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By LISA LIDDANE
The Orange County Register
Sunday, September 19, 2004
DUE IN DECEMBER: Beatriz Sandoval is eagerly awaiting the birth of her child. “I have calmness throughout this pregnancy,” she says.
SANG H. PARK, THE ORANGE COUNTY REGISTER
For as long as she can remember, Beatriz Sandoval always longed to have children. And as long she could help it, she would not let breast cancer stand in the way.
Sandoval was 32 when she was diagnosed with fast-growing stage 1 breast cancer in 1999. She confronted not just the question of survival but also the question that others like her who are 40 years and younger face: Can I still have a child?
Chemotherapy, a staple of cancer treatment, can cause infertility.
“When my doctor mentioned the risks of chemotherapy damage to the ovaries, the words went beyond my ears and down to the depths of my soul,” she said. “The idea that I might not be able to have a child was much more overwhelming and had a huge impact on my diagnosis.”
There are fertility treatment options, but these have to be weighed carefully against survival issues.
More doctors are discussing these fertility options with patients, but there’s still a long way to go, said Dr. Lynn Westphal, assistant professor at the department of obstetrics and gynecology at Stanford University in Palo Alto. “A lot of women may not get information from their oncologists,” she said. Doctors may be so focused on their patients’ survival that they don’t always bring up fertility options.
Sandoval broached the subject of fertility with her doctor, Dr. Tariq Mahmood at St. Joseph Hospital in Orange.
“When the (doctor) gave my husband and I the diagnosis, he asked if we had any questions. I told him I had only one question: ‘How is this going to affect my ability to nurse a child?’
“He looked surprised and puzzled. Most of the questions he gets when he gives patients the bad news are related to dying. He hesitated only for a second before he deadpanned, ‘Well, it will affect your ability to switch breasts, because you’ll only have one to use.’ “
After Mahmood realized how important childbearing was to Sandoval, they discussed a plan of action. Sandoval turned to Dr. Lawrence Werlin, a reproductive endocrinologist in Irvine. “He understood the urgency of the situation and suggested freezing embryos,” Sandoval said. This was the first part of in-vitro fertilization.
Mahmood identified a small window of opportunity after mastectomy and before chemotherapy and radiation for Sandoval to undergo hormonal treatments to stimulate her ovaries. During that window, Werlin retrieved 16 eggs from Sandoval’s ovaries and fertilized them with sperm from her husband, Jorge Sandoval. Two days later, the couple had 11 viable embryos, which were frozen.
Sandoval began chemotherapy, then segued immediately into radiation. In June 2000, she began taking the drug tamoxifen for 18 months as a cancer preventive measure. The typical tamoxifen regimen lasts five years, but sometimes, oncologists shorten the duration if a couple is considering having children and the patient’s health permits.
In 2002, two years after Sandoval completed her cancer treatment, she and her husband began trying to conceive naturally, but to no avail.
Earlier this year, they decided to continue with the last part of in-vitro fertilization: embryo transfer. While being monitored for any sign of recurrence, Sandoval received hormones to thicken the lining of her uterus, which was needed to support a pregnancy. Werlin implanted four of the Sandovals’ embryos.
Two weeks later, Sandoval learned she was pregnant. Her baby is due just before Christmas.
Surviving breast cancer and coping with fertility challenges, she said, has given her serenity, strength and a sense of what matters.
“I have calmness throughout this pregnancy,” she said. “I understand what’s important. We have a crib in our bedroom. It’s great if you have a nursery you can decorate, but if you can’t have one, that’s OK.
“What’s really important is bringing life into this world. I live for the special moments. I absolutely cherish watching and waiting for my waistline to expand.”
She and Jorge have decided not to find out the sex of their baby.
“Everything we had to do to have this baby was so deliberate, so methodical and clinical that I wanted the chance to experience something traditional, something magical. So I proposed to my husband that we wait until the birth. At first, he asked how we would know what to shop for. I told him that was the least of my worries.
“I have had a lot of time to think about what kind of mother I want to be,” she said. “The last five years have been so full of many trials of different types. I’ve defined my own convictions and have a stronger sense of confidence.
“My greatest hope is that I will able to do everything possible for my child to make sure he or she has a chance to become a remarkable and responsible human being. The rest of it will come in time.”
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Coastal Fertility Medical Center offers one of the most affordable fertility treatments and is completely transparent regarding the costs of procedures and any other expenses that you may have to pay before commencing your treatment. This differentiates us from some fertility clinics that reduce prices before the signing of the contract but charge you extra later on. We make sure our patients are well aware of any possible extra pricing that may occur over the course of their treatment.
