE IRREGULAR MENSTRUAL PERIODS, WHICH IN TURN MAKES IT HARD FOR YOU TO CONCEIVE
kingzlee	Dr. if they just found a 4-5 cm fibroid submucosal, should be stop ttc this month until we schedule the surgery? I just did the clomid challenge and would like to take the opportunity to try. Urologist said Dh's low motility is okay because of the high total motile count.
Symharmony	What do you do if you can't afford IVF and your insurance doesn't cover infertility?
frustrated	Do most people try the injectible drugs after Clomid, or go straight to IVF? What are the pros and cons of the injectibles?
Dr_Abbasi	kingzlee yes.
	qpnmwzni joined
melissa3	what is the success rate for someone 25yrs old with PCOS, and that's the only problem?
kingzlee	thank you
kingzlee	::biggrin
frustrated	What is the clomid challenge?
honeybumblebee	I OFFICIALLY STARTED TRYING TO GET PREGNANAT MAY 2004. MY GYNO STARTD ME ON CLOMID THINKING I JUST NEEDED A LITTLE HELP.....THAT WAS ALMOST 3YEARS AGO, AND STILL NOTHING
Dr_Abbasi	Symharmony, that is a difficult question. Shared risk if you qualify.
onecaras	What is a normal FSh for someone my age, 31?
Symharmony	Thanks
kingzlee	Frustrated - day 5-9 they put you on clomid and take b/w on cd 10 to see the ovarian reserve #'s. I'm 37 and used to smoke so RE wanted this done.
Ana_Gonzalez	Doctor Abbasi - Do you think age is a factor in number of eggs to use for IVF if the eggs are donated from a young donor? I am 61. And is it important to stay recumbant after implantation and for how long?
Dr_Abbasi	Melissa about 60-70%of conceiving.
frustrated	I'm on Clomid, but have never done the Clomid challenge - I take it day 3-7. Is that something I should do?
deb_capone	I just want to thank Dr. Abbasi for her time, expertise and answering your questions tonight. This is a great session...
Dr_Abbasi	frustrated. Clomid challenge is an evaluation of the ovarian reserve, More info on our website www. columbiafertility.com
catherine	Would you suggest IVF before Clomid if money isn't an issue?
Dr_Abbasi	Honey, you need to see an RE.
honeybumblebee	DR. WHAT DO YOU RECOMMEND, AFTER TRYING CLOMID FOR 2 YEARS AND NOTHING
Dr_Abbasi	onecaras, Less than 10.
kingzlee	frustrated - i have one friend on clomid and dr never did the challenge, I believe it is because of age they call for it - he said it helps give him a base line on what he will be working with and what med dosage should be.
honeybumblebee	DR, WHAT DOES F.A.C.O.G.
melissa3	how do RE decide a three day transfer or a five day trnasfer?
Dr_Abbasi	Ana age is a factor for you for carrying the pregnancy.
frustrated	so maybe clomid challenge is not approp for a 31 y.o.?
tamany	fellow of academy of ob/gyn
Dr_Abbasi	catherine Not necessarily.
honeybumblebee	SO, IT WOULD BE COMPLETELT DIFFERENT TREATMENT IF I SEE AN RE
qpnmwzni	sorry I lost the connection. What is your opinion again on the amount to transfer for a 37 year old with a healthy uterus using donor egg?
frustrated	Dr - how do you feel about guafenisin (sp?) for trying to thin cervical fluid?
Dr_Abbasi	melissa it depends upon the # and quality of embryos and the risk of multiple preg.
alexandria07	dr, i was wondering if you got my message?
kingzlee	dr. my clinic is basically one stop shopping and they do everything onsite, iui, ivf, sa, etc. are there any reasons to not do it within the clinic?
Dr_Abbasi	qpnmwz 2 embryos.
blissfinder	qpnmwzni - I was 37 when I had my donor egg IVF, and my doctor transferred 2 embryos. they were fairly good quality.
