Meet IVF Lab Manager Katherine Scott, BA, M.Sc.
One of the best things about hanging around at the Norwalk office of Reproductive Medicine Associates of Connecticut (RMACT) is who you bump into to chat with informally. A reminder: I do work there so I’m not simply “hanging around” because that just didn’t sound right, did it? My point is that the unplanned meetings that take place there, for me, are often as important as the formal meetings.
Yesterday, I had the privilege of meeting Katherine Scott for the first time. Scott is our newly appointed IVF Lab Manager. I’d heard a lot about her but had not met her yet.
She described herself as not warm and fuzzy. Her words. I actually found her quite engaging and friendly. And very, very smart. I hope she wasn’t quite smart enough to realize that I didn’t understand some of what she was saying when she started talking about the technical and scientific aspects of the lab. I’m not a clinician, so I stick firmly to my belief that it is the reason I didn’t understand all of what she was saying.
So I’m actually way overdue to introduce Katherine Scott, BA, M.Sc. to you. Funny how that works though, getting to talk to her in person, there’s now more that I can share.
First thing you get from Katherine Scott is her passion. She lives and breathes the lab. Her life commitment is her work and her interest and desire shine through her words and her eyes. She talks about the advances in the labs and her excitement is palpable. I feel very lucky that she has landed here with us.
Second thing that you get from Scott is her compassion. Interesting, given that she describes herself as not warm and fuzzy. Without revealing personal information about her, let me just say that she spends free time giving back to the community in quiet, unsung ways. It’s just part of who she is and reflects what she believes in. One of her biggest concerns that she expressed yesterday, several times, is that she isn’t necessarily compassionate enough with patients. We talked quite a bit about personality and how what appeals to one person may be directly opposed to another person. We talked about maintaining personal integrity rather than people pleasing, as it is impossible to please every person that we run across in our lives. After speaking to her, I’m not at all worried about her speaking to patients. Her professionalism and care in her work are reflected very beautifully in her words. Patients will easily understand how well she does her job; caring about their care and their embryos.
We also talked about the skill sets needed. Do we need an embryologist to be warm and fuzzy? Is that a necessary skill set for a lab manager? Or is the skill set that we need and want for a lab director to have to manage and handle the scientific and clinical aspects of handling sperm, eggs and embryos?
I vote for the latter. We need the right person for the right job. There’s no doubt in my mind that Katherine Scott is a wonderful choice for a lab manager. She is smart, (very smart), she is passionate about her field of medicine/science, she is dedicated, she is devoted and she is extremely qualified.
And aren’t all of those the things we all want in a lab manager?
Keep reading, Scott will be submitting blogs regularly starting sometime in April.
Katherine Scott, it was a pleasure to meet and speak with you.
Happy weekend everyone.
IVF (in vitro fertilization) Laboratory Manager K. Scott, BA, M.Sc.
As Manager of RMACT’s Embryology Lab, Katherine is responsible for all clinical laboratory functions in RMACT’s laboratories, including embryology/IVF, andrology and endocrinology. She works with RMACT’s team of Board Certified reproductive endocrinologists to perform assisted reproductive technologies (ART) and to lead clinical research.
Katherine has experience in cryopreservation and vitrification of oocytes and embryos, as well as embryo manipulation, culture, transfer and biopsy. She also has extensive experience with male infertility, including semen analysis, cryopreservation and preparation for IUI, ICSI and IVF. She is passionate about her clinical responsibilities and how her work in the lab affects the lives of patients and parents to be.
Katherine’s affinity for math and statistics drew her to study psychology at University of Alabama. As she concluded her degree, she was recruited to provide statistical support for Nathan Treff, Ph.D., at Reproductive Medicine Associates of New Jersey (RMANJ). Katherine’s enthusiasm, diligence, and technical acumen were quickly recognized as she moved into the Embryology laboratory and facilitated first with on-site training, then with institutional support in the pursuit of her Masters of Biochemical Sciences with an emphasis on Clinical Embryology and Andrology from Eastern Virginia Medical School. During her time in the laboratory, Katherine has enjoyed the opportunity to refine her skills, participating in more than 10,000 IVF (in vitro fertilization) cycles. Armed with this experience, Katherine began to travel, teaching vitrification to other laboratory professionals across the country. Katherine joined the RMACT team in 2013.
