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Dr. of the Month: Dr. James Goldfarb

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James Goldfarb, M.D., M.B.A.
Director, University Hospitals Cleveland, Division of Reproductive Endocrinology and Infertility

March 2010

When I see an opportunity that I can do something for patients that hasn’t been done before, it’s a very satisfying thing.

Dr. James Goldfarb’s resume is a litany of firsts: In 1983, his clinic program was responsible for the first in vitro fertilization (IVF) birth in Ohio and three years later, they made history again with the first ever IVF birth with a surrogate. As if that weren’t enough, in 2004 his practice was responsible for the state’s first preimplantation genetic diagnosis (PGD) baby.

Dr. Goldfarb brushes off kudos saying that his inspiration to try new things comes solely from his patients.

“If it wasn’t for the patients at the beginning who were willing to be pioneers, we never would have been here,” he says, adding that the world’s first surrogacy pregnancy came about when a couple approached The Cleveland Clinic (where Goldfarb served as Director of the Department of Obstetrics and Gynecology) with the idea. The husband was a cardiologist and his wife lost her uterus when a pregnancy (via IVF in England) went wrong. The cardiologist, reading the medical literature, proposed combining his sperm with his wife’s egg again but suggested that they implant the resulting embryos in a surrogate.

“They shared the proposal with several clinics,” says Dr. Goldfarb. “We thought it was a very exciting possibility so we talked to our lawyers and our review board and we all agreed to do it as a one-time trial. Obviously, we were fortunate enough that it worked and so it became an ongoing program.”

Dr. Goldfarb’s commitment to serving his patients continues in his work as the co-founder and Medical Consultant for The Cleveland Clinic’s non-profit Partnership for Families program. The first program of its kind in the United States, Partnership for Families subsidizes second IVF cycles for clients who can’t afford to fund a second cycle on their own.

Once again crediting his patients, Dr. Goldfarb explained how in late 2003, he got a phone call from a former client who wanted to help other patients get a shot at a second IVF cycle. “She always said that she had her babies because her parents could afford to help her go through IVF,” Dr. Goldfarb explains, adding that her phone call came at an opportune time. “I had just gotten a letter from two school teachers who needed a second IVF cycle but couldn’t afford it and then I got her call and it all fell into place.”

The program expanded to help cancer patients undergoing chemotherapy access fertility-sparing procedures (such as egg retrieval and egg freezing). To date, the program has served well over 140 fertility patients and more than 35 cancer patients.

When asked about what he sees in the future of fertility treatments, Dr. Goldfarb, former president of SART, the Society of Assisted Reproductive Technology, says he sees two important developments.

“We really want to do an even better job cutting down the rate of multiple pregnancies,” he says. “From SART’s standpoint, the American Society of Reproductive Medicine guidelines do emphasize -- in certain subsets of patients -- that the recommended number of embryos is one.”

Citing the growing research that shows that for many patients, transferring one embryo leads to success rates that are in line with treatments where more embryos are transferred and eliminates much of the risk for multiple pregnancies, Dr. Goldfarb hopes to see the 30 percent twin rate drop in the next few years.

Dr. Goldfarb says he can also envision a time in the near future when clinics won’t need to fertilize all of the eggs retrieved in a single cycle as freezing and storage techniques improve. Instead of banking on some loss, doctors will be able to more selectively choose which embryos to store, eliminating the ethical dilemma many parents find themselves in when confronted with leftover embryos.

Because of his humility and generosity as well as his forward-thinking scientific practice, salutes Dr. Goldfarb as a doctor who wows us!

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