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In June, RSC Bay Area IVF clinic co-founder Dr. Donald Galen met with some of his first success stories, Elizabeth Castro and Brian Strickland, at the clinic’s 25th anniversary celebration. Now, the fertility clinic is looking to continue celebrating by adding an online photo gallery of some of the more than 4,000 healthy babies they have helped couples conceive since 1984.

The Success Stories gallery on RSC Bay Area’s Facebook page, shows the miraculous results of hard work and persistence by parents who were once frustrated only to have their family dreams come true. An online photo gallery showing happy babies and healthy children may also help to inspire others to make it through the often tough times of infertility.

“Our first babies have grown up and no doubt scattered far and wide,” said Galen, adding that he wants to reconnect with previous patients to study the impact of IVF on their lives. And while many of the children may be living around the country or in some cases around the world, the photos give them a chance to see their shared background experience.

RSC Bay Area’s journey began 25 years ago when the clinic made medical history with some of America’s first “test tube babies.” In 1986, Travis McCullar became only the second baby in the United States born from a frozen embryo. One of Galen’s first successes, 24-year-old Elizabeth Castro was the first lab-conceived baby in the East Bay area. Once considered to be controversial medical miracles, babies born through in vitro fertilization are now bonded primarily by their parents’ great relief and the fact that they are never accidents. Let us share the joyous result of your medical miracles through your baby photos.

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Paternal age and obesity diminish fertility

SAN RAMON, CALIFORNIA – Infertility physicians at Reproductive Science Center of the Bay Area have found that their male patients follow the findings of a recent study that indicated sperm quality begins to deteriorate after age 35.

According to the new study reported in the Aug. 1 issue of Obstetrics and Gynecology, sperm quality starts to go downhill after age 35 and indicates that paternal age is a significant risk factor for miscarriage. The study of almost 14,000 pregnancies, conducted by Dr. Karine Kleinhaus of Columbia University, showed that women with partners ages 35 or older had nearly a threefold increase in spontaneous abortions compared with women whose partners were younger than 25.

“Many of the male patients we treat were married later in life or in the course of their second or third marriages found they were unable to conceive–even if they had children from a previous marriage,” says Dr. Kirsten Ivani, IVF lab director of the Reproductive Science Center of the San Francisco Bay Area (RSC). “Sperm quality is clearly impacted as child-bearing is increasingly delayed – for both men and women. It is already well documented that fertility declines because of a limited number and quality of eggs for women as they get older, so this is research should alert men to similar issues.”

It may be that the clock ticks even faster for overweight men. New research from the National Institute of Environmental Health Sciences showed that men with increased body mass index (BMI) were significantly more likely to be infertile than normal-weight men. A 20-pound increase in men’s weight may increase the chance of infertility by about 10 percent. The majority of men who participated in the study were more than 30 years old. Obesity affects nearly one-third of the adult American population (approximately 60 million).

According to the American Obesity Association, the number of overweight and obese Americans has continued to increase since 1960, a trend that is not slowing down. The Columbia research found that the risk of miscarriage of a fetus conceived by a father over age 40 was 60 percent greater than if the father were 25 to 29, irrespective of other factors that have been linked with increased miscarriage risk, such as the mother’s age, maternal diabetes, poor maternal health and smoking during pregnancy. The increased risk of miscarriage does not just apply to fathers in their 40s, however. The miscarriage risk in a pregnancy involving a father aged 35 to 39 was three times higher than the risk if the father were under 25.

Data from the study showed that 1,500 of the women suffered miscarriages, while 12,000 carried their children to term. “This new study provides important information for people – of all ages – who are planning their families,” says Dr. Ivani. “It means that men should be sure to get the medical attention they need to uncover medical problems underlying infertility.”

In fact, the American Society for Reproductive Medicine (ASRM) has set an upper age limit of 40 years old for semen donors because of the increased risk of genetic abnormalities in the offspring of older fathers. According to the ASRM, infertility is a male problem 35 percent of the time; a female problem 35 percent of the time, a combined problem of the couple 20 percent of the time, and the final 10 percent is unexplained.

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“Fertile Awakenings” program one of a handful nationwide interlinking traditional western and alternative fertility care

SAN RAMON, CALIFORNIA – This month the Reproductive Science Center of the Bay Area, one of nation’s oldest IVF practices, launches “Fertile Awakenings,” one of the first programs to provide coordinated care by a team of traditional western fertility specialists and complementary and alternative medical practitioners.

Though the medical community is divided about complementary and alternative medical approaches to infertility, many patients have been using them successfully. However, it is rare for their care to be coordinated between all medical providers.

The program includes a panel of RSC physicians and the Fertile Awakenings team of alternative practitioners, who will review infertility treatment for patients on a case-by-case basis. When appropriate, they will recommend complementary treatment to be offered at RSC clinics as well as other locations, such as acupuncture at RSC’s Orinda clinic, mindfulness training and stress reduction courses at RSC’s San Ramon location, confidential phone coaching, and uterine massage and nutritional counseling at Harmony Acupuncture.

