Tishrei 5781 Magazine_Print

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A Time Support Groups Breaking Misc
News!
Join our phone support groups from the Collection Kits
comfort and privacy of your home! New insurance law in New York are available
State requires large group at the
Phone Support Groups on the following topics: health insurance plans gemachim
 Primary Infertility statewide to cover 3 cycles in Monsey
 Secondary Infertility of IVF. It also requires all and Boro Park
 Unsuccessful IVF commercial insurance plans
 Pregnancy Loss Support to cover all pre-cancer
 Male Factor Infertility
 Men's Support Group treatment fertility preservation.
 Mothers of Couples Experiencing Infertility
Contact the A TIME helpline
Email [email protected] or [email protected] for more details.718.437.7110
or call 718-686-8912 for the info

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Call Chaya 718-258-5002
or Vivienne 917-783-9514 for assistance

Meals Inspiration! Car Rides

Be welcomed home after an Information! Chizuk! Rides to and from your center from Williamsburg
exhausting day of procedures Find it all 24 hours and back call Chesed 718-218-9000
with a gourmet meal to warm a day whenever you
need it by calling Rides to and from your Manhattan center from
your body and heart. Boro Park and back call Chesed 718-431-0111
You will be registered for this service Kol Chaya:
718-298-2646 Rides to and from your Manhattan center Lakewood and
when ordering hashgacha. back call Lakewood Bikur Cholim 732-905-3020 Ext. 117
Available in many areas. (Yiddish or English)
Darchei Chesed of Monsey 845-425-4070
‫לע״נ ר׳ ישעי׳ בן ר׳ משה זי״ע מקערעסטיר‬

TISHREI 5781 | SHAAREI TIKVAH 51

| CHIZUK FROM WITHIN • BY: GOLDY

A Unique

Type of Simcha

Iwanted to make a siyum, a kiddush, a party. I type of mazel tov, yet it’s such a big simcha for
wanted to invite all my friends and neighbors us.
to come by and wish me mazel tov. I wanted
people to knock on the door with presents and Four years after getting married, just around

platters of cake. I wanted to get up and give a the time of our fourth anniversary, we were

speech. I wanted to shout Just as we able to perform the mitzvah of
on the mountaintops: our wedding night. Four years of

Do you know what just dealt with all talking to countless rabbanim and
happened? Do you know getting countless different opin-

the miracle Hashem did the challenges ions. Four years of going to all dif-
for me? But, no, we did of the past few ferent types of therapists hoping
none of that. We smiled years in private, each one will be the one who will
and rejoiced, but alone. have a way to help us. Four years
Just as we dealt with of going to different gynecologists

all the challenges of the we thanked and doctors and trying to find
past few years in private, a solution to a problem that so

we thanked Hashem for Hashem for the many people did not understand.
the neis He did for us in

private, too. neis He did for us Four years of so much stress and
so much difficulty, but all hidden,
in private, too.“What was the grand ma-
all quiet, not something we could

zel tov?” you’re probably talk about with other people. My

thinking. “What’s the big friends with kids couldn’t have

neis that is such a secret that she can’t tell known what was going on, and my IF friends

anyone?” It’s a good question. Our mazel tov is could not have understood. I didn’t feel com-

very unique and very different than any other fortable anywhere. Not with my friends who

52 SHAAREI TIKVAH | TISHREI 5781

had two or three kids and not with my IF perform this private mitzvah. It feels to me

friends either. I felt like I was in my own world. like this success was very much connected to

the tremendous efforts I had put into going to

With so much stress in this area of life, going the mikvah with joy.

to the mikvah was very difficult for me. An-

other month of trying and of failing. Another Now, I’m going to ruin this story for you. I’m

month of disappointment added on to so many sorry. I should really end off here and leave

other months of disappointment. you all inspired and uplifted. But, as we all

Until I learned more about What happens know, this is real life. Real
life requires a lot of work

taharas hamishpacha. I tomorrow doesn’t and a lot of getting up
learned about the beauty matter, as long as again, and again, and nev-
of going to the mikvah no I make the most er giving up. So, I could
matter what comes next, no end here, but I won’t. This
matter what happens after. I aspect of our marriage

learned about using the mik- of what I can do is still very difficult and
vah as a time to connect with challenging. Yes, we per-

Hashem and to daven and to to serve Hashem formed this mitzvah once,
give myself renewed hope, but since then, there are

renewed connection. I got right now. many more challenges to
myself a beautiful bag and deal with in this area, and

beautiful things to put inside. I still need to work to stay

I reignited my excitement and my passion strong, to fight the good fight.

for this mitzvah again. I combed my hair and

removed all negative thoughts with the knots. At the same time, though, I’m so grateful to

I brushed my teeth and brushed away any bad Hashem that throughout everything, I have

past experiences. I reconnected to Hashem the beautiful mitzvos of taharas hamishpacha

and to His mitzvos. I resolved that no matter to hold on to, and to serve Him with passion

what happens, I will enjoy this special mitzvah in these mitzvos. What happens tomorrow

of going to the mikvah. I came home feeling doesn’t matter, as long as I make the most of

happy that I was able to go to the mikvah and what I can do to serve Hashem right now. And

enjoy it without connecting it to what may or that’s what we’ll all keep doing, whatever our

may not work out later. situations are, with whatever it takes. With a

beautiful bag in hand, no matter what will be

And, now I get a mazel tov. Because during tomorrow, we’re off on a mission — to do the

that month of going to the mikvah with joy best we can to serve Hashem today!

and with connection, we finally were able to

HAPPINESS IS A DIRECTION, NOT A PLACE.

TISHREI 5781 | SHAAREI TIKVAH 53

| CHIZUK FROM WITHIN • BY: ELISHEVA M.

Ilove getting random calls from random
people. You pick up the phone and you
have no clue who is going to be on the
other end, and hopefully it’s just some
random person who is trying to sell you the
newest French Mustard or something like
that.
So when my phone rang with a random
number and I happened to have a minute,
I picked it up. And what do you know?
They were really trying to sell me French
Mustard!

Kidding. But almost!

It was an acquaintance of mine (the type
you say hi to on the street but don't have
her number saved in your contacts). She
called to make me an offer that she felt I
couldn't possibly refuse. It seems that a
few years ago, I had done her a big favor
for which she still feels hakaras hatov.
(Just to note, I have never heard any men-
tion of this favor previously). Either way,
she wanted to inform me of a new product
she recently started marketing. It’s a new
diet program, complete with a kit, supple-
ments and all. After selling it for a while
and seeing its amazing results, she decided

54 SHAAREI TIKVAH | TISHREI 5781

to offer it to me as a gift because apparently, this diet But losing 10 pounds really did appeal to me, espe-

kit has superpowers that can cure infertility for good. cially if it’s totally free. So I called my rav and asked

if we’re allowed to take her up on this offer, consider-

I mean, she didn’t actually say that. What she really ing that it is spurred by her absolute conviction that

said was that she knows several people, who, you it’s going to cure our infertility. I mean, I didn’t want

know, were having issues with getting pregnant, and to take advantage of her naivete for my personal gain

then they did this diet, and it really helped, and she (scratch that, for our personal (weight) loss). Our rav

hoped that I didn’t mind her saying that, just she re- actually laughed and told us it’s completely fine; if

ally cares and noticed we were waiting the caller is naive enough to really think it’ll cure our

a bit. infertility, then we can definitely take her up on

the offer.

Oh, good morning! I’m

glad you noticed after So we decided to do

five years that we were some of our own re-

waiting a bit... search. Losing weight

is awesome, but I only

Anyway, she offered it to me She just wanted to do it if it’s
free of charge, which was really sounded so safe — which not all diets are.
sweet of her. I just wasn’t quite Dr. Google is awesome at answer-
sure why I’d want to do it — ing this kind of question, so he was

besides for losing 10 pounds, sure that this our first go-to. It definitely looked
of course, which is totally fine interesting. Didn’t see any informa-

with me. But she sounded so was going tion linking this diet with fertility or
convinced that was my cure, so anything remotely related, but we

I threw caution to the wind and to do it, were still considering it.
asked her what it helps with

fertility-wise. She said it helps that this was Twenty minutes into intense re-
balance hormones. the magical search, my husband decided he
cure we’d been needed a break and went to get
I almost burst out laughing waiting for. some chocolate from the cabinet.
on the phone. I mean, balance When he came back, he said, “You
hormones? Sure, that can be a know what I think we should re-
big issue if you’re trying to have search? I think we should check out
kids. And I understand that there how chocolate improves fertility.

are lots of people who would C’mon, this stuff has to be healthy

rather go with a natural cure than with medications somehow!”

and injections. But… well, first, I was tempted to ask

her if it helps balance male hormones, too. Howev- So we switched gears and I Googled, “How does

er, I decided to skip since I didn’t want to cause her chocolate improve fertility?”

to faint; she had probably never even heard of male

factor infertility. Second, she just sounded so sure We just knew there must be something healthy about

that this was going to do it, that this was the magical it. My grandmother eats a square of dark chocolate

cure we’d been waiting for, that I should convince her every day and claims it’s a real superfood — you

to call all my infertility friends and let them know know, up there on the list right after salmon and cod

about this secret remedy. I mean, this could solve all liver oil.

IF problems! A TIME can close its doors forever! Any-

one waiting should just do this diet and then — walla! And guess what? She’s right! (Of course. Grand-

Problem solved! Yeshuos and nechamos for gantz mothers are always right.) Even Dr. Google agreed

Klal Yisroel! this time.

TISHREI 5781 | SHAAREI TIKVAH 55

Apparently, chocolate is super healthy! In fact, eating even more than in blueberries and acai berries! — can

chocolate on a consistent basis almost guarantees improve sperm and egg health.

one to land in the maternity ward within the next

year and a half! Or at least close to that. You can’t Not only that, but chocolate is also great for losing

imagine how many incredible facts we found about weight. Get that! So it’s a perfect cure for at least

the health of chocolate. Not only does it contain some people with PCOS, as it helps lower insulin

cocoa beans, but some of the chocolate bars we de- resistance.

vour and love even include natural cane sugar. In the

fancy ones, it’s even organic. Basically, chocolate has just about the same health

equivalency as eating a vegetable platter. Almost.

The articles we read stated that it’s a known fact

that chocolate helps fertility. Somehow, in five years The only issue is that not all chocolate is created

of TTC, I missed this vital aspect. Not sure why I got equal. In the chocolate world, the darker you get,

so caught up with medical treatments meanwhile… the better. Milk chocolate, unfortunately, does not

include all those healthy benefits, and white choco-

Chocolate has lots of antioxidants and is packed late (yikes! That’s my favorite!) doesn’t really include

with essential minerals, vitamins Basically, any of them, either. So we’re stuck
and who-knows-what-else you chocolate is with the dark chocolate, the kind
need for conceiving. One of the just about that contains at least 70% cocoa. In
vitamins, arginine, promotes blood fact, the milk chocolate and white
flow to the ovaries and uterus. This the same chocolate varieties often have the
facilitates better egg quality and exact opposite effects. The un-
a high maturation rate, along with healthy chocolates actually cause
a thicker uterine lining. Chocolate weight gain (sigh. I really thought I
also contains high levels of sero- had something going for me here…

tonin — the natural antidepressant thing as life has its disappointments some-
— which can help lower stress times) and can therefore inhibit

levels while enduring infertility. So eating a conception in some cases.
that should help all of us who have vegetable
unsuccessfully tried the “just relax” So the take-home message is that
advice. There are minerals like iron, platter. dark chocolate can help fertili-
zinc, potassium, manganese and ALMOST. ty, but only if consumed in small
calcium all found in Schmerling’s amounts, optimally about a square
bars. These promote healthy DNA or two a day. Obviously, they sug-
in eggs and sperm and also bal- gest only organic cane sugar, with
ance hormones. (See? Chocolate no added caramel. (Oh, well.) You

really is just as good as dieting! It know you’ve got the real deal when

also balances all the hormones!) the first ingredient listed is either

Chocolate can also improve ovula- chocolate liquor or cocoa, and then

tion and decrease the rates of PMS, lower just go for the one with the least ingredi-

cholesterol and blood pressure, protect and ents.

hydrate your skin, improve memory, re-

duce any inflammation, improve Armed with this precious info, my

your immune system, and act as husband and I have embarked on a

a natural mood enhancer (that new fertility journey. Each day, he

much I knew already). The religiously consumes those superfood

antioxidants found dark chocolate squares. This is bet-

in chocolate — and ter than IVF, I think!

supposedly there

are a bunch of them,

56 SHAAREI TIKVAH | TISHREI 5781

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TISHREI 5781 | SHAAREI TIKVAH 57

| CHIZUK FROM WITHIN • BY: GOLDIE BURGER
58 SHAAREI TIKVAH | TISHREI 5781

I have a wish, a desire,
That is so very strong.
A dream that's yet to come true,
One that I’ve envisioned for too long.
I wish to hear your first cry,
To gaze at your beautiful face.
To watch your tiny mouth open,
To hold you in a tight embrace.
To feel your cheek against mine,
To smell your honey-sweet scent.
To count ten perfect fingers and toes,
To watch you sleeping content.
I wish to see your sparkling smile,
To enclose my index in your palm.
To bathe and dress and feed you,
To hear you gurgle when you're calm.
I wish to give all the love I have,
To whisper it in your ears.
To hug you close to my heart,
To wipe away your tears.
I wish to see your teeth come in,
Watch you roll over on your own.
To hear you say your first words,
To see you walking alone.
You are constantly on my mind,
All day I dream of holding you.
And I pray that very soon it shall be,
No longer a dream, but all too true!

