Dr. Treiser’s interview with New Jersey Life Magazine

By jtervooren on September 11, 2009

Miracle Maker

By Brianne Harrison

Infertility affects one in six couples trying to conceive in the US today, and trying to overcome that can be a stressful, exhausting process. A desire to make that process less stressful and more personal led Dr. Susan Treiser, one of the few female board certified Reproductive Endocrinologists in her field, to co-found IVF New Jersey with her colleague, Dr. Michael Darder, in 1990. A practice that started with one center in Somerset has grown to include offices in Freehold, Hamilton, and Annadale, and a fifth office will soon open in Short Hills. IVF New Jersey boasts a high success rate and offers personalized services that run the gamut from in-vitro fertilization to gestational carriers to acupuncture. Dr. Treiser sat down with New Jersey Life to discuss founding IVF New Jersey, and the many changes and advances in this field of medicine that she’s seen over the years.

What drew you to this field of medicine?

As part of my medical training, I had to do a residency in obstetrics and gynecology, and I really enjoyed being that much a part of women’s lives, starting from when they’re young, to when they have children, and then through menopause. So I decided to make that my specialty, and within that specialty is the subspecialty of reproductive endocrine. That was the area where all the really significant changes were happening in terms of helping patients get pregnant in vitro and all the subsequent procedures that have followed. So that was a really exciting area for me to be involved in. I was always interested in research and there was a lot of very significant research happening in the reproductive medicine subspecialty. So many changes have taken place that we’ve incorporated into the way we take care of patients over the years.

What are some of the most significant advances that have been made?

Over the last almost 20 years we’ve been in practice, the overall success rate has improved dramatically, and that’s because of a lot of the subtle changes that have taken place in the lab and certainly within our own program here at IVF New Jersey. Our own success rate has increased tremendously over the last two decades we’ve been in practice as well. A lot of advances have been made, like working with low-number sperm and PGD [preimplantation genetic diagnosis], which allows you to select specific genes to eliminate certain illnesses. We’ve been doing egg donation really since we started the practice in 1990, and that’s certainly given women who are at what we call an “advanced maternal age” the opportunity to have children even though they’ve run out of eggs. That’s just one of the services we offer women who are past a certain age or who have undergone medical procedures that have resulted in them no longer being able to produce eggs.

Over the last two years we’ve also been able to do gestational surrogacy using gestational carriers for those women who have medical issues whereby they cannot carry a pregnancy. So now, if, for instance, they’ve had a hysterectomy because of cancer, as long as they still have their ovaries, they can still have a child that is genetically theirs, it’s just carried by someone else. Having a hysterectomy doesn’t necessarily mean that your ovaries are removed as well. Some women have genetic abnormalities that affect their uterus; they can get a gestational carrier and still have a child that is genetically linked to them.

Over the course of the years, we’ve seen more and more of those types of procedures occurring. Attitudes have changed: When we first started doing egg donations, people were coming in very quietly, they didn’t want anybody to know about it, but the number of people using egg donation has increased tremendously over the last few years, most likely because there are so many older women who are getting married later and having children later. This is an opportunity for them to fulfill their dream of having a family despite the fact that they’re over the age of forty.

How did you found IVF New Jersey?

I had my training for reproductive endocrine at Columbia in New York, and there were few centers that really offered all of the services of a large academic center in a private setting. One of the difficulties that we saw when our patients came to a large university is that they had to go from one department to another to have everything done. We really wanted to provide a comfortable environment where they’d come in, everybody would know who they were, knew what needed to get done, and they didn’t have to go to a hospital environment. We wanted to create a center that provided everything that an academic center would provide—a laboratory and excellent statistics—but in a private setting that was much more comfortable for our patients. I think we really achieved that. We started off with just one office, which was in the Somerset area, and we’ve now expanded to Hamilton and Freehold and we’re about to open another office in the Short Hills Area. So now we’re able to provide these types of services throughout New Jersey—personalized service, and all the great advances that are available in this field.

What are some common myths about fertility treatment and IVF?

One of the first things is, if you don’t get pregnant after a certain amount of time, depending on your age, you should see a doctor. There’s a certain amount of time where, if you don’t have a problem, you should get pregnant if you’re really trying. So we say that if you’re 30 and younger, if you’re not pregnant within one year, then you should go see a physician or a specialist, or if you’re 35 and over, you should see a specialist after 6 months. A lot of people tell women, especially younger women who are, maybe, in their 20’s and have been trying for two years, “Oh, relax, go on vacation, it’ll happen, you have to give it more time.” That’s the first common myth. I think you should set your expectations on a realistic level and if you’re not pregnant within a year when you’re 30 or within 6 months if you’re over 35, you should go and see a fertility specialist.

Another common myth is that people think that in vitro is what gives you these high-order multiples, like quintuplets or sextuplets. Most fertility centers, like us, only implant two, sometimes three embryos. You only really see the high-order multiples in situations where patients take infertility medications and then just have intercourse or intrauterine insemination, and you don’t have any control over the number of eggs that become fertilized and therefore how many will actually implant. Certainly there are some centers that may implant an excess number of embryos, but that is rarely seen these days. For the most part, most centers practice good medicine and follow the established guidelines for how many embryos should be put in, which is based on the patient’s age.

What are some important things to consider before starting fertility treatment?

