In April of this year, Dr. Carolyn Givens attended the annual meeting of the Pacific Coast Reproductive Society in Palm Springs, California. This is a meeting attended by approximately 200 infertility specialists, embryologists, nurses and other fertility professionals.

At the meeting, Pacific Fertility Center’s study entitled “Outcomes of Natural Cycles vs. Programmed Cycles for 1390 Frozen Embryo Transfers” was presented by Dr. Givens in an oral presentation in the scientific portion of the meeting program.

Following the presentation, Dr. Givens was awarded the Society’s Practicing Physician Award for the best scientific presentation by a physician in full time private practice. Congratulations to Dr. Givens!

As a patient undergoing fertility treatment, the many months of testing, uncertainty and waiting had begun to take its toll. Dividing my life into two week increments no longer had the same hope and anticipation that defined my first few months of trying to conceive. Seemingly harmless questions from friends and relatives, like “So…any good news to report?” had become annoying questions that received a snappy response.

Attending the Mind/Body workshop was a valuable experience on many levels. We began the day with a tasty breakfast and coffee while we introduced ourselves and spoke briefly about our own experiences trying to conceive. PFC instructors Peggy and Allison presented the research on the stress/infertility connection, and spoke about the isolating nature of infertility. Because the topic of infertility is not openly discussed in social situations, the person or couple going through treatment often lacks social support.

Next, we were introduced to relaxation techniques, which Allison and Peggy call “Minis” because they are short and easy to incorporate into daily life. We lay on yoga mats in a darkened room and slowly counted our breaths, letting go of the tension in our arms and legs. We were led through some basic tai chi moves, and then ended with a guided relaxation that put me immediately to sleep.

After a delicious lunch the discussion moved to the cognitive distortions that frequently emerge during stressful periods and cause people to magnify their problems. Peggy and Allison led us through some cognitive restructuring steps, which can help identify a true thought versus a magnified and distorted fear.

Questioning negative thought patterns is a difficult but extremely helpful way to take some of the blame off of myself and ease the level of stress I was feeling. Hearing that others had the exact same thought patterns as I did was also extremely reassuring and made me feel as though I was not alone in my challenging journey.

The next part of the day was my favorite. We learned a variety of yoga postures that can easily be done in a desk chair or in front of a computer. My co-workers may think I look funny, but I have been contorting myself at my desk ever since, and found that it truly does relieve the physical stress of staring at a computer all day, and provides me with a nice mental break before I start a new task.

After another guided relaxation session, which again left me in a deep sleep, we convened as a group to review the day. Peggy asked us to think about what brings us joy, and how we incorporate those things into our lives. As I looked around the room, most people were smiling as they wrote down the things that bring them joy – everything from pets, partners and family to bubble baths, traveling, and good food.

As we finished the day with questions, answers and good-byes I left feeling refreshed from my mini-naps and excited to have some tangible skills to utilize whenever I find myself too stressed to relax. From our very first discussions over breakfast to our final activity, I felt the isolation of my own stressed out perspective melting away. I’m grateful that I attended the Mind/Body workshop, both for the feeling of community and the concrete relaxation skills I came away with.

The Mind/Body Workshop was an invaluable experience. I came away feeling like I had:

• Gained tangible relaxation and yoga skills that I can use in my daily life.
• Decreased feelings of isolation and anxiety.
• Finished the day feeling calm, centered and ready for my journey to parenthood!

Erika Linden

Infertility can cause extreme feelings of stress and isolation. From diagnosis to treatment, the stress of infertility can affect every area of life including marriage, job, and family relationships. Pacific Fertility Center’s Mind/Body Workshop is designed to address the emotional and physical strain caused by infertility treatment and the far-reaching effects it has on one’s life. These workshops are run by Pacific Fertility Center’s Peggy Orlin, MFT and Allison Chamberlain, RN, who were both trained by Alice Domar, PhD, a Harvard Medical School expert and pioneer in the subject of the mind/body connection to fertility. The next Mind/Body Workshop will be held on September 8th. Please call 888-834-3095 for class information, fees and your registration form. This one-day workshop is a loving and supportive environment in which you can gain self-awareness and practice techniques that will give you strength as you travel on your journey.

- Allison Chamberlaine, Mind/Body Instructor and Clinical Coordinator The workshop provides people with a safe space to learn relaxation techniques and to connect with others that know how difficult the infertility experience can be.

