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2 Doctors Give Birth to Full-Service Fertility Clinic


Hanging on a wall in the offices of Drs. Richard Buyalos and Gary Hubert are the testimonials to their company's success.

Arranged behind a pane of polished glass are birth announcements, ultrasound images of embryonic twins and photographs of day-old zygotes that in nine months will emerge as fuzzy-haired newborns.

"By and large, this is a pretty happy field," Buyalos said. "There's an extraordinary amount of satisfaction in it."

Since opening Fertility and Surgical Associates of California two months ago in Thousand Oaks, the two have played a pivotal role in the making of more than a dozen families.

As the only full-service fertility and in-vitro fertilization clinic in Ventura County, as well as the only one between Los Angeles and the Bay Area, both have been kept busy counseling and helping couples bring babies into the world.

Previously, local couples who were having a difficult time conceiving a child would have to go to Los Angeles or farther to get the same kind of assistance.

"We specialize in every aspect of fertility here," Hubert said. "There are any number of treatments available, from timed conception to fertility drugs to in-vitro fertilization, and it's all something that we're able to do right here."

Before launching the local center, Buyalos and Hubert worked at the UCLA Department of Reproductive Endocrinology and Infertility.

Both are board certified and continue to work at the UCLA School of Medicine as clinical professors.

It was just 20 years ago that the first in-vitro--or test-tube--baby was conceived.

At that time it was like science fiction becoming reality, but the procedure since has become more advanced and is now considered routine.

There are about 300 fertility clinics in the country to help the estimated 15% of couples who have difficulty conceiving a child.

Many had been operated out of hospitals, but the economics of reproductive medicine have changed so much that cost-conscious hospitals are beginning to phase out their programs, turning the industry over to clinics such as Fertility and Surgical Associates.

The concept of in-vitro fertilization is fairly straightforward, but--because of its extreme delicacy--the process can be difficult and expensive.

The procedure, reserved for the most extreme cases of infertility, begins with a battery of tests to check the health of the prospective mother.

If she is deemed a good candidate, eggs are harvested from the ovaries.

Then, using hollow glass tubes finer than a human hair, clinic technicians pierce the cell wall and fertilize the egg.

After cell division has begun, the eggs are transplanted back into the mother. Doctors then monitor her for several weeks to determine whether any of the zygotes survived and are continuing to develop.

At some hospitals and clinics, the procedure can cost as much as $18,000, the doctors say.

Because the entire procedure is done in-house, Buyalos and Hubert said, they are able to keep costs down. A single in-vitro fertilization procedure costs $5,000 and three cost $7,500.

In addition, they said, they are able to give patients a better standard of care because they are involved with the process from beginning to end.

The clinic employs a trained embryologist to do the actual fertilization procedure and monitor development.

"We personally do every aspect of this process, from the ultrasound exams to the [transplant] with our own hands," Hubert said.

After six years, two doctors and many in-vitro attempts, Lori Cangemi decided to visit the center, where she met with Hubert.

The difference, she said, was startling.

"Before I didn't think I was getting the attention I needed, but Dr. Hubert was great. . . . He'd sit with me and read my chart, and I could just tell that the wheels were turning," she said. She got pregnant shortly thereafter, but because of a rare uterine problem, the embryos did not survive.

Cangemi, 37, with the help of her sister decided to pursue a surrogate pregnancy.

Hubert implanted four of Cangemi's eggs into her sister and hoped for the best.

"She called me two days later and said she could tell she was pregnant and was pretty sure it was twins," Cangemi said. "It was amazing."

And true. In about seven months, Cangemi and her husband are due to become the parents of two children.

"I'd been through a lot before going there and never really felt any of the other doctors I visited could really help me," she said. "But I really felt taken care of there. . . . It was easy and they were honest with me all the time."

As for the future, Buyalos and Hubert said they already have had more patients turn to them than they initially expected, and they think that will continue.

"We always knew the area was underserved, so I'm not that surprised that we're busier than we anticipated," Buyalos said.


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