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.

PFC is proud to announce that all 5 Pacific Fertility Center Partner physicians have been named top reproductive endocrinologits on the U.S. News Top Doctors list.  Drs. Philip Chenette, Carolyn Givens, Carl Herbert, Isabelle Ryan, and Eldon Schriock were selected as top doctors based on a peer nomination process by U.S. News Top Doctors and Castle Connolly Medical Ltd.

Congratulations to each of you for this incredible honor!

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.

Infertility & Reproductive News featured Pacific Fertility Center and interviewed Dr. Herbert for their August newsletter issue. 

Click here to read the article in Infertility & Reproductive News.

Article originally written by Erica Reder and was published in The New Fillmore.  Article was slightly shortened for length.  To read the complete article and to see pictures, click here.

It’s 7:30 on a Tuesday evening, and nearly every seat in Dino’s Pizza at the corner of Fillmore and California is taken. Couples and families crowd the tables, sharing pizzas, draft beers and sodas. Three television screens broadcast the Tennessee-Vanderbilt basketball game, while mob movie stills and portraits of famous athletes stare out from the walls.

But the newest decoration hangs from the balcony. It’s a blue blanket that proclaims: “BABY BOY.”

Owner Dino Stavrikikis struts among the diners, his photo-loaded iPhone at the ready. Customers gush over pictures of the month-old baby named Santino, while the proud father regales them with tales from the crib. “I really love talking about this story,” says Dino, who’s on a first name basis with nearly everyone in the neighborhood. “I talk about it 10 times a day.”

Santino Vasili Stavrikikis was born on January 22. But the story began a year and a half ago, when the 50-year-old bachelor set his sights on becoming a father.

“There wasn’t one specific day that it hit me and I said, ‘Okay, this is what I need to do,’ ” says Dino. “It was just at this point in my life — you know, you get a little older.”

When the idea of having a son took root, he turned to his customers for advice. “I don’t know what anyone does for a living, but everyone does something,” he says. “So I was kind of throwing out words here and there, and hoping someone would hear me and say, ‘This is where you need to go.’ ”

That moment occurred in August 2009 when friends of Dr. Carl Herbert, a fertility specialist and president of the Pacific Fertility Center, came to Dino’s for dinner. “I started talking about it,” Dino recalls. “They all just stopped eating and said, ‘We have the guy for you.’ ”

Still, Dino admits he had a steep learning curve. “I didn’t know what a surrogate was, I didn’t know what an egg donor was,” he says. “I just kind of knew something about the process.”

And the options seemed overwhelming. He had to choose both an egg donor and a surrogate mother.

But other variables would prove beyond his control. “In January of 2010, within three days my egg donor and carrier fell apart,” says Dino. “I had to start the process all over, start the finances all over. But not once did I think it wasn’t going to happen.”

After losing two egg donors to failed tests, Dino met his best match yet. “Once I met her, I knew she was the right one,” he says of his third, and actual, egg donor.

Searching for a surrogate mother, Dino found the winning combination in a Southern California woman named Dusty Kenney. “We clicked right away,” he says.

Kenney agrees. “I feel really blessed that we found each other because we have such a good connection,” she says. Kenney has a daughter of her own, but she too was new to the world of surrogate pregnancies.

She and Dino kept in close contact throughout her pregnancy, which resulted from the implantation of the donor’s egg fertilized by his sperm. “He would call and check on me probably every other day,” she says. “He would fly down all the time and hang out and he would cook me dinner. He was supportive through the whole process.”

Dino had planned to visit more often as Santino’s February 23 due date approached. “I was going to fly down there on the 15th of February and check into a hotel and just wait it out,” he says. But as it happened, everyone was caught off guard when Santino arrived a month early.

“I got the phone call on the 22nd at 5 in the morning,” Dino recalls. He was there when Santino made his appearance that afternoon at 5:18 at Cedars-Sinai Medical Center in Beverly Hills.

