Q&A WITH DR. THOMAS C. VAUGHN
Question: What inspired you to focus your medical training on infertility?
Answer: I was very interested in Obstetrics and Gynecology in medical school but I became more interested in infertility as I progressed through my OB/GYN education. I found the practice of infertility to be more intriguing than the practice of obstetrics and gynecology. I enjoyed the reconstructive surgery required for the practice of infertility more than surgical procedures for general gynecology such as sterilization, hysterectomy, etc. And, the patients having difficulty conceiving are really engaged in their health care which makes the practice very enjoyable.
Question: What do you typically recommend at the first appointment for a couple who’s been unsuccessful getting pregnant on their own?
Answer: Many social habits can reduce the chance of conceiving. It is important to identify those habits and encourage changes that are beneficial. Smoking strongly reduces the chances of conceiving and increases the chance of miscarriage. Smoking should be avoided. Also, it is important to limit caffeine and alcohol. These are things that couples can do on their own to maximize their chances of conceiving. Also, it is a good idea to explain the tests necessary to diagnose the cause of their infertility. It is important to make a plan for the couples to complete these tests in a short period of time. After completing the diagnostic tests, it is a good idea to meet with the couple again to discuss the appropriate treatments. Sometimes there is no identifiable cause for the infertility and the patient is considered to have “unexplained infertility.” Although this diagnosis may sound discouraging to a couple, there are many treatments that can improve their chances of becoming pregnant.
Question: What is the biggest challenge for you, as a physician, in the infertility field?
Answer: The biggest challenge is encouraging couples to ask for assistance early in their quest to become pregnant. It is recommended that couples seek advice if they have had 6-12 months of unprotected intercourse and have not conceived. The age of the egg is one of the most difficult barriers to overcome. Fertility for women begins declining at age 30 -31. Unfortunately, some patients delay asking for help until they are in their late 30s or early 40s.
Question: The average success rates for births at fertility clinics have roughly doubled in the past decade. What do you attribute the increased success to?
Answer: Success rates have increased significantly with in vitro fertilization because of improvements in the IVF laboratory environment. Also, a new procedure for cryopreservation of embryos and oocytes called vitrification has revolutionized the procedure and increased the success rates. Many women are cryopreserving their oocytes prior to treatment for cancer since chemotherapy and/or radiation can destroy the ovary, rendering a woman infertile. Cryopreservation before treatment gives them hope of being able to become pregnant after completing their cancer treatments.
Question: We came to almost every appointment with you together, as a team. In your experience, are husbands getting more involved in the infertility process these days than they were in the past?
Answer: Yes. After all, at least 40% of the time there are issues with the sperm. Therefore, it is really important that the husbands attend as many appointments as possible. Most husbands are interested in accompanying their wives for appointments but their work doesn’t always allow them to be present. Clearly, husbands are invited to attend all appointments and consultations.
ABOUT THE EXPERT
A native of Dallas, Texas, Dr. Vaughn received his undergraduate degree from the University of Texas at Austin. He completed his medical school training and residency in Obstetrics & Gynecology at the University of Texas Medical Branch in Galveston, Texas. He attended Duke University Medical Center in Durham, North Carolina, for his fellowship in Reproductive Endocrinology & Infertility. Dr. Vaughn was a founder of Austin’s oldest and largest In Vitro Fertilization Program in Central Texas. He has served as the President of the Medical Staff of the Seton Health Care Network. Dr. Vaughn is Board Certified in both Obstetrics & Gynecology and Reproductive Endocrinology & Infertility.