- Peggy Orlin, Mind/Body Instructor and Marriage and Family Therapist

Tuesday February 1st was a busy day here at Pacific Fertility Center. The front office was busy with their usual patient appointments, comings and goings for consultations, ultrasound scans and blood draws. In the procedure area and the lab, we were having one of our busier days, with 7 retrievals, 5 fresh embryo transfers and 1 frozen embryo transfer scheduled. It’s rare for us to have so many procedures on a single day, but because the exact date of a patient’s retrieval is uncertain and depends on their response to stimulation drugs, we get a day like this a few times per year. Fortunately, PFC has an exceptionally large and well-equipped laboratory, so we can cope easily with variations in case load. Also, both our nursing and embryology staff schedules are flexible enough to allow us to schedule extra staff when necessary. On that Tuesday for example, we had 8 of our 9 embryologists on duty in the lab

Even though most patient appointments don’t happen before 8 AM, lab and nursing staff are here between 7 and 7:30 in the morning to open up the facility and perform the usual quality control (QC) checks before the work day can begin. In the lab, once all QC and start-up procedures have been completed and documented, we begin looking at embryos that are to be transferred that morning, thawing frozen embryos for transfer, evaluating fertilization for the previous day’s patients, retrieving eggs and processing sperm samples. The nursing staff is busy checking in patients for retrievals, doing all their pre-operation checks and setting up IV bags, and coordinating patients for embryo transfers. Mornings are definitely our busiest time; we do this every day (7 days a week) so we like to think that the work flows smoothly.

At approximately 8:30 AM, right in the middle of the action, the power to our building and to those in a 10-block radius, went out. When a power outage occurs, there’s a split second when everything goes dark, but before you can think about it, emergency power kicks in and we almost seamlessly continue working. However, as part of our procedures for disaster preparedness, we have protocols for working during a power outage, and these immediately become active. First we check our emergency power generator and then all vital equipment to make sure that everything has power and is functioning normally. In the lab, one of our 15 incubators reset itself and went into calibration mode, so we simply moved its contents to a new home. No other problems or incidents occurred that day. We completed all retrievals and transfers in the usual way and our biggest concern was simply wondering why the power had gone out.

On the nursing end, patients were escorted up and down 5 flights of stairs because the elevators shut down, but otherwise their day was uneventful.

Emergency procedures and back-up power are a vital part of our operation. Our emergency generator will run our facility for 36 hours, or longer with the addition of diesel to the tank. The generator gets a 30-minute test run and an inspection every week. It receives a full service a minimum of 4 times a year and immediately after any power outage. After this instance, a service technician checked the generator and refilled the tank.

In the event there is a power failure when no one is present, the system will automatically switch over to back-up power. The alarm system in the lab then proceeds to dial each embryologist in turn on his or her home and cell phones until the call is received and verified with a code. All vital equipment is alarmed which enables us to check the status of the equipment from a remote location. We also have auditory monitoring capability and can listen to the background noise in the lab (such as a fire alarm) at any time. If it is necessary, we are prepared to have an individual physically present in the lab within 30 minutes of getting an alarm call.

Embryos and sperm in freezers don’t actually need power at all, provided that we physically fill the cryo tanks with liquid nitrogen once or twice a week. The computers that usually monitor and automatically fill these tanks do need power of course, but they are not essential to maintain refrigeration.

On February 1st, power was restored after 90 minutes, however we never know the time or duration of a power outage. At Pacific Fertility Center, we remain well rehearsed and prepared, just in case it happens on the busiest morning of the year.

I emigrated from Uzbekistan to America with my parents and two daughters (Isabella and Elina) in January of 1996. It was a bittersweet experience to leave behind my home, my friends, and my profession, but I was giving my children the ability to pursue a better future. Adjusting to the change would have been a lot more difficult if it weren’t for the US government organizations that helped my family financially. Also, we were lucky enough to arrive to San Francisco – the best city in the world. We all fell in love with San Francisco at first sight. At the same time we recognized that we have to work hard to be worthy residents of this beautiful city and country.

