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Our Newsletter

San Diego Fertility Center publishes a monthly newsletter "Miracle News". Read the latest articles on this page and missed issues in our archive on the main website.

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Fertility Patient Seminar October 3 -The Hope for a Family

Join us for an informative fertility seminar to learn about exciting reproductive options. Dr. Hummel and Dr. Kettel will be speaking about embryo adoption and egg donation, unique options you may not have yet considered. You will also hear from a family who is experiencing the joy of pregnancy through embryo adoption. This seminar will be helpful both for couples who have undergone IVF and have remaining embryos. It also will be educational for couples who would like to learn of another way to become pregnant. “This is an excellent opportunity to meet the staff at SDFC,” comments Dr. Kettel, “the event is free and you will be able to ask questions and get detailed information on those treatment options.” The seminar will be held on Tuesday, October 3rd at 6:00 p.m. in our fertility center in Carmel Valley. We will have refreshments and appetizers during a break session. You will have the opportunity to ask questions and tour the facility after the main program. To RSVP, please call 858-720-3173 and let us know how many will be attending.
If you are interested in attending other fertility seminars with Drs. Hummel and Kettel, you can do so online. We have fertility seminar segments available on topics such as IVF, blastocyst transfer, egg donation and more. Request passwords and instructions to view online by sending an email to seminar@sdfertility.com.

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Protein May Hold the Key for Female Fertility

Scientists at the University of North Carolina, Chapel Hill, recently published a study that identifies a gene that may affect female fertility. The study evaluated the fertility of female mice that had only one copy of the gene and compared it to the fertility of mice that had two copies of the gene. Results indicated that female mice with only one copy of the gene had “significantly reduced fertility”. While the mice mated with male mice that also had either one or two copies of the gene, it made no difference in the fertility rate of the female.
The gene is responsible to produce a protein called adrenomedullin, which affects, besides other functions in the body, the success of implantation of the embryo into the uterine wall during pregnancy. Previous studies showed that decreased levels of adrenomedullin result in a higher risk of pregnancy complications. Even though the findings are with mice, the new study, leads to believe that minor “alterations in gene expression in the human population may contribute significantly to overall reproductive health.” The study has been published online in The Journal of Clinical Investigation, Sept 14, 2006.

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Patient Satisfaction No.1 Priority

San Diego Fertility Center’s first priority is our patient satisfaction. More couples are choosing San Diego Fertility Center for their fertility care than ever before. Due to our increasing popularity, we do our best to ensure that all of our patients’ needs are met. We are continuously working hard to understand first hand from our patients what is important to them. Through patient surveys and comments we are able to put programs in place to meet our patients needs. In an effort to thoroughly evaluate our current patient satisfaction, our executive team started a detailed patient satisfaction evaluation program. Our Patient Advocate and CEO, Lisa Souza has been interviewing existing and former patients during a face-to-face meeting. This allows us to determine what our patients identify as their priorities for care and service. “The patient’s personal perspective is our No. 1 commitment”, comments Lisa, “Fertility treatment is an emotional roller coaster for couples to begin with and we want to make each one of them feel like they are well taken care of”. Our success in meeting these key needs of our patients will be monitored and reported frequently to staff. Each of our staff members is committed to our patient satisfaction program success. Patient’s comments are also welcome via our website. Visit www.sdfertility.com and contact our marketing department via the “Contact Us” page.

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New Fertility Test Soon in the US?

The question about how fast the female biological clock is ticking has been on many women’s mind. A new fertility test that may predict a woman’s ovarian reserve via a blood test might answer that question. The test kit is called “Plan Ahead” and sold over the Internet by the British company Lifestyle Choices. The test is simple: The woman sends in a small blood sample (3ml) taken on day 3 of her menstrual cycle to a laboratory. The test measures three hormone levels in the blood and compares the results to the numbers of the average fertility for the woman’s age. The tested hormones are Inhibin B, AMH and FSH. Inhibin B and AMH tend to decline the closer the woman’s menopause approaches. FSH levels in the blood increase when menopause nears. According to the retailer, the resulting hormone levels determine the number of eggs in the ovaries and estimate what the reserve will be over the next two years. The manufacturer points out that a woman’s chances to conceive are influenced by many other factors besides her ovarian reserve such as the quality of the eggs, the health of her fallopian tubes and the fertile health of the sperm involved.

As of now, Plan Ahead is only available to European customers, but the developers are considering whether to market in the U.S. To get an indication of a couple’s fertility in the U.S., a woman will get the following tests done: FSH and Estradiol on day 3 of her menses, and Day 21 progesterone. measure healthy hormone levels. A hysterosalpingogram (HSG) is a tubal dye test to exclude blockage in the fallopian tubes as a cause of infertility. A male can have a semen analysis test done to confirm whether or not sperm is a factor in the couple’s fertility. In approximately 50% of patients, there is both a male and female factor involved as a diagnosis of infertility.

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The Hope for a Family

Join us for an Educational Seminar with San Diego Fertility Center Specialists Dr. Hummel and Dr. Kettel and hear from a family who is experiencing the joy of pregnancy through embryo adoption, an option you may have never considered. This seminar will be helpful both for couples who have undergone IVF and have remaining embryos and for couples who would like to learn of another way to become pregnant. The seminar will be held on Tuesday, October 3rd at 6:00 p.m. For more information, please call or email Kathryn Deiters at (714) 278-1020 or Kathryn@Nigbhtlight.org. or Lisa Souza Van Dolah at 858-794-6363 or reception@sdfertility.com, RSVP to 858-720-3173.
This seminar is offered with funding support from the U.S. Department of Health and Human Services under Grant #EAAPA941000. The statements and opinions expressed are solely the responsibility of Nightlight Christian Adoptions™ and do not necessarily represent the official views of the Department.

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More to See About Third Party Programs

When patients give us feedback, we listen. Based on numerous requests from our egg donor patients, we are currently expanding the online egg donor database. Since it is very difficult to decide on a donor based on one single photograph, each donor profile will be equipped with a new photo portfolio. The photo portfolio will include various photos of the donor candidate, such as a baby or early childhood shot, a full-body and side view and close-up portrait.

In addition, we now also accept donor applications from outside the San Diego area. The application process will be very similar to the ones for local donors. Interviews and screening tests can be done without traveling to our center. By accepting outside San Diego’s donors, SDFC will be able to enlarge the donor pool of highly qualified candidates to choose from.

We are also planning a “Third Party Conference” for patients. Since there have been multiple requests for more information about egg freezing and embryo donation besides egg donation and surrogacy, a patient seminar open to the public will be scheduled sometime this fall. The seminar will be sponsored by the San Diego Fertility Foundation and Snowflake, who are both non-profit organizations in California with embryo donation (aka embryo adoption) programs. The exact date of the seminar will be announced in one of the upcoming newsletters.

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Single IVF Maybe Less Expensive Than Multiple IUIs Followed by IVF

A study confirms what Drs. Hummel and Kettel have known for many years.
In cases of unexplained infertility, going through IVF alone is more cost-effective and more likely to result in a pregnancy than going through IVF after multiple unsuccessful IUI cycles. Researchers at the Institute of Public Health in Cambridge, Great Britain examined the outcome of fertility treatment of 100 couples and determined the cost-effectiveness of IUI versus IVF via a mathematical model. Since fertility treatment is part of the public health plan in the UK, it is in the country’s special interest to save the taxpayers’ money. Even though one single cycle of IUI is less expensive than IVF, the couple has a much lower chance of getting pregnant with the first attempt. On the other hand, IVF together with ICSI has a much greater success rate on the very first try.

Undergoing many attempts of IUI make it more expensive for couples, especially if the couple ends up undergoing an IVF cycle at the end anyway. “This fact is not always understandable to couples with a diagnosis of unexplained fertility”, comments Dr. Hummel. He adds: “It is gratifying that a study finally showed that we can save couples expenses by going through IVF right away.”

The estimated cost savings calculated in the study wasn’t small – the amount of money that could have been saved by the 100 cases in the study would have paid for 54 additional couples’ IVF treatment.