“I HAVE HAD DREAMS, AND I’VE HAD NIGHTMARES.
I OVERCAME THE NIGHTMARES BECAUSE OF MY DREAMS.” – JONAS SALK

TISHREI 5781 | SHAAREI TIKVAH 59

8THIEPLSPTSOTOP| SUPPORT • BY: DR. MARIA COSTANTINI, RMA NY
OBSESSING
For sure, it seems nearly impossible to stop obsessing about pregnancy while dealing with infertility. You
spend countless hours at the doctor’s office — checking this, assessing that — all in the hopes of having an
egg get fertilized and an embryo implant. Here are some ideas for how to get pregnancy off your mind, or at
least deal with it in a more healthy way.

1. MAKE A 2. MAKE THE
LIST OF THE
POSITIVES. DAY A

Literally write down everything that you are CELEBRATION!
grateful for. If you can stretch yourself, also
write down the things you are able to do now Plan something amazing for yourself on the day
without the added responsibility of a new child. your period comes (or is expected to come). It
Really try to appreciate your life, just as it is right can be getting together with your favorite peo-
now. It may sound cliché, but it really does work. ple for dinner or drinks, going to your favorite
So much of our obsession and sadness comes restaurant, going for a manicure, getting a mas-
from the belief that “If only I had a child, my life sage, etc. — whatever makes you HAPPY!
would be complete.”
Try your best not to discuss the fact that your
Believing that your life is wonderful and is un- period came, or if you do, only talk about it in a
folding exactly as it should be releases you from positive light (i.e. “well my cycle is predictable
being stuck in thinking life will not go on if you and right on time!). If you are able to create
don’t get pregnant. This doesn’t mean that you something else to look forward to on that day,
stop hoping for a child. It just means your life is the pain and disappointment will be just a little
full of other amazing things that you have the less intense.
time right now to really focus on and appreciate.

60 SHAAREI TIKVAH | TISHREI 5781

3. CHANNEL YOUR 6. RETHINK
INNER PERFORMING YOUR
POWER. SHOTS.

Find a song that makes you feel empowered and It’s really hard to put infertility out of your mind
like the strongest person in the world. Put it on ev- when you have to take daily hormone shots. Try to
ery device you have that can play music. Whenev- find ways to make getting your shots more fun or
er you need it (waking up for morning monitoring, less of a big deal. Play your favorite song, eat some
after a shot, result, or other milestone), play it, sing chocolate afterward, talk with one of your best
it, and dance to it. friends right after, etc.

This may sound and look silly, but if you internalize The goal is to take your shot and move on quickly
the words and let yourself truly enjoy, you really to something that you really enjoy.
will feel better. Just give it a try.
7. HELP
4. FIND THE WORDS AND SOMEONE
THOUGHTS THAT WILL ELSE.
BRING YOU PEACE.
One of the quickest ways to help you stop obsess-
Whether it’s an inspirational quote, a poem, or a ing over your own challenges is to be of service to
line from a song, find physical words that bring someone else. Volunteer at some worthy organiza-
peace to your mind. Print them out or write them tion, participate in a fundraiser, or do random acts
down. Meditate, read and internalize them, no less of kindness. You can become a mentor, or you can
than three times a day. Memorize them as best as reach out to a friend in need.
you can. Carry them with you. There is something
incredibly powerful about consistently focusing You have unique gifts, skills and nurturing qualities
your mind on words and thoughts that help you that can benefit others. Use and develop them now
feel good. instead of later.

5. LIMIT THE AMOUNT 8. STOP TAKING
OF TIME YOU WALLOW 1,000 PREGNANCY
IN SADNESS. TESTS.

It’s inevitable that you will feel really sad and just Whether you are undergoing infertility treatment
want to cry. That’s okay. Feel the emotion and be or not, most people trying to conceive have taken a
aware of the thoughts that fill your mind. Mourn pregnancy test, or two, or three hundred. It’s a very
the fact that your life is not going how you expect- predictable set of experiences. You think you’re
ed it to. Be angry that you don’t yet have some- having pregnancy symptoms; your period is a cou-
thing you really want. Just don’t stay there. ple of hours late, you just want to be sure. It can’t
hurt to take the test, right? Right??!!! Well, it does
When you have your down moments, give your- hurt, especially when the result is negative.
self no more than five minutes at a time to be sad.
When the five minutes is up (or even before), stop Sometimes the reality of the negative test can
immediately and do something else. help you feel like you “know for sure” and can help
you move on. Other times, it becomes its own ob-
session that leads you down a road that’s hard to
get off of.

“BE STRONG ENOUGH TO STAND ALONE, SMART ENOUGH TO KNOW WHEN YOU NEED
HELP, AND BRAVE ENOUGH TO ASK IT.”

TISHREI 5781 | SHAAREI TIKVAH 61

| SUPPORT • BY: L. BENDAYAN AND F. MOZES

> C ompare prices at different pharmacies financially in paying for your treatments or
and shop around for medication quotes. medications, you may still be able to claim
Make sure to ask if they offer a discount for costs as medical expenses. Speak to your
patients of your center/doctor. accountant for details.

> Price around for storage facilities and make > M edication gemachs: Scout out gemachs
sure to ask if they offer a discount for A in your area. You can often get many costly
TIME members or for your center. medications that way.

> Medical expenses deductions: Save your > Free samples: Ask your nurse if there
receipts or ask your clinic, pharmacy, are any free samples in the office for the
storage facility, etc., for year-end payment meds you need. They can save you a pretty
reports, and report it when filing taxes penny!
so you can possibly get a deduction on
your tax return. Make sure to include > I f practical, it’s worth finding out if there
any copays, procedure costs, insurance are medications available at a gemachs
premiums, storage fees, medication outside your city or free samples at a
costs, etc. Even if you received help different branch of your fertility clinic.

62 SHAAREI TIKVAH | TISHREI 5781

The drive down to pick it up or the cost of medications are interchangeable, with
a courier service may be well worth the the difference being the manufacturer.
money you save on pricey medications! For example, Gonal-f and Follistim can be
interchanged even within the same cycle.
> T he Compassionate Care Program provides
eligible patients savings based on income. > S ubstitutes: Ask your nurse if any
Eligible patients may save 25%, 50% or 75% medications can be substituted for other,
off the self-pay price for the following EMD less costly ones. For example, Endometrin is
Serono products: a very expensive med — even with insurance
Gonal-f ® coverage. It can often be replaced with
Prometrium, which has a small copay/cost.
Ovidrel ® PreFilled Syringe
> W almart $4/30-Day and $10/90-Day
Cetrotide ® prescription program offers generics on
many commonly used meds. One that would
> You need to apply online and submit some be helpful to many IFers is Levothyroxine
income information from your tax return. (generic for Synthroid). Check the Walmart
You can use the discount for multiple cycles near you for details.
during a year. You need to reapply each year.
> M edcal Pharmacy is a great resource. They
> Through the Compassionate Care GO Direct offer extremely low prices on many meds,
Rebate program, eligible self-pay patients and often have discounts with your specific
can receive a discount, via rebate, off their center. For example, RMANJ’s price at
out-of-pocket costs for the following EMD Medcal for Ovidrel is $50 — less than most
Serono products: of the copays! They offer free delivery in
Gonal-f ® Brooklyn and Lakewood. They also offer
Ovidrel ® PreFilled Syringe shipping.
Cetrotide ®
> Even if you don't have IVF coverage, you may
> You must submit your original pharmacy still have coverage for some medications
receipt along with the rebate form within that are not flagged by the insurance as
90 days of original pharmacy receipt date of "fertility meds," but are also used for other
service or fill date. conditions. (For example, Lupron 14-day kit
may be covered.) Make sure to speak to your
> The ReUnite Assist program provides insurance company about each medication.
discounts off of specific fertility drugs for
eligible self-pay patients. You will need > I f one of your meds gets denied by insurance,
to provide income information (1040 tax it may be the quantity that is the problem.
document) For example, some insurances will not cover
multiple vials of PIO at once, but will cover
> The medications eligible for discounts are: one at a time. While it may be annoying to
order a weekly refill, the upside of having
Follistim AQ Cartridge meds covered can't be beat.
Ganirelix Acetate Injection
Pregnyl > App called Fertility Drug Calculator: You can
input the meds and doses you need and the
> I t's worth applying for both the app prices it out for you at a multitude of
Compassionate Care and ReUnite Assist pharmacies.
discount programs to see if you get a larger
discount from one program. Many of the TISHREI 5781 | SHAAREI TIKVAH 63

| SUPPORT

Things
I Would

SAY

64 SHAAREI TIKVAH | TISHREI 5781

I'm going to try and make this as least depressing as possible, but
for those of us suffering with IF, most milestones are not fun ones.
October marks the "36 Months of TTC" anniversary for my husband
and me. I can't decide if they have been the longest three years of
my life or the shortest! There are many things I wish I could tell the
three-years-ago self. Here are a few:

#1. Stop being so hard on yourself. #9. Take care of yourself. Love yourself
This isn't going to be easy, but you will because you are going to dip into some
make it through. of the lowest lows and you are going to
need to be strong and pick yourself back
#2. You aren't in control.I know you up. You can do it.
think you are but you aren't!
#10. Be patient and lean on your trust
#3. Write things down. Know what in G-d. He knows what is best for you,
tests have been done and which ones even if at many times it doesn't seem
haven't. Take charge of your health like it. He does have a plan for you, but
and treatments. it still hasn't been revealed. Use your
faith to help other women suffering
#4. Trust your instinct. If you think with IF to remain hopeful that one day
something isn't working, don't keep we will all find our contentment.
trying the same thing month after
month. Speak up! I can't believe it has been three years.
I have come to realize that infertility
#5. Don't be afraid to reach out for has equipped me with many great
help sooner. You will find more support qualities. Patience. This one is obvious.
than you would ever expect in places Strength. I am mentally stronger than
you would never expect. I would have ever imagined. Wis-
dom. My eyes have been opened to a
#6. Take it easy on your poor husband. world that is real, things don't always
He can't even begin to understand come easy, things aren't always as
what you are going through. In fact, in they seem. Humility. What is more
three years he still won't fully under- humbling than realizing you aren't in
stand. Take the time to explain things control of your body? And love. Our
to him. relationship has been tested time and
time again, but somehow, at the end of
#7. Communicate often; don't hold the day, we are a closer and stronger
things in. couple than pre-IF.

#8. Make the best of the situation you Juliesjunkdrawer.com
are in. Keep exploring the things you
love, don't act as if life is on pause —
because it isn't.

TISHREI 5781 | SHAAREI TIKVAH 65

| SUPPORT

Appreciating
the Present

Self-Gifting
for the IFer
(and her friends!)

