As a leading fertility doctor for thirty years, NYU Langone's Dr. Jamie Grifo started practicing at a time when people had fewer family-building options available to them. He talks to ELANZA Wellness's Catherine Hendy about how he has seen fertility evolving as more people delay parenthood, emerging fertility technologies, and his battle to walk the line between education and anxiety.
For some fertility doctors, the stories of the patients they treat remain with them, many years after they leave the operating table. Dr. James Grifo is clearly one of those doctors. It is 5 years since he treated reality TV producer Danielle Gelfand, and yet still his voice fills with pride and emotion as he admiringly tells her story.
At almost 40 she had just about "given up hope" of finding a life partner and reluctantly turned to egg freezing to preserve her chances of having a biological family in the future. As Gelfand wrote in a moving article about her wedding for the New York Times, she did end up finding her person. And, at age 48, she walked down the aisle to him in the presence of their miracle two year old daughter.
The "guest of honor," as she coined the fertility specialist, had magicked the little girl into the world from those younger, frozen eggs eighteen months after she met her (now) husband.
As he told me about the people behind the old article, Dr. Grifo struggled to locate it saved on his desktop computer. He emailed me a link a few days later with just three jubilant words:
"I've found it!"
It's easy to see why the article - and the family - still command a place in his heart.
In one photograph that accompanies the piece, the bride, her daughter, and the mother of the bride are walking up the aisle and you just can make out Dr. Grifo behind them, part of the bridal party, smiling serenely as the sun streams through onto the assembled guests.
I joke that he must feel like God when he has a good day at work, but he shrugs this off - not easily flattered after balancing the highs with the customary equal number of lows after decades in practice.
“It's a miraculous story,” he says. “But the reality is, it's a lot harder to get pregnant than people realize - especially when you're older, when miscarriage rates are higher.”
That's a fact Grifo didn't just pick up in medical school, but in life.
When the fertility doctor and his wife faced their own struggles to build their family many years ago – they endured 5 unsuccessful rounds of IVF before finally welcoming two much longed-for, cherished daughters – he was supposed to carry on as a colleague at work, and a patient in parallel.
"The process of being treated as an infertile patient is stressful, upsetting and depressing," he says. "On top of that, it was also kind of awkward."
Dr. Grifo is sitting casually in his office on 1st Avenue in New York City when we speak: a rare break in a relentless working day that started at 7am and will continue long into the evening.
"One of the reasons someone like me is so busy is...we're having our families in our 30s and the system just isn't designed for that. There's also anxiety, because there's pressure about when to have a child," he says. "And everyone is delaying it more than ever."
The room is adorned with relics of the past -- thank you letters, photos of swaddled newborns, media cuttings -- and the realities of the present - a rainbow desk flag and printed charts showing egg quality decline by age. It’s where he meets his patients in person and where he conducted video consultations during the pandemic.
"The elephant in the room with my patients is always: what if I can't have a baby?" he says. "And until you do, that question is always there."
The painful irony of a fertility specialist finding himself facing fertility treatment to build his family somehow makes his story an even harder listen than if it were any other patient telling it.
As he gently talks about those years, I find myself having to blink away stray tears. No matter, it becomes clear, as I spot the Kleenex box on his desk. He's a fertility doctor. He's used to tears.
We pause for a moment listening to the buzz and hum of the city beneath us. I look around the room and see the happy ending from his own journey captured in framed photos of healthy, smiling daughters - memories that might never have been made but for modern technology. Daughters that are growing up in a world that offers far more choices than for previous generations of women when it comes to education, career, family choices - and fertility.
It's hard not to feel deeply moved by the stories and deeply in awe of the science that take place within the walls of clinics like this.
Grifo is that rare blend of both a personable physician and an exacting scientist, having obtained a Phd and pioneering genetic screening and egg freezing techniques, with his research earning him multiple industry awards.
He is double Board Certified in Obstetrics and Gynecology and Reproductive Endocrinology, after completing his residency at Cornell University Medical Center, and his Fellowship in Reproductive Endocrinology at Yale University.
He is also a past President of the Society for Assisted Reproductive Technologies (SART) and serves on the Ethics Committee of the American Society for Reproductive Medicine (ASRM), whilst still spending some of his squeezed time training the new generation of doctors in reproductive endocrinology - including, unbelievably, one of his own IVF babies, born twenty-five years ago after her mother received treatment from Dr. Grifo.
We talk about the changes in how we approach reproduction - on a personal and a societal level - that have shifted over the decades since then.
There are few fertility doctors more quoted in the national media (Oprah, Vogue, The New Yorker and Wired, to name a few) or who have been situated closer to the front lines of changing family-building dynamics in the United States than Dr. Grifo at NYU Langone: the average age of a first time mother in New York City is creeping higher into the thirties with each passing survey and is officially the highest in the county.
Grifo has weathered all these changes in his working and his personal life and now, in his mid sixties, has a clear perspective on the challenges individuals and society now face when it comes to how the fertility industry must adapt to longer, later trends in modern lives.
So what can we do to better prepare people? "It requires more education in a way that is respectful," he says. "The dialogue about planning your fertile life needs to happen now more than ever because we clearly are waiting longer and suffering because of it."
"I'll see someone who is 40 show up and she'll say: 'Gee, doc, I've tried for 2 months to get pregnant, what's wrong?' Really? What did you think your chances were in 2 months of trying?" You're expecting it to be quick because you were told 'have sex one time and you'll get pregnant' your whole life and 'it's so easy, you're in control' - two things that are completely wrong...'Well, nobody told me that, I should be pregnant shouldn't I?'
"It's really sad when that happens. If you don't know the science behind it, the biology behind it, then you're set up to be disappointed if things don't work out well."
"You're making reproductive choices either by ignoring the whole thing and letting life play out, or you're making reproductive choices by being aware of what the data is and then factoring that in to the choices you make."
His advice to anyone seeking care is to ask around and get opinions on the whole patient experience at the clinic in question. "You want to be comfortable not just with the doctor, because the doctor is not the only one taking care of you. There's a whole team of people who make sure you get good care."
Also, he adds, people should think about seeking medical care even before they try to get pregnant, booking a preconception consultation and thinking about lifestyle - with nutrition being "a big element."
As for the future, Grifo seems calm and focused on driving further developments for his patients. "Right now in the United States 2% of babies are born through IVF. We are using more and more technology, we are freezing more eggs, because women are delaying childbearing by plan - so we're going to be more technology-dependent.
"People who are going to be having their babies older are going to be using more technology - there's ways to avoid some of the things that happen like miscarriage, that's a really positive thing. We just have to keep getting better and better at what we can offer to get healthier outcomes and reduce those risks, that's really our job - to try to help our patients."
This is an article by ELANZA Wellness, the digital fertility coach from an interview conducted in June 2021. To find out more about Dr. James Grifo, NYU Langone Fertility Center or other clinics in New York City, visit the ELANZA Clinic Discovery Tool.
About Dr. Grifo:
Dr. Jamie Grifo has been the Program Director of the New York University (NYU) Langone Fertility Center since 1995. He is also the Director of the Division of Reproductive Endocrinology and a Professor of Obstetrics and Gynecology at the NYU School of Medicine.
He is Board Certified in Obstetrics and Gynecology and Reproductive Endocrinology, as well as being certified by the Accreditation Council for Gynecologic Endoscopy.
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