Katherine is a member of the American Society of Reproductive Medicine (ASRM) and American Board of Bioanalysts (ABB).
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CCS IVF: Prize Winning Fertility Treatment Update
Three years ago, Reproductive Medicine Associates of Connecticut (RMACT) had news to share with the world and we sent out the press release below, which you can read in its entirety. Since then, CCS has been a scientific technique that has been used successfully by our patients when it’s medically appropriate. Successful as defined by pregnancy and also as defined by babies born. One of the most common reasons for using CCS is for repeated miscarriages of seemingly healthy pregnancies. It’s probably not necessary to say how heartbreaking that is for men and women who are hoping to have a baby. CCS also gives peace of mind when there have been repeat losses, that with CCS, the possibility is much, much lower. Without a doubt, CCS has changed the lives of many men and women who have been trying to become pregnant and to deliver a baby.
Three years later, CCS continues to make significant differences in the lives of our patients.
RMACT recently participated in a breakthrough study titled "A Prospective Randomized Controlled Trial Demonstrating Significantly Increased Clinical Pregnancy Rates Following 24-Chromosome Aneuploidy Screening: Biopsy and Analysis on Day 5 with Fresh Transfer," which was led by Infertility Specialist Richard Scott, M.D. and Nathan Treff, Ph.D., of Reproductive Medicine Associates of New Jersey (RMANJ), an affiliate of RMACT.
Pre-Implantation Genetic Screening (PGS)
This study, which earned the top research award from the American Society for Reproductive Medicine (ASRM) in October 2010, examined technology that is the first and only fully validated system to reliably evaluate all chromosomes in a small biopsy obtained from an embryo during in vitro development. This is the first and only prospectively randomized trial showing real benefit from Pre-Implantation Genetic Screening (PGS) and RMACT is the only fertility practice in New England to offer it.
“This technology will revolutionize reproductive medicine,” said infertility doctor Mark Leondires, M.D., Medical Director of RMACT and Lead Physician for RMACT on the Clinical Study. “The purpose is to identify the best embryos for a healthy pregnancy. By selecting chromosomally normal embryos without damaging them, pregnancy rates were dramatically increased to more than 90 percent and miscarriage rates were lower compared to the control group. This data is historic in its nature and implications.”
Sustained implantation rates were 75 percent in the study group, much higher than compared to 56 percent in the control group. Clinical pregnancies, which are a typical result of genetic abnormalities, were significantly lower in the study group (60 percent) than versus the control group (92 percent).
“Our goal is one embryo, one healthy baby," said Dr. Scott. "So, the driving force behind most of our research is to assess reproductive competency to better predict which embryo will most likely produce one healthy baby. This is the first study of its kind that has shown dramatically improved clinical pregnancy rates with blastocyst biopsy, 24 Chromosome Aneuploidy Screening and fresh embryo transfer. Though similar screening technologies are being marketed, none have been validated through the critical studies, culminating with a randomized clinical trial, which provides this high level of medical evidence.”
The procedure starts when a couple goes through In Vitro Fertilization (IVF) Treatment with intracytoplasmic sperm injection (ICSI); the embryo is then grown to the blastocyst stage and a small biopsy of five to 10 cells is taken from the embryo on day five to six days of life. The biopsy sample then goes through computer analysis to identify any abnormalities among the chromosomes. This process identifies chromosomal disorders such as Down syndrome before the embryo is transferred into the female patient’s uterus. This error rate of the technology is less than one percent in more than 4,000 embryos tested.
