Sivan 5782 / June 2022

Jun 2, 2022 | new newsletters | 0 comments

BS”D

Dear Friends,

As we anticipate the celebration of Kabalas Hatorah, we join you in wishing all of Klal Yisroel a wonderful Yom Tov. 

Here at Tahareinu, we remain committed to our mission of spreading awareness about the latest innovations in women’s health and fertility. 

To that end, we share within this edition fascinating new insights gleaned from conferences we’ve attended around the world. 

Read and gain insight! 

Also, look out in your inboxes for details about the well-regarded Tahareinu course for professionals, starting after Shavuos.

Thank you, 

Yitzchok Melber

RABBI AND MRS. MELBER ATTEND ACOG CONFERENCE IN SAN DIEGO

As the only Jewish people in attendance at the American Conference of Gynecology (ACOG) in San Diego, Rabbi and Mrs. Melber represented our community and gained tremendous insight regarding the absolute latest updates in the field.

One presentation focused on Abnormal Uterine Bleeding (AUB), a topic about which there is increasing awareness throughout the medical world. 

Of course, the PALM COEIN model was presented, and the recommendations were very much in line with Tahareinu’s advice. 

The buildup for treatment goes as follows: 

  1. NSAID (Non-steroidal anti-inflammatory drugs) such as Ibuprofen
  2. Hormonal treatment: Lysteda
  3. Progesterone
  4. Combination treatment (if patient is not looking to conceive)

HTRS: TECHNOLOGY REVOLUTION IN HYSTEROSCOPY

Professor Chaimovitz, head of OB/GYN in Laniado Hospital, presented this innovation.

HTRS, or hysteroscopic tissue removal systems, are set to replace D&C throughout the medical world. 

The facts are:

  • With blind D&C, only 50% of the uterine cavity is viewed in 60% of cases.
  • With blind D&C, only 40% of placental remains are removed. 

This technology combines a hysteroscopy with a new machine that can remove not only polyps, fibroids, and adhesions, but products of conception much more effectively as well. 

The conclusion? This should be the new standard of care and completely replace blind D&C.

RABBI AND MRS. MELBER IN CHICAGO, LAKEWOOD, BROOKLYN & YERUSHALAYIM

Following the ACOG, Rabbi and Mrs. Melber flew to Chicago. 

Rabbi Melber presented an extremely comprehensive two-day seminar to Rabbanim, and Mrs. Melber presented to the Kallah teachers. 

They also met with couples and individually with local professionals. 

In Brooklyn and Lakewood, Rabbi Melber presented at the Tahareinu yearly conference with over 120 Rabbanim in attendance. 

One topic that was highlighted was Progesterone. 

On the one hand, progesterone is notorious for causing trouble such as AUB, irregular cycles, and staining. 

However, when administered properly – in the correct time, form, and dose – it is extremely effective and is in fact the solution to many common challenges. 

Many women naturally have low progesterone, and common symptoms include spotting, infertility, and miscarriages. 

Each case and scenario must be evaluated carefully and the right guidance must be given. We were pleased to present this crucial information to the Rabbanim so they can in turn be of help to their communities. 

Of course, guidance must be double checked with one’s doctor for clarity. 

Progesterone for 5 stages of life: A handy guide

  1. Kallah: Aygestin should be used to control a woman’s cycle. The standard dose in the US is 2 pills a day, or 10 mg. In Europe, most countries use 15 mg a day, so if a woman has staining while taking 10 mg she should discuss using 15 with her doctor. This is for Kallahs or anyone who wants to reschedule their period, but not as contraception. It is generally used after ovulation, and is safe to use even if she may be pregnant.
  2. Provera should be used when women are not allowed to use Aygestin, for example those with a tendency for clotting or women over 45.
  3. Micronized progesterone is used for preventing miscarriages. Pregnant women shouldn’t use Aygestin for this; they neeed the micronized version created int eh US or Dydrogesterone/Duphaston in Europe of Israel. For stopping staining and preventing miscarriages it must also be the right method – given as a suppository; even if she gets the pill she must insert it as a suppository. The dosage must be 400 per day for the US, though the European and Israeli versions are assumed to be more effective. 
  4. Mini-pills: Most cause staining and breakthrough bleeding, so it is important to take the best on, the Slynd. It is now available in the States and most countries in Europe. Because it has a higher dosage it has a 90% success rate, and in Tahareinu we prefer it also for emotional wellbeing. 
  5. IUD, such as Kyleena/Mirena: Try to avoid using it if possible, as they often cause issues. These should only be used if there is no other option or for long-term use for older women.

OTHER UPDATES:

  • As we’ve mentioned before, the first line treatment for overweight PCOS patients is to lose just 5% of their body weight, which can have overall positive effects on their fertility. 
  • The 6th version of semen analysis was recently released, which includes an expanded investigation and a particular focus on DFI (DNA Fragmentation Index). All labs should be including this option soon, and it is Halachically preferable as it will only require one sample vs. an additional sample for DFI.
  • Dr. Bar-Tuv, Dr. Barak and Dr. Peretz of Israel published research for the success rate of the Microscopic testicular sperm extraction (microTESE) procedure when combined with the IMS method. The research shows a greater success rate when these techniques are combined. This is currently only performed in Israel, and couples do travel to Israel to have this treatment. 
  • When Rabbi Melber presented in Boro Park along with fertility expert Dr. Michael Werner, he recommended TRT (testosterone replacement therapy) for males with under 300 units in order to boost fertility. He recommended under 300 units should be treated

See below for information on our upcoming webinar!


Got a question about relieving tahara problems, infertility, reproductive health, pain or other related issues?

call the Tahareinu hotline

Call the Tahareinu Hotline Today

For ongoing infertility, recurrent pregnancy loss, or reproductive genetic issues,
you and your spouse are warmly invited to schedule an in-person, phone or Zoom consultation with our founder and president, Rabbi Yitzchok Melber.

Please send an email to rabbimelber@tahareinu.com Include your first name and location, and briefly describe your issue.

Personal consultations are for more involved reproductive issues. Note the Israel
office has reopened for in-person consultations,
in line with the country’s coronavirus status.

IMPORTANT
Most Tahareinu issues are addressed by our hotline advisors, 13 hours a day, 5 days a week. If you are unsure whether to schedule a consultation, call the hotline first.