Your Care Team

Congratulations to our very own board certified reproductive endocrinologist, Gilbert Mottla, M.D., from our Annapolis, MD, office who was recently honored with the 2017 Arnold P. Gold Foundation in Humanism in Medicine Award by the American Society for Reproductive Medicine (ASRM).

This is an award that honors an ASRM member who, as a practicing physician, has best demonstrated the ideals of compassionate and respectful care for a patient’s physical and emotional well-being.

“Throughout his distinguished career, Dr. Mottla has advocated for improving infertility policy by testifying in front of both state and national legislators. Most important has been his passionate support of our nation’s injured veterans. This effort paid off when Congressional support was given to provide IVF services through the U.S. Department of Veterans Affairs,” said Chief Executive Officer of Shady Grove Fertility, Mark Segal.

For years, Dr. Mottla has demonstrated a commitment to helping expand coverage to our nation’s wounded veterans. For 2 decades a ban on advanced reproductive technology in the form of in vitro fertilization (IVF) at the Veterans Administration (VA) meant that for approximately 1,800 veterans of the Iraq and Afghanistan wars who have suffered injuries to their reproductive system, these soldiers were forced to pay for this expensive treatment out of pocket or forego the chance to have a family of their own. Among his many efforts, Dr. Mottla, in close collaboration with the ASRM and the Society for Assisted Reproductive Technology (SART), helped establish the IVF for Veterans Program. This temporary program of IVF care for veterans was supported by 103 fertility practices across the country and offered deep financial discounts on services as a way to immediately provide IVF care until Congress ultimately acted and removed the 20-year ban. Wounded veterans now have access to the IVF care they need in order to start or grow their families.

“I had the distinct privilege of being the medical voice in this successful effort. There were so many other people and organizations who worked equally hard or harder together to change policy, including my fellow SGF colleagues, the ASRM, RESOLVE: The National Infertility Association, the Wounded Warrior Project, pharma, and the Bob Woodruff Foundation for veterans, among others. The synergy of these efforts now enables our wounded veterans to receive IVF care to start or complete their families,” remarks Dr. Mottla.

The Arnold P. Gold Foundation website describes its vision of humanistic care delivered in the medical arena as “Humanistic medical care is not simply compassion. It is the best of medicine. When skilled physicians build caring, trusting, and collaborative relationships with patients, studies reveal more appropriate medical decisions, better patient adherence with treatment plans, and less costly healthcare outcomes.”

The Foundation recognizes that it is not enough to simply be a very knowledgeable physician, or a deeply caring person, but the blend of all facets of medicine that impacts patients. It calls on the highest level of multiple related skills, including demonstrated compassion and empathy in the delivery of patient care, competence in scientific endeavors, respect for patients, families, and co-workers, cultural sensitivity for those with diverse backgrounds, understanding of a patient’s need for interpretation of complex medical diagnoses and treatments, sensitivity to patient’s psychological well-being, and more.

“I had an excellent experience with Dr. Mottla. He is attentive, knowledgeable, and compassionate. He took the extra step to call me directly to discuss our fertility plan. I am happy to say I am now 8 weeks pregnant with our first IVF treatment,” shared one of Dr. Mottla’s patients.

“The Gold Award is one of the most prestigious in our field and is awarded as a nationwide recognition of patient-centered advocacy. It is especially well-deserved by Dr. Mottla for his tireless advocacy, especially for the most vulnerable of our patients,” stated Eric A. Widra, SGF Medical Director.

“The ASRM is always quite discerning in choosing who to recognize, and it’s been a privilege to work alongside with Dr. Mottla and his SGF colleagues to advance our legislative agenda in support of family building of all types,” said Barb Collura, President and CEO of RESOLVE.

Robert J. Stillman, M.D., Medical Director Emeritus of Shady Grove Fertility, “This is a well-deserved honor for Dr. Mottla. While he consistently serves his patients with compassion and clinical expertise, more importantly, patients here and everywhere have benefited from his considerable efforts.”

“Dr. Mottla was our doctor for two rounds of IVF. After our experience with the first, there was no doubt in our mind that we would look to him when we were ready to try for number two. We couldn’t have been more right in that choice and, if I ever feel we want a third child, I would absolutely turn to him again. He was always extremely pleasant to talk with. His explanations were thorough and presented in a way that we understood. We also always felt very comfortable asking questions of any kind. He even went out of his way to call me after hours twice,” said a former patient of Dr. Mottla’s.

