At University Reproductive Associates, more than half of the pregnancies occur via non-IVF procedures, and patients are followed by practice physicians until eight to 10 weeks of pregnancy.
University Reproductive Associates’ Dr. Peter McGovern explains how his practice’s personalized approach to fertility medicine enhances the patient experience and outcomes.
According to the Centers for Disease Control and Prevention, 1% to 2% of all U.S. births annually (roughly 4 million births per year in the U.S.) occur via in vitro fertilization (IVF), a procedure that involves the surgical extraction of eggs from a woman’s ovary, the combination of those eggs with sperm in the lab (outside of the body), and the re-insertion of fertilized eggs directly into the ovaries or fallopian tubes to enable development of an embryo. But while the procedure has surged in popularity since its introduction over four decades ago, IVF isn’t the only path to a successful pregnancy for many couples.
In the following interview, Peter McGovern, MD, board-certified reproductive endocrinologist, infertility specialist, OB/GYN and co-founder of Hasbrouck Heights-based University Reproductive Associates (URA), discusses the role of IVF in the overall fertility medicine portfolio, the range of fertility medicine available to women/couples, and the benefits of the compassionate and personalized treatment provided at URA.
Please share a bit about the success rate of IVF.
Peter McGovern, MD, board-certified reproductive endocrinologist, infertility specialist, OB/GYN and co-founder of University Reproductive Associates.
Dr. McGovern: By stimulating a large number of eggs at once, IVF addresses multiple problems at the same time and increases the chances of harvesting a good egg. While the success rate of a given egg retrieval cycle depends on the female’s age (because the number of genetically abnormal eggs increases with age), the success of an embryo transfer is typically 50% to 60% per genetically normal embryo transferred. Some patients will have multiple genetically normal embryos in a single egg retrieval cycle, while others may take several egg retrieval cycles to achieve a single genetically normal embryo.
How do you feel that IVF has been positioned or perceived by society?
Dr. McGovern: It is appropriate to immediately consider IVF if certain conditions are present (including blocked fallopian tubes, very low sperm counts or known genetic traits). Some patients think that IVF is what you do when you’re infertile and some fertility practices subscribe to the theory that “all roads lead to IVF.” At URA we disagree. If you are overtreating people with unnecessary IVF, there can be medical risks to this strategy. Multiple studies show that IVF pregnancies are more prone to gestational diabetes, hypertension, pre-eclampsia, placenta accreta and other serious obstetrical and neonatal complications. We advise proceeding with IVF if the circumstances warrant this option but recommending IVF to all infertility patients just to save time or make more money isn’t the right thing to do.
Please discuss URA‘s personalized approach to fertility medicine and embracement of the many different fertility methods available (alone or in combination) as appropriate for each patient.
Dr. McGovern: We know that one size doesn’t fit all — people are individuals with unique problems, reactions to medication, preferences, beliefs and budgets, and we’re respectful of their individuality. We discuss all available options that have a reasonable chance of success with each patient and bring them in as a decision-maker so that the plan we formulate together is one that they agree to and feel comfortable with. I’m always surprised by how many of our patients get pregnant before we even finish their testing; I think that our process of meeting with patients, discussing their issues and options, and determining a plan going forward gives them a sense of confidence and helps them relax. It is confirmation that their situation isn’t hopeless, and that peace of mind is often comforting and helpful to the pregnancy process. Ultimately, our goal is to manage infertility problems using all available resources. URA is a lot more than just IVF. We do IVF and we do it well, but we treat patients like we would family members and aren’t here to do a sales pitch for IVF or encourage that procedure if it’s unnecessary.
University Reproductive Associates physicians discuss all available options that have a reasonable chance of success with each patient and bring them in as decision-makers so that the formulated plan is one that they agree to and feel comfortable with.
What percentage of patients at URA get pregnant with treatment/procedures other than IVF?
Dr. McGovern: More than half of the pregnancies at our practice occur via non-IVF procedures (e.g., ovulation induction medications, artificial insemination, minimally invasive reproductive surgery, etc.). We love science and technology and many great advances have taken place in the field of IVF over the last several decades, but sometimes a simpler approach is better.
For how long after they get pregnant does URA continue to see its patients?
Dr. McGovern: While some infertility practices immediately release patients back to their obstetrician as soon as they have a positive pregnancy test, we follow them at URA until eight to 10 weeks of pregnancy. We do this because reproductive issues may often occur during the first few weeks of pregnancy (ectopic or tubal pregnancy, miscarriage) in our patients, and we are expert in the management of these issues. We always refer pregnant patients back to their OB doctors by 10-11 weeks, in plenty of time for their prenatal screening for any abnormalities in the baby. We believe it is better continuity of care to monitor them carefully in their early pregnancy and to send them back to their obstetrician with a viable pregnancy, not just a positive pregnancy test.
Finally, URA is a physician-led practice. Why is physician leadership important in a fertility practice?
Dr. McGovern: URA is invested in the field, continuously participates in research projects, and has run a three-year fellowship training program for Rutgers-New Jersey Medical School in Newark since we opened in 2003. These activities add value to patient care in that we’re not just practicing today’s fertility medicine but are also staying ahead of the field and helping to educate the next generation. From an organizational perspective, being owned by a private equity company can focus practitioners on generating revenue for shareholders first and then practicing medicine. We don’t look at each patient as a revenue stream — we’re trying to help them achieve pregnancy. At URA, our No. 1 priority is always the patient.
For More Information
With locations in Hasbrouck Heights, Hoboken and Wayne, University Reproductive Associates has been helping patients complete their journey to a joyful pregnancy for over three decades. For more information, call 201-288-6330 or visit uranj.com.
— By Susan Bloom
