The Reproductive Science Center of New Jersey combines a commitment to sensitive care with a state-of-the-art program. We proudly present Fertility Talk with RSCNJ. Here's Melanie Cole..

Melanie Cole: More and more women are choosing to move forward, building their families without a partner. Welcome to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole and we're discussing fertility options for single women today. Joining me is Dr. William Ziegler. He's a specialist in reproductive endocrinology and infertility, and he's the Medical Director of the Reproductive Science Center of New Jersey.

Dr. Ziegler, it's a pleasure as always. Tell us a little bit about what you've seen and some important considerations if single women want to enter into fertility treatments. They've decided they're not going to wait around for a partner. They want to do this. They want to have a baby.

Dr. William Ziegler: Well, we're seeing this more and more often, especially with more men as well as women putting off childbearing till later on in life. It's sort of like a career choice, I guess, that they want to establish themselves in the workforce. So they may put family on kind of the back burner, but it also puts off even possibly having an intimate relationship.

So in that situation, we will see these women come into our office and they're looking at fertility options and we have a few that we can discuss with them. One is that if they want to use their own eggs, then we talk about donor sperm. There's also, in some women who are older and their ovarian function is not the best, then we talk about even using donor egg as well as donor sperm. And there's always an option of what's called embryo adoption.

So when a patient comes into our office and they want to have a child without a partner, then we start to look at their ovarian function, we make sure their uterus is okay, and we make sure their tubes are open. And based on those factors, we then bring up different topics and see what they are comfortable doing. And donor sperm seems to be the most popular option, especially in women with normal ovarian function.

When we talk about using donor sperm, we actually have to try to match the donor to the patient with regard to blood typing, with regard to cytomegalovirus status. This is a respiratory infection that if they have not been exposed to it, we don't recommend them using a donor who has been exposed because it can actually affect a child within the first trimester theoretically. So therefore, we try to mitigate that situation.

And when they pick out a donor, every woman has a different profile in which they're looking at. And they have different, what I refer to it as category A criteria, whether it's height, weight, hair color, eye color, body built. We always stress that we'd like to have a donor who has had proven fertility, so we know in which they have a good, basically, track record.

And based on their medical situation, we may use some medication with them. Clomid or letrozole or some other medication help improve their ovulation. And then, we do an insemination. We would get the sample sent into our office and then from a sperm bank. In most cases, we just have to thaw the sample and then we do the insemination process. So that's the most popular treatment option for these patients. And again, there are some other options such as using donor egg and donor sperm, as well as embryo adoption.

Melanie Cole: Well, so I'd like you to speak a little bit more about that, but before you do, and I want you to tell us what embryo adoption really is when they're picking their sperm donor, are they involved in picking it? You said you're matching blood type, all of these different things, but do they get to see what he looks like? Do they get to see family history, all of that sort of thing?

Dr. William Ziegler: Yes, the sperm donors actually go through a very extensive questionnaire, including a family pedigree. So they actually know the donor's background, the donor's family history. They also get to see pictures of the donor and that is important. But also you have to realize that as you are selecting out a donor, once you put in your ZIP code, you may notice your donor list gets smaller very quickly because donors can only be used a certain amount of a time in a specific area. So they try to minimize the possibility of half-brothers and half-sisters meeting.

So we do help out the patient in selecting. If they have an issue where they are down to two or three donors, we will help them within the selection process. But before they even start selecting out a donor, we do testing on the patient to help them with that selection right off the bat like I mentioned before. We give them specific criteria that in putting in helps minimize that list, so it gives them the highest quality sperm donor possible

Melanie Cole: How interesting, what you just said. That's fascinating, Dr. Ziegler. And what's embryo adoption?

Dr. William Ziegler: Embryo adoption, in many cases, when couples go through in vitro fertilization, they are looking short-term. They're looking at, "I want to be pregnant now." They're not looking long-term that, "Okay. Now, my family is complete and I still have five embryos still cryopreserved. What do I do with them?" And that is a quandary that patients are left with.

In many cases, they could either have the embryos basically discarded. They could give them to research. They can give them to another couple. Or they can actually give them to an embryo adoption bank. And currently, you can buy sperm, you can buy eggs, but you cannot buy an embryo because it is a potential human being. And therefore, you need to adopt the embryo.

And there are several different embryo adoption agencies out there in which we work with closely, that a patient can actually contact the adoption bank and putting characteristics in which are important to them and they will be matched with an embryo. And these are embryos are normally from couples that have conceived in the past, but they're just extra embryos that the couples don't want to have destroyed. They would like to have another person use those embryos and have the joy of having a baby.

But again, it is an adoption process similar to adopting a baby or another child. You do need to fulfill specific requirements. And a lot of banks have their own internal exclusion as well as inclusion criteria.

Melanie Cole: I think that's lovely how far has your field come. Wow, isn't that just amazing? Now, segue a little bit into we've talked about single women, so what about same-sex female couples that want to have children? Would you handle them any differently than just a single woman or are there other avenues they can explore? Tell us how these differ or how they're the same.

Dr. William Ziegler: Well, the same options that I mentioned before are open to a same-sex couple, except they do have some more options that they can look into. And one that has really picked up some pace within the last few years is what's called co-IVF. And that is where the one female partner, we would retrieve her eggs, take donor sperm, make embryos and put them into the other partner. So they're both basically playing a role in this child's upbringing. So that is another option in which they can do.

Also, what that allows is that we can actually freeze embryos. And actually, if the other partner then wants to carry at that time later on, then we can use embryos that are related to the child in which they already have, but the birth mother is different. The birth mother would then be the genetic mother, as opposed to the first child where the birth mother is not the genetic mother. So there are some options which are available for these patients.

There's also a procedure out there at this point in time where there is an incubation unit that can be placed within a woman's vagina that can incubate the embryo and then it is transferred into the other partner. The way this is performed is there's an egg that is retrieved from the one partner. And the egg is put into an incubation tube with sperm and it's put in the vagina of the other partner. So it's basically incubating in the vagina. Fertilization occurs and then is taken out of the vagina on day five. The embryo itself, if it is a good quality embryo, can then be transferred back into the woman in which the egg was retrieved from. So again, this is another way that a same-sex couple both can play a role in the creation of their child.

Melanie Cole: Another therapy in your armamentarium of tools to help people that want to have a baby. Dr. Ziegler, that's absolutely so fascinating. Wrap this up for us. What would you like us to know about fertility options for single women and even same-sex female couples about just this huge toolbox that you've got that can really offer them so many options for fertility?

Dr. William Ziegler: I think when a single woman or a same-sex couple are looking to conceive, in many cases, they don't know where to turn. They don't know where to get the information or the correct information. There's a lot of information they can get from the internet, which a lot of it is wrong. And I think having an open conversation or having an open avenue that these patients can come to a specialist and find out these options without trying to go through a maze to get this information, I think is very important.

That is why a lot of times we do free phone consultations, just so they can get the information in which they need. And then they can make a decision of whether or not they want to take that next step and go to a specialist to find out some more information. A lot of patients, they just want the initial information so they can understand it better before they take that jump and go right into treatment or go into an evaluation process.

Melanie Cole: What an interesting field you're in, and ever expanding, Dr. Ziegler, and you're such a great guest. Thank you so much for that informative episode.

That concludes this episode of Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. For more information, you can always visit FertilityNJ.com to get connected with one of our providers. Please remember to download, subscribe, rate, and review this podcast and all the other Reproductive Science Center of New Jersey podcasts. I'm Melanie Cole.