David R. Meldrum, MD
From UCLA to RPMG
I have been asked many times why, after spending a dozen years on the full-time faculty at UCLA, being tenured as an associate professor and sure to reach full professor in short order, I would leave for private practice. At that time being a full-time faculty member involved research, clinical care, administrative duties, and teaching. If you factor in travel for speaking engagements and professional meetings, then doing everything well and having reasonable time left over for family and leisure time is simply impossible. I particularly enjoyed patient care and did not to want to delegate it to residents and fellows, even if that was possible with something as complex as IVF. Fortunately today, there is a clinical series which allows someone to concentrate on clinical care with less research and travel. It’s unfortunate that the university took so long to realize what was glaringly apparent to me. So, after much contemplation Claudia and I decided to make the leap off of the treadmill.
Fortunately the leap wasn’t so difficult since I had a 2 year waiting list of patients at the rate that UCLA was allotting me operating room space. At that stage in the development of IVF, egg retrieval required laparoscopic surgery because ultrasound guided retrieval was just getting underway. (Our UCLA program was actually ahead of the curve on non-surgical egg retrieval having established the first successful pregnancy in the U.S. by passing a needle under ultrasound guidance across the full bladder into the ovary to draw off the eggs). Again there Alan Trouson’s lessons led me to fill the bladder with culture medium to avoid any toxic effect of urine on the eggs, which was probably crucial to our early success (her name is Greta, here with her mom, Nancy, and her dad, Dick. However, that technique was not sufficiently proven by achieving one pregnancy to abandon laparoscopic retrieval just yet). Fortunately my UCLA embryologist, Minda Hamilton, lived closer to the South Bay where my wife’s relatives lived and she accompanied me in setting up a program in Redondo Beach where we have been ever since. Dr. Art Wisot, a local physician interested in infertility, also joined us and has been a treasured colleague ever since.
Our Redondo Beach program flourished and although Minda recently retired, a number of key people we recruited early on are still with us many years later. Lisa, who initially began as a lab tech measuring hormones is now the IVF lab director in La Jolla, and Diane, who initially joined us as a receptionist, manages our front office people working at multiple locations. Gabe Garzo worked with us in Redondo for a few years and now heads the UCSD RPMG Regional Fertility Center in La Jolla.
However, it was still a small “mom and pop” operation and I felt we could do much better with more people on the team. Dr. Bill Yee, who was running a successful IVF program in Long Beach, actually lived closer to Redondo. We began to talk and subsequently merged into what is now known as “Reproductive Partners Medical Group” that has grown to 7 physicians, and approaching 100 employees in 4 locations (Beverly Hills, Redondo Beach, Westminster, and La Jolla). I have always believed in the value of teamwork, and RPMG illustrates that so well. Due to our high success rates and our well-organized team of professionals we have steadily grown during the recent economic downturn while other programs have seen their volume drop as much as 30%.
Our website, www.reproductivepartners.com, will give you all of the information you will need to assist you in becoming a patient. Be sure to also avail yourself of the educational material posted there, and the forum, where you can pose questions. You can see our physicians at any of the 4 locations. Our medical records are electronic, so if you find another office is more convenient for part of your care, you just need to inform the nurse taking care of you. Although your primary RPMG physician will be overseeing your care, for daily visits and for procedures you will see more than one physician. Be reassured we are all highly experienced and follow uniform protocols. Think of it as a built in second or third opinion. Four or six eyes are always better than two. If you find that you want to be followed by someone different from the physician you first saw for your new patient visit, simply ask the nurse and she will make that change. The physician will not be offended. We all want you to be as comfortable with your care as possible.
Above all keep in mind that the thing that will maximize your chance of success more than anything else is the number of treatments you have. Too many patients become discouraged and simply give up. It is well documented that in states or countries where IVF is fully covered, the major reason for failure is giving up. That is one of the reasons you may wish to have your embryos tested to be sure they have the correct complement of chromosomes (see quads). That will prevent you from going through transfers with embryos that are not capable of implanting or developing. That is also the reason we are recently suggesting multiple cycles in poor responders with freezing of all embryos and just a single embryo transfer. We know that couples have difficulty coping with multiple failures. Be sure also to take full advantage of groups with Resolve, and stress reduction techniques such as yoga and mind/body to allow you to better cope with unsuccessful cycles.
After my many years seeing infertility patients in the South Bay, most times that Claudia and I go somewhere locally for a walk we see one of my successes. Be sure to stop me and say hello. I always like to see how you’re doing, and of course to see how your kid/s are doing. Or send pictures or stop by the office. All of our staff gets a great lift out of seeing the product of their labors and their former patients as parents.