PHYSICIAN PROFILE

STRESS & INFERTILITY

COPING & THE HOLIDAYS

ZIKA VIRUS

FERTILITY 101 VIDEOS

Relax. Chill out. Let it happen. HealthCircle offers several programs

and support systems for you

Mary Casey Jacob, Ph.D., ABPP, offers her advice on getting through the

holidays when coping with infertility

Important information for you on holiday travel and staying safe

David Schmidt, MD, is board certified in Obstetrics & Gynecology

and Endocrinology & Infertility

Educational videos featuring our staff with answers to some of the most

commonly asked questions

Volume 1 Issue 4 Winter 2016

KNOWLEDGE REALLY IS POWER How genetictesting can make it easier to avoid a difficult outcomeThe study of the human genome has had a profound impact

throughout the practice of medicine. But it has become

particularly helpful for couples seeking to achieve their

dream of bringing a healthy baby into the world. (cont. inside)

Now, two commonly used genetic tests in In Vitro

Fertilization (IVF) – Pre-Implantation Genetic

Diagnosis (PDG) and Pre-Implantation Genetic

Screening (PGS) – can spot potential problems

before an embryo is implanted, thereby avoiding

the likelihood of a miscarriage, the inheritance of a

genetically-carried disease, or conditions related to

an abnormal chromosome count.

TWO TESTS WITH ONE PURPOSE

PGD: Thus far, scientists have identified hundreds

of life-threatening and debilitating diseases that

can be screened before an embryo is implanted in

the mother’s uterus. PGD is used during IVF to test

for inherited conditions that are called “single gene

disorders.” As noted, a wide range of conditions can

be detected, but the most common include Cystic

Fibrosis (a disease that affects the body’s mucus and

sweat glands, often causing chronic lung infections),

Sickle Cell Anemia (a disease of the red blood cells

that can cause attacks of pain and damage to vital

organs and lead to early death), Thalassemia (a group

of inherited blood diseases that cause red blood cell

deficiencies, the most severe of which results in fetal

or newborn death), Tay Sachs Disease (a fatal disease

of the central nervous system that destroys nerve and

brain tissue leading the blindness, paralysis and death

by the age of 5), and Myotonic Dystrophy (a disease

that can show up at various stages of life and in

varying degrees of severity, affecting different types

of tissues and organs). In addition, translocations

(when chromosomes break and the fragments rejoin

to other chromosomes), that may cause miscarriages

can also be detected.

PGS: A normal embryo has 46 chromosomes – 22 pairs

of non-sex chromosomes and 2 sex chromosomes

(X and Y). When an embryo is missing or has extra

chromosomes, the condition is called “aneuploidy.”

Embryos with aneuploidy are typically not viable,

meaning that they will fail to implant in the uterus,

or will result in a miscarriage. When embryos with

aneuploidy do come to full term, Down Syndrome (a

duplication, in part or in full, of chromosome 21) is the

most common genetic abnormality.

PGS uses the most advanced genetic testing currently

available to screen for aneuploidy and provides the

most accurate results possible. PGS [and PGD] are

also highly accurate, with 98% accuracy in diagnosing

the presence of genetic defects. Both tests have a

common purpose: to offer you the greatest chance

of successfully bringing a healthy, normal baby into

the world.

SHOULD YOU CONSIDER PGD OR PGS TESTING?

Many believe that the genetic screening of embryos

before they’re transferred can spare couples the

emotionally difficult decision of having to consider

terminating a pregnancy if a defect is found by the

second trimester. Also PGS is an effective tool for

sex selection in screening for sex linked diseases or

simple family balancing.

The choice of whether or not to consider genetic

screening during IVF depends on your specific

situation. If there’s a family history of a genetic

disorder, or if the mother is over 35 years of age,

or if there is a history of recurring miscarriages, or

if there is a history of severe male factor infertility,

you may want to talk with your physician about the

advantages of pre-implantation genetic screening.

As always, our goal is to provide you with the greatest

chance of realizing your dream of starting or adding to

your family. With an individualized approach to care,

we’ll work with you to consider the appropriateness

of genetic screening – as well as all other technologies

available – to help you achieve success.

P GD & P GS T EST I NG

(cont. from cover story)

How genetictesting can make it easier to avoid a difficult outcome

Dr. Schmidt is a lead physician at The Center and is board certified in Obstetrics & Gynecology and Reproductive Endocrinology &

Infertility (REI).

