Merry Christmas

I am wishing you all a very Merry Christmas now as I will be taking some vacation time over these next 10 days. I hope that Santa brings you lots of nice goodies and also hope that you can handle the emotional turmoil that can come with the holiday season. Well-meaning and no so well-meaning friends and relations often feel quite comfortable weighing in on fertility and family matters. All I can say is to hang in there and know that I am hoping and...

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Photoshop and Other Holiday Traditions

Here at Dominion Fertility we gather each year around the Christmas tree to take a staff photo. Unfortunately, trying to get everyone together is a bit like herding cats so I end up having to photoshop in the missing staff members. Since this photo doctoring represents the only digital work that I do each year, I end up having to relearn Photoshop each December. So here is the result of my hard work. In a future post I plan to identify which staff...

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Happy Thanksgiving!

Thanksgiving is one of my favorite holidays. It is a time for family togetherness and reflection upon our many blessings. Recently, the Wall Street Journal ran an article about how those individual who express gratitude are healthier, happier and wiser than those who spend a great deal of energy griping.So as I am about to head home following a busy Thanksgiving morning at Dominion, I would like to take a moment to express my own gratitude before...

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Natural Cycle IVF. Part 3: It Works

Although I anticipated posting this final part concerning NC-IVF two weeks ago, it took me longer than I had anticipated to pull all the data together and organize it into a coherent discussion of NC IVF. So after much effort here it is....In December 2006, my partner here at Dominion, Dr. Michael DiMattina, attended the First World Congress on Natural and Minimal Stimulation IVF in London, England. Now, London is not the greatest place to visit...

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Natural Cycle IVF. Part 2: Patient Interest

So in the last post we discussed the development of stimulated IVF and how it made the entire process more efficient resulting in improvements every year in the IVF success rates. Yet patient interest in Natural Cycle IVF persisted. Why? Well I am not a patient so I offer these opinions based upon 14 years of practice and thousands of patients that I have had the privilege to treat for infertility.Reason #1: Fear of fertility drugsThe drugs that...

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Natural Cycle IVF. Part 1: History

Over the next series of blog posts I want to address several specific issues concerning Natural Cycle IVF. First I will cover the early history of IVF. Then I will describe why Natural Cycle IVF remained attractive in spite of lower success rates. Thirdly, I will review some pertinent research on Natural Cycle IVF. Finally, I will discuss our decision to offer Natural Cycle IVF and how our opinions differ from those of other clinics. This will include...

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Happy Belated Halloween

I must admit that I still enjoy Halloween. Nothing quite takes you back to your youth like walking around the neighborhood on a crisp fall evening while kids run from house to house extorting treats from the adults who stayed behind to dole out the candy. In particular I enjoy carving pumpkins and each year my kids seem to pick the hardest designs to test my ability. It takes a steady hand and a great deal of patience to carve those overgrown squashes...

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ASRM Update #4: Natural Cycle IVF

I really hate roller coasters. But I hate the spinning tea cup ride even more. All of this dates back to my childhood when I tossed my cookies after playing on the spinning spaceship ride at the playground near my home in Milton, MA. The other children were quite amused by my barfing but what can you expect from 10 year olds.Here is a classic photo of yours truly at age 10 with my Crazy Car in my driveway in Milton. Note the outstanding fashion...

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ASRM Update #3: 3rd Party Reproduction

Greetings from the mile high city where I have yet to sleep past 5 am since I remain on East Coast time. All the zombies have left town and only the attendees of the ASRM remain...some of whom do ressemble zombies although better dressed. Yesterday I attended a course on the role of mental health professionals in IVF and in particular in 3 rd party reproduction. Well it was certainly an eye-opener. Although I have had some unusual requests over the years (most commonly a woman who wants to use her adult daughter with husband #1 to be an egg donor...

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ASRM Update #2: High FSH and Zombies

Yesterday at the Post Graduate Course that I attended there was a great deal of discussion about ovarian reserve testing (ORT) and what it really means. As I have indicated in several past blogs ORT predicts response to fertility drugs and age predicts egg quality. So ORT does not indicate if a woman has any good eggs left...the only proof of a good egg is of course the delivery of a healthy baby. The overall consensus was that ultrasound and antimullerian...

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ASRM update #1: Size does matter

Hello from Denver where the annual meeting of the ASRM is being held. American Society for Reproductive Medicine that it. Well it seems that this is the meeting where I will be unable to keep my big mouth shut. Yesterday at the Practice Retreat for the members of the Society for Reproductive Endocrinologists I spoke my piece about practice size. As a 3rd generation physician I feel strongly that the patient-doctor relationship must be at the center of all care. So that is why we try to do as many sonograms as possible on our own patients and ditto...

