The Center for Reproduction and Infertility at Women & Infants Hospital treats a wide range of patients, from teenage girls to post-menopausal women, with all sorts of gynecological issues that require more expertise than a typical primary-care physician can handle.
The bulk of the center’s practice, however, is infertility treatment – helping couples that have trouble conceiving. Along with offering traditional in vitro fertilization, the facility has been deemed a national “center of excellence” for its in vitro maturation work. Providence Business News spoke with Dr. Sandra A. Carson, the center’s medical director, a professor at The Warren Alpert Medical School of Brown University, a researcher and a nationally recognized expert in her field.
PBN: How hard have your patients typically tried to conceive before seeking your help?
CARSON: In general, we recommend that patients who can’t get pregnant despite one year of regular intercourse see us if they’re younger than 35. If they’re older than 35, they see us after about six months.
Seifert Systems Invests in Energy Efficiency to Strengthen Operations
For manufacturers, energy is more than just another operating expense. It plays a critical role…
Learn More
PBN: Is there a growing demand for these services? To what extent is it driven by women waiting longer to have children?
CARSON: I think people are now much more comfortable admitting that they’re having trouble getting pregnant, and they’re asking to see a reproductive endocrinologist right away. … Women are starting to delay their childbearing a little bit – because they want to have a career and tend to get married a bit later – but usually not so late to face the consequences of older age. It is harder to conceive when you’re older, and more important, our tools [to help them] don’t work as well when they’re older. So when someone plans to have a family, they don’t expect to be infertile … but if they wait until they’re 40 … if they get pregnant, it’s great, but if they need our help, our tools don’t work as well as when they’re 35. … But we can use somebody else’s eggs and you can become pregnant with somebody else’s eggs – that’s easy – but you might not want that.
PBN: What is the typical process that a woman undergoes at your center?
CARSON: We will do any testing that has not been done by their ob/gyn to try to figure out why they haven’t gotten pregnant, but we minimize the amount of diagnostic testing that we do, because most women would rather just have a baby than go into an extensive workup to see why. So we limit the testing and go directly into therapy. Most of the time that’s in vitro fertilization, and we have a very successful program. We’ll have a woman come and have her ovaries monitored with ultrasounds and blood tests, then we put a little needle in the ovaries and take out the eggs, mix it with her partner’s sperm, then put embryos back in the uterus, and two weeks later we do a pregnancy test.
PBN: You were recently named a center of excellence for in vitro maturation. Can you explain how it works, and what its benefits are?
CARSON: Some women make a lot of eggs, and [in vitro fertilization] becomes dangerous for them. So when that happens, we don’t give them the drugs that stimulate the ovaries to make eggs, but rather allow them to have their own cycle, and we put the needle in and retrieve eggs that are immature. We’re able then in the laboratory to mature those eggs … and then we mix them with sperm [and proceed with as with in vitro fertilization]. … This technique we just started last fall, so we have only a few patients, maybe 10 that have done it. We’re training physicians from all over the country to do this; that’s what being a center of excellence means.
PBN: You chair the Food and Drug Administration Advisory Committee for Reproductive Health Drugs. Are you seeing big advances in this field? What kinds of concerns do you address on the committee regarding safety and other issues?
CARSON: I just started that. The first meeting was [earlier this month]. All drugs that are given to pregnant women or regarding their reproduction have to be approved by the FDA for that indication. The FDA takes the studies from the drug companies and looks at the data … and then takes it to a panel of experts [which] responds to specific questions from the FDA and provides some labeling advice. … So we review contraceptives, fertility drugs … there’s a constant request from the FDA to approve new drugs. Interestingly, though, there are very few new contraceptives being approved for women.
