Growing up in a small town in New England, where the population of dairy cows outnumbered townspeople and the nearest neighbors were miles away, gave me the desire to work with people. As an Amherst College student in Massachusetts, my anthropology studies led me to an economic development project in eastern Africa. Upon my return the social and economic needs of people right here in the United States became more clear to me. My honors thesis included field work with homeless populations in southern California documenting their remarkably savvy ways of engaging in local politics and with the media to meet their basic needs and improve their quality of life.

As a graduate student at the University of Southern California I studied visual anthropology and media production in the schools of Anthropology and Film and Television. I received a Masters Degree in Film Production with an emphasis on ethnographic film.  My focus then shifted to interactive communications. I spent several years working for companies in Northern California that were developing low-cost and easy to use interactive technologies that would enable increased communication among distributed populations. I worked in usability and market research, which meant discovering how people interacted with these products in order to improve their usability and user experience.

After my experience in communications, I returned to a more anthropology focused career.  I joined a UCSF research team studying fertility decision-making.  For the next 8 years I worked in the field of medical anthropology with an incredible team of experts that included a distinguished Reproductive Endocrinologist and a pioneering Medical Anthropologist conducting research into patient experiences and decision-making with reproductive technologies and third-party reproduction. I worked with scores of patients who had experienced infertility and benefited from reproductive technologies to build their families. This turned out to be a great synthesis of my interest in people in their personal and social contexts and my love for technology which has continuously motivated me to better understand how social and technological innovation can be used to improve the quality of peoples’ lives.

I am privileged to now work with the amazing talent at Pacific Fertility, where as a Research Analyst on Cynthia Willson’s team, I shepherd clinical studies that continue to increase our understanding of human reproduction and the ways in which new and old technologies may improve fertility outcomes and patient experiences. One of our current studies investigates how the use of Traditional Chinese Medicine such as Acupuncture may affect birth outcomes and patient quality of life during treatment. Patients enrolling in this study may have the opportunity to receive acupuncture treatments before and during IVF at our in-house acupuncture clinic as well as having some IVF medications donated while they are in the study. I also have the honor to be helping conduct a trial of a ground-breaking imaging technology that is designed to predict which embryos at early stages of development will be most likely to result in viable blastocysts and subsequent pregnancies and births. Patients enrolling in this study are helping future IVF patients improve their chances for success while they also may be eligible to receive some reimbursement of IVF expenses. New studies are in the works that will be expanding our knowledge about the role of genetics in treatment as well as aspects of patient decision-making. Stay tuned for updates as research opportunities become available.  I am incredibly excited to be at the crossroads between the highest standards of treatment and patient care and new technological innovation that will continue to allow more people to create their treasured families.

ASRM 2011 Updates

In addition to the magical wonders of Disney, Orlando welcomed reproductive endocrinologists from around the world this October to attend the annual meeting of The American Society for Reproductive Medicine (ASRM).  Several members of Pacific Fertility Center were among the participants. 

Preimplantation Genetic Screening (PGS)

PGS was again a hot topic of discussion.  Multiple presentations showcased the recent technological advances in this field.  The ability to perform comprehensive chromosome analysis using microarray technology instead of the first generation method of FISH (fluorescent in situ hydridization), which could only test a selected number of chromosomes at a time, has increased the accuracy and the detection rate of embryonic aneuploidy (abnormal number of chromosomes).  Laboratory advances such as biopsy of the trophectoderm (the outer cell layer of a day 5 embryo) and vitrification (a method of rapid cooling of embryos that minimizes ice crystal formation) have further improved success.  As the result of the above-mentioned technical breakthroughs, we have seen a measurable increase in the pregnancy rate and a decrease in the miscarriage rate from IVF using PGS.  Additionally, two respected groups independently presented data supporting the use of PGS as a successful embryo selection tool to promote elective single embryo transfer (the process of transferring one embryo at a time into the uterus to reduce the risks of multiple gestation).  The pregnancy rates from a single PGS-selected euploid embryo were 58% and 60.7% compared to 42% and 40.7%, respectively, from a morphologically comparable but non-PGS-selected embryo.  Moreover, the miscarriage rates decreased to 6% and 6.3% from 12% and 12.5%, respectively.  The risk of multiple gestation was essentially eliminated (1-2% monozygotic twining).

