As vaccines become more widely available, a practical question has arisen regarding the timing of vaccine administration with respect to certain invasive reproductive care treatments. In general, it is recommended that:

Patients scheduled for elective surgery or outpatient procedures, including oocyte retrieval, embryo transfer, and intrauterine insemination, avoid COVID-19 vaccination at least three days prior and three days after their procedure. This recommendation is not because being vaccinated is unsafe, but rather because known side effects of the vaccine may impact intra-operative and post-surgical monitoring. Common side effects after COVID-19 vaccination, especially after the second dose, include fever, chills, fatigue, myalgia, and headaches, which typically occur and resolve within three days. Anesthesia impairs normal thermoregulatory control and may be impacted by pre-existing fever. Additionally, these side effects would make it difficult to determine if a post-procedure fever is related to the vaccine or to a developing infection related to the procedure. Finally, many medical facilities may not allow patients into their facility or proceed with any elective procedure if a patient has COVID-like symptoms, including those that are possible side-effects of the vaccine, even if their COVID-19 test is negative. Practices should notify and encourage their patients to communicate with their surgeons and fertility programs when they become eligible for COVID vaccination. This will help coordinate planned surgical procedures, fertility testing and treatment, and will decrease the chance of inadvertent procedure cancellation.

Claudio Benadiva, MD, HCLD Announced As New Medical Director at The Center for Advanced Reproductive Services

Alison Bartolucci, PhD, HCLD Promoted to Laboratory Director

Farmington, CT, January 19, 2021… The Center for Advanced Reproductive Services (The Center), a prominent family building program, announced Dr. Claudio Benadiva as Medical Director. Dr. Benadiva, who previously served as The Center’s High Complexity Lab Director, replaces Dr. John Nulsen, who is stepping down as medical director to focus more on The Center’s IVF and Donor Egg Programs as well as its academic mission. Dr. Alison Bartolucci has been promoted and will replace Dr. Benadiva as High Complexity Laboratory Director.

As Medical Director, Dr. Benadiva will be responsible for oversight and have responsibility for ensuring appropriateness and quality of services and care is continually provided to all patients and their families as prescribed in The Center’s clinical policies and procedures and applicable national standards.

As High Complexity Laboratory Director, Dr. Bartolucci will be responsible for the day-to-day operation, management, organization and supervision of the laboratory operations and staff and for ensuring that the highest standards in quality, safety and success rates are met.

According to The Center’s CEO, Paul Verrastro, “A cornerstone of The Center’s success is the in-depth experience of our clinical leadership team. Both Dr. Benadiva and Dr. Bartolucci are considered thought leaders in the field of reproductive endocrinology and infertility (REI) and have distinguished themselves nationally as committed clinicians and academics. This combination of clinical care and basic science is what translates into success for our patients. Residents of Connecticut and our surrounding towns are lucky to have this team available to them to meet their family building needs.”

Both Dr. Benadiva and Dr. Bartolucci have extensive experience in the REI field. Dr. Benadiva has been a lead physician at the Center since 1998 and is the former High Complexity Lab Director. Under his direction with Dr. Bartolucci by his side, The Center’s lab has received national recognition for its high standards and has received CAP Laboratory Accreditation, a program designed to ensure the highest standard of care for all laboratory patients. Dr. Benadiva is a Clinical Professor of Obstetrics & Gynecology at UConn Health, is a Fellow of the American College of Ob/Gyn, and is board certified in Obstetrics & Gynecology and Reproductive Endocrinology and Infertility. During Dr. Benadiva’s 3-year REI Fellowship at Cornell, he spent 18 months focusing on IVF research in their world-famous lab. During this time, he worked elbow to elbow with fertility pioneers like Jacque Cohen, PhD (embryology), Santi Munne, PhD (PGD/S) and Gianpiero Palermo, PhD (ICSI).

