Home July 2014 Making A Mishpucha

Making A Mishpucha

Although the traditional means of making babies involves “when a man and woman are in love and live happily ever after,” today that is not always the case, and sometimes it’s just not that straightforward. Nowadays, men and women are waiting much longer to get married and start their own families. Sometimes this is due to putting their careers first, pursuing their educational goals or the all too common problem of just not meeting the right person yet. No matter what the reason, though, women just aren’t procreating as early as they used to. According to the Centers for Disease Control and Prevention, the number of women having their first children between the ages of 40 to 44 has actually increased fourfold from 1985 to 2012.
Potential parents are choosing to build families with opposite-sex partners, same-sex partners and sometimes on their own. There is definitely a shift in the perception of what constitutes a parental unit today, and infertility treatment helps aid these couples and single parents alike. Fertility treatment also helps want-to-be parents overcome the pitfalls of biology. Women are most capable of conceiving while they are in their mid-20s. As women get older, this probability starts to drop. By the time they are in their 30s, the odds of getting pregnant start to decline, at 37 women experience a significant drop in success rates and that number drops even more sharply after 40. With women waiting until later in life to start families, this can be a real problem. Perhaps this is why the U.S. has seen a $3.5 billion market for fertility treatment emerge since 2012, according to Marketdata, a market-research firm.
There are several different options out there for fertility treatments: fertility medications, artificial insemination, in vitro fertilization and surrogacy. Each option is approached differently, and they are as unique as the people who are pursuing them, so there is no “right one.” It is different for everyone. For more detailed information on these procedures, please visit: infertility.about.com.
While fertility treatments are miraculous in many ways, Jewish legal authorities have raised some concerns about how fertility technology is used, the most surprising of which pertains to surrogacy. Traditional Jewish law suggests that when the sperm and egg of two Jewish people are implanted in a non-Jewish surrogate mother, the child born is not automatically Jewish. According to most Orthodox and Conservative rabbis, Jewish status is determined by the mother who carries the child to term — not by the child’s genetic material. These rabbis would require conversion for any child born to a non-Jewish surrogate.
How you chose to pursue your dreams of being a parent is a very personal journey, and what route you take is something that will take a lot of consideration. There are different options, different time frames and different specialists to consider. JLife magazine caught up with one very special and successful fertility doctor, Dr. Larry Werlin from Coast Fertility Center in Irvine, Calif. and asked him about his path and practice.
How long have you been practicing fertility medicine in Orange County? 32 years
Do you have children? Three children
What was your relationship to Judaism growing up? Very strong relationship with Judaism. My grandfather was an orthodox rabbi and I actively participated in Hebrew school in all functions that occurred in our temple.
Where did you study medicine? Mount Sinai School of Medicine, New York City
What are some milestones in your education, research and practice that you are particularly proud of? 1) I was the National Fellow in Reproductive Medicine at the National Institute of Health; this is where I did my fellowship from 1980-1982. 2) I published the original studies utilizing a medication called Lupron for the treatment of Endometriosis.  This was done during my fellowship. 3) I have been a faculty member at UCI MC, and have enjoyed participating in the residency education program. 4) In August 2003, I was the lead investigator in the first randomized prospective study published to evaluate the benefit of Pre-Implantation Genetic Screening (PGS) in high-risk patients. 5) Our group at Coastal Fertility continues to present new clinical research at our annual national meetings.
What made you decide to specialize in Fertility Medicine? I deal with a population that is basically healthy and when we are successful it is the most exhilarating feeling one can experience. When unsuccessful, although emotionally devastating, the recovery is likely to occur and other options become available. Secondly, reproductive medicine allows me the ability to work with hormones in fine-tuning the process of trying to successfully conceive.
What do you like the most about your area of practice? The ability to help couples achieve their ultimate goal of having a family.
I’ve heard that many of your past patients stay in touch. Can you please elaborate? This is an emotional journey.  There is an emotional bond that develops between the physician, the patients and the practice.  We are always excited to hear from our patients on Facebook, our website, through holiday cards and our Annual Halloween Party where we host approximately 500 families.
What are some of the more unique thank you gifts you have received over the years? The most common gift I received are dolls that look like me.
Have you felt any effects of the changes in coverage that we have seen since the Affordable Care Act passed? Primarily in California insurance does not play a significant role in fertility care.
Israel covers fertility treatment as part of their national health care program. Are there any international studies or research findings that you feel the U.S. can benefit from? There was a large study published from Israel about one or two years ago involving 85,000 patients who received fertility medication. This study was beneficial in that it showed that patients were at no greater risks for various cancers based on utilization of fertility medication in non-high risk patient groups.
Have you noticed any average trends (age or otherwise) in regards to couples that seek treatment? As patients become better educated with respect to fertility care, we are seeing patients from all age groups.  There does appear to be a trend with women who are not yet ready to pursue a family and have other goals such as business or professional goals, who are now utilizing fertility preservation techniques.  This offers the opportunity of freezing their eggs at a younger age, and then pursuing their family when they are ready.
Are there any lifestyle choices and/or practices that you can recommend to couples trying to get pregnant? There is no question that eating correctly, exercise, and maintaining a healthy lifestyle can only benefit a couple.  Alternative techniques such as acupuncture can also be beneficial in conjunction with fertility care.
Are there any lifestyle risk factors couples should avoid in order to become pregnant? Smoking, excessive alcohol use, or recreational drug use are factors that can have a negative effect on your ability to conceive.
During the first trimester, are there any practices you would recommend to expectant mothers? The most important advice I can give, is to live a healthy lifestyle during the first trimester. This is the time when all the organ systems develop.
What is the most exciting thing you have seen in your field in the last ten years? The first one is that patients are better educated about their own physiology and what is available for fertility care.  Secondly, the development of Pre-Implantation Genetic Screening (PGS/PGD) has been beneficial in helping high-risk patients successfully achieve a pregnancy and prevent certain hereditary diseases from continuing in families. Thirdly, the use of fertility preservation in both the cancer patients and non-cancer patients has given these people new life choices.

Tracey Armstrong Gorsky is a contributing writer and managing editor of JLife magazine.

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