I think that once a patient’s decided they need to see a physician they need to see a specialist. A lot of times I’ll have patients say they went to see their gynecologists and the gynecologist said do this, or do that, and if it doesn’t work, the patient feels like they wasted a lot of valuable time. I think the first thing a patient should do is get a recommendation for a fertility specialist that they should go and see. When they’re looking at centers, there are a few things they should definitely consider. They should check to see if the center provides all the different types of fertility services, from the most basic to the expanded services like IVF, egg donation, or gestational carrier. They should also find out how involved the physicians are, are they making the return phone calls—we make all the return phone calls. We also do all of our own ultrasounds, so in every interaction the patients have with the doctors—which is rather frequent during the course of the cycle—we’re able to constantly talk to them about how they’re doing in their cycle, how everything is going. Those are very important things to consider. This is a very stressful process and you want to make sure that all the staff members are completely familiar with the different procedures so if you have any additional questions, they’ll be able to answer them in a professional manner.

What are some things patients should do to prepare for treatment?

I think a lot of time, ahead of time, patients start to become aware of their own bodies. Women try to keep track of when they’re ovulating, whether they’re ovulating around the right time of month and trying to have intercourse around that time. We certainly want them to be healthy—no smoking, drinking, drugs—and that they’re taking prenatal vitamins. Ideally, you want to make sure that your weight is good. You don’t want to be heavy, because many studies have shown that it does become more difficult to conceive as your weight increases, and also the miscarriage rate increases. Also, if you’re very thin, that’s not good either, if you’re not getting your period, that’s certainly not good, so to prepare yourself, you need to be more conscious of your weight, more conscious of your body, and making sure you’re taking good care of yourself: taking vitamins, being careful with your diet, trying to limit the amount of caffeine, definitely not doing any recreational drugs, just really being healthy.

What are some important questions for a patient to ask her fertility specialist?

You definitely want to ask what sort of services the specialist provides. You also want to find out what their statistics are—that is, the statistics for that particular treatment center. People often think that the overall statistics are universal, They’re not. The IVF statistics are specific to each center, so you need to make sure you’re going to a center that has a good laboratory and good IVF. Those statistics are available to every patient by going to the CDC website (http://www.cdc.gov/ART/). You can find all the statistics for IVF centers across the United States.

Like I said earlier, you want to know how involved the physicians are. Are they the ones doing the phone calls? How flexible are the hours? Those are very important things to consider because it is such a stressful process and one that usually requires months and months of trying, so you want to make sure you’re in a comfortable situation and getting the information you need every time you come into the office.

I noticed IVF New Jersey offers acupuncture services. Does this actually help with the process?

Most women find it very relaxing. Because it’s such a stressful procedure, we feel that anything that could relax you, whether it’s yoga or acupuncture, is certainly helpful. With regard to acupuncture, there are no definitive studies that say that it helps increase the success rate of fertility treatments. There are some studies that say that it does and some that have shown it doesn’t, but it certainly doesn’t harm anybody, and it’s never been shown to decrease the success rate, so if there’s even a chance that it’ll increase the pregnancy rate, and people find it relaxing, that’s something that we would promote. Some people feel that, if they’re having an embryo transfer, having acupuncture just prior to the transfer causes relaxation and might help the uterus and improve the odds of implantation. There are no definitive studies that have shown that that is true, but our feeling is we want to try and promote anything that might be helpful for the mind or the body. Anything that helps patients get pregnant is something we would want to promote as long as it doesn’t harm them in any way.

Is using a surrogate becoming a more common practice?

We’ve had an increase in the number of people using surrogates, but we only do it when there’s a true medical reason for using a surrogate. For women who just don’t want their bodies to get out of shape–I’m sure there are places that would offer them a surrogate, but at IVF NJ you must have a medical reason, such as a severe medical condition whereby you cannot sustain a pregnancy, such as kidney problems or severe diabetes, or, of course, someone who has had a hysterectomy. We’ve also had patients who went through a previous pregnancy and had a lot of complications and were told that they should not carry a pregnancy again. Those are the situations in which we would consider surrogacy. I would say that the number of people who are looking for that has gone up because it’s now more accessible. We work with a number of different agencies who help find the gestational carriers and work on getting the legal contract together, and then we just provide the medical service portion of it.

You mentioned earlier that there’s been a rise in people seeking fertility treatments. Is that because there’s less stigmatism about it?

I think people are more accepting of all the different ways that we can now make a family and ultimately still feel that it’s your family. I always say to people, when your dreams don’t come true, you need to change the dream. It doesn’t matter how you get there, when you walk out of the hospital with a baby, that is your child, no matter how it was conceived and born, whether through egg donation, a gestational carrier, sperm donation, or IVF. That is your child. In the past, fertility treatments were more frowned upon, but now it’s hard to pick up a magazine without finding an article related to either IVF or egg donation or gestational carriers. It has become much more commonplace. It’s not something you have to talk about quietly so nobody overhears. I think people feel more comfortable with it, they really understand what’s really involved in the process, and they know that having a child through IVF is not unnatural, which is how I think a lot of people thought of this before.

Are there any new treatments on the horizon or treatments that are really starting to gain ground now?

Egg freezing is becoming much more common. We have an increasing number of women right now who are not married or aren’t ready to get married and have children but who are going ahead and freezing their eggs kind of as an insurance policy so if they don’t meet the man of their dreams or if they do and then they have difficulty getting pregnant because they’re at a later age, they can go back and use these eggs that were harvested when they were much younger. This way, they don’t feel so pressed to have a child right away when they’re not ready. We’ve certainly seen an increase in the number of people who are looking for those services. In the past we only did that for patients who were about to go through chemotherapy and they were trying to freeze their eggs because there was a good chance they would be in menopause after their therapy.

Is this a relatively new process?

It is very new. The success rate for freezing eggs and then being able to use them has been very low in the past, but that technology has improved tremendously over the last five years. As with any other fertility treatment, you really need to do your homework if you’re considering this. You have to make sure you go somewhere where they’ve done it a lot, not a few here and there, to ensure you’re in good hands.

Posted in Uncategorized |