Dr_Abbasi	frustarted, that is fine.
frustrated	what should the dosage be - i read 3 tsp, TID
Dr_Abbasi	kingzlee, all clinics are like that.
qpnmwzni	blissfinder, did you have a healthy baby from this?
frustrated	and what days should the guafenesin be taken?
Dr_Abbasi	frustarted yes.
catherine	why not necessarily? What is a strength of Clomid vs IVF? I guess I'm just going by rate of success.
honeybumblebee	DR, WHAT TYPE OF TREATMENT CAN I EXPECT WITH AN RE
	vanessa joined
Dr_Abbasi	frustrated from days 7-10
frustrated	what about taking a baby aspirin every day to prevent miscarriage?
Dr_Abbasi	Catherine, because it depends upon the reason for the infertility and the patients age. there are many factors to consider
vanessa	i just found out i have pcos. i had 15 cysts on each ovary, is that a lot?
onecaras	Honey, an RE can do so much more than a OBGYN. They are experts in helping people conceive.
qpnmwzni	for those that have never taken clomid before, it made my PMS sky rocket. Do your research and ask your doctor any questions you have
blissfinder	qpnmwzni, no, I did not. I did not get pregnant. My case was an unusual one. From what my doctor said, most people in my situation would have gotten pregnant. The donor we picked had been through the process before with two other couples, and both of them got pregnant.
Dr_Abbasi	honey, a more thorough evaluation and a more proactive approach
Dr_Abbasi	frustrated yes that is ok.
	jblewin left
catherine	ok, thanks. what if there are no reasons they can find for the infertility, all the statistics are perfect for both partners? been trying for a year. i'm 34.
Dr_Abbasi	vaness for PCOS it is not. They are small cysts.
deb_capone	To interject, one of the services of The AFA is to make referrals to REs in your area. Just call us and we can refer you to a doc like Dr. Abbasi near you.
frustrated	Thank you so much Dr. Abbassi, I am signing off now
honeybumblebee	OK....IS THERE ANY SPECIFIC INFO I SHOULD GIVE THEM, OR ANYS SPECIFIC QUESTIONS T ASK
	frustrated left
blissfinder	qpnmwzni - one other thing, I would recommend that, if possible, you pick a donor who has been through it at least once, and has had a positive result. Not 100% a requirement, but that is what was recommended to me. And, that is what makes it possible for me to go forward beyond treatment, without any doubt that we did all we could.
Dr_Abbasi	catherine then the diagnosis is Unexplained infertility and that needs IVF.
qpnmwzni	blissfinder, can you tell me why your case was unusaul. Through my experience the last 7 years, everything has been unusual for me.
kingzlee	Dr., what is the avg success rate of a preg. with a 4-5 cm mucosal fibroid? Is that high risk? do they place woman out on disability usually for this?
Dr_Abbasi	kingzlee.I do not know about disability but yes it is risky in that it can cause miscarriages,
catherine	thank you again. this is so helpful. does the egg retrieval hurt? i'm seriously pain averse. then again that's probably a reason not to get pregnant in the first place, right?
onecaras	DR. Is FSH lab sensitive? I've heard that different fertility clinics have widely varied FSH level limits to determine IVF success.
honeybumblebee	WHERE CAN I GO TO FIND AN RE IN MY AREA
blissfinder	Cat-egg retrieval doesn't hurt, because you are under anesthesia
Dr_Abbasi	Catherine, egg retrieval is done with sedation it does not hurt.
tamany	Thanks so much for answering my questions.
Dr_Abbasi	honey where are you?
	tamany left
honeybumblebee	MIAMI, FLORIDA
alexandria07	do you believe that accuppuncture helps with the ability to conceive?
qpnmwzni	catherine, egg retrieval does not hurt. Happy thoughts. You've made it that far:)
Dr_Abbasi	onecars, they can vary but most labs use the same assay.
kingzlee	arecommendations for re's in mi
Dr_Abbasi	honey go see DR> MARIA BUSTILLO.
