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Doctor of the Month: Dr. Valerie Montgomery Rice
Valerie Montgomery Rice, M.D., Meharry Medical College, Nashville, TN
FertilityAuthority is pleased to honor Dr. Valerie Montgomery Rice as Doctor of the Month. A clinician, researcher and academic, Dr. Montogmery Rice has demonstrated an ongoing commitment to women’s reproductive health. She currently sees patients at Meharry Medical College, teaches at Meharry Medical Center, and serves as the Executive Director of the Center for Women’s Health Research, also in Nashville.
Age and Fertility
When discussing her infertility practice, Dr. Mongomery Rice says, “What I’m probably seeing the most — and probably the most concerning — is we continue to not get the message out to women that they should not delay attempting pregnancy.
If people say, ‘What’s the biggest factor for achieving pregnancy?,’ it’s age for women," she continues. "The older you are, the more chances you have that something has impacted your ability to get pregnant."
She adds that in her opinion, there is "no ideal time ... to achieve pregnancy based on your life career. We want to encourage women to have support systems in place, but we also have to tell women that, seriously, after the age of 35, your chances of achieving pregnancy without intervention start to decrease every year. I definitely encourage women to be independent, to have exciting careers. But being a person who has a very intense career, I had to fit kids in pretty reasonably so I could have the opportunity to have that part of my life. And so I knew there wasn’t going to be any ideal time."
Dr. Montgomery Rice generally tells healthy women in their late 20s or early 30s who are anxious because they haven’t become pregnant in six months to continue trying for a year. Approximately 15 to 20 percent of couples who have nothing physically wrong with them will not get pregnant the first year; however, 80 percent of those will probably get pregnant the following year, she explains.
“Sometimes it’s just a matter of time," she explains. “But if someone is 38 or 39, that’s a totally different story. We have to do an appropriate workup and give people realistic expectations."
What women don’t understand, according to Dr. Montgomery Rice, is that "women over 45, or women 43 and having twins, aren’t using their own eggs. You want to delicately be able to say to [older patients] ‘here are your options,'" she explains. "I take them through a rational level of thinking about this — so they are realistic."
Research in Women’s Reproductive Health
Prompted by curiosity around the reproductive challenges secondary to hormonal disruption, Dr. Montgomery Rice has been interested in and has been conducting research since medical school, including a number of large clinical trials with the industry and the National Institutes of Health (NIH). In 2005, Dr. Mongomery Rice opened and became the Executive Director of the Center for Women’s Health Research, which focuses on diseases that disproportionately impact women of color.
“All women are seen in the center,” Dr. Mongtomery Rice says, “But we decided that because we are seeing such a significant change in demographics — that is, by the year 2050, 51 percent of all women in this country will be a woman of color — we decided to focus on those diseases that impact women of color.” Their current research focuses on fibroids, breast health and AIDS/HIV.
According to Dr. Montgomery Rice, research has shown that there is a 20 percent decrease in success of IVF in African American women. She believe there are two factors: poor ovarian reserve (they have a higher chance of having an abnormal clomid challenge test) and the presence of fibroids.
“We also know that we are seeing women of color referred [to an infertility doctor] later as compared to Caucasian women," she says. "And we are looking at that and trying to get some education points out that say that these women have a higher chance of having fibroids. We have data now that even when you control for age, there may be some challenges with ovarian reserve. And so you probably want to go to IVF a lot sooner for some of these women.”
Given the range of her experience, we asked Dr. Montgomery Rice what she considers to be some of the high points of her career. She names a few: starting an infertility practice at the University of Kansas; launching her current practice at Meharry Medical College after the original practice had gone dormant; and ongoing research in the field of infertility.
“I’m also very proud of how even though IVF has become very dominant in our profession, that people have always considered research a vital part of how we answer the wave of questions we have to address when a woman comes in and says ‘Why can’t I get pregnant?' We don’t just say we can get most people pregnant with just doing IVF," she says. "We really are still diligent with doing the level of investigation to ensure there’s not some disorder there that can be corrected prior to a woman going to IVF.”
FertilityAuthority congratulates Dr. Montgomery Rice on being awarded Doctor of the Month. Her dedication to the ongoing advancement of women’s reproductive health in research and in practice is certainly admirable.