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.

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! 

How does metabolism affect fertility? PFC’s Dr. Liyun Li may be able to shed some light on this interesting question. She has studied extensively a key hormone regulater of body weight and appetite called ghrelin, and found that its levels in the ovaries may affect egg and embryo quality.  Her work has just been published in the peer-reviewed and the highly respected journal Fertility and Sterility.

For abstract, see here.

Tune in for a Channel 5 news special! The story shares the journey of Dino, a single restaurant owner, and his quest to have his own son. The special also features PFC’s Dr. Carl Herbert.

The two part special will air on Channel 5 on Wednesday, November 16th at 11pm and Thursday, November 17th at 6pm.

You won’t want to miss it!

In case you missed Dr. Carl Herbert on the Fertility Forum radio show, you can download the Podcast on iTunes or the MP3 version from the Fertility Forum website.  Hear Dr. Herbert talk about the History of ART, Genetics, Fertility Preservation, Egg Banking, and other topics in the field of Assisted Reproductive Technologies. 

We hope you enjoy!

Tune in and listen to PFC’s Dr. Carl Herbert talk about the History of ART, Genetics and ART, Fertility Preservation and Egg Banking on The Fertility Forum radio show Monday, October 17^th from 6-7 pm PST.

To listen, you can call in live to 877-864-4869 or go to The Fertility Forum webpage and listen there.  You can also click the LIVE CHAT button on the website to IM live during the show!

If you can’t tune in on Monday, you can download the audio AFTER the show from either the site above OR iTunes.

Don’t miss it!

I was born and raised in Shanghai.  My father, a university mathematics professor, was one of the first generation of college graduates in China after the Cultural Revolution.  My mother, though intelligent and bold, never had the opportunity to pursue higher education.  They were “tiger parents” long before that term even existed.   This was the era before China had opened its door to the West, and disposable income was limited.  Nonetheless, they spent every penny towards my education and broadening my horizon.  I was the only child in my neighborhood to take private lessons in Chinese calligraphy and classical Chinese painting.  We spent weekends touring art exhibits and museums.  To ensure that I would succeed in school, my father taught me English and algebra during my summer breaks.

My childhood years spent holding the calligraphy brush played a critical role in helping me stay connected with my cultural roots after my family’s immigration to Canada when I was twelve.  Through the mastery of this traditional art form, I gained a deeper understanding of Chinese history and culture.  It has given me a platform with which I was able to continue my study of the Chinese language and literature long after English had become my primary language of learning.

My family’s immigration to Canada was serendipitous.  My father initially took us abroad for a one-year visiting fellowship at the University of Manitoba in Winnipeg.   It was the summer of 1989, when the communist regimes throughout Europe fell like dominos and in Beijing the bloody suppression of student demonstrators for democracy occurred in Tiananmen Square.  Although we were not politically involved, my family was given the opportunity to seek asylum in Canada. My parents decided to stay.

What followed was the classic immigrant story, filled with the hardships of survival in a foreign country away from loved ones, and, at the same time, the never diminishing hope and optimism for the attainment of the “American dream”. 

After attending junior and high school in Canada where I excelled in math and science, I applied to colleges in the U.S. with a vague plan to have a career in the sciences.  With this in mind, I was convinced that MIT offered the strongest programs in virtually every scientific discipline.  My years at MIT were the most formative period in my professional and personal development.  My professors and research mentor opened my eyes to the wonders of biology and inspired me to pursue a career in the study of the human body.  I became fascinated by how the body functions, especially the mysterious process by which a single stem cell develops into a complete organism.  At the same time, I continued to pursue my interest in Chinese by taking graduate level courses at Harvard and obtained a minor in Chinese literature along with my S.B. in Biology from MIT.

My interest in the human body led me to study medicine at Harvard Medical School.  During medical school, I conducted research in developmental neuroscience, which led to my honors thesis.  In addition, I became clinically interested in women’s health, a multifaceted discipline with broad psychosocial, political, as well as ethical implications.  I realized that I wanted to take care of women, promote reproductive health, and be a part of building families.  To that end, I completed a residency in Obstetrics and Gynecology at the University of California, San Francisco (UCSF).  During my residency, I learned to treat women of all ages and with every type of ailment from morning sickness to ovarian cancer.   It soon became clear that while I enjoyed delivering babies, I resonated most with patients who could not conceive.  Furthermore, the combination of advanced technology and cutting edge research in reproductive medicine perfectly matched my long held passions in science and technology.  Having come to that realization, I decided to pursue subspecialty training in Reproductive Endocrinology and Infertility, and was accepted into the fellowship at Columbia University Medical Center in New York. 