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New Digital Interface Connects Patients with Laboratory

SDFC’s patients are well educated about fertility treatment and have great interest in each step of the infertility treatment process. For this reason, Drs. Kettel and Hummel decided to have monitoring equipment in the embryology lab installed. Digital cameras have been connected to the lab’s microscopes and laser equipment, so that patients can view their embryos right before their embryo transfer. Each exam room in the office has a state-of-the-art monitor and intercom system connected to the embryology lab, which allows communication between patients and laboratory staff without a risk of contamination in the lab. Images of the embryos are printed on new printers for patients for their personal keepsake. “We allow patients to virtually look the embryologist over the shoulder, so that they can be assured that their embryos are in good hands.” comments David Pyatt, COO at SDFC. He adds, “With the new equipment we are also one step closer to implementing our electronic medical records system”. A complete electronic medical records system in the informational age improves efficiency of staff and administrative tasks and enhances patient care for SDFC patients, with improved security features. This is just another indication for SDFC’s leading position pioneering modern standards in fertility care.

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Excess Folic Acid During Fertility Treatment May Increase Chances of Twins

A new British study suggests that a woman increasing her folic acid intake during fertility treatment, in which more than one embryo is transferred, also increases her chance of having twins. Folic acid, a B vitamin has been known to protect against birth defects such as spina bifida. Since the U.S. health department started recommending supplements of folic acid during pregnancy in 1992, the occurrence rate of spina bifida has dropped by 32%, according to the CDC. The research conducted by Paul Haggarty at University of Aberdeen observed the folate levels in blood of 602 women undergoing fertility treatment. Results showed that women with high blood concentrations of folate had a higher rate of twin births. However, folate levels did not affect the overall chances of getting pregnant. Drs. Hummel and Kettel prescribe folic acid supplements to our patients. It is important, however, that patients do not use other folic acid supplements (other than the prescribed prenatal vitamins and folic acid).

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PGD and Sex Selection

Using PGD simply to choose the baby’s gender is still controversial these days. In some fertility centers, sex selection is only considered for couples with a high risk to pass along sex-linked disorders such as hemophilia. However, when fertility patients are asked if they would like to have preimplantation sex selection as part of their treatment, 41% say “yes”, according to data published by University of Illinois at Chicago (UIC). An argument against sex selection is the presumed bias against female babies. However, the majority of patients at UIC wished for a baby girl.

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Egg Donor Program Improved Patient Care

A growing number of patients from all over the world come to San Diego Fertility Center to take advantage of our premier egg donor program. Our newest staff member, Jenna Lake, will assist recipient couples through the program as an Egg Donor Program Liaison. Being a graduate from the University of California, San Diego, with a degree in psychology, she really enjoys helping others to achieve their goals and dreams. While pursuing a career in sales & marketing, she endured her own struggle with infertility; one that brought her directly to our center. Jenna's personal experience with fertility treatment offers patients a unique insight into the world of infertility. By offering an empathetic ear, Jenna assures that our egg donor recipients feel exceptionally nurtured throughout the course of their treatment. She is spearheading many exciting future initiatives that include support groups, on-line chat programs, and other innovative means of supporting our patients during this exciting and emotional process.

In addition, SDFC’s online egg donor database has now been restructured and is even easier to use. Visitors coming to the online egg donor website can search our database for donors without having to get a password to find out how many donors in our database would fit their preferred key features of eye color, hair color, and/or ethnicity. If search results show no donors, visitors know already that we currently do not have a donor that matches their criteria. If there are results displayed however, visitors can request the level 1 access to review basic egg donor information to decide if they would consider a candidate. “It pays to check back on the database often”, comments Chris O’Kane, egg donor coordinator, “Because at any point in time we have 40 egg donor applications we are processing as fast as we can to offer a large donor pool to our patients.” Not every donor applicant ends up in our database. In fact, only about 10% of applicants pass the very strict screening process at SDFC. Factors such as family medical history, educational background and health history of a donor need to be ideal to become enrolled in our egg donor in the database. Our egg donor program is anonymous and in order to get access to the detailed information about a donor, couples need to become a patient at San Diego Fertility Center. For more information about our egg donor program go to our website: www.eggdonor4u.com or contact Jenna Lake.

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Low Carb Diet May Improve Reproductive Health in Women with PCOS

Study findings published in Fertility & Sterility (March 2006) showed that dietary management during PCOS treatment might improve fertility problems. Dr. Chystal Douglas at the University of Alabama at Birmingham put women with PCOS between the ages 19 and 42 on three different diets for 16-day periods. The first diet regimen consisted of a regular diet, then an enriched mono saturated fatty acid diet and last a reduced carbohydrate diet with about 43% carbs, 45% fat and 12% protein. Results indicated that a diet reduced in carbohydrates may lead to decreased insulin production which over time, can improve reproductive health in women with PCOS.

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Attractive Financial Options at San Diego Fertility Center

Many fertility patients are not that fortunate to be enrolled in an excellent medical insurance covering fertility treatment. Over the years, our Center has developed attractive financial options that try to alleviate this financial disadvantage for many couples.

Our Success Guarantee program is a risk sharing program. The price covers both the fresh IVF cycle as well as all frozen embryo cycles produced as a result of the first fresh Cycle. You are refunded the appropriate percentage if at the end of the complete cycle we are unsuccessful in achieving a healthy pregnancy. The Success Guarantee Program has clinical requirements, that patients must meet before this finance option is available to them.

The other finance options offer cash discount pricing, which is available to all patients that have insufficient insurance coverage for their treatment cycle. Our IVF one cycle cash discount package is offered for a global fee of $7,400, which includes required monitoring and treatment associated with one IVF cycle.

Our Multi-cycle cash discounted packages were created for patients who want the option of doing more than one IVF cycle at a discounted rate. The IVF two Cycle cash discount package is $11,700 and the IVF three Cycle cash discount option is $15,700. Our multi-cycle options enables patients to complete second or a third cycle respectfully, if the first IVF cycle is unsuccessful. These package prices do not include additional fees such as fertility medications, PGD, lab fees, like assisted hatching, ICSI, embryo freezing as well as anesthesia for egg retrieval or cost of frozen embryo transfer.

Our comprehensive fees avoid the confusion and extra cost of paying individual fees for each separate component of the complicated IVF process. To find out what is included in the cash discounted fees and other restrictions, please go to our website or contact our finance specialist.

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More Financial Aid for Cash Paying Patients

The alliance between the pharmaceutical company Serono and the fertility drug pharmacy Freedom Drug recently formed a new patient support service called FertilityAssist. This program was specifically designed to help cash-paying patients stay in treatment and increase their opportunity for successful treatment by making fertility medication more affordable.

FertilityAssist offers all Serono fertility medications free of charge to patients undergoing a third IVF cycle if they have not been successful after their prior two attempts, if they purchased Serono medication through Freedom Drug for their 1 st an d2nd cycle. This program was created with the fact in mind that about 70% of couples who begin treatment eventually succeed in conceiving a child. The reality, however, is that it may take multiple treatment cycles before achieving a successful pregnancy. (see also our article “How many fertility treatment cycles are enough?”, Miracle Newsletter, 2/2006). To be eligible, Serono’s drug Gonal-f® must have been distributed by Freedom Drug Pharmacy for the patients’ 1 st and 2 nd cycle. The pharmacy will tract two prescriptions paid by a patient and notify that if a third cycle prescription is needed it would be provided by the pharmacy at no charge. Another requirement is the prescription for the third cycle must be filled within 18 months after the date the medication for the first cycle was ordered. For more information about the program, please go to www.fertilitylifelines.com or ask our staff.

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Our Fertility Experts About Prenatal Vitamins

Drs. Hummel and Kettel advise patients to start taking prenatal vitamins before undergoing fertility treatment. In fact, it might be of benefit to start months before starting IVF. Since there are many good prenatal vitamins available over the counter, our physicians don’t see a need for patients to get prescription prenatals. Drs. Hummel and Kettel would like to point out just a few things to be aware of when choosing a prenatal vitamin.
There are three essential nutrients that a woman in her reproductive years should get in their daily-recommended dosage: iron, calcium and folic acid. It is not advisable to double up on the recommended dosage or to combine multivitamins with prenatals, even if one vitamin falls short in the daily recommended amounts. Increasing the recommended dosage can cause you to go beyond safe levels of vitamins and minerals, which can be harmful to your body. Most multivitamins fall short in providing enough calcium, and taking a separate calcium supplement like TUMS (200 mg each) is fine.
Dr. Kettel points out that prenatal vitamins don’t carry the Food and Drug Administration’s approval (FDA), which means that they don’t need to follow a required standardization. When choosing a prenatal vitamin, make sure it has the “USP” on the label, which indicates that the U.S. Pharmacopeia has approved it for safety and quality.

