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 Heidi and Randy Smith tried to have a baby for many years. Today, with Dr. Sherman Silbers’ help, they have Caroline. |
THE MIRACLE WORKER
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By Sue Britt
Heidi and Randy Smith, of Chesterfield, had tried to get pregnant since they were first married, when Heidi was 26. After a year of trying unsuccessfully on their own, they sought medical advice. They were sent to an infertility doctor, and Heidi was put on medicine that is supposed to help produce more eggs.
Still nothing.
The Smiths charted Heidi’s temperature every day. It wasn’t dropping when it should, which suggested a problem with ovulation. They went to another infertility specialist, who put her on daily shots.
“After two rounds of that, and thousands of dollars, nothing happened,” Heidi says.
Then, more than four years after the Smiths first sought medical advice about their inability to conceive, she picked up the book, “How to Get Pregnant with the New Technology,” by Dr. Sherman Silber. She waited to finish the school year at Warren Elementary, where she taught second grade, and then contacted Silber.
“I was amazed that this brilliant doctor, who travels all over the world, was at
St. Luke’s, 10 minutes from my house,” Heidi says. “Whenever I have had a question, whenever I have had doubts, Doctor Silber has just looked me in the eye, looked my husband in the eye, and said, ‘Relax.’ When we sat in his office the first time he said, ‘You will have a baby.’ It wasn’t a year later that we were sitting in his office with our little girl, Caroline.”
| Dr. Sherman Silber. |
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The Smiths’ story is not uncommon. Silber, director of the Infertility Center of St. Louis at St. Luke’s Hospital, says many couples waste years of their lives and thousands of dollars on outdated treatments and unnecessary tests that have little scientific validity. Worse, he says a commercial aspect that has developed out of the current infertility epidemic cultivates inappropriate care.
“It’s some of these stupid, unnecessary things that are done for infertile patients that nickel-and-dimes them up,” Silber says. “It seems like it’s inexpensive...$50 here, $100 there, $500 there...Before you know it they’ve spent $10,000 on nothing of any use whatsoever. We don’t do it that way. We do not do any unnecessary or fruitless expensive diagnostic procedures. We only cut right to what is going to work for them.”
Not that you’ll be in and out of Silber’s office for the price of a romantic dinner for two.
“We had it in our heads that we would do (in vitro) three times. That’s $60,000,” Heidi says. “People talk about the money, but you have to think about what’s important...We don’t travel as much as we used to, but it’s fun to go walk around the park and do things that don’t cost money.”
But Silber says even more important than the money wasted on ineffective treatments is the waste of time. Women in their early 20s have up to a 2 percent chance of infertility problems; by their mid- to late-30s, that number jumps to 25 percent. By age 40, more than half of all women are infertile. Silber says each trip to the doctor is another day the woman has forever lost about 30 eggs. If a month goes by, she may lose 1,000 eggs.
“If you waste a year of the patient’s time, you’re hurting their chances of getting pregnant, because the biggest problem is that biological clock. There would be no infertility if everybody wanted to have a child when they were 18-years-old,” Silber says. “If you are burdening patients with these frivolous diagnostic tests and multiple (treatments), and all this stupid stuff—that on rare occasions really is necessary...but for the vast majority of people this is absolutely just a waste of time—there is another detrimental effect. Not only is it wasting their money, but it’s lowering their ultimate chance of getting pregnant because it’s allowing the clock to tick fruitlessly.”
One of Silber’s current patients, who asks to remain anonymous, is in that over-40 group. She and her husband already have children from previous marriages, but for this couple, who found love again, making a baby together is important. The husband had a vasectomy that Silber reversed, and she takes pills and injections that will hopefully produce viable eggs.
She records how she feels every day as the hormones course through her system. It’s a sort of preconception baby book. “Two days after I stopped (one of the treatments) I started to blow up like a big balloon...I was driving in my car...I could feel all this emotion. I wanted to start crying in the middle of the car. I could feel the hot flashes really bad,” she says, looking at her husband with a smile. “I was a mess that night.”
It has been interesting for her husband as well. He has suffered the repercussions of her hormonal ups and downs. But, as many find when they visit Silber, a sense of humor will always save the day.
“You could kill your husband, because we already have his sperm frozen,” Silber jokes during their visit.
When the laughter all around subsides, Silber makes a serious point. “Once you’ve been through all this, this is the most romantic way possible to get pregnant,” Silber says. “You really do go through an awful lot together.
For the Smiths, they say there is no regret for the money spent, the trips to the hospital for blood tests and ultrasounds every other day, the hormonal ups and downs, the soreness from surgery, and the rest. The product of the effort is well worth it, Heidi says.
