Infertility approach conceived to cut risk

For most couples, conceiving a child is the result of a little privacy and a few love songs.

But for millions of American couples dealing with infertility issues, conception opportunities occur only through unnatural methods, often requiring patience, optimism and some cash.

Even then the outcome might not end in a pregnancy.

Dr. Geoffrey Sher, a local reproductive physician, believes his new approach to treating infertility not only doubles a couple's chances of conception but decreases the odds of multiple births and children with birth defects such as Down syndrome.

Sher's method is known as comparative genomic hybridization, or CGH, and utilizes the same process as traditional in vitro feritilization. But before eggs are fertilized, they undergo genetic tests to determine whether they are normal or abnormal.

In vitro fertilization, or IVF, is a common procedure in which an egg is fertilized outside the womb.

"The common cause of people having problems with reproduction, whether it be infertility, miscarriage or birth defects, is that the little embryo is abnormal. The inability to tell which embryo is abnormal has permeated the whole field of fertility for years,'' said Sher, medical director of Las Vegas-based Sher Institutes for Reproductive Medicine.

"This new technology, people will be able to choose one embryo to make one baby more than 70 percent of the time. We will also be able to determine if an egg is going to miscarry or result in a miscarriage if fertilized. We also can determine gender. ... This (study) changes everything in IVF, and the point is, it is Las Vegas where this research is being conducted.''

Nationally, in vitro fertilization works only 33 percent of the time, he said.

Preliminary results of Sher's study, conducted in Las Vegas, were peer-reviewed and published in January's edition of Fertility and Infertility, a journal of the American Society for Reproductive Medicine.

Eleanor Nicoll, a spokeswoman for the organization, said Sher's work is known across the country.

Shawna Demes, a Las Vegas woman who participated in Sher's study, said she'll never be able to explain the science behind the conception of her daughter, Greenlee. But what she does know is that she has a healthy 5-month-old as a result of it.

It took her and her husband four years and $40,000 in IVF costs to get their first and only child.

"I was sure the news was going to be negative,'' Demes said about learning of her pregnancy last year. "When I answered the phone, all I heard was, 'Well, you're pregnant.' I didn't believe her.''

Demes said her disbelief was the result of previous miscarriages and other letdowns while trying to conceive between 2001 and 2005.

Unlike her husband, she had run out of optimism.

"I didn't think it was going to work,'' she said, staring at Greenlee, who was sitting on her lap at their eastern Las Vegas home. "I couldn't be any happier. She's wonderful. It was worth all the pain and money.''

During the CGH study, one or in some cases two embryos that came from normal eggs were placed into the uteri of 35 women enrolled in the experiment. Of those women, 28 became pregnant and 26 delivered healthy babies. Six sets were twins.

Based on those results, Sher says CGH offers a lot of promise, especially in decreasing a woman's chances of having multiple births.

The inability to identify reliably the embryo most likely to produce a healthy baby is the primary reason most IVF practitioners have tended to transfer numerous embryos at one time. Inserting multiple embryos often leads to multiple births, Sher said. But there are short- and long-term medical risks to mothers who deliver twins and triplets, as well as to the babies.

Also, the combination of low in vitro fertilization success rates and the risk of multiple births has caused health insurance companies to refuse to pay for the process. As a result, couples such as the Demes spend thousands of dollars out of their own pockets.

"IVF is like flinging spaghetti up against a wall. Sometimes too much stays and sometimes there's none at all,'' Sher said. "And they (health insurance companies) have a right to be reluctant. Imagine if you get a triple pregnancy. There's a 50-50 chance one or more of those children will be physically or mentally handicapped. There's a 50-50 chance the baby will die or that soon after childbirth, the baby or babies will be diagnosed with a disease. Insurance companies don't want to end up paying millions of dollars trying to rescue babies.''

Nicoletta Williams, 43, who owns a store with her husband in Florida, also participated in Sher's study. Though she and her husband were financially stable enough to afford in vitro fertilization treatment, they made some sacrifices.

Williams lived apart from her husband for a month while renting a New York apartment to undergo IVF treatments.

The couple also had to move to Las Vegas for a year so they could be close to Sher and deliver their baby at Summerlin Hospital.

"I don't know how many families can pick up and leave like that. My guess is, not many,'' she said. "I know some couples would probably break the bank for a child.''

Today, the Williamses have a 9-month-old son, Owen.

Dr. David Grainger, president of the Society for Assisted Reproductive Technology, called Sher's study interesting and one that "modestly" adds to existing literature within the field. However, he added in an e-mail that the Las Vegas study might have been too small to be conclusive.

He said it needs to be expanded and replicated in other centers before any claims can be made about it.