Fundamental to the mission at Shady Grove Fertility is to make fertility treatment more affordable and accessible to more people. Dr. Mottla is among many of our physicians who have led the charge on various access-to-care issues on behalf of our patients. Most recently, he and Stephanie Beall, M.D., of our Columbia and Towson, MD offices, advocated for fertility preservation prior to cancer treatment coverage to be included in the Maryland Mandate. Both testified at the local and state levels to help legislators understand how the additional stress and costs leave many patients with a very difficult choice: pay for cancer treatment or risk losing the ability to have a baby in the future.

The Arnold P. Gold Foundation in Humanism in Medicine Award stands among other distinctions earned by Dr. Mottla. He has repeatedly been recognized by Washingtonian magazine and What’s Up Annapolis magazine in the top doctor’s edition for reproductive endocrinology and infertility.

Dr. Mottla will be recognized as the recipient of the Arnold P. Gold Foundation Humanism in Medicine Award for Practicing Physicians during the Opening Ceremony of the 2017 ASRM Scientific Congress & on October 30, 2017, in San Antonio, Texas.

To schedule an appointment with Dr. Mottla or any of our reproductive endocrinologists, please contact our New Patient Center at 888-971-7755. 

Weight can be a sensitive topic but it’s important to address because it can not only affect your overall health but it can directly affect your ability to conceive and maintain a healthy pregnancy. Fertility treatment on the other hand can be an isolating and emotional journey. Of course all people cope with their emotions differently. Some may relate to feeding their emotions with comfort foods while others may lose their appetite and skip meals when they feel lonely, anxious, or sad. While these coping strategies may be an escape and bring some short-term emotional relief they can also lead to unwanted weight gain or weight loss.

A recent retrospective cohort study of nearly 240,000 IVF cycles found there is indeed a relationship between a woman’s weight and in vitro fertilization (IVF) outcomes. The researchers specifically looked at implantation rates, pregnancy rates, pregnancy loss rates, and live birth rates. Ultimately, data showed there is a progressive and statistically significant worsening of IVF outcomes as a woman’s body mass index (BMI) increased, and the same rang true for underweight women (BMI <17). There appears to be an ideal BMI range of 18-25, where researchers noted IVF outcomes and success rates to be the highest.

Despite these facts, it’s important to validate that diet and lifestyle changes are quite difficult to make at times, especially in stressful and emotional times. Lack of motivation, fatigue, time constraints, financial concerns, and physical aches and pains all add up, making commitments to lifestyle change that much harder. It’s most helpful to have a manageable plan, realistic goals, and a boisterous support network to set yourself up for success.

Set Realistic Goals

Nutritionists, counselors, and health coaches would most likely all agree with the old adage ‘a plan is only as good as its execution.’ Even more so, it’s about maintaining a healthy, loving, and realistic mindset. Setting unrealistic goals often makes them more difficult to achieve, which may lead to negative feelings of guilt and failure, ultimately resulting in giving up on the plan completely. It’s ok to start small, with only one or two diet or lifestyle changes at a time. These should be measureable, with a timeline, to help with accountability and tracking success. When weight loss is a goal, start with a manageable 5 pound goal rather than 25 pounds. It’s important to note, even modest 5-10 percent weight changes can have a profound improvement on health and fertility.

Build a Support Network

It’s certainly helpful when your partner is committed to making some diet and lifestyle modifications with you. When the whole household chooses to make and embrace small changes, all are more likely to succeed, which ultimately facilitates a long-term lifestyle change.

It is also beneficial to broaden your support network and feel comfortable turning to others for motivation and accountability. Think about a cooking club, an exercise partner, or walking group. Connect with an old friend, family member, work colleague, or even a new group of women in your community. There are many free groups out there that can help you on your journey. Don’t be afraid to try something new. Maybe that’s what you need to get you out of an unhealthy rut.

For any lifestyle change to stick long-term you must believe in it and feel comfortable working it into your daily routine. Once this becomes a manageable new norm, it’s time to add another modification to the plan. Barriers to change inevitably get in the way of success, so be prepared for bumps in the road. Don’t be discouraged by a “bad” day.  When making diet changes, you have the opportunity to ‘start fresh’ and ‘get back on track’ at least three times a day. Remember it’s not all or nothing, there is no perfect, and you don’t have to wait until next week to clean up your act. You can get right back on track at the very next meal!