Dr. Bartolucci joined the Center in 2012 and most recently was Operational Laboratory Director. She received her PhD in 2019 from Eastern Virginia Medical School and is a Faculty Instructor at UConn Health. She started her embryology career at Mass General under the guidance of Catherine Rancowski, PhD, and was later was mentored by embryo grading pioneer Lynette Scott, PhD. Dr. Bartolucci completed her PhD in basic science research at UConn Health under the mentorship of John Peluso, PhD.

With news of the FDA emergency use authorization of a COVID-19 vaccine, ASRM released a new statement from its COVID-19 Task Force, and joined with other OB/GYN organizations on a statement.

Click here for statement from American Society of Reproductive Medicine [ASRM] https://cutt.ly/vhKKOTD

The ASRM COVID-19 Task Force statement emphasizes the importance of shared decision making between patients and their physicians but is very clear that, “The Task Force does not recommend withholding the vaccine from patients who are planning to conceive, who are currently pregnant, or who are breastfeeding (1,2,3) and encourages patients undergoing fertility treatment to receive vaccination based on current eligibility criteria.”

The report also states that virus mitigation strategies, such as universal masking, physical distancing and reducing social interactions must be followed even though some people now have access to a vaccine.

In addition, the statement addresses head-on a piece of misinformation which has been circulated by antivaccine ideologues and states that the mRNA vaccines “are not thought to cause an increased risk of infertility, first or second trimester loss, stillbirth, or congenital anomalies.”

ASRM also joined with the American College of OB/GYNs, the Society for Maternal Fetal Medicine, the Society for Gynecological Oncology and the AAGL in a joint statement from the OB/GYN community. It too emphasizes access to the vaccine for pregnant and lactating women and the importance of decisions about the vaccine being made by patients and their physicians.

Fertility Treatments and COVID 19 Vaccine

We are all excited about the recent developments and promise regarding Covid 19 vaccines. These vaccines have not been extensively studied in pregnant women. However the American College of Obstetrics & Gynecology [ACOG] is recommending that for Health Care Workers [HCWs] who are pregnant or trying to get pregnant the vaccine should not be withheld.

The vaccine may have side effects including chills, muscle aches, possible “fever” (3 % incidence of fever after first injection and 15 % incidence of fever after the second injection) lasting up to 3 days. If you chose to take the vaccine and develop  a fever (100 degrees or higher); per CARS COVID 19 screening policy you will not be allowed in a CARS office as we will be unable to ascertain if the fever is the result of vaccine reaction or an actual COVID infection. This may result in your treatment and/or cycle being postponed or cancelled.

Therefore, it is ultimately your choice to take the Covid 19 vaccine during fertility treatment, however you must understand a possible reaction may be cause for us to postpone your treatment or cancel your cycle.  Another choice for patient’s choosing to be vaccinated is to postpone fertility treatment until completion of the 2 step vaccine process. Thank you.

 

Christmas Week

Thursday, Dec 24. All offices opened but closing by 2-3pm. If you have an emergency please call The Center’s main number and you will be connected to MD on call.

Friday, Dec 25. Farmington office opened for scheduled cycling patients only. All other offices closed. No unscheduled clinical services. If you have an emergency please call The Center’s main number and you will be connected to MD on call. No IUIs. Follow directions provided on the IUI line.

Sat, Dec 26 & Sun, Dec 27. Will operate as a normal weekend. Farmington office will be open and all other offices close

New Years Weekend

Thursday, Dec 31. All offices opened but closing by 2-3pm. If you have an emergency please call The Center’s main number and you will be connected to MD on call.

Friday, Jan 1. Farmington office opened for scheduled cycling patients only. All offices closed. No unscheduled clinical services. If you have an emergency please call The Center’s main number and you will be connected to MD on call. No IUIs. Follow directions provided on the IUI line.

Sat, Jan 2 & Sun, Jan 3. Will operate as a normal weekend. Farmington office will be open and all other offices closed.

TOGETHER we can help fight hunger! 

Thanksgiving is approaching fast and the need for food is greater than ever.  For the month of November, please help by donating unexpired canned goods or non-perishable food items to the annual CARS food drive. Our goal as a Center is to collect 100 lbs. (Did you know that 100lbs can provide for 80 meals?)

