PagesArchives
Categories
January 6th, 2012
Happy New Year everyone!
2011 was an awesome year! We had our best pregnancy rates ever for IVF! (67% of all embryo transfer procedures in patients less than 35 years old resulted in a clinical pregnancy!) We welcomed another reproductive endocrinologist, Dr. Dana Ambler to our staff. She and her family are adjusting well to our area. (Although I do think the hot and humid weather this summer was a bit of a shock).
If any of you have followed the “personhood amendments” recently in the news, I am interested in your thoughts. In essence, “pro-life” advocates have a new means to legislate against abortion. They have proposed in numerous states (Mississippi, Arkansas, Nevada, Ohio, and others) that a life begins at fertilization. Their stance is that a one day old embryo is the same as a 30 year old person.
Now I’m treading in dangerous waters here given that across the U.S., 50% are pro-choice and 50% are pro life. I am absolutely not about to debate abortion. But a law that attempts to make abortion illegal should simply do that. Make it illegal. This law has far more implications that affect women’s health in numerous ways. IVF would be illegal. Embryo could not be cryopreserved for any reason. If my patient had an ectopic pregnancy that was rupturing and causing her to bleed, I could not remove it since I would be “killing a person”. Birth control pills and IUD’s that inhibit implantation would be considered illegal. Dropping a dish with a one day old embryo in the lab would be equivalent to murder. If a patient dies and has two children, but three frozen embryos, do the embryos have the ability to inherit 1/5 of their estate? Do the frozen embryos around the country have to be immediately transferred to a uterus somewhere?
This is my blog. So I can rant about whatever – and I really hope I don’t offend anyone. But I hate politics! Lawmakers frequently write a bill to address one issue but “add on” numerous other unrelated items to “sneak in” their pet projects as a new law. This is no different. They are sneaking in anti-abortion laws by a change in definition of a person. Pro-life advocates should continue to stand firm in a stance against what they feel is right. But jeopardizing the health of women and removing the rights of infertile couples to build their family is wrong.
IVF can be a very ethically and emotionally charged subject. (and I love to discuss its merits with anyone). But IVF is one of the most “pro-family” technologies that exist! My patients are stable, loving couples who simply want to build their family. Just as doctors need to know the side effects of the medicines they prescribe, lawmakers need to know the side effects of the laws they pass. In this case, the side effects can be very detrimental to women’s health.
Happy new year to all of you! I hope 2012 is a great one.
Godspeed,
Dr S
Posted in Uncategorized | No Comments »
October 17th, 2011
Being just slightly overweight can affect the chance of having a baby through IVF, according to a study at Guy’s and St Thomas’ NHS Foundation Trust. Women with a BMI higher than or equal to 25 had more than double the risk of miscarriage compared with women who had normal BMI. If you know how to calculate your BMI, you must be a math wiz. I, on the other hand, have to use a calculator or go on the web and do it. But a BMI of 25 isn’t that big. So. . . .in our quest to make the best recommendations for those attempting IVF, we now really stress the importance of weight loss (in addition to the other things such as no smoking or drinking).
If you wonder how everyone else (large, small, smokers, drinkers, crack users) gets pregnant so easy, join the club. The point here is that if you have not conceived after years of trying and you are faced with IVF, lifestyle changes have a big impact on whether you are successful.
Have a great day. . . .and grab those veggies.
Dr. S
Posted in Infertility | 3 Comments »
October 4th, 2011
I have been a bad blogger. Tons have things going on. . .
• New website release (thanks to my wife, Amelie and the great folks at Russo Advertising!) . Love to hear your comments about it. Some like it, some say the old one is easier to find stuff, but like the look. Let us know!
• New partner! Dr. Dana Ambler – a real catch for us in South La. She is in one word. . . awesome! Just to let you know, there are only about 20 -25 graduating fellows each year in our specialty in the entire country. Dana is originally from N.Jersey and trained in Pennsylvania. So why would a Yankee come to the deep south? Great place to raise a family (she and her husband, Drew, have two young boys) and great opportunity to start a practice. My patients already love her and she has fit in remarkably well. We’ll have her blogging in no time.
• Baby Fair! October 23 is right around the corner. We have over 1500 babies since we started. Our Celebration Day is one of the best days of the year . Every year, I say, “let’s only do this every other year.” It’s a lot of work – but we always have a great time. The Saints game won’t conflict with our time either. Ya’ll come on!
• IVF success! This year has been our most successful year ever. I can’t release stats til after the moms deliver, but I am very excited about our pregnancy rates thus far.
Til next time. . . .
Godspeed,
Dr. S
Posted in A Day in a Life | 2 Comments »
May 6th, 2011
Gift of Hope 2011
Wow! What a great year for the Gift of Hope program! Many of you don’t know how this program was started or is carried out. My wife and I initiated the program in 2006 with the intention of providing a full IVF cycle for one deserving couple who otherwise may not be able to afford it. Sounds pretty simple right? Here’s the catch – it’s not easy to determine who is more deserving. It’s simply impossible.
