Ken Mosesian

To our professional members:
In this edition of Professionally Speaking you’ll hear what two doctors have to say about a couple of issues facing almost everyone dealing with IVF: sperm collection and stress.

Sperm collection is a sensitive subject, on which Dr. Bamman is able to shed some light. Often times, giving sperm samples is a cold, business-like experience. As you know, the guy goes in, leaves his sample in a cup, and then goes about the rest of the day. He’s left feeling like a gear, in a well-oiled process, rather than a crucial half of

a loving, intimate relationship with his wife. But wait, the sperm collection can be more intimate than you think!

Let’s talk about the stress load of IVF treatments. It’s heavy – early morning doctor visits, constant questions from friends and family, and the expense (especially if round one doesn’t work). Many couples dealing with IVF enjoy the intimacy of the small practice setting, but most of the time those smaller practices don’t have therapists on staff to help couples cope. So, what do those practices do when their patients need some professional emotional support? Find out in this edition of Professionally Speaking.

Best regards for a safe and healthy summer.

Ken Mosesian
Acting Executive Director

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When Intimacy Turns Into Business
The American Fertility Association

Bob Bamman

“Particularly with larger clinics, a large degree of sensitivity has been brought into the process. Most large clinics aren’t just sending the guy off into the local men’s room to perform his act,” Bamman says.

As in vitro and other forms of assisted reproduction evolve, the guy becomes a more integral part of the baby-making process. Bamman says keeping the couple connected and making them both feel like they are really working together to make their family is often challenging.

Now practices even have special rooms set up which are larger and have couches, lounge chairs and pictures on the wall, to make it warmer and more inviting to man…and woman? Some practices now let the wife be present during the sample collection process.

“Ideally, I think it’s great to have her involved in helping him become sexually aroused. It helps the whole picture for them in terms of being together through this in building a family,” says Bamman.

In a perfect world, the couple would be able to have an hour and a half alone in a room, instead of fifteen minutes.

Bamman says, “Think about the idea of sexuality and romance, what’s the ideal room? To me the ideal room is warm, fireplace, romantic music.”

There are time and money constraints on many practices. Anything beyond fifteen to twenty minutes might slow down the overall production.

Practices which don’t allow the wife to be present can do some things to ease pressure. They can make sure

the door leading to the collection room is locked and clearly marked, in order to keep someone from knocking on the door while he’s taking care of business.

Some practices actually have a little door on the wall connecting the collection room to the lab. This saves the guy the hassle and embarrassment of hauling his sample down the hallway, passing Lord knows who along the way.

Bamman also says the room shouldn’t connect to the waiting room.

“Masturbation is a very private thing. They don’t want to come out of a room with people in the waiting room going ah, guess what he just did. That’s not going to help them relax and achieve a decent orgasm,” says Bamman.

It’s not always a good idea to have the wife present.

Bamman says, “There’s nothing new about the fact erotic material exists; that most men use them to augment the sexual satisfaction in their life. These materials are there to help the male become aroused. For some guys, that’s the better route, depending on what’s going on in their relationship.”

For years, sexuality and romance have been a very important part of procreating. Go back to the stone-age when it meant sitting in a cave by a warm fire. Time will tell if the old fashioned ways of doing things will find their way into the most technologically advanced medical practices in the country.

“I haven’t heard about the fireplace in the collection room yet,” says Bamman.

An active professional member of the American Fertility Association, Bob facilitates workshops and coaching groups addressing the emotional aspects of infertility, men’s infertility issues, and adoption. Specialized clinical training includes infertility/adoption at the Karen Horney Institute, the Center for Family Connections (Cambridge), and the Ackerman Institute for Family Therapy. A veteran of the infertility experience and an adoptive parent, Bob maintains a private practice located in mid-Manhattan (34th St.) working with men, women, and couples. Bob also provides adoption consultation services and New York State mandated pre-adoption Homestudy services.
Phone: 646-872-9032
Email: BobBmmn@aol.com.

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The Stress Factor-E: Explore Your Options
by The American Fertility Association

Dr. Jessica Brown

The stress of IVF treatments and starting a family is often similar to what you experience when there’s a family death, divorce, or an illness threatening your life or the life of someone close to you.

Dr. Jessica Brown is a Reproductive Endocrinologist and Clinical Assistant Professor at the NYU School of Medicine, who says a number of things combined, can cause stress.

“I think we do demand a lot from patients. They have to remember a lot of details. They have to remember to take medications at different times, specific doses. Certainly getting

instructions can be stressful,” says Brown.

Morning trips to the doctor can put couples behind schedule and stress them out about being late for work. And then there’s the stress on the pocketbook.

Brown says, “There is a financial stress since many people feel that they don’t have the ability to pay for another cycle if they aren’t successful with their current treatment.”

There are conflicting reports about whether stress actually affects pregnancy rates. Certainly no report shows stress is beneficial. Brown runs a small practice where patients confide in her, which means sometimes it’s up to her to decide whether to recommend professional help from a therapist.

“I don’t tell people they need to do stress-reduction programs to give them a better chance, but I clearly tell them if they’re really stressed this will make the whole process easier and give them a feeling of more control, and to help them deal better with the stress that’s involved,” says Brown.

Though first, Brown will lead patients to some free advice.

She says, “I try to give them all the options. I mention

organizations like AFA, which oftenhave support groups of networks of therapists, or other resources that help them.”

Brown says there are pluses to going to smaller IVF clinics which offer a more intimate setting where patients tend to look at their doctors and nurses like extended family. She also says there are upsides to visiting the larger clinics.

Brown says, “Even though they’re [NYU] a big practice, I think they do better than average as far as not giving people that ‘factory feel,’ and try to give them as much care, and having their own wellness program, and having their own psychologists, and having doctors who really do talk to their patients more than average. I don’t think it means you’re impersonal, and just because you’re small it doesn’t mean the opposite.”

Dr. Jessica Brown is a 1987 Graduate of NYU School of Medicine. Her medical specialties are Reproductive Endocrinology and Infertility, and Comprehensive Gynecology. She’s board certified in Ob/Gyn, Obstetrics and Gynecology, Reproductive Endocrinology and Infertility, and Reproductive Endocrinology.
Madison Women's Health & Fertility, PC, 50 East 77th Street, New York, NY, 10075. Phone: 212-639-9122

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