Same goes for exercise… whiles it’s ideal to get in 30 minutes of moderate physical activity daily, it’s important to remember we need to start somewhere. Even short bouts of physical activity throughout the day add up. Try to get more walks in, climb the stairs at work, and never sit for longer than an hour without standing and stretching. When you can, chisel out 15 to 20 minutes for more intense activity, whether it’s a trying a home exercise video, using some free weights, completing a circuit routine, or finding an enjoyable class at the gym.

There’s no denying that achieving a healthy weight for fertility through diet and lifestyle changes are difficult. No matter who you are and what your long-term goals are, you must remember to start small, with realistic, manageable goals. The Wellness Center at Shady Grove Fertility is available to help you on your journey to better health. To learn more or make an appointment please call 301-610-7755.

To learn more about achieving a healthy weight for fertility and pregnancy or to schedule an appointment with one of our reproductive endocrinologists, please call 1-877-971-7755 or click here to complete this brief online form.

Written by: Meghan Sylvester, RDN, LDN

In another win for science, researchers at Oregon Health and Science University (OHSU) successfully performed gene editing on human embryos, removing the gene that causes hypertrophic cardiomyopathy—a disease that affects roughly one in 500 people.

If born, babies of these embryos would be free of the heart condition and also not pass on the mutation to their children.

Although researchers do not plan to transfer embryos from the study to women, this research is the first step to using similar genetic editing techniques in reproductive medicine, such as in vitro fertilization (IVF) treatments.

But wait…

Does this new advancement mean “designer babies?”

Not at all.

This cutting-edge technology means doctors and patients will have more tools to use when fighting and preventing disease. The technology is nowhere close to being able to edit the genes that determine physical characteristics, intelligence, or athletic abilities, for example.

SGF fertility expert Dr. Stephen Greenhouse offers his perspective on the recent OHSU study and explains what it means for our patients.

Gene Editing and IVF

Think of gene editing as high-tech scissors—if there’s a gene that causes a disease, a doctor would be able to remove the abnormal gene from DNA and then replace those genes with a normal one to prevent a disease from occurring.

Right now, performing this procedure on an egg or sperm is practically impossible to do without also causing damage. Instead, gene editing is carried out on very early-stage embryos, shortly after fertilization.

The benefit of genetic editing in combination with traditional IVF methods is that more healthy embryos are created.

For instance, suppose a couple comes to SGF for fertility treatments, and both partners are carriers of the cystic fibrosis gene. There is a 25 percent chance that their baby will have cystic fibrosis.

In the IVF process, our doctors genetically screen the embryos prior to transfer to identify those with two abnormal genes, which would indicate cystic fibrosis in the embryo.

Currently with IVF and pre-implantation genetic diagnosis (PGD), we can identify those embryos that would be unaffected with cystic fibrosis. On average, one in four embryos would not be suitable for transfer.

With gene editing and IVF, the parents and their doctor wouldn’t have to choose which embryos to transfer as doctors could remove the abnormal genes in the affected embryos, thereby increasing the number of healthy embryos ready for transfer.

Fighting Genetic Disease at the Source

The OHSU study specifically targeted the gene for hypertrophic cardiomyopathy. But scientists could use the same gene editing technology to target other genetic diseases and disorders such as:

• Autosomal dominant disorders
• Cystic fibrosis
• Sickle cell disease
• Tay-Sachs disease

People with these and other genetic diseases would be good candidates for gene editing treatment when it becomes available. However, gene editing would only be an option for people with a known genetic abnormality for which scientists know the specific gene that causes the disorder.
Even still, human gene editing isn’t the answer for every illness.

For example, hypothyroidism is easily treated with medication, so a difficult and invasive procedure to cure it would not be necessary. On the other hand, if a devastating illness such as Tay-Sachs disease is detected, genetic editing may be worthwhile.

Research Today, Medical Treatment…Tomorrow?

As of today, genetic-editing technology is in the early stages of development with procedures happening only in research settings, not in clinical ones.

In fact, the U.S. Food and Drug Administration (FDA) requires special permission for genetically edited embryos to be transferred into a womb.

Right now, the FDA isn’t funding this research.

Though there is not a ban on human gene editing in the U.S., the lack of funding means progress will be slow.

Researchers must present their studies to institutional review boards (IRBs) to ensure that their methods are safe and ethical.

Several more years of research are needed before genetic editing technology is ready for use with patients. Even when the technology becomes available, the question of cost remains.

Will insurance cover human gene editing? Will the procedure only be available to higher income families? Our goal at SGF is to make treatment available to all and to remove the barriers that stand in the way of creating a family.