About Comprehensive Chromosomal Screening
What separates this technique of Comprehensive Chromosomal Screening (CCS) from other PGS processes is that the embryo is able to grow for five or six days, allowing the cells to split and the chromosomal analysis to be more accurate. In addition, since the technology can be used to find small breaks in chromosomes and even single gene disorders it defines itself as the most robust and reliable technology for evaluating pre-conception embryos available. RMANJ has previously shown 24 chromosome analysis technology to be significantly more reliable than other existing methods. However, with this latest clinical study, the new technology has been improved because it no longer requires freezing embryos for weeks before thaw and use. The breakthrough is based on a shorter timeline, which has better results; the same comprehensive screening is conducted within hours instead of days. It is the first technology of its kind that allows for assessment of blastocysts and still enables a fresh embryo transfer, which generally has a higher success rate than freezing embryos.
The study included patients seeking IVF who were less than 43 years old and had no more than one prior failed IVF cycle. The control group underwent routine care and typical screening methods, whereas the study group underwent biopsy of the blastocyst and CCS on day five.
In a related retrospective evaluation presented with this research, the study shows that this new technology dramatically decreases the occurrence of abnormal pregnancies such as Down or Turner syndromes. This technology will allow women in their late thirties and forties, who normally have a high risk for genetic abnormalities, to nearly eliminate these risks and thereby maximize their chances for a successful pregnancy with in-vitro fertilization. CCS represents a major step forward in helping patients have healthy pregnancies and thereby allowing them to choose a single embryo transfer to minimize the risk of twins.
“A singleton pregnancy is the safest for mother and baby,” stated Leondires. “This technology will allow couples to choose a single embryo transfer without jeopardizing their chance for success. It is truly an amazing advance which will change the landscape of reproductive medicine in the future for both patient and physicians.”
Infertility affects 7.3 million Americans and for 20 percent of infertility patients the cause is unknown, according to The National Infertility Association. Through 24 chromosome aneuploidy screening, fertility doctors can determine which embryos are normal, increase healthy pregnancies while at the same time reduce the number of miscarriages. The technology will transform reproductive medicine and instill confidence in transferring only one embryo, leading to fewer multiple gestations. In addition, for patients who have had several miscarriages, it can enable them to make informed decisions about their next steps, such as working with an egg donor.
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IVF News - More Babies, Less Multiples
In the news today! The "Number of test-tube babies born in U.S. hits record percentage," reported The Chicago Tribune, along with other outlets picking up the same IVF news released by SART (Society of Assisted Reproductive Technology) and announced in ASRM (American Society of Reproductive Medicine) Bulletin Volume 16, Number 12.
More IVF babies (when are they going to stop calling them test-tube babies? For goodness sakes, it’s just a little outdated, no?) were born in 2012 than in any other year since the inception of the scientific and technological treatment in the 1980’s.
SART released that data based on the fertility practices that verify and report their treatment results. For those challenged by infertility or more correctly, sub-fertility, this is great news. Technology is working, despite all the recent media buzz about men and women being mislead about succeeding in creating their families with IVF.
IVF Success Rates Released
So let’s be really clear. The numbers are these:
165,172 IVF cycles and 61,740 babies. IVF succeeds and it fails. Many of those cycles represent people who have undergone more than one cycle, having had both an IVF cycle failure and then an IVF cycle success. Many of these 61,740 babies are twins; fewer are triplets or higher order multiples (3 or more embryos/fetuses/babies).
These are the statistics. I’m not going to tell you whether they are good or bad statistics. You, anyone, can read them any way you want. An average of 1/3 success. An average of 2/3 failure. Too many twins. More singletons. Technology that is used to help create families. Technologies that cost a lot of money and result in people still not having their babies. Any point of view has its own validity. There is no one right point of view. IVF fails. IVF succeeds. IVF fails at a larger rate, on average, than it succeeds.
I have a few points that I’d like to focus on.
1. It does matter where you are in treatment. It does matter what the pregnancy rates are; that the fertility program you are considering reports to SART. To me, that’s one of the few slam dunks. For the pregnancy results to be verifiable and not just what someone would like you to believe. If it turns out that the fertility practice that has the highest pregnancy rates in your area is one that you are considering, dig a little deeper. Pregnancy rates aren’t the only means in which to measure success. Odd sounding? Consider. If a fertility practice will not take a patient over the age of 40 or 42, or 44, given that over the age of 35 IVF is far less successful, then that’s a practice that is treating patients who will skew their statistics down, not up. If a fertility practice will not accept patients for IVF with a FSH of over 12 or 16, or 18, there again, you have a program that is only accepting patients that will, statistically, do very well with IVF.
