Category: General

A Word From Our CEO

Friends and Colleagues,

Change is never easy, but almost always good. In September of this year, I began a transition plan that will bring to an end one of my proudest and most rewarding opportunities–Chief Executive Officer of The Center for Advanced Reproductive Services (CARS) an Academic Affiliate of UConn School of Medicine. The change is effective December 23, 2022.

My career in fertility has been both challenging and rewarding. To get up every day and know I was part of making the kind of difference in people’s lives that only comes through the gift of family was fulfilling and humbling. The heart of CARS is the patients. Always has been. Always will be.

The culture of CARS has always attracted and retained outstanding employees whom I have been privileged to lead and serve. I will miss them all, but treasure what we accomplished together. This is a move I have been personally contemplating for the past few years, but COVID and the challenge of filling this role kept pushing my timeline out.

Earlier this year a person who I would describe as the perfect candidate materialized and we jumped on the opportunity to recruit him. Brian Miller, PhD is a long-term colleague and friend of CARS with over 20 years’ experience in the fertility field. His talent and skill combined with an intimate understanding of the CARS culture make him a perfect fit. I am happy to share Brian and I have been working together since September and will continue to do so through the end of the year. CARS will have the support of Brian and I, the MD and Management Teams, and our management partner First Fertility to make certain this is a seamless, successful transition.

Many of you have inquired about my next step. For the short-term (Q1, 2023), I will be taking on a part time, consultative/project-based role with First Fertility, CARS’s management company. Beyond that, I am leaving open at least for now.

My life has been immeasurably enriched by my 23 years at CARS. This is a very positive step for me at this time in my life and most importantly secures the long-term administrative leadership of CARS. I am gratified to have been supported and mentored by so many talented and generous people. And I am especially grateful to have had a part of being able to inspire many, many people with hope and help them fulfill their dreams of building families.

Paul Verrastro, CEO

Thank you Dr. Nulsen

Practice News

There are several changes that will be occurring at The Center for Advanced Reproductive Services [The Center] over the coming months.

Dr. Nulsen
After 35 years of dedicated service, Dr. John Nulsen will be retiring from The Center. Dr. Nulsen will stop seeing new patients as of October 1, 2022 and continue to care for patients currently in treatment through December 16, 2022. Patients of Dr. Nulsen will have the option of transitioning their care to any of our other Farmington based doctors; Dr. Engmann, Dr. Benadiva, Dr. Schmidt or Dr. Grow. To facilitate a smooth and comfortable transition of care, CARS will be offering Dr. Nulsen’s existing patients a complimentary 30-minute virtual consult with their new provider.

Biographies and videos of all our doctors are on our website. Should you need to speak to someone about choosing your new doctor please call Susan Lyko, Farmington Practice Manager at 860.321.7082, EXT 8008 or Jennifer Christensen, Hartford Practice Manager at 860.525.5253, EXT 8105. You can schedule your virtual appointment with your new provider by calling our front desk at 844.467.3483.

Join Us In Saying Thanks

To anyone who would like to send best wishes to Dr. Nulsen, you can do so by sending an email to: ThankYouDrNulsen@uconnfertility.com. We are also collecting photos for a very special book for Dr. Nulsen; these can also be sent to the same email address.

Dr. Engmann
Effective November 1, 2022 Dr. Engmann will be moving his practice from the Hartford office to our Farmington location. Current patients of Dr. Engmann may choose to follow him to Farmington or continue on in the Hartford office under the care of Dr. Prachi Godiwala who will be joining the team as of October 1, 2022.

Once re-located to the Farmington office Dr. Engmann will be working with Dr. Nulsen’s nursing team. Dr. Engmann’s Hartford nursing team will be supporting Dr. Godiwala in Hartford.