One in six couples experience infertility, which likely means you, or someone you
know has navigated or is currently navigating this experience. It can be a rela-
tively short journey for some, or seemingly endless for others, but at some point,
it's mentally and physically draining for everyone going through the process.
To most people, gifting takes on the connotation of happy occasions (dare we
say births? Or the anniversaries? gasp.) but the truth is, as an IFer, no one de-
serves to celebrate the everyday ups and downs (and even downer downs)
more than you.
Yep, you deserve it.
It may sound silly, but a gift can make all the difference, even for a moment’s
time. A “treat yourself” moment can go miles in pushing through a roadblock
in your personal IF journey. It’s a way of showing your support — to your-
self! — for the experiences you’re facing and the person you’re becoming.
Here’s our gift guide for those going through IVF:

66 SHAAREI TIKVAH | TISHREI 5781

CALMING CANDLE: $12.00 / etsy.com PINEAPPLE BOO BOO PACK: $8.25 / etsy.com

This all-natural soy wax candle is hand-poured These adorable boo boo hot or cold packs are per-
into a reusable jelly jar and available in a variety fect for soothing those belly shots during treatment.
of amazing scents and in different sizes. They are made with rice and 100% pure essential
oils. You can choose from lavender, peppermint,
eucalyptus, and unscented. Not to mention they are
pineapples, a widely-adopted symbol of IVF.

2020-2021 IVF PLANNER: $29.99 / etsy.com FERTILITY CADDY: $35 / myvitro.com

We all know how much planning goes into an We all know how overwhelming it is to receive
IVF cycle. This planner was made by an IVF all of your IVF injections at once. MyVitro
patient, specifically designed for women going created this caddy to help you feel in control of
through fertility treatment. Each month comes your fertility treatments. Now you can organize
with space to write in your cycle day, as well as your medications and other supplies in this
a notes section, to-do list, lunar calendar, journal storage case at home.
prompts for retrieval/transfer day, and more!
With this nifty planner, you’ve surely got this!

TISHREI 5781 | SHAAREI TIKVAH 67

IVF SOCKS:
$12 PER PAIR / etsy.com

These awesome socks will
give your doc (and nurse
and anesthesiologist too!) a
chuckle when they get the
view of their surprise under-
sides! Choose from a variety
of fun messages.

EMOJI BANDAIDS: CAR AIR FRESHENER:
$3.99 $6.65 / zazzle.com

If you're in IVF treatment, there's no shock You’ll be spending all that time in it… time to
that there are needles involved in the give your car a new fresh scent! And make
process. Here, you can cover each one to it something inspirational to look at while
match your mood and transform your tar- you’re at it.
get practice wall into a mood board. It will
make injections so much more fun.

68 SHAAREI TIKVAH | TISHREI 5781

PATTERNED BANDANA: Car decals:
$17.25 / zazzle.com $6 / etsy.com

Need to wear a mask to monitoring? Well, Decorate your car in style for the travels,
bandanas work (almost) just as well! You but keep it discreet enough so that people
just might break the silence in the waiting shouldn’t have too many questions!
room with this one.

TRAVEL COFFEE MUG: You've Got This
$24.99 cafepress.com/zazzle.com IVF can be a difficult journey. If you're TTC, spoil yourself a bit — you
deserve it! If you know someone in treatment, let them know you're
Because how else are you going to there for them by giving them one of these thoughtful gifts.
get through this drive awake?
Based on a post by Dina D'Amelio on rmact.com

IF YOU’RE SEARCHING FOR THAT ONE PERSON WHO WILL CHANGE YOUR LIFE,
TAKE A LOOK IN THE MIRROR.

TISHREI 5781 | SHAAREI TIKVAH 69

| MEDICAL

GDuiudTrelirinneegastFfmorerEetnixlteisrtcyise
If you’ve been trying to conceive, you have probably
heard and read about how beneficial staying active fertility specialist and keep these guidelines in mind.
is for your fertility. And it is true that getting regular
exercise can help with fertility in a variety of ways. 1. Ask About Your Fitness Routine Before
It helps with weight management, hormone balance, Starting Treatment Cycles
circulation, and metabolism. So it might come as a
surprise that exercise and fertility treatments don’t If you’re planning on starting fertility treatments, it’s
always mix. a good idea to take some time to prepare before you
get started. Preconception counseling and care will
During fertility treatments like in vitro fertilization help you prepare your body for pregnancy and fertility
(IVF), women should hold back on exercise. Light treatments. One of the things you should talk to your
workouts are okay during some parts of an IVF cycle doctor about is your level of physical activity and if you
while you should opt-out of exercise completely during should alter your exercise routine.
others. For clarification on how to handle exercise
and fertility treatments, make sure you consult your There’s a balance that you need to strike when it
comes to exercise and fertility. Just enough can

70 SHAAREI TIKVAH | TISHREI 5781

benefit you, and too much can work against heavy weight lifting, running, interval Workouts like heavy weight lifting, running, interval training, or
you even if you’re not in a treatment cycle. training, or other high-impact activities other high-impact activities redirect blood circulation to the muscles
As you’ll see as we get into the rest of the redirect blood circulation to the muscles
guidelines, it’s not a good idea to take on instead of to the uterus, ovaries and eggs. instead of to the uterus, ovaries and eggs.
an intense fitness routine during fertility
treatments. It’s also not advisable to start a While you shouldn’t be engaging in high-
more vigorous routine once you’re pregnant. intensity and high-impact activities, you
So, if you want to get in better shape for shouldn’t be sedentary either. Aim for light
pregnancy, it’s best to put in the work at an or moderate-intensity activities for short
earlier stage. periods of time, such as:
Yoga (but no inversion)
2. Consider Taking a Break From Exercise Tai chi
During Certain Parts of the Cycle Walking
Swimming (but no flip turns while doing
While your doctor may give you the go- laps)
ahead for exercising during parts of a
treatment cycle, you should refrain from 4. Limit the Amount of Time You
exercising at certain points. Many doctors Spend Exercising
recommend not exercising at all during the
week of egg retrieval. During that stage of A 2006 study published in Obstetrics and
treatment, your ovaries are enlarged from Gynecology found that getting regular
being stimulated and exercise may increase exercise before in vitro fertilization can hurt
the risk of a rare condition called ovarian your chances of success. This was especially
torsion. true of women who exercised four hours or
more per week. If you want to exercise, keep
Ovarian torsion occurs when an ovary twists workouts to around 30 minutes or so and
on the ligament that it is supported by. This only exercise two or three times a week.
cuts off blood supply and causes severe
pain, nausea, and vomiting. Twisting a lot 5. Find Low-Intensity Activities for
or moving too vigorously may make torsion Stress Relief
more likely. Again, it should be noted that
this is rare, but following your doctor’s orders If you are someone who enjoys working out
about exercise and fertility treatments will and relies on physical activity for stress
make it even less likely to happen. relief, find other ways to channel that
energy. If you are in a part of the cycle when
Another time you should be extra careful it’s safe for gentle exercise, try some of the
about exercise during fertility treatments is things listed above. If you are unable to work
during the two-week wait after the embryo out at all during part of the treatment cycle,
transfer. Rigorous exercise may decrease try finding a hobby like gardening or painting
the embryo’s chances of implanting. So, if to use as an outlet.
you do exercise, it’s important that it’s not a
strenuous workout. If you’re worried about exercise and fertility
treatments, talk to your fertility specialist
3. Avoid High-Impact Workouts about their recommended guidelines
because they will have the best information
When it comes to exercise and fertility on how to care for yourself during treatment.
treatments, doctors agree that women
should avoid high-impact and workouts Carolinas Fertility Institute
during a treatment cycle. Workouts like

TISHREI 5781 | SHAAREI TIKVAH 71

| MEDICAL • BY: DR. TANMOY MUKHERJEE, RMANY

LowA-dRjuevsianpnotInVdTFinrgefoartPmaetnitesnts

As reproductive endocrinologists, we occasionally Another question that often comes up is the possible
face struggles in the management of patients who do utility of adjuvant treatments. While it is important to
not respond well to traditional treatment protocols. realize that these are indeed nutritional supplements,
When undergoing IVF, one of the keys is to optimize and have not been FDA-approved for reproductive
the number of eggs retrieved so that we can find care, there is some literature supporting the use of
a healthy one that will develop into a high-quality some of these adjuvants.
embryo, enhancing the chance of conceiving and
delivering a healthy baby at term. In some patients, • DHEA: Randomized controlled trials examining low
individualized protocols such as estrogen priming and response to medical stimulation have been inconsis-
Lupron microflare, have been able to increase the tent. In most studies DHEA was initiated 3 months
number of eggs and increase the likelihood of deliv- before IVF until the end of ovarian stimulation at a
ery in those with low baseline follicle counts or prior dose of 50mg-75mg. The current evidence is not
poor response, but unfortunately these approaches statistically significant and a definitive recommen-
do not work for all patients in this situation. dation cannot be made. However, for the majority
of patients, DHEA treatment is considered safe and
Often, we are asked whether there are any adjuvant results in few, if any, side effects. Given its safety
treatments that could be used to increase the re- profile, some low responders may benefit from DHEA
sponsiveness of the ovaries. There is both an art and utilization.
science that need to be called upon as we formally
answer this question. Attention should always be • Growth Hormone: In vitro studies suggest an im-
paid to the mind and body connection. Though we portant role for GH in follicle growth and differentia-
cannot necessarily say that if a woman is stressed tion. Recent randomized controlled trials comparing
or anxious she will be a low responder, we do believe GH adjuvant cycles and traditional cycles demon-
that being in the ideal mental and physical states strated no improvement in pregnancy rates. Current-
can only enhance the body’s ability to respond well ly there is no strong evidence suggesting the efficacy
to treatments. Among the various options for stress of GH use. Given its high cost, unknown long term
relief, we work most closely with acupuncturists, and safety profile, and DEA recommendation against
have had good experiences and positive outcomes in off label use, utilization of Growth Hormone for the
many cases. treatment of low responders is not recommended.

72 SHAAREI TIKVAH | TISHREI 5781

Often, we are fer-
asked whether there are any ence.
adjuvant treatments that could be However,
used to increase the responsiveness of one study by
the ovaries. There is both an art and Tremellen using the following antiox-
science that need to be called upon as idants did find an increased birth rate in
we formally answer this question. men with severe male factor infertility.

• Coenzyme Q10 or ubiquinone-10 (CoQ10): CoQ10 > 1 00 mg Ascorbic Acid (Vitamin C)
is a nutrient known to be responsible for producing
energy and stabilizing the membranes of some cells, > 25 mg Zinc (Zinc Sulphate Monohydrate
perhaps including eggs and sperm. CoQ10 appears to
assist the mitochondria and cell power and energy > 400 IU D-Alpha-Tocopherol (Vitamin E)
production. While efficacy data is limited, many low
responding patients add CoQ10 to their treatment > 5 00 µg Folic Acid
regimen.
> 6 mg Lycopene
• Antioxidants for the female partner: Antioxidants
are biochemical compounds that reduce the oxidative > 333 µg Garlic Oil (equiv. allium sativum bulb fresh 1g)
damage caused by reactive oxygen species. Com-
monly used antioxidants include N-acetyl cysteine; > 26 µg Selenium (as Selenomethionine)
melatonin; Vitamins A, C, and E; Folic acid; Myo-ino-
sitol; and zinc and selenium. The cost of antioxidants In summary, optimizing fertility involves optimizing
may vary due to the different formulations. No pub- both the female partner’s and, if applicable, the male
lished studies have investigated the effectiveness of partner’s health. This includes attention to the mind
antioxidant use before IVF. The current evidence does and the body. Protocols should be chosen to neither
not support the routine use of supplemental antioxi- minimally nor maximally stimulate the ovary, but
dants for women undergoing IVF. rather to reach the optimal response. Additionally,
couples should not delay treatment unnecessarily,
• Antioxidants for the male partner: Two random- as ovarian aging is the greatest obstacle to achiev-
ized trials examining Vitamin E (400IU) and folate ing reproductive success. While in the process of
(0.5mg) and live birth rate did not find a statistical dif- undergoing targeted evaluation and treatment many
patients chose vitamin supplements. This overview
may assist in understanding and choosing these
adjuvants for patients who are undergoing fertility
treatment.

