Dr. Ghassan Haddad explains different fertility treatments on Great Day Houston.
FEMALE VOICE: Weâ€™re back, everybody. Now, we talked about this a little bit earlier. Millions of women, they struggle each year to get pregnant and to have a child, but a medical procedure is now helping women give birth to healthy babies. So here to explain is Dr. Ghassan Haddad and of course his patients, Ellen and Brian Wood. Now first of all, your story is intriguing to me. You had two beautiful childrenâ€”theyâ€™re at home, two beautiful children, and then suddenly you said, you know what? We want to expand our family. We want another child. ELLEN: Mm-hmm. FEMALE VOICE: And then four miscarriages later you canâ€™t have a baby. So sort of take me from there, Ellen. MS. ELLEN WOOD: Well, we do have two children and weâ€™ve always wanted a third, so we decided to start trying. It was about five years ago. Immediately we just had problems. We couldnâ€™t get pregnant, finally went to see our doctor, got on some basic fertility medicine and got pregnant. Then we got to about 12 weeks and - - [audio skips] had seen the heartbeat and everything, and we decided to tell our other kids, our two children. They were very excited. We went back in to see the heartbeat again and it was gone. So our kids were devastated, as we were. At 12 weeks I thought it was okay to tell them. We got pregnant again and I didnâ€™t tell them this time, but we lost it again at 12 weeks, approximately. FEMALE VOICE: You were, you were at this time seeing a fertility doctorâ€”a specialist? ELLEN: Not at that time. FEMALE VOICE: Okay. ELLEN: Then I said we need to go see someone. Because quite frankly, unless you have three miscarriages in a row they really donâ€™t think thereâ€™s anything that much wrong with you. Itâ€™s very common to have miscarriages, but my first two children came so easily I didnâ€™t expect to have any problems. I went to a fertility doctor in Houston and immediately started doing some treatments, and had another miscarriage. Then we decided to go to Houston Fertility Institute. Once we got there, it was kind of like we were home. MR. BRIAN WOOD: We were relieved. FEMALE VOICE: Because no one could figure out exactly what the problem was at this point? ELLEN: Right. No one really thought I had anything wrong with me because I had two healthy children and I didnâ€™t have problems with them at all. So nobody thought anything was wrong with me. They just said itâ€™sâ€”normally you can have miscarriages. FEMALE VOICE: So this is going on in her body, but as her husband, Brian, youâ€™re thinking I just want to find out why. I want to help her. BRIAN: Certainly, very emotional. Having the miscarriages and everything was very trying onâ€”emotionally and physicallyâ€”on her body, both. FEMALE VOICE: And so then youâ€”When you then decided to make a switch and really do something about, thatâ€™s when Dr. Hassad [sic] comes in here. You look at this sort of pattern and you do this with a lot of woman, your clinic does, and you go through these things and you say hereâ€™s the problem. So take us from where Ellen came in. DR. GHASSAN HADDAD: Well, what Ellen is having isâ€”the experience sheâ€™s having and Brian is absolutely rightâ€”itâ€™s a very emotional experience. Going through recurrent miscarriages can be very devastating to a couple. Whenever a couple comes with two or more miscarriages they qualify for what we call recurring pregnancy loss. Patients that have recurring pregnancy loss we do a workup on, and part of that workup is looking at the chromosomes of both mom and dad. When we did the testing, Ellen had a chromosomal translocation, which means a piece of chromosome has detached and stuck on another piece. FEMALE VOICE: We have a picture of that just to show you. I mean, itâ€™s sort of a technical term, but this is a chromosomal problem that can happen in a lot of women. DR. HADDAD: Right. Itâ€™s not uncommon. Itâ€™s about 8% of patients that have recurrent pregnancy loss will have a chromosomal translocation. FEMALE VOICE: This kind of looks like a big mess. [laughter] DR. HADDAD: In this picture you can see Chromosome No. 5 