Dr. Godiwala
We are excited to announce that Dr. Prachi Godiwala will be joining the CARS team effective October 1, 2022 and will be seeing patients in our Hartford office. She graduated from UMASS School of Medicine in 2015 and completed her Ob/Gyn residency at George Washington University. Dr. Godiwala completed a three-year Reproductive, Endocrinology and Infertility [REI] fellowship at The Center and UConn School of Medicine. During this time, she distinguished herself as a compassionate and skilled provider as well as committed researcher and academic.

For Dr. Engmann patients choosing to continue receiving care in the Hartford office, CARS will be offering a complimentary 30-minute virtual consult with Dr. Godiwala. You can schedule this visit by calling the Hartford office at 860.525.8283.

We are here for you
At The Center we appreciate you choosing us for your fertility care. We are committed to supporting you through these changes within our practice. Thank you for your continued support.

Coverage at Work Program

Four Ways To Manage Endometriosis Naturally

by Ami Chokshi, Integrative Fertility Coach

Endometriosis affects women in their reproductive years and is a condition where the tissue that lines the uterus may be found in other places of the body, like in the abdomen, ovaries, or fallopian tubes.

Endometrial lining typically sheds during a woman’s period, but with endo, it gets trapped in these other areas outside of your uterus. It can also irritate your nerves and cause pain in many women. This can lead to chronic inflammation and an accumulation of scar tissue.

Endo warriors know how painful and stressful this condition can be and how the symptoms can take over your life, including debilitating period cramps, long and heavy flow, fatigue, bloating, constipation, painful sex, and infertility.

These tips may help reduce your symptoms –

Use your fork

Eating a diet that is plant-focused, high in nutrients, low in toxins, supports balanced blood sugar, and removes common triggers like gluten, sugar, and caffeine.

It includes eating a variety of vegetables – like leafy greens, cruciferous veggies like broccoli and cauliflower in each meal – as well as fresh fruits, especially berries.

Stable blood sugar is a critical component in this way of eating, so one way to do this is to combine fiber – through vegetables, whole grains, or additions like ground flax or chia – with a protein in every meal.

Clean up your environment

Because endometriosis is both an inflammatory and immune problem, endocrine-disrupting chemicals and other environmental toxins can worsen it.

Taking a look at your overall environment to make sure you are drinking clean water, breathing clean air, and eating clean food can help reduce the inflammation.

Sometimes the culprit is right in front of you. For example, one of my clients with endo is a hairstylist. When we examined her environment, she was consistently exposed to harmful chemicals from the hair products she was using with her clients. When she switched to cleaner hair products, her symptoms lessened.

To switch up your household products to cleaner ones, check out the Environmental Working Group’s website (ewg.org). This website offers tons of insightful guides to help you switch to cleaner products.

Supplements to Consider

N-acetyl cysteine or NAC is a powerful antioxidant. It supports inflammatory response, may lower tissue damage, and it supports your liver to purge those fertility-mugging toxicants in your system. In a 2013 study, women who regularly took NAC saw a reduction in ovarian endometriosis. This included lowering the severity of pelvic pain and having a less heavy flow.

Another antioxidant that supports endometrioses is pycnogenol, which is a plant extract that comes from French maritime pine bark extract. It offers numerous health benefits due to its combination of organic acids, procyanidins, and bioflavonoids. Over four weeks, Pycnogenol helped reduce pain from severe to moderate.

Fertility Massage

Finally, consider working with a practitioner who is trained in Arvigo massage or a physical therapist who has experience with endometriosis. These therapies can help break up adhesions, and they complement the food and lifestyle changes you are making.

Endometriosis can be all-consuming, so I hope these tips are helpful to reduce inflammation and balance your hormones to support your fertility and desire to get pregnant.

Sources:

• PMID23737821
• Pine bark significantly reduces endometriosis

New research on obesity & infertility

Women with obesity receive inconsistent counseling about the impact that their weight can have on fertility and about weight loss strategies before they begin infertility care. This was a key finding of a research project conducted at CARS with the results presented at the ASRM Scientific Congress & Expo.