Though I immensely enjoyed working as a criminal defense lawyer in Uzbekistan, I did not have the time to simultaneously get a U.S. degree in law and support my two children. Therefore, I went to study medical billing and had my first job at Complete Medical Billing. I later accepted a job at a dental office where I honed my medical billing skills further. Several years later, I joined Pacific Fertility Center, which has and continues to be an interesting and enjoyable experience with a friendly environment. Though I am merely a medical biller, I still have a lot of pride working in a company that gives families the gift of life. I have been very vocal about my job because I feel that PFC is an invaluable company and I am grateful to be a part of it.

On a personal note, my daughter Isabella is working as a business analyst and has a four-year-old daughter who I love and of whom I am immensely proud.

Elina has just finished her freshmen year at USF and plans to pursue employment law in the future. After living in America for eleven years, I have not come to regret my move. It has presented my children with opportunities both on a personal and academic level, has made me a stronger person, and has widened my ability to uphold Jewish holidays more openly than I was capable of doing in Uzbekistan.

I look forward to many more years at PFC and appreciate the skills I have learned and the people I have met.

Asya

DonateYourEggs.com

Pacific Fertility Center provides an in–house egg donor agency as a convenient way for our patients to find carefully screened egg donors. Our Egg Donation Agency is always looking for new egg donors to add to our registry. Do you know a college graduate, a student, a young professional or an exceptional woman who might be willing to make a life-altering difference? She could be a young woman who has chosen to delay childbearing or has decided to be childless and wants to help others become parents, or she could be a mother who wants to share the joy of parenthood through the gift of egg donation.

Please send them to our agency’s Egg Donor website. The website has more information about becoming an egg donation and also has an online application.

Please note: Because age is a critical factor in the success of IVF with egg donation, egg donors must be healthy and between the ages of 21 and 29.

Click here: PFC Egg Donor Agency for information about the services we provide egg donor recipients.

From time to time, PFC has visitors to the Center wishing to learn more about the field of infertility. We have had medical students from UCSF, visiting reproductive endocrinologists from Europe, and most recently, an acupuncturist studying for her doctorate in Traditional Chinese Medicine (TCM).

Heidi Kao is a licensed acupuncturist and herbalist in San Francisco and a student at the American College of Traditional Chinese Medicine, one of only 8 colleges accredited to award a doctoral degree in the U.S. She is also involved in teaching other TCM students at the college.

Her private practice is specialized in women’s health and chronic pain management, as well as an entire range of ailments. She is now interested in learning more about the Western medical approaches to infertility to better serve her infertility patients. Heidi is spending a minimum of 12 hours per month at PFC, working primarily with Dr. Givens. She is observing everything from initial consultations to ultrasound monitoring and inseminations as well as all the in vitro fertilization procedures performed at the Center. She is also spending time in the IVF laboratory, familiarizing herself with the behind-the-scenes activity of the lab.

We are also learning from Heidi. She is providing literature on the practices of TCM with regards to improving fertility. She has developed a survey for the Center in order that we might know more about how many of our patients are using complementary TCM in conjunction with their fertility treatments here. She is also involved in demonstrating her practices to the staff at the Center.

Please welcome Heidi if you see her around the office during the next few months.

Carolyn Givens, MD

My Name is Rosemarie S. Tagle. I am the billing manager at Pacific Fertility Center. I was born in the Philippines, the youngest child in a family of six children–three boys and three girls. Our parents brought us to America to seek a better life and for better opportunities. We immigrated to the U.S. when I was only three years old. We were fortunate that our father served in the United States Armed Forces during World War II because this gave him preferential treatment; we were classified as non-quota immigrants and were able to come to the U.S. without any problems; others weren’t as lucky.

In 1967, my family sailed to the United States on the USS Cleveland Cruise Ship. At the time, with six children in tow, it was the most economical way to travel. The journey took us nineteen days. We disembarked at Pier 37 in San Francisco. Waiting for us was our father who arrived a year earlier to get settled and prepare for our arrival. We have remained in San Francisco ever since.

I chose a secure career in the health care field and obtained my Medical Assistant certificate at Bryman College in San Francisco. My first job was working in an Ophthalmology practice. It was a one-physician office with a receptionist, the doctor and me. I enjoyed being a Medical Assistant; however, when a position for Office Manager became available in the Ophthalmology practice, I was ready for more challenging work. I applied for and was offered the job and stayed with that practice for the next fifteen (15) years.

