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Exceptional outcomes through technology, research

Hearing the words, “you’re pregnant” can be an exciting, life-changing moment. But for many couples struggling with infertility, the journey to parenthood is frustrating, stressful, and can at times feel hopeless.

Brooke Schmitt and her husband, Daniel, know this feeling. For almost two years, the young couple struggled to start a family, but infertility issues got in the way of achieving their dream of parenthood.

“When I went to my OB/GYN, they ran several tests, and it turned out that my numbers were really low,” Brooke said. “Since my ovaries were not releasing eggs, my doctor recommended that I consult with a fertility specialist.”

After initial consultations with other providers, Schmitt chose Texas Children’s Pavilion for Women. She was referred to Dr. Paul Zarutskie, a reproductive endocrinologist at the Family Fertility Center.

 
A state-of-the-art facility

Since opening in July 2014, the Family Fertility Center has become a regional and national leader in providing advanced fertility services to families who have had difficulty conceiving. The center’s reputation was bolstered even more in 2016 when its success rates for in-vitro fertilization (IVF) reached a remarkable milestone — 47 percent of embryo transfer patients at the center achieved clinical pregnancy.

Dr. William Gibbons, chief of Reproductive Medicine at Texas Children’s Pavilion for Women and founding director of the Family Fertility Center, credits the center’s success to numerous factors, first among them the support of Texas Children’s Hospital.

“Texas Children’s allowed us to have resources that many IVF programs don’t have,” Gibbons said. “[They] enabled us to build the absolute best lab that we could have, and we have almost as much research lab space as clinical lab space.”

The research underway at the Family Fertility Center is conducted in collaboration with physicians and scientists at Baylor College of Medicine, Rice University, the University of Valencia, Spain, and other institutions. Investigations are performed by career researchers and by clinical physicians, who commit at least 10 percent of their time to research.

Aside from its long-term value in contributing to scientific and medical understanding, the Family Fertility Center’s research capability helps support the clinical mission as well.

“There are just so many questions in our field; What is a good egg? What makes a pregnancy successful?” Zarutskie said. “Those are our two big areas of research. Having the resources and expertise to be able to to answer those questions and do something about it is tremendous.”

In addition to its research capabilities, the Family Fertility Center is the first in Houston and among the early adopters in the United States to offer the EmbryoScope, an embryo monitoring system that provides continuous moving time-lapse images of embryos as they grow. This technology allows fertility specialists to identify the healthiest embryo to transfer to the patient to improve IVF success.

 
Creating a miracle

Realizing the uncertainties that often accompany fertility treatments, the Schmitts relied on Texas Children’s expertise and state-of-the-art capabilities to help facilitate their dream of becoming parents.

After consultation with Zarutskie and his team, Brooke and her husband elected to pursue IVF. The first step in the process was ovulation stimulation, in which Brooke was treated with hormones and other medications to stimulate the production and release of eggs. Despite a complication known as ovarian hyperstimulation (which occurs in a small percentage of women undergoing ovulation stimulation) the process was ultimately successful.

“I was really lucky — my numbers were great,” Brooke said. “They retrieved about 41 eggs, and 39 of them fertilized successfully.”

After five days of incubation, however, the number of living embryos had fallen dramatically.

“Every day, Dr. Zarutskie would come to me with a report,” Brooke said. “By day three, we only had 12 or 15 eggs that hadn’t died. He was like ‘Brooke, I’ve never seen somebody start with so many and now have so little.’”

Extraordinary support

The emotional complexity of fertility treatment is difficult to overstate. Some couples are seeking to become pregnant. A young woman may be electing to freeze eggs for possible fertilization and implantation later. Or an oncology patient may be having concerns about the possible impact of cancer treatment on future fertility. Many patients seeking help at the Family Fertility Center face considerable uncertainty, and the center offers support of many kinds. In addition to the medical team, patients and their families are offered psychosocial support from staff psychologists and psychiatrists and have access to financial counselors.

There are so many little pieces between the patient’s medical condition, the surgical history, the psychology and psychiatry, and struggling with the desire to have a family – the impact all of this has on the couple is immense,” Zarutskie said.

“But we have a tremendous team, from the physicians and nurses to the medical assistants who take care of them. From the moment they first walk in the door, our staff is very, very sensitive to their specific needs.”

 
A positive outcome

At the end of day five, 12 of Brooke’s embryos were still living. All of them underwent genetic testing, and five of them were healthy. She and her husband, Daniel, implanted an embryo. The other four healthy embryos were cryogenically preserved for future implantation.

Brooke was implanted with an embryo on February 5, 2016. Then, there was the wait.

“You’re supposed to wait 10 days until you go back and do the pregnancy blood test,” Brooke said. “They don’t want you to do [an over-the-counter] pregnancy test because sometimes your results can be false-negative or false-positive.”

Nevertheless, Brooke and Daniel couldn’t wait — and the test came back positive.

“I took a photo of the test stick and texted it to Dr. Zarutskie and said, ‘I’m so sorry I cheated, I know I’m not supposed to take a pregnancy test but I did,’” Brooke said. “The line was really obvious, and he said, ‘Oh yeah, you’re really pregnant!’”

After blood work confirmed the pregnancy, Brooke and Daniel told her parents.

“My dad said, ‘This is great, but I don’t believe it until Dr. Z says it’s true,’” Brooke said. “So Dr. Zarutskie texted my dad and said, ‘Congratulations, you’re going to be a grandpa!’”

Sophia Schmitt was born October 19, 2016.

“It’s the most surreal feeling to know that you’re a parent and you’ve made this baby,” Brooke said. “We know we couldn’t have made her without the help of Dr. Zarutskie and the fertility team. Between the talent and the state-of-the-art technology there, it was a perfect combination that produced a perfect outcome.”

For more information about Texas Children’s Family Fertility Center, click here.