The Fertility Chase (TFC) show today covered numerous concepts including genetic testing of the embryo, embryo donation (embryo adoption), egg donation and affordable infertility coverage.

Pre-Implantation Genetic Diagnosis:
Edward L. Marut, M.D., from the The Fertility Centers of Illinois was featured in the first segment. The infertility couple, Kelly and Tom, was unable to conceive over a three years. Basic treatments were performed without success wherein they underwent In Vitro Fertilization (IVF) twice and failed. The final and successful outcome occurred when they did a third IVF procedure combining it with Pre-implantation Genetic Diagnosis (PGD). In PGD, a single cell from each of the embryos is screened for chromosomal defects such as Down’s syndrome. Nine out of the possible 24 chromosomes were examined. PGD is commonly done for genetic disease, gender selection, to transfer a single embryo, recurrent miscarriage and when there is a history of failed implantation such as this couple. Apparently only two out of twelve sampled embryos were probed as normal. A male child was eventually delivered.

As women age, the quality and quantity of their eggs decrease. In this case, quality seemed to be the issue. While not every one agrees, it is thought that PGD may decrease miscarriage rates and decrease the delivery rates of genetically abnormal offspring such as Down’s syndrome. I too have used PGD to decipherer the reason why embryos have failed to implant and will frequently find that nearly all of the embryos are indeed genetically abnormal. PGD has its strengths and weaknesses, however, in this particular instance, it may truly have saved some time and heartbreak. I thought the piece was well done.

Embryo Donation:
OK, this is going to be hard to review as this was my own segment In the making for over a year, I thought Exodus Productions did a wonderful job with it. To view, please visit: http://www.vimeo.com/11762266.

Kerry (commissioning parent) and Christiana (surrogate) did an amazing job opening up their lives to the media to tell this important story.

Christiana (below) is the surrogate carrying Kerry's donated embryo.

Walt and Amy’s side of the story was that they would much rather donate their embryos than other alternatives should they never use them themselves. Amy is set to deliver very soon and I hope they use their own beautiful embryos for themselves but, in case their first child is a little hellion and they decide not to have any more (which I doubt), I would be more than happy to find a wonderful home for them.

Walter and Amy with baby in between.

None of this entire story would have been possible without the generosity of the couple that donated the embryos to Kerry. In addition, they did not stipulate that we couldn’t give their embryos to a single woman. This was an amazing gift from undoubtedly an amazing couple. Since these embryos came from a distant facility and not our own, I will probably never have the privilege of thanking them directly.

We will be covering the topic of embryo donation in great detail in the months to come. Right now, we have over 140 abandoned embryos and we are trying to get these designated to either personal use or embryo donation. I feel we are both patient and embryo advocates.

All kidding aside, I surely hope you enjoyed the segment as much as I did.

Egg Donation:
The third segment had many players from Long Island IVF, one of the busiest IVF facilities in the country. Reproductive Endocrinologists Dr. Daniel Kenigsbert and Steven Brenner and Embryologist Glenn Moodie, Ph.D. were the experts. Carolyn and Nicholas were a infertility couple and Donna was also a patient who sought treatment. The theme had to do with egg donation. As stated a few paragraphs above, as a woman ages, the quality and quantity of eggs decreased. At times, we also see young women who surprise us in that they seem to be very close or have actually entered menopause. When there aren’t enough healthy eggs around, an excellent option is egg donation.

I was struck by Donna’s story of four IVF cycles with one physician and another four with a different one. New York is a mandated state, which means that a certain amount of infertility has to be covered by insurance companies. I have unfortunately found that insurance coverage often leads to poor decisions. I had one patient recently that was told she was had to undergo six intra-uterine insemination procedures before doing IVF. The problem was that her Fallopian tubes were very damaged and severe pelvic adhesions were present. I recommended moving forward with adoption or IVF but IUI procedures were not on my radar screen. Doing IUI procedures was a very foolish and expensive (i.e., wasteful) step before IVF in this instance. Getting back to The Fertility Chase, Donna probably needed to move to egg or embryo donation long before the eighth IVF procedure. If none of them had been covered, she surely would have made the decision sooner and with less heartbreak.

Lastly, the egg donor stated it took weeks for her to complete the pages of needed information. Our patients have told us that it took less than 30 minutes to do it on our website (http://www.dreamababy.com/eggdonation.htm) . These are young patients and their medical histories should be pretty simple. Perhaps the donor was just being overly cautious but the TFC viewers or my readers should know that it isn’t that difficult or time consuming to do.

Cost of Infertility:
This was a great segment featuring the Gunderson Lutheran Fertility Center. Dr. Kathy Trumbull was the Reproductive Endocrinologist. Two couples were highlighted, Crystal and Larry as well as Bobbi Jo and Marty. Both of the men apparently had male-factor infertility, Crystal had polycystic ovarian syndrome and Bobbi Jo, stage I endometrioisis.

I couldn’t tell what treatments were used for which couple. Dr. Trumbull’s discussion regarding infertility patients seeing a general physician for the simple stuff but to find a Reproductive Endocrinologist when too much time passes or the issues are growing in their complexity. This is actually a statement that needed to be stated long before now so hats off to Dr. Trumbull. Infertility, especially the issues as presented by TFC, are well beyond anyone’s care besides a Reproductive Endocrinologist.

The issues of cost of infertility care will probably come up again in a future TFC program. It is a difficult issue but few areas of medicine require such a tremendous amount of physician and nursing training, continuous equipment upgrades and an extraordinary amount of time committed to our patients. Hats off to Gundersen Lutheran if they are truly able to make it more affordable in my home state of Wisconsin. I truly wish I could give it away free.

Summary:
Well that is it for now. It was wonderful to be part of The Fertility Chase. Even though my show has aired, my commitment is to continue to watch each program and report back to my readers my thoughts and comments. If you agree or disagree with whatever I say, please do not be shy and leave a comment or two. In the mean time, be fertile.