The practice grew during those years from just two to a total of nine employees under my management as well as an addition of an Optometrist and an Optician. Eventually, the office expanded to include the first Optical boutique in San Francisco. Sadly, I left the practice in 2000 after Dr. Leon B. Metz, Jr., the physician for whom I worked, developed cancer and passed away. I was devastated. Dr. Metz, along with his wife and children, became my close friends over the years. I credit Dr. Metz for teaching me the ropes of running a practice well and helping me grow. Though I had the opportunity to continue to work at the office, I decided that it was time to move on.

Shortly after my decision to leave, I heard of a job opportunity at Pacific Fertility Center. At the time, I knew little about IVF or other fertility treatments, but it sounded like an interesting place to work. In 2001 I joined the PFC team. Although I knew it would be an adjustment moving from a small office to a larger one, it did not take long for me to realize that I was going to enjoy working at PFC.

On a personal note, I am the mother of two children; my daughter is 23 years old, and my son is 20 years old. My daughter is a nursing student at San Francisco City College. My son is in the process of obtaining his Barber license and is hoping to open his own shop. I also have a five-year old granddaughter who is in kindergarten and is my pride and joy. During my free time, I take ballroom and Salsa classes, and occasionally have the opportunity to perform.

I also enjoy taking classes at San Francisco City College where I recently obtained an A.S. degree in Administration of Justice/Criminology and a certificate in Forensic Science. I came to this new degree in the process of trying to help a relative who was in trouble with the law. My family and relatives were struggling to understand what was happening, so I became the family’s resource for “information interpretation” and stepped in where I could to help during the justice process.

I have learned so much since I started at PFC six years ago. Working here has been a very rewarding and challenging experience. Being the financial manager allows me to see first hand the financial sacrifices that couples and/or individuals make on their journey to becoming parents. I am proud to be a part of a team that can help fulfill that dream. I admire and respect each of the physicians, as well as the rest of the PFC team for their total commitment and dedication to providing the best possible care to patients without reservation. I feel very fortunate to be a part of this team and to be working towards the same goal. Being a manager in any medical practice is always a good way to help people, but this practice is special. We are in the business of giving the gift of life.

Rosemarie S. Tagle

Pacific Fertility Center Team
Left to Right: Front: Philip Chenette, MD, Isabelle Ryan, MD, Carolyn Givens, MD
Back: Joe Conaghan, PhD, Carl Herbert, MD, Eldon Schriock, MD

2006 IVF Pregnancy Rates
Pacific Fertility Center is pleased to share our in vitro fertilization (IVF) pregnancy rates for 2006. Our outstanding in vitro fertilization pregnancy rates are made possible thanks to our team of ABOG board certified specialists in Reproductive Endocrinology and Infertility and highly trained embryologists.

Pacific Fertility Center’s investment in enhanced methods of embryo culture has improved outcomes with in vitro fertilization. New incubators, culture media, and procedures have increased embryo quality and embryo implantation rates. Each embryo has a higher potential to produce a pregnancy, which allows us to transfer fewer embryos, reducing the risk of higher order multiples.

Our technology offers better pregnancy rates with fewer numbers of embryos transferred. Based on this improvement we are instituting a new emphasis on single embryo transfers and expect to significantly reduce the risk of multiples and achieve our goal of “optimal” pregnancy outcomes.

2006 Highlights:
• Pregnancy Rates with Day 5 (Blastocyst Transfers) – Selecting day 5 (blastocyst) fresh embryo transfers, we achieved a 59% pregnancy rate per transfer for women under age 35 using their own oocytes. As remarkably we achieved a 49% pregnancy rate per transfer for all women under age 43 using their own eggs.

• Outstanding Oocyte Donation Pregnancy Rates – Oocyte donation pregnancy rates are one of the best indicators of an outstanding IVF laboratory. Last year we achieved a 73% pregnancy rate per transfer for fresh day 5 transfers in women using donated oocytes. As not all donor oocyte recipients used a day 5 transfer, the combined pregnancy rate for all Day 3 or Day 5 fresh embryo transfers was an outstanding 66%.

Notes on Pacific Fertility Center statistics:
1. Pacific Fertility Center does not restrict IVF to only those patients most likely to succeed, (a practice which often leads to higher pregnancy rates). Our less restrictive approach is confirmed by our high percentage of Decreased Ovarian Reserve, DOR (a basal FSH level of 10 mIU/mL or higher). As reported by SART/CDC in 2005, 24% of PFC patients were diagnosed with DOR.

