Making Babies
Dr. Russell Foulk and the Idaho Center for Reproductive Medicine and Idaho Center for Reproductive Medicine offer hope for couples with fertility problems.
Story in "Today's Physician"
December 1999
By Laura Ashbire
Although infertility has been a constant throughout human history, people are becoming more aware of the issue and what they can do to help conceive a child.
With the arrival last year of the Idaho Center for Reproductive Medicine, couples now have local access to advanced technology and expertise to assist them in their desire to become parents.
The Center has been in Boise since 1998. In October 1999, the center moved its location to 100 East Idaho Street, Suite 301, in the Mountain States Tumor Institute (MSTI) building, near St. Luke's Regional Medical Center.
"Idaho was the largest metropolitan area in the country without an advanced reproductive services center," says Dr. Russell A. Foulk, medical director. "People are glad to stay locally. This community has needed this service for a long time."
Prior to the clinic's establishment here, couples needed to travel to the University of Washington or the University of Utah in Salt Lake City for highly technical procedures, such as intracytoplasmic sperm injection (ICSI), embryo cryopreservation or in vitro fertilization (IVF).
With local treatment available and an improved patient understanding of infertility, Dr. Foulk and his staff hope to bring happy endings to what is, for many couples, a "long and frustrating journey."
Infertility is treatable, in most cases, by less complicated measures than people have come to expect, such as therapies that will balance hormones to encourage regular ovulation or increase sperm count, explains Dr. Foulk. The average length of treatment to correct an ovulatory problem, for example, is usually one to two months. Following correction, women can become pregnant within three to five months.
And for even the most sophisticated of procedures, such as IVF, which is necessary in only three percent of infertile couples nationally, pregnancy is achieved in the vast majority of cases.
IVF, because it sparks a lot of interest and curiosity gets all the "glitz and glamour," he says, but in reality it is the option of last resort in about 10 percent of Dr. Foulk's higher risk patients.
"There are a tremendous number of misconceptions about infertility," he says. "Friends and family will tell the couple to just relax and they'll get pregnant, or to take special herbs. This can be really frustrating. And in the meantime, the couple is forestalling suitable treatment. Infertility is not a choice, but rather a disease of the reproductive system and should be approached correctly just as cardiovascular disease or diabetes. If infertility is not treated appropriately, then it can become chronic and debilitating."
The first step toward treatment is finding the cause, which involves detailed consultations and diagnostic tests for both the male and the female.
"Many people think of infertility as primarily the woman's problem," explains Dr. Foulk. "But actually, it is a couple's problem. Forty percent of the time, the problem lies with the female, 40 percent of the time it is with the male and 20 percent of the time the problem is with both the man and the woman. That's why it is so important to see both, so we can talk about each of their histories and risk factors."
Aided by the most sophisticated equipment available to the field of assisted reproductive technology (ART), Dr. Foulk and his staff have, since January of 1999, achieved an ongoing pregnancy rate of 54 percent, well over the national average of about 30 percent.
Dr. Foulk is a board certified obstetrician/gynecologist, who completed his residency at the University of California at Irvine and his fellowship, in Reproductive Endocrinology, at the University of California at San Francisco, during which he trained in andrology (male infertility) and embryology.
His staff includes Genie Andrews and Michelle Boyles, front office; JoAnne Overgaard, C.N.P.; and lab director Bret Anderson, M.S., reproductive biology, who joined the clinic in March after working as the lab supervisor for the Pacific Fertility Medical Center in Los Angeles.
The Idaho Center for Reproductive Medicine includes a small waiting room, two private consultation offices, two monitoring rooms where eggs are harvested and embryos are implanted, an andrology lab where sperm is analyzed and prepared and a stateoftheart embryology lab.
"We have the most sophisticated computerassisted sperm analysis equipment available in the country," says Anderson.
Between the monitoring rooms and the andrology lab is one of the "cleanest rooms in Idaho" --- a room filtered of all particulates and volatile organic compounds.
This is where the miracles take place, and where Anderson is the "first babysitter" to the microscopic embryos housed in one of four incubators until they are ready for implantation three to five days after egg and sperm are united.
Also included in this sterile environment is the intracytoplasmic sperm injection (ICSI) equipment, a sophisticated microscope/computer which allows Anderson to isolate and manipulate a single sperm (the smallest cell in the human body). The sperm can then be injected into the waiting egg with a tiny pipette and implanted in the mother's uterus.
"The ICSI technique was invented in Belgium in 1992 and was introduced in Idaho when we opened in 1998," explains Dr. Foulk. "It overcomes virtually all causes of male infertility. Men who have had vasectomies can still become fathers using this technology. As an alternative to surgery, we just extract sperm in the area above the blockage."
Conception is more of a possibility than ever for infertile couples. The cost of treatment however continues to be a concern for many people.
"The vast majority of couples achieve pregnancy with relatively low costs," says Dr. Foulk. "Most people can get pregnant without IVF, but even the few who require IVF, the most expensive procedure, will pay less than they would for surgery for many other ailments or for a week's stay in the hospital."
If cost is burdensome to a couple, there are programs through the center to help with discounts and financing.
"We feel a commitment to the community here, so it hits us personally when a couple comes in for treatment," says Dr. Foulk. "If we are unable, for some reason, to get a couple to conceive a child, then, at the very least, they will learn the reason why it was not possible. Then they can have closure in that area of their life."
By the time babies are born, many successful couples have developed strong bonds with the people who have assisted them in this most intimate of quests.
Dr. Foulk and his staff have been notified of several blessed events by grateful couples who have brought their infants by to visit or have sent pictures for the office bulletin board.
"I happened to run into one couple in the mall parking lot," says Dr. Foulk. "We must have talked for an hour about their baby and their experience."
But Dr. Foulk didn't mind. He loves people and his work and it shows.
"You can have all the best equipment in the world," he says. "But it's the skill of the staff that makes a good clinic." ---TP
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