Following the Preimplantation Genetic Screening process, which helps ensure there are normal chromosome numbers and detects possible genetic disorders, the most healthy embryo(s) are selected to be implanted into your or your chosen surrogate’s womb. 2 weeks after the transfer of the embryo, your physician will conduct a final blood test to determine the level of hCG (human chorionic gonadotropin) in your body. Increased hCG levels usually indicate a positive pregnancy test.
For fertilization to take place, the collected egg and sperm are combined in a petri dish and cultured in an embryo incubator. This dish is closely watched to check whether any of the eggs have been fertilized. Once the egg is fertilized, it is referred to as an embryo or a blastocyst on the 5th day of development. Our in-house embryologist carefully nurtures every embryo to the right time, even if it means working outside the standard business operating hours. For instance: If an oocyte is not mature, our laboratory will wait for it to mature and then ICSI it at the right time.
The egg retrieval is a slightly invasive medical procedure that takes about 20 to 30 minutes. You will be given an anesthetic to make you sleep for the duration of the procedure. Using ultrasound technology, your doctor will harvest your eggs transvaginally with a small, hollow needle connected to an ultrasound probe. Once your eggs are collected, your partner’s semen or donor sperm you have pre-selected is used for fertilization. The sperm are washed and prepared, and the top-quality sperm extracted is used to fertilize the eggs.
Your doctor will create a customized medication schedule that contains information about the fertility medications and hormone injections you have to take. Medication and injections are taken to encourage your ovaries to mature a large number of eggs for fertilization. Since women don’t respond to fertility drugs and hormones the same way, personalized protocols are crucial to the IVF cycle success. At Coastal Fertility, we will monitor you closely, letting you understand the changes occurring in your body and keeping track of how your egg follicles are growing.
On-site consultations typicallyinclude a standard fertility evaluation, consisting of a physical examination, complementary follicular ultrasound, and testing to enable your doctor to know your present fertility status and draw up a treatment plan.
This consultation includes a detailed medical evaluation with a doctor. You and your physician will review your health records and have enough time to talk about your goals and get answers to your questions. We recommend that you jot down all your questions before the visit to allow you to make the best use of the time spent with your doctor.
Your Reproductive Endocrinologist will take all factors into consideration and create a comprehensive plan of care, otherwise known as the treatment plan. This plan will include treatment recommendations from the physician and enable your financial coordinator to make a precise quotation once you meet.
Our globally respected team of specialists are helping improve IVF technologies to enter into a generation of better outcomes for infertility. Although you’ll have a doctor guiding you, you are also going to benefit from the experience and insights of other doctors during case review collaboration meetings, which take place every week. So, you won’t just rely on the expertise of a specialist but benefit from the knowledge of many reputed fertility experts.
The infertility industry is currently segmented, with each service or treatment being handled by a different provider. Our all-inclusive model simplifies an otherwise complex and difficult process. We are here to revolutionize the infertility industry by offering a one-stop-service model to assist our patients through infertility challenges while reducing physical, emotional, and financial risks.
Our fertility clinic focuses on helping you build your family regardless of your sexual orientation or the gender you choose to identify with. We are even taking further steps to make LGTB people feel more welcome at our fertility clinic. Each of our patient-facing staff goes through LGTB training to let family-building clinicians provide necessary support and make you feel highly welcome.
We know that every situation is different and that everyone requires different treatments. Unlike facilities that take “a one-size-fits-all” approach for all cases, our fertility specialists use more than 40 customized protocols to raise the chances of success. The customized approach even extends to our fertility laboratory. Our on-site lab director and his highly-experienced team nurture every embryo and egg to increase the odds of success of each cycle.
Our team specializes in difficult cases and help patients who may have been considered “hopeless” at other fertility clinics. Thanks to our personalized solutions, expertise, and internal collaboration, weare able to maximize pregnancy success rates that are well above the industry average, even in difficult infertility cases.
Upon your arrival, you will check in with a Patient Care Coordinator. We will obtain your insurance information for benefits verification, a copy of your identification and take a picture for your electronic medical chart
Coastal Fertility is the leading provider of fertility solutions located in Orange County. Join us to get free updates on fertility news, treatments, infertility solutions and more.
Coastal Fertility is the leading provider of fertility solutions located in Orange County. Join us to get free updates on fertility news, treatments, infertility solutions and more.