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Pregnancy Rates Stay High With Single Embryo Transfer

Since the development of fertility treatment, the risk of multiple births has been associated with IVF in the public mind. The transfer of multiple embryos increases pregnancy success, but also increases the chance for multiple births. However, techniques and technology have greatly improved in recent years and the total number of embryos per transfer can often be reduced to one single embryo.
Two recently published studies (Fertility & Sterility, Dec. 2005) conducted in Seattle and Australia show that implantation and birth rates are nearly the same when patients transfer only one high quality embryo instead of two. In this study, patients with similar characteristics and diagnosis were divided into two groups, one group received a single embryo at the transfer and the second group received two embryos at the transfer. Results showed that there was a significant difference in the number of twins, while the pregnancy rate was nearly the same. Dr. Kettel applauds the study results, but notes that the final decision on embryo numbers will depend on the patient’s diagnosis and medical history. A single embryo transfer is not for everyone.

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How Many Fertility Treatment Cycles are “Enough”?

When undergoing fertility treatment such as intrauterine insemination (IUI) or in-vitro fertilization (IVF), it is important to view each treatment cycle as an independent event. This means that if the first cycle fails, the next cycle has an equal chance of working! Drs. Hummel and Kettel tell their patients that this cycle independence holds true for each type of treatment for at least three treatment cycles. Examining the clinical efficacy of a given treatment protocol, the cumulative pregnancy should be viewed as the likelihood of conception within a reasonable time frame, approximately 3-4 cycles, and NOT after only one attempt.
When deciding when to move from one treatment protocol to another, our physicians review what has been learned from the preceding treatments. Did the ovaries respond appropriately? Is sperm quality as expected? Did the endometrium reach a target thickness? Is egg quality good? Were the hormone levels appropriate? By examining the response to a treatment cycle, the couple and their fertility doctor can decide when it is appropriate to move from one treatment protocol to another.
By and large, if a treatment is going to work, it will be effective within three cycles. The majority of success occurs during the first three attempts and this presents a reasonable interval in which to schedule a consultation with Dr. Hummel or Dr. Kettel.

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Fertile Hope’s Special Mission

According to Fertile Hope, 90% of men and women diagnosed with cancer in or before their reproductive years are at risk of losing their fertility permanently due to cancer treatment. Unfortunately, the patients’ cancer treatment such as chemotherapy, radiation therapy or surgery may affect the patient’s fertility. The non-profit organization, Fertile Hope, was founded six years ago to raise awareness about cancer patients’ fertility issues and to provide information and support to cancer patients.

Drs. Hummel and Kettel are proud to be part of Fertile Hope’s “Sharing Hope Centers”, offering their services to women and couples facing this life-altering challenge in their life. With Fertile Hope’s financial assistance program, treatment programs such as embryo freezing and egg freezing with Dr. Hummel and Dr. Kettel prior to cancer treatment are made possible.
For more information about Fertile Hope’s financial assistance program, which is also an affiliation of the Lance Armstrong Foundation, please go to www.fertilehope.org.

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How to Find the Best Fertility Specialist for Your Treatment

Selecting the fertility specialist for your fertility treatment is the most important decision you have to make upfront. Therefore, it is crucial to do a little research on the specialists and clinics you are considering. As the only fertility specialist, who received the honor of “Best Doctor in San Diego”, Dr. Hummel was recently interviewed by a local TV news station about this topic. He mentioned in his interview (available in our online video collection at www.sdfertility.com), to which resources couples can turn to find advice on finding the right fertility doctor.

1. Your OB/Gyn should be the first contact where you can address concerns about your fertility and get initial testing done.

2. Research a fertility doctor’s credentials. Find out if a board-certification and Fellowship training beyond OB/Gyn residency has been completed. In addition, does he/she have any recent reputable awards and credentials such as “Best Doctors in America” or “Best Doctors in San Diego”.

3. Ask trusted friends and nurses about their patient care experiences.

4. Contact the local medical society for recommendations. The San Diego County Medical Society knows doctors who are in good standing.

5. Cost considerations. Check with your insurance company what is covered; research the cost of your treatment at the clinic of your choice, if they are offering special financial programs such as a risk sharing program.

6. Research the clinic’s success rates. Trust only official numbers verified by the Center of Disease Control (www.cdc.gov). Projected numbers published by a Center can be misleading and may not reflect statistics based on live births.

For more information about our fertility specialists credentials, go to our website at www.sdfertility.com. Details about our financial plans and our “Risk Sharing Success Guarantee Program” and our success rates can also be found on our website.

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Secure Egg Donor Application Now Available Online

San Diego Fertility Center takes its own in-house egg donor program to the next level. Egg donor candidates can now submit their application via the Internet. Using a specially developed interface on our website www.eggdonor4u.com, egg donor applicants create their own donor records, which their can complete and update on their own schedule. The entered information is stored in a secure socket layer (SSL) database. Once completed and submitted, the application is reviewed and approved by our egg donor coordinator, Chris O’Kane. The donors’ anonymity is protected throughout the entire process. As before, screening criteria are very strict to ensure compliance with the guidelines of ASRM and the best possible chances for successful treatment.

But wait, there is more. Taking the egg donor applications online is the first step. In the next few weeks, we will also have the entire list of egg donors converted into a searchable database for the convenience of our egg donor recipient patients worldwide. Check back often at www.eggdonor4u.com for more information.

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New Website at Www.sdfertility.com

With the focus on our cyberspace visitor’s interests, navigation on the recently launched, new-look website is designed to lead the visitor to the point of interest faster. Whether you are just browsing for general information about infertility or looking for specific information about our center, you will get to the correct page right away. The home page gives you an overview of the most important content. If you are completely lost, you can check out the “Site Center”, where we created easy to follow instructions on “How to use this site”.
The original site has been active since October 2001 and the new site will serve our infertility community even better. “The new website with its state-of-the-art Internet features reflect the excellence of patient care couples receive at the San Diego Fertility Center,” comments Constanze Scherer, Director of Marketing and developer of the new site.
One of the key features of the site is a new interactive character. The virtual tour of the Center, the fertility self-test, and the interactive web seminars make the site one of the most attractive medical websites on the Web.
Another highlight of the new site is the site-wide search feature. Type in any keyword in the search window on the upper right corner of the page and click on the arrow. Results will be displayed instantly sorted by relevance.
Besides extensive content and optimal navigation, the site complies with the American Society for Reproductive Medicine’s ‘Guidelines for Advertising by ART Programs’. It also follows the American Medical Association’s “Guidelines for medical and health information sites on the Internet”, and carries the quality seal of the Health On the Net Foundation (HON). The contact forms are transferred via Secure Socket Layer (SSL). Using cascading style sheet (CSS) design and XHTML valid code, the site is Section 508 compliant, which is helpful for physically disabled visitors and for visitors accessing the site via handheld devices. (See the full list of credentials and honors).
San Diego Fertility Center has received great feedback about our previous website over the past years. With the new site, the Center hopes to raise the bar for quality of patient care on the Internet for the benefit of infertility patients worldwide.

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Over-the-Counter FSH Tests

There are a number of FSH (follicle stimulating hormone) self-test kits available on the market. These are offered to women who experience infertility or are approaching menopause. These tests are not appropriate for a woman of reproductive age trying to conceive, who wishes to accurately determine fertility potential. These tests only give a result of a certain threshold of FSH level, like 30 mlU/ml, which might be an indicator of early menopause. Drs. Hummel and Kettel recommend appropriately testing FSH levels in combination with estradiol (E2) via a more precise blood test on Day 3 of a woman’s cycle. The blood test provides a specific level of FSH between 5-15 mlU/ml, which is a better indicator of fertility. If you are interested in getting tested for FSH, please ask your OB/Gyn.

