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June's RE of the Month: John J. Zhang
John J. Zhang, M.D., M.SC., PH.D., H.C.L.D.
New York, NY
FertilityAuthority had the pleasure of meeting Dr. John Zhang in his office in NYC last month. The meeting was the result of our research for an article on Mini-IVFTM, a protocol Zhang’s practiced exclusively for five years (more than 7,000 cases), and one he’s passionate about. We were so impressed by his treatment philosophy that we’re featuring Dr. Zhang as FertilityAuthority’s RE of the Month for July 2009.
An IVF Cycle by any Other Name
There are many "lighter" versions of conventional IVF being practiced in clinics across the country: IVF-Lite, Gentle IVF, New Hope IVF, Hope IVF, Eco-IVF, Micro-IVF, Minimal Stimulation IVF. However, Zhang's Mini-IVF TM protocol, and the philosophy that guides his work, is unique; this low-stimulation treatment was originally developed by the Kato Ladies Clinic in Japan. Mini-IVF TM stimulates ovaries with minimal oral medication (Clomid) to produce the best quality eggs a woman's body can mature in one cycle. Injections are used in some Mini-IVF TM treatment cycles, but not all, and a nasal spray is used in lieu of HCG to trigger ovulation. The treatment is tailored to each patient.
"Conventional IVF uses a greater amount of medication and injections to produce a greater quantity of eggs, but the excess eggs are genetically invalid," according to Zhang. In most patients, Zhang says, regardless of the number of eggs created, very few will be good quality. “Once you’re beyond 33 to 35, you’re only going to produce two to three good eggs,” he says. He’s a firm believer in quality over quantity.
In addition to minimal medication, there are, according to Zhang, other benefits to Mini IVFTM: many cases are single embryo transfer, the risk of multiples is reduced, the cost is lessened because of the lack or minimal use of injectable drugs, there is a reduced risk of ovarian hyperstimulation, and egg retrieval is briefer, less painful, and does not require anesthesia since there are fewer follicles to be retrieved.
Mini-IVFTM is Like a Hybrid Car
Dr. Zhang uses several analogies to explain the protocol and why it’s his treatment of choice. For instance, he compares the procedure to a hybrid car with two sources of power – electricity and gas. He likens the oral medications in the Mini IVF(TM) cycle to running on electricity, with the injection acting like a gas pedal – to give your body the extra boost it needs.
Love Your Mother Earth (and Ovaries)
Throughout our conversation, Zhang emphasizes that Mini-IVFTM is a philosophy. For doctors and for patients who adopt this philosophy, he says, it’s not about the money or the reduced cost of treatment. It’s about the way you treat your body throughout treatment – what you’re putting into it, and what you’re getting out of it. “Ovaries are precious like the earth,” Zhang says. On earth, he adds, things grow better with gentle, organic fertilization. He suggests that we think of the ovary as a mini-earth, and Mini IVFTM as an organic approach to infertility treatment.
Know Thy Fertility
Dr. Zhang underscores the importance of patient education, and says, “Don’t underestimate the patient.” He recognizes that the more information fertility patients have, the more involved they’ll be in their treatment, and the more likely they’ll be to find a treatment plan that will work for them.
JOHN J. ZHANG, M.D., M.SC., PH.D., H.C.L.D. is the founder and director of New Hope Fertility Center in New York, NY. He is an early pioneer of minimal stimulation IVF & natural cycle IVF, embryo and egg freezing by vitrification, and cytoplasmic transfer.
After completing his medical degree at the Zhejiang University School of Medicine in China in 1984, Dr. Zhang studied male infertility, earning a Master's Degree at Birmingham University in the UK, in 1985. He was one of 80 overseas student recipients of the British Postgraduate Scholarship in 1989.At Cambridge University, Dr. Zhang studied in vitro maturation and fertilization of mammalian oocytes, earning a Ph.D. in in-vitro fertilization in 1991. In 1997, after more than 10 years of training and research in the biology of mammalian reproduction and human embryology, Dr. Zhang pursued and successfully completed a residency in the Department of Obstetrics and Gynecology at the New York University School of Medicine. In 2001, Dr. Zhang was chosen to become the first Fellow in the Division of Reproductive Endocrinology and Infertility of New York University School of Medicine.
His major research interests are oocyte reconstruction by nuclear transfer, and long term cryopreservation of oocytes, embryos and ovarian tissue. He is one of a handful of reproductive endocrinologists in the U.S. who also holds a Ph.D. in embryology with an additional certification as high complexity laboratory director. Dr. Zhang is also on the editorial board of FertilityAuthority.com.