One of the top physicians in the Greater Baltimore Medical Center's highly successful in-vitro fertilization program has left to open his own free-standing fertility clinic in Towson.
Dr. Santiago L. Padilla opened the Fertility Center of Maryland at 110 West Road last week after resigning earlier as associate director of GBMC's Fertility and In-Vitro Fertilization Center.
His new clinic is believed to be the second for-profit fertility practice to be established in the Baltimore area outside a hospital setting. Such free-standing clinics are a growing phenomenon in states like Maryland where medical insurers are required to cover in-vitro fertilization.
Another private fertility clinic, Infertility Associates, has been operating for three years at 1122 Kenilworth Drive in Towson, just a few blocks from Dr. Padilla's office. It was established by Dr. Raphael C. Haciski, former head of Union Memorial Hospital's fertility program.
Two others offer services in Washington's Maryland suburbs: the Montgomery Infertility Institute in Bethesda and the Fertility Center in Rockville.
Such clinics are extremely expensive to set up, requiring a great deal of high-tech equipment. But some analysts expect them to become highly profitable as more couples who had chosen to delay having children start trying when in their 30s or 40s and find they're having trouble