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| . |   One of the longest-standing infertility programs in New York has a new home. In January, 2001, the Center for Women’s Reproductive Care at Columbia University moved to new, larger offices at 1790 Broadway. This convenient location by Columbus Circle is accessible to patients from all five boroughs, and makes early morning treatments easy to schedule.
To learn more, visit www.columbiafertility.org
The Center for Women’s Reproductive Care at Columbia University (CWRC) specializes in challenging cases. Dr. Sauer, the Program Director, explains: “We accept patients we think have a chance to succeed, even if that chance is low. We don’t endorse therapies for patients who aren’t able to benefit, but we value accepting difficult cases. We’ll work with you for as long as you wish to try.” The Center can be more accepting partly because, as the academic practice of Columbia University, it isn’t subject to the same pressures as a private practice. “Naturally, we want our high quality of care to be reflected in a high success rate, but more so, we want to help all patients succeed. Accepting challenging cases demonstrates this commitment,” says Dr. Sauer. What does it mean to be an academic instead of a private practice? Every physician at the Center is a salaried, full-time faculty member at Columbia’s College of Physicians and Surgeons. So patient payments do not provide personal income for the staff. And each physician is required to maintain excellence in three challenging areas: outstanding clinical care, innovative research and superlative teaching.
The Center is widely recognized for its excellence in research and clinical care. Faculty members are invited to be featured expert speakers around the world. Here at home, Dr. Sauer helps set policy for practitioners in the field as an appointee to the Medical Advisory Board to the New York State Task Force on Life and the Law. And the Center receives accolades in the press as well. Each year, it's in the elite group of fertility experts recognized by Good Housekeeping, Best Doctors, New York Magazine and others.
Frustrated by her lack of success, Joan came to the Center. Due to her age and thyroid condition, we advised Joan to undergo aggressive therapy with in vitro fertilization and a “poor responder protocol,” including high dose gonadotropins and a GnRH antagonist to stimulate ovulation. Seven eggs were obtained, of which five were fertilized. To further improve her chance of success, the Center performed “assisted hatching,” which may increase pregnancy rates for women over 40. This procedure places a small opening in the shell of the embryo to encourage implantation. Very happily, Joan’s next pregnancy test was positive and her ultrasound confirmed a normal pregnancy.
If you’re having trouble enjoying normal life during treatment, you should know you’re not alone. Feeling grief, anxiety, anger, shame and more is completely normal. You may feel as though no one else knows what it’s like. But most patients go through the same range of feelings — including the sense of isolation. As you go through treatment, there are many ways you can minimize the emotional stress. Following are four important steps to help. 1. Get educated about infertility treatments. Knowing more can reduce your anxiety about what lies ahead. Talk to your primary doctor and GYN, and do research at www.columbiafertility.org and www.asrm.org 2. Become less isolated by choosing at least one close friend or family member to confide in about your experience. You can often make new friends to talk to in infertility support groups as well. 3. Put extra time into your relationship with your partner. The stress of treatment can result in a decreased sex life, increased fighting, anxiety, or moodiness. Try making “dates” to do things you used to enjoy more often together. 4. If you’re having trouble keeping up with things like work or your social life, it’s good to seek professional help. Other signs you need help include having trouble sleeping or eating normally, thoughts of death, and pervasive sadness, depression, anxiety or hopelessness lasting more than two weeks. Dealing with infertility is always an emotionally challenging process. The good news is that identifying the sources of your stress and taking steps to address them, even just by talking to a friend, really can make the experience easier. If have questions or would like to speak with
