Transcript of Penn Vital Signs episode:
Fertility
 Heather
Kahn (host): With all of the complexities of medicine,
we are still inspired by the most fragile things…
the beginning of life. Yet even mother nature
sometimes needs a helping hand. And that's when
some couples unable to conceive children turn
to doctors for help.
 Dr.
Pfeifer: "There are so many changes that
are taking place in this field that it's very
exciting to be part of it and the successes keep
getting better over the years."
Sharon Keifer: "They're strong... they divided...
the last couple of days. They're just full of
life, you know, they're ready to go... I think
it's going to work this time."
NARRATOR: Penn Vital Signs is sponsored by Merck.
Here's your host, Heather Kahn.
Heather Kahn (host): For centuries, couples have
struggled with the mysteries of infertility. While
more than 14% of couples cannot conceive without
medical intervention, doctors are making advances
right here in Philadelphia, the birthplace of
modern medicine. Dr. Christos Coutifaris is Director
of Penn Fertility Care at the University of Pennsylvania
Medical Center.
Dr. Coutifaris: "If a couple has tried to
get pregnant having regular intercourse for over
a year and has been unable to conceive a pregnancy,
then by definition, this couple has an infertility
problem. And it is a fairly common condition.
It happens in approximately one in seven couples
in the United States."
Heather Kahn (host): Counselor Andrea Boxer has
helped many such couples.
 Andrea
Boxer: "Most people find it very helpful
to have someone to really be able to deal with
all of the stresses created by suddenly learning
that you now have an infertility problem."
Andrea Boxer: "Learning how to deal with
infertility in and of itself is a crisis. You
have to help people be realistic about what the
outcome of the treatment is going to be."
Heather Kahn (host): Sharon and Jim Keifer are
now facing that harsh reality. After six years
of marriage, they've been unable to conceive naturally.
 Jim
Keifer: "Sharon comes from a big family and
we have brothers and sisters who have children
and we just knew we wanted to have a family some
day, and we like being with the kids in our family."
Sharon Keifer: "It was always a dream of
mine to have my own family, so when it didn't
happen right away it was a little shocking but
we always knew that we wanted to be parents."
Heather Kahn (host): Frustrated by their many
natural attempts, the Keifers researched in-vitro
fertilization, or IVF, a medical intervention
that has helped thousands of couples become parents.
In Philadelphia, the Keifers turned to Penn Fertility
Care, which is among the leaders in the region
for research and pregnancy success rates.
Dr. Coutifaris: "The Keifers and I met approximately
a year and a half ago. They came with the diagnosis
of endometriosis so they had attempted pregnancy,
it had not worked out and IVF had been recommended."
Heather Kahn (host): For Sharon and Jim, the
desire to have children of their own has never
been stronger.
 Sharon
Keifer: "I read this quote recently from
Jeremiah, and it went something like "Before
I formed you, I knew you." And it just made
me realize that somewhere up in heaven our baby's
waiting to be sent down to us."
Heather Kahn (host): When we come back we'll
follow Sharon and Jim as they go through the IVF
process … and we'll be there to discover
if their dreams of parenthood have come true.
Sharon Keifer: "I think we'd be great parents
and are ready to roll with the punches and do
what it takes."
Heather Kahn (host): We'll also bring you inside
the delivery room at Phoenixville Hospital. There,
through the eyes of Carl Homa, you'll watch as
his wife Silvia gives birth to the children they
thought they would never have. If you have questions
about infertility, you can chat on-line with some
of the doctors from this show by logging on to
pennhealth.com now and for two hours after the
show. You can even make an appointment by calling
1-800-789-PENN. We'll be right back.
Commercial Break 1
Heather Kahn (host): Infertility programs around
the country rely on experienced specialists and
the latest advancements to bring hope to their
patients. As one of a select group in the nation
supported by the National Institutes of Health,
Penn Fertility Care offers patients the latest
infertility treatments.
 Dr.
Barnhart: "The success rate for all of these
infertility practices has dramatically improved
over the years and it basically has dramatically
improved because we've been able to look at each
aspect of this process and make it better and
because of that, we can now offer success rates
that are practically 3 times as high as they were
10 years ago."
Heather Kahn (host): Jim and Sharon have decided
to place their hope in the hands of Dr. Coutifaris
and his team.
Dr. Coutifaris: "They came through, they
had the one cycle of IVF. They didn't get pregnant
and now the plan is to proceed with the second
fresh cycle of IVF."
Heather Kahn (host): During in-vitro fertilization,
doctors can help a couple get around the medical
problem causing the infertility. By combining
the egg and sperm artificially, an embryo is produced
that can be placed back into the uterus. After
months of preparation, doctors are ready to delicately
retrieve the eggs from Sharon.
 Dr.