At Columbia, I was fortunate to be taught by some of the pioneers of the field, Drs. Roger Lobo and Mark Sauer, who have trained many respected Reproductive Endocrinologists around the country, including PFC’s very own Dr. Chenette.  Under their guidance, I conducted research on how follicular hormones affect human oocyte and embryo quality, which has led to several published manuscripts in peer respected journals, as well as my fellowship thesis.  Clinically, I became interested in treating patients with polycystic ovary syndrome (PCOS) and other endocrine disorders, as well as fertility preservation, for patients who desire to delay childbearing for either medical or social reasons.

While I was a resident at UCSF, I met and fell in love with my husband and we welcomed the birth of our daughter last year.  We both love the Bay Area and decided that San Francisco is the place where we want to raise our family.  I have always had the highest regard for the physicians at PFC, one of the most respected fertility centers in Northern California.  Therefore, it is my pleasure and privilege to be able to join Drs. Herbert, Schriock, Givens, Chenette, and Ryan in their mission to help women and families of the Bay Area and beyond in achieving their reproductive potential.

Throughout all these years of training and research during which I learned many exciting new skills and technologies, I still derive the most profound joy and satisfaction from the very first glimpse of a beating heart on ultrasound and the accompanying excitement in my patient’s eyes.  It was not until I held my own daughter and she flashed me one of her toothless gummy grins that the notion finally hit home: life is precious and the love for one’s child knows no boundaries.  I am truly lucky to be in a profession where I have been granted the privilege to take part in the creation of a family, a privilege that I will honor and treasure throughout my career.

We appreciate your interest in research opportunities at Pacific Fertility Center (PFC). As a private practice we are committed to conducting research that will promote and advance the field of reproductive medicine. We welcome your questions about potential participation in research, also known as a “clinical study”.

Currently, PFC has several research opportunities for which you may be eligible. If you would like further information regarding research opportunities at PFC, please ask your physician. The opportunities for which you may be eligible can be identified and discussed at your physician consult. At that time you may be connected with research personnel who can guide you through the process.

If you are not a current PFC patient, please contact our New Patient Coordinators to make an appointment to speak with one of our physicians. 415-834-3095.

Our Active Studies include the following:

A RANDOMIZED, CONTROLLED CLINICAL TRIAL OF THE EFFECT OF TRADITIONAL CHINESE MEDICINE ON IVF SUCCESS RATES

Who Is Sponsoring This Study?

 The study is Sponsored by Pacific Fertility Center and is overseen by Eldon Schriock, M.D. Grant support providing medications and funding for study development has been provided by EMD Serono, a biopharmaceutical company.

What is the Purpose of This Study?

The purpose of this study is to determine the value of combining Traditional Chinese Medicine (TCM) Protocols including acupuncture with In Vitro Fertilization (IVF).

The Auxogyn Eeva Study

Who Is Doing The Study?

Auxogyn, Inc. has selected Pacific Fertility Center as one of several centers to participate in The Auxogyn Eeva Study

Why Are We Doing This Study

Auxogyn is initiating a clinical study in an effort to submit data to the FDA to support the claim that the Eeva System may be used to identify embryos at day 2 that are most likely to form blastocysts. As a result, the Eeva System Study is an investigational study and is a non-significant risk device.

How Data Will Be Used

The data collected in this study are intended to demonstrate the effectiveness of the Eeva System to successfully capture and record images of embryo development within a standard incubator and accurately identify those embryos on day 2 that are most likely to form blastocysts. The results may lead to effective methods for embryologists to identify the most viable embryos so that embryo implantation and pregnancy outcome may be significantly improved for future IVF patients. A higher success rate such as that seen with blastocyst transfer may be achieved for day 2 embryo transfer by using the Eeva System to select embryos; therefore, the adverse events associated with extended culture may be avoided. It may also facilitate implementation of single embryo transfer on cleavage stage (day 2 or day 3) and reduce multiple pregnancies. In summary, this new technology may increase IVF success rates within a given cycle and improve pregnancy and birth outcomes.

