As a doctor, my primary goal is to fix whatever is wrong with my patients, and since I’m an OB/GYN and fertility specialist, that usually means helping them get pregnant and have a healthy baby. Unfortunately, despite my best efforts and the best medicine and technology available, sometimes infertility issues cannot be overcome. In those cases, after the patient and I have worked through the utter frustration we both feel - usually with a healthy expression of tears landing on my shoulder – the subject of adoption comes up.

At the recent Jewish Connections forum – “What to Expect When You are Not Expecting” – hosted by Jewish Family & Children’s Service in St. Louis, Infertility & Adoption Support, Inc., Vice President Julie Lewis addressed the emotional difficulties patients face when deciding to pursue adoption. After candidly sharing her own struggles with infertility, including eight courses of intrauterine insemination (IUI), Julie confirmed what I always counsel patients considering adoption to do – do your homework and get ongoing emotional support. Not only do you have to work through what can often be a time-consuming and expensive labyrinth of adoption paperwork, home visits, etc., but you also must take the time to adequately mourn the loss of having a baby the way you envisioned.

It is a loss – don’t let anyone tell you anything else or make you think you shouldn’t feel the way you do. And just like any loss, you must work through your grief to be able to emerge stronger, maybe sadder, but ready to tackle the challenges and the joy of adoption. Look for organizations like Infertility & Adoption Support in your area, or even online support groups and forums. You can find more information regarding state-by-state online support at Adoptive Families, a national adoption magazine website, or Adoption.com. RESOLVE, the National Infertilty Association, also is an excellent resource for a variety of issues affecting those battling infertility.

Fertility Partnership can help you find the right adoption support resource for you should you choose to pursue adoption. Regardless of the means, our goal is to help you begin or complete your family, and we’ll do everything in our power to support your efforts to do just that.

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I was not surprised at one of the opening comments at the recent Jewish Connections forum by my longtime friend Dr. Diane Sanford, a nationally recognized psychologist. Dr. Sanford also is president and co-founder of the Women’s Healthcare Partnership, a fertility, pregnancy and postpartum emotional health counseling group in St. Louis. According to Dr. Sanford, various studies have shown that infertility can be as stressful as breast cancer for women. As I partner with women struggling with fertility issues every day, I am aware of the sheer depth and breadth of emotional pain women battling infertility can face. Dr. Sanford’s comments made me even more firmly believe that the body and mind must work together to overcome infertility.

Early on in my career, I learned the importance that must be placed on aligning the physical and emotional by focusing on believing fertility is possible. Emotional well-being and positive thinking may sound trite, but I’ve seen firsthand how depression and an “I give up” way of thinking negatively impacts fertility treatments. Why would an organism that perceives its surrounding as stressful or hopeless want to reproduce itself? It’s as if your mind prepares your body, especially your uterus, to “welcome” an embryo. Techniques such as visualization and meditation has helped many of my patients turn away from feeling “barren” and “empty.”  

It’s not always easy to reach out for emotional help, especially while undergoing fertility treatments. Maybe you don’t want to admit you’re feeling anything but positive, maybe you don’t feel as if you have time to do anything else other than medical care, or maybe you’re used to achieving your goals on your own and don’t want to admit that help is needed. Whatever the case, I can’t stress enough the importance of emotional health in the overall success of IVF or any efforts to get pregnant, as well as Fertility Partnership’s commitment to caring for the whole patient using whatever resources are necessary to nurture body, mind and spirit.

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Recently, I had the honor of speaking, along with a great panel of fertility, surrogacy and adoption experts, at a Jewish Connections forum – “What to Expect When You are Not Expecting” – hosted by Jewish Family & Children’s Services in St. Louis. Not only did I enjoy meeting those who attended and sharing more about medical advances in infertility, but I came away with an even stronger belief that infertility is an issue for the body, mind, and spirit and must be treated holistically to achieve the best outcomes.

There was so much great information communicated at the forum that I wanted to share it with those of you who couldn’t attend in person in my next few blog posts. Please let me know your thoughts on the panelists’ perspectives and how Fertility Partnership can help care for the whole person in the quest to begin a family.

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As Fertility Partnership gathers momentum, we’re continuing to use a variety of methods to spread the word about our clinic’s unique mission and services. I am thrilled that our second cycle has twice the number of patients as our first, but I still cannot help but wonder why OB/GYNs don’t more readily refer patients to fertility doctors. I have a unique perspective on this issue, because I am sure I am one of the few obstetricians who was engaged in IVF while also practicing general obstetrics and gynecology.

The fact of the matter is that many obstetricians don’t want to refer onward. Several reasons come to mind, most of them involving good intentions. First, they know how expensive advanced reproductive technology is and want to solve the problem for their patients much more affordably using simpler, less expensive measures. Some don’t refer because they simply enjoy being a doctor and want to be involved in the “healing process.” From personal experience, I can tell you there’s no greater thrill than calling a patient who’s struggled to have a baby and saying to them, “Guess what? You’re pregnant!”

I am sure there are those doctors who just don’t like admitting they don’t know what to do when a patient can’t get pregnant, so they simply say, “Well, let’s just give it a few more months.” Also, there sometimes is a concern that if they refer their patient out to a fertility doctor, the patient will never come back - their doctor-patient relationship will be undermined by the process, or the specialist will send the successfully pregnant patient to a high risk obstetrician or to another physician who is a better referral source.

In the end, precious months are often wasted. Clomid is given inappropriately, for the wrong reason, and for too long. With the recent study from the University of St. Andrews and Edinburgh University in Scotland that found a woman loses 90 percent of her egg quantity by age 30, we should all be concerned about not wasting valuable time. I built the Fertility Partnership with a goal of developing strong relationships with referring doctors so that many of the obstacles to timely reproductive care can be overcome. We will not price-gouge their patients, we will communicate well with the referring doctor and ensure the patients return to them if the patients choose to, and we will work with the doctors who want to solve the problems in their own practice. It’s just one of the reasons our name is Fertility Partnership.

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Our first cycle is just about over. Every patient made beautiful embryos, and every patient has a chance to realize their dream of having a baby. I cannot express in words the feelings of pride, satisfaction, and a host of other emotions that are running through me. Fertility Partnership is finally here. Our mission - deliver the best care possible in the warmest way and with the fairest prices.

Highlights of our first cycle:

--Our very first case was a donor case for an unusual reason - gonadal dysgenesis (The abnormal development of ovaries, which means that there are no or few eggs and sex hormones are not being produced).
--We transferred three phenomenal-looking embryos to a 40-year-old patient for whom the ovarian reserve indicators were not good, and we had a frank talk before her cycle about the chances of success. Given the beautiful embryos we transferred, however, the patient, her husband and I are all excited that they have a strong chance for a pregnancy.

--A PCOS patient who hyperstimulated when given a protocol for IUI, but did just fine with IVF and may have embryos to freeze.

Our week ended on another high with the KTVI-FOX 2 interview with Margie Ellisor. I went on prepared to speak about IVM - in vitro maturation of partially stimulated oocytes - but Margie was very focused on talking about our mission. It was exciting to hear her enthusiasm for our work and purpose. The funniest moment? When the KTVI viewers got a great chance to see the back of Fertility Partnership Embryologist Aaron Buck’s head!

As we wrap up this first cycle week, we’re staying in close contact with our current patients while evaluating and beginning to help our new patients. It’s been a long week but one of the most rewarding of my entire medical career.

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