The study, conducted by Dr. Margaret O’Neill and Dr. John Nulsen noted that obesity is an increasingly important contributor to infertility among women of reproductive age. It also has been associated with increased maternal morbidity and reduced fecundity. Obesity reduces infertility treatment success as well, the researchers said, requiring complex workup before treatment begins.

Despite these obstacles and risks, few doctors regularly engage in weight counseling. Women with obesity, then, often seek infertility treatment before being advised to lose weight or counseled on how best to do so.

https://bit.ly/3aZSH6k

Ease stress from TTC with self-care

If you are looking for a form of self-care that’s nurturing, grounding, warming, and relaxing – try Abhyanga. Help ease your stress from TTC with this self-care practice you can do from home. Head over to the ink in our bio aead the latest from our Health Coach Ami Chokshi:

3 Things You Can Do if You are Trying To Conceive with PCOS

by Ami Chokshi
National Board Certified Health & Wellness Coach

September is PCOS month, and PCOS-related infertility affects so many women these days. PCOS symptoms often include:

• Irregular periods,
• Weight gain or weight loss resistance,
• Hair growth on your face or body,
• Acne, and
• Dark patches of skin

…. but you already know this if you have PCOS.

So, let’s talk about how you can manage your symptoms to support your fertility journey.

Insulin resistance is often a major factor associated with PCOS, and this means that your body cannot respond properly to the insulin it makes. Keeping your blood sugar steady throughout the day will help you sustain healthy hormone levels, keep your mood even, and support a more regular menstrual cycle.

I work with women who want to maximize their chances of getting pregnant by optimizing their health. These are women who are asking their doctors, “what else can I do outside of treatment.” These are some tips I share with them to get them started…

Step 1: The Winning Food Formula

Food is where I start, and the first step to managing your PCOS is to eat in a way that keeps your blood sugar steady. The winning formula is: Fiber + Protein.

I recommend eating both fiber – in the form of veggies – and protein in every meal. This dynamic duo will keep your blood sugar from spiking in either direction. And, it works regardless of what diet you subscribe to…from vegan to keto. It will keep you from feeling hangry, irritable, or sleepy. And it will help you keep your weight in check. If you are trying to lose weight, remember this catchy phrase…

“Fiber and protein in every meal makes losing weight no big deal.”

You can apply this to your daily meals by:

• Adding spinach to your scrambled eggs,
• Including kale with a low sugar smoothie and a plant-based protein,
• Eating a big salad with chicken for lunch, and
• Covering half of your plate in veggies plus a protein for dinner. 

Step 2: Move Your Mass

Next, incorporating high intensity interval workouts decreases insulin resistance and is the best exercise to mobilize excess body fat.

This can look like a 20 minute HIIT workout from Fitness Blender (check out some the HIIT workouts here🙂

…or 3 sets of the Scientific 7-Minute Workout (here is the app).

If you have had a heavy meals and need a quick blood sugar stabilizer, lace up your sneakers and go for a walk. Even 10 minutes around the block will help lower your blood sugar.

Step 3: Flush it out

Finally, drink your H20.

 I know you know this, and you have heard this a dozen times… But, how often are you doing this? Staying hydrated helps remove excess sugar from your blood through your urine. Half of your body weight in ounces is often the guideline, so if you weigh 150 pounds, aim for 75 ounces of water. Another way to know is to check the color of your urine. Aim for pale yellow.

Hydration isn’t only about drinking water.It also means making sure you have an adequate electrolyte balance. Electrolytes – like potassium, magnesium, and sodium – can be added to your water and are critical for replenishing needed minerals and feeling hydrated. They support chemical reactions that take place in your body for optimal hormone health.

A basic rule of thumb is this: if you have go to the bathroom within 5-10 minutes of drinking water, consider adding electrolytes (or even a pinch of pink sea salt) to your to your next glass.