TISHREI 5781 | SHAAREI TIKVAH 73

| MEDICAL

WE ASKED DR. EDWARD MARUT, IVF MEDICAL
DIRECTOR AT FERTILITY CENTERS OF ILLINOIS, THE

10 MOST COMMON QUESTIONS HE HEARS ABOUT
PROGESTERONE SUPPLEMENTS:

74 S HA A REI TIKVAH | TISH RE I 5781

What is progesterone? How do you determine if
Progesterone, a naturally occurring hormone in someone needs progesterone?
the body, is stored in fat tissue and produced by First, a patient’s medical history is assessed.
the corpus luteum, a hormone-secreting structure The lack of regular menstrual cycles suggests
that develops from the follicle after an ovum (egg) a problem, such as with Polycystic Ovarian
has been released. Progesterone is found in the Syndrome. Previous pregnancy losses may be
ovaries, adrenal glands and in the placenta during a sign of inadequate progesterone production.
pregnancy. Each month, progesterone is released Properly timed blood tests to measure
to stimulate the uterine lining in preparation progesterone levels may be done in the woman
for pregnancy. When progesterone levels are who has regular menses. A biopsy of the uterine
abnormal, menstrual periods can be irregular. lining may even be done (although an uncommon
practice these days) to determine a lack of
What role does progesterone play in fertility, progesterone effect. Sometimes, progesterone
conception and pregnancy? is used empirically, that is, just to make sure the
Progesterone plays multiple roles in the level is normal, since you can’t have too much
reproductive cycle. In respect to fertility, progesterone!
progesterone is produced after ovulation.
Sufficient amounts are needed to conceive How is progesterone incorporated in an IVF cycle?
and to maintain a pregnancy. If this production During the egg retrieval process, the cells that
is inadequate, a progesterone supplement normally create progesterone after ovulation
may be necessary. Once a woman conceives, are removed along with the eggs. Progesterone
progesterone plays a key role in thickening the supplements are then required to prepare the
uterine lining, which allows a growing embryo body for pregnancy and thicken the uterine lining
to attach to the womb. Prior to eight weeks of to support successful embryo attachment in
gestation, the production of progesterone is mainly the womb. Progesterone may also be required
derived from the corpus luteum. It is critical that during the pregnancy to safeguard against
progesterone levels support pregnancy during pregnancy loss. Continuation of progesterone
these early stages to prevent pregnancy loss. supplementation is advisable, on an individual
After ten weeks of gestation (even twelve in some basis, even up to 12 weeks of pregnancy in a cycle
women) progesterone is mainly derived from the where embryo transfer is done.
trophoblasts, which play a key role in nourishing
the embryo and forming the placenta. What are the side effects of progesterone?
Depending on the route of administration, there
What infertility issues does progesterone help to may be no side effects, especially with vaginal
address? preparations, which have a direct uterine effect,
Progesterone supplements are commonly used rather than a systemic one. Vaginal discharge
in women with infertility diagnoses such as or irritation are possible with these forms. If
ovulatory disorders, recurrent pregnancy loss, injectable or oral preparations are used, side
and in conjunction with Assisted Reproductive effects may include pain, swelling and bruising at
Technology (In Vitro Fertilization, Embryo Transfer, the injection site, headaches, breast tenderness,
Frozen Embryo Transfer, etc.) Progesterone drowsiness, dizziness, fluid retention, bloating, hot
supplements help to compensate for low flashes, constipation, and everything that mimics
production of the hormone after ovulation. pregnancy symptoms! These symptoms may

TISHREI 5781 | SHAAREI TIKVAH 75

persist into a pregnancy as well, or stop when the been shown to be equally effective in fertility
drug is withdrawn. treatment. Less reliable are:

Is progesterone safe? • Prometrium (oral tablets, also prescribed for

Natural progesterone, which is used during vaginal use, 200 mg 1-2x/day)

fertility treatment, poses no threat to a woman • Progesterone suppositories (200 mg 1-2x/day,
or a pregnancy. It is important to note that the compounded by a pharmacy. Not FDA approved
Food and Drug Administration (FDA) does not and unregulated)
differentiate between natural progesterone

and synthetic progesterone (progestins) in its The decision of what progesterone supplement

warnings. Progestins are mostly used to suppress will be used is dependent upon a physician’s

ovulation and are found in judgment and personal

birth control pills. They are SUFFICIENT AMOUNTS preferences, as well as a
only used in preparation for patient’s particular situation.

fertility treatment. In older ARE NEEDED TO In the past, intramuscular
studies synthetic progestins

have been linked to a slightly CONCEIVE AND injections were commonly
increased risk of certain used as a result of the lack of

birth defects if used during TO MAINTAIN A other available preparations.
pregnancy. The FDA has PREGNANCY. Multiple studies have
conducted a thorough review shown no difference in the

of relevant published studies IF THIS PRODUCTION outcome of IVF treatment
and has found there is no when compared to vaginal

increase in birth defects IS INADEQUATE, A progesterone, and some even
resulting from exposure to have even shown superiority

any progesterone in early PROGESTERONE of vaginal progesterone.
pregnancy. SUPPLEMENT MAY An additional advantage
of vaginal progesterone

What different types BE NECESSARY. is that it does not cause
of progesterone are the pain of intramuscular

prescribed? progesterone injections.

During fertility treatment, In some circumstances,

a woman may be prescribed the following combinations of different types of progesterone

progesterone supplements in these common may be prescribed.

doses:

• Crinone 8% (vaginal gel, once or twice per day) What costs are associated with progesterone
medication?

• Endometrin (vaginal tablets, 100mg Compared to other fertility drugs, progesterone
2-3x/day) tends to be less expensive, and insurance
generally covers one form or another.

• Progesterone in oil (intramuscular

injection, 50-100 mg once a day) Who is not a candidate for progesterone

medication?

Patients who have had an allergic reaction to

These three routes one form of progesterone should be switched to
noted above another form, even in the middle of treatment.
have Side effects specific to a certain form of
progesterone are also a reason to switch.

www.fcionline.com

76 S HA A REI TIKVAH | TISH RE I 5781

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TISHREI 5781 | SHAAREI TIKVAH 77

| MEDICAL • BY: DR. GEOFFREY SHER

Ovarian
Hyperstimulation
Syndrome (OHS):

Its Evolution and Reducing
Its Incumbent Risks.

Ovarian hyperstimulation syndrome is not at risk before the hCG is
(OHS) is a condition where a woman administered. If a woman who
receiving fertility drugs (usually develops OHS does not conceive
gonadotropins) over-responds by within 10 to 14 days of hCG
developing a large number of ovarian administration, as the hormone clears
follicles, which upon administration the woman’s body, the condition
of hCG, “triggers” a series of systemic spontaneously and very rapidly
events that can place the woman’s resolves on its own.
health and even her very life at risk.
If on the other hand, she conceives,
The development of OHS is linked the severity of OHS can worsen
to the effect of hCG and thus does and progress to the point that large
not arise until the hCG trigger is amounts of fluid collect in her
administered. In fact, the woman abdominal cavity (ascites) and her

78 SHAAREI TIKVAH | TISHREI 5781

kidneys, lungs, and heart are compromised, be accompanied by The
to the point of her life being placed at risk some discomfort development
(severe ovarian hyperstimulation syndrome due to bloating of OHS is linked
— OHSS). This risk increases progressively and ovarian to the effect
as the hCG production by the developing enlargement. If no of hCG and
root system (placenta) of the conceptus pregnancy occurs, thus does not
“fans the flames.” all such symptoms arise until the
and signs dissipate hCG trigger is
The good news is that even if she does within twelve to administered.
conceive and develops OHSS, with fourteen days of In fact, the
its serious risks, the condition will the hCG trigger. If
nevertheless self-resolve seven to eight pregnancy ensues, it
weeks into the pregnancy. The challenge, sometimes worsens
therefore, is to institute measures that will and thereupon
keep overstimulated women out of harm’s dissipates as
way by delaying the hCG trigger until ovarian function is
they are out of risk. To do so, requires that taken over by the
women with 25 or more ovarian follicles be developing placenta,
critically reassessed for OHSS risk-factors around the eighth
prior to receiving the hCG trigger and that or ninth week of
women who have undergone egg retrieval pregnancy. Mild OHS
and are thereupon deemed to be at risk of is never an indication
developing OHSS be critically reassessed to cancel and defer
for that risk, prior to undergoing a fresh embryo transfer.
embryo transfer.
woman is notModerately severe
In fact, in the event of the latter it is
advisable to wait until five to six days OHS: Here, the
post egg retrieval (when viable embryos
will have reached the blastocyst stage) at risk until thislarge number of
in order to allow for the maximum time
possible before making the final decision emptied (aspirated)
as to whether to proceed to a fresh embryo ovarian follicles in
transfer versus deferring the embryo
transfer to a subsequent cycle (FET). point.the hyperstimulated

Mild OHS: A large percentage of women ovaries re-fill with
undergoing controlled ovarian stimulation fluid and become
(COS) with administration of the hCG significantly
trigger, will subsequently experience enlarged. In such
mild abdominal distention with a modest cases, there will usually be a moderate
collection of fluid in the pelvis. This can amount of free fluid in the abdominal
cavity (ascites) and even in the chest cavity
(pleural effusion). There will usually not be
any vomiting, diarrhea, diminished urine
flow, severe abdominal pain or shortness of
breath in cases of moderate OHS.

TISHREI 5781 | SHAAREI TIKVAH 79

Here again, if following embryo transfer no pregnancy occurs,
symptoms will get worse for about seven days, plateau in the ensuing
four days and then dissipate twelve to fourteen days of the hCG
trigger. Should pregnancy ensue, it will worsen but then resolve as
ovarian function is taken over by the developing placenta, around the
eighth or ninth week of pregnancy. In many such cases physicians will
elect to proceed with fresh embryo transfers. However, with recent
advances in embryo cryopreservation (vitrification) — where frozen
embryo transfers (FET) now yield results that are at least as good as
with the transfer of “fresh” (unfrozen) embryos and considering that
when using vitrification, 80% to 90% of frozen embryos will survive
the freeze-thaw in the same condition as the time they were frozen.
There is a strong movement toward freezing embryos and performing
FET in a subsequent risk-free cycle.

Severe ovarian hyperstimulation syndrome (OHSS): OHSS presents
with these symptoms too, but these are usually much more severe
with the abdomen becoming much distended with fluid (clinical
ascites), often to the point of causing severe pain and shortness of
breath. The latter is due to the combined effects of gross ovarian
enlargement and ascites that “splints” the diaphragm and causes
labored breathing.

The increased intra-abdominal pressure also commonly exerts
pressure on the upper gastrointestinal tract causing the stomach to
slide through the diaphragmatic opening through which the esophagus
passes, leading to a functional hiatal hernia with gastric reflux, pain
and often also vomiting.

In addition, ovarian enlargement stimulates the vagus nerve. This can
cause a slowing of the heart rate (bradycardia), sweating, diarrhea,
and vomiting. These effects alone are sufficient to warrant that the
woman with OHSS undergo thorough hematologic, biochemical and
physical evaluation, and sometimes that she be admitted to hospital
for treatment and close observation. It is also advisable in all such
cases, that all embryos be cryo-stored so that the embryo transfer can
be done in a subsequent hormone-prepared cycle after the OHSS has
resolved.

Transvaginal draining excessive abdominal fluid (paracentesis) :

In cases of severe, symptomatic ascites that causes significant
pain, and difficulty in breathing, paracentesis affords immediate
symptomatic relief and, since it relieves the buildup of intra-abdominal
pressure, reducing the compression of blood vessels it allows for
improved liver, kidney and intestinal function. The effect is transient
and only lasts a few days. Thus paracentesis might have to be repeated
every few days (as needed) until the condition resolves.