This was made very evident this year. For the record, I am a bystander in the process. My job is to make sure the applicants, in fact, need IVF. Some applicants have better prognosis than others and the committee asks me (in times of tie breakers) which couple may have a better chance. But in reality, it’s a hard job. This year, as in most years, I read the applications even though I am not on the committee to choose. My motivation is, admittedly, out of curiosity. I also admit it has made me much more aware of my patients’ plight with a very frustrating disease. The letters in the applications put more humanness behind each patient that I see. The unsolicited letters from family and friends confirm how important this is to each of my patients. When I saw a couple for a consult this morning, I thought of how many people they would tell about the consult; how many family members would call to see what I recommended; how many friends they would share this journey with. It’s not unlike a diagnosis of cancer – treatment options filled with uncertainty and oftentimes long duration of therapy with only a possibility of success.
Thank you to all who applied for the Gift of Hope. Ultimately my dream would be free IVF for all who need it. (and I won’t get on my soapbox of why insurance companies choose to ignore this diagnosis as a true disease, but instead classify it as a sort of elective diagnosis – as if you all volunteered to by childless). Our winner this year is an awesome couple: Jill and Michale Crommelin of DeRidder, La. Jill is a school teacher and Michael is an active duty soldier in the Army, currently stationed in Afghanistan. They have been patients for a long time. They have been “patient” for a long time. I cringe each time her pregnancy tests are negative after less invasive treatments have proven unsuccessful. (as I do with all of the negative tests). They both keep a positive attitude despite Michael fighting for his life and our freedom and despite their childlessness.
The program is not however, as described by one applicant as “that free-baby-program”. I can not guarantee anything. I can only help give patients some more hope to build their family. For all of you who applied and were not chosen, please don’t lose heart. Please don’t think you were not selected because of a deficiency or because some “greater power” doesn’t want you to have a child. Keep focused and God will open a door for you. I truly believe this.
For those of you that know anything about baseball, you will be happy to know I am a Chicago Cubs fan. The Cubs have not won a world series in 108 years. (The longest drought in major league baseball) Yet each year, I scour the web for draft picks and trades in hopes that this year – is our year. Since I was 15 years old, each year I honestly think that the Cubs can still win it. I am just an optimistic person. Please share in my optimism for your chances of building your family. For now though, join me in congratulating an absolutely awesome couple in winning an opportunity to become parents. Jill and Michael – congratulations! Thanks also to my wife, Amelie and to the GOH committee for the numerous hours that they spent reviewing each application . Till next blog,
Godspeed.
Dr. S
Posted in Gift of Hope | 2 Comments »
January 12th, 2011
Couple Desperate For Girl Abort Twin Boys Conceived Through IVF
http://www.medindia.net/news/Couple-Desperate-For-Girl-Abort-Twin-Boys-Conceived-Through-IVF-79220-1.htm#ixzz1AkqMIXDS
Couple Desperate For Girl Abort Twin Boys Conceived Through IVF
Those who know me, know that I’m not one to bash technology. I love the opportunities that we have been given by the amazing advances in technology. I think I have 6 or 7 iPods, 1 iPad, several laptops and the list goes on and on. I’m amazed that we can now identify a carrier of over 150 genetic diseases with a drop of saliva. I am convinced that the specialty of Reproductive Endocrine and Infertility is one of the most advanced technologically of all the medical specialties.
But c’mon people. This story (see the link above) makes me want to vomit. I recognize the desire for family balancing – equal boys and girls, one cat, one dog, white picket fence etc. – but this story depicts the exact reason why technology in our specialty needs to be limited to some degree. Just because we can select gender at the time of IVF doesn’t mean it’s right. This couple aborted a viable twin pregnancy because they were boys. They didn’t have some genetic disease – just a Y chromosome – just. .. .boys.
We have a wonderful counselor who is available to all of our patients to discuss all of their concerns while going through infertility treatment. Many times, just counseling can help couples realize their “desire” for a specific gender should not supersede their desire just to be parents. I doubt the couple in the story had such counseling. I doubt they thought about anything except their own selfish wants for a girl.
I struggle as a parent on a weekly basis (understandable as I have two teens and one 11 yo). I never have thought at anytime that their inherent gender had any real impact on what kind of person they are becoming and what they will contribute to this world. I know many docs in my specialty feel that gender selection is appropriate and should be left to the parents. I just disagree. (and the American Society of Reproductive Medicine also disagrees) Technology should be utilized to improve our health, to eradicate disease and to minimize suffering. To terminate a pregnancy just because of the gender just makes me sick.
Posted in IVF | 14 Comments »
December 26th, 2010
I realize I have not blogged in quite some time. I hope all of you had a great holiday. I am excited to welcome a new partner, Dr. Dana Ambler. She will begin seeing new patients in August. She is a very intelligent and compassionate doctor who will offer fresh and insightful opinions about how to help all of our patients. I have been looking for almost 5 years for the right partner and think all of our patients will also appreciate her great attributes. Til next blog,
Godspeed,
Dr. S.
