Dr Thomas Kosasa
Dr. Thomas Kosasa turned his back on a comfortable life in the family business — ABC Stores — to pursue the life of a Renaissance man, and for years the life of a playboy.
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Infertility affects more than 6 million people in America, or 10 percent of the people of reproductive age. An estimated 39,000 couples in Hawaii experience infertility. Most cases can be treated, according to Kosasa.
In vitro fertilization (IVF) literally means “fertilization in glass.” Actually plastic dishes are used today in a process that involves collecting eggs and sperm from a couple with a non-surgical technique and fertilizing the egg outside of the body. The fertilized eggs (embryos) are then transferred into the woman’s uterus.
As medical director of the Pacific In Vitro Fertilization Institute, Kosasa leads a team of highly qualified specialists who use modern technology to help infertile women achieve a successful pregnancy. The institute, located at Kapiolani Medical Center, is the first and most experienced IVF clinic in Hawaii, established in 1985.
More than 1,600 babies have been born with Pacific IVF’s help. The Institute made front-page headlines 20 years ago with the birth of Jacquelyn Low, Hawaii’s first test tube baby. That was only seven years after the world’s first IVF baby was born and four years after the first IVF baby in the United States.
Kosasa’s colleagues at Pacific IVF Institute are Philip I. McNamee, M.D., Carl Morton, M.D., and Thomas T.F. Huang Jr., Ph.D. The Institute is affiliated with the internationally respected Galileo Research Center in San Francisco, providing real-time, ready access to scientists involved in cutting edge research. Thanks to this connection, Hawaii now has access to pre-implantation genetic diagnosis that helps couples minimize the risk of miscarriage and genetic defects.
IVF has created plenty of buzz in the medical field because of its breakthroughs in dealing with the human biological clock. All the stories these days about miraculous high-tech fertility treatments and 50- or 60-year-old women giving birth might make one wonder, has the biological clock been reset?
The truth is the clock is just about where it’s always been. The average woman’s ability to get pregnant begins to slow down as early as 30, according to research. By 40, fertility drops steeply, and even with the most advanced medical techniques, very few women over the age of 44 are able to have a baby using their own eggs. Among this group, childlessness really is a huge problem, a national survey points out. Infertility can be due to male factors as often as female factors or a combination of both.
Women aren’t the only ones with a ticking biological clock. Men’s fertility declines with age, too. Since 1980, there has been an almost 25 percent increase in men aged 35 to 54 fathering children in the United States, according to the National Center for Health Statistics. Men are waiting later than ever to start a family.
IVF was originally designed to help women whose tubes were blocked. Now this technology is helping men, which Kosasa says is a “real turn of events.” Among the latest advances in IVF is a process called intracytoplasmic sperm injection. This allows men with extremely low sperm count or who are sterile to have children, Kosasa explains. The technique involves the injection of a single sperm into an egg to fertilize it. It does not harm the egg, and pregnancy success rates are approaching 50 percent.
Other advances in IVF, according to Kosasa, are assisted hatching and blastocyst embryo transfer. Assisted hatching increases the chances for embryo implantation for women over the age of 35. New laser technology allows the hardened shell of a fertilized egg to be weakened prior to transfer into the uterus.
Advances in laboratory techniques now allow embryos to be cultured an additional two-three days to an advanced stage of development before it is transferred to the womb. This allows for identification of the healthiest and most robust embryos, which have the highest potential for implantation. Fewer embryos (one or two) are transferred to the womb, thus reducing the risk of multiple births.
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