“It is becoming more common for infertility practices to offer a multidisciplinary approach, integrating western and eastern medicine, along with a Mind/Body program. There is some evidence that this combined approach may improve success for some couples,” said Louis Weckstein, M.D., IVF and Medical Director of RSC. “A collaborative program that addresses the stress as well as the medical aspects of infertility care more raises the bar for fertility care,” said Weckstein.

“Helping to manage the brutal stress and emotional rollercoaster of infertility can go a long way in supporting medical treatment for infertility,” he added.

More patients like Lidia Gutierrez, a 39-year-old San Ramon engineering consultant who is completely healthy but having difficulty getting pregnant, are using acupuncture while undergoing in vitro fertilization (IVF). “When Dr. Weckstein showed me the research on superior pregnancy rates for patients who used both methods, my husband and I agreed it was the best way to proceed,” she said. Gutierrez began acupuncture treatments in June in preparation for her first IVF cycle in August. Some studies show acupuncture increases the success of embryo implantation as well as improves relaxation and reduces stress.

Most fertility experts agree that reducing stress is key for many of their patients. Stress signals the pituitary gland that the body is in trouble, which can slow the release of the luteinizing hormone, which in turn triggers ovulation. Even if ovulation occurs, a shortage of the luteinizing hormone could mean a lower level of progesterone, a hormone necessary to nourish and sustain an embryo’s implantation.

Infertility patients who have endured many months or years of frustration may have low emotional reserves and benefit from the emotional support of a professional coach. Research showed that couples who participated in group counseling sessions were more likely to get pregnant than couples who did not. The Fertile Awakenings coaching program also helps patients navigate the stress of decision-making regarding complex treatment options, such as determining which assisted reproductive techniques are appropriate, when to consider use of a donated egg or sperm, a gestational carrier, or cease treatment and consider other choices.

Separate German and Chinese studies of 160 women combined who used assisted reproductive techniques, as reported in the April 2002 issue of Fertility and Sterility, found that 42.5 percent who included acupuncture with their treatment achieved pregnancy compared to 26.3 percent who did not use acupuncture. Other studies have shown that sperm quality benefits from acupuncture treatment as well.

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Many of the first “IVF babies” were born amidst ethical concerns over the ‘brave new world’ technology that became commercially available in the mid-80s. RSC fertility specialists like Dr. Donald Galen, who began his practice in 1975, have been leaders in developing the reproductive technology that has enabled a steady stream of medical breakthroughs and “greater freedom for individuals to alter their reproductive lives,” said Galen, who is now surgical and research director of RSC.

The past 25 years have put his “maturing but still-young medical specialty” under a wholly different kind of lens than was the case when Galen helped the family of Travis McCullar of Livermore. In 1986 when McCullar was born in Walnut Creek, he was the nation’s second successful transfer of a previously frozen embryo into a mother’s uterus. “In those days I was frequently involved in live televised debates with medical ethicists on the news of Travis’ birth!” recalled Galen.

Early infertility practice by specialists known as reproductive endocrinologists, i.e., OB/GYNS who completed years of advanced training in reproductive endocrinology and infertility, related primarily to tubal surgery for women, which wasn’t very successful, said Galen. “Once we were able to retrieve eggs vaginally to use for IVF, the field changed radically. The births of the first IVF babies turned the world upside down, and it was terribly exciting,” Galen said.

“Fortunately, much of the initial concern about test-tube babies, cloning, and designer babies has been assuaged by the medical benefits of reproductive technology. From gender selection to deciding who has rights to be parents, we probably will always face unresolved issues around embryo technology both within the medical community and society at large,” he added.

In recent decades, advancements in embryology technology have dramatically improved IVF pregnancy success rates and healthier babies. In vitro pregnancy rates continue to soar far beyond those in the first decade of IVF, when most women had a 5 to 10 percent chance of conceiving through IVF. (Today, the national average is better than one in three.) The development of intracytoplasmic sperm injection (ICSI) in 1993 allowed for the treatment of male factor infertility, and recent successes with egg freezing and embryonic genetic screening have been embraced by thousands of couples who not long ago would likely have not been candidates for IVF.

Below is a summary of recent developments and issues that Galen said are shaping both medicine and society today:

Reduction of multiple births

The trend toward more single embryo transfers particularly for older women to improve success rates and avoid the complications associated with multiple births. Currently, physicians routinely transfer two or more embryos for women that are 35 or older. The future of reproductive medicine is focusing on improving techniques for growing and selecting the best quality embryos.

Cryopreservation

Science may give women of the future greater ability to postpone marriage and family even more with newer approaches like vitrification. With traditional slow-freeze techniques, the egg is stored in liquid nitrogen until it is ready to be thawed and fertilized. On the other hand, vitrification fast freezes the egg, which prevents the formation of ice crystals in the egg. Ice formation is dangerous because it may rupture the cell membranes causing cellular destruction. Early studies have shown improved survival and pregnancy rates with the vitrification process.