2. Be aware of the issues. I would not suggest that you discriminate against a fertility practice that accepts patients who may not do as well as other patients, who, by definition, will skew their pregnancy statistics downward. But be aware of these issues. Ask the questions, even if they do not apply to you. Because conversely, the fertility programs that are eliminating patients who might cause a drop in their pregnancy rates are also, in essence, artificially raising their pregnancy rates. Please note, I did not say they were being misleading or lying. It just makes perfect common sense, statistics aside, that if a fertility program will not take patients that are “difficult” (high FSH, low AMH, advanced maternal aging, premature ovarian failure, etc.) that there pregnancy rates will be higher.
I am not saying don’t use these practices. I am saying KNOW what the fertility programs that you are considering use as a barometer to accept patients. If you have any of the criteria that make you a “difficult” patient, you will want a fertility practice well versed in handling those issues, both in the medical treatment they provide and the support services they offer.
3. Be an educated patient. It will serve you well. It will help you avoid the feelings that have been expressed by so many recently in the public eye about having been deceived and betrayed. Know the questions to ask and if you are not sure, educate yourself. SART, ASRM, ACOG (American College of Gynecology) are all reliable and responsible websites and organizations that you can trust. They are a great place to start. The patient not-for-profit organizations are also full of helpful and reliable information. Try the following websites: Resolve, The American Fertility Association, INCIID (InterNational Council on Infertility Information Dissemination), Fertility Within Reach, PVED (Parents Via Egg Donation), A.T.I.M.E. (A Torah Infertility Medium of Exchange), and Centerlink (The Community of LGBT Centers).
IVF Statistics and Considerations
Finally, on a very human note, there are babies being born, enlarging families, every single day, from IVF (in vitro fertilization) treatment. They are not IVF statistics. They are not 30% of a baby. They are the 100% baby that are the dreams that their parents are dreaming when they come into fertility treatment. They are real, tangible, flesh and blood children who cry and poop and sleep and eat and drool.
There’s a lot to consider when reading an article about statistics. Ultimately, you will take away from such an article what you most want to believe. Maybe you will take away from this article what you most need to believe.
Educate yourself; learn more about the fertility treatment and program that you consider using. Honor your feelings and, if you need to, find a way to silence so that you can discover what you are feeling. Statistics and facts can only lead you so far. Only you will know what is right for you.
We’re here to help.
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Affordable IVF: The IVF Opportunity Plan Option
No one denies that infertility treatment can be costly. In fact, for many patients, the cost of IVF (in vitro fertilization) is their primary concern before learning more. The fertility doctors and financial specialists at RMACT strive to offer affordable IVF options to bring the cost of IVF within reach. One of these options is the IVF Opportunity Plan.
Is there Infertility Insurance Coverage?
Infertility insurance coverage varies among providers. Some insurance providers do not offer coverage for fertility services at all. Others offer limited amounts of coverage, depending on individual plans and treatments. The IVF Opportunity Plan is an option, exclusively available to patients at RMACT, for those who do not have insurance coverage for infertility treatment. In addition, if a patient decides to withdraw from treatment, the plan offers refunds matched to various stages of the process.
What’s in IVF Coverage?
The IVF Opportunity Plan covers a group of comprehensive services provided by RMACT's team of surgeons, nurses and other specially trained patient care professionals. The coverage includes baseline blood work and ultrasound, IVF Teach class, cycle monitoring (blood work and ultrasounds), egg retrieval, anesthesia for the egg retrieval, embryo transfer, ICSI (if appropriate, on all eggs retrieved), assisted hatching, embryo cryopreservation and one year of storage, and cycle medications for up to and including ten days of stimulation. Certain specialized costs that may be relevant for some IVF patients cannot be included in the plan and these are described clearly at the beginning of the process.