and 13, the blue ones are 5; the green ones are 13. FEMALE VOICE: Oh, okay. DR. HADDAD: You can see how 5 and 13 over there on the left side of the screen are stuck to each other. FEMALE VOICE: Okay. Right there. DR. HADDAD: Right. And theyâ€™re not supposed to be stuck to each other. And this is what we call the carrier type. If you look upâ€”actually itâ€™s off the screen, Chromosome No. 5. FEMALE VOICE: Mm-hmm. Well, there it is over here. DR. HADDAD: Well, then nextâ€”the one next to it is the one thatâ€™s off the screen, but thatâ€™s all right. FEMALE VOICE: Okay. Just kidding. [laughter] So it wasnâ€™t there. Thatâ€™s the problem. DR. HADDAD: Right. But I can see Chromosome 13, the two ones that she has, one is longer than the other one. FEMALE VOICE: Mm-hmm. DR. HADDAD: And thatâ€™s a piece of Chromosome 5 thatâ€™s stuck on 13. Thatâ€™s the problem that she had. FEMALE VOICE: So you identify this problemâ€” DR. HADDAD: Right. FEMALE VOICE: â€”and then you say, okay, now how do we fix it. DR. HADDAD: To fix itâ€”well, sometimes it can fix itself on its own in the sense that sheâ€™s had two healthy babies at home. About 20% of the times the pregnancy will be normal, but 80% of the time the pregnancy will be genetically abnormal. Out of those 80% most of them will miscarry, but every now and then one of them will make it to term and she will deliver a baby that is not viable, which is even more devastating than going through miscarriage. FEMALE VOICE: Yes, which is what was happening. DR. HADDAD: Well, she was having the miscarriages. FEMALE VOICE: Mm-hmm. So then thereâ€™s a process that you call PGD, which I think isâ€” DR. HADDAD: Right. FEMALE VOICE: â€”sort of likeâ€”I describe it as almost like you get to sort of testâ€”and this is the process actually. You can tell us whatâ€™s going on and then Iâ€™ll give my laymanâ€™s term of it. DR. HADDAD: Sure, sure. Well right now weâ€”this is an 8-cell embryo. Weâ€™re going to make a hole with that laser we just did in the shell of the embryo. Using a robotic microscope, weâ€™re coming in with thatâ€”that path on the right side, and weâ€™re going to take out one cell from the eight cells. FEMALE VOICE: Okay. DR. HADDAD: So thatâ€™s one cell that weâ€™re going to take. FEMALE VOICE: Mm-hmm. DR. HADDAD: And weâ€™re going to take this cell and analyze it for a genetic defect that the patient has. FEMALE VOICE: So then this cell goesâ€”you put this in a littleâ€” DR. HADDAD: On a slide. We put it on a slide. FEMALE VOICE: On a slide. DR. HADDAD: And we have a special chemical that we put on it to preserve it and then we test it. FEMALE VOICE: So this is how you basicallyâ€”when you talk about PGDâ€” DR. HADDAD: Right. FEMALE VOICE: â€”you genetically diagnose an embryo. You can get in thereâ€” DR. HADDAD: [interposing] Prior to implantation. Thatâ€™s very important. FEMALE VOICE: Right. Because thereâ€™s amniocentesis, things like that that you can do after the embryoâ€” DR. HADDAD: [interposing] Thatâ€™s after the fact. FEMALE VOICE: â€”has been implanted. DR. HADDAD: After the fact. FEMALE VOICE: And then itâ€™s too late almost, because you donâ€™t know. DR. HADDAD: Right. FEMALE VOICE: But this is before it is implanted. You can take it out, look and say, wow, this child has cystic fibrosis. You have to test it for different things. DR. HADDAD: Right. FEMALE VOICE: You can only test one cell at a time, right? DR. HADDAD: You can only test one cell atâ€”well, you can test two cells, but you donâ€™t want to remove more than one cell from an 8-cell embryo. FEMALE VOICE: Okay. So you, you test itâ€”basically like you take a little bit of this little juice out and you test it to see whatâ€™s in it. DR. HADDAD: Pretty much, and you can test for pretty muchâ€”almost any genetic disease thatâ€™s out there. In their case itâ€™s a chromosomal translocation that we were testing for. FEMALE VOICE: Okay, so this isâ€”thatâ€™s sort of a fancy term which is kind of hard to understand, but what you did is when you finally took it out you said, oh, this is exactly what she has. DR. HADDAD: Right. FEMALE VOICE: And then you wentâ€”out of all the embryos you picked the