“It’s heaven. She’s just like heaven. She’s so inquisitive and so brilliant. It’s amazing to think this little person was conceived the way she was conceived, and she wouldn’t be here if it weren’t for Doctor Silber. It’s a miracle when you think of what he does. He’s making so many miracles happen for so many people who couldn’t get pregnant on their own,” Heidi says. “I can’t say enough about him. He is just a true gift to this world.”
And for the record, Heidi is pregnant again.
Bearing Dreams:
How one doctor turned St. Louis into the infertility treatment capital of the world.
By Sue Britt
Dr. Sherman Silber, says he knew he would be a doctor when he was 5 or 6—because his parents told him so. Since then, it has been a meandering path to his current position as director of the Infertility Center of
St. Louis, located at St. Luke’s Hospital in Chesterfield, where he has practiced infertility treatment since 1976.
He graduated from the University of Michigan School of Medicine in 1966 and went on to complete his internship in California, at Stanford University, specializing in cardiac surgery in 1967. Then it was off to Alaska, where he worked for the U.S. Public Health Service, providing health care for Eskimos, Indians and Aleuts. It was there that, despite his background in cardiology, he was first led in a direction that would eventually culminate in a world-renowned career in the field of infertility care.
Although Silber was trained as a cardiologist, what was lacking in Alaska at the time was a urologist. Silber stepped in. “I became the village urologist for two years,” he says.
He returned to Michigan and studied urology, but his path took another turn when he became involved in organ transplants. It was then he practiced his micro-surgical techniques, doing kidney transplants on rats. That work secured Silber a job at the University of Melbourne-Royal Medicine Hospital in Australia.
With his background in urology, and his vast experience in microsurgery, one day he took on a new challenge. Combining the two skill-sets, he tried something that had never been done before. “Everybody was saying vasectomy was not reversible,” he says. “I was really good at (microsurgery) and I said, ‘Let’s try this.’ When I got back to the U.S. and reported (my success in 1975), all of a sudden, I was famous.”
By this time he had moved to the University of California at San Francisco to continue his work in transplantation, but the news of the vasectomy reversal created such immediate, worldwide excitement, his department chair told him he was going to start an infertility clinic there.
But shortly thereafter, as often happens to those who marry someone from St. Louis, he was urged to consider making his home in the Midwest. “I didn’t want to leave (the University of California at San Francisco), but when I saw St. Luke’s, I was surprised,” Silber says. “They were so flexible.”
He knew he could grow at St. Luke’s, and even though he continues to operate in famous institutions all over the world, he says St. Luke’s is unique in the simple and vital policy of making patients comfortable.
“There’s no place, in terms of clinical care, that matches St. Luke’s,” Silber says.
He says his concerns for his patients’ comfort are well listened to. “It would just be talking to the wind at other institutions,” Silber says. “Patients come from everywhere. It’s important that they feel comfortable here.”
Silber set up shop at St. Luke’s in 1976, which at the time was “out in the middle of nowhere,” and just staying afloat financially. Soon “hundreds and hundreds of patients were flying in from all over the world (for vasectomy reversals),” and St. Luke’s “was back in the black,” Silber says. “Word got out very quickly that something amazing was happening out here,” he says. Last year alone, Silber performed 357 procedures.
Silber, author of three medical textbooks, four best-selling books for the layman (including “How to Get Pregnant with the New Technology”), and over 200 scientific papers, has a long list of firsts in the field of infertility treatment. Whether in the world, in the United States or in the St. Louis region, these firsts include: vasectomy reversal; tubal ligation reversal; testical transplant; donor egg pregnancy; surrogate pregnancy; pre-implantation genetic diagnosis; ovarian tissue freezing; egg freezing; and, most recently, the world-famous first-ever ovarian transplant.
“Every innovation in the infertility field has come from our little institution in Chesterfield,” Silber says. “Who’d have ever thought this is where most of the infertility advances have been made?”
Common fertility
procedures
In-vitro fertilization (IVF):
Fertilization takes place outside the body, in a small glass dish. The fertilized eggs are then placed directly into the uterus. IVF is used in cases where the fallopian tubes are damaged, preventing natural pregnancy, but is useful for almost all types of infertility.
Intra cytoplasmic sperm injection (ICSI):
The eggs and the sperm are fertilized in the laboratory, by direct injection of a single sperm into each egg. The embryos then are placed into the uterus with no surgery, just as with IVF. Dr. Silber and colleagues in Brussels were the original developers of intra cytoplasmic sperm injection for the severest cases of male infertility. |
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