2. PFC performs a substantial volume of IVF and oocyte donor cycles. This allows for better statistical accuracy of our data, (the fewer number of patients – the less statistically significant the rates become). We feel it keeps all of us well attuned to the practice of ART.

3. Although we individualize treatment to each patient’s diagnosis and prognosis, our goal is to adhere to ASRM guidelines on the maximum number of embryos to transfer, in order to lower the risk of high order multiples.

The American Society for Reproductive Medicine’s (ASRM) annual meeting was held in New Orleans. It is the largest meeting for reproductive medicine specialists and scientists in the world. From our practice, Dr.s Givens, Schriock and Conaghan attended, as well as embryologists Jean Popwell, PhD and Jennifer Andres. Also, PFC nurse Allison Chamberlaine and PFC’s Marriage and Family Therapist Peggy Orlin attended. In addition, the genetics counselor with whom we work closely, Lauri Black from California Pacific Medical Center, was an attendee and active participant.

PFC’s embryologists attending ASRM’s research poster session Jean Popwell, PhD (left) and Jennifer Andres (right).

Single-Embryo Transfer: Minimizing Risks & Maximizing Outcomes
Dr. Givens attended a post-graduate course entitled “Moving Toward Single-Embryo Transfer: Minimizing Risks and Maximizing Outcomes.” This two-day course dealt with a pressing issue in assisted reproduction: the high incidence of multiple gestations. With the ever-increasing success of in vitro fertilization and the significant improvement in embryo implantation rates, the incidence of twin and higher-order pregnancies has risen dramatically in this country. Many countries now regulate the maximum number of embryos that can be transferred into the uterus at one time. The course topics included a summary of optimal medication protocols, several lectures on pre-cycle evaluation and testing and embryo transfer techniques.

Oocyte Freezing, PGS & Blastocyst Embryo Transfers
On the laboratory side, there were several talks on evaluation of eggs and embryo selection techniques, embryo freezing technology, including a debate about the usefulness of pre-implantation genetic screening (chromosome analysis of embryos) embryo selection. The combination was a fascinating mixture of new ideas, refinements in current technology, as well as a welcome opportunity to network and discuss with others the latest developments in reproductive science. Topping the list of presentations in New Orleans were those concerning the continuing refinements in oocyte freezing technologies, the more selective use of preimplantation genetic testing and the ongoing scrutiny of blastocyst stage embryo transfers.

Slow-freeze vs. Vitrification
The traditional slow-freeze technology used so successfully with embryos for many years, has essentially stalled with oocyte freezing. It appears the slow-freeze technology has finally met its successor: a process called vitrification. Slow freezing has had very limited success with oocytes due to their large size, high water content and their extreme sensitivity to cryoprotective chemicals and to changes in temperature and pH.

Vitrification, a technology that cools cells so rapidly that ice does not form, has been such a success for oocyte freezing that many labs are now abandoning slow freezing altogether. Here at PFC, we have been developing protocols for oocyte vitrification throughout 2006 and are actively working on blastocyst vitrification. It was reaffirming to see that this technology has gained wide acceptance, and is showing excellent results.

Preimplantation Genetic Screening (PGS)
While vitrification is on the rise, it was interesting to see that another technology, Preimplantation Genetic Screening (PGS), was lacking in new improvements or viable alternatives. Embryos have been screened for extra or missing chromosomes for over 15 years now, but the technology has not advanced significantly over that time. It is still possible to count only 12 chromosomes in an embryo. Although the error rate per chromosome is very low, the accumulated error rate becomes significant as we count more chromosomes. PGS was “under the microscope” in several presentations in New Orleans and it appears PFC’s limited use of genetic screening is well justified. Specifically, PGS does not improve embryo selection and pregnancy rates in younger patients. Its use is limited in older patients because there are often too few embryos available to justify testing. The patients who benefit most from PGS are the younger patients who experience recurrent miscarriages. However, unless there is evidence that previous pregnancies were genetically abnormal, PGS may provide limited benefit to this group.

