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When David Sable, M.D., is asked to list his most significant influences, the Director of the Division of Reproductive Endocrinology at The Institute for Reproductive Medicine and Science of Saint Barnabas does not mention famous physicians or scientific pioneers. “The patients are my role models,” says Dr. Sable. “Their courage and resilience under stress are a constant source of inspiration for me.” Dr. Sable, who was educated and trained at institutions including the University of Pennsylvania, New York Hospital, Cornell University, Brigham and Women’s Hospital and Harvard Medical School, leads the Institute at a time of great opportunity. He feels privileged that his experienced reproductive endocrinology team has been paired with “some of the best embryology talent in the world, all working together to create the finest infertility center in the nation.” Now, more than any other time in history, medicine can offer infertile couples the best hope of having a child. By shortening the diagnostic and treatment process at The Institute, physicians have significantly increased the likelihood that patients will conceive. A shortened process is especially important when advanced maternal age is an issue. Instead of generating another year of frustration, says Dr. Sable, the unique medical advances mean more accurate and timely treatment plans for couples. Despite the encouraging pregnancy rates, couples may still feel discouraged during their medical journey. The Institute team looks for ways to meet the emotional and physical needs of couples, knowing that both are important in the care of the whole patient. Dr. Sable identifies the following as “emotional trouble spots” that may occur for couples seeking infertility treatment: Confusion over what test results may mean During the part of the ovulatory cycle when women are checked every morning, some patients feel overwhelmed by the influx of test results and are confused as to which findings hold significance. To assist patients, Dr. Sable and other physicians perform the morning ultrasound scans rather than employing a technician. Through these consultations, patients learn immediately if results are important. Anxiety over not getting an answer One of the frustrations of infertility care is the inability of physicians to tell some patients exactly what is keeping them from getting pregnant. Unfortunately, cases do arise where every identifiable abnormality has been treated appropriately, yet the couple still does not conceive. Dr. Sable says experience tells physicians that pregnancy may require much more aggressive approaches than the diagnosis implies. With each new treatment plan for his patients, he also includes an "if this does not work" plan, so patients never feel they have “no where to turn” if a treatment fails. Depression caused by a painful procedure An important part of a physician’s role is to minimize discomfort, but unfortunately some infertility procedures do hurt. According to Dr. Sable, part of the physical discomfort that some women feel is compounded by the nagging voice inside them that says, "This pain is your punishment for X." The X could be anything from using the pill in college to letting someone copy an exam in grade school. Dr. Sable and his team are mindful of the possible feelings of guilt involved for patients and offer a voice of reassurance. The stress of the ongoing process No child grows up hearing bedtime stories about infertility treatment. In fact, many people spend a great deal of effort trying to avoid pregnancy. It is a tough realization that pregnancy, now wanted, will not come easily. Once treatment is sought, some couples find that their constant focus on the difficulty may feel unrelenting. To combat stress, Dr. Sable recommends that patients engage in any activity that brings them comfort, including yoga, massage therapy and other forms of recreation. While reducing stress may not solve infertility, it can help couples cope with the problem. “I have found that most couples are extremely supportive of each other,” says Dr. Sable. “The process is so much more tolerable when approached as a team.” [ top ] |
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