Spotting—Doesn’t Necessarily Mean Bad News

One of the most frequent patient calls during fertility treatment is unexpected vaginal bleeding. This brings out the worst fears, especially in fertility patients. Fortunately, in most cases, an easy explanation can be found which doesn’t have to be bad news. After an embryo transfer or intrauterine insemination (IUI), some of the possible causes might include:
Implantation Bleeding: Some of our patients experience light bleeding after a blastocyst transfer. According to Dr. Kettel, light bleeding may occur, when the blastocyst implants in the uterus wall. This is perfectly normal.
Bleeding after Intercourse or Exercise: Sometimes sexual or other strenuous physical activity may irritate the cervix and causing light spotting.
Fibroids and Polyps: Many women develop these growths in the uterus or cervix. They are often non-cancerous, but can cause bleeding at any time in the cycle, or in early pregnancy. Often times, an ultrasound can confirm that the pregnancy is developing just fine.
Infection: A bacterial infection of the cervix and cause occasional bleeding. It is harmless and can be cured with antibiotics.
If you experience spotting during your treatment cycle, don’t panic! For your peace of mind, call our office and we’ll take care of you.

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IVF Children are Smarter

Researchers at the Free University in Brussels found that children who were conceived using IVF treatment with ICSI (intracytoplasmic sperm injection) on average have a higher IQ than naturally conceived children. Since its introduction in 1992, critics pointed to ICSI as potentially causing delays in an IVF baby’s development and behavior. ICSI is used in a large portion of IVF treatments at the San Diego Fertility Center.
The European study observed and measured the intelligence and overall development of 151 eight-year old children conceived with IVF treatment using ICSI. Results showed that the average IQ of children conceived with fertility treatment was on average 112, while the children conceived naturally had on average an IQ of 107. For the same reasons ICSI likely does not have any impact on lower IQs it likely is not the cause for higher IQs. It is suspected that couples who had a child through infertility treatment give their child more attention than parents who conceived their child naturally.

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Egg Freezing at San Diego Fertility Center

The San Diego Fertility Center is embarking on a “new” and exciting technology in human IVF: Oocyte Cryopreservation also known as Egg Freezing. The technique involves the freezing of eggs (female gametes) so they can be stored for future use. New freezing methods have lead to a resurgence in the desire to cryopreserve oocytes. Vitrification is a quick-freeze technique that stores the egg in a glass like capsule. Slower freeze methods used for sperm or embryo cryopreservation have proven less desirable for preserving human oocytes. Our Lab Director, Bill Venier and his staff are working in conjunction with other IVF centers and healthcare professionals to investigate different freezing technologies, with emphasis on vitrification, to cryopreserve the human egg and preserve a woman’s reproductive potential.
Egg freezing is an up and coming technology, which is starting to be offered by IVF clinics worldwide. The concept has been around for decades with little success until recently. Success rates are still considerably lower than sperm or embryo freezing but have achieved consistent survival rates leading to the birth of healthy babies.
Successful egg freezing has many benefits, which include reducing the cost of egg donation cycles, preserving a woman’s fertility potential until a time that is more desirable, or for women who are going through treatment such as cancer that may reduce or threaten their reproductive health. “The egg freezing technology is still considered experimental”, comments Bill, “Research is ongoing to provide sufficient data on safety and which freezing method produces the best results for our patients.”
Only a small number of births have been reported worldwide, however Drs. Kettel and Hummel are excitingly optimistic that egg freezing techniques will improve and provide a safe alternative for preserving a woman’s reproductive options.

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New Alliance Benefits Fertility Patients

The cost of fertility drugs is a significant component of the expense when undergoing fertility treatment. A recently formed alliance between Serono, a leading pharmaceutical company in Reproductive Health, and Freedom Drug, the nation's largest fertility pharmacy, will forward cost savings advantages to fertility patients and provide enhanced support programs to our staff. Egg donor recipients will also be able to benefit from the program that offers fertility drugs at a lower cost. An online “e-prescribing” program will be set up in the next few weeks that allows treating physicians to send in prescription requests and refills via the Internet.
The program will be offered though Serono’s Fertility Lifelines program, which includes additional fertility support services for patients at no cost. For more information go to www.fertilitylifelines.com or go to www.freedomdrug.com.

San Diego Fertility Center Leading the Way in Research

As a state-of-the-art fertility clinic in Southern California, the San Diego Fertility Center is a popular site for fertility research studies. San Diego Fertility Center is currently conducting two studies about IVF and one study about preimplantation genetic diagnosis (PGD). PGD is a genetic tool used to identify chromosomal abnormalities in embryos before a pregnancy occurs. The preliminary research results are promising, as Dr. Kettel described in a recent TV interview.
In order to participate in a research study, couples have to become established fertility patients with the Center and meet the criteria for study participation.
For more information about our research studies, please contact our research coordinator, Tammi Massaglia, MSN, RN. To watch the video of the TV interview with Dr. Kettel go to www.sdfertility.com.

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Body Mass Index’s Impact on Egg Donation Success Rates

Bodyweight can influence fertility. The body mass index (BMI) is a measurement of degrees of obesity. A recent study conducted by the Reproductive Medical Associates in New Jersey observed the chances to become pregnant of over 500 women with different BMIs undergoing fertility treatment using donor eggs. The women were divided into categories according to their BMI, which are considered underweight, normal, overweight and obese. Results concluded that no correlation can be established between the women’s BMI and her chance of embryo implantation and pregnancy success rates using donated eggs from another women. (Fertility & Sterility, Vol. 83, No. 6, June 2005)

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New Fertility Drug With Many Advantages

Fertility treatment is continuously improved with the help of research, and partnering pharmaceutical companies. One of the most recent developments is the newly introduced fertility drug called Menopur® by Ferring Pharmaceuticals. Menopur® is used during in-vitro fertilization (IVF). It is a purified preparation of human menopausal gonadotropin (hMG) containing hormones necessary for human reproduction. According to Ferring, it is the first and only fertility treatment approved by the FDA on the basis of pregnancy success rates. Menopur® contains equal amounts of 75 IU follicle stimulating hormone (FSH) and 75 IU luetinizing hormone (LH) to induce follicular maturation for egg retrieval. It has a lower risk of irritation at the injection site, a side effect, which is seen with the other hMG drugs. Drs. Kettel and Hummel see benefit for their IVF patients since Menopur® has clinically based proof of not only effectiveness and safety, but more importantly, of a high success rate in producing healthy pregnancies.
Another advantage of Menopur® is the easy reconstitution with the recently introduced Q Cap. The Q Cap allows mixing without needles and eliminates the stress and risk of accidental needle sticks during mixing. The application allows mixing together in the same syringe, which can reduce the number of injections for mixed protocols (FSH and hMG) without effecting the content of each drug. Using the Q Cap also assures that patients get the complete amount of medicine out of the vial.

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Phone Consultations for Egg Donation Expedite Scheduling
San Diego Fertility Center’s own Egg Donor Program was established in 1989 and is among the most successful programs in the United States. Now, for the convenience of new patients who already know they need egg donation as fertility treatment, we offer free phone consultations with our Egg Donor Program Coordinator, Chris O’Kane. “Many patients are aware that egg donation is required for treatment and prefer not to wait for a consultation with their doctor”, comments Chris O’Kane, who has been leading the Egg Donor Program at SDFC for over a decade. She adds, “For these couples we can schedule a phone consultation right away and get them started with treatment immediately if they wish”. This concept allows patients to begin treatment as soon as possible and still get the premier patient care from Drs. Hummel and Kettel. Phone consultation results are discussed with the physicians and treatment plans are decided by the treating doctor. “Patient treatment protocols are identical whether the patient had a phone consultation with Chris or a formal consultation with the physician,” says Dr. Hummel, “The doctors are still managing their treatment and making the decisions about couples’ treatment plan.”
The egg donor program has it’s own dedicated website www.eggdonor4u.com, where patients have easy access to Drs. Hummel and Kettel’s online egg donor database. Couples can scroll through the recently added list of photos or read the profile of their choice. All donors are highly qualified and all pass strict screening guidelines set by the Society of Assisted Reproductive Technology and the American Society of Reproductive Medicine.
For phone consultations or for information about our online egg donor database, please contact Chris O’Kane or call our office.