Research like what’s taking place at OHSU and other facilities will open up new avenues of treatment for our patients, leading to refinements of the treatments we currently offer at Shady Grove Fertility.

It’s exciting that in the future we may be able to transfer a higher percentage of embryos and increase the chance of conception for our patients.

 Medical Contribution by Stephen Greenhouse, M.D. of SGF’s Fair Oaks and Haymarket, VA offices

To learn more about gene editing and IVF or to schedule an appointment with one of our 40+ reproductive endocrinologists, please call our New Patient Center at 1-877-971-7755 or click here to complete this brief online form.

When it comes to having a baby, nothing is predictable. In the recent Main Line Parent magazine article, Taking the 360 Degree View of Motherhood: Navigating the journey from pregnancy to new mom, and beyond, Dr. Isaac E. Sasson of the SGF Bala Cynwyd and Chesterbrook, PA offices shares why Shady Grove Fertility is the right choice for those looking to start or grow their family.
If you think you may need help in order to conceive, there are a few things to consider, Sasson advises.

Age is a Key Factor

A woman’s age is the number one contributing factor when it comes to having a baby. SGF recommends, for the best chances of pregnancy, for couples in which the woman is younger than 35 who have been having unprotected intercourse for over a year, to see a fertility specialist for evaluation. If you are 35 to 39, an evaluation is warranted after 6 months of unprotected intercourse with no conception; and after 3 months or immediately for women 40 and older.

Individualized Care Team

Once you decide to start your fertility journey, Sasson reminds couples that SGF provides you with all of the resources you need, including your doctor and nurses, a patient care representative, a financial counselor, and even access to a fertility-focused mental health support team and number of support groups. We also regularly offer informational webinars and physician-hosted seminars to educate men and women about fertility causes, symptoms, testing, treatment, and success rates, even what to expect throughout the process.

“Having an individualized team and care plan allows for uniform message and communication so that your doctor and nurse know you the best and can personalize treatment for you rather than one size fits all,” Sasson said.

Afford Fertility Treatment in Pennsylvania 

After meeting with your doctor and discussing the right treatment plan for you, the next conversation is about the cost. Cost is a huge factor when it comes to fertility treatment and SGF is committed to removing the financial barriers of treatment. In fact, we offer a Shared Risk 100% Refund Program for IVF using your own eggs or donor eggs.

With Shared Risk, patients pay a flat fee for up to six rounds of IVF treatment or donor egg cycles, and subsequent frozen embryo transfers (FET). Approximately 82% of patients who participate in our Shared Risk Program will take home a baby. Patients who do not take home a baby or choose to withdraw from the program at any time receive a 100% refund (some exclusions may apply).

“This takes away the stress and anxiety associated with the expensive fertility treatment,” Sasson said. “Rather than the traditional model of ‘try again, pay again’ with no end in sight, you know exactly what is going to happen—you will either deliver a baby, or receive a full refund.”

This program allows those trying to have a baby to have peace of mind that they can keep trying, or if the treatments don’t work, they can use the refunded money for additional treatment or even adoption.

“Our practice philosophy is to always put the patient first, providing the most comprehensive, efficient, financially responsible and compassionate care. Our goal is to empower couples to choose what is best for them,” Sasson said.

Shady Grove Fertility in Pennsylvania

There are four Shady Grove Fertility offices in Pennsylvania located in Bala Cynwyd, Chesterbrook, Harrisburg, and Reading. The Chesterbrook office is a full-service, state-of-the-art center and laboratory where IVF and egg donor procedures take place. Services at each location in Pennsylvania include patient consultations, monitoring, andrology services, and IUI.

The staff in Pennsylvania includes six board-certified reproductive endocrinologists, a medical support team, and embryology laboratory staff.

You are ready for this child, but maybe your body is telling you otherwise. If you’re not getting the results you want, speaking with a fertility specialist could be the next step in the right direction for you. To schedule an appointment with one of our physicians in PA, MD, VA, or Washington, D.C. call 877-971-7755.

BMORE Lifestyle host, Christina Denny, recently sat down with Dr. Ricardo A. Yazigi, a board certified reproductive endocrinologist at the Shady Grove Fertility Towson and Bel Air locations in Maryland, to discuss the medical procedure of in vitro fertilization (IVF). He and Denny discussed what IVF is and how it works. Dr. Yazigi also shared important information about affording IVF and dispelled common myths associated with fertility.

