Meet the local experts improving fertility health
UNFORTUNATELY, the journey to conception for at least 15 per cent of the world’s population who come face-toface with the devastating reality of fertility and reproductive challenges may be arduous, especially for couples in countries where resources are scarce and they have little knowledge of how or where to access effective, economical medical advice and treatment.
Fortunately, more specialists are investing in reproductive and fertility health, and have dedicated their time to optimising couples’ chances through medical innovations, therapies and other effective treatments to help them become parents.
Of course, your obstetriciangynaecologist will be able to guide your through the process when you have conditions like endometriosis and polycystic ovary syndrome, but here are some of the other experts who are using science to improve fertility health and reproductive care for couples facing infertility.
Dr Patrice Monthrope
Dr Patrice Monthrope is an obstetrician-gynaecologist/fertility specialist and senior medical officer for Noel Holmes Hospital. He is also the medical director at Western Fertility in Montego Bay.
He received his medical and specialist training at the University of the West Indies (UWI), Mona and his master’s in Human Reproduction and Embryology from the University of Valencia, Spain.
Dr Monthrope has been performing the Tubal Cannulation procedure used to treat blocked tubes in patients diagnosed with proximal tubal occlusion successfully for over 10 years, with many successes.
The procedure is performed hysteroscopically, which is a minimally invasive procedure that uses a small scope used to view the inside of the uterus after entering the vagina and cervix
(no cutting is involved). It is then possible to view the entrance of each Fallopian tube where it is attached to the uterus — this area is called the ostia and is where the proximal blockage often occurs, and thus it can be cleared at this time. Cannulation is a day-case procedure, thus the patient is able to go home the same day and most times returns to work the following day.
If successful, the procedure allows the patient to avoid a more expensive, invasive surgical procedure and also the need for In-vitro Fertilization (IVF) which was thought to be the only solution for patients with proximal tubal occlusion at one time.
Many countries like Jamaica with a high incidence of tubal factor infertility (blocked tubes) also have reduced access to diverse and affordable fertility treatments. Dr Monthrope said that fertility treatments in such countries are usually a low priority with government reproductive health programmes using resources to focus on family planning and contraception rather than infertility. This results in poor access and often cost-prohibitive treatments for infertility that are not covered by insurance.
As a fertility specialist, Dr Monthrope also offers other affordable and innovative solutions to patients with fertility challenges.
Dr Monthrope’s study was recently published in the
Journal of Minimally invasive
Gynaecology, November 2021
edition.
Dr DAVID Abner brown
Dr David Abner Brown, an obstetrics and gynaecology consultant with over forty years of experience, a member of the Royal College of Obstetrics and Gynaecology and former head of Department of OBGYN at the Cornwall Regional Hospital, has employed an alternative which saves the tubes of women experiencing ectopic pregnancies.
The alternative, termed Suture Haemostasis, according to Dr Brown, will save the tube and arrest the haemorrhage, rather than result in removal of the tube, which would reduce the woman’s fertility chances by 50 per cent.
Suture Haemostasis is the use of sutures to prevent further bleeding from the ectopic site. This would lead to healing of the tube and recanalisation after the products of ectopic conception are removed.
Dr Brown is internationally recognised for his technological innovations.
He was inspired to develop the alternative to traditional techniques where the woman’s tube would be removed because of the damage caused by the ectopic pregnancy and the impending risk of intra-abdominal haemorrhage. For these women, in many instances, their only gateway to motherhood would be through IVF, especially if the other tube became obstructed.
Dr Brown received both his undergraduate and graduate-level training at UWI, and his work over the years has been widely published in international journals.
In November of last year he presented his tube preservation technique at the American Association of Gynecologic Laparoscopists in Austin, Texas.
Dr Brown’s dream is to see more of the local fertility innovations taught and practised locally to provide women with the most cost-effective and efficient options to become parents.
DR SHARIFA FREDERICK
Dr Sharifa Frederick spends most of her days at the Hugh Wynter Fertility Management Unit (HWFMU) at the University
Hospital of the West Indies (UHWI), with families exploring the barriers to their conception efforts and devising plans to surmount them.
She has a vested interest in creating equal opportunities for patients wishing to conceive but are plagued by fertility-related challenges.
She acknowledges that her passion to pursue obstetrics and gynaecology, and her ultimate love affair with fertility management, were heavily influenced by her father, Professor Joseph Frederick, a trailblazer in the field who has been recognised for his pioneering work in assisted reproductive technology in Jamaica.
Dr Frederick received her Bachelor of Medicine, Bachelor of Surgery from UWI, Mona. She later completed her residency in obstetrics and gynaecology and her fellowship in minimally invasive surgery and reproductive medicine at UHWI.
PROFESSOR JOSEPH FREDERICK
Professor Joseph Frederick is widely recognised for his pioneering work in assisted reproductive technology or in-vitro fertilization in Jamaica. He received training in the United Kingdom and the United States, and established the Assisted Reproductive Unit to provide services for the treatment of infertile couples in Jamaica and throughout the region. Professor Frederick was primarily responsible for the introduction of operative laparoscopic procedures at the UHWI. The unit is now able to treat patients with ectopic gestations as outpatients, and to perform other advanced gynaecological operations.
Professor Frederick’s research interests have focused on the epidemiology of specific conditions within reproductive health, particularly uterine fibroids and pelvic inflammatory disease, both of which can contribute significantly to gynaecological symptoms and admission to hospital and have a major impact on reproductive function and fertility.
Other research has focused on male and female infertility, and the increasing prevalence of male infertility. Professor Frederick has also conducted research on the role of auto antibodies in spontaneous recurrent abortion.
His professional activities have achieved widespread recognition.
Professor Frederick received his undergraduate and postgraduate training at UWI. He has been recognised by the Royal College of Obstetricians and Gynaecologists, UK and the American College of Obstetricians and Gynaecologists with the award of Fellowship to these colleges.
DR VERNON DACOSTA
Dr Vernon Dacosta heads the HWFMU at The UWI, and has been a celebrated specialist in fertility and in vitro fertilisation for over two decades. The HWFMU offers assisted reproduction technology as one of its clinical services, using a number of advanced techniques that aid fertilisation. These include IVF, egg freezing, Intrauterine Insemination or IUI, Intracytoplasmic Sperm Injection or ICSI, Surgical Sperm Retrieval or SSR, and gamete donation.
The unit’s vision is to be the world’s highest quality academic sexual and reproductive centre, providing the best medical procedures and the most satisfying patient experience.
In a previous interview with
All Woman, Dr Dacosta implored women to have some of their eggs, or fertilised embryos, stored until they are ready to have children.
“They say that the best time for a woman to get pregnant is between 24 and 28, but many of those who come to us now are in their 40s, which is way too late,” Dr Dacosta lamented, noting that infertility is on the rise globally in both men and women.
“Many women now are waiting until they have completed university, start their jobs, and then by the time they realise, they’re in their 40s.
“Your fertility potential as a woman starts to decline after 28 years old,” he said. “If you are going to delay having children, come in your 20s or early 30s and let us collect your eggs, freeze them, and then when you’re ready, you come back for them.”
Donor sperm, he said, is also available for women who can’t find, or who choose not to have a baby with a partner when they are ready to have children.