Collection boxes are set up in the waiting room of each office. All items will be donated to Iglesia de Dios Pentecostal which one of our staff is a member of.

Examples of what you can donate:

–          Cheese or peanut butter crackers

–          Pudding

–          Granola Bars/power bars

–          Ramen noodles

–          Pasta/sauce

–          Trail mix/packaged nuts

–          Peanut Butter

–          Canned Vegetables and fruit (With pull top opening)

–          Soups (With pull top opening)

–          Mac and Cheese

–          Canned Tuna/chicken

–          Boxed drinks and juices

–          Pop Tarts

–          Packets of Oatmeal

–          Apple sauce

–          Bags of rice and beans

Thank you for all of your help!

Once again, the Center has distinguished itself at the American Society for Reproductive Medicine (ASRM) Virtual Congress through our commitment to academics and research. ASRM’s annual meeting is the premier education and research meeting for Reproductive Medicine. Our clinical team of MDs, fellows [past and present], residents, and lab staff worked tirelessly throughout the year to complete a variety of thoughtful and relevant research projects. Below is a list of all the oral and poster presentations that were accepted to ASRM.

Our research mentor of the year award goes to Dr. Lawrence Engmann. He is a wonderful teacher and has shepherded many of these projects to completion. His inspired ideas, knowledge of the literature, his gentle guidance, and knowledge of statistics have guided our residents and Fellows to make these presentations happen. Several manuscripts are in preparation for peer review journals. Dr. Engmann, thank you!

Truly outstanding work!

Oral Presentations

1)      THE EFFECT OF OBESITY ON EUPLOIDY RATES IN WOMEN UNDERGOING IN VITRO FERTILIZATION (IVF) WITH PREIMPLANTATION GENETIC TESTING (PGT) – Stephanie Hallisey, Reeva Makhijani, Jeffrey Thorne, Prachi Godiwala, John Nulsen, Claudio Benadiva, Daniel Grow, Lawrence Engmann

Oral Session Title: IVF Outcome Predictors 2

2)      BLACK RACE RESULTS IN LOWER LIVE BIRTH RATE (LBR) IN FROZEN-THAWED BLASTOCYST TRANSFER CYCLES (FET): AN ANALYSIS OF 7,002 SART FET CYCLES – Reeva B Makhijani, MD, Alicia Y Christy, MD, Prachi N Godiwala, MD, Kim L Thornton, MD, Daniel R Grow, MD and Lawrence Engmann, MD

Oral Session Title: Health Disparities

https://www.asrm.org/news-and-publications/news-and-research/press-releases-and-bulletins/black-women-experiencing-lower-birth-rates-in-fet-cycles

 

Poster Presentations

3)      OUTCOMES AFTER ADJUNCT GROWTH HORMONE TREATMENT WITH A LOW, INTERMEDIATE, OR HIGH DOSE PROTOCOL IN IVF CYCLES WITH POOR RESPONDERS – Reeva B Makhijani, MD, Stephanie M Hallisey, MD, Prachi Godiwala, MD, Chantal Bartels, MD, Daniel R Grow, MD, Lawrence Engmann, MD, John Nulsen, MD and Claudio A Benadiva, MD

4)      PREGNANCY OUTCOMES IN LETROZOLE OVULATION INDUCTION FROZEN-THAWED EMBRYO TRANSFER CYCLES AS COMPARED TO NATURAL AND PROGRAMMED CYCLES – Prachi Godiwala MD, Reeva Makhijani MD, Chantal Bartels MD, Alison Bartolucci PhD, Daniel Grow MD, John Nulsen MD, Claudio Benadiva MD, Lawrence Engmann MD

5)      EMBRYOLOGIC OUTCOMES IN INTRACYTOPLASMIC SPERM INJECTION (ICSI) CYCLES UTILIZING SPERM SELECTED VIA A MICROFLUIDICS DEVICE COMPARED TO STANDARD SELECTION – Prachi Godiwala MD, Jane Kwieraga BSc TS, Reeva Makhijani MD, Chantal Bartels MD, Alison Bartolucci PhD, Daniel Grow MD, John Nulsen MD, Claudio Benadiva MD, Lawrence Engmann MD