It completely changed Dino’s life. A man who says he had “never lived with anybody” acquired not one but two new roommates: his baby son and a live-in nanny. “She’s phenomenal,” he says of the nanny. “We’ve really gotten along, and we’re making it work.”

They weren’t so sure a month ago when Dino and the nanny brought Santino up from Los Angeles. “We got home at 6 o’clock on Thursday night,” he recalls, “and we just looked at each other like, ‘Now what?’ It forced us to get into fifth gear right away.”

Santino’s temperament makes things easier. “He’s really patient,” says Dino. “He’s a good sport.”

His surrogate mother agrees. “He just has such a calm, sweet personality,” says Kenney. “He doesn’t cry unless he’s hungry.” She has visited Dino and Santino since the birth, and expects to continue to make regular visits. “I imagine I’ll see them once a month,” she says.

Kenney also has thought ahead. “I would imagine it would be like the role of an aunt,” she says. “I just want to be there for him. I think the more fans a child has when growing up the better.”

The egg donor has yet to meet Santino, but Dino expects that she will. “She lives in Florida, but she wanted to be involved as much as she could,” he says.

In the meantime, Santino gets plenty of attention. “Every day he gets two or three presents from around the world,” says Dino. “Everybody comes in and asks for him. It’s turned out, he’s not my son; I’m his father.”

Those who have yet to meet Santino will have ample opportunity when they stop by for pizza. “I want to bring him more and more and more,” Dino says. “But he’s got to get a little bigger.”

Until then, a message painted on the restaurant windows announces to customers and passersby alike: “Santino has arrived.”

Dino says he plans to take down the signs after Santino’s 40-day blessing, a Greek Orthodox rite that will take place in early March. And he’s already dreaming of Santino’s future. “He’ll definitely be working at Dino’s when he’s really young,” says Dino, “just kind of walking around and helping me out.”

For now, father and son see each other mainly outside of the restaurant. “I have to work,” says Dino, “but my schedule’s really flexible.”

The two have already created some memorable moments. “On Saturday, we hung out and watched The Godfather,” Dino says. In the film, Santino is the first-born son of New York Mafia boss Vito Corleone — and the name, which means “little saint” in Italian, stuck with Dino when he first saw The Godfather 35 years ago.

“Dino means ‘the sword,’ ” says Dino. “So it’s the sword and the little saint, which to me means we’re basically watching each other’s back.”

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.

I was born in the Lower East side of New York City, my father’s hometown, to quite young parents. At six months of age, we moved to Paris, my mother’s hometown, and I played in the streets and parks of Paris until I was 9.  I spent every Wednesday with my maternal grandmother (schools were in session Saturday to Tuesday, and Thursday to Sat), often spending hours in the Bois de Boulogne (a park along the western edge of Paris).  We spent quite a few summers in the South of France where we would raise small chicks and rabbits, which became dinner at the end of our vacation.  I am the oldest of five children. 

My parents later divorced, and my father moved all 5 of us children to the States.  First, we lived in Washington DC, where I attended the French school for one year, and then soon enrolled in the local parochial school.  My childhood included ballet lessons, camping trips, art projects, and lots of neighborhood adventures with my best friend Lucia.

In high school, our family moved to Boston after my father changed jobs.  I spent 3 years at Brookline High School, where I was exposed to a broad palette of academic topics.  I knew that I loved science, so my father recommended I study Latin (the root of many scientific words).  However, I was also fascinated by Asian philosophy and art, so I started studying Mandarin.  I studied both for 3 years.