Posted in Uncategorized | 2 Comments »
September 22nd, 2010
Dr. Howard Jones, known by everyone in our specialty as the “Father of IVF” is 100 years old. Even today, he still gets up and comes to work every day. He has trained thousands of new doctors and is a remarkable man. I remember meeting him at a conference one year and how genuine he was to get to know little ol’ John Storment from Louisiana. He speaks so eloquently and is amazing to hear stories of the beginning years of IVF. They had no fancy equipment or extensive labs that we have. There were no precise estrogen measurements or vaginal ultrasounds to accurately predict the growth of the eggs. No books had even been written on the subject. Reproductive medicine is in its infancy even today. In the 1980′s the chance of pregnancy with IVF was less than 15%. Today, most clinics report a greater than 40 – 50% chance of pregnancy in women under 35. We can test embryos for disease prior to transferring them. It is a remarkable field of medicine. Dr. Jones is an amazing man and everyone who has been successful with IVF has him to thank. For some nice light reading, i refer you to this article.
http://www.wavy.com/dpp/news/health_news/doctor-still-working-hard-at-100
Til next time,
Godspeed!
Posted in IVF | 2 Comments »
August 23rd, 2010
What’s new in IVF?
Trying to keep up with all of the “latest and greatest” trends in medicine is one of the most challenging but fun things that I do. Sometimes (even at really weird times in the middle of the night) I find myself reading about the amazing techniques that researchers develop to help our patients and think how lucky I am to be in this profession. The difficult part for me is to discern which treatments are genuinely beneficial with good supporting research. It’s a lot like watching TV commercials – no matter how cool it is to think that Crazy Glue is strong enough to support a guy dangling from his hard hat glued to a construction beam – you really have to be suspicious. My job is to steer my patients in the right direction after reading the details.
My opinion of the top five new approaches to fertility in the last few years are:
1. Single embryo transfer: The transfer of just a single embryo rather than two or more is proving to be as successful with lower rates of multiple pregnancies.
2. Universal Genetic Testing: (See previous blog). This test is amazing! One completely non invasive test that checks if parents are carriers of over 100 diseases. (BEFORE they are pregnant.)
3. Mini-Stim IVF: An IVF technique that relies on a woman’s natural cycle or using far fewer meds than usual. This results in fewer eggs, but for some women with good prognosis, the cost savings can be huge. (with a similar pregnancy rate)
4. “Fast track” IVF: Most patients begin fertility treatment with a few cycles of intrauterine inseminations (IUI). If these are not successful, they move on to IVF. Some patients are better served by going straight to IVF (in the long run, this can be the least expensive and most successful option)
5. Egg Freezing / Fertility Preservation: This technique was traditionally designed for women going through chemotherapy that may negatively affect the egg quality. With new techniques, the procedure can be offered to women wishing to preserve their fertility if they are not yet ready to conceive.
Thanks for reading!
Til next blog,
Godspeed,
Dr S
Posted in Infertility, IVF | 1 Comment »
July 19th, 2010
Hello again,
Some husbands have wives that constantly remind them to mow the grass. Maybe I’m lucky. Mine just “reminds” me to blog more often. Sorry I haven’t blogged in awhile. The Carters (Gift of Hope recipients) have been an awesome couple to get to know. They are like most of my patients – eager, anxious and hopeful. Robin had her egg retrieval yesterday and had many mature eggs that fertilized very well. Some of you are following their progress on twitter and facebook also and already know this. We will transfer the embryos back in a few days and then will enter the most difficult part of the IVF process. .. the waiting game. The 10 days after the transfer but before the pregnancy test are the most difficult for every patient. The “what if’s” and “whys” seem to be more predominant at this time. This is really no different than any couple trying to conceive and having to “wait” for the result. I encourage all of you to keep busy during the “waiting” time. It’s much better than reviewing every last detail of your cycle and comparing it to 200 of your closest “web friends” on the fertility websites. This can be consuming. Remember: control that which you have control over. I wish all of you best of luck in your pursuits and remember to keep the faith!
Until next blog. . .
Godspeed.
Dr S
Posted in Gift of Hope | 2 Comments »
May 31st, 2010
There have been a lot of questions this week about the recent study linking IVF and autism. I have not read the study in detail, but have read the summaries of the study and their methods for the study. The researchers asked the parents of autistic children enrolled in one center, “how did you conceive”? When 12% of them conceived through IVF, they assumed that the IVF caused the autism. These researchers didn’t mention that perhaps the age of the mothers was different than the average population; perhaps their health was very different from the average population; what were the mothers exposed to during pregnancy? (I could go on and on. .. )
The point is studies like this are called OBSERVATIONAL studies. We don’t know if IVF causes autism; heck, we don’t know what causes autism! It’s such a complex disease that there are likely multiple factors. No fertility doctor wants to cause patients harm or put their children at risk for disease. But we must be careful about making assumptions. My theory is that autism (much like many diseases) is influenced by many factors. It is a very important disease deserving a lot of attention to find the cause and possibly a cure. Just hold off on assuming that this one study is the answer.
Godspeed!
Dr S
Posted in IVF | 2 Comments »
|