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How Men and Women Deal With Infertility
When it comes dealing with infertility, men and women may seem to be from different planets. It is important that couples trying to conceive understand each other’s different ways of thinking and problem solving.
Men usually develop an attitude of too much optimism, convinced that each month might be successful. He is often times the one generating hope and the drive for both to continue trying. The woman may take his optimism as a state of denial on his part. Women tend to be more realistic, feeling grief and identity loss. Becoming educated, seeking help and getting treatment are part of her problem solving methods. Taking action is the right thing to do when struggling with infertility, especially since time delays could translate into lower chances for success as time goes by.

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SDFC is Popular Destination for “Fertility Tourists”
Drs. Hummel and Kettel’s reputation of excellence reaches far beyond San Diego County. More and more couples outside San Diego struggling with infertility choose to travel the extra miles to receive the world-class patient care at SDFC. Hotel discounts, travel information and customized treatment plan make the stay for out-of-town patients more of a stress free, relaxing vacation in Southern California.
Couples in Europe have an increased need to look for fertility treatment elsewhere. With a recently introduced law in the UK, sperm and egg donors loose their anonymity, which will lead to a donor shortage and the need to go abroad.
Waiting lists are long and take years for being accepted for fertility treatment. In the meantime, the woman’s biological clock keeps ticking and chances for successful treatment are decreasing. At SDFC, a convenient phone consultation can be set up within a few days.
Treatment itself is costly in Europe. Three out of four couples undergoing IVF in the UK have to pay out of pocket for their treatment, which costs between 3,000 to 6,000 Euros. Traveling couples are taking advantage of excellent currency exchange rates.
Drs. Hummel and Kettel’s success rates are among the highest in the U.S. In 2004, IVF pregnancy rates for women below the age of 35 averaged 67.3% and women ages 35 to 37 averaged 65%. The egg donation pregnancy rate for women all ages was 88.5%. Regulation, licensing and safety is always a concern for patients. San Diego Fertility Center meets the strict guidelines of the American Society of Reproductive Medicine and the Society of Assisted Reproductive Technology. The embryology lab is licensed with the CA State Prov. Tissue Bank and is CAP and CLIA certified. The Surgery facilities are licensed, by the State of California, and certified by Medicare and AAAHC.
For more information about hotels and treatment plan for out-of-town patients, financial information, success rates and licenses and certifications, please go to our main website.

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Keeping More in the Pockets of Cash Paying Patients
Cash paying patients now benefit from a financial assistance program when it comes to infertility medication prescriptions. Last year, the pharmaceutical company Organon, who produces and distributes the follicle stimulating hormone (FSH) product Follistim, won the exclusive formulary contract with Pharmacy Benefit Manager in the category of FSH. The contract allows five of the major mail-order pharmacies to pass on a discount to cash paying patients who do not have insurance benefits covering fertility drugs. Pharmacy Benefit Manager provides a discount for Follistim to Arizona Apothecary Shops, MDR, IVPCare, Freedom Drug and Schrafts Pharmacy, who pass on the discount to their customers. Cash paying patients calling for a prescription order are automatically enrolled in the program, which will end November 2006. Without the program, the standard cost for a single 75 IU vial Follistim ranges between $60 to $65 at the participating pharmacies. However, it still pays to shop around for the best cost since the prices and discounts vary among the pharmacies mentioned. After the cash discount, the cost of the Follistim vial ranges from $49 to $52. For a contact list of participating pharmacies, please go online or ask our staff.

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Choosing Surrogacy Program at SDFC
Because San Diego Fertility Center saw the need for gestational surrogacy increasing in recent years, we expanded the scope of our surrogacy program. Both Dr. Hummel and Dr. Kettel have extensive experience and report excellent success rates in this fertility option. We work together with all surrogate agencies in the US. Surrogacy success rates at SDFC currently are 80.5% clinical pregnancies per transfer. Protocols are constantly changing and improving therefore we think that the clinical pregnancy rate per transfer most accurately reflects the current performance of our surrogacy program.

Because we believe in our outstanding clinical expertise and pregnancy success statistics, we can offer a risk sharing financial option we call “Success Based-Risk Sharing Plan”. This plan is based on the principles of mutual commitments. It requires certain entry criteria, which are likely to be met by couples choosing surrogacy because of the surrogate’s ideal reproductive history. The program outcome is a birth of a live born child, or a refund. A couple’s application is reviewed based on clearly defined entry criteria like hormone levels, sperm quality and age of the egg.

Some couples may find a surrogate who is a family member or friend, but the majority will take advantage of our national network of third party facilitators. We work with all major surrogate agencies and attorneys specialized in reproductive law and can recommend patients the best choices to find a surrogate. For patients who do not live in the San Diego area, we also provide a nurse practitioner dedicated to the formulation and coordination of your treatment plan. This has proven to be a very smooth process and cost effective for our patients. For more information about the surrogacy program and the success based-risk sharing plan go to our website.

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Two Bright New Stars at San Diego Fertility Center
“The heart and soul of our practice has always centered around the wonderful people who help us make dreams come true at the San Diego Fertility Center,” says Dr. Hummel. We focus on keeping the philosophy of “high-tech, high-touch” intact by surrounding our patients with caring professionals who can guide them through their journey of parenthood. We would like to welcome two bright new stars to the already all-star group of staff we have working together at SDFC.

Kelly Dei has joined the nursing core and will help facilitate and coordinate the treatment plans created by Dr. Hummel and Dr. Kettel. Her was position was created by the promotion of Carrie Cheshier to our Patient Liaison Coordinator. Carrie will now be readily available to streamline cycle coordination. Kelly graduated from the University of Wisconsin with a Bachelor of Science in Biology. She has seven years of experience with fertility patients from coast-to-coast. She adds a warm smile and quick wit to her experience.

Catherine Mi has also just joined our embryology team. She will bring her knowledge and experience to our patients from her training at the California Polytechnic State University. Before joining SDFC, Catherine gained experience for two years in a biotech laboratory.

Dr. Hummel and Dr. Kettel and the rest of the staff are delighted to have Kelly and Catherine join their winning team.

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Added Improvements at SDFC for Your Benefit
Upon popular demand, the San Diego Fertility Center’s free online fertility seminar is now permanently available on our website. With topics like: the impact of age on fertility, IVF, PGD, egg donation and available financial plans, couples can get a first impression of treatment options and our medial team. The seminar is 37 minutes long and uses a state-of-the-art interface to allow attendees to follow Dr. Hummel and Dr. Kettel give their presentation, ask questions via email and review handouts. For more information go to our website.

Our embryology team is now able to capture laser micromanipulation procedures performed during IVF. With the latest video equipment, procedures such as ICSI, assisted hatching and PGD biopsy can be recorded as a simple MPEG file on DVD. The videos will be available on our website download center in the near future.

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Who is to Blame for Missing Infertility Insurance Benefits?
One of the first steps when starting fertility treatment is the insurance benefit check. Couples often find out that infertility diagnosis and treatment is covered by their insurance, but IVF and other fertility treatments are excluded. The majority of SDFC patients reside in California, one state out of 13 with an infertility mandate in place. However, it is a “soft” mandate, which gives employers the option to offer infertility benefits. Since it is not required, not many employers actually purchase the coverage.

Many patients are not aware of the fact that it is actually their employer who make the final decision about what is included in their company health insurance and what isn’t. So, instead of being upset with your insurance company, you might want to talk to your Human Resource Manager to find out what it would take to have them include advanced treatment like IVF in your insurance benefits. If you would like to make your voice heard on a higher level, send a letter to your U.S. Senator. The national self-support group RESOLVE encourages couples to call or write your U.S. Senator. For more information about your state’s mandate go to www.resolve.org and select “Advocacy”, where you can also find sample letters to Capitol Hill.

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New Website Answers Questions About Infertility
Many couples struggling with infertility are most comfortable doing their own research on the Internet before moving forward. Decisions have to be made and a well-informed couple is the ideal patient at San Diego Fertility Center. In order to shed more light on infertility, a brand-new comprehensive website might be helpful. With the new website at www.fertilityjourney.com, baby making challenged couples can find detailed information about fertility diagnosis and treatment every step of the way. The website discusses symptoms and tests for women and men when a fertility issue is suspected. Treatment options and after therapy advice is offered and emotional and financial aspects of infertility are outlined. The online tool also includes a clinic locator, glossary of terms and a newsletter. Fertilityjourney.com might give a couple the necessary assurances during their journey to parenthood.