Coutifaris: "What we are seeing are the follicles,
they look like dark, black holes on the screen
and that's fluid. The follicles have fluid and
that's how fluid looks on ultrasound. This fluid
contains mature eggs. So when the fluid gets passed
into the laboratory, the embryologist looks under
the microscope looking for the eggs from each
of these follicles. When an egg is observed in
the laboratory, then the embryologist basically
notifies us by shouting that there was an egg
there and we can hear it in the operating room."
Heather Kahn (host): Once the medical team has
successfully retrieved the eggs, Dr. Coutifaris
makes sure that Sharon knows how many eggs will
be available when fertilization begins.
Dr. Coutifaris: "What I do is I write on
her palm how many eggs we got, so when she's a
lot more awake she will be able to look at the
palm and see how many eggs we got."
Dr. Coutifaris: "Patients come to see us
and to see an infertility specialist....ultimately
to bring a baby home. In our program we have a
physician who is specialized in taking care of
the males but also the females.."
Heather Kahn (host): Dr. Pasquale Patrizio is
among few in the country able to treat both men
and women as a couple.
 Dr.
Patrizio: "Having one person that knows the
couple and can perform surgery on both of them,
it's extremely accepted and seen extremely as
a big plus by the couples."
Heather Kahn (host): This unique advantage of
Penn Fertility Care is a part of the overall team
approach. IVF Manager, Deb Schafer.
Deb Schafer: "I feel like I can give them
a little bit of control. They don't have any control
over why they're infertile, or why they can't
have a child and that's extremely frustrating.
I find that if you can work with them to let them
know that you're here for them... it's a treatment
process, but I help them map out their cycles,
look at their commitments, whether it be work,
vacation and try to personalize their care and
their treatment process within their own schedule
and make it a little bit easier."
Heather Kahn (host): Personalized care is what
brought Silvia and Carl Homa to Penn. As a couple,
they faced infertility after Silvia experienced
problems with her fallopian tubes.
Carl Homa: "We gave up… basically.
This is our last. You know, we wanted to do this.
If we didn't… we felt if we didn't do this,
we would be wondering the rest of our lives, you
know, what, would we have another child."
 Silvia
Homa: "I didn't want to be forty and think,
I wish I would have had one more kid. So, we knew
the only way we could have more children was through
the in-vitro fertilization."
Heather Kahn (host): Physicians were able to
use cryo-preserved embryos from Silvia's earlier
IVF efforts. Unlike Sharon Keifer, Sylvia had
embryos remaining from her first round of IVF.
Those embryos were kept cryogenically frozen,
then transferred to Sylvia's uterus. Finally,
seven months ago, Silvia and Carl heard the words
they were longing for. Pregnant. Dr. Susan Roitman
of Penn Care at Valley Forge OB/GYN has been Silvia's
physician since 1992 and delivered her the couple's
first two children and now she'll be delivering
their twins.
Dr. Roitman: "To this point she's had a
very uneventful pregnancy for twins and I think
compared to many of our other patients who have
twins, she's really sailed through."
Silvia Homa: "Sean, he knows that there
are two babies in my belly and he points to them
and, you know, he thinks he has two babies in
his belly also."
 Carl
Homa: "And I have two babies in my belly.
Sometimes they're in my chest." (laughs)
Silvia Homa: "Stephan, he's been really
good. He's been a real big help. He would like
a girl in the worst way, a baby sister. So we're
hoping to at least give him that."
Heather Kahn (host): When we return, Silvia's
delivery day arrives, as Sharon faces the embryo
transfer procedure, bringing her one step closer
to motherhood. And we'll join a birthday party
for a very special pair of three-year-old girls.
If you have questions about male or female infertility,
you can chat live with doctors from this show.
Log on now to pennhealth.com. We'll be right back.
Commercial break 2
Heather Kahn (host): Today, Darby and Rachel
Kearon are turning 3 years old, but there was
a time when their parents thought they could never
have a family.
 Becky
Kearon: "We are married eleven years this
past April. Got married in Philadelphia... Just
wanted to take a year to be a married couple and
then decided after a year that we wanted to start
our family. And seven and a half years later there
was still no family."
 Heather
Kahn (host): Becky and Chris Kearon say they were
naïve to think they could get pregnant easily.
But even after seven and a half years of trying,
Becky was still unsure about medical intervention.
Becky Kearon: "I wanted to have a baby naturally
and surprise my husband with a houseful of balloons
when I was pregnant or, you know, a fairytale
story of how you're supposed to have a baby. All
of the timing and the lack of romanticism about
it, you know, it was hard for me to get a grip
on… until we went to the group at the University
of Penn. We came home and it just was, it was
clear to us what we're going to do."
Heather Kahn (host): On In late August of 1999
at Phoenixville Hospital after nearly a decade
of waiting, Becky and Chris welcomed Rachel and
Darby into their lives.
Becky Kearon: "You have to let go of the
fairytale kind of, and trust that if you know
what you want, which is a child, there's other
ways to have the fairytale. Working with a doctor.
