September 16, 2014

Fertility

Road to Parenthood

Preimplantation genetic testing and in vitro fertilization let couples minimize the risk of passing along a hereditary disease.

Diane Sears | 11/1/2008
In Vitro Fertilization
A technician monitors the in vitro fertilization process. [Photo: Eurelios / Phototake]

Reproductive Advances

The reproductive field has come a long way since the late 1970s to 1990s, when fertility treatments produced scores of triplets and quadruplets, which are rare these days, says Dr. Marc Bernhisel, director of the IVF-embryology and clinical labs for Reproductive Medicine Group in Tampa. The physicians are able to select one or two ideal embryos rather than transferring more embryos to prevent multiple pregnancies. IVF enables infertility doctors to use the male partner’s sperm even when the count is very low. In the past, they were relegated to using donor sperm.

One of the most promising developments, Bernhisel says, is the ability to store and freeze eggs and sperm for later use. This is especially helpful for people who face cancer treatments and other issues and for women who are aging or are near the end of their natural egg-producing years.

Also on the horizon: Possibly curing or correcting a disease detected in a fertilized egg before implanting the embryo into the mother.

In 1997, Chuck and Dena Oldham were trying to conceive a child, and fertility tests showed no reason they shouldn’t keep trying. Both 33, they felt they still had plenty of time.

Then, Chuck Oldham went to his doctor with what he thought was a stomach ulcer, but the diagnosis was much more serious: Multiple endocrine neoplasia type 1, a rare disease that affects the endocrine glands and releases excessive levels of hormones into the bloodstream. It ended up producing tumors on Oldham’s parathyroid, adrenal glands and pancreas.

Oldham remembers the day a physician gave him the diagnosis and told him the disease was hereditary. He was with his wife. “I can’t tell you not to have children,” the doctor said, “but I wouldn’t do it.”

“I can remember walking out of that office with Dena, in tears,” says Oldham, an editor who works for a Tampa publishing company on a contract basis. “I don’t know how much was the impending surgery and how much was the news that we couldn’t have children.”

Doctors removed the glands that held the tumors, and the couple started talking about adoption. Then in 2005, Dena Oldham read a magazine article that mentioned preimplantation genetic testing. What if they could somehow determine ahead of time whether their baby would carry the disease?

They visited Dr. Marc Bernhisel at the Reproductive Medicine Group in Tampa and came up with a plan: They would capture eggs and sperm from the couple, fertilize the eggs in vitro and send the fertilized eggs to a lab, where scientists would run genetic sequencing on them. The eggs that didn’t carry the disease would be implanted in Dena Oldham’s uterus.

But then came another stumbling block: Oldham was diagnosed with cancer and would have to go through surgery and then radiation therapy. They’d have to work quickly to capture his sperm.

The doctor predicted a 50-50 split of healthy and diseased eggs — exactly what the genetic sequencing found. In May 2007, doctors implanted two healthy embryos, and one took. The Oldhams’ son, Ian, was born in January.

“We understood it doesn’t happen for most people on their first rotation,” Chuck Oldham says. “We were very, very lucky. Until that baby came out and started crying, we were still prepared for it not to happen.”

Tags: Healthcare

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