The Wall Street Journal,
Personal Journal
February 3, 2004

“The New Math on When to Have Kids”

“The biggest issue for many women [in the U.S.] is waiting too long to start having children, not spacing them three years apart,” says Arthur L. Wisot, a fertility specialist at Reproductive Partners in Beverly Hills, Calif.”

Easy Reader,
July 31, 2003

“Nature and science make Mickey Rooney Grandpa”

But their famous grandpa and their parents know that the boys were born of both nature and science, via the now fairly common procedure of in vitro fertilization, performed at the uncommonly renowned Reproductive Partners Medical Group in Redondo Beach .”

Ladies Home Journal,
May 2003

“A Tale of Two Mothers”

“In February 2000, the women went to Gabriel Garzo, M.D., and Arthur L. Wisot, M. D., of a fertility practice called Reproductive Partners, which has performed more than 40 successful procedures with surrogates in the last five years.”

Excerpt from

The Journal of Clinical Investigation
Volume 102, Number 11, December 1998, 1978-1985

Role of Vascular Endothelial Cell Growth Factor in Ovarian Hyperstimulation Syndrome

Ellis R. Levin, Gregory F. Rosen, Denise L. Cassidenti, Bill Yee, David Meldrum, Arthur Wisot, and Ali Pedram

   Controlled ovarian hyperstimulation with gonadotropins is followed by Ovarian Hyperstimulation Syndrome (OHSS) in some women. An unidentified capillary permeability factor from the ovary has been implicated, and vascular endothelial cell growth/permeability factor (VEGF) is a candidate protein.
   Our results indicate that VEGF is the FF factor responsible for increased vascular permeability, thereby contributing to the pathogenesis of OHSS.

Excerpt from

As seen in...

November 15, 1998
By Maureen Donohue

Retrospective Study

   IVF Success Rates Not Affected by Multiple Cycles.
   Success rates for in vitro fertilization do not decrease significantly with the second and third attempt, reported Dr. David R. Meldrum of the Center for Advanced Reproductive Care in Redondo Beach, Calif., and his associates.
   The investigators analyzed data on 4,043 cycles of oocyte retrieval from 54 fertility treatment programs (Fertil. Steril. 69[6]:1005-09, 1998).
   Pregnancy rates for cycles 1, 2, 3, 4, and >4 were 34%, 29%, 26%, and 21%, declining significantly for >4 cycles.
   Delivery rates were 27%, 27%, 23%, 16%, and 15%, declining significantly beginning with cycle 4.
   The delivery rate for women aged 40-42 was half that of women under age 40. Assisted hatching was strongly related to improved pregnancy and delivery rates for patients under 40 years of age.
   The investigators also compared their results with eight previous studies and found that the results were similar despite different measures and study designs.

As seen in the Daily Breeze
October 4, 1998
By Mary Moore

Newborn Hope

   Imagine struggling unsuccessfully for years to have a baby the natural way and then finally undergoing in-vitro fertilization - only to end up in what many consider a more difficult situation. Pregnant with more viable embryos than you can handle.
   The choice: Eliminate some of the embryos or have a gaggle of babies at once. Multiple births are expensive, not to mention a greater health risk for the mother and the babies. And choosing among several embryos can be an emotional and morally difficult process for couples already on edge from trying so hard to have children.
   Researchers at the Center for Advanced Reproductive Care, a fertility clinic in Redondo Beach, are in the midst of clinical testing of a new variation on in-vitro fertilization that may give couples an alternative. The process, called blastocyst transfer, incubates embryos for five days - two days longer than traditional in-vitro fertilization methods - before doctors implant the seeds in a woman's uterus.
   The result is something akin to Charles Darwin's theory on survival of the fittest.
   Doctors determine which of the older embryos have the best chance of making it through a pregnancy and they implant two of the strongest. In traditional in-vitro methods, doctors scatter-shoot three or more embryos into a woman's uterus in hopes of randomly improving her chances of pregnancy. 
   "This is going to be a huge advance in reproductive services," said Dr. Art Wisot, one of the doctors working on the study at Reproductive Partners Medical Group in Redondo Beach. "We think we've licked the major problem - high-level multiple pregnancies." The key to blastocyst transfer was the discovery that 5-day old embryos have different nutritional needs than those that are 3 days old, the normal incubation period for embryos before they are implanted in the womb.
   By feeding the older embryos a special culture medium, doctors can cultivate them longer and give them more time to mature. Wisot's clinic is conducting the study with doctors at the Colorado Center for Reproductive Medicine, where blastocyst research began two years ago. In Redondo Beach, the study includes 23 women. Some are undergoing blastocyst transfers and some are undergoing conventional in-vitro methods. The Redondo Beach clinic will continue adding women to the study through the end of the year. Those eligible to participate are women younger than 40 who produce 10 or more eggs that doctors can retrieve and who have eight or more embryos after fertilization.
   Wisot said the procedure costs $500 more than traditional in-vitro methods, which normally run $10,000.
   So far, Wisot said, the results for blastocyst transfers in Redondo Beach look good. "In the patients we've done so far, the pregnancy rate is the same," Wisot said. "We're really running neck and neck in both groups." Farther along in their study, embryologists in Colorado are finding similar pregnancy rate success. In December 1996, they performed blastocyst transfers on eight women; five became pregnant.
   Last year, the Denver fertility clinic conducted random clinical trials on more than 90 women, performing traditional in-vitro fertilization on some and blastocyst transfers on others. Meg and Tony Casey, who moved from Redondo Beach to Colorado seven years ago, are among the Denver clinic's success stories.
   The couple had ruled out in-vitro fertilization, fearing they would be faced with multiple births or the trauma of having to selectively reduce the embryos. But when they got nowhere after five years of fertility drugs and insemination treatments, the couple tried a blastocyst transfer. Their son, Cole, was born months ago.
   "It sounded like this procedure was more likely to work," said Meg Casey, 35. "The health risks with regular in-vitro were too great. The babies can end up with cerebral palsy and other birth defects. And I knew I could never reduce the number of embryos."
   "When you seek fertility help, you think, We've waited this long, why would we want to give up a baby? That's what's so great about this procedure. You don't ever have to get in that position."
   Indeed, the increase in multiple births among women who have in-vitro fertilization has been among the harshest criticisms of the process. Improvements in neonatal care have improved the chances of a woman bearing healthy triplets - any more than that and the health risks grow for the mother and the newborns.
   "With high-level multiple pregnancies you're risking prematurity and developmental disabilities," Wisot said. "You're not doing anyone any favors by ending up with a child that has cerebral palsy. That's very difficult for couples to think about. The best treatment is prevention. This method prevents multiple pregnancies, which has been the most serious consequence of (in-vitro fertilization) techniques."
   Wisot's concern is that couples under-going blastocyst transfer, fearing that two embryos are not enough despite the longer incubation period, will end up implanting more.
   "More is not necessarily better - more can get you into trouble," he said. "That's the reason we're doing this. You have to resist temptation of letting your doctor tell you that he'll put back three or four embryos to increase your chances."