About GENESIS Fertility

Comprehensive services

Everything about the GENESIS practice reflects our dedication to serving the individual patient. Foremost is the comprehensiveness of what we provide. This includes not only the expert services of reproductive endocrinologists, but also care from other specialists that can be crucial to success. They include:

• A urologist specializing in male fertility, on site
• A psychologist with special expertise in counseling individuals and couples with infertility, on site
• A genetic counselor, with special training in counseling about genetic diseases and the fertility procedures used to overcome them, on site
• Reproductive scientists who are able and willing to discuss with patients the laboratory techniques they use for assisted conception, on site

These professionals are supported in their work at GENESIS by a nursing, clinical and administrative staff whose energies are exclusively focused on the alleviation of infertility.

Location and Physical Space

The main office of GENESIS is located in the beautifully designed Calko Medical Building, on the corner of Bay Parkway & 60^th Street in Brooklyn  – conveniently accessible by bus, train or car. It is fifteen minutes from the Verrazano Bridge and Belt Parkway, making it easily accessible not only to our Brooklyn patients but also to patients from the South Shore of Long Island, Staten Island and the New Jersey Coast. Valet parking is available inside the building; this is an especially useful feature for those patients requiring frequent visits during a treatment cycle. Unlike patients who use practices located amidst the congestion of Manhattan, patients in treatment at GENESIS generally find that they are able to come and go without hassle and without having to lose time from work. GENESIS also operates satellite offices conveniently located in central Staten Island, Park Slope, Forest Hills Queens and Hewlett, Long Island.

The GENESIS facility was specifically designed and built to house all of the elements necessary to deliver state-of-the-art fertility care. The colors and décor were chosen to foster a relaxed atmosphere. The reception area has the feel of a reading room. The consultation rooms are warm and inviting. Examination rooms are spacious, with private access to bathroom facilities. The operating suite and full laboratory facilities are located onsite.  Our patients requiring advanced care appreciate having these facilities on site. This keeps the total care of every patient in the hands of our dedicated staff. Patients at GENESIS have no need to come into contact with any hospital staff or any others who may not understand the ordeals of infertility.

As a way of providing an appropriate environment for patients struggling with infertility, we have chosen not to line our walls with the many pictures of babies. (We have, however, hung thousands of thank-you notes on our walls; most patients generally appreciate and are encouraged by them.) Successful patients are referred early to their obstetricians, so no active patient ever shares the reception area with a woman who is visibly pregnant. As a rule, we discourage all patients from bringing children to our office. (As much as we appreciate visits from former patients and their children, certain times are designated for such visits.)

Support staff

Every staff member at GENESIS has been sensitized to the needs of individuals and couples with infertility. From the first contact to the last visit – usually, on the way to the obstetrician – patients at GENESIS will feel that every aspect of their care has been delivered by professionals who understand their needs and always have their best interest in mind. While we cannot guarantee the ultimate outcome of patient care, we do guarantee that every patient is treated with respect and compassion. In keeping with our mission statement, we always put “Patients First”.

Record keeping

Most medical offices use computers to keep track of billing issues. At GENESIS, we use computers to keep track of all clinical information on every patient. We believe that electronic recording all of all patient medical data is fundamental to patient safety. An electronic medical record is created for every new patient, linking all information about her with that of her spouse or significant other, as appropriate. The complete medical history, as well as the physical exam, physician assessment and treatment plans are all documented electronically.

The ready availability of charts on the computer network fosters immediate and thorough documentation. Information cannot be lost or misread, a crucial element in preventing medical errors. Additionally, the system eases the process by which all of us do our jobs, giving us more time to keep every patient physically and emotionally comfortable during her treatment cycles. In a very real way, therefore, the electronic record is an essential ingredient behind the personalized attention that distinguishes care at GENESIS. (The best people, of course, being the major part.)

While some practices are just now integrating information technology into patient care, and most others still use paper charts, at GENESIS we have over a decade of experience in using electronic records successfully in the care of many thousands of patients. We are proud that our record of success is matched equally by our record of safety.

Patient Education

The physicians leading GENESIS have been in practice for over two decades. Over time, they have developed an approach to patient education that is evident in every aspect of care. Essentially, an educated patient is our best patient. To that end, we take pride in explaining to our patients the rationale underlying our approach to treatment, as well as all the pertinent information that must be understood prior to commencing treatment. Additionally, we provide explanatory written handouts for virtually every step of treatment. Nearly all of these have been prepared by physicians. Thus, they reflect the GENESIS philosophy and process.

The majority of our nursing staff have received formal certification by the American Society of Reproductive Medicine. When advanced reproductive technologies are planned, the nursing staff gives formal instruction covering all the procedures critical to proper patient care. Most patients coming from other practices are surprised at the level of detail that describes these presentations. At GENESIS, we take pride in having you understand not only what we do but also why we do things certain ways. Your knowledge of the processes we use assists us in delivering proper care and optimizing the outcome. Educated patients are our most successful patients, too.

