Melanie Cole (Host): Having a baby can be one of the most rewarding experiences of a lifetime, but some couples need help to get pregnant. And understanding your fertility options is key to starting that amazing process. Welcome to Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole. Joining me today 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 to have you join us today. I'm so glad we get to meet in person. I'd like you to start by just telling us about yourself and how you came to RSCNJ, how you got into this field, why this specialty?

Dr. William Ziegler: Well, I think I want to go back several years. When I was in junior high school, I was fascinated by the field of medicine and that made me want to do some volunteer work. So I started volunteering in the emergency room, in radiology. I then joined the Medical Explorers, which was part of the Boy Scouts of America.

And at that time I was also a Boy Scout. So I learned more and more about the medical field. I learned about the different specialties. A lot of times you were focused on just being a doctor, but there's other ancillary services that help physicians accomplish what they want to do for a patient.

And then I decided I wanted to go into medicine. But you do have to do some prerequisites before you get there. And that's where college comes into play. So I looked at the different disciplines to see which ones scored the highest on the MCAT, which is the medical entrance examination.

And I found out that chemistry major scored the highest. So I then majored in chemistry. I have a major in chemistry. I have a minor in physics as well as biology. So I was very science oriented. During that time also, I was involved with volunteer work at the local hospital, which was on Staten Island.

I went to Wagner College. At that point in time, I decided I wanted to go into medicine and I then started to apply and I found out that there was not just MDs, but there were also DOs and it's different philosophies and I learned the philosophies and I realized I really wanted to go the osteopathic route.

I applied and I then what, I was accepted at the University of Osteopathic Medicine Health Sciences in Des Moines, Iowa, which is the second osteopathic school, and I spent two and a half years there. We learned the general discipline of gross anatomy, histology. And then I decided let me do a rotating internship here.

I still wanted to figure out where exactly I wanted to focus, and then I realized I wanted to go into OBGYN. So I then from there, went to Christiana Hospital and I did my residency there. It was four years. The hospital's quite busy. We did 7,000 deliveries a year. I had a very good surgical experience, but then I realized that there was this subspecialty called reproductive endocrinology, which was growing.

At that point in time is when IVF really started to blossom, and more and more patients that were deemed sterile in the past, were now able to have their own genetic similar child. And doing a rotation in reproductive endocrinology, really opened my eyes to the point that I wanted to apply and I did.

And I was, at that time there were only 27 spots in the whole country for reproductive endocrinology. There were only two other DOs in which we're boarded through, what is called ABOG. And I am the third in which it was boarded. I went to the University of Vermont. It was three year fellowship, and I had a wonderful experience from the surgical techniques to help patients get pregnant, as well as, the technical part where you have IVF, where we can manipulate eggs and sperm, donor egg, donor embryo. Then when I graduated, I wanted to come back home, which was New Jersey. I was away for 14 years in all my training. And I joined a practice here.

At that time we had one child and then we had a second. So we stayed in the area because of family. The place that I was practicing, I couldn't practice medicine the way I felt I should be practicing medicine. So I wanted to enter into a practice or create a practice that provided cutting edge technology, state-of-the-art, technology, but make it in a warm, caring, compassionate environment. Yes, a lot of what we do is in a lab, but that doesn't mean the practice has to have that lab impression. We don't need the white walls. We don't need the stainless steel tables. I then left that practice and started this one in 2004, with that objective is to provide the most up-to-date technology in a warm, caring environment.

We are not a, as some people say, a mill. We are not just putting people through, we actually care about our patients and tailor our therapies to what they need, not what is going to generate the revenue for the practice. It's what does that couple need? Cause not everybody needs IVF, not everybody needs inseminations and sometimes it's just a little bit of encouragement or instruction of when to have relations.

And that is what we provide and our staff is very, very attuned to that also, cause we hire people and we train them to be aware of the frustrations that couples go through in trying to have a baby and the experience of seeing their faces when you show them a heartbeat for the first time when they thought they could never have a baby, that it is quite overwhelming.

Host: How lovely what you do for a living. You're able to help so many people. You work with a wonderful man, Dr. Martinez. I'd love for you to tell us a little bit about how you two work together and the services that you offer.

Dr. William Ziegler: Dr. Martinez joined us around 10 years ago, and we do have three offices. I mainly go between our main office, which is in Eatontown, New Jersey to Toms River. Dr. Martinez, he's out in our Lawrenceville office and in our Eatontown office. The way that we approach patients are very, very similar, and that is why we've been together for such a long time.

Every patient we discuss, we know each other's patients. So when we're on call and a patient calls, it's not that you are Dr. Martinez's patient or you are Dr. Ziegler's patient. You are RSCNJ'S patient. And we know you and we know what you're going through. We know the medication you're taking. We know where you are within your cycle.

We can answer questions for each other's patients because they are all our patients. And if there's a difficult patient, we do talk to each other and we come up with okay, what's going to be best for that patient? Not what's going be best for your patient, or what's going to be best for my patient? It's what's going to be best for our patient. How are we going help them get through this process. And when I say them, it's basically the couple, whether it is a same sex relationship, maybe it is a heterosexual relationship. Sometimes it's just a single person going through, but it is still a them, mainly because you're using sperm and you're using eggs.

Two things are involved and if you have a couple sitting in front of you, you just can't focus on the one person who's going to be carrying the baby. This is a couple's thing, and they both have to be together and they have to be on the same playing field in moving forward. And sometimes we understand that not every couple is the same and they may not have the same views, or there may be some conflict that has affected their ability to come together and to create a family. And we have to understand that and intervene early from a psychological standpoint as well as a medical standpoint. And I may pick it up on Dr. Martinez's patients or he may pick it up on mine and then all of a sudden it's like, okay, how do we work together and help them achieve the dream of having a family.

