Avoid getting stung...advice from Dr G at Dominion Fertility

No good deed goes unpunished. I spend a fair amount of time traveling between our Fair Oaks and Arlington offices in order to do my best to do all the egg collections and embryo transfers on my own patients. So when my wife called to say that there was a lot of unanticipated activity in our neighbors backyard that seemed to involve significant tree work I thought that it would be helpful for me to pop in on my way back to Arlington for a quick look. Once at home I assured myself that the neighbor was not decimating trees on my side of the fence and thought that I could quickly knock some items off my project list and clear out a cedar dog house that our dog refuses to use. Bad idea. Did you know that bumblebees have small nests that usually are in the ground? I didn't. Did you know that bumblebees can make a nest in an old dog mat instead of in a hole in the ground? I didn't. Did you know that bumblebees are usually pretty docile and slow to anger and slow to sting a human....unless their nest is disturbed? I didn't. Did you know that angry bumblebees go for the eyes of any intruder who disturbs their nest? Well, I do now...

So as I ran screaming like a little girl away from the dog house, the angry bees followed and one of them managed to sting me on my eyelid. In short order my face started to swell on that side in spite of ice and benadryl. For some reason, this series of events elicits laughter from everyone who hears the story...my wife, the nurses, DrD.... I returned in time to see my afternoon patients. I wore my biggest set of glasses but did warn patients that indeed my face was swollen on one side. Of course, they could no longer look anywhere else and spent the consultations fascinated by my facial asymmetry.

So what does this have to do with Reproductive Medicine? Well, I guess the point I am trying to make is that you never know when you are going to get stung....in the eyelid. When counseling patients about a course of treatment one of my biggest concerns is that of multiple pregnancy. With twins (and worse) you just never know when you are going to end up in a tough situation. Twins have a markedly increased risk of preterm delivery compared with singletons and all the problems that go along with prematurity. Time Magazine recently had a cover story about preemies and how far we have come in handling our smallest patients. But the best treatment for prematurity is prevention. Electing to pursue IVF instead of superovulation and IUI will help. Preimpantation genetic screening to identify the normal embryos will help since if we transfer a single genetically proven normal embryo then the risk of twins will be incredibly low (although not zero because of the chance of identical twins). I spend a lot of my day trying to convince patients that twins are not a "buy-one get one free" type of deal. There is a cost involved....to the family, the children and to society. So try your best not to get stung....go with elective single euploid (genetically normal) embryo transfer and watch out for those damn bumblebees.