80 SHAAREI TIKVAH | TISHREI 5781

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TISHREI 5781 | SHAAREI TIKVAH 81

| HUMOR • BY: F. MOZES

The Waiting Room GameWeareallwaytoofamiliar
with the waiting room scene;
everyone sitting around with bleary eyes,
bloated bellies and jumbo coffees…

Sometimes the waiting can +4 points
feel endlessly boring, if someone
-9 points announces their
so here's a game to help if you cover pregnancy for the
pass the time. your mouth as entire waiting
you mumble room to hear +3 points
Add up your points if she passes
+5 points and have fun! brachos
if you are around her
wearing +8 points
makeup ultrasound

-2 points shots
if you are still
if you manage
in pajamas
under your to say some +5 points
sweatshirt Tehillim if you have a

-2 points copay higher
if you’ve
already had -4 points than $45
more than
two coffees if you pretend

+6 points you don't know -5 points
if you’ve had
none and are her if you don't have
still holding a copay (well,
your head
truth is you did
up
+6 points if pay $18K for the
privilege of being

you then meet here….)

someone you -4 points
know if you are pretend-

ing to text someone

-5 points -4 points (who in the world would
if you dare if you look to you be texting at 6:00
make eye your left when
contact with she does that a.m?!)

anyone +6 points

if the receptionist
shouts across the

room that they
need a urine sam-

ple from you

82 SHAAREI TIKVAH | TISHREI 5781

+5 points -3 points +4 points
if you will be if you’re here if there is a
late to work minyan of Jews
because of this with your in the room
appointment husband

+5 points -5 points
if you’ll be if you’ve parked
heading
straight to illegally
work from
+4 points
here if your wait
time is more
-5 points HAPPY
if someone than 45 WAITING!
minutes
is crying
+5 points
+3 points if the doctor
if you need to
wait more than is late
30 minutes
even if it’s just +4 points
for blood work
if you’ve arrived
-2 points
if you are here +4 points before the +10 points
just for blood if you’ve traveled receptionist
if you are
work more than 35 min- still sporting a
smile (even if it's
+5 points utes to get here
if you’ve covered by
brought your -5 points a mask…)
laptop to work if you came
remotely while +6 points
you wait late if you’re reading
this magazine
while you wait

+4 points +6 points
if your alarm
was set for if you have to be
earlier than pricked multiple
times until the
5:00 a.m.
phlebotomist
-5 points finally succeeds in
if you snoozed
it more than finding a vein

three times +4 points
+4 points
if this is the if you’ve accepted
fourth time
the fact that your
this week that
you are at name will forever be
monitoring
mangled as long as

-4 points you’re cycling.

if your name has
a “ch” in it and
+5 points the receptionist
if there's a pronounces it
woman with a correctly
kid sitting near

you

TISHREI 5781 | SHAAREI TIKVAH 83

| HUMOR • BY: DINI HIRSCH

IT TAKES
A VILLAGE

84 SHAAREI TIKVAH | TISHREI 5781

If it takes a village to raise a child, what does it take A boss who’s mad over the many missed hours
to birth a child? A coworker who’s surprised: Why so sour?
It takes: A friend who tries to be sensitive and caring
A doctor who’s raking in the money A mother-in-law who acts too overbearing
A nurse who seems sweet as honey A cashier — the stack of chocolate, he’s eyeing
A pharmacist for medication and injections A curious neighbor who is constantly prying
A phlebotomist for the daily collections A cleaning lady to save the too-long day
A taxi driver for daybreak trips A receptionist who ensures you actually pay
An aunt with many helpful tips A mashgicha to oversee — caring and discreet
A grandmother with segulahs on her weekly call A cousin who offers you the kvatter seat
A big sister who clearly knows it all A rav to answer the million-and-one calls
A brother who wants to know how much you pay A bodekes to clarify once and for all
A niece who says your name for Tehillim each day A most wonderful and caring A TIME staff
A classmate you meet about once a year And fellow ATIMERs with whom to cry and laugh!
A yenta with a too-obvious stare

TISHREI 5781 | SHAAREI TIKVAH 85

| HUMOR

BIRFE ATKaIkNeGs NOEvWerS!:CsasohtlmWliosgmsteemhdutetbeiaroNhlamrdeetspoisMeenieejiuItswudcwwg'hledmtgwfsasN:eaa-eihhtpbnnaFacsrntRtoedeheelcMibhrmowloknoeecnaoeeiseNtbnuuvapeuotsneispownertgretplM:eolsorrlehiwRwgl.Twyasaroinb”awaNmoaneeatetasrhtaeonipsks:Mt:oertvehptceoaydrtNodouimiT“wnesenMRkohnodnfte,mgWNehtttes’nigregibeeFslwsM:ontsgheawyetiwNeeshrnputYeotgr:alR:esraieiw…ooehsIeoetenotdde“HosFsyehm:ssonusopewrDaposRhuetoWpseiInpttewmr.agywaFoehonorehsl:Rlvoeoedtehnnrecsouihp“e’oawrbntenRssnatf.attduTtlienounseispotohftdneh:rinarlhnrtlrtodd!ctnodrissdpd“woeotturghpesrara.Sntef:noi”ebmehlrorsbitftoml’a…eaymernaone!!o:ltotuertyentsmtcaMDlned…lmgbhn!:sah,tdtddtlayaoTh“e.a.pesylayoi”wv,eyctSurnnetvxtueIasohe,Res'osai’tvuetmlrldutnaaaesmiElesrwst-relbyetvyesaoropma.ioseoeeee.shchir.yneunrs.daieiacoooseanarnShostmepuelMhytmuuade?dt:eevogncof.neheaN!oefohd”p:aefsurMes…aiNaraspnctwyN”pdoenrsiti.aone-sitM:eelalggrMwploRpr…epioeNhkefuaeso:”tesfeeMetbyWpeprtsRewwmelbIcnoeleinesoorcnierdn’st:aisotpwwt.sdhewe”aMiln:NRsosfbloeed,ynly“loerieyyderodotIoodTtrMrpihpwoirwkses:ecnussdihp.eenNopu,nd“eaiec’!osesnlnolybgrYepoyo:eellcraeltpclMRaou.np’wOewpaewstoce.mwneln.utoe’roettdefluesraseoedoirpytessIue:Rmo:tct’ta’amhulcFixmRPossmIyngehaotii7nlaokcnuitrosl,evkdioitouad:xa,ttnsujsgh0brigenpnnfeteres5:ttcidtsmafoousmooeo0e’hesc“im:etetaefec3irctedwwsrItaynobsoftslramltieus0tIanioaofr!gs.ats:to.myarcmdu.mkiosagnhaI.tc“ooodrt.hgAimseelkeks.eaTmkedhu”unm.loh.n,n.nelshfneyciaotteiusbTolsdanoeahd’orhmobtfltsptsurhgewshtaeoupoern.tatirs.aitaoorowoscrTke.noewhsyTtnIcglssioThnmwu’ali…leanhmtokenaueaeniatltmsnobseioirgnytectfzncyptyuuo’hslclfeeshut.eou”eostLraooobipechidwtunvrovaytfoekaefraigtaesohnifisbhslt-rntouSylglaaeeytedryrhhkprie.oat6.ceteh’unohs,drmelne-

86 SHAAREI TIKVAH | TISHREI 5781

Hmm…
no milk?

Oh, I keep
the food in

this one

Menopur hCG Cetrotide
Menopur

Z-pack

Lupron Lupron Lupron

formin
Metformin

Progesterone Follistim Pen
in Oil

TISHREI 5781 | SHAAREI TIKVAH 87

| HUMOR

What I
Will Say
to My
Infertility
Doctor on
My Last
Day of
Infertility

88 SHAAREI TIKVAH | TISHREI 5781

I’m pretty sure that when my time is over with my clinic dressing room doesn’t have a mirror. All dressing
Reproductive Endocrinologist (aka Infertility Doctor), rooms should be this merciful.) There I stood wearing
the whole scenario will be pretty uneventful. But a hospital gown accessorized with a paper hat and

just like at every job I’ve ever worked at, I always paper booties. All I could think of at that all-important

fantasized about the glorious way I would say moment was: “I’ll bet this is how they’ll dress me at

“goodbye.” In the case of the IVF clinic, I rehearsed the asylum.”

what I was going to say over and over week after So while I thank you for your service,

week, month after month. wWdmtitoeiogh'orhorate.lu, pTlrouhnofesufhtdtinhoougaurot, err. I do think such minor details like
improved scrubs may go a very long
I even had a title for the way.
exchange: “What will you say to
Dr. Bennett on your last day ever And once we’re at this point, may I
at his clinic?" It was my hybrid recommend you provide a give-out
version of: "What would you do to all members of your clinic? Sure
if you knew you only had a week those pens you gave when we
to live?" and "What would you do first walked in are super cute. But
for a lifetime supply of milchig ice
something more useful may go a long way.
cream?"
Perhaps consider including a bumper sticker in your
Hi, Doctor Bennett. I just wanted to thank you for
welcome pack, kind of like the ones new drivers have
everything you've done for me over these few (few?
on their cars. Instead of saying "Student Driver," it
ha!) years and just mention a couple of things….
could say "IVF Patient." That would send the same vital

I know you're a busy guy. And I know all you've done message as friends, family and unsuspecting strangers

for me; my insurance company has been good enough approach: "Stay back. Stay way, way back. This person

to itemize all of it on a monthly statement. But I really is not responsible for her actions. This person could

tried to keep my calls to you at a minimum...a minimum lose all control at any moment." As an added perk, it

of twice a day. So firstly, please do excuse me for that. would confirm my mother-in-law’s suspicions. She

Although, truth to be told, I feel compelled to mention wouldn’t even need to ask.

that getting your attention by phone was no easy The same would apply to the IVF-sticker-wearer in the

task. I mean, how come every time I was at the office, supermarket. Shopping cart wheels would squeal as

there you were at the front desk looking for something people switched check-out lines:

or other or gabbing with someone or other mere "No, that's okay. I think I’ll just take the bar of soap
inches from where the phones were ringing, I’m buying and get on that line over there behind the
and yet somehow whenever I called, the woman with the six screaming kids, two jam-packed
receptionist always had to take a shopping carts, an overflowing accordion coupon file,
message so you could call me back? three gift cards and a checkbook. Yeah, the one with

I suppose then I shouldn’t take the cashier that has the 'Trainee' name tag (I think

much more of your time with my that's French). Yes, her. The one who can't seem to

imponderables. If you’ll allow master the art of finding the end on a roll of receipt

me one small suggestion, tape, has switched on her blinking number light and

though, may I request is nonchalantly calling for 'the key' and asking if she

you stock your clinic can go on break. Don't worry. Yeah, yeah, I'll be fine.

with more fashionable Anything so I shouldn’t have to get in line behind her."

garb? After all, we Yeah, that would be moi.

IFers tend to give an Excuse my ramblings, Dr. Bennet, but put it this way: I
outsized significance look at infertility treatments as a door. We're pushing,
to our outer bearings. I with all of our might, on that door — the door to our
remember being at your future. But for now our screws are loose and maybe
clinic for my egg retrieval just maybe, we've become unhinged.
and looking at myself up
and down as best I could Once again, I thank you."

from head to toe. (The A hybrid of two articles at laughingisconceivable.com

TISHREI 5781 | SHAAREI TIKVAH 89

| HUMOR

LaughsHumor From the Trenches:
that only
IFers get!
Enjoy this collection of real-life stories
collected from real-life IFer’s.

90 SHAAREI TIKVAH | TISHREI 5781

I had a six-year-old boy at my • Right before our first FET
house for Shabbos. On Friday I was sitting with my sisters
night, he watched intently as I recently moved, and when I listening in to their discussion
I lit the candles, covered my met my neighbor she asked me of how hard it is to dress boys
face and whispered. He then how my apartment is and if I’m cutely. I had nothing to add to
exclaimed, "You don't have to enjoying the garden. (Seems like the conversation but tried to
daven; you don't have kids!" when she moved in, she put in a take part and made some inno-
lot of effort into making her gar- cent comment. I guess I seemed
• den beautiful.) I answered her really worried about my child-
that it’s shared with my upstairs to-be's wardrobe, because my
During the corona crisis I neighbor, and I want to split it. sister said: "Big deal, just take a
was speaking with one of my “Do you have a little one?” she girl!"
customers, and I mentioned that asked me.
I was working from home. She •
replied, "Oh, that doesn't really Though I knew exactly what she
work, with all the kids around." I meant to ask, I innocently an- I remember that when I was
told her I don't have kids yet, to swered, “No, it’s actually a nice starting to work my way around
which she responded: "Good for size!’’ the kitchen I asked my mother if
you, so you'll have them when it’s possible to freeze eggs...
you choose to." Haha, as if that's •
the way it goes… Well, now I know!
You know how they say that
• if it rains on your wedding day
it's a segulah for children?
One Friday night I decided to
liven up our quiet seudah of two. So my husband had this insight:
I told my husband, "Let's dance." Maybe we were zoche to frozen
We got up and sang and danced embryos because it snowed on
and ran around the table. It was our wedding day!
fun, until the neighbor one flight
down asked me on Motzei Shab- ••
bos who my guests were at the
seudah...

