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Wednesday, April 29, 2009 01:01 am

Making babies at SIU

Embryologists reflect on science, faith and their life-giving work

Jim Kontio, the embryology laboratory supervisor and senior embryologist, talks with nurses Michele Pfeiffer, on the left, and Janet Toohey, on the right. A multi-disciplinary team of physicians, nurses, embryologists and other professional staff work tog

Jim Kontio knows what it’s like to lose.

After he and his wife Meganne married, the couple quickly decided that they wanted a baby. They were both older, Kontio says, and realized that they were running out of time. What seemed tough in the beginning became tougher as Kontio’s wife suffered from several complications, was hospitalized and miscarried their first child.

“There were a lot of times that we never knew if we were going to be successful,” he says.

Senior embryologist Vicki Gindlesperger examines embryos in a small culture dish under the microscope. She moves embryos from one dish to another using a device attached to a small, thin glass pipette.

Kontio managed the in vitro fertilization laboratory at Fertility Unlimited in Akron, Ohio, and reached out for help. He and his wife became infertility patients, and after a successful round of ovulation induction and intrauterine insemination, they conceived twins.

Thirteen years later, Kontio, now 48, works as a senior embryologist at the new Southern Illinois University Fertility and In Vitro Fertilization Center at the SIU School of Medicine. The facility formally opened in January and already at an early stage in the program, the staff has seen several positive pregnancies. Kontio feels blessed, he says, to help parents stuck in the same situation that he once faced.

“I understand where these people are coming from, and their feeling of desperation, the feeling of disappointment, the loss,” Kontio says. “I can tell them, too, that being persistent, sticking with it and believing in the people who are providing the service to you makes all the difference in the world.”

Jim Kontio, the embryology laboratory supervisor and senior embryologist, places a specimen in the incubator at the SIU Fertility and IVF Center. Thanks to medical innovation, embryologists can observe embryos’ growth in the incubator for up to six days.

Kontio and Vicki Gindlesperger make up the embryology team, led by laboratory director Dr. Mary Ellen McAsey. “The lab” performs such tasks as measuring male and female hormone levels, analyzing the motility and shape of sperm or assisting with IVF — the procedure in which eggs are retrieved from a woman’s ovaries, fertilized with sperm in the laboratory and placed inside the woman’s uterus after they become embryos. Between the three of them, they boast 74 years of experience in treating patients with reproductive and endocrine problems.

These senior embryologists aren’t your typical lab technicians. Sure, they demand pristine work conditions and relish high-tech instrumentation. But they also crave patient contact. They don’t want to “fill a niche service,” as Kontio puts it — they want to make a difference. They even go against the scientific grain and believe that a higher power guides their creation of other human beings.

When Kontio and Gindlesperger discuss their work, they don’t use the words gametes or embryos. They call themselves temporary foster parents, given charge to a lab full of other people’s babies. The fact that these babies inhabit incubators or freezers doesn’t matter to them or their patients.

Senior embryologist Vicki Gindlesperger assesses sperm count and sperm motility at the SIU Fertility and IVF Center. If a patient has a low sperm count or slow-moving sperm, they become candidates for intracytoplasmic sperm injection, a procedure that inj

“Believe me, [the parents] think of them as their children,” Gindlesperger says. “They don’t think of them as my eggs, my sperm.”

L ike Kontio, Gindlesperger understands the
plight of her patients. She gave birth to two children (her son followed in her footsteps and became an embryologist), but couldn’t conceive any others. Gindlesperger, who’s now 63, says that at the time, no one even mentioned the possibility of polycystic ovarian syndrome, a common cause of women’s infertility that affects hormone levels, periods and ovulation.

Gindlesperger worked her way through Case Western Reserve University in Cleveland at a tissue culture laboratory and graduated in 1969. After raising her kids, she trained as an embryologist with Cleveland’s Mt. Sinai Medical Center LIFE program, which was responsible for the first surrogate birth in the United States. She helped start a new program at University-MacDonald Women’s Hospital in Cleveland, where she worked alongside Dr. J. Ricardo Loret de Mola, the current practice director of the SIU Fertility and IVF Center. After opening a private program at Reproductive Medicine Associates of Texas, Gindlesperger made her way to SIU in early 2009.

Kontio, who also helped design and set up three programs, didn’t start in embryology either. He wanted to be a doctor until his professor at Adrian College in Michigan encouraged him to accept a graduate school gig in reproductive physiology at Michigan State University. Kontio studied squirrel monkeys, baboons and chimpanzees at the school’s endocrine research center. In 1984, he moved to an IVF position at Akron City Hospital in Ohio. He then worked in a private-practice setting at Fertility Unlimited for 15 years before joining SIU in 2008.

Even though Kontio and Gindlesperger just met earlier this year, they already share more than the storage closet-sized office space on the lower level of the SIU Clinics/Moy Building. They both moved to Springfield ahead of their families to accept the embryology positions. Since they’re on call 24/7 and work long hours, they joke that they can read each other’s minds.