In the business world, it is common to identify certain “benchmarks” that serve as measures of quality. Airlines use their on-time rate. Financial services use their rate of return. In medicine, the benchmarks that define quality can be much more difficult to define. What we’ve outlined above is what we believe are measures of quality, and by those measures we define the quality of care as exceptional. But there are also other benchmarks of high quality medical care; in the field of reproductive medicine one benchmark stands above all the rest – the delivery of a healthy baby.

As a member program of the Society for Assisted Reproductive Technologies, or SART, we report pregnancy rates from the in vitro fertilization program at GENESIS on an annual basis. These rates are available on line at http://www.cdc.gov/art/ or on our website, www.genesisfertility.com. Our pregnancy rates have for many years been at or better than the national average, and certainly competitive with the other programs in our area. We  make a considerable effort to avoid multiple pregnancies so that our patients have the greatest chance of having a healthy pregnancy. To appreciate just how good our statistics are, however, it is helpful to understand just how to read the data from SART.

There are several limitations to the SART statistics. Understanding those limitations goes a long way to explaining why the outcomes at GENESIS are a cut above the rest:

(A) SART has chosen to publish data from IVF cycles only. The database says nothing about what happens in any given practice to patients who are treated by methods other than IVF. Thus, patients who conceive using alternative, less aggressive interventions, are not represented in the statistics. To a certain extent, practices that use IVF more conservatively, saving it mainly for their most difficult cases, are penalized by the focus of the database on IVF pregnancies only. This is certainly the case at Genesis where, for financial and other reasons, most patients are able to turn to IVF under difficult circumstances. That notwithstanding, our pregnancy rates from IVF remain robust.

(B) Patients entering fertility treatment generally would like to know their chances of conceiving using a particular treatment. While optimally they would prefer to conceive within one treatment attempt, most educated patients understand that assisted pregnancies, like natural ones, occur over time. Yet, the SART database is focused not on pregnancies per patient but rather on pregnancy rates per cycle. This focus has forced many reproductive specialists to do whatever it takes to maximize the chance of pregnancy during any given cycle, even if it means putting back more than an appropriate number of embryos. But inflating the pregnancy rates in this way comes hand in hand with multifetal pregnancies. SART is making a concerted effort of educating the public on the dangers that may accompany triplet and quadruplet pregnancies but sometimes their advice is ignored. Even the added risks of twin pregnancies are not insubstantial. Medically, pregnancy with a singleton fetus after two tries at IVF is certainly preferable to a pregnancy with twins or triplets on the first. Yet, as long the SART focus remains as it is, consumers will not appreciate the nuances of its numbers.

(C) Every page of the SART database warns the reader not to compare pregnancy rates among programs because “entry criteria differ.” The term entry criteria refer to the specific indications that different programs use to offer IVF treatment to patients with infertility. Many fertility practices, especially in competitive and medically over-served areas like New York City, market themselves to the public specifically as IVF programs. Their goal is to attract patients specifically for the purpose of conceiving through IVF. Of course, there is nothing wrong with this from the patient’s view, as long as she is well-informed and ultimately successful. But from a different perspective, if the reason for using IVF is simply that the patient has infertility, then the utilization of IVF in such a program is inappropriately high, and the pregnancy rate artificially inflated. This “fast-track” approach to IVF may make sense in an area where patient financial resources are not an issue, as for many of the clientele in Manhattan-based programs. For most other programs, however, the way IVF is used is quite different and the success rates necessarily differ as well.

Another way in which entry criteria can affect a program’s IVF statistics is by being very restrictive. Many of those same programs where the utilization of IVF is very high will also restrict its use mainly to patients with the very highest chances of achieving pregnancy through IVF. This is especially so at programs offering “money-back guarantees.” Patients who have failed multiple previous cycles, are older, have evidence of poor ovarian function, or who have other medical reasons to expect failure are generally denied the opportunity to undergo IVF. This keeps the success rates high (while, of course, serving to lure better prognosis patients to the practice, further feeding the cycle of success).

At GENESIS, we offer IVF to our patients according to standard, well-accepted medical protocols. Many patients who might conceive with IVF at other programs successfully conceive at GENESIS using less aggressive measures. When patients do enter our IVF program, we generally transfer the minimum number of embryos that will give a realistic chance of conception, but with a minimal chance of multifetal pregnancy. We take pride in the fact that our pregnancy rates are high, yet we still have one of the lowest multifetal pregnancy rates in the New York City area, and perhaps in the nation. Finally, at GENESIS we treat patients, not our IVF statistics. Being on the very top statistical rung is not something we chase, because it comes at a cost of being overly selective and closing the door on too many “difficult” patients. We welcome patients who have failed IVF at other programs into ours, so long as they are aware of the risks and benefits of doing so. Happily, many patients who have failed at other programs have succeeded in our hands. These are just some of the elements that prompt us to boast of exceptional outcomes at the GENESIS program.