“In Vitro Fertilization Succeeds In Spite Of All Odds”

Center For Reproductive Health Perfects Novel Approach

Robbin Braboy says the best part of his day is when he first arrives home from work. "As soon as my daughter sees me she wants a big hug. It is such a thrill to pick her up and just hold her in my arms."

It is a moment Robbin Braboy wasn't sure he would ever get to enjoy. Like 15 percent of American couples, Robbin and his wife, Kim, had infertility problems. It took medical science and a miracle - in the form of in vitro fertilization - to help them accomplish their dreams.

The Braboys began planning for a family shortly after their marriage in 1987. Two years later, they underwent a year-long series of tests with their obstetrician & gynecologist to identify the reason for their infertility. The results of all the standard tests were normal, but a dye test of Kim Braboy's fallopian tubes revealed blockages. Surgery was successful in partially clearing one tube. Over the course of the next four years, the couple tried artificial insemination eight times, but their efforts were unsuccessful. The Braboys remember those months as among the most difficult of their fertility treatment. "The process took its emotional toll on us," said Kim. "Each time, we'd be excited and get our hopes up, only to be left disappointed and grieving."

In late 1995, the Braboys were referred to Dr. Jaime Vasquez at the Center for Reproductive Health in Nashville, TN. The Center specializes in fertility and assisted reproductive techniques. Other women's health services include treatment for endometriosis and related therapies. Dr. Vasquez recommended in vitro fertilization (IVF) and embryo transfer. "The condition of Kim's fallopian tubes was incompatible with sperm-egg interaction and subsequent fertilization," he explained. "In patients with a mechanical impediment to fertility, such as tubal factor without hydrosalpinges, IVF success rates are exceptionally high."

With IVF, doppler guides a needle into each follicle in the ovary and the follicular fluid containing multiple oocytes (eggs) surrounded by granulosa cells is aspirated. The process takes about 30 minutes, the patient is mildly sedated and experiences no discomfort. The eggs are inseminated for IVF and the cleaving embryos are transferred into the uterus via a smooth catheter. The embryos attach to the endometrium within the uterine cavity. This procedure is performed at the center with high accuracy leading to outstanding success rates. A new IVF technology available at the Center includes a novel approach recently described in Australia and perfected at the Center. The embryos are cultured for approximately 6 days in the sophisticated Center laboratories. Either 2 or 3 expanding blastocysts hatching from the zona pellucida are gently transferred to a well-prepared endometrium leading to remarkable success. The preparation of the endometrium includes hormone supplementation as well as medications to prevent rejection of implantation by the patient's local immune system.

For the Braboys , preparation for IVF included 10 days of leuprolide acetate subcutaneous injections to prevent premature ovulation, which Robbin administered to Kim. "When there's a possibility you can have a child, you can do anything," shrugged Robbin, who is a supervisor for a steel company. Preparation for IVF also included accurate monitoring for two weeks preceding Kim's oocyte aspiration, for which the couple had to drive 125 miles several times from their home in Paducah, KY to the Center. Finally, in February 1996, Dr. Vasquez performed IVF at the Center. Within two weeks, a blood test confirmed a pregnancy and on October 28, 1996, a healthy, full-term Karah Robbin Braboy (7 pounds, 14 ounces) arrived.

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