board-certified reproductive endrocrinologists work
closely with couples in finding the formula for fertility
through diagnosis and various treatment options.
A look at the statistics shows that the difficulty
to conceive is traced to the man in 40 percent of all
cases and to the woman in another 40 percent. Both
sexes contribute to the difficulty 15 percent of the
time, and the cause is unknown in the remaining 5 percent.
In recent years, a more sophisticated generation of
medical therapies and surgical techniques have emerged,
as reproductive medicine specialists continue to refine
existing treatment methods to improve the chances of
conception for couples with even the most difficult
Several major advances have been made in techniques
used for in vitro fertilization (IVF), a popular
process that involves joining a woman's egg and man's
sperm in a specially cultured laboratory dish, where
fertilization occurs and the fertilized egg then is
implanted in the woman's uterus.
Intracytoplasmic sperm injection (ICSI) is emerging
as the most effective IVF technique in overcoming male-related
problems that involve low sperm counts or obstructive
sperm problems. The procedure is performed by directly
injecting a single sperm into a harvested egg in an
attempt to create a viable embryo.
When sperm cannot be obtained because of certain medical
conditions, including diabetes, trauma to the testicles
and congenital problems, microsurgical epididymal sperm
aspiration (MESA) may be considered. This procedure
is performed by a urologist who works with a reproductive
endrocrinologist in surgically retrieving the most
mature and motile sperm cells from the epididymis.
They then are injected into the harvested egg.
On the female side of IVF, physicians are finding
that an embryo left to mature for several more days
in a laboratory dish before being placed in a woman's
uterus can improve her chances of having a baby.
Called blastocyst transfer, the technique is performed
when an embryo reaches four to five days old ---the
blastocyst stage ---before being implanted in a new
type of culture medium that is better at simulating
conditions in a woman's tube and womb.
The technique also can reduce the number of multiple
births because fewer and more mature embryos are transferred
---rather than multiple ones.
What are the chances of conceiving a baby with IVF
and other assisted reproductive techniques? The national
success rate averages about 26 percent — about
the same as the rate for fertile couples who conceive
on their own.
Chairman, Department of Obstetrics and Gynecology
Section Chief, Reproductive Endocrinology and Infertility
Department of Obstetrics and Gynecology
Robert Graebe, M.D., has been section chief of Reproductive
Endocrinology and Infertility since 1985, after spending
several years as a clinical instructor at the Yale
University School of Medicine, New Haven, Conn.
He earned his medical degree from the University of
Guadalajara, Mexico, before he completed his residency
at Monmouth Medical Center and a fellowship in reproductive
endocrinology and infertility from Yale University
School of Medicine.
Board certified in obstetrics and gynecology, Dr.
Graebe has participated in several major clinical trials
of highly advanced medical technology systems and is
extensively published in professional journals, including “Current
Concepts in Obstetrics and Gynecology,” “Infections
in Surgery,” “Obstetrical and Gynecologic
Clinics of North America” and “Reproductive
He is a member of the American College of Obstetricians
and Gynecologists and the American Fertility Society,
and serves as a faculty member and contributor to “Cutting
Edge,” a nationally recognized educational seminar
for physicians sponsored biannually by Monmouth Medical
Miguel Damien, M.D., has been a member of Monmouth’s
medical staff since 1990. He earned a medical degree
from Dartmouth Medical School and completed his residency
in obstetrics and gynecology at the Harvard Medical
School, Boston. He then received fellowship training
in reproductive endocrinology and infertility at Harvard
Medical School and University of Connecticut.
Board certified in obstetrics and gynecology with
subspecialty certification in reproductive endocrinology
and infertility, Dr. Damien is a member of the American
Society of Reproductive Medicine, Society of Reproductive
Endocrinologists, and the Society of Assisted Alternative
William Ziegler, D.O., joined Monmouth Medical Center’s medical staff in 1998 after completing a fellowship in reproductive endocrinology and infertility at the University of Vermont.
He holds a medical degree from the University of Osteopathic Medicine and Health Sciences in Iowa before receiving his residency training in obstetrics and gynecology at the Medical Center of Delaware. Dr. Ziegler completed his fellowship in Reproductive Medicine at the University of Vermont in Burlington.
Dr. Ziegler is a member of the American Society for Reproductive Medicine and a fellow of the American College of Obstetrics and Gynecologists. He started the first egg donor program based in Monmouth and Ocean Counties. He has performed extensive infertility research and has been published in several professional journals, including the “American Journal of Perinatology” and “Journal of Assisted Reproduction and Genetics,” as well as the textbook, “Office Gynecology”.
Jessica S. Mann, MD, joined Monmouth Medical Center’s medical staff in Oct. 2011. She is Board Certified in Obstetrics and Gynecology and has completed a fellowship in Reproductive Endocrinology and Infertility at the University of Connecticut.
She holds a medical degree from the University of Florida School of Medicine before receiving her residency training in obstetrics and gynecology at Bellevue Hospital and NYU Langone Medical Center.
Dr. Mann is a fellow of the American College of Obstetrics and Gynecologists and a member of the American Society for Reproductive Medicine. She has published articles in peer review journals and presented her research at conferences of the American Society of Reproductive Medicine and the Society for Gynecologic Investigation.
Althea O’Shaughnessy, MD, joined Monmouth Medical Center’s medical staff in June 2012. She is a Board Certified Specialist in Reproductive Endocrinology and Infertility.
She holds a medical degree from the University of Rochester School of Medicine before receiving her residency training in obstetrics and gynecology at the University of Connecticut School of Medicine. Dr. O’Shaughnessy completed her fellowship in Reproductive Endocrinology at SUNY Downstate Medical Center.
Dr. O’Shaughnessy is a member of The American Society of Reproductive Medicine and a fellow of The American Board of Obstetrics and Gynecology. While holding a teaching position at The University of Medicine and Dentistry of New Jersey, Dr. O’Shaughnessy was involved in numerous published research articles related to the field of Reproductive Medicine.
For more information about Reproductive Endocrinology
and Infertility at Monmouth, call 732-870-5500.
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