Blastocyst stage embryo transfers
While younger patients (those under 35) don’t benefit from PGS, they are the patient population most likely to benefit from blastocyst transfers. Culturing embryos for 5 days to the blastocyst stage, instead of the more traditional day 3 embryo transfer, is one of the main ways in which the laboratory staff can help in selecting the “best” embryo for single embryo transfer (SET) patients. Blastocyst culture techniques are well refined now and support the commitment within the community to transfer fewer embryos at one time. Furthermore, the promise of vitrification can reassure patients that their remaining embryos can be stored indefinitely when preserved at the blastocyst stage. Several presentations showed that blastocysts which were vitrified early, before their cavity (or cyst) had expanded too much, benefited most from the technology. In more advanced blastocysts, artificial reduction of the cavity gave superior results. It may not be long before vitrification is the procedure of choice for preserving all blastocysts.

2006 ASRM guidelines for numbers of embryos to transfer
The new 2006 ASRM guidelines for numbers of embryos to transfer were presented. See Tables 1 and 2 below.

The topic of whether or not federal or state legislation should regulate the maximum number of embryos to transfer was also discussed. Many people in the general public support such legislation but those of us in the field (and most patients) are opposed to the government regulating medical practice and arbitrarily setting limits on embryo transfer. In order to forestall such legislation, it is obvious that we must decrease the number of twin gestations (the number of triplet and higher-order gestations has already dramatically decreased in the last 5-7 years). At Pacific Fertility Center we have instituted a new emphasis on single embryo transfers and expect to significantly reduce the risk of multiples and achieve our goal of “optimal” pregnancy outcomes. (See From Us to You in this issue for a discussion of our 2006 statistics and please see Conception Health in this issue for a discussion of why it is important to try to achieve single baby conceptions.

– Carolyn Givens, MD and Joe Conaghan, PhD

Who am I?
Hello my name is Elizabeth Zeiter and I was born and raised right here in Northern California. I come from a family of doctors and health professionals, so naturally I had a desire to study medicine too. The summer before college I attended a National Youth Leadership Forum on Medicine where I confirmed my interest in the medical field. That fall, I began my life journey on the road to become a doctor at the University of California at Davis. For two years I studied math and science. At the end of a stressful second year, I knew that I needed a break, so I decided to take a quarter off and explore my other passion. I have always been drawn to people and their cultures. My new schedule consisted of history, sociology, anthropology and international relations classes. This gave me an opportunity to learn and understand the many backgrounds and traditions of the diverse people with whom I lived with and attended classes. It was at this point that I decided to go down a different path. I received a Bachelor’s degree in International Relations. My last year of college I began an internship with the American Cancer Society promoting a breast cancer early detection program with the Latina community of Yolo County. I was hired full time right out of college and worked until the grant funding ran out. I took advantage of my time off and decided to travel and explore Europe.

How I found PFC?
Back from Europe, fresh and ready to join the work force again, I began an optimistic hunt for a job. I knew that I wanted a position that would both satisfy my passion for medicine and love for humanity. So I went from job interview to job interview and no luck. I decided to temp for a while and continue to job hunt. I stumbled across a position at PFC. I did not know much about IVF, IUI and egg donors, but it sounded interesting. After meeting Dr. Ryan and Dr. Schriock, I knew that this was the place for me.

My Experience at PFC?
My experience at PFC has been very rewarding. I am surrounded by compassionate people working towards our one goal, helping patients build a healthy family. As Program Manager of the Egg Donor Agency, I have the opportunity to work with both egg donors and recipients. My position allows me to learn a great deal about medicine and technology and permits me to share my compassion for humanity with people from all over the world who desire to expand their family. Most importantly, I am at a job where I leave at the end of the day with a big smile because I have made a difference in someone’s life.

On a more personal level?
If I am not at PFC, I am taking off on a new adventure somewhere around the world to places I have never been before. I also love to volunteer my time to various charities and enjoy participating in group trainings for full and half marathons that raise awareness and money for a variety of special causes.

– Elizabeth Zeiter is Manager of Pacific Fertility Center Egg Donor Agency which is located in the same building as our fertility center. Ms. Zeiter facilitates the egg donation process for current and prospective egg donors and is readily available to answer donor and recipient questions regarding the egg donation process. She assists recipient patients with the process of choosing an egg donor, as well as coordinates communication between the Egg Donor Agency and the medical clinic.

UPDATE: Elizabeth is no longer the manager of the PFC EDA. For information on the current program director, Daragh Castaneda, click here. We wish Elizabeth luck in her all of her endeavors now that she has left the PFC family