Have a funny IF story to share?

Email it to [email protected] so the rest of us could laugh along!

TISHREI 5781 | SHAAREI TIKVAH 91

IIto tammkepphooorrmttaaennwttithNNyouuuammndbbueesrress. Always here for you
Always here for you
to take home with you and use.

Helpline....................................................................................................................................................... 718-437-7110 • [email protected]

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RR'’ YCSahnakuimyl RWAoarsoxelnne.rU.....n......g....e.....r.......................................................................................................................................................................................................................................7.....1...8.. 79-611878--665-88696-1-82139e01x27te•1x1a7td2•m0rai4nbi•sbtsiruraontsgioeennr@@aattiimmee..oorrgg

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A Time Locations

Main Office: Florida: Israel:
1310 48th Street Suite 406 - Brooklyn, NY 11219 T: 305-260- 6377 T: 073-280-0800
fl[email protected] [email protected]
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[email protected] [email protected]

Helpline: Midwest: Belgium:
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HUG
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44-797- 328-6827 www.atime.be
[email protected] [email protected]
T: (718) 686-8912 Ext: 143

92 SHAAREI TIKVAH | TISHREI 5781

PROGRAMS & SERVICES

ADVOCACY NATIONAL CONFERENCES 3

Grant lobbying for infertility funding; bringing awareness of need Nationally recognized medical conferences where leaders in the
for new legislation to elected officials; keeping A TIME couples field of infertility convene for a full day program of lectures and
apprised of changes to infertility-related legislation. workshops. A TIME couples attending have the opportunity to
learn from and meet with the best in the field.
ANNUAL WEEKEND RETREAT
PREGNANCY LOSS SUPPORT PROGRAM
A Time’s annual relaxing and awe inspiring weekend getaway is
exclusively for infertile couples from around the world who join Immediate contact with couples who experience a pregnancy
together for the chance to escape their challenges. It provides loss or stillbirth. Arrange with Chevra Kadisha for burials. A
our members the opportunity to speak with other couples TIME also offers support groups and 1 on 1 counseling. A
experiencing similar stresses. compassionate, supportive package including inspirational
stories, soothing music, uplifting poems, and chocolate, is sent
EDUCATIONAL EVENTS to ladies who experienced the loss of a pregnancy.

Educational and inspirational monthly seminars run by leading 90 PACKETS SENT PER MONTH
doctors and therapists, providing comprehensible medical
information in a warm and friendly atmosphere. QUARTERLY MAGAZINE

AVERAGE OF 75 ATTENDEES PER EVENT A comprehensive and very popular magazine exclusive for A

TIME couples and for fertility centers is published 4 times a year.
Each magazine offers informative articles from medical
FAMILY BUILDER PROGRAM professionals on the advances in infertility; uplifting stories from
A large resource that aids our couples during every aspect, of
their medical consults, diagnostic testing, treatments, A TIME members sharing their experiences; lists of available
medical resources in members’ communities,
medication, and counseling. humor, inspiration, information and a readers

HASHGOCHA SERVICE 7,000 write column where we share letters from each
other.
Under strict Rabbinical guidance, through the A ACTIVE
TIME Hashgocha program we ensure the MEMBERS 4,500 ISSUES MAILED
continuity of Klal Yisroel by providing
professionally trained Mashgichim / Mashgichos AND (unfortunately) GROWING REFUAH NETWORK
for all procedures requiring Hashgocha .
Interest-free loans as well as a comprehensive
90 supervisions per month in 8 Centers list of lending society’s providing free items and
services for our couples.

HELPLINE SHABBOS NEAR HOSPITAL

Professionally trained volunteers answering all Full accommodations for hotels, food, local information, and all
questions regarding infertility, and providing referrals guidance other necessities are provided for those who need to be in close
and support to anyone who turns to A TIME for assistance. proximity to a hospital over the Sabbath or any Jewish Holiday. In
addition to the care and concern for the comfort of our members A
OVER 1,900 CALLERS PER MONTH TIME arranges for a nurse to assist in Shabbos Courier services
when needed.
IN-HOUSE THERAPY
A Time provides professional therapists specializing in the
treatments of couples dealing with the challenges of infertility. 15 COUPLES PER MONTH
Our counselors are available by appointment.
SUPPORT GROUPS
Therapist-run workshops in person or via phone support
INSURANCE ADVOCACY & SUPPORT addressing many of the issues faceing infertile couples.

On Staff professional representatives fighting rejected insurance 500 COUPLES IN SUPPORT GROUPS
claims and providing a resource network for infertility-related
insurance coverage.

LENDING LIBRARY THE COMMITTEE FOR HALACHA
AND TECHNOLOGY
The A TIME library is a fully stocked reference library providing
the most up to date information available in books, magazines, The committee is comprised of leading Rabbis and doctors who
periodicals, and lectures (audio and visual). Materials cover train other Rabbi’s worldwide in the intricacies of infertility in
procedures, medications, inspiration, motivation and anything Jewish Law.
else related to infertility.
WWW.ATIME.ORG
250 VISITORS PER MONTH
A TIME’s website, provides our couples with a plethora of
MEDICAL REFERRALS & RESEARCH resources, including over a dozen infertility specialists who
answer questions that are both posted on message boards and
When it comes to referrals to medical specialists for the infertile emailed to them directly; chat forums to share ideas and
couple there is no better place to turn to then A TIME. Upon experiences, medical information and emotional support
request, our staff will consult with medical specialists to assist available 24 hours a day; a calendar and description of A TIME
and educate the couples. A TIME will do the research on any events for the coming year.
recommended treatments available to our couples.
50,000 POSTS ANNUALLY ON OUR FORUM
1300 REFERRALS PER MONTH
TISHREI 5781 | SHAAREI TIKVAH 93

Turning Patients into Parents

Ronald O. Perelman and Claudia Cohen

Center for Reproductive Medicine

of Weill Cornell Medicine

For more information Director: Zev Rosenwaks, M.D.
visit IVF.org or call
(646) 962-2764. Owen Davis, M.D.
Ina Cholst, M.D.
Six conveniently located offices: Pak Chung, M.D.
Rony T. Elias, M.D.
Upper East Side 1305 York Avenue at 70th Street Dan Goldschlag, M.D.
Upper East Side 215 East 68th Street Hey-Joo Kang, M.D.
West Side 2315 Broadway at 84th Street Isaac Kligman, M.D.
Tribeca 40 Worth Street Alexis Melnick, M.D.
Long Island 1300 Franklin Avenue, Garden City Samantha M. Pfeifer, MD
Westchester 657 Main Street, Mount Kisco David E. Reichman, M.D.
Glenn Schattman, M.D.
Steven Spandorfer, M.D.

94 SHAAREI TIKVAH | TISHREI 5781

Rabbinical Guidance
Institute of Halacha and Technology
A project of A TIME

RaAbbinical Guidancevailable to you exclusively through A TIME, the Institute of Halacha and Technology provides complete Rabbinical guidance to all
who seek advice and authority on issues pertaining to gynecology, reproductive medicine, high-risk obstetrics and related medical
proceduIrness.tUitnudteer tohef aHusaplicaecshoaf Raabnbdi BTineycomhninoLlaondgayu, Rabbi Ausch, Rabbi Shmuel Fuerst and Rabbi Shmuel Meyer Katz, a team of
the most tkhneomwloesdtgAceuatbptlienroganejdedgcdetisatodinvfgauAnicsheTsedIinMRmaEbobdoenrnimmheadviceinbee.en trained by leading medical professionals to answer questions in halacha
involving

clusively through A TIME, the Institute of Halacha and Technology provides complete Rabbinical guidance to all

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R' Shimon Katz8 45-782-2533 R’ Hershal He8i4lp5-r4e2n6-2348 CROW71N8-4H35E-I3G8H98TS718-436-6515

n 845-781-8170 R’ Burech Lederrich R' Avrom71B8e-r4g3s7te-i0n4 20 718-851-2706 718-839-5296

NEW SQUARE R’ Eliezer Sternbuch 718-871-2488

R' Yosef Yisroel Eisenberger H: 845-35R4’-P33in3c9h/uCseWll: 8ie4n5-d304-3438 CHICAGO 718-436-8432

845-426-2348 CROWN HEIGHTS R' Shmuel Fuerst 773-539-4241
718-337-6890
FLATBUSH R’ Avrom BHe: r7g1s8t-e2i5n2-7243 718-839-5296

R' Benyomin Cohen CHICAGO771188--387553--01472182 FAR ROCKAWAY

er H: 845-354R-'3E3l3ie9ze/rCHealrla: r8i 45-304-3438 R' Binyomin Forst

R' Eliezer Sholom Heisler

R’ Shmuel Fuerst 773-539-4241

WILLIAMHS: 7B1U8-R2G52-7243 FAR ROCKAWAY QUEENS 718-337-6890 718-268-1147

R' Hershel Aus7ch1 8-375-0422 718-435-1502 R' Hershel Welcher
718-853-1718
R’ Binyomin Forst

QUEENS TISHREI 5781 | SHAAREI TIKVAH 95

Nurses

Specialty nurses provided by A TIME are available to administer injections when necessary.
As a member, you are welcome to make use of this inimitable service. The following nurses are available to give injections:

State City Name Phone Fee State City Name Phone Fee
NF
California NF Passaic Aliza Feit, RN (917) 521-2262 NF
NF
Encino Farzaneh Tabibian, RN (818) 906-8586 NF Passaic Chaya Bracha Hirsch (201) 390-3803 NF
FEE
Los Angeles Mimi Andrusier, RN (323) 219-7731 Passaic Shalva Hirsch, RN (973) 202-8969 NF
NF
Valley Village Renee Mazlin, RN (818) 508-6311 NF Passaic Sarah Schiffman, RN (973) 943-2107 NF
NF
Valley Village Yael Rosenthal, RN (818) 505-0247 Passaic Shifra Eisenman (973) 464-1965
NF
Florida NF Teaneck Rachel Abraham, RN (201) 575-1432 NF
NF
Boca Raton Yehudis Kaplan-Finman, CNM (305) 731-3890 Teaneck Lisa Rothschild, RN (201) 692-0323 / (917) 443-6739 NF
NF
Boca Raton Shoshana Kassorla RN BSN. [email protected] NF Teaneck L'Via Weisinger, RN (201) 801-0784 NF
NF
Boca Raton Sara Bienenfeld PA (954) 224-5333 NF Teaneck Rachel Yolkut, RN, BSN (201) 357-5874 Fee
NF
Boca and Miami Judith Kaplan (305) 731 3890 NF West Orange Dina Goldstein, RN (973) 325-1812 NF
NF
Boyton Beach Sandra Goodman (718) 541-5242 NF Westgate Ella Rachel Mann, RN (732) 370-5687 NF

Coral Springs Sara Hurwitz RN (954) 650-6138 NF NEW YORK:
NF
Fort Lauderdale Marissa Rosenbaum (954) 540-5203 NF Bronx: Bronx Linda Torres, RN (718) 513-0116 Fee (A/S)
NF
Hollywood Shira Melcer-Freitag RN (561) 302-1604 Riverdale Sarah Adelson, RN (718) 796-8850/(917) 442-4545 NF
NF
Miami Beach Aventura (786) 290 7708 NF Riverdale Stephene Bellin, RN (212) 799-6531 Fee
NF
Miami Beach Bina Weiss RN (845) 323 1427 Riverdale Sandra Goodman, NP (718) 543-6809 NF
NF
Miami Beach Malka Feibush (856) 534-6658 NF Yonkers Rina Ginat, RN (914) 562-4433 NF
NF
Illinois NF Brooklyn: Bensonhurst Dina Lapp, RN (718) 837-2970 Fee
NF
Chicago Chaya Siegel, RN (773) 761-1631 / (773) 620-6139 FEE Boro Park Janie Friedman, RN (718) 436-9847 NF