I applied to college knowing that I wanted not only a strong scientific program, but also the opportunity to continue my Mandarin studies.  Bridging both these diverse interests lead me to the University of Massachusetts at Amherst, where I majored in Microbiology.  My work-study job later evolved into a research opportunity that developed into my Honors thesis.  At the same time, I was also pursuing a minor in Asian Studies, and the opportunity came to be a member of the first group of ten American exchange students to attend Beijing Normal University (teaching university).  This was truly my dream come true, going to mainland China, as the country was slowly allowing westerners to visit.  I spent the summer in Taiwan to further improve my language skills, and then lived in Beijing at the University for one school year. I jumped on every travel opportunity that presented itself, and had some amazing experiences exploring parts of China where no foreigners had been to in many decades.  My language skills truly allowed me to have personal contact with the local Chinese which would otherwise not have been possible.  As the cliché goes, I learned more about myself in China than I did about the Chinese themselves, but this is the beauty of travel and stepping outside of one’s cultural comfort zone. I turned 21 years old in China.

Once I returned to the States, I matriculated and decided that I needed to spend some time with my French family.  I worked in Paris for a year, and traveled extensively throughout Europe.  I then returned to the States and lived in Palo Alto, doing research with a biotech startup company. During this time I was deciding what my next career steps would be.  Should I pursue medicine and apply for an MD, or should I pursue research and apply for a PhD?  Pursuing an MD was more in line with my overall goals, and two years later I was bound for medical school at UC Davis.

I knew that I wanted to pursue women’s health care.  I also was fascinated with the growing field of fertility treatment because it was a triumvirate of scientific, ethical and surgical frontiers, all of which resonated for me.  When I applied for residency, my mentor encouraged me to consider a new program at UCSF, which was a combination of residency and Reproductive Endocrinology (REI) fellowship. While this was a very big commitment to seven years of training, I knew after interviewing that this was a perfect combination for me.  Fortunately, I was accepted, and thus embarked on a long career at UCSF. 

I completed my residence, fellowship, and was on faculty at UCSF for a few years.  During this time, I was very active in basic science research investigating the role of endometriosis and fertility.  In 2000, I left UCSF and joined my 4 current partners at PFC.  We now have created a most unique fertility center, with a state of the art laboratory, dedicated and devoted staff, acupuncture center, research center, and a special combination of personal care with the benefit of input from the five MDs who are seasoned fertility providers. 

While I was a resident at UCSF I met my husband, who himself was an Internal Medicine resident.  After his Chief Residency year, he did a fellowship in Gastroenterology.  Fortunately we were both able to complete all of our training while staying in San Francisco, the city we call home.  We have three wonderful daughters who love adventure, travel, playing sports …… and while none of them will become doctors like their parents, all three have a giving heart and are involved in careers and activities of giving back to their communities.

When not at work, I enjoy time with my family, as well as good food and wine, foreign films, reading, photography, yoga, and just quiet times.

I am privileged to be in a profession where I touch so many people’s lives and dreams.  Every birth announcement is a reminder of this privilege, and every failed treatment cycle is a new commitment to do my best.

-Isabelle Ryan, M.D.

Born into a musical family, some of my earliest memories are of visiting musicians and musical instrument makers.  I was fortunate to meet Carl Geyer in Chicago, who built some of the world’s finest French horns.  His shop was full of raw materials, the valves, tubes, and bells associated with a French horn.  I watched as Mr. Geyer shaped them into beautiful instruments, ones that professional musicians from all over the world came to play.  For me, these visits became early lessons in craftsmanship, quality and personal responsibility.

My father, a conductor and horn player, expected each of his five children to play an instrument.  I turned to Oboe.  There are many stories about oboe players, mostly revolving around the fact that playing the oboe is a real challenge; the oboe being “an ill wind that nobody blows good”. 

However, I pursued the art and craft of the oboe and learned from some of the top master oboists and conductors of the day.  My instructors came from major symphony orchestras in Indianapolis, Cleveland and Chicago.  I met and was influenced by world renowned conductors and composers;  Leonard Bernstein, Aaron Copland, Dika Newlin, and Peter Shickele.  Working with masters you learn that, while there are many ways to accomplish a task, the path chosen must be done correctly and pursued with passion.