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Latest IVF Success Statistics Available Online
Every year in January, the Center for Disease Control (www.cdc.gov) publishes verified success rates for fertility clinics in the U.S. A total of 391 clinics are required to report their statistics, which are publicly available after a two-year delay due to generating the data of live births and an extensive verification process involving SART and ASRM.
Couples looking for a fertility clinic often use the most recent CDC report to decide on a clinic. Since patients are interested in the most current data, Dr. Hummel and Dr. Kettel also make the most recent reported success rates available on their website.
However, couples are cautioned not to choose a clinic solely on statistical success rates. Success rates can be affected by many things, for example denying treatment to patients with a low chance of success in order to improve the center’s statistics. “At the San Diego Fertility Center, we have an ‘open door’ policy,” comments Dr. Hummel, “We will work with every couple who seeks treatment to reach their individual goals, using the latest and most effective technology. We have an honest, ethical approach with realistic expectations shared before treatment is initiated.” For this reason, Drs. Kettel and Hummel are proud of their ART success rates, which are among the highest in the U.S.
For CDC’s report go to www.cdc.gov/reproductivehealth/art.htm, for SDFC’s 2004 success rates go to www.sdfertility.com/statistics.htm and read Dr. Hummel and Dr. Kettel’s article about statistics.

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Hormone Leptin Influences A Woman’s Fertility
The hormone Leptin is known to be released by the body’s fat tissue into the bloodstream to control appetite and weight. Besides it’s influence on the body’s complex energy regulation process, it also plays a major role in women’s reproductive hormone levels. A recent study conducted by Massachusetts General Hospital observed the effects of Leptin given to women who had stopped menstruating and developed hypothalamic amenorrhea due to very low body fat. Results showed that women treated with Leptin resumed mensrual periods and reproductive hormone levels normalized. Current research is looking at treatments using Leptin for conditions such as eating disorders, bone-loss, and infertility.

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Hope for Women with Polycystic Ovarian Syndrome (PCOS)
Stanford University Medical Center in Palo Alto is currently conducting a PCOS study with promising results. PCOS in women is characterized with high levels of testosterone and insulin, adversely effecting the woman’s ovulation. In the study, the women are treated with a combination of the fertility drug Clomid and an insulin sensitizer called metformin. Once the effectiveness of a combination these drugs is determined, PCOS might be treatable with these combined medications.

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Top Ten Reasons To Choose San Diego Fertility Center
There are more than just ten reasons to choose SDFC for your fertility needs, but we summarized the most important ones:
1. Drs. Hummel and Kettel, both are board-certified in obstetrics, gynecology and reproductive endocrinology.
2. Both received numerous awards and recognitions like “Best Doctors in America” and “Best Doctors in San Diego”.
3. Our physicians are members of the Society of Assisted Reproductive Technology (SART) and 14 other professional organizations (see CVs on web site).
4. SDFC’s facility integrates an on-site fully accredited embryology lab and a state-of-the-art surgery center with its own staff specialized in fertility patients.
5. Since inception in 1989, Drs. Hummel and Kettel have helped to bring over 4,000 babies into the world and have over 40 years of collective experience.
6. Our physicians pioneered treatment options such as egg donation IVF, PGD and blastocyst transfer in San Diego and play a leading role in fertility research.
7. Using the latest, state-of-the-art, laser equipment and treatment options, success rates are among the highest in the U.S. and continuously rising.
8. The in-house egg donor program developed to one of the largest physician-supervised programs on the west coast, applying the strictest criteria to egg donor screening (see “top ten reasons to choose our egg donor program” Miracle News 9/2004)
9. SDFC is proud to offer its own financial program for IVF and egg donation, offering a money-back guarantee if a couple doesn’t have a baby.
10. Patient education is very important to Drs. Kettel and Hummel. Using latest high-tech multi-media educational tools, they make sure patients are informed every step of the way. For a collection of free patient educational material, go online to our main web site and choose “Download Center”.

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SDFC as Example of Excellence for Other Clinics
As an award winning center part of the Fertility Nursing Centers of Excellence (FNCE) in the Western States, the San Diego Fertility Center recently hosted a training program for nurses new to the fertility world. Since attendance for the training was limited, the Serono FNCE awarded 10 nurses from existing and new centers in California and Arizona to be part of the two-day program. The participating nurses had only six months or less experience in the field of fertility. They benefited from the insights and recommendations in patient care Drs. Kettel and Hummel and the staff at SDFC presented to them during the program. “We can tell them more in a few hours than any text book or training guide could in weeks, “ commented Dr. Kettel, “we are proud to pass on our knowledge to other clinics for patients’ benefit.” During the program, a friendship was established between the nurses and the staff at SDFC which will last long after the program.

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Soy—Negative Impact on Fertility?
Soy and tofu products are known to make good headlines: It is beneficial for women with menopausal symptoms and for cancer prevention. Soy is also known as excellent source of protein during pregnancy, especially for vegetarian women. However, women trying to conceive should eat soy products in moderation because of their plant-derived estrogen known as isoflavones. If over-consumed, isoflavones have different effects on a woman’s body. Studies have shown that high levels of soy protein may increase menstrual cycle length and decrease FSH and leutinizing hormone levels. But no need to panic! Most people do not consume 60g of soy protein daily for over a month, which would generate this effect, according to research. Like with any food, eating in moderation and implementing a healthy food variety in your diet will ensure that you get all the important nutrients for your body without any adverse effects.

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First Look at Plans for 2005: Embryo Donation Program
Pregnancy success rates for infertility treatment at SDFC are increasing each year! Therefore, it is no surprise that the number of unused, frozen embryos stored in our lab increases as well. This is one reason why Drs. Kettel and Hummel are working to develop an Embryo Donation Program for their patients in 2005.
One focus of this exciting program will be an embryo donation process for couples desiring to help another couple to become parents. "We are the first clinic in San Diego offering this program," comments Lisa Souza, CEO and Patient Advocate at SDFC, "And we are working hard to develop a quality donation program." There are an estimated 54,000 frozen embryos in 430 clinics in the U.S., which are not being used. It is policy at SDFC to inform patients about their options to make a decision about unused embryos once they have completed infertility treatment. Existing patients will be able to give a gift with our Embryo Donation Program-a priceless gift for couples who are not able to become pregnant with their own embryos-the gift of parenthood.

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Explanations for Unexplained Infertility Cases
Couples who are struggling with becoming pregnant are familiar with the routine diagnostic tests that are helpful in determining the cause of their infertility. However, if testing and diagnostic procedures cannot determine the reason why they pregnancy is a challenge, their diagnosis becomes "unexplained infertility". Despite the fact that 15% of infertility cases are due to "unexplained infertility", and an additional 3% cope with recurrent pregnancy loss, new tests can give answers to these diagnoses. Drs. Hummel and Kettel are actively involved in research to develop such successful therapies.
An Inhibin B test can assess if ovarian stimulation may be impaired during an IVF cycle. Patients with low inhibin B hormone levels may have more success with IVF by a simple adjustment in the fertility drug protocol.
Further, researchers have found that higher levels of antiovarian antibodies (AOA) have a negative effect on the ovulation induction process during IVF. Testing for elevated levels of AOA can also help to evaluate cases of early menopause (premature ovarian failure).
Also, a new test for thrombophilia can explain 10% of cases due to recurrent pregnancy loss. Thrombophilia is a condition in which women tend to form blood clots during pregnancy. Blood clots can endanger oxygen supply and nourishment for the growing fetus. Women with recurrent pregnancy loss can also be tested for natural killer (NK) blood cells. Elevated levels of NK cells show that the body doesn't appropriately adjust to a pregnancy and that a immune system directed treatment plan may be beneficial. Infertility research is continuously working on uncovering the mystery behind "unexplained fertility" cases, giving hope to more couples struggling with infertility.