How Much Does IVF Cost?
It's one of the most common questions: how much does IVF cost? After qualifying for the IVF Opportunity Plan, patients pay $11,750 for one IVF cycle. A full refund will be granted upon withdrawing from the program before starting medications. After starting medications, a $4,050 refund will be granted. If your cycle is cancelled prior to egg retrieval due to a medical reason (i.e., poor response, premature ovulation) you will receive a refund of $5,055. If you have your egg retrieval but do not have an embryo transfer, you will receive a refund of $650.00.
Financial Flexibility for Affording IVF
People can withdraw from the IVF Opportunity Plan at any time. Unlike some fertility centers that try to reduce costs by using lower medication doses or by limiting access to their programs, RMACT seeks to improve pregnancy outcomes by offering the highest quality treatment to everyone. We want to help you find the financial opportunity that meets your needs. Additional payment programs for affordable fertility treatment at RMACT will be highlighted in upcoming posts.
Patients who choose The IVF Opportunity Plan at RMACT are treated by our outstanding team of surgeons, nurses and other specially trained patient care professionals. Find
out if The IVF Opportunity Plan is right for you. To learn more, contact a Financial
Service Representative at RMACT at (203) 750-0400.
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Pregnant with Twins: One Couple's Reaction
Bear with me, there’s a blog out there that I want to comment on concerning IVF and twins. Namely, the blog about a couple who is pregnant with twins and are “pissed off” about it. Being me, I have a few things I want to say first.
Becoming pregnant and having a safe and healthy delivery and beautiful baby afterwards.
Those are the goals when you are up against infertility issues.
A lot of us go through a period of wishing, hoping, and even praying for twins.
You have your baby. And your baby has its sibling.
And so you’re done.
Some of us stay in that phase and are thrilled when that is what comes to pass. Two babies at the same time. Twins.
Many of us move on to feeling that one at a time, or simply one is a safer, healthier, even saner choice.
IVF and Twins: Elective Single Embryo Transfer (ESET)
Certainly the infertility field and most board-certified reproductive endocrinologists and fertility programs are moving away from multiples with elective single embryo transfer (ESET). There are many reasons why conceiving, carrying and delivering a single baby is preferable to multiples.
Main reason: it’s safer for baby and mom. The outcome is more predictable with just one at a time.
Really. We all know this.
Thank goodness so many twins and multiples are born healthy and strong and vital. And that so many moms make it through just fine as well. That’s a huge comfort for any of us carrying more than one. Good prenatal care, eating properly, exercising moderately, sleeping and listening to your doctor’s advice carefully will help ensure a good outcome.
This is the longest preamble in history to talk about the blog on CNNHealth yesterday.
Title: “We’re Pissed” to be pregnant with twins.
Here’s a quote from the dad to be: "To say we're excited would be an exaggeration," the dad wrote on Babble.com in an anonymous post that recently started trending on social media. "More truthfully, we're pissed. And terrified, and angry, and guilty, and regretful."
I know this is not politically correct. I know that we’re all supposed to be happy and thrilled because there’s a healthy, on-going pregnancy and that infertility has been conquered. I know that those of us who are still not pregnant could feel really resentful and angry towards this couple for speaking out about their upset.
I want to send them a thank you note.
What I have learned about human nature is that we are not unique. Well, we are, of course. We are all individuals and have our own DNA and personalities. Of course we do.
We also have a lot more in common with every other human being on earth than we do with any other species.
That’s a lot to have in common.
And in my humble opinion, there are folks out there that are relieved that this couple opened their mouths and said what they were not comfortable saying. Because it’s not politically correct or okay. And they said it anyway. They have voiced what some of us may have felt when we found out that there was more than one gestation.
That they’re scared. And upset. And maybe they would have preferred childfree to two at one time.
I thank them because if it relieves guilt and shame for other people pregnant with more than one, then that’s a good deed.