6)      EFFECT OF BODY MASS INDEX (BMI) ON PREGNANCY OUTCOMES IN FROZEN-THAWED BLASTOCYST TRANSFER (FET) CYCLES – Adrienne Schmidt MD, Prachi Godiwala MD, Reeva Makhijani MD, Chantal Bartels MD, John Nulsen MD, Claudio Benadiva MD, Daniel Grow MD, Lawrence Engmann MD

The Center for Advanced Reproductive Services [CARS] had been hoping the governor would get us to level 3 so we could begin to allow partners and spouses in the offices. We are not at level 3 however, current state guidelines are allowing for partners, spouses and close family members to visit in hospitals and nursing homes.

At this time, CARS has decided to relax our policy and allow partners and spouses into the practice on a limited basis. Partners and spouses will be subject to the same rigid health screening and temperature checks as patients. Currently, this would mostly include:

• Partners/spouses at pregnancy scans

• Partners/spouses at IUI

• Partner/spouses in PACU at transfers

• Partners/spouses or family members needed at other visits to provide translation services

Thank you to everyone who entered our Q2 2020 Fertility Massage Therapy Grant. This was a tough quarter of the year for everyone, with Covid causing uncertainty and obviously high levels of stress. We appreciate all of those who took the time to enter and have selected a patient from the Bristol area as this quarter’s winner whose story is below and who prefers to remain anonymous. She has, however, agreed to discuss her journey, including her losses, in the hopes they may help someone else in the process.

I really struggle with this question but I will give it a shot. I had a stillborn daughter in January 2006, and 2 more unsuccessful pregnancies by October 2008, and then in 2009 another miscarriage. Needless to say, those were really traumatizing years. All the losses were in the second trimester and after years of being treated, I finally had some answers. Testing showed it was all because of an incompetent cervix. So, fast forward a few years later and 2 more miscarriages and 2 failed cervical cerclages I found information about a TAC (Transabdominal Cerclage). I hoped this was going to be the answer to all my problems. In 2018 my ObGyn (my sweet angel) successfully placed an abdominal band (a few actually for security) on my abdomen and BAM!!! We hope that I can get pregnant. 

At this point, I was with a different partner and he went through the TAC surgery with me and we used protection because we weren’t ready for a baby. Around early 2019 he and I moved in together and started not to use protection and try to see if we could have a baby. Well, months and months went by, and nothing. I had an appointment with my ObGyn and asked to have my tubes checked and have my fiancées sperm tested and that’s how we ended up at the Center. After testing we learned his sperm isn’t very good and I probably have some other issues now too. Oh, and during my TAC surgery, they removed some pretty good-sized fibroids. Also during my fallopian tube and uterus check, they found some more fibroids. 

I wish I was more excited but I am very exhausted. This has also caused me to gain a little weight and the COVID probably has some play in that as well. I recently found a huge patch of loss hair and my ObGyn believes I didn’t ovulate this last month because my cycle is usually 29-33 days and it went 48 days this month. It scared me, especially because when I finally got my period today it was unusually heavy for almost 24 hours, out of control heavy, and just like that it is almost gone. Very weird. 

I think my body could use some relaxing because all of this has been stressing me out a bit. I’ve struggled with depression in the past and it has been difficult being quarantined but I am definitely more than ready to go through these procedures and see if I and my partner can have a live healthy pregnancy and baby (actually I’m terrified and nervous and totally freaking out but I have to speak my peace into existence so I have to work on that). I think this would help me mentally and physically get prepared and motivated for this journey we are getting ready to embark on in August. 

Sorry, I am so long-winded but I definitely gave you the super short version. Thank you for your time and I hope you choose me for a massage. I hope none of this makes you sad because I am ok. I refrain from sharing sometimes because of how people react but I truly am ok and I am glad to be in your care here at The Center. Thank you and God Bless.