“Jim and I spend more time together than we do with our spouses,” Gindlesperger says. “I feel like his mom. Or grandma.”

The pair even discovered that they share a patient, who had one baby with Kontio’s program in Akron and another baby with Gindlesperger’s program in Cleveland.

The embryologists begin each day around 7:30 a.m. They put on their navy blue polyester scrubs and protective hats, masks and shoe covers. They walk across a thin, sticky mat that pulls dirt off their shoes and enter the sterile, near-clean lab (ranked cleaner than hospital operating rooms).

At the top of the to-do list: more cleaning. The embryologists check the lab and instruments, plastic-ware and dishes daily for contaminants. They evaluate equipment to ensure that it’s functioning properly and yielding the same environment for every one of their cases. They monitor the temperature and humidity in the incubators, refrigerators and freezers, as well as the temperature and humidity of the air-handling system, for the same reason.

“Out in the real world, being obsessive-compulsive is looked on as a neurosis,” Gindlesperger says. “But in the world of IVF, it’s a positive.”

In many IVF programs, laboratory personnel aren’t allowed to work directly with patients. Kontio explains that some management thinks it’s inefficient, that personal investment takes too much time and energy from embryologists.

He and Gindlesperger disagree. They each signed on at SIU because, among other incentives like state-of-the-art equipment, it offered patient interaction. They can come to work, Kontio says, and act as a positive force in other people’s lives.

“It’s half art, half science,” Gindlesperger explains. “We all have oldest child syndrome. We’re trying to take care of the world.”

Fertility treatment usually begins with medication to stimulate ovulation and development. The fertility team then pairs the medication with intrauterine insemination, the procedure that deposits sperm inside the female patient’s uterus. If the couple doesn’t conceive, staff move on to IVF or to intracytoplasmic sperm injection, the procedure in which embryologists inject a single sperm into an individual egg retrieved from the female patient’s ovaries.

Embryologists assist physicians with female patients by measuring the level of human chorionic gonadotropin, a hormone produced during pregnancy that can be detected in blood or urine samples. They use hCG levels as an estimate: levels increase as the pregnancy progresses.

The lab works with male patients by performing semen analyses. They determine if the male produces sperm at normal concentrations by evaluating their number, motility and shape in samples under a microscope. If the patient has poor quality or very few sperm, staff decide to use intracytoplasmic sperm injection or sperm aspiration, the procedure that obtains sperm directly from the testicle using a needle, as treatment.

At noon each day, the entire SIU fertility and IVF team convenes. They discuss each patient and their progress, successes and failures. Once a month, they conduct in-depth reviews of each patient and decide how successes can be applied across the board. Kontio, who says he transferred from a practice where physicians made all of the decisions, calls this a unique exchange that benefits patients, physicians and lab personnel.

Kontio shares the story of the first baby that he helped “foster” in Ohio. He grew close to the parents and kept in touch with them after they conceived. When the mother went into labor, she called Kontio and demanded that he make the 45-minute drive to her hospital to witness her son’s birth. She told him, Kontio recalls, that since he was the first person to see him, he should be the first person to hold him.

“As soon as that baby was born, he was placed in my arms,” Kontio says. “I got to say, ‘I saw you when you were just a little, tiny speck.’ That’s the kind of connection that you make.”

Kontio and Gindlesperger continually receive letters, e-mails and pictures from the babies and families that they’ve helped. Kontio’s first baby, Donald, is now 23 years old. Gindlesperger, whose first baby is also 23, says she can’t even count the number of grandparents, aunts and uncles that she’s met who are grateful for their grandchildren, nieces and nephews.

Dr. Mary Ellen McAsey, the laboratory director for the SIU Fertility and IVF Center and director of research for the obstetrics and gynecology department, examines adult stem cells that have migrated in response to chemical signals secreted by ovarian can

“They call this a roller coaster ride for the patients,” Gindlesperger says. “The way that we work, it’s also a roller coaster ride for us. We get attached. When we’re talking about being foster parents, it’s not just to the embryos, it’s actually to the patients themselves.”

“We’ve been there, we’ve been down the road with other patients like them,” Kontio agrees. “We’re happy when they’re happy.”

Embryologists have a penchant for having everything just right. Some become superstitious. They wear the same socks or lucky shoes for each procedure. Kontio and Gindlesperger are a little different. They call on faith.

When the SIU doctors inject the embryos into their female patients, Gindlesperger recites four Hail Mary’s in the time that it takes to remove the catheter. When Kontio leaves the lab every night, he says a prayer asking for positive outcomes for his patients.

It’s surprising to hear scientists talk about spirituality, but the senior embryologists maintain that they couldn’t do their work — help create a child — if they didn’t believe that a higher power was guiding their hands. Their stand on science is spiritually based, Kontio and Gindlesperger explain, because they intimately experience the complex nature of human life every day.

“We have a respect for the divine nature of human beings,” Kontio says. “And for the fact that we have the opportunity to be involved in creating another human being. You can’t lose that respect. If you do, that’s when you let things slide. That’s when you fail.”

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