Why is it so difficult to conceive at 40 or 45? How much does IVF improve success rates? What’s the upper age limit for donor egg treatment? Women up to age 55 can get pregnant at the same rate as younger women using donated eggs. After age 45, patients undergo screening for high risk factors. This issue, the spotlight is on Melvin Thornton II, MD, the Center’s Medical Director. What does the Medical Director do? Dr. Thornton works intimately with the Program Director and the nursing, embryology, andrology and social work staff to be responsive to and supportive of patients.  “Every day, the Medical Staff meets to consider each patient’s latest lab results and create individualized treatment plans,” Dr. Thornton explains. “I am responsible for discussing these plans with patients and initiating, monitoring and carrying them through, from the day-to-day management of patient cycles, to ultrasounds and tracking lab results.” In this manner, Dr. Thornton collaborates with the entire faculty to deliver personal and individualized care. “One of my most important responsibilities is to create a supportive environment for patients. Sometimes that’s as simple as making calls and explaining things. I let patients know how everything is going so they don’t leave feeling vague or uncertain. And I encourage hope. Because every time you try, there is a real chance for success.” Another way the practice supports patients is by offering services 365 days-a-year. “Most centers close for a vacation or have ‘shut down’ periods. We don’t. We’re here whenever you can make the time. After all, women ovulate on holidays, too,” he quips. Dr. Thornton is a board-certified specialist in Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility. He served his Internship and Residency at the University of Southern California School of Medicine (USC). He then completed Fellowships in Gynecologic Pelvic Surgery and Reproductive Endocrinology and Infertility at USC, where he also served as an Assistant Professor of Obstetrics and Gynecology, conducting research in post-surgical adhesion prevention. And why did Dr. Thornton leave sunny L.A.? To collaborate with Dr. Sauer on leading-edge research at the Center. Current research is focused on ovulation induction, stimulating medications, and treatment protocols for women of advanced reproductive age. For more on Dr. Thornton, visit our Web site: www.columbiafertility.org  • Coming soon: This summer, The National Geographic Channel will feature doctors from the Center in a documentary on embryo donation produced by New York Times Television. • Look for re-broadcasts: PBS aired “Incredible Human Body, A National Geographic Special” on February 26, 2002. It follows a Center patient through her IVF experience, including fertilization, embryo transfer, pregnancy and her delivery of twins. • The Wall Street Journal, April 17, 2002, interviewed Dr. Sauer regarding the viability of commercial egg banking in “Fertility Clinic Set to Open First Commercial Egg Bank.” • The New York Times, Science Times, April 30, 2002, covered the Center's clinical program for HIV discordant couples in “Parenthood Help for Men With HIV.”
CWRC is published periodically by
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The Center’s new offices are comfortable, welcoming and appealing, and feature newly-constructed rooms for IVF procedures and endoscopic surgeries as well as an embryology laboratory with state-of-the-art equipment and technology. In these facilities, the Center’s internationally - recognized medical staff — including four fully-trained embryologists — provide a comprehensive array of infertility services to patients from around the world.
If you’re having difficulty getting pregnant, the last thing you want to learn is that an infertility program might refuse you precisely because you're having trouble. Yet it happens to many couples. They’re classified as “difficult” cases due to age and other factors, or because they’ve failed some treatments. And they may have trouble accessing care. 
Patients benefit from the staff’s academic activities in many ways, though the Center is not a teaching practice. “Our physicians collaborate with Columbia University scientists on trend-setting research,” says Dr. Sauer. For example, the Center is currently conducting clinical studies on ovulation induction and male factor infertility. Some patients participate in the trials directly, and others benefit when the Center leads the development of better treatments. 
A current patient of the Center — we’ll call her Joan — arrived in our office this fall. A recently married 42-year-old, Joan and her husband had tried to conceive for over two years. She had already seen two physicians and received simple infertility treatments, including multiple cycles of clomid (oral fertility medication) and intrauterine inseminations. Joan also has a history of hypothyroidism, and takes thyroid medication. 
Most patients say that going through infertility treatment is like riding a roller coaster of hopes and fears. You have to cope with an uncertain future, intimate medical treatments and even social stigma. It can put a lot of strain on you — and your relationships. 
What are the success rates for women over 40?