Impact of Parental Support on Pregnancy Outcomes (IPSO) Trial- Day 3 Preimplantation Genetic Screening (PGS) With Day 5 Fresh Transfer

Who Is Doing The Study?

Gene Security Network (GSN) has selected Pacific Fertility Center as one of several centers to participate in The IPSO Trial

Why Are We Doing This Study?

The purpose of the study is to determine whether PGS – testing of embryos created during IVF for chromosome abnormalities prior to transfer to the uterus – improves pregnancy and implantation rates in patients when compared to patients whose embryos are not tested. PGS will be conducted using 24 Chromosome Aneuploidy Screening with Parental Support from Gene Security Network

Dr. Chenette was honored as Fertility Doctor of the Month by FertilityAuthority.com!  Below is the story they featured.

Philip E. Chenette, MD, Pacific Fertility Center, San Francisco, CA

July 2011

FertilityAuthority.com is pleased to honor Philip Chenette, MD, as Fertility Doctor of the Month.  We recognize San Francisco fertility doctor Philip Chenette for his progressive and patient-focused practice at Pacific Fertility Center in San Francisco, CA, and his philosophy of individualized care for the fertility patients he treats.

“Our focus in on the individual patient,” says Dr. Chenette.

From the diagnostic regimen to fertility treatment to holistic services such as acupuncture, mind-body and nutritional support, the entire process is tailored to the patient’s specific needs. “My 9 a.m. patient, she’s my boss, and I have to get the job done with her,” Dr. Chenette adds.

Involved from Beginning to End

At Pacific Fertility Center, the fertility doctors are the ones who do their patients’ ultrasounds, egg retrievals and embryo transfers for IVF cycles. “It makes a real difference in outcomes,” Chenette says. “I’m the one who knows you the best and I can see things my partners may not see.

“There are so many details in fertility — all the pieces of the puzzle that have to come together,” he continues. “And those things don’t happen by themselves. As a doctor, you can’t entrust that to chance. I have to be there in the mix — guiding things, lending my 20-plus years of experience to keep things on a good path.”

Age-Related Infertility

From a clinical perspective, Dr. Chenette’s emphasis is on age-related infertility, including diminished ovarian reserve and aneuploidy (chromosomal abnormalities). He has seen improved success rates and reduced multiples in those patients.

“We’re now working on fertility preservation,” Dr. Chenette says. He is a champion of egg freezing and says that randomized control studies indicate that it’s a viable option for preserving fertility.

“Fertility preservation is a route to reproductive choice,” Dr. Chenette says. “Not everyone gets married young and can have children young.”

One of his goals is to drive some critical mass around fertility preservation. That includes contacting and building relationships with Ob/Gyns and other physicians who see patients with diminished ovarian reserve to encourage them to talk with their female patients about fertility preservation. He’s currently involved with putting together a program at a local hospital where an advisory group will help guide best practices in the area.

Inspiration in New Technology

For Dr. Chenette, the new technology involved with fertility treatment was what sparked his interest in a career in the field early on — and it is what continues to drive him today. He talks about the important insights we’re starting to gain about the genetics of eggs and embryos, and early embryo diagnostics.

“For the first time we’re starting to understand what makes a healthy egg — and that’s such wonderful information,” he says.

Nominate Your Fertility Doctor

FertilityAuthority.com features a dedicated fertility doctor (reproductive endocrinologist) each month. You can nominate your favorite fertility doctor by clicking here. We will contact you if your fertility doctor is chosen to be our Fertility Doctor of the Month.

PCRS Meeting Review

Pacific Fertility Center’s team directed the Pacific Coast Reproductive Society’s annual meeting in April this year.  Dr. Carolyn Givens was President of the Society and Dr. Joe Conaghan was Program Co-Chair at the meeting this year.  And what a meeting it was!

Optimizing success rates for patients was the focus, with presentations on “Improving Live Birth Rates”, videos on the importance of early embryo development, optimizing treatment protocols, and early embryo testing.  There were sessions on stress reduction, discussions on single embryo transfer, healthy debates between experts, and conversations about new advances that will improve patient care.

Alice Domar, Richard Tucker, Michael Alper and Richard Scott were among the luminaries presenting at the meeting.  Right alongside them was Joe Conaghan, Carolyn Givens, Lauri Black, and Paul Turek with matching skills and knowledge.  All were directed at improving care for our patients.