Embryonic disease screening

Pre-implantation genetic diagnoses (PGD) allows physicians to screen embryos for genetic diseases, such as cystic fibrosis and Tay-Sach’s disease, prior to IVF. The number of diseases detectible by PGD is growing geometrically and now numbers in the hundreds. The technique can be also be used to select embryos of one gender in preference. It may be possible to make other “social selection” choices in the future as well. “However, as genetic testing becomes more sophisticated it poses ethical issues about creating ‘designer babies.’ And as many colleagues ask, just because we can, should we?” poses Galen.

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“Wanted: Pioneer IVF Babies: Are you One?” RSC celebrates 25th anniversary by re-uniting up to 280 of America’s oldest “test-tube babies” in June

SAN RAMON, CALIFORNIA, (February 12, 2009) – To celebrate its 25th anniversary as of the one of the nation’s first private IVF clinics, the Reproductive Science Center of the San Francisco Bay Area (RSC) announced today the launch of “Wanted: Pioneer IVF Babies. Are You One?” – a nationwide six-month campaign to attempt to reconnect with nearly 300 of their first success stories, conceived in the years 1984 through 1986.

Established in 1983, just two years after the first successful birth through in vitro fertilization (IVF) in the United States, RSC was also responsible for the nation’s second successful birth of a baby from a frozen embryo.

RSC’s first baby born through IVF was born March 18, 1985, although the practice no longer has information on the family’s whereabouts. (Patient privacy standards prohibit the practice from disclosing the family’s names publicly, but RSC has begun a search for the baby and her parents.) RSC estimates that about 30 “IVF babies” were born through their practice that same year; about 100 others were born in 1985, and another 150 were born in 1986. All are now in their 20s, and the practice’s six physicians hope to meet as many as possible as adults at a special RSC Family Day reunion, June 14, 2009, from noon to 4 p.m. at Little Hills Ranch in San Ramon.

“Our first babies have grown up and no doubt scattered far and wide,” said Dr. Donald Galen, one of the founding physicians of the practice and a fertility expert still active at RSC. “We also wish to reconnect with them for further study of the impact of IVF on their lives and to continue to collect long term data to help future generations.”

RSC is using a variety of means to try to locate these first IVF babies, especially through the Internet. The oldest baby found will have his/her travel expenses paid to attend the June reunion. RSC’s Facebook page features more information on its 25th Anniversary and nationwide search for its original IVF babies. A subgroup has been added to the page exclusively reserved for families of RSC’s original babies to exchange comments and share stories of their “miracle babies” then and now.

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A California IVF pioneer marvels at initial outcry

As Louise Brown turns 30 on July 25, Bay Area fertility expert Dr. Donald Galen reflects on fears of the past, hopes of the future

SAN RAMON, CALIFORNIA, (July 21, 2008) – With this month marking the thirtieth birthday of the world’s first “test-tube baby,” one of the Bay Area’s first fertility specialists says that much of the initial ethical worries over the ‘brave new world’ technology has given way to unforeseen developments and medical advancements that few could have predicted over the last three decades – accompanied at the same time by the rise of new ethical and sociological questions.

On July 25, English postal worker Louise Joy Brown celebrates her 30th birthday as the world’s first child born through in vitro fertilization (IVF). With subsequent advancements in embryology technology have come both medical breakthroughs and greater freedoms for individuals to alter their reproductive lives. The combination, said the IVF pioneer, has put his maturing specialty under a wholly different kind of lens than was the case in 1978.

“In the early days I was frequently involved in live televised debates with medical ethicists on the news of that birth,” said Dr. Donald Galen, who began his practice in 1975 and is now surgical and research director of Reproductive Science Center of the Bay Area. Galen was responsible for the nation’s second successful transfer of a previously frozen embryo into a mother’s uterus in 1986 in Walnut Creek.

“The first IVF baby turned the world upside down, and it was terribly exciting. But much of the initial concern about test-tube babies, cloning, and designer babies has been eclipsed by widespread acceptance of the medical benefits of reproductive technology,” Galen said.

“Furthermore, our procedures and quality control are infinitely superior now.” In the early days, what took weeks of testing and diagnosis now takes a few days and seems almost routine, “but it never lacks for miracles.”

During the last few decades, advancements in embryology technology have dramatically improved reproductive medicine with higher success rates and healthier babies. In vitro pregnancy rates continue to soar far beyond those in the first decade of IVF, when most women had a 5 to 10 percent chance of conceiving through IVF. (Today, the national average is better than one in three.) Since 1993, the development of intracytoplasmic sperm injection (ICSI) allowed for the treatment of male factor infertility, and recent forays into donated human eggs and genetic screening have mushroomed in popularity among couples who not long ago would likely have not been candidates for IVF.
“From gender selection of unborn babies to deciding who has rights to be parents, we probably will always face unresolved issues around embryo technology both within the medical community and society at large,” Galen added.

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