Pregnancy Emotions and Honest Admissions
Admitting to mixed or even negative feelings is not easy to do. But it’s honest. And it’s not a predictor, by the way, about how they will do as parents. Feelings aren’t reality. Feelings can pass. They can change and shift, especially with the help of a mental health professional.
Many of us are thrilled to become pregnant with multiples.
But not all of us.
And for those of us who are not, I applaud this couple for speaking so frankly about what others may not want to say. It can relieve the shame and guilt of these feelings.
So please, let’s not judge them. They’re not asking you to feel differently. And they are entitled to how they feel and to say it out loud. I know it’s hard to hear. Still, they have the right to say it.
More tomorrow on how to make choices and avoid situations that truly are not right for you.
Lisa Rosenthal's Google+
Navigating the Fertility Treatment Path
Fertility treatment is often a process that changes midstream. Often, fertility treatment is compared to a roller coaster or a stream that meanders down, lazily moving around rocks in the way. Or a road with detours. Or a path with many bends. There are many metaphors out there that fit. Simply put, it all just doesn't always go as expected. And that's not simple at all.
In over 25 years of being a patient and educator, I rarely hear someone say that infertility feels like the path that they were meant to be on. In the larger picture, it's not a path we would embrace or even choose. In the day to day of fertility treatment, delays and changes are equally unwelcome. Even when necessary, we feel disappointment and frustration when treatment changes direction, especially abruptly.
When a cycle gets cancelled, it can feel devestatingly disappointing. It does not feel like a postponement, it feels like a pregnancy will never happen. It feels, deep inside, in our cells, that this is the sign that a baby will never come. Or a healthy, growing pregnancy will occur instead of a loss.
It's hard, even almost impossible to put it into perspective.
The only news in fertility treatment that is welcome is good news. Very good news. That everything is going perfectly. That everything is on schedule, that our clinical response is just what our doctors want to see.
Even that is not always reassuring when we have had "perfect" cycles before that have been unsuccessful.
What to do?
The cycle, embryo, fertility treatment plan will not always go perfectly and still we get pregnant. Sometimes, in a cycle, almost nothing goes well and we get pregnant.
IVF Cycle Journeys
Just last month, I spoke with a friend who was in her fifth round of IVF who wanted to go out and drown her sorrows with a margerita or four. Because she was sure that her cycle hadn't worked.
Her pregnancy test was the next day. I encouraged her to wait until the following evening as the pregnancy test could be positive. After so long in treatment, she knew it wasn't.
I assured her that she could not actually know that.
She told me all the symptoms and reasons why this was so. Everything she felt and didn't feel physically. How the cycle itself had gone badly.
Still, she decided she could wait one more night for a fabulous drink.
And yes, she was pregnant.
And yes, just this past week, she heard a heartbeat.
When she least expected it.
When it shouldn't, couldn't have happened.
The delays and starts and stops are heartbreaking.
They may be those detours on your way to parenthood.
I wish they weren't there. I wish this was a smoother trip for you.
My bigger hope and dream is that baby in your arms.
And I'll keep you company while you travel this path.
Lisa Rosenthal's Google+
Bear with me.
I haven't written a blog about the weather in a long time.
So here goes.
Rain or snow?
It's October, I live on the east coast of the United States.
Let's go with rain.
Unless it snows.
For those of us who experience infertility, these rapid changes in temperature, precipitation and forecasting feel very familiar.
Changes in medication and treatment, even in the middle of an IUI (intrauterine insemination cycle) or IVF (invitro fertilization) cycle are fairly common.
Just like the weather, the smallest of details add up and create change.
As one of my best friends always quotes, "a butterfly flaps it's wings in Paris and we have a hurricaine in Florida".
Anyone out there have trouble with these swiftly changing plans? Anyone out there feel out of control?
Welcome to infertility.
My friends are floating around in my head today. So is my sister.
Here's what I consider.
The Serenity Prayer:
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Oh, what I wouldn't do for an extra dose of wisdom today.
Fertile Yoga tonight in Brookfield/Danbury.
I'm looking forward to seeing you.
Until then, I'm just keeping an eye out for what's going on outside.
Sometimes that's just easier than checking the weather forecast.