Dr. Schmidt has special interests in IVF, ovulation induction, endoscopic surgery and research. Several of Dr. Schmidt’s research projects have been accepted for national publication or presentation, and he has received numerous awards including the Dr. Spero Neckles Award for Outstanding Resident Research. “The research really ties in state-of-the-art, or the latest advances in our field and brings it quickly to the clinical arena.”

Meet Dr. David Schmidt

“Each and every patient; it’s very rewarding in the end when we can help

them achieve a pregnancy that they otherwise had a difficult time achieving.

The reward is really phenomenal.

I love what I do.”

Relax. Chill out. Let it happen. As unwelcome as that type of advice may be for women dealing with infertility, evidence does suggest that while stress does not cause infertility, infertility does causes stress.

Developing coping strategies to manage stress factors related to fertility treatment can help patients achieve better overall health and a more positive outlook during treatment.

At the Center, we have developed HealthCircle, a holistic approach to fertility care. This full circle approach offers several programs and support systems that patients can incorporate into their treatment plans including acupuncture, yoga classes, nutrition and weight loss plans, Reiki, health coaching, and individual and group solutions that can provide relief from emotional stress.

De-stressing the situation

Winter 2016

“It is well established that smoking affects several areas of our health including heart diseases, lung diseases as well as cardiovascular

diseases, but what most people are not aware of is that smoking reduces the chances of a woman’s ability to conceive.”

See the full video to learn more about smoking and fertility. Also visit our Video Library at www.uconnfertility.com to learn more

about topics involving fertility, treatments, the Center, and our doctors.

A guest on NBC’s Connecticut Spotlight, Dr. Lawrence Engmann, discusses how smoking

can impact fertility.

Winter 2016

Sharing Our Patients’Love“This year we celebrate our fourth holiday with our little gift. We are forever thankful for the care, compassion and expertise that you gave us to help start our family.”

“ Our dream has come true! We feel so blessed and we thank you and your team for all the encouragement and kindness, and for the new addition to our family.”

“ We often think of our infertility journey. Words cannot express our gratitude and appreciation to the Center for giving us our two miracles. We continue to give hope to others battling infertility.”

In celebration of this holiday season, we'd like to spread some of the joy that our patients share with us. We love receiving their family holiday cards.

*Have you seen our new educational videos?

Our YouTube channel is full of videos with answers to some of the most commonly asked

fertility questions.

Read more on our Facebook page @uconnfertility

Hey friends over 40, go ahead and hit snooze on that biological clock! Thanks to the updated Connecticut insurance mandate, all health insurance policies sold or renewed after January 1, 2016 are now required to cover infertility treatment for people age 40 and older.

There are limitations and exemptions to the updated law. The best way to determine your specific coverage is to work closely with your insurance carrier to examine all the benefits of your plan.

You can also visit our www.uconnfertility.com for links to documents addressing the insurance mandate and informational videos.

Now turning 40 no longer means the clock has to stop for those interested in exploring fertility treatment.

40+Stopping The Clock

Connecticut resident Jessica Mahoney celebrated her “rainbow baby” with a magical photo shoot. Photo: ©JoAnn Marrero. All rights reserved.

2 Featuring Ami Chokshi 2

We understand the unknown can cause apprehension or anxiety, but we think every patient’s first visit should be an

exciting and comfortable experience, so we’d like to give you an idea of what to expect.

First we’ll take your vital signs, review of your medical history, and possibly conduct a brief physical exam, which may include a vaginal ultrasound, allowing us to determine the best approach for your treatment. After your exam you will discuss your diagnosis and treatment plan with your doctor. Together you’ll talk about any additional tests or procedures that may be needed.

During your visit you’ll meet members of our staff, including medical assistants, APRNs, clinical nurses, residents, Fellows, and doctors. Once the exam, consultation and introductions are done, you’ll meet with a financial services representatives to discuss your health benefits as it relates to your treatment.

It’s our mission to provide the highest standard of individualized care to every patient, beginning with the very first visit.

WHAT HAPPENS DURING

YOUR FIRST VISIT?

Most big holidays are celebrated with a focus

on family. If you are struggling to have a family, or have more children, holidays may be especially painful times. Thinking about how to be gentle with your self can help. Here are some specific suggestions: If you are buying gifts, do so online or at small shops and avoid malls that are thronged with families.