That's the path in life that you've been dealt
and if you want to get to the edge of the road,
you have to go with it and trust. To not be scared."
 Dr.
Roitman: "She's 35 weeks. If the babies were
to be born today, they probably would do quite
well but twins at that gestational age really
do very, very well and don't have major problems."
Heather Kahn (host): Three days later Silvia's
labor has begun. Although a month early, the delivery
team is prepared. Husband Carl follows the action
with his video camera.
Dr. Roitman: "Okay… Here we go. Girl
A. Hi Mommy! What do you think?"
Carl Homa: "Hi Honey. So is that Caitlin?
Is that Catey? Here comes the second one. Wow,
they're big kids."
Dr. Roitman: "And it's a… girl! Two
girls. YEA!!! Dad, look. She's adorable."
Carl Homa: "That's B. She's gotta be jumpin'
all over the place."
Dr. Roitman: "Woo! Hi Mommy! Another girl!"
Carl Homa: "Hi sweetie!"
Nurse: "Congratulations."
Silvia Homa: "Thank you."
Carl Homa: "Two girls. Good thing we have
two girl names."
Dr. Roitman: "What's the second one?"
Carl Homa: "Carin."
Heather Kahn (host): Soon after, family arrives,
and Siylvia and Carl are proud to present the
newest members of the Homa family.
Heather Kahn (host): As mom and dad get to know
their new children, another couple, not far away,
is hoping for good news of their own. Three days
after the egg retrieval, Sharon's embryos are
growing.
Dr. Coutifaris: "We show them their embryos
and then we discuss with them the quality of the
embryos, how well they have developed in the last
three days in the incubators and we make a decision
together of which embryos and more importantly
how many embryos we are going to transfer."
Heather Kahn (host): With her transfer complete,
Sharon recalls her first moment seeing the images
of the dividing developing embryos.
Sharon Keifer: "They look like little flowers.
To me they're little babies. Beautiful. They're
strong. They divided the last couple of days.
So, they're just full of life, you know, they're
ready to go… I think it's going to work this
time."
Heather Kahn (host): Coming up, Silvia and Carl
bring their new babies home. And Sharon and Jim
take the test that will tell whether she has finally
become pregnant.
Dr. Coutifaris: "If you see one line, come
closer, if you see one line it's negative, if
you see two lines, it's positive."
Heather Kahn (host): In a moment, we'll see the
results. If you would like to learn about IVF
and other infertility procedures, log on to pennhealth.com
now and for two hours after the show. You can
chat live with the doctors you've seen here. We'll
be right back.
Commercial Break 3
Heather Kahn (host): Life has certainly changed
at the Homas. And nobody is more proud than big
brother, Stephan.
Stephan Homa: "They're the cutest sisters
that anyone could ever have."
Silvia Homa: "He really is a help. He really
wants to be a big help when it comes to his sisters."
Carl Homa: "Yeah, oh, he loves his sisters…
That's the joy of his life. He has always wanted
one sister and now he has two."
Silvia Homa: "This is Carin, Carin Nicole
Homa, and this is Caitlin, Caitlin Marie Homa.
You know that's a whole new ball game for me and
for Carl, having two girls. So, I was happily
surprised and they both are very different looking
and very pretty, beautiful babies."
Dr. Coutifaris: "The two weeks following
the transfer are very stressful because after
all the attention that we have given the couples
with the daily visits and the daily phone calls
and so this is sort of the culmination of this
two-week period of pretty high anxiety, very stressful
because there's no such thing as half pregnant.
Either they're pregnant, the woman is pregnant
or she is not."
Sharon Keifer: "It was a roller coaster
of emotions since the transfer, overall it's an
amazing feeling and we feel very fortunate that
we could see things from such an early stage."
Heather Kahn (host): The years of trying and
hoping have come down to this moment. Sharon and
Jim Keifer will now have the chance to watch the
pregnancy test results appear before their eyes.
Dr. Coutifaris: "So we'll go next door and
have you give us a urine sample and we'll go from
there. Okay?"
Sharon Keifer: "How long does it take? One
or two minutes?"
Dr. Coutifaris: "It's fairly quick. If you
see one line, come closer, if you see one line
it's negative, if you see two lines, it's positive."
Sharon Keifer: "I see one and a half. I
don't know."
Dr. Coutifaris: "It's two lines. It's two
lines. It's positive."
Sharon Keifer: "Is it? Oh my God really?"
Dr. Coutifaris: "Yep! It's right there."
Sharon Keifer: "Thank you!"
Dr. Coutifaris: "This is great. This is
great! Congratulations."
Sharon Keifer: "I'm so happy. I've taken
so many of these."
Heather Kahn (host): Sharon and Jim Keifer's
lives have been forever changed thanks to in-vitro
fertilization. Just weeks later, they heard their
baby's heartbeat for the very first time during
an ultrasound. With this milestone, they are one
step closer to parenthood. Be sure to join us
for the next season of Penn Vital Signs.
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