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DrG on NBC

Clearly there was a lot of interest about IVF following the exciting announcement that Dr. Robert Edwards had been awarded the Nobel Prize. I was asked to speak about IVF on the Midday Show on the local NBC station here in Washington. I have been on TV a couple of times and I usually find it very painful to watch but this time I actually was pretty satisfied with how things went. The worst experience I had was on CNN when I was on a panel with Pete Singer and Arthur Caplan. Those two went after each other with a vengeance and I was left just sitting...

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Robert Edwards Wins Nobel Prize for IVF

Earlier this week the Nobel Prize Committee announced that Robert Edwards had been awarded the Nobel Prize for Medicine in recognition of the groundbreaking work on IVF that led to the birth of Louise Brown in 1978. It is hard to remember a time when IVF was not part of our fertility treatment options and yet just 3 decades ago IVF was more science fiction than science fact.Drs. Steptoe and Edwards ushered in a new era in reproductive medicine with...

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Question 36. Do I need endometriosis surgery if I am already planning to pursue IVF?

I wish sometimes that medicine was more like engineering. In engineering there are lots of straight lines and right angles. You can usually describe any problem with specific equations and most of the time there is clearly one right answer. Unfortunately, medicine is not engineering. There are some questions that cannot so easily be answered with a definitive "yes or no." My wife is an engineering PhD, so I can easily understand why very intelligent people can just want to scream when faced with some of the uncertainty inherent in medicine...especially...

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Question 37. What is the difference (if any) between intrauterine insemination and artificial insemination?

What's in a name? Sometimes not much I guess and certainly we throw around medical jargon quite freely in our practice sometimes forgetting that all this can be quite confusing to patients. I recently had a patient that came in requesting IUI with ICSI. She was very frustrated when I explained that you really cannot do ICSI unless you do IVF. However, she was adamant that she didn't want IVF with ICSI she wanted IUI with ICSI. I just was unable to make her understand the difference between IUI, IVF and ICSI. Oh well, she probably posted on some...

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Question 35. Are there medical treatments for endometriosis?

Occasionally I am asked to see a patient with endometriosis who is not interested in fertility. Although I can certainly manage these patients, I honestly think that they are better served by going to a non-fertility clinic RE. Our practice is pretty much 100% geared to the needs of fertility patients and I wonder if those patients who are not seeking pregnancy ultimately feel like a fish out of water in our waiting room....Fortunately there are some effective medical treatments for endometriosis. Unfortunately, all of these treatments shut down...

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Question 34. Does surgery for endometriosis improve pregnancy rates?

Where does all the time go? Seems like just yesterday that I was writing the last post before I went on vacation and now I realize that a whole month has passed. You may have wondered "where is Dr. Gordon?" "Why hasn't he posted a new blog that will make our day a little brighter and put a little more zip in our step?" "Why do the 6 of us keep reading this blog if he doesn't care enough about us to spend just a few minutes posting his words of wisdom?" "Why didn't I buy Apple stock at $25?" Wait that last question is the one that I keep asking...

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Question 33. What is endometriosis and how is it diagnosed?

You know I should have really been an Orthopedic Surgeon. I have spent so much time in their offices recently that I could have been much more useful to my family if I had specialized in something more practical. Of course, then we probably would have had fertility problems instead.....On the other hand, endometriosis is a problem that I know something about.....But that being said, our understanding of the link between endometriosis and infertility remains less than clear cut. It was not unusual to diagnose endometriosis in a patient undergoing...

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Question 32. Should I consider using a sperm donor to conceive?

So first we had Snowmaggedon and the Gordon family was without power for six days and now we have experienced Summerggedon! Sunday afternoon an intense thunderstorm ripped through the Washington DC area and did widespread damage. Over 300,000 taxpayers were without power and that included yours truly. Fortunately the power was restored last night after more than 48 hours of pioneer living. Needless to say we were very happy to rejoin the 21st century. On the other hand, the simplicity of going to sleep soon after sundown and waking up early in...

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Setting the Record Straight About NC-IVF

I am posting this recent blog by Dr. DiMattina which addresses some recent inaccurate information about Natural Cycle IVF that is circulating out in cyberspace.DrGHello Everyone!Recently, there have been many mistruths appearing on-line about our NC-IVF program. So, I am writing to set the record straight and provide you with honest information about our experience with NCIVF. As you well know, the internet provides a platform which all too often...

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Question 31. What can cause my husband to have no sperm at all and can we still have children together?

Summer is in full swing here in Washington DC and we are really getting cooked these past few weeks. I have been trying to be a real handyman this past week and have been granted a special dispensation by my wife in regards to the use of power tools. My project has been to strip off the paint and rust of an old patio set by using my power drill and a steel brush. Actually it has been very gratifying to see years of rust submit to my efforts. Does this have anything to do with infertility and IVF? Probably not, except that being a man is more than...

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