Stick with these basics and be sure you are sleeping 7-9 hours, and you will notice results…from better energy and weight loss to calmer hormones.

Want help getting started? Check out my free PCOS 7 Day Meal Plan. Simply share your email here, and I will send it (plus additional fertility tips) to you right away!

Welcome Reeva Makhijani, MD

We are pleased to announce that Dr. Reeva Makhijani has joined The Center as a Lead Physician. She is also an Assistant Professor in the Department of Ob/Gyn at UConn School of Medicine. She will be seeing patients in the Center’s Branford, New London and Farmington locations. Dr. Makhijani is involved in all aspects of fertility care and family building and has passionate professional interests in fertility preservation, transgender health, oncofertility and third-party reproduction.

According to Dr. Daniel Grow, Associate Fellowship Director at the Center, “Dr. Makhijani has distinguished herself as a compassionate doctor and gifted academic and researcher. We are proud to have her as part of our team. Together, we will continue our commitment to clinical excellence and family building, one patient at a time.”

Dr. Makhijani is Board Certified in Obstetrics and Gynecology and board eligible in Reproductive Endocrinology & Infertility [REI]. Her REI Fellowship was completed at The Center and UConn School of Medicine, joining Dr. Schmidt, Dr. Engmann and Dr. DiLuigi, all of whom were past REI Fellows with The Center and UConn. During her 3-year fellowship at the Center, Dr. Makhijani authored many publications, posters and presentations on fertility.

Dr. Makhijani graduated with her medical degree in 2014 from NYU School of Medicine and completed her Ob/Gyn residency at Brown University/Women & Infants Hospital in Rhode Island where she was administrative chief resident in 2017-18. She has been the recipient of numerous awards and honors for her commitment to teaching and academic excellence.  

To Our New Patients at Our Branford Office

As part of welcoming Dr. Makhijani to the shoreline community, the Center for Advanced Reproductive Services is happy to offer the convenience of ZocDoc to our new Branford patients. ZocDoc will allow you to see doctors’ open appointment times and instantly book your Branford office new patient appointment online.

Ambulatory Surgery Center Achieves AAAHC Accreditation

The Center for Advanced Reproductive Services (CARS) ambulatory surgery center has been accredited by the Accreditation Association for Ambulatory Health Care (AAAHC). Accreditation distinguishes the CARS ambulatory surgery center from many other outpatient facilities through its adherence to rigorous standards of care and safety. Status as an accredited organization means CARS has met nationally recognized standards for the provision of quality health care set by AAAHC. “Accreditation underscores our commitment to providing the highest possible levels of quality care,” stated Paul Verrastro, CEO, The Center for Advanced Reproductive Services. “We are extremely proud to have our efforts recognized with this accreditation.”

While the onsite survey is an important component of the process, ongoing compliance and continuous improvement are part of the accreditation maintenance mindset that a facility should integrate into its daily activities long after the survey has been completed. The intent of accreditation is for organizations to adopt policies and procedures that fuel ongoing quality improvement and self-evaluation every day. Ambulatory health care organizations seeking AAAHC accreditation undergo an extensive self-assessment and onsite survey by AAAHC expert surveyors – physicians, nurses, and administrators who are actively involved in ambulatory care. The survey is peer-based and educational, presenting best practices to help an organization improve its care and services. More than 6,100 ambulatory health care organizations across the United States are currently accredited by AAAHC.

1095 Strong is a transformational movement and call-to-action spearheaded by the AAAHC to equip ambulatory leaders with the best of what they need to operationalize quality practices. The three-year, or 1,095-day, period between accreditations is a critical time when ambulatory health organizations, with help from proven experts, can develop the kind of everyday habits that enable leaders in the industry to provide the utmost in quality care to their patients. Organizations, such as CARS that earn AAAHC accreditation embody the spirit of 1095 Strong, quality every day, an ongoing commitment to high-quality care and patient safety.