Dr_Abbasi	Alex, yes there is data supporting that.
onecaras	Thank you for your time doctor!
kingzlee	sorry, i wanted to type middlesex county, nj?
catherine	thanks so much!! has anyone out there done it? and maybe can talk some time? on the site?
honeybumblebee	WHERE CAN I FIND DR MARIA BUSTILLO
blissfinder	qpnmwzni-we may want to talk off-line. sounds like we have some things in common. hard to summarize my case.
melissa3	does it take more then two weeks to get started on IVF, i have been on the pill for three months, the RE told me next time i come in we will get started on IVF cycle will start three weeks after appointment. DO you know DR.Cowart?
qpnmwzni	blissfinder, did you try another donor?
Dr_Abbasi	Honey she is in MIAMI. Look her up in the phone book. She is known there.
honeybumblebee	OK. THANKS SO MUCH FOR ALL YOUR HELP
Dr_Abbasi	melissa that is too long I don't know why. No I do not know that doctor.
	nansmontoya left
	vanessa left
honeybumblebee	::wink
blissfinder	qpnmqzni-no. was going to, but then decided to stop treatment instead. we had had the best donor we could find. She was very young, had two kids of her own which she got pregnant with while on the pill, and had had success with two other couples prior to us. and, we found out that the couple after us was also successful at getting pregnant.
qpnmwzni	blissfinder, would be interested in talking with you more. what is the next step?
honeybumblebee	GOODLUCK MELIISA3 ::cool
blissfinder	email me: mer@fresperspectivecoaching.com. thanks.
catherine	yes, good luck--i'll be in your shoes in a few weeks.
	honeybumblebee left
melissa3	thank you same to you honey
deb_capone	One of the promises we make to all of our guests is that we start and end on time! So, we are in the home stretch.
Dr_Abbasi	blissfinder, did you check your uterus for immunological issues?
	onecaras left
deb_capone	Dr. Abbasi can take one more question and then wrap it up for tonight.
catherine	ok, one final: how to handle disappointment of not getting pregnant on IVF?
Dr_Abbasi	Tough. Therapy and a good support system
catherine	thnks!!
blissfinder	Dr. Abbasi. Yes, a bit. Had considered doing IVIG at one point, and go that route, and decided not to pursue.
	alexandria07 left
Dr_Abbasi	I would try it I have had suscces with it.
qpnmwzni	blissfinder, will email you thanks
deb_capone	Please join us next week when Nancy Harrington from IVPCare hosts a session on maximizing the nursing professionals for support and information. There is never a question that is NOT Significant!
blissfinder	Deb and Dr. Abbasi, thanks for the forum. It helps to know other people are in the same boat.
qpnmwzni	Thank you Dr. Abbasi and everyone else
catherine	yes, thanks again. great way to get a second opinion, and support.
deb_capone	Dr. Abbasi, thank you for your time. This was a terrific session.
	kingzlee left
Dr_Abbasi	I enjoyed it. Thanks.
deb_capone	Blissfinder, we are here every Tuesday night...from 8-9pm Eastern. We look forward to seeing you next week.
	Symharmony left
deb_capone	Dr. Abbasi, is there a contact point for Columbia Fertility Associates in case someone wants more information?
blissfinder	Deb-is there a way to save this transcript?
deb_capone	It will be posted online in about a month.
Dr_Abbasi	Yes there is. Contact me at docivf @verizon.net
	blissfinder left
	vanessa joined
	blissfinder joined
deb_capone	Thanks Dr. Abbasi.
	blissfinder left
deb_capone	Good night everyone.
vanessa	i recently foun d out that i have pcos. during the ultra sound it showed 15 cysts on each ovary, s that a lot of cysts
Dr_Abbasi	Good night.
melissa3	::smile
	Dr_Abbasi left
	vanessa left
	nans left
	deb_capone left
	melissa3 left
	catherine left
	Ana_Gonzalez left
	qpnmwzni left
	Cat left

The Art of ART

Categories

Chat Archives