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November 28, 2013

Mothers, doctor describe embryo implant process

NEW CASTLE — The birth of Anna Marks was an involved scientific process.

But more than a year later, her parents and her aunt — who carried her — are overjoyed at their little blessing.

The process was facilitated by Dr. Robert Leon Collins, a board-certified reproductive endocrinologist with the University of Pittsburgh Medical Center’s Center for Fertility and Reproductive Endocrinology.

Collins’ main office is at Womancare Center in Hermitage, which partners with Magee Woman’s Hospital.

He explained the scientifics of the process when a woman carries another woman’s child.

When a volunteer or friend carries the baby, she is called a gestational carrier, he said, whereas surrogate is a legal term with financial remuneration.

“The egg donor has to go through an in vitro procedure to have the eggs harvested, and we use the husband as the sperm donor,” Collins said.

He emphasized a woman’s age is important in producing healthy eggs.

Melinda Marks of New Castle and her sister-in-law, Joann Lamb who bore the baby, both were over 40, and that was a concern to Collins.

“There are a lot of factors for the success,” he said, including the egg donor’s age. The younger she is, the better chance for success. There also are better odds if the host uterus is normal.

Collins said his biggest concern was Marks’ age.

“My primary concern was whether she would be able to respond well, and she did,” he said, noting that Lamb also had a history of successful pregnancies without complications.

Both women had to be synchronized through a timing process so the embryo could be transferred successfully to the host uterus, Collins explained.

He first ordered a battery of tests — bloodwork and ultrasounds for both and for Lamb, a hysterosalpingogram or X-ray that shows the inside of uterus and fallopian tubes.

Ed Marks, the baby’s father, had a sperm analysis, and some of his sperm was frozen for the fertilization process, his wife explained.

After all the testing, the two women took hormones to synchronize their ovulations to within a week of each other. That took about a month, according to Melinda Marks.

She explained she stayed on the medication to continue producing eggs and Lamb was on medication to build up her uterine lining.

During the final week, the two women went every other day for ultrasounds, Marks to check her egg production and Lamb to check the size of her uterus.

They went to Pittsburgh on Sept. 16, 2012, for the egg retrieval, but when doctors extracted the first two eggs, neither fertilized.

“The whole cycle was a bust,” Melinda Marks said.

So they spent another month resynchronizing.

On Nov. 13, 2012, Dr. Anthony Wakim, a pioneer in the embryo fertilization field, took 10 eggs from Marks. Six were mature and when they were united with her husband’s thawed-out sperm, three eggs fertilized.

“They knew within 24 hours we had three embryos,” Melinda Marks said.

All three were transferred into Lamb’s womb. One was successfully implanted “and it’s Anna,” Melinda Marks said.

Lamb received progesterone shots every day for 12 weeks to maintain the pregnancy.

Collins explained the host does not contribute anything genetic to the pregnancy.

“It’s done in a petri dish in the lab, and the eggs and sperm are maintained in culture conditions.

“They are not transferred until three days after they are embryos. Any extra ones available can be frozen to use in the future, if necessary.”

In addition to the scientifics, both couples had to go through psychological counseling to make sure they were mentally prepared.

They also were required to sign a 28-page legal contract drawn up by attorneys, setting Lamb’s physical limitations during pregnancy and requiring her to return phone calls. The pact spelled out travel restrictions and prohibited her from taking drugs, using alcohol or smoking.

She also was prohibited from any intimate relations with her husband until after the transfer was made.

“I had to consult them before I even took a Tylenol,” she said.

Lamb credits Collins and Dr. Kelly Palumbo, the obstetrician, and the University of Pittsburgh Medical Center for being “so wonderful and so caring” through the process.

She encourages other women who are willing and able to fulfill the surrogate mother role for families desperately wanting children.

“I think there are other women who have good pregnancy experiences who, if they’re willing to do this, there is a need.”

Collins said he is pleased the process was a success and happy to meet Anna.

“They brought the baby by the office a couple of weeks ago,” he said. “It’s always good to see when it works out.”

(Email: dwachter@ncnewsonline.com)

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