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Reproductive Medicine Center ranks high among nation's infertility programs

Since its inception in 1999, the Reproductive Medicine Center (RMC) has been amassing stories and statistics that demonstrate its outstanding performance.

Chelsea Korsh knows the value of the statistics, but she and her husband, Michael, have lived the RMC’s successes. Chelsea was diagnosed with ovarian cancer in 1997, one year before she was married. Doctors removed all of her left ovary and part of her right ovary. When she and Michael were unable to conceive “the natural way,” she consulted the RMC’s Theodore Nagel, M.D., on the advice of a friend. “Dr. Nagel made us so comfortable,” says Chelsea. “He was matter-offact, and he had vast knowledge. He was calm and confident, and thatmade us confident. We felt like we were understanding him and being completely understood at the same time.”

In less than a year, after a successful round of in vitro fertilization (IVF), Chelsea was pregnant with twins. She delivered Jane and Jillian on March 9, 2001, and exactly 18 months later, delivered twins Frank and Angela.

“Throughout the whole process, I felt that they were doing all they could do and were moving at the best pace possible,” she says. “With infertility, that’s critical because when you want a baby, every day that you don’t have one seems like a lifetime.”

Backing up success stories like the Korshes’ are the national statistics. In 2003 the Centers for Disease Control and Prevention reported that the percentage of in vitro fertilization cycles resulting in live births at the RMC was 48.6 percent for women under age 35—more than 11 percentage points higher than the national average of 37.3 percent.

Complication rates, typically indicated by the percentage of multiple births, also are considerably lower than the national average at the RMC. Although the rates of twins were comparable, the proportion of RMC patients under age 35 having triplets or more (3.4 percent) is about half that of the national average of 6.4 percent.

“Simply stated, we provide patients with an excellent chance of pregnancy,” says Mark Damario, M.D., medical director of the RMC and an associate professor in the Department of Obstetrics, Gynecology, and Women’s Health. “And our numbers regarding low rates of triplets or more are continuing to improve.” In 2004, 46.3 percent of RMC patients under 35 who underwent IVF delivered, and only 1.3 percent of them had triplets.

When asked about the secrets of the RMC’s success, Damario credits the expertise of the multidisciplinary staff. “I think that we work as a very good team,” he says.

Laboratory director Christopher De Jonge, Ph.D., agrees. “If there was a deficiency in any one discipline, our patients would not realize the successes they have had,” he says.

The program has been recognized for its high quality by its peers. That’s partly because the center transfers a relatively low number of embryos (an average of only 2.2 embryos for women under 35 in 2004) and still has high live birth rates.

“A lot of these outcomes are related to the degree of quality control and the quality process that occurs in our laboratories under the leadership of Dr. De Jonge,” says Damario. “He is continually striving to carefully check the conditions under which patients are receiving treatment.”

Along with De Jonge’s vigilance comes his and his colleagues’ dedication to research. Currently De Jonge is collaborating with several centers nationally and internationally to determine the effect of “broken” DNA in the sperm of men who are trying IVF with their partners; fertilization rates, embryo quality, and term births will also be measured as part of this study. He is also looking at the phenomenon of genetic imprinting in humans, specifically human embryos resulting from IVF, with researchers at the University of California, San Francisco.

In the meantime, Damario and Nagel are researching how long women undergoing IVF require hormone supplementation after their eggs are retrieved and fertilized. (Decreasing the duration of the hormone supplementation would decrease cost and discomfort, De Jonge explains.) Nagel is also heading a long-term study of IVF patients to enhance their and their babies’ treatment.

The Korshes keep in touch with Nagel and the RMC whenever they can. Chelsea has brought the four kids in to see the staff—” it was quite the sight to see,” she recalls—and often serves as a reference when families have questions about the IVF process.

“We are so grateful for all they have done, and my husband and I still talk about the care we received there,” she says. “From the second I walked into their office, I felt I was in good hands. More than three years later, I still feel the same way.”