Limit how many holiday gatherings you attend. Practice saying, “Thank you for the invitation but I will not be able to attend.” You do not have to explain or defend.

Instead of generating anticipatory anxiety by asking yourself “what if ” questions, spend some time thinking about how you will answer. Rehearse!

If you know a baby will be at the event, decide in advance if you will hold it or not (if offered). Would it comfort you or torture you?

If you are trying to conceive with a partner, agree on a “get me out of here” signal in case the event becomes too overwhelming. This might mean leaving early or even just taking a walk for some fresh air. Helping in the kitchen can also be a great “time out.”

Give yourself permission to go away for the holiday or to start your own family traditions that may include staying home this year.

If attending religious services are important for your holidays, consider doing so on a college campus where the focus won’t be on the children in the congregation.

Consider taking a break from fertility treatments over the holidays.

Remember, it is normal to feel grief when one has not been able to have the children one desires. Others may not always understand, but it is normal.

GETTING THROUGH THE HOLIDAYS WHEN COPING WITH INFERTILITYMary Casey Jacob, Ph.D., ABPP

FROM OUR VIDEO LIBRARY

Life can be complicated for women who are interested in having children, but just aren’t ready yet. Be it careers, education, or health issues, egg freezing can help take the pressure off women who are facing this challenge.

Egg freezing allows women to store their eggs at a younger age, for future use. Another benefit of egg freezing is instead of storing embryos this process eliminates some of the ethical and religious concerns that accompany embryo freezing, storage and disposal.

Our doctors and embryologists have been perfecting the egg freezing and thawing process through extensive clinical trials. In fact, the Center is proud to offer egg freezing only after having demonstrated measurable success during an IRB approved clinical trial. •

uconnfertility.com

EggFreezing

�� ��

101

Holiday Travel and ZIKAThe holiday season is prime travel time for many, including women who are pregnant or

interested in becoming pregnant. It is highly recommended by the Center for Disease Control (CDC) that women preparing to travel should seek travel health advice from their doctor, and stay updated with information about the Zika virus.

The CDC has a designated website where you can find the most current information about Zika, information about US areas with Zika, and health advice: www.cdc.gov/zika.

You can also sign up to receive Zika updates for your destination with CDC’s new text messaging service. Text PLAN to 855-255-5606 to subscribe.

An academic affiliate of UCONN School of Medicine

uconnfertility.com

844.HOPEIVF

FARMINGTON

2 Batterson Park Road

Farmington, CT 06032

(844) 467 3483

NEW LONDON

4 Shaws Cove

Suite 201

New London, CT 06320

(877) 860 8044

HARTFORD

50 Columbus Blvd.

Suite 2

Hartford, CT 06106

(860) 525 8283

The Center is an academic affiliate of the UCONN School of Medicine? We are a specialized program of the division of Reproductive Endocrinology and Fertility and one of

the largest and most successful IVF programs in the Northeast. We offer one of less than 40 postgraduate fellowships for Reproductive Endocrinology and Infertility (REI) in the United States. Due to our national reputation as a "Center of Excellence," acceptance to one of our fellowship positions is very competitive. Fellows also participate in ongoing clinical research. This has resulted in several first author publications and national conference presentations for our fellows. Over the past three years, the fellows have presented 18 abstracts at national meetings and have published 13 articles in peer reviewed journals. Plus, we not only have REI fellows, but also Ob/Gyn residents and medical students training here as well.

DID YOU KNOW?

MONTHLY EVENTS

FIRST & THIRD Wednesdays

YOGA 5:30-6:30pm

THIRD Thursdays

RESOLVE Infertility Peer Support

Group 7-9pm

Check our website at uconnfertility.com for pre-

registration information. And like our Facebook page

for the most up-to-date information.

NEW!Spring 2016

T he Center continues to demonstrate success:

Not only in the percent of live births achieved, but also in our ability to lessen the potential for pregnancies with twins, triplets or more. As the largest fertility center in the state with 1,275 IVF cycles in the last year, we continue to lead in both the region and the nation.

To learn more about our success rates and those of other programs, please visit the Society for Assisted Reproductive Technologies website (www.sart.org). Click on IVF Success. A comparison of clinic success rates may not be meaningful because patient medical characteristics and treatment approaches may vary from clinic to clinic.