Chicago Bina Simon, RN (773) 508-6841 Boro Park Gary Guttman (917) 701-5900 Fee

Skokie Julie Feinberg, RN (847) 682-4649 Boro Park Miriam Herman, RN (347) 496-1155 NF

Skokie Beth Schwartz, RN (847) 674-6018 Boro Park Pilar Morales, RN (718) 309-3007 Fee (A/S)

Maryland Boro Park Rechy Moseson RN (347) 831-7433

Baltimore Jenny Fogel, PA (410) 764-1082 Boro Park Ruchy Cohn (646) 320-1256 NF

Baltimore Rus Ifrah (484) 477-2170 Boro Park Tami Frenkel (917) 533-3587

Boro Park Esther Weiss (347) 564-0485

Baltimore Evelyn Shnier, RN (410) 358-7532 Boro Park AJ Rothstein (Male) (718) 650-1155

Silver Springs Chani Feldman, RN (301) 452-8693 Boro Park Shulamis Nove (718) 972-4263 NF

Michigan: Boro Park Simi Phillip PA (718) 724-9944 NF

Southfield Debby Kaplan, RN (248) 552-9254 Boro Park Laurana Sapolla, RN (646)358-7362/(718)331-5991 Fee (A/S)

Missouri Boro Park Leah Sprei, CMA (718) 252-0305 NF

St. Louis Chava Weinman, RN (314) 862-3358 Boro Park Barbara Sundak, RN (718) 859-7340 Fee (A/S)

Texas Houston Tzipora Schoen (818)263-4171 Boro Park Shevy Serhofer, RN (718) 810-8222 NF

New Jersey Canarsie Penny Peterson/Monroe,RN (917) 757-9055 Fee (A/S)

Bergenfield Leah Kramer, RN (201) 384-3094 Crown Heights Tzipora Clapman, RN (718) 774-9313 Call 8:30AM or 5:00pm

Deal Dina Grazzi, RN Cell:(732) 809-7777 Crown Heights Chayenka Silberstein (347)406-4975 / (718)-778-7935 NF

Edison/Highland Park Aviva Wolgemuth, RN Cell:(347) 563-3661 Crown Heights Esty Slavin, PAC (718) 774-1843

Englewood Stefanie Schwartz, RN (201) 816-8396 Mnhtn Beach/Flatbush Adina Erez, PA (917) 334-4134

Fair Lawn Naomi Nussbaum, RN (201) 739-9872 Marine Park Sarah Goldman, RN (718) 216-6812 NF

Highland Park Draizy Wald, PA (917) 754-7754 Flatbush Allison Tawil 732-796-8242

Hillside Goldy Malek (845) 323-7718 Flatbush Chany Bodenstein, RN (917) 496-3188 / please text NF

Hillside Yossi Malek (845) 323-7717 Flatbush Chava Kaplowitz, RN (718) 338-5080 NF

Lakewood Alanna Fayazi, RN (732) 905-9110 Flatbush Elisa(kautcher) Hurewitz (718) 336-0136 NF

Lakewood Ariel Beniflah (215) 531-1968 Flatbush Chava Levy, RN (718) 998-4939 FEE

Lakewood Baila Geltzehler, RN (732) 439-0309 Flatbush Rina Dayan (917) 499-6488

Lakewood Bracha Cohn, RN (732) 370-7622 Flatbush Judy Lustig, RN (718) 998-2391 NF

Lakewood Chaya Bodner, RN (732) 367-0044 Flatbush Cindy Melamed, PA (917) 445-3015 NF

Lakewood Chaya Valot (917) 499-383 Flatbush Yael Saadon (718)530-8102 NF

Lakewood Chani Friedman, RN (732) 267-7704 Flatbush Leat Romano, RN (917) 331-7373 NF

Lakewood Chanie CHapler (646) 673-2825 Flatbush Shalva Shashitsky, RN (718) 645-7934 NF (D/O)

Lakewood Chana Tropper,RN (732) 730-0808 Flatbush Rachel Halpert RN (917) 860-1634

Lakewood Esty Caplan, RN (732) 367-5415 Flatbush Esty Baida (718) 954-6333 NF

Lakewood Esther Greenspan, RN (732) 363-4108/(347) 449-3178 Flatbush Baila Horowitz (347) 419-3006 NF

Flatbush Rachel Halpert RN (917) 860-1634 NF

Lakewood Esty Horovicz (718) 578-1996/(732) 363-8476 Kensington Marina Dukhan, DO (718) 284-2264 NF

Lakewood Esther Pernikoff, RN (732) 901-4412 Kensington Tirtzah Karuszyner, RN (347) 512-9511 Fee

Lakewood Fraidy Portnoy (732) 905-2470 Sea Gate Chany Kimelfeld, RN (718) 372-1115 NF

Lakewood Libby Weiss,RN (732) 961 9893 Williamsburg Chaya S. Franczoz, RN (718) 625-1223 NF

Lakewood Michal Brull, CPT (732) 886-3238/(732) 552-8954 Williamsburg Yitty Mandel (718) 208-8919

Lakewood Penina Danziger, RN (848) 525-4993 Long Island Valley stream Rosa Fernandez, RN (347) 495-1126 Fee (A/S)

Lakewood Roiza Tesler 347-309-3353 Elisa Horowitz (917) 445-1405

Lakewood Shoshana Diamond, RN (412) 414-6619 Great Neck Betty Bandary, RN (516) 773-6174 NF

Lakewood Tziporah Joseph, RN (718) 614-5902 Great Neck Orly Steinberg, RN (516) 567 8221 FEE

Lakewood Varonica Rizzi (732) 364-7770 X5 Lawrence Rivky Fischer, CNA,CPT (516) 239-0219 NF

Long Branch Jacqueline Gemal, RN (732) 829 3172 Lawrence Dr. Mermelstein (516) 371-9594
96 SHAAREI TIKVAH | TISHREI 5781

State City Name Phone Fee State City Name Phone Fee

Lawrence Miriam Rivka (Adler) Rozen 917-741-4286 Far Rockaway Shani Feierman (718) 734-7250 NF
(917) 670-0390
Woodmere Alyssa Sacks RN (646) 331-7916 NF Bayswater Malki Schuler, RN (718) 745-3893

Woodmere Ariella Davidman Flushing Anat Benjamin, MD (718) 539-7736 / (917)224-8487 NF

West Hempstead Audrey Davidowitz, MD (516) 486-0454 NF Buffalo Flushing Miriam R. Heimowitz, RN (718) 261-4373
West Hempstead Yael Roth
Shevy Serhofer, RN (917) 588-2546 Flushing Ruty Koenig, RPAC (718) 793-9666 NF

(718) 810-8222 NF Jamaica Esther Natanov, RN H: (718) 380-9730 / W: (718) 283-6587 Fee

Manhattan: Cindy Melamed, PA (917) 445-3015 NF Kew Gardens Adina (516) 279-9069
Arielle Siegel, RN (516) 695-9744
Lower East Side Leah Homnick PCA, CPT (917 -554-1459 NF Kew Gardens Rivka Leah Zuckerman (215) 817-9597

Kew Gardens Irina Aronova, RN (718) 544-0367 Fee

Upper West Side Fabiene Rottenberg, DPM (212) 724-4457 NF Kew Gardens Aviva Gluck, RN (917) 579-5427 NF
Upper West Side Shira Westreich, RN (212) 595-5122 NF
Kew Gardens Dena Friedman FNP-BC (201) 759-5761 NF

Upper West Side Rachel Rindner (305) 409-9147 Kew Gardens Sheva Turk, RN (718) 263-6521 NF
(305) 409-9147
Upper West Side Rachel Rndner (212) 781-4216 Kew Gardens Esther Roman (718) 487-3754 NF

Washington Heights Sharon Sommer, RN Kew Gardens Adina Berger, RN (845) 659-5108 NF

Monroe: Vickie Nowosielski, RN (917) 743-3507 Fee (A/S) Kew Gardens Rivka Leah Zuckerman (215) 817-9597 NF
Rivky Sandel, CPT (845) 629-1212
Dorothy Prey, RN (845) 928-6296 Fee (A/S) Staten Island: Marcia Brathwaitte, RN (917) 841-5273 Fee (A/S)

Eileen Grimes, RN (845) 928- 8269 Arlene Jacobson, RN (718) 983-0138 NF
Monsey: Chaya Back, RN (732) 267-3988
Sherry Broidy, RN (845) 928-3391 NF Esther Kay, RN (718) 370-3515
Fee
Ohio:

Samuel Feder (845) 362-6080 Cleveland Heights Aviva Kupfer, RN (216) 932-8933 NF
Brocha Lichtenstein, RNC Leviah Hauer (216) 308-0453
Leah Lichstein, RN (845) 356-0939 NF (D/O) Cleveland Heights Leah Kushner, RN (216) 371-1265 NF
Leah Webster Aliza Feingold, RN (614) 239-6356 NF
Malka Weinstein, RN (845) 362-0990 NF Cleveland Heights

(845) 642-4333 Cleveland

(845) 362-0288 NF (D/O) CANADA:

S. Monsey, Airmont Chaya Becker, RPA (845) 352-0969 Montreal Mrs. Demercur, RN (514) 739-1462 NF
Faigy Hershkowitz, RN (514) 341-6399 Fee
Spring Valley Blimy Brill (845) 354-1211 / (845) 558-1447 NF Montreal Flora Sasportas, RN (514) 735-8145
Aldith Baker, RN (416) 667-1276 Fee
Spring Valley Yehudis Reichman, RN (845) 354-0682 / (845) 499-5216 NF Montreal Eve Gallingan, RN (416) 787-5154 Fee
Chavie Kestenbaum, RN (416) 787-0067
Spring Valley Chevy Unger RMA CPT (845) 422-5400 Toronto Joanne Lang, RN (416) 783-8782
Queens: Far Rockaway Rena Gordon, RN (718) 471-8985 Elisheva Lightstone, RN (416) 256-0470
Far Rockaway Esty Klein, RPAC (718) 501-3860 NF Toronto Malky Meckler, RN (416) 789-0893
NF Rochel Travis, RN (416) 631-9409
Toronto

Far Rockaway Gittel Weinstock (917) 613-1780 Toronto
(718) 868-3935
Far Rockaway Faigy Singer, RN (410) 522-8879 NF Toronto

Far Rockaway Yehudis Brown, RN, BSN Toronto

Far Rockaway Sarah Schechter, RN (718) 327-3250 NF Toronto
(917) 841-8693 NF
Far Rockaway Avigail Weiss, RN ENGLAND:

Far Rockaway Dina Kret (516) 375-1989 NF London A TIME England office 020-8800-2153 / email: [email protected]

If a nurse is needed on Shabbos, call Chaya at 718-258-5002 or Vivienne at 917-783-9514

A/S=Available Shabbos, D/O =Doctor's Order, NF=No Fee

If you know of any other nurses who would be willing to provide this crucial service, especially in neighborhoods not yet covered, please let
us know. And many, many thanks to all those listed above. A TIME is not responsible for any treatments administered by any of the Nurses or

Nurse Practitioners listed herein. Nothing herein constitutes medical advice and all readers are recommended to consult their physician.

A TIME (A Torah Infertility Medium of Exchange) does not recommend or endorse any providers listed here.
Please use this information at your own discretion and responsibility.

For More Information, Please Call (718) 686-8912 ext. 202
Dedicated to the Memory of Charlie Weiss ‫נתן קרפל בן משולם ע”ה‬

We are currently updating the names on our Labor/tehillim packet.

