Frequently Asked Questions About Infertility

My sister had infertility for over 10 years.  I went with her through the anguish in her and our entire family and understood from her point of view as well as parents, who could not become grandparents, the anguish of not being able to conceive of a child.  These were the early days before IVF. 

When I came out of my army service, it was 1981.  Louise Brown was the first IVF baby born in 1978.  That was followed by a long hiatus and finally in 1981, the same year that I finished my army service as a physician, the first IVF baby, Elizabeth Carr, was born in the United States.  From afar, back in Israel, I followed with great anticipation the development of in vitro fertilization, which at the beginning of the 1980’s was considered to be a scientific miracle.  It was only three years later that I decided to make a change in my career and leave a surgical residency in Israel in favor of an OB/Gyn residency in the United States aiming to become a subspecialist in infertility. 

I realized that IVF was not a random occurrence, but was rapidly becoming a reproducible and reliable method of helping women become pregnant, who would have otherwise remained childless.  I decided at that point that I had to be a part of this amazing field and have never regretted it since.

A specific patient comes to mind.  Relatively early in my career as a reproductive endocrinologist I came to treat a patient who was born without a vagina.  I helped create a vagina for her by using her own skin graft. 

Over ten years later, the patient came back, desirous of having a child.  Since she did not have a uterus but had ovaries, I was able to retrieve eggs from her ovaries and with her husband’s sperm create embryos that were then transferred to her sister, and she conceived of a child.  That closed an amazing circle for me as well as for my patient. 

Compassion

Never give up.  There are always options for you to have children. The sky is the limit.  Find a fertility specialist that you trust, and stick with her or him until you have a baby.

Practically everything.  When I was a fellow, vaginal ultrasound was introduced and it changed the way we do IVF from a cumbersome laparoscopic procedure that took over an hour with general anesthesia, to transvaginal aspiration that takes a few minutes and is done under IV sedation.  While the first decade of IVF in the 80’s and into the beginning of the 90’s was what I call the decade of the female, males still faired poorly, and if there was little sperm or no sperm, donor sperm was usually used.  The invention of ICSI in the 90’s, first in Europe, and then in the mid-90’s finally in the United States, created a revolution in the treatment of the infertile male, making even males with very little sperm or obstruction of their system, capable of fathering genetic children.  With pre-implantation genetic diagnosis, the ability to pluck out a single cell from an embryo and make a genetic diagnosis on embryonic health, has been an amazing development, comitant with so many advances in genetics itself.  We are in the midst of the genetic revolution, and getting a handle over people’s genetic misfortune and being able to reverse it.

Our center currently has five physicians, all of whom are board certified in reproductive endocrinology and all of whom have been trained in Ivy League institutions.  A sixth physician that we are adding this summer is a young woman coming straight out of fellowship at the University of Pennsylvania, thus continuing this tradition.  The center is extremely well organized.  All the notes are typed and easily retrievable from the patient’s records.  Our staff is trained to be courteous and sensitive to the patients.  The center is extremely organized due to a strong professional leadership and business leadership.  Patients are provided with written material, both hard copies and on line, practically on every treatment they are being offered.

The Health System now encompasses 14 hospitals with several more major affiliations with other hospitals. The system has some of the best doctors in New York, definitely the best on Long Island. Therefore, once you are a patient within our system, you have a network of highly qualified physicians who have had excellent training practically in all medical, surgical, and pediatric fields.

I find all areas of fertility treatment fascinating. My interest in in vitro fertilization is both from the clinical as well as the laboratory point of view as I am in charge of the Andrology and IVF lab. I am extremely interested in pre-implantation genetic diagnosis (PGD), a program that I started several years ago, and is growing by leaps and bounds. I also run the donor-egg program, and consider it a blessing that I can offer patients who struggle with reproductive aging, to extend their fertility and create families for them.

Yes, I do.  Patients come in all the time to show me their babies.  Sometimes they continue their contact for years and send pictures, Christmas cards with their babies’ pictures, or come for repeat visits.  Occasionally, I get to see babies that I have helped create grow up and several of them as young teenagers.  It is amazing to see a whole human being that you know originated from a small embryo.

Don’t give up.  I know this is tough.  As I said before, the sky is the limit. There is no situation where ultimately you cannot end up having a baby, even if there are no eggs or even if there is no sperm, with an open mind, we can help you have a family.