Medicine gives life a helping hand

By JOHN CRAWFORD

Special to The Times

Every year, IVF New Jersey would hold a holiday party to which the infertility practice invited former patients. It was a warm occasion. Not only would the patients' children be there -- children brought into the world through the help of the practice -- but the party also demonstrated the closeness that can develop between infertility clinicians and their patients.

IVF New Jersey assists with a momentous and happy time in people's lives, a fact that cements an intimacy between doctor and patient.

"Most doctors don't have that bond with patients," says Dr. Susan L. Treiser, a reproductive endocrinologist and co-director of the infertility practice, which has offices in Somerset, Lawrenceville and Freehold. "It makes it special."

The practice's most successful treatment is in vitro fertilization. Legal and moral issues may surround the unused embryos created through IVF, but the procedure can bring joyous results to patients' lives by literally giving the miracle of life a helping hand. "It is a miracle of life, and in some way, we have a hand in creating that," Treiser says.

On the flip side, the intricate and involved undertaking can also cause lots of stress for those going through it. Patients have frequent and draining visits, and they can be wrung through an emotional roller coaster, going from hopeful to anxious as they wait for results, then to devastated if they don't become pregnant.

The staff does their best to support patients, and if necessary, the practice has psychologists it can refer patients to, Treiser says. "Emotionally and psychologically, it's very difficult. There is no guarantee of success."

Given that the procedure costs about $10,000, patients also may face considerable financial strain if they're paying out of pocket. New Jersey does have legislation requiring the reimbursement of infertility treatment if a business has 50 or more employees.

In a nutshell, the IVF process starts with the patient taking medication to stimulate her ovaries to produce multiple eggs. During a women's normal cycle, only one egg is released, but the medication will increase that number to between 10 to 20.

In a minor medical procedure, the women's eggs are extracted and combined with a man's sperm. About 75 percent of the eggs will be fertilized, and the majority of these will divide into two or more cells to become embryos.

The progress of the embryos is evaluated as they continue to grow and divide in culture for three to five days. Ideally, if enough high-quality embryos are still viable after three days, they will be allowed to grow for an extra two days. Embryos that are 5 days old are known as blastocysts, and because they're more advanced, they have a better chance of conception.

After the embryos are transferred to the women's uterus, patients wait a suspenseful two weeks to see if they're pregnant. Overall, IVF New Jersey has an average success rate of 50 percent with IVF, but that average tumbles in older women. If using her own eggs, a woman over the age of 43 has a less than 2 percent chance of getting pregnant.

For that reason, IVF New Jersey discourages the procedure in older women, though the practice will allow patients up to the age of 50 to undergo IVF if they're using donated eggs from a younger woman.

Typically, an IVF patient is in her mid-30s to early 40s. However, Treiser is seeing more women in their younger 30s, even 20s, using the procedure. "Women are more savvy," she says. "There is greater awareness of women's biological clocks. There is increasing awareness of reproductive potential."

Treiser recommends women under 35 look into infertility treatment if they've tried to get pregnant for a year. Women 35 and older should seek treatment if they've tried for six months. "You don't want to lose your window of opportunity," she said.