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New: Fertility Retreats
More and more patients are taking advantage of acupuncture during infertility treatment and acupuncturists serve the increasing demand for infertility related services. New on the list of services are fertility enhancing retreats, which outline a program for 1 or more days. The program usually takes place in a luxurious spa and may incorporate acupuncture, yoga, massage and other energy balancing, relaxing treatments. Contact local acupuncturists for more information. A list of acupuncturists can be found on our website.

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SDFC Fall Highlights With Improved Patient Care
In the last two months of 2004 SDFC is going strong with exciting new features for our patients to enjoy with their care.
Online Patient Seminar November 1st—30th: The online fertility seminar in June/July was very popular, so Drs. Hummel and Kettel decided to put the seminar again on their website during the month of November. “It is an excellent opportunity for couples who have not decided on fertility treatment and who just want to find out what we have to offer”, comments Dr. Kettel. Dr. Hummel and Dr. Kettel will present treatment options such as in-vitro fertilization (IVF), PGD and egg donation. The last item on the agenda will cover financial options like the attractive “IVF Success Guarantee”. For more information, please go to our website or send us an email.
Virtual Tour: With patients from all over the world in mind, we created a virtual tour of our facilities. Before visiting our Center in person, patients can look around in the doctor’s offices, the nurse’s station, our exam rooms and even zoom in on our state-of-the-art equipment inside our embryology lab and Del Mar Surgery Center. Go to our website—it’s definitely worth seeing!
Patient Identification: As a new security measurement, nurses will request to take a photo of the patient couples during one of their first visits. The photo will be maintained in the patient’s confidential medical records and help support our Center’s data identification management. When you come and see us, be ready to smile!

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Women With Recurrent Pregnancy Loss Benefit From PGD
During this year’s American Society for Reproductive Medicine (ASRM) annual meeting, Drs. Hummel and Kettel presented new findings in their PGD research study. The study looked at patients who are known to be at higher risk for aneuploidic embryos. 76 patients with either a case of recurring pregnancy loss or advanced maternal age took part in the study. Results showed that patients with recurrent pregnancy loss undergoing PGD had a 46% pregnancy rate, compared to the control group’s 41% success rate. The benefit of PGD was even more obvious in the patient group with women in advanced maternal age. Their pregnancy success rate using PGD was 30%, compared to the control group who showed only 18% success rate.

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Avoiding the Flu Without Vaccination
Fertility patients need to be extra careful during flu season to ensure treatment success. However, during a flu vaccination shortage like this year, there is no reason to panic. Being in good health is the best defense against the flu. Your immune system stays strong with a well-balanced, healthy diet, enough sleep at night and an overall low stress level in your life. Drs. Kettel and Hummel also recommend washing your hands more often. Supplements like echinacea and St. John’s Worth are to be avoided. Studies showed that visiting the sauna once a week will also enhance your body’s defense system.

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Drs. Hummel and Kettel Are Voted “Best Doctors in San Diego”
Drs. Hummel and Kettel would like to thank the medical community for electing them as “Best Doctors in San Diego” in 2004. Both Dr. Kettel and Dr. Hummel have been on the Best Doctors list every year since the program started in 2001.
This year, for the first time, the list is generated by strictly confidential votes of physician members of the San Diego County Medical Society (www.sdcms.org). With over 4,000 doctors in 30 different specialties in the San Diego area, the nomination process is very rigorous and, unlike some peoples perception, doctors cannot exert influence to be included. The list is published in the October issue of San Diego Magazine.
“Being on the Best Doctors list is a responsibility,” says Dr. Hummel, “We want to lead the way in patient care and set new standards in patient satisfaction.” With continuously new educational tools, patients get the care they deserve. The center is in the process of developing a virtual tour through the facility similar to the process used in real estate. With the increasing number of out-of-town patients, couples can virtually “walk” through the Center and Surgery Center on their own before their first consultation. Also upon popular demand, the online patient seminar on the website will be available at the end of October. See our Center’s profile in the October issue of San Diego Magazine and go to our website for more information about the virtual tour and fertility seminars.

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New ASRM Guidelines on Embryo Transfer
SDFC’s IVF success has led to new guidelines published by the American Society For Reproductive Medicine (ASRM) for embryo transfers. Guidelines for the number of embryos transferred were revised to reduce the chance for multiple gestation which holds an increased risk for the mother-to-be and her babies.
The guidelines take the woman’s age into consideration when deciding how many embryos to use for the embryo transfer. For a patient under 35 in normal circumstances, it is recommended that not more than two embryos be transferred. On a fresh cycle with the best diagnosis and chances to become pregnant, a transfer of one single embryo should be considered. For patients older than 35, more embryos may be transferred, depending on their chances to become pregnant. As recommended by the ASRM committee, SDFC will use their own success statistical data to formulate the best possible treatment plan for each individual patient and obtain consent on the number of embryos before the embryo transfer.

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National Infertility Awareness Week (NIAW)
The self-supporting, non-profit organization RESOLVE was organizing the annual National Infertility Awareness Week for September 26 through October 2, 2004. Local chapters throughout the U.S. hosted events like online conferences with infertility expert panels, live chats and toll-free hotline medical call-in events. Not only during NIAW, RESOLVE offers support for couples throughout the year with local “Cookies & Conversation” groups, and monthly meetings covering topics like endometriosis, male fertility, and fertility treatment options. Visit the San Diego chapter online at www.resolvesd.org.

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Top Ten Reasons For Choosing SDFC’s Egg Donor Program
When choosing an egg donor program, not all programs are created equal. The following are the top ten reasons that make SDFC’s program so special.
1. We follow the strict guidelines set by the American Society for Reproductive Medicine (ASRM) for our Center’s egg donor program. We conduct egg donor screening in-house and criteria for the egg donor’s physical & mental health are very strict. An applicant who does not meet our requirements does not become a donor at SDFC.
2. Our cost for egg donation is lower than some agencies.
3. Having one of the largest egg donor programs in Southern California, we have a great selection of egg donors to choose from.
4. You are under the care of premier fertility specialists, Dr. Hummel and Dr. Kettel, who both have received numerous awards and nominations like “Best Doctors in America” and “Best Doctors in San Diego”.
5. With a proven track record of over 14 years, our egg donor program is well established.
6. Your privacy is protected. We are HIPAA compliant and patients’ and donors’ medical records are kept according to the strict guidelines of the Health Insurance Portability & Accountability Act.
7. Our clinic has an excellent track record and some of the highest success rates in the county.
8. We have several financial plans for egg donation, offering a success guarantee if you don’t have a baby.
9. We work with egg donor agencies, if we cannot provide you with the donor of your choice. A selection of egg donor agencies is available on our website.
10. All of the treatments are done in our state-of-the-art facility that is licensed and accredited by AAAHS and the State of California. As a full-service fertility center, we offer a broad spectrum of patient resources. Our websites www.sdfertility.com and www.eggdonor4u.com contain Internet seminars, video presentations, and other resources for patients such as law firms
specialized in reproductive law and stress-reducing therapy recommendations.

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Early Diagnosis of Tumors Thanks to Fertility Treatment
The connection between male infertility and increased risk of testicular cancer had been confirmed in previous research. Developments in the past years show that tumors may be detected in early stages thanks to the work-up of male fertility patients who undergo testing prior to fertility treatment, . Male fertility patients can undergo ultrasound screening as part of their infertility work-up. With help of the trans-scrotal sonography, small, suspicious mass can be identified, which otherwise would stay undetected in a manual physical exam.
Early diagnosis of testicular cancer increases the chance to conserve testicular tissue and use less drastic surgical treatment.

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Fruits and Vegetables May Prevent Endometriosis
According to research, eating fruits and vegetables might be a way to fight an infertility-causing condition called endometriosis. A study observed a group of 1000 women who were divided in two groups according to their diet.
Results showed that women who included fresh produce into their diet were less likely to develop endometriosis. Women who had a diet high in meat and no greens showed a higher risk of the painful condition.
Endometriosis is characterized by pain, bleeding and adhesions and effects a large percentage of infertility patients. Drs. Hummel and Kettel always
recommend to patients a balanced diet during infertility treatment.

