So I must admit that between the loss of Twinkies and my constant exposure to post-apocalyptic fiction I have not been a real laugh it up type of guy this week. Then my dog keeled over. Dollie is a 13 year old miniature schnauzer and she has developed vertigo and is having a really hard time walking and doing typical doggie activities. So now I face the difficult choice of deciding if and when to help my little friend cross over the Rainbow Bridge. Sigh.
Sometimes you just have to pick yourself up, dust yourself off and head into the future and not look back so much at the past. No Twinkies. No problem.
In medicine, especially reproductive medicine, we are always striving towards that elusive goal of achieving a healthy singleton term delivery as fast as possible. Change can come slowly or in staggering leaps forward. ICSI was a leap. The movement away from GIFT was a bit slower. GIFT involved a traditional trans-vaginal egg collection followed by a laparoscopy with a number of eggs and sperm mixed together and transferred into the fallopian tube. GIFT was helpful in cases of infertility in patients with normal tubes and normal sperm...and no significant endometriosis....so that really leaves you with unexplained infertility patients and Catholic patients who follow the specific admonition against combining eggs and sperm outside of the body. In any case, although GIFT here in Washington DC was pioneered by my partner at Dominion, Michael DiMattina, we have not done a case in years. Sometimes there is a boomerang phenomenon. Such as Natural Cycle IVF. NC IVF was employed by Steptoe and Edwards culminating in the delivery of Louise Brown back in 1978. Now we are seeing a resurgence of interest in NC IVF as is clearly evidenced in our own practice where this year about 80% of our IVF will be performed in unstimulated cycles. Not what we would have predicted when we started the program in 2007.
So what's old is new again. Maybe Twinkies will be gone for a while but then return. But just in case I am headed out this morning to buy a bunch of boxes. With a shelf life measured in decades they will be just the thing to help me ride out the zombie apocalypse.
