Lancaster Physician Summer 2021 - 29

SUMMER 2021
While she was recovering from her third
surgery, however, someone handed Judy a
pamphlet about a new clinic in Norfolk,
Virginia. Two retired Johns Hopkins physicians,
Howard and Georgeanna Jones, were
working in the emerging field of in vitro
fertilization (IVF) there and looking for
patients who might benefit from this new
and often controversial area of medicine.
While 14 babies had already been born
in England and Australia as a result of IVF,
the U.S. was lagging due to controversy and
limits on federal funding. After a failed IVF
attempt in 1973 at a top New York hospital,
research within the medical mainstream
had pretty much stopped.
Willing to try anything that might result
in her having a baby, Judy convinced her
doctor to provide a recommendation. She
was considered a viable candidate, and
she and the Joneses decided to proceed
with IVF.
A fertilized egg was implanted in her
uterus in April 1981, and her daughter,
Elizabeth Jordan Carr, was delivered by
Caesarian section on December 28 - the
first IVF baby to be born in America.
" We'd finally been blessed, " Judy said
after having her daughter. (The US' First
Test Tube Baby n.d.)
More than 40 years later, millions of
babies have been born through IVF and
numerous other major breakthroughs in
fertility have occurred.
Lancaster Physician reached out to area
physicians who specialize in fertility issues
to learn more about those advances and what
the future of this field might look like. We
talked to representatives of WellSpan Health,
Penn State Health, Penn Medicine Lancaster
General Health, and UPMC Pinnacle.
WELLSPAN HEALTH
Dr. Jessica Wirth-Tocks,
an obstetrician-gynecologist
with WellSpan Health,
tells her patients
that
dr. jessica
wirth-tocks
90 percent of infertility
issues can be overcome with some sort of
medical treatment.
The problem, she said, is that not everyone
within that 90 percent can afford access to
those treatments.
" It's sometimes as much of a financial issue
as it is a medical issue, " Wirth-Tocks said.
" Unfortunately, finances play a huge part in
this particular problem. "
Currently, Pennsylvania does not require
insurers to either cover or offer coverage for
infertility diagnosis and treatment, for which
costs can be prohibitive. The National Conference
of State Legislatures reports the average IVF
cycle can cost between $12,000 and $17,000,
not including medications that may be needed.
Most people require more than one round of
treatments. (State Laws Related to Insurance
Coverage for Infertility Treatment 2021)
Other treatments related to fertility issues,
such as freezing of eggs or genetic testing of
embryos, also can be costly.
Worry about how to afford fertility treatments
can add to the emotional burden already
experienced by someone who is having difficulty
becoming pregnant.
" That can be a devastating experience, "
Wirth-Tocks said. " I can't tell you how many
times I've sat and held the hand of a woman
who really wanted three children and can't
even have one. "
Causes for fertility issues vary, Wirth-Tocks
explained. Abnormal semen or another issue
related to the male account for a significant
number of issues, while women who delay
trying to become pregnant until they are older
may experience problems related to the release
and development of eggs.
" The older you get the fewer eggs you have
and the more abnormal they become, " said
Wirth-Tocks.
Conditions such as endometriosis, damage
to the fallopian tubes, uterine or cervical disorders,
or ovulation problems also can result
in fertility issues.
LANCASTER 29 PHYSICIAN
According to Wirth-Tocks, however,
improvements in the field of fertility treatment
have been steady and significant, and
she is hopeful that many people desiring to
have a child will be able to do so in the future.
More targeted selection of embryos for
use in IVF, better genetic testing to identify
chromosome problems, better egg-freezing
techniques and other advances have dramatically
moved the field forward. Hopefully,
she said, an increasing number of people
will be able to gain access to treatment and
fulfill their wishes to become parents.
" I think we have a lot to look forward to
in this field of medicine, " Wirth-Tocks said.
" I'm looking forward to being a part of that. "
PENN STATE HEALTH
Dr. Samantha Butts
dr. samantha
butts
employs a holistic approach
when treating patients
experiencing problems
associated with fertility and
believes that pregnancy
should be a women's health issue that is
discussed long before someone starts trying
to become pregnant.
" These conversations can and should
happen, " she said. " The more education
someone has about their overall health and
potential issues surrounding pregnancy, the
more prepared they can be. "
A professor of obstetrics and gynecology
and chief of the Division of Reproductive
Endocrinology and Infertility at Penn State
Health, Butts said between 10 and 12 percent
of all couples trying to conceive will
experience issues related to either the male
or female, or both.
While a specific issue such as uterine
fibroids or abnormal sperm production
can cause problems, a medical condition
such as diabetes or obesity also can result
in fertility struggles. Lifestyle choices such
as smoking also can make pregnancy more
difficult to achieve.
Continued on page 30
Lancaster Physician Summer 2021

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