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New Digital Tools of the Next Generation at SDFC
Using modern technologies and state-of-the-art medical equipment are
vital elements for Drs. Kettel and Hummel in providing excellent patient service. The new data management tool called Digital MD has been one of the latest implementations at SDFC. Digital MD is a leading-edge information technology tool, which allows the computation and visualization of patient data such as embryo development and grading, cryopreservation and assisted hatching. Doctors and embryologists can collaborate
electronically about findings, diagnoses, and patients’ progress.
The application’s network capability and compatibility with the Center’s
patient management application MillBrook makes clinical case management easy. Right now, an electronic file and a patient folder with hard copies is kept for each patient. “We sometimes search to find a file because it’s on somebody’s desk”, says Annette Gilliland, Dr. Kettel’s medical assistant, “This won’t happen with the electronic patient files”.
Another tool of modern technology is the new laser equipment in SDFC’s embryology lab. SDFC is one of the first clinics on the West Coast using laser equipment for procedures like zona laser biopsies for PGD and laser assisted hatching. The laser guarantees best care for embryos during those procedures and highest level of accuracy, which may result in higher embryo quality and ultimately higher pregnancy rates for SDFC patients.

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SDFC Welcomes Caroline and David
With our nurse Tamara Tobias leaving to pursue her career in Seattle, Drs. Hummel and Kettel found an excellent addition to the team with Caroline Connor, CRN. She graduated from Vanderbilt University School of Nursing with a Masters of Science in Nursing, and a Women’s Health Nurse Practitioner Certificate. She has been working in the field of Women’s Health since 2002 and during her short time at SDFC, she has already become one of our patients’ favorite nurse practitioners.
Another valuable addition to SDFC’s team is David Pyatt. As the new Chief Operating Officer, he is in charge of clinical and administrative planning and management. He received a Masters in Health Administration from University of Colorado and joined SDFC after his position in Management Analysis at San Diego Children’s Hospital.

Unique Gonadotropin Pen Introduced to SDFC Patients
Last month, the Food and Drug Administration (FDA) has approved a new device developed for the delivery of follicle stimulating hormone (FSH) Gonadotropin, which is used during infertility treatment. Drs. Hummel and Kettel have found that the device, which is called Gonal-f® RFF Pen, make injections for patients much more tolerable. The pen is pre-filled and ready to use. The flexible multi-dose FSH is designed for infertility patients, who simply select their dosage on the pen’s dial before injection.
“Our patients have been waiting for the FDA approval since they heard about it during the research studies”, comments Dr. Kettel, who conducted one of the studies for Serono, “It is a relief for every patient, who is afraid of needles”. Gonal-f RFF Pen is available in three sizes with single-dose and multi-dose vials of 300 IU, 450 IU or 900 IU. For more information consult with our staff or go online to www.seronofertility.com.

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SDFC Embryo Laboratory Goes Online
The presentation of the embryology laboratory team, “Mystery Behind the Microscope” is one segment SDFC offers to our patients during IVF treatment. Until now, patients had to come into our Center to attend a presentation offered one evening every six weeks. This made it difficult for out-of-town patients to be present. But not anymore. The state-of-the-art rich media management system Stream OS, used for Internet broadcasting enables
patients worldwide to attend the presentation via the Internet. This technology has been used for the Center’s fertility seminar last month. The seminar was so well received in the community that Drs. Hummel and Kettel decided to keep the fertility seminar available for the month of July.
“The new online presentation of the embryology lab will complement our multimedia educational collection beautifully”, says Dr. Hummel, “State-of-the-art technologies reflect our leadership in offering high quality fertility treatment and patient care.” Embryologists Kathy Smith, Shannon Lee and Bill Venier explain what happens to patient’s eggs after retrieval and illustrate the process of ICSI, embryo development and other IVF lab procedures.
The presentation will be available on our website starting July 21, 2004. For more information about the seminar and the lab presentation go to our website or request information by email: seminar@sdfertility.com.

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Our Egg Donor Program’s New Website
SDFC’s web site is an helpful source of information for our patient thanks to the continuous growth of content. Voted one of the best physician websites on the Internet in 2002, the site has grown to an extent where it was good to create a new separate website for one of the major programs at the Center. “Our in-house egg donor program is one of the largest physician supervised programs of its kind in Southern California”, comments Dr. Kettel, “With over 150 pages of educational pages on our main site, we want to make sure that our patients find the information they are looking for quickly”. At
www.eggdonor4u.com, patients will find answers to questions exclusively about the Center’s Egg Donation Program. It has a different design and layout, but the quality of patient service and high standards of care are the same you can expect at a premier fertility clinic. Go to www.eggdonor4u.com for more information.

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New Fertility Prescription Refill Program Gains Popularity
The cost of fertility medications is always a concern for our patients. Apothecary Shops of Arizona (ASA) has always been one of the mail-order pharmacies for SDFC patients. Patients enjoy their free overnight shipping, 24/7 availability of a pharmacist, free injection instructions on CD ROM, free
needles and syringes and sharps containers. Recently, The Apothecary Shops have joined the Genesis IVF Network, an elite group of fertility centers that have consistently demonstrated excellence in our field. For Genesis IVF fertility practices like San Diego Fertility Center, Apothecary Shops have
introduced a program that gives our patients an advantage. $100 gift certificates help patients who have insurance coverage for their meds. If patients order on a self-pay basis, a gift certificate for one free vial for every 10 purchased is available. Being located in Arizona the company offers a return privilege for unopened injectable medication ordered only through Apothecary, please call for details. This program is exclusively for fertility centers part of the Genesis IVF Network.
For more details about The Apothecary Shops, please call Jeff @ (877) 792-7684 or visit www.fertilitymeds.us.

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SDFC Patient Education Seminars Now ONLINE
Our free fertility seminars are very popular events for couples who are trying to conceive and researching medical treatment options. Drs. Kettel and Hummel decided to take the seminar to the next level and hold it live over the Internet on June 22nd and make the recording available until August 2, 2004. They chose this state-of-the-art rich media management system called Stream OS, which is the latest technology used for Web broadcasting of events in sports or entertainment. Attendees will be able to access the live broadcast event by logging in to a web page on www.sdfertility.com. A special interface makes it possible to follow the presentation, watching the physicians on the screen and listening to their live discussions. With a computer at home or office, seminar attendees will be able to access and print seminar handouts and ask questions per email.
“Since we have patients coming from all over the US and from overseas, we want to make our seminar available to all of our patients”, states Dr. Hummel, “Instead of having couples come to us and dealing with traffic, we go to them.”
Besides medical topics such as IVF, PGD and egg donation, Lisa Souza also presents the popular financing plan “IVF Success Guarantee” and introduces the staff and the facilities.
For a detailed agenda visit our web site at www.sdfertility.com. A password will be required to attend the seminar between June 22 and August 2, so please send an email to seminar@sdfertility.com to request login information.

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Not-to-Stress is Critical Factor for Your Fertility
A recent study conducted at UCSD disclosed a link between the stress level of fertility patients and their chances of success. The study observed the stress level of 151 women while being treated for fertility with either IVF or GIFT.

According to the study, published in Fertility & Sterility, women who had more worries about the treatments and financial burden produced 20% less eggs for egg retrieval and had 19% less eggs successfully fertilized compared to women who weren’t stressed as much.
“This is why we encourage patients to take advantage of stress-reducing complimentary therapies”, says Dr. Kettel. As a full-service fertility center, SDFC makes other resources available to help the patients lower stress levels. Those resources include local acupuncturists, chiropractors, massage and yoga therapists and more. Go to our list of affiliations for more information.

New Fertility Hotline Most Helpful for Unanswered Questions
Getting the answer to a specific fertility related question can be difficult. There are couples who are just beginning to research options for fertility treatment or couples who already started treatment with a fertility specialist, but might be overwhelmed by the vast load of information available and welcome some guidance and reassurance. That’s why the new information hotline called Fertility LifeLines™ was introduced last month. Highly trained customer support specialists, nurses and insurance specialists for infertility are available every day of the week answering questions on a toll-free hotline. Whether you have questions about insurance coverage, medication, or just looking for general information or emotional support, a simple phone call might help you with your fertility concerns. Give it a try! Call toll-free in the U.S. 1-866-LETS TRY (Mo-Fri: 5am-9pm, Sat-Sun: 5am-3pm PST).

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