In 1995, Dr. Emmett Branigan opened the Bellingham IVF & Fertility Care center with his wife, Antoinette, with the hope of giving patients the highest level of fertility care on a smaller and more personal level.
Now, the clinic sees about 150 patients a year, and in late September, the clinic reached its 1,000th baby conceived through in vitro fertilization (IVF).
Branigan served on the staff of a larger clinic for four years before deciding to move to Whatcom County. At his previous job, he saw patients being shuffled through the process, never knowing what doctor they were going to see. For him, that was a problem.
At Bellingham IVF & Fertility Care center, Branigan is the only physician and sees patients through every step of the process. In most clinics the doctor would only see the IVF patients and would not do the basic procedures.
“But we’ve done that from the very beginning,” Branigan said. “From the most basic treatment to the highest of high-tech things. We do it all.”
He and his wife chose to start their clinic in Bellingham because of the ideal location north of Everett and south of Vancouver, B.C. The location allowed them to get a big enough population base to support the clinic. A facility with the fertility services the clinic offers would normally need a population of at least 250,000.
“I love helping people get pregnant. A huge benefit of being in Bellingham is that I can’t go to the store or any event around town and not see somebody that we didn’t help,” he said. “Most people that do what I do wouldn’t have that, (they) might not even know if they got (their patient) pregnant.”
Creating a family
The clinic holds true to how it was established, a small practice with a one-on-one basis, said Cheryl Rouse, a nurse and IVF coordinator. Rouse has worked at the clinic since 2005 and said with the size of the clinic, she really gets to know the patients she works with.
Rouse’s favorite part of the job is helping clients achieve their dream of conceiving a child. At the clinic, they develop lasting relationships with the patient to the extent where couples bring their children back to meet the staff, Rouse said.
“That is when you know the dream is complete. It’s fun to watch the kids and families grow,” she said.
Rouse describes Branigan as a family man before a physician.
“He is a father and you really see that come through his work at the facility,” she said. “He wants patients to have to the same opportunity he has.”
The clinic offers a number of services along with IVF including ICSI (a direct injection of sperm into the egg), blastocyst culture (an advanced culture system), embryo freezing and donor oocytes. The cost of IVF ranges from $10,000 to $12,000 with an additional $2,000 to use frozen embryos. Over the years, Branigan has had 10 academic papers published based on his research to improve fertility treatments.
IVF was developed in 1978 to help couples have children. Since then the practice has moved from developing new methods for assisted reproductive technology to making the methods more efficient.
“Even if you are at peak fertility, your odds of getting pregnant and having a baby in a single try is 20 percent,” Branigan said. “That’s not that efficient.”
One way the process has become more efficient is by putting the woman on birth control pills to synchronize the release of her eggs. With IVF, Branigan said the process follows a normal menstrual cycle, which can be irregular for some women.
Many women are born with more than 500,000 follicles, which hold immature eggs, and every month about 50 or more follicles go from a dormant state in the ovaries to being activated, Branigan said.
“Once they’re activated in a natural cycle they are kind of like seeds, but the body will only water one of them,” he said.
Women should only have one large follicle that releases one mature egg in a natural cycle, because one is the healthiest pregnancy, he said.
“When we do in vitro fertilization we would like more than one egg,” he said.
Changing the odds
Branigan will give the patient a little more follicle stimulating hormone, a hormone that is responsible for follicle growth, than normal. Instead of watering just one egg, the body waters more of them for the opportunity to fully mature, he said.
Egg retrieval is similar to having blood drawn, but with anesthesia, Branigan said. With an ultrasound, which is a little bigger than a pen, a needle and anesthesia he directs the needle into the ovary without hitting anything. Then he directs it into the center of one of the follicles and sucks the fluid and cells with hopefully the egg into a test tube, he said. This procedure takes about a half hour with an additional hour for recovery.
The egg is placed with the sperm and after evidence of fertilization, the embryo is placed back into the uterus.
“All we really did was take a perfectly natural cycle and turned it into a maximally stimulated cycle,” Branigan said. “Remember, if you are naturally trying to conceive with one egg you have a 20 percent chance. With this we have between a 50 to 60 percent chance.”
Most people go through life trying to prevent a pregnancy. Once they are ready, 20 percent to 25 percent of couples will have some degree of fertility issues. Of those, 5 percent to 10 percent might need these procedures.
“In the old days (30 years ago) there wasn’t a lot we could do. Now we can deal with virtually every problem,” he said.
For a woman at 40 years old, it is three to four times more difficult to get pregnant and have a child than for a woman under 35 years old. Once a woman is 43, it’s more than 10 times more difficult, he said.
At that point, there’s a low chance that a woman is going to get pregnant with her own egg. For those women, their options are no kids, adoption or a donor egg.
If a woman wants to donate her eggs, she would go through the IVF process as well. She would not be losing any of those eggs because they would have died normally. Donors are giving someone the ultimate gift, Branigan said.
“To me there’s nothing better than helping someone with their family,” Branigan said. “And that’s what we look at; we’re trying to turn couples into families.”