Many years have passed since I played in an orchestra, but those early experiences are still with me each day I practice medicine.  The symphony is a wonderful analogy to describe the work in our practice.   In an orchestra there are nearly a hundred individuals of diverse backgrounds, origins, and personalities. There’s a conductor at the helm, working the notes placed on paper by a master of composition.  The mastery and craftsmanship, performed by a unified team devoted to a single goal, using all the skills available to them, creates a performance of great beauty and power.

Similarly, at Pacific Fertility Center, the doctors compose a treatment plan and direct the team.  We give our staff the best of class tools.  Our staff orchestrates the performance; a highly talented group of people applying their best skills to the unique problems of each individual patient.  It is an honor to work with the patients that entrust us with their care. We continue to pursue the best in fertility technology and pregnancy rates.

On reflection, perhaps I became interested in fertility medicine because it gave me the same sense of structure, purpose and wonder as playing the oboe as a young student.  I was inspired by the announcement of the first pregnancy from in vitro fertilization. The application of medical technology to help a family achieve their dreams was a landmark event.  Controversy and hoopla ensued, but the truth stood clear, that a small baby – a new child – was held in its parents’ arms as a result.   For me, this was a momentous event that inspired me to attend medical school at Indiana University, residency in obstetrics and gynecology at the University of Pittsburgh’s Magee-Womens’ Hospital, and ultimately a fellowship in reproductive endocrinology and infertility at USC.

USC was a crucible of fertility technology.  Roger Lobo was performing extraordinary work on ovulation induction and PCOS.  Some of the pioneers of IVF and oocyte donation were rewriting the book on fertility care.  Lobo, Rick Paulson and Mark Sauer published the first report of oocyte donation in women over 40 years of age (New England Journal of Medicine, 1990).  The protocol diagram in that paper is my design.

After completing fellowship, I returned to Chicago to join Anne Wentz in developing the program for in vitro fertilization at Northwestern University.  Anne came from the Gerogeanna and Howard Jones Institute tradition, and was a real master of the embryo transfer.  We established a successful program synthesizing the best of East and West coast protocols, advancing the theory and practice of embryo transfer, developing new techniques for male fertility problems, and developing fertility preservation for endangered species. 

California called me back, and I joined Pacific Fertility Center (PFC) in San Francisco in 1991.  At PFC, I was fortunate to meet Dr. Herbert who later established The San Francisco Center for Reproductive Medicine.  Dr. Herbert’s vision of patient-centric fertility care was pioneering and contemplated my own interests in quality care.  In 1999, we carried this vision forward joining with Drs. Schriock, Givens, and Ryan from the University of California to form Pacific Fertility Center as we know it today.

Being an early member of the profession, I have been blessed with many opportunities to apply technology to patient care.  I developed an embryo transfer system with Danforth Biomedical and was awarded a patent, “Methods for endometrial implantation of embryos”.  We were early adopters of networking technologies in the early 1990s and developed one of the first fertility support websites, PacificFertilityCenter.com (at that time sfivf.com) in 1993.  My wife was responsible for the early work leading to FertilityWire.com, which continues today as an educational resource for patients.  Ongoing interests in genetics, fertility preservation, and imaging are leading to new developments that we will apply to clinical care in the near future.

Today I am a husband to a remarkable wife and three wonderful girls.  I have many outside interests in skiing, music, bicycling, and aviation.  I was pleased to receive a “Best Doctors in America” award and recognition in “America’s Guide to Top Obstetricians and Gynecologists”. Our entire family went to New York for the American Fertility Association’s Kokopelli Ball, where I received the AFA’s Family Building Award. 

One of my interests includes teaching young doctors that are contemplating their roles in the field, and I was asked to join the faculty at UCSF where I teach these bright young minds.  I am reminded of how unique our profession really is, seeing  it again through their eyes.  Reproductive Medicine has grown much since that first IVF pregnancy and I am proud to be part of its continuance into the future.

-Philip Chenette, M.D.