What is IVF?

In vitro fertilization (IVF) is a procedure that involves one or more eggs retrieved from a woman’s ovaries and then fertilized with sperm outside the body. Stimulation of the ovaries to produce more than one egg occurs because the goal of IVF cycles is to have many mature eggs available in order to increase the chances of success with treatment.

Dr. Yazigi explained that during fertilization, embryos are formed outside of the body and kept in the laboratory for a few days in order to grow. After progressive development, the highest quality embryo (in some cases, embryos) is then placed back inside the uterus. Two weeks after the embryo transfer, the woman will take a blood pregnancy test (called a beta pregnancy test) to determine if the treatment was successful.

While IVF is often not the first step in fertility treatment, it is commonly used to achieve pregnancy; nearly 40 to 50 percent of couples going through fertility treatment utilize IVF.

Affording IVF

Dr. Yazigi pointed out that in the state of Maryland there is a mandate for IVF, which means that insurance companies provide coverage for the treatment process. At SGF, we accept more than 30 insurance companies and about 90 percent of SGF patients will have insurance coverage for the initial physician consultation. Further, a large majority of patients will have coverage for diagnostic testing and fertility treatment, including IVF.

In addition to insurance coverage, SGF also offers many exclusive financial options including our flagship Shared Risk 100% Refund Program. This program is available for patients using IVF, donor eggs, and/or gestational carrier. The purpose of this program is for patients to take home a baby or receive 100% of their money back. Patients also have the option to opt out of the program at any time and still receive their money back.* Of the total number of patients who participate in the Shared Risk 100% Refund Program, 82% take home a baby.
*some exclusions apply

Common Fertility Myths

Fertility Myth #1: Infertility is planned.
According to Dr. Yazigi, an important myth to remember is that you will not know if you will face infertility until you start trying to have a baby, unless other known factors are present. If the woman is under the age of 35, it is recommended to see a fertility specialist if you and your partner have been having unprotected sex for over a year and have not successfully conceived. If ages 35 to 39, it is recommended to see a specialist after 6 months of unprotected sex; if 40 or older, we recommend seeing a fertility specialist right away.

Fertility Myth #2: Infertility is a female problem.
One of the most common myths is that only women can be infertile. In fact, 40 percent of infertility is because of a female factor, 40 percent due to a male factor, 10 percent is a combination of male and female factor, and 10 percent remains unknown. Because infertility is more than just a female disease, it is our recommendation that couples stick closely to recommendations of their age and time of trying and don’t hesitate if they suspect infertility. Male fertility testing is equally important as female fertility testing and should be completed in a timely fashion.

Fertility Myth #3: I’ve had one baby, I won’t have trouble conceiving baby #2 or #3.
People think that just because they already had one successful pregnancy they won’t have issues having more children. However, this is a myth. Having a successful pregnancy and then not being able to conceive again is known as secondary infertility. Age is a popular cause of this, but other causes can be internal complications from a previous pregnancy, weight gain, and male factor.

About Dr. Ricardo Yazigi

Dr. Yazigi is board certified in obstetrics and gynecology and reproductive endocrinology/infertility and has more than 25 years of clinical experience. Dr. Yazigi was the head of the division of reproductive endocrinology and infertility at Temple University School of Medicine, PA, from 1991 to 1997 and joined the Greater Baltimore Medical Center Fertility Center in Baltimore, MD, in 1997. He is currently an assistant professor at Johns Hopkins University School of Medicine. Dr. Yazigi has published numerous scientific papers and has lectured both in the United States and abroad and currently sees patients at the SGF Towson and Bel Air Locations.

To learn more about IVF or to schedule an appointment with Dr. Ricardo Yazigi or any of our other 35+ physicians, call 877-971-7755 to speak with one of our New Patient Liaisons.

 At Shady Grove Fertility, we’re here to give you the caring support you deserve as you start or grow your family. As a leading fertility and IVF center of excellence, we offer patients individualized care, innovative financial options, over 30 accepted insurance plans, and pregnancy rates among the highest of all national centers. We offer patients the convenience of 19 full-service and 6 satellite locations across Maryland, Pennsylvania, Virginia, and Washington, D.C. More than 1,700 physicians choose Shady Grove Fertility to refer their patients, and more than 96 percent of our patients say they would recommend Shady Grove Fertility’s 35+ physicians to a friend. With 10 Shady Grove Fertility babies born each day, your dream of starting or growing your family are within reach.