We were excited to note the parallels between the data presented and our own work at PFC.  Several years ago, we made the commitment towards decreasing our multiple pregnancy rates by adopting a policy of encouraging elective single embryo transfer in qualified patients.  We have found that 24-chromosome aneuploidy screening (via informatics-based single nucleotide polymorphism microarray technology by Gene Security Network) of trophectoderm biopsy has significantly enhanced our ability to select the embryo with the best implantation potential.  Our improved vitrification program has also allowed us to reassure our patients that their unused embryos can be safely stored for future use, thus removing the pressure to transfer more embryos at one setting.  We are very proud of our success so far in achieving our goal as we are currently the number one ranked program in the nation of the fewest number of embryos transferred in donor cycles (1.4 embryos per fresh cycle) while maintaining a high pregnancy rate of 57% (of all programs with more than 20 donor cycles per year, 2009 SART).  For more details on our experience with single embryo transfer and its pregnancy rates, please read “What are my chances of having a baby from a single IVF cycle” by our embryologist, Erin Fischer, and laboratory director, Dr. Joe Conaghan, in this issue of Fertility Flash.

Fertility Preservation

Another interesting topic that deserves attention is fertility preservation using oocyte cryopreservation. Two centers with extensive experience in this area shared their outcome data from both methods of cryopreservation, slow freeze and vitrification.  A center in Atlanta vitrified over 2000 oocytes from donors with an average age of 26 years.  Of the 1772 oocytes rewarmed, 88% survived, 75% fertilized, and 51% resulted in viable cleavage stage (day 3) embryos.  Live birth rate per cryopreserved oocyte was 11%.  The other presentation by a group in New York reported their experience of rewarming 536 cryopreserved oocytes using both slow freeze and vitrification from non-donors with an average age of 32 years.  The overall live birth rate per rewarmed oocyte was 5.5%.  Study is ongoing to compare the efficacies of slow freeze and vitrification.     

PFC’s own data with vitrification of oocytes is comparable to, if not better than, the results presented at our national meeting by various groups across the US.  A 5-10% live birth rate per oocyte in women under the age of 35 years translates to a respectable chance of having a baby in the future from one to two treatment cycles in the present (10-20 oocytes can be expected to be cryopreserved per cycle).   As we further perfect our own techniques of vitrification, we will be increasingly more confident in our ability to offer young women with a viable option for future family planning in addition to embryo freezing and donor gametes.  Future research is needed to achieve the same type of success rates in older women.   

Participating at ASRM is always an educational experience.  We enjoyed sharing our own clinical and research endeavors with our colleagues across the US and all over the world.  Our position as the nation’s leader in many of the most cutting-edge technologies in our field is a validation of our commitment to excellence and to provide our patients with the highest quality care available.

According to Resolve, Rep. John Lewis (GA) introduced a bill in the U.S. House of Representatives on November 30 that would provide eligible taxpayers a tax credit for the out-of-pocket expenses associated with infertility medical treatment. 

The “Family Act of 2011,” HR 3522, is a companion bill to S 965 which was introduced in the U.S. Senate in May 2011.  Advocates can now push for action on the two bills including bipartisan co-sponsorship, Committee hearings, and a vote in both chambers.

If you would like to support this bill, contact your U.S. Representative and ask them to co-sponsor HR 3522.  According to Resolve, you can do this by completing the following:

Contact your Representative right now.  It takes 3 minutes through RESOLVE’s Action Alert System. PLEASE review the online letter and personalize it with your story.  Personal content is far more impactful than a form letter.

To learn more about The Family Act 2011, visit the Resolve website today!