For many people, there are few joys greater than learning they are about to become parents. In the same vein, there are few pains worse than the heartache endured by those who wish to have a child but struggle to conceive.
Discouraging, isolating and capable of damaging even the strongest of relationships, infertility can threaten the dream of building a family. When fertility issues persist, women throughout the area and, in fact, from around the world find the solutions they seek through Reproductive Medicine Associates of New Jersey (RMANJ).
RMANJ, which has 10 fertility clinics throughout New Jersey, offers comprehensive fertility treatment in a comfortable, state-of-the-art setting. The practice’s team of physicians, nurses and other professionals offer patients a broad scope of treatment options and choices in care, including a highly successful in vitro fertilization (IVF) program. As part of its complete wellness care, RMANJ offers complementary services such as nutritional counseling, yoga and online support groups, all designed to create a positive experience—in every sense of the word—for women looking to add to their families.
“I feel privileged to work at RMANJ,” says Thomas A. Molinaro, M.D., MSCE, FACOG, a board-certified reproductive endocrinologist, obstetrician and gynecologist, as well as clinical assistant professor for the Department of Obstetrics, Gynecology and Reproductive Science at Rutgers Robert Wood Johnson Medical School. “We are uniquely devoted to research and education as a foundation for improving conception rates for patients. Our motto is to do the right thing for the patient, and that involves doing everything we can to better understand what causes infertility and how to treat it. In part because of the things we’re doing here, fertility treatment is vastly different than it was just two years ago, and it will be different two years from now. We’re doing things here we never thought possible.
“A third of our patients are from outside of the state [of New Jersey], and many are from outside the country—Europe, Asia, South America, Canada, the Middle East,” he continues. “We have one patient here at our facility in Basking Ridge who is from Russia. She first came to us in 2013 because she had trouble getting pregnant there. We got her pregnant, and now she’s working on getting pregnant with her second child.”
Although all patients who walk through the door share a common goal, each patient is treated uniquely, based on her individual circumstances. Some women may require simpler treatment, such as carefully prescribed fertility medication, whereas others will be best served by cycles of IVF, which is the process of fertilization by manually combining an egg and sperm and then transferring the viable embryo to the uterus. RMANJ, for its part, enjoys a 60.8 percent delivery rate among IVF patients under the age of 35, which is among the highest in the nation.
“This is an exciting place,” Dr. Molinaro says. “It has one of the biggest research programs in the country in this field, all funded from within the practice. We also have a fellowship that is training the next generation of reproductive endocrinologists; it’s one of only 45 fellowship programs in the country. What I love most about this place is that it’s not afraid to innovate. We could have great success rates in IVF now, and we do, but if we see something that will give us even better success rates for our patients, we will change course tomorrow.”
Making Miracles
Years ago, women relied on their primary care physician or OB/GYN to determine when it was time to meet with a fertility specialist. These days, more and more women are “taking charge of their own health” by becoming more self-educated, according to Melissa C. Yih, M.D., FACOG, a board-certified reproductive endocrinologist, obstetrician and gynecologist. She joined the practice last year, when RMANJ acquired her former practice, IVF New Jersey Fertility and Gynecology Center.
“For a woman under the age of 35 who has been trying to conceive for a year, it’s probably not a bad idea to do some basic testing,” she says. “The same thing applies to someone who’s 35 to 40 and has been trying six months without success. And for women over the age of 40, if you have been trying for three months and haven’t been able to conceive, it is better to come in sooner rather later for an evaluation. In the case of someone 40 or older, there is a smaller window of opportunity to conceive; you don’t want to panic, but you don’t want to waste time either.”
To improve a woman’s chances for success, RMANJ has developed a 24-chromosome screening process called SelectCCS, which safely screens an embryo to determine whether it has a normal or abnormal number of chromosomes. Considering recent data, which suggests as many as 70 percent of miscarriages are due to embryos with too few or too many chromosomes, the use of sophisticated screening technologies such as SelectCCS during the embryo-selection process can improve the efficacy of an IVF cycle.
Complementary technologies such as single embryo transfer (SET) are helping RMANJ redefine—and refine—the IVF experience. SET essentially enables an RMANJ physician to place a single viable embryo, vetted through SelectCCS, to increase the likelihood of a full-term pregnancy with fewer complications, such as twins. Previously, physicians would have placed multiple embryos to improve a woman’s chances of becoming pregnant but, in the process, also increasing the likelihood of a more complicated pregnancy.
“Our goal is to get the patient pregnant with a healthy embryo as soon as possible in order to reach her goal—a healthy baby—without wasting time,” says Dr. Yih. “With SET and SelectCCS, since we know the embryo is genetically normal the likelihood of achieving a pregnancy is higher. As a result, we can put back fewer embryos; instead of putting back two embryos, we can put back one and still have equal success while also reducing the risk of twins. Some people might want twins, but a twin pregnancy is higher risk to mother and child.
“Additionally, with genetic testing and vitrification (cryopreservation, or freezing embryos), we can save any extra embryos achieved during an IVF cycle for future use,” she continues. “This is important especially for older patients. Once you’re over 40, the chance of having a genetically abnormal embryo goes up significantly. But if a woman has SelectCCS normal embryos frozen, it takes the pressure off. She essentially has frozen her fertility in time.”
Since its founding in 1999, RMANJ’s team of physicians has helped deliver more than 30,000 babies to loving families from across the globe. This includes beneficiaries of Helping Heroes Build Families, a program established in 2012 to provide fertility treatment to U.S. military personnel and their spouses. RMANJ has since provided more than $150,000 in free services to help active-duty military personnel in New Jersey realize the dream of parenthood.
Regardless of the circumstances, each birth has been a miracle, according to Dr. Molinaro.
“I’ve worked with hundreds of families, maybe a thousand, and every time I’m there with them, hearing a heartbeat, it’s a special moment,” he says. “The looks on people’s faces when they realize they have conceived, it’s a moment that never gets old. I’m grateful every time I get to share that experience with a happy couple.”
To find an office, set up an appointment or learn more about Reproductive Medicine Associates of New Jersey, call 973-656-2089 or visit www.rmanj.com.
Photograph courtesy of RMANJ