Host: So tell us a little bit more about your philosophy of care, Dr. Ziegler, because you're such a nice man, and I imagine that these couples feel so comfortable speaking with you. Tell us as an Osteopath too. I love that you brought that up right at the beginning because I want to ask you how you care for the whole person. You're not just helping this woman, as you said, you are helping couples, but also she's a whole person. And so tell us a little bit about your philosophy of care.

Dr. William Ziegler: Well, I think the first thing is, is we are not a family doctor's office. You know what it's like when you go to your primary medical doctor, you know he's going to listen to your heart and lungs. He's going to feel, he's going to feel your neck. You know what's going to happen. In our office, couples and patients don't know what happens here.

It's like a black box. So what we first do is if they want, we can do a free phone consultation. They call, they say, I wanted a a free phone consultation. One of us will call back that patient and we will address any concerns they have or any questions in which they may have read. And then on the internet, that social media sometimes is not always correct, so we help them understand what they're reading, what they're seeing, and what we can do for them. So when they walk in this office, they actually know what we're going to be doing. We're going to be doing a physical exam, we're going to be doing an ultrasound, we're going to take a detailed history, we are going to be doing a physical examination, and they know that's going to happen.

So that makes it more comfortable for them to come into our office. When they're here, part of it is putting to bed the myths, which people hear about, what they should be doing. Maybe I should be eating this food or maybe I should be doing sit-ups over here right after that I have relations. There's all different myths out there.

Part of our job is to say, okay, let's toss that aside. This is what we need from you. And it's usually three pieces to this puzzle for us to get the picture. And that is we need to evaluate the male partner's sperm and just if there is one. We have to make sure the uterus and tubes are okay on the female partner and we have to find out her ovarian age cause we have women that do come in here and they're 25 years old, but their ovaries are acting like they're 35.

So we need to assess the couple as a whole and that gives us our picture. And from that picture is where we decide on what are we going to be doing. And that's where it's a team approach. And it's not just the physician team. It is the patient and the physician. We are all on the same page. This is what your options are.

And a lot of times these options are governed by two things. One, their insurance coverage. There's 17 states that cover fertility treatment and New Jersey is one of them. Second is that patient's frustration. It's mainly the female patient. The one who's always being asked, when are you having a baby?

Or, have you guys been trying, you know, all these things. Or they're hearing about their colleagues getting pregnant and they're getting frustrated. So I need to know what, how much energy is in their emotional battery so we can guide them. We have patients that don't want to get aggressive and they just want to do timed relations.

Okay, fine. This is how you do it. Now let's set a limit; when is it not going to be beneficial to continue doing that? And now we need to change gears. And now when we change direction, how aggressive do you want to get? So I think incorporating the patient into the decision making process and not just pushing patients to in vitro fertilization, which is what people always hear happens in a fertility center.

We do IVF, yes we do, but we do a lot of other things, also. And maybe you don't want IVF and that's totally fine. Or maybe you don't have coverage for IVF. Okay? What can we do for you? How can we help you? And you need to feel comfortable with whatever we do. If you're not comfortable with it, it's not going to benefit anybody.

So we all need to be okay, and we all need to work as a team.

Host: Well, it is really shared decision making and I'm so glad that you told us about that. Now tell us, cause this is one of my favorite questions, Dr. Ziegler, and you and I have spoken many times; what do you do for fun? Tell us a little bit about your family life outside of work. What are some things that your patients or even your colleagues may not know about you?

Dr. William Ziegler: Outside of the office, I am a musician. I do play guitar and I think my wife thinks I have too many. But I don't think you can ever have too many guitars. But I used to be in a band and I used to play, I used to play quite a bit, especially in undergrad. When I was at Wagner College, I used to play guitar quite a bit and that gave me a lot of pin money to use.

Outside of that, I, that I am still involved within the Boy Scouts. I am the Medical Director of two Boy Scout camps. One is Quail Hill and the other one is called Forestburg Scout Reservation. One is in New York and the other one's in New Jersey. And I founded the Health and Safety Committee, which has now grown from just six people to now I think there's around 80 people that are on this committee now. So I'm very much involved with making sure that the standards at the Boy Scout camps are exceptional. So in case something does happen, we have the equipment and the facilities there to help the scouts as well as the scout leaders in case they get injured.

On the academic side, I am also on faculty at Jersey Shore University Medical Center and I am Associate Clinical Professor at the Hackensack Meridian School of Medicine, as well as at the New Jersey Medical School, which is part of Rutgers. So we do get a lot of students as well as residents who rotate through our office.

So I am very much into education. I do like the outdoors. I do like to go camping. Again, I think that's part of the Boy Scout in me. And I do have two children and they both went through Boy Scouts. They both became Eagle Scouts which I'm very proud of. And my wife and I like to travel. It's getting to that point where I like to check things off my bucket list.

So, we've been doing a significant amount of traveling, even short little weekend trips here and there. Again, I think that also helps with psychological wellbeing instead of always working. But I do love what I do. I've never had a day that I dreaded coming to work, or I thought of work as being work. I'm coming to my office where I'm comfortable and again, just helping out patients is very much rewarding.

Host: You are a busy man, and you know what they say? If you love what you do, you never go to work. So I agree with you and I play guitar too, so that's really fun. We'll talk about that someday, but, thank you so much Dr. Ziegler, for joining us today. It was a pleasure to meet you in person, and I'm so glad we got to hear about you and the Reproductive Science Center of New Jersey. So thank you again for telling us about you and for joining us today. And for more information, please visit fertilitynj.com to get connected with one of our providers. That concludes this episode of Fertility Talk with RSCNJ, the Reproductive Science Center of New Jersey. I'm Melanie Cole. Thanks so much for joining us.