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Fertility Doctor of the Month: Dr. William Schoolcraft
William Schoolcraft, M.D., Colorado Center for Reproductive Medicine
FertilityAuthority honors Dr. William Schoolcraft as Doctor of the Month for his forward-thinking mindset. In 20-plus years, he and his colleagues have taken infertility research and practice in a number of positive directions.
Schoolcraft began his career working with Dr. David Meldrum, one of the early practitioners of IVF. Although Schoolcraft had opportunities to work in high-risk obstetrics and gynecologic oncology, those fields were well established. IVF brought an opportunity to get in on the ground floor of a new field, which greatly interested him.
Following his training with Meldrum, Schoolcraft moved to Denver. “I was convinced that we needed to push the field forward. I kind of combined [Meldrum’s IVF] system, which at the time was the best, with micromanipulation (assisted hatching and ICSI) which was brand new at the time and he hadn’t incorporated. So I took the best of his program and the newly developed micromanipulation technique, and blended them and really came up with a special [IVF] program,” he says.
In the 1990s Dr. David Gardner joined Schoolcraft’s practice and, “He brought the ability to grow embryos to the blastocyst stage,” says Schoolcraft. “And so we pioneered blastocyst culture, and that allowed us to transfer fewer embryos, allowing us to maintain our high [success] rates and not end up with high order multiples. And then we had to figure out how to freeze these blastocysts, so we developed blastocyst freezing.”
Embryos and Eggs
“Our future goal of research is No. 1, to develop a non-invasive method of screening embryos. To just take the [culture] media that the embryo was in, and analyze it and never touch the embryo, never biopsy it,” Schoolcraft explains. “We think we can develop a profile of what the embryo is secreting that will tell us how it’s behaving and how it’s performing, and how healthy it is. And those secretions may even relate to the chromosomal status of the embryo,” he adds.
“And then the second area of research that we’ve just hired a new Ph.D. to work on is, for lack of a better term, the egg,” he says. “Because the thing we’ve ignored over the last 20 years is the aging woman and her aging eggs. We’ve told her we can identify her aging eggs by FSH and AMH levels, and when we can’t use her eggs, we tell her to use donor eggs, but that’s a bypass. It’s akin to 30 years ago when men had low sperm counts or zero sperm counts, it was, ‘just use a sperm donor.' And of course that works, but it was a bypass. It wasn’t a fix.”
“And so that’s really our push in the next five years,” says Schoolcraft.
Individualization and Compulsiveness
“Individualism and compulsiveness.” Those are the terms that Schoolcraft uses to describe his treatment philosophy. He says that many patients come to him after having failed multiple cycles at other fertility clinics. “The first thing I do is go through their records and their history and try and be compulsive at looking at everything that was done and figure out what was missed.” That might include checking chromosomes, and looking at the uterine cavity for adhesions or a uterine septum.
“And then assuming the workup is complete and we’ve checked every factor we can check and treated everything we can treat ahead of time, we try to tailor not only the stimulation, but the laboratory phase," Schoolcraft explains. “Is day-3 culture best, or is day-5 culture best? Is aneuploidy screening best or freezing their embryos the best? How many embryos should we transfer to get them one baby? All of these things have to be factored into one case,” he adds.
“So people often ask me, what’s your protocol? And I say, I’ve got 12 protocols. For stimulation. it depends on the patient. Blastocyst culture is great for a lot of people; it’s the wrong choice for some patients. We try to look at what didn’t work and obviously not replicate that,” he says.
Book Proceeds to Research
In his “spare time,” Schoolcraft authored the recently published If At First You Don't Conceive (Rodale, 2010). His profits are being donated to the Colorado Foundation for Fertility Research, a non-profit of which he’s a member of the board. The foundation is comprised of all scientists (they don’t do any clinical work) who are working on a lot of the research projects Schoolcraft discussed.
FertilityAuthority applauds Dr. Schoolcraft’s commitment to research and advancement of fertility treatment. We congratulate him, and his well-deserved honor of Doctor of the Month.