Dr. Spencer Richlin Explains Why an Obstetrician Cares About Fertility Screening
Part of my job at Reproductive Medicine Associates of Connecticut (RMACT) is outreach to local Obstetricians/Gynecologists (OB/Gyn). The most pleasant way that is done is that I accompany one of our board certified reproductive endocrinologists (Dr's Mark Leondires, Spencer Richlin, Joshua Hurwitz, Cynthia Murdock and Shaun Williams) to a lunch at the office of an OB/Gyn.
Yesterday, it was Dr. Richlin and myself. I hadn't seen him in a while. I didn't forget how smart he is, really, I didn't. Listening to him explain the difference between PGD (pre-genetic diagnosis) and CCS (Comprehensive Chromosonal Screening) though, reminded me again how smart he is.
Be very clear, when you have two physicians talking about medical issues, as a lay person, I tend to get a bit lost. Less so these days then years ago. Also, they are kind and explain some of it as they go. Sometimes, like yesterday, they get so excited that the conversation just spirals away from me. It was fascinating listening to these men and women talk in such an animated way about their chosen fields of medicine and noticing where they intersect.
Why does an Obstetrician Care About CCS?
Why should an OB/Gyn care about CCS? Simple answer. One that I understood easily. Less pregnancy loss because there are almost no chromosomal abnormalities in the tested embryos (not zero, but less than 2% error rate). Given that almost 25% of all pregnancies result in miscarriage, that's important for an OB/Gyn to know. Pregnancy loss is hardest on the parents to be, without a doubt. I know. I had two of them. Pregnancy loss is also very challenging for a doctor's office to handle. There is the medical piece of it, which is often very straight forward, but not always. There is also the emotional piece of it, which is far less straight forward and needs to be handled on a patient by patient basis. There is often a lot of grief around a miscarriage even more potent when infertility was a struggle first. Our doctors and medical staff grieve with us when there's a loss.
Another reason that an OB/Gyn should care about CCS? Single pregnancies. When an embryo that has been found to be healthy is transferred back, the chances of pregnancy are much higher (and the risk of miscarriage much lower) and therefore allows for less embryos to be transferred back. Twin pregnancies frequently result in healthy babies and healthy moms. Often, though, there are more complications for both the babies and the mothers, even in a twin pregnancy. Certainly when we start to talk about higher order multiples (pregnancies of 3 or more), there will almost certainly be complications and probable compromises in the health and well being of the babies and the mother. An OB/Gyn would much prefer to see patients who are pregnant with one baby; they know that there is a much greater chance of a healthy baby and mom and much less chance of complications.
I got all this yesterday, again, while having the honor of hearing these physicians speak to one another. Yet another reason that I love my job! Fascinating conversations about women's health and family building, with doctors that really care. What's not to love?