Since there are many distinguished Rabbonim who advocate reciting Tehillim for others whilst in the throes of childbirth, among
them Rabbi Mordechai Finkelman, Rav Yosefi and Rav Nissim Yagen of Yerushalayim, we have compiled a beautiful tefilla said
while in labor along with a Tehillim list of our couples upon the couples' request. We send it to OB/GYN offices, to labor coaches,
doulas as well as expectant couples (upon request). If you would like to be on this list please contact A Time:

Email: [email protected] • Call: 718-686-8912 ext. 200 • Fax: 718-686-8927

Please make sure to include the following information:

Your First & Last Name Contact Phone #

Husband's Full Hebrew Name Wife's Full Hebrew Name

Please make sure the spelling is correct.

Please note, we only accept names given by the individual couples and only the Tehillim names are printed.

TISHREI 5781 | SHAAREI TIKVAH 97

ImShpaobrtbaonst Near A TIME LibrarySha
AthdEe-dmrHeasosilesps ital? [email protected]

[email protected]
ByoriunrgsABeToIMlrofE LiPbraaryrkand Conference Center England

By appointment

[email protected] We’ll1310 48th Street, Brooklyn, NY 11219 Call Henny: (208) 800-2153
[email protected] bringMonday-Thursday 9:00 AM-5:00 PM [email protected]
[email protected]
Appointments are available at other times. Israel
[email protected]
[email protected] the rest!Call Shaindy: (718) 686-8912 extension 209 By appointment:
[email protected]

[email protected] A luxurLiaouksewood Tziry: 073-2800-800
[email protected]
ShabbCoasll: (973)494-2334
[email protected] packagore(7t3o2)370-7025,
[email protected] ensure your
[email protected]
comfort awaCyome and browse through our huge selection of medical and
[email protected] chizuk books and CD's selected especially for you!
[email protected] from home For general library information call:

[email protected] Shaindy Blau (718) 686-8912 extension 209 | email: [email protected]
Please call Chaya Kar
[email protected] 718.258.5002
Vivienne Moskowitz
Includes meals, breakfast, paper 917.783.9514
goods and candles, reading material,
and all amenities you have at home
Sara Barris, Psy. D • 718-544-0932‫נ ר‘ ישעי בן ר‘ משה זי“ע מקערעסטיר‬S“‫ע‬p‫ל‬eciaavlaiizlaeblse ininNYaalnldaNrJeas of fertility and adoption

Stay at Home

for Shabbos

Courier service Please call
for bloodwork Chaya Kar
needed on 718.258.5002
Shabbos at no Vivienne Moskowitz
cost to you 917.783.9514

There is no charge for hashgacha services.

98 SHAAREI TIKVAH | TISHREI 5781

‫און טאקע דער גליקליכער מינוט האט זיך אנגערוקט‬
‫"יאנקי‪ ,‬קום אהער צו מיר" ווען אלע בליקן האבן אויף מיר שטארק געקוקט‬

‫"דא האסטו קינדל!" רופט ער זיך אן מיט א קול גדול ולא יסף‬
‫בשעת איך האף בלויז אז איך זאל קענען מאכן פון דארט א זרוע חשף‬

‫"אמן" הערט זיך פלוצלינג א פאראייניגטע געשריי‬
‫"איבערעס יאר א קינדל אין די האנט" דערקלערן זיי‬

‫"א קינדל‪ ,‬א יונגל!" איז איין חכם מוסיף‬
‫"בקרוב ובניקל ממש" ימים על ימי מלך תוסיף‬
‫די קלוגשאפט איז מוסיף והולך פון מינוט צו מינוט‬

‫ווען מיין הויט ווערט אזוי גלאטיג געשינט‬

‫*‬

‫און אט קומט שוין דער נעילה‬
‫שמחת תורה מיט'ן ספר תורה שאולה‬
‫דער פרייליכער מנין פאר הקפות דורך די 'עידזש' מעמבערס‬
‫א קליינעם שול'כל האט מען געדינגען פון די ארענדערס‬
‫אלע יונגעלייטלעך רוקן זיך אן מיט די פיצקעס מיט קאפ דאשיקעס‬
‫א מאשנעם בינדט ארום די געצארטעלטע נאשיקעס‬
‫"וואה‪ ,‬דאס איז דיינס?" הערט זיך ווי איינער פרעגט פונעם צווייטן‬
‫"דאס איז א קאפי פון דיר" טוט ער תיכף אנטשיידן‬
‫"ער איז אונטערגעוואקסן קיין עין הרע" קומט ער אריין קלאר‬

‫"ברוך השם‪ ,‬יא יא‪ ,‬שאר"‬
‫און אצינד די הקפות מ'טוט שוין כמעט פארענדיגן‬
‫לאליס און קענדיס און זיסווארג ס'פליט אין די לופטן שטענדיגן‬
‫און אט איז מען שוין צום לאנג ערווארטעטן קריאה אנגעקומען‬
‫און א סקרוך אין די ביינער האט מיר ארומגענומען‬
‫"‪ 500‬פאר כל הנערים" געבט דער טיכטיגער געוועזענער ישיבה גבאי חק"ס א געשריי‬
‫"זעקס הונדערט!" לייגן צו אויפמאל אנדערע צוויי‬
‫"טויזנט דאללער פאר כל הנערים" טוט דער גבאי שוין שמייכלען‬
‫ער קלערט שוין איבער די אינטשעס בקר וואס מ'וועט קענען צושטעלן פאר די מיילעכן‬
‫"צוועלף הונדערט דאללער צום דריטן מאל" קומט דער שפיל צו אן ענדע‬

‫געקויפט האט דאס אונזער גרויסער גביר מענדע‬
‫ער פירט אן עמעזאן ביזנעס מיט גרויס סוקסעס‬
‫כאטש קיינער ווייסט נישט דער אמת וואס איז עס‬

‫אבער דאס איז אמאל קלאר פאר יעדן‬
‫אז רעדן פון געלט און חלומות טוט ער דאס מערסטע וועבן‬
‫"איך בין מכבד יאנקי מיט כל הנערים" הערט זיך זיין פרעקלדע שטימע‬

‫און איך ווער פלוצלינג רויט און געל ווי א לימע‬
‫"נא יאנקי יאנקי‪ ,‬הארי אפ" איז ער ממשיך ווען קוים דעם אטעם ער כאפט‬

‫זיין גליק און אטענטשען מ'קען אין די לופט געבן א טאפ‬
‫"רבותי הייבטס אויף די טליתים שנעל" רופט ער אויך אויס‬

‫"יעדער זאל האלטן זייער קינד אין די הענט אדער שויס"‬
‫"נא יאנקי הייב אן די ברכה‪ ,‬יעדער זאל זיין שטיל"‬

‫חוץ פון די געשרייען פון די קינדער קען מען הערן אפי' א טריל‬
‫"מזל טוב מזל טוב!" גייט מענדע התחלה‬

‫ווען די געשרייען פאלגן נאך ווי קינדערגארטן אין שולע‬
‫"איך בין מנדב די הערינג און גאלע" הערט זיך די דינע שטימע פון לייבי‬
‫"די טשאלענט מיט שטיקער אינעווייניג גייט אויף מיין קאנטע" לייגט צו חיימי‬

‫"רבותי מאכטס ענק גרייט ווייל ס'גייט זיין נייעס פיינע‬
‫ווען אלע מיינען בלויז די טובה מיינע‬
‫דאס איז עס בקצה היריעה‬

‫זאל יעדער האבן א שנה טובה ומתוקה‬

‫‪TISHREI 5781 | SHAAREI TIKVAH 99‬‬

‫"זאל דער אויבערשטער העלפן בקרוב ממש"‬
‫הער איך ווי עס וואונטש מיר דער משמש‬

‫דער ערשטער אין די סעריע פון ברכות א טוץ‬
‫און איך ווייס נישט וואו צו זיך באהאלטן און נעמען שוץ‬

‫איך שלייך זיך דורך צווישן די פילע שורות בענק‬
‫ווען א הויפן פון בליקן און ברכות מ'געבט מיר א שענק‬
‫"דו קענסט דעם תפארת שלמה אויף וד' פקד?" הער איך פלוצלינג א שטימע‬

‫א איד מיט א גרוי באוואקסן בארדע פילע‬
‫"איך זאג דאס אלץ פאר יונגעלייט וואס ווארטן אויף זש"ק" דערקלערט ער‬

‫און יעצט געבט ער מיך מיין שעיר‬
‫"איר ברויכט פארשטיין" איז ער מוסיף מיט א שטימע א הויכער‬
‫"איך בין אויך אריבער דעם פעקל" וויקלט ער אויף דעם מח זוכר‬
‫"אריבער ‪ 16‬חדשים האב איך געווארט אויף א ישועה" שטעלט ער קלאר‬
‫"איך פארשטיי גענוי וואס דאס מיינט" געבט ער זיך א קרעכץ אונטער‬
‫"און דערפאר שפיר איך זיך באקוועם צו מחזק זיין אנדערע" פארענדיגט ער מונטער‬

‫אבער פלוצלינג הער א פוצקע פונעם אנדערן עק שול‬
‫עפעס א פינגער פוינט צו מיר אין ציל‬

‫"איך האב דיר געקויפט דעם עליה" גרויסט ער זיך‬
‫ווען א שמייכל איז אויסגעצויגן אויף זיינע לעפצן פון די אויגן ביז די שיך‬
‫געווען איז דאס אודאי דער חכם וואס האט אין ישיבה געלערנט מיט מיר‬

‫און זינט דאן געבט ער מיר יעדן טאג א שיעור‬
‫מיט פקחות'דיגע דברי חכמה און שטיק‬
‫שענקט ער מיך יעדן טאג א ציק‬

‫*‬

‫און אט קומט שוין דער סוכות צו גיין‬
‫אה‪ ,‬דאס איז דאך א ליכטיגער יום טוב‪ ,‬אזוי שיין‬
‫"יאנקל‪ ,‬איך האב פאר דיר א בשורה טובה" שפיר איך א קלאפ אין פלייצע‬
‫מיין שווער האט מיך דעריאגט מיט א פנים א פארשצווייצטע‬
‫"איך האב פאר דיר פלאץ אין מיין סוכה צו שלאפן" שטעלט ער די פלאן פאר‬

‫און מיין שמחה שטאפלען הייבן זיך ביז גאר‬
‫"נע‪ ,‬איך וויל נישט דעם שווער מטריח זיין" פרוביר איך מיין מזל‬
‫"דו ברויכסט פארשטיין יאנקל טייערער" איז ער ממשיך מיט חנופה‬
‫"היות דו האסט דאך נאכנישט קיין געזונדל‪ ,‬וועט דיר דאס זיין פיל באקוועמער אזוי" געבט ער מיר א נזיפה‬

‫זיין אנטשלאסנקייט האט זיך אנגעזען אויף אלע זייטן‬
‫און אויב איך ווייס וואס ס'איז פאר מיר גוט זאל איך א קאנפראנטאציע מיט אים פארמיידן‬

‫*‬

‫און אט קומט שוין שמיני עצרת צו גיין‬
‫און יעצט דארף מען זיך גרייטן פון דאס פריש צו שטיין‬
‫זיצן אלע זין און איידימער כשתילי זיתים ארום דעם טיש‬
‫נאך פיל איידער מ'האט סערווירט פאר'ן ציבור די פיש‬
‫אינעם סוכה האט מען א רבי'שער קידוש געפראוועט מיט גרויס פרייד‬

‫יונג און אלט‪ ,‬אלע אן קיין צווישנשייד‬
‫און אט איז די פרייליכע מינוט אנגעקומען‬
‫די קינדל איז געקומען אין סוכה אריין צו שווימען‬
‫אין א פראכפולער טאץ איז עס געשטעלט געווארן פאר'ן שווער‬

‫פאר מיר האט נישט אויסגעפעלט מער‬
‫ווי נאר איך האב געזען זיינע שמאלציגע בליקן‬

‫וועלכע האבן געטון צו מיר קוקן‬
‫איז מיר קלאר געווארן וואס איך האב אצינד צו ערווארטן‬

‫איך קוועטש אזוי דעם טיש דעם הארטן‬

‫‪100 SHAAREI TIKVAH | TISHREI 5781‬‬