ones that didnâ€™t have that. DR. HADDAD: Absolutely. And those are the ones thatâ€” FEMALE VOICE: [interposing] And those are the onesâ€” DR. HADDAD: â€”we put back in the uterus and she gets pregnant with a healthy baby, like she is right now. FEMALE VOICE: Which, youâ€™re pregnant right now, right? ELLEN: Yes. [applause] FEMALE VOICE: Thatâ€™s so great. Now, Ellen, tell why this is so cool, too, that youâ€™re doing it on Great Day Houston. ELLEN: Well, because we havenâ€™t told our children that we are expecting, and they have been wanting a baby for so long that we thought this would be a great way to share it with themâ€”that weâ€™re going to have a baby. FEMALE VOICE: Thatâ€™s so cool. This is so cool. [applause] FEMALE VOICE: Now, Dr. Haddad has some of the list of things that you can look for. Like this is where you would be a candidate for PGD or this type of procedure that Ellen went through. DR. HADDAD: Sure, sure. FEMALE VOICE: Okay, these are some of them. DR. HADDAD: Well, patients that have history of a genetic disease like cystic fibrosis, which is an extremely common genetic disease. About 1 in 20 to 1 in 25 Caucasians carry it. FEMALE VOICE: Mm-hmm. DR. HADDAD: Sickle cell disease, which about 1 in 25 African Americans carry it. FEMALE VOICE: Mm-hmm. DR. HADDAD: Pretty much any genetic diseaseâ€”Huntingtonâ€™s disease, muscular dystrophy is one of the common ones, thalassemia, hemophilia. Pretty much all genetic diseases, if a patient is a carrier where she does not have the disease herself, she can pass it on to her children and they can have it. Using this wonderful technology, medical technology, we can make sure the baby does not haveâ€” FEMALE VOICE: [interposing] Doesnâ€™t have it. DR. HADDAD: â€”this devastating disease. FEMALE VOICE: Now, thatâ€™s what I think is amazing because in your case it was preventing you from actually having a baby. But in a lot of cases what it is, is that you end upâ€”you can see from these embryos that you had when you take that little sample that you saw, you can see that the baby hasâ€”it could have cystic fibrosis. DR. HADDAD: Right. FEMALE VOICE: Or it could have Down Syndrome or Sickle cell anemia, and thenâ€”you can then pick the healthy embryos. Because out of all the embryos that you thenâ€”the eggs that you fertilize to make these embryos, there are some that are going to be unhealthy. DR. HADDAD: Many will, many will be abnormal and those are the ones you do not want to put back into the uterus. FEMALE VOICE: Mm-hmm. Because a lot of people just see this asâ€”and the controversial part of it is that, oh, this is for people who want to choose their gender. But as we can see clearly, it is not always used just to choose the gender of the baby. Itâ€™s toâ€” DR. HADDAD: No. Yeah. FEMALE VOICE: â€”choose healthy babies. DR. HADDAD: Gender selection is one of the indications for PGD, or of this medical process that weâ€™re talking about, but most of the time that weâ€™re doing PGD, itâ€™s doing it for genetic diseases, to prevent medical diseases to be transmitted from one generation to the next, to help bring into life a healthy baby. FEMALE VOICE: And itâ€™s important to go to the right doctor because I was reading a lot about theâ€”when they justâ€”it looked like that it was quick. That they just took the little cell out, but theyâ€™re like blastocytes. They can be damaged very easily. DR. HADDAD: Right. FEMALE VOICE: And then it could cost you a lot of money to get nothing. DR. HADDAD: It takes a lot of experience to be able to do it. Absolutely. FEMALE VOICE: Yes, you have to be very experienced, which is what Dr. Haddad is. So anyway, everybody, I want to thank you so much. And congratulations. [applause] ELLEN: Thank you. FEMALE VOICE: And make sure you go to the Houston Fertility Institute. If you have questions, theyâ€™ll answer some of those questions for you. The number is right there on your screen. And then of course, the website is hfi-ivf.com. And thank you so much, Dr. Haddad, for being here. DR. HADDAD: Thanks for having me on the show. FEMALE VOICE: All right. Stick with us. We have more. Great Day Houston will be right back.