Pacific Coast Reproductive Society is one of the important professional organizations supporting fertility care.  Although they are a West Coast organization by title, Pacific Coast has developed national and international status in our field by focusing on the patients. As described on their website, “PCRS provides an outstanding forum for the exchange of information, and the advancement of the ideologies of reproductive medicine in a relaxed and collegial setting building relationships that foster the integration of current knowledge to ensure quality medical care for patients.”

Pacific Fertility Center is pleased to support Pacific Coast Reproductive Society.  We are looking forward to applying these advances, and already working on the new advances we will be talking about next year!

-Philip Chenette, M.D.

Pacific Coast Reproductive Society Highlights

One of the highlights of this year’s meeting was a talk by Sheryl Kingsberg, Ph.D., a Professor in the Dept. of Reproductive Biology and the Chief of the Division of Behavioral Medicine at Case Western University. Dr. Kingsberg’s area of expertise is in Human Sexuality and sexual disorders in women. She gave an excellent synopsis of “normal” sexuality in our culture and how we have come to view and define that norm. She also provided background on the physiology of sexual excitement and sexual response in women. She spoke about the different classifications of sexual disorders, which includes Hypo-active Sexual Desire Disorder (what we know as low libido), Sexual Aversion Disorder, Female Sexual Arousal Disorder, Female Orgasmic Disorder, and the Pain Disorders: Dyspareunia (painful intercourse) and Vaginismus (localized vaginal and vulvar pain).

Dr Kingsberg also covered the topic of sexual dysfunction and sexual function. One of the most valuable things she discussed was that doctors should use a sexual function checklist. Here is the checklist she presented:

Please answer the following questions about your overall sexual function in the past 3 months or more:

Please answer the following questions about your overall sexual function in the past 3 months or more:

1. Are you satisfied with your sexual function?
   • Yes
   • No              If no, please continue.
2. How long have you been dissatisfied with your sexual function?
3. The problem(s) with your sexual function is: (mark one or more):
   1. Problems with little or no interest in sex
   2. Problems with decreased genital sensation (feeling)
   3. Problems with decreased vaginal lubrication (dryness)
   4. Problems reaching orgasm
   5. Problems with pain during sex
   6. Other
4. Which problem is most bothersome?  Circle one: 1  2  3  4  5  6 
5. Would you like to talk about it with your doctor?
   • Yes
   • No

Many of us at the conference realized there is a need to identify and assist our fertility patients that also may be suffering from sexual dysfunction. We need to spend a few moments covering this topic with our patients. We will be considering how to add these types of questions to our current patient history forms. We want to identify the patients with sexual dysfunction in addition to fertility problems so we may assist them in finding the appropriate resources for treatment.

-Carolyn Givens, M.D.

Genetic Testing Breakthrough

Genetic screening techniques are a prime topic of research and dialogue in the IVF community.  We continue to seek techniques that are 1) accurate, 2) have quick turnaround times for results, and are 3) versatile enough to be able to give a breadth of testing results on one embryo, as well as 4) cost effective.

One of the exciting presentations at PCRS was by a firm called Gene Security Network (GSN), whose laboratory is in Redwood City, CA. GSN has been on the forefront of providing pre-implantation embryo genetic testing which is accurate, covers all 23 pairs of chromosomes including the sex chromosomes, and provides results within 24-48 hours post embryo biopsy (therefore negating the need to freeze embryos while waiting for the genetic results, as with the CGH technique). This technique, developed by GSN, is called Parental Support.

Parental Support is a new technology for Preimplantation Genetic Diagnosis (PGD) that tests all 24 chromosomes in a single cell from an embryo (called a blastomere) for a variety of genetic abnormalities. The test reliability typically exceeds 99% and results are returned within 24 hours in time for Day 5 embryo transfer.

Single gene mutations (such as cystic fibrosis) have been traditionally tested for as one genetic test only.  Dual testing, the ability to test for both single gene mutation and aneuploidy screening was not able to be done accurately or easily.  GSN has been working on this challenge of dual testing, and had just announced the birth of the first baby born after such dual screening—a healthy baby girl.

This announcement was also exciting for us, since the patient who is now a proud parent of a healthy baby, was a PFC patient.

We continue to collaborate with GSN on current and upcoming clinical trials, pushing the frontiers of genetic testing of embryos, and of diagnostic testing that promotes the creation of healthiest babies possible.

-Isabelle Ryan, M.D.