Newswise — Like many couples in their late 20's, Jeannie Alkire-Brewer and her husband David were eager to start a family soon after they were married. Two years later -- and still childless -- they turned to the internet to find a gynecological specialist whose expertise could help them conceive.
Their search led them to Cedars-Sinai Medical Center where three specialty clinics -- the newly-launched Center for Reproductive Medicine, the Center for Women's Continence and Pelvic Health, and the Center for Androgen-Related Disorders -- function hand-and-hand to provide a comprehensive approach to the diagnosis and treatment of the full spectrum of women's gynecological disorders.
Infertility is the main focus of the Center for Reproductive Medicine, but women with other reproductive disorders such as endometriosis, recurrent miscarriages, fibroid tumors or ovarian cysts are also under the care of medical co-directors Lee-Chuan Kao, M.D., Ph.D., and Margareta D. Pisarska, M.D. In addition, the Center provides treatment for puberty-related disorders, irregular menstrual cycles, and infertility treatments such as ovulation induction/insemination and in vitro fertilization.
The Brewers were attracted to Cedars-Sinai because of the reputation of Ricardo Azziz, M.D., Chair of Cedars-Sinai's Department of Obstetrics and Gynecology, Executive Director of The Androgen Excess Society, and director of the Center for Androgen-Related Disorders at Cedars-Sinai. Dr. Azziz is a renowned expert in polycystic ovary disease, a gynecological disorder that was found to be the underlying cause of Alkire-Brewer's infertility. According to Dr. Azziz, polycystic ovary syndrome (commonly referred to as PCOS) is the most common cause of female infertility and affects between five and 10 percent of women in the U.S. Women with PCOS often have irregular menstrual periods or none at all, excess hair growth, and may also have other health problems such as abnormally high levels of insulin, obesity, high blood pressure and heart disease.
Despite the long trips in southern California's heavy traffic, Alkire-Brewer feels that the extra effort to travel to Beverly Hills from her home in Whittier were "well worth it;" sometimes this meant having to drive back and forth as many as three times a week while she continued her full-time job as a middle school reading teacher. "The staff was always able to answer any question I had. Now I understand more about PCOS, especially the connection between my weight gain and my insulin deficiency," she says.
Her treatment at Cedars-Sinai began with tests to rule out any other undiagnosed disorders that might be contributing to her infertility. After about a year of treatment under the direction of Drs. Azziz and Kao to regulate both her insulin and menstrual periods and to initiate ovulation, the Brewers finally received the news they've been waiting three long years to hear. They're expecting their first child in May, 2005.
Both Dr. Kao and Dr. Pisarska engage in research activities in addition to their clinical practices. Dr. Kao's research interests focus on gaining a better understanding of the molecular processes of human embryo implantation and their link to endometriosis. Endometriosis occurs when tissue, which normally lines the inside of the uterus, grows outside the uterus, and is a frequent underlying cause of infertility. Currently pharmaceutical and surgical treatments are available to treat other aspects of this reproductive abnormality but there is not a method to improve the implantation process.
Dr. Pisarska's research interests are in the area of ovarian function and fertility preservation, specifically how ovarian follicles develop and digress. "I'm looking at genes that play a role in regulating the number of eggs that develop in a given month," Dr. Pisarska says. "This may explain why some women lose their reproductive capacity prematurely. Hopefully, this may one day lead to ways to extend fertility in women." Infertility becomes more pronounced after the age of 35. Many women experience infertility due to aging eggs and premature loss of the eggs that are available. With a better understanding of the underlying mechanisms, Dr. Pisarska hopes that one day there will be ways to prolong a woman's fertility.
In addition to Drs. Azziz, Kao, and Pisarska, physicians in the Center for Reproductive Medicine include Wendy Chang, M.D., Hal Danzer, M.D., Thomas Kim, M.D., Sam Najmabadi, M.D., Peyman Saadat, M.D., and Mark Surrey, M.D.
As the Center grows, Drs. Kao and Pisarska are expanding their collaboration to include a physician who specializes in male urological problems, citing a "male factor" as being present in about 40 percent of all couples seeking infertility consultation and treatment. "Some of the treatments for male infertility involve minor surgical procedures to 'retrieve' sperm cells," Dr. Kao explains. "In a situation where there is sexual dysfunction on the male side, medical therapy or electoejaculation might be needed which fall within the expertise of a urologist." Genetic counselors are already available to assist with the care of couples with inheritable diseases. They also are looking to add a psychologist in the near future to help support couples with infertility or recurrent miscarriages.
For more information about the Cedars-Sinai Center for Reproductive Medicine, please call (310) 423-9964.
A Magnet Nursing designated facility, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For the fifth straight two-year period, it has been named Southern California's gold standard in health care in an independent survey. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities and its broad spectrum of programs and services, as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and was recently fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP).
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