“There are two ways to live your life – one is as though nothing is a miracle, the other is as though everything is a miracle.” – Albert Einstein
We are very excited about our new relationship with The Fertility Institute of New Jersey and New York, and we recently had the pleasure to talk with Dr. Inna Berin, one of the highly qualified Reproductive Endocrinology and Infertility specialists at the Institute. You can listen to the interview or read the questions I asked Dr. Berin and her response below.
Click here to play the interview:
Can you share with us your background and why you decided to get into the field of reproductive endocrinology?
I am originally from Moscow, but moved here as a child, and grew up in Brooklyn. I went into residency thinking that I wanted to do obstetrics, I loved delivering babies and the excitement of labor and being on the delivery floor. I’ve always been interested in women’s health issues, and I began to realize that women are at their most vulnerable state when they are struggling with infertility. A passion around helping women who are having difficulty conceiving quickly grew, to reassure them and treat them for whatever the issue may be. Infertility is a lonely place, frequently people do not want to tell family and friends that they are trying, or that they haven’t been successful, and there are always questions that they are too embarrassed to ask. A lot of women spend the majority of their 20’s trying not to get pregnant, and it always comes as such a shock when things don’t work once they are actually trying… So I always remember feeling how unfair it seems, and how much I wanted to help these women to have a family that they always dreamed of.
Share with us a little bit about the Fertility Institute of NJ and NY
I think that our center is quite unique – yes, we have the technology and the success rates that rival some of the biggest programs worldwide – but we are unique in how we care for our patients. We really care about them, and get to know them very well, we understand their emotional needs, and we fully support them and hold their hand is they go through all the steps in their journey to become parents. We are able to be flexible, we think outside the box, and we try to minimize the stress that’s associated with infertility treatment – everyone from the front desk to the nurses to the doctors are compassionate and supportive.
What are your thoughts on the stress-infertility connection?
It’s undeniable that there is a strong psychological component to any aspect of physical well-being, but I think especially in infertility. Although I think that stress doesn’t CAUSE infertility in most cases, infertility can certainly result in stress, every month – first hoping that the woman is pregnant, trying to time intimate relations according to the biological clock, and then dealing with disappointment when the woman gets her period. All this accumulates with months of trying, and can become a significant disruption to the couple’s lives, and emotional and psychological well-being. This spills over into other parts of their life – work, family, friends.. It can become an all-encompassing goal, with little that the couple can do to control what happens. Going to a fertility specialist is no less stressful – thinking of what the problems may be, talking about the most intimate aspects of someone’s life, taking the intimacy out of it and making it a science with inseminations or in vitro attempts… I always try to decrease a couple’s anxiety level about both their workup and their treatment, and I frequently recommend that together with their treatments they use either relaxation tapes or acupuncture, or even psychological counseling when appropriate. Their visits to me are another opportunity for myself and our staff to encourage them, and support them throughout their treatment.
Do you have any opinion on specific diets to follow while trying to conceive?
There are many gimmicks, supplements, programs out there which promise to boost both female and male fertility. From my experience, and from the scientific literature, I don’t believe that there is anything special that may really influence someone’s ability to conceive. Certainly keeping a healthy balanced diet, with minimizing processed foods, quickly digested carbohydrates and junk food, and emphasizing fruits and vegetables is the best option to keep someone healthy so that they have a healthy pregnancy. Eating whole grains, beans, vegetables and whole fruits—all of which are good sources of slowly digested carbohydrates—can improve ovulation and your chances of getting pregnant. Limiting fish to 3x week, and avoiding fish with high mercury levels (Marlin, Tilefish Swordfish Shark Mackerel (king)Tuna ( bigeye, Ahi). Fish that’s OK to eat is Trout, Tilapia, Haddock, Perch, Flounder) Prenatal vitamins 3 months prior to conception is always good to maintain good folate level and minimize the risks of neural tube defects. If someone is diabetic, it’s best to optimize glucose control, to keep HgbA1C below 5.6
What are your thoughts on the role in the mind-body connection and how we can all use it to our advantage?
One of the most dreaded advice that a couple who is struggling to conceive can hear is “just relax, and it will happen”. And it’s true, for most people it’s not easy to “just relax”, but there is some truth to that. We all know the examples of “miracle” pregnancies – someone who went through multiple IVF cycles, and doctors said they will never conceive, and so the patient adopts or gives up, and then gets pregnant the next month on her own… I had a patient who had really bad pelvic scarring, where I thought that her fallopian tubes were completely blocked off from the ovaries, and in addition, there was severe male factor and significantly diminished ovarian reserve, and several IVF cycles had failed because of poor embryo development. I recommended IVF with donor egg as the couple was ready to do anything to have a baby, and they agreed. In the month that she was getting ready to do this, she got pregnant spontaneously, and she is now about 25 weeks pregnant! This is certainly a very rare occurrence, but just proves that there is still some things that we don’t know about the particular factors that come together for someone to get pregnant. Another great example – I had a patient in Boston who was a physician, and had a very busy and stressful practice. She was relatively young, and had good ovarian reserve. She tried to get pregnant with more conventional methods, but eventually ended up doing IVF. 4 attempts with IVF were not successful, she never had a pregnancy, despite beautifully developed embryos. Mind you, while she was cycling, she was maintaining her busy practice without slowing down. She ended up going to another IVF center in a different city, in New York, and taking a 3 week vacation with her husband to do that. While she was cycling, they went out to restaurants, to Broadway shows, and really enjoyed their break. She got pregnant with twins on the first try! The only thing that was different, was the fact that she finally slowed down, and reduced her stress level. So although it’s not easy to “just relax”, with some help (like with Circle + Bloom fertility programs, for example), women may be able to do just that – relax… So I truly believe that there is a strong mind-body connection in fertility.
If someone is thinking of seeing a specialist, what would be the top three questions you would suggest them to ask?
The first step is to make a decision to see a fertility specialist at the appropriate time – I would recommend not waiting any longer than 1 year for a woman who is younger than 35, and no longer than 6 months or even less for a woman over the age of 35. Even for these subcategories, there are variabilities – for instance, a 26 year old who gets very irregular periods only a few times a year should see a fertility specialist sooner, because she is not ovulating, and will need some kind of treatment in order to ovulate. Once someone makes that important first step, they have to find a fertility specialist with whom they will be comfortable, and one that will work with them on their goals. One question to ask is what will be involved in a fertility workup — how can the health of their ovaries, tubes, and uterus, as well as the quality of sperm be tested. Frequently, the doctor can make some initial impressions regarding the etiology of the couple’s infertility from history and ultrasound alone, so the first visit may be very informative. Another question to ask is who will be seeing them for the duration of their treatment, and who will be doing the procedures. In practices which have several physicians, it is very common that the patient sees the “doc of the week” on their visits, and only sees their own physician for follow up visits if treatment is not successful. In other practices, like ours, the patient’s physicians sees them at all their visits and does all their procedures — there are benefits to both methods, so it’s just important to know what to expect. And finally, a patient can ask whether the physician recommends any complementary or alternative medicine approaches to pursue while they are getting their treatment – relaxation program, acupuncture, support groups may be examples of such treatments.
About Dr. Inna Berin
Dr. Inna Berin is a highly qualified specialist in Reproductive Endocrinology and Infertility, joining us from Harvard University.After obtaining her undergraduate degree at New York University with honors and receiving the President’s Service award for leadership, she attended the Mount Sinai School of Medicine, where she obtained her medical degree and was recognized in the medical community by serving as the vice president of Medical Student section of the American Medical Association.
Following medical school, Dr. Berin completed her residency in Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons – St. Luke’s-Roosevelt Hospital Center, where she was appointed Administrative Chief Resident during her final year. She was then selected for a fellowship in Reproductive Endocrinology and Infertility at the renowned Massachusetts General Hospital. While there, Dr. Berin was appointed ‘Clinical Instructor’ in Obstetrics and Gynecology at Harvard Medical School, and worked alongside some of the foremost leaders in the fields of reproductive biology and infertility. She is a member of the American Society for Reproductive Medicine, Society for Reproductive Endocrinology and Infertility, and the American Medical Association.
Dr. Berin possesses clinical expertise in all aspects of infertility and reproduction. In addition, Dr Berin has trained in the most advanced techniques of minimally invasive reproductive surgery.
Dr. Berin has been recognized by patients and peers as being an exceptionally compassionate physician, and she takes great pride in providing outstanding medical care and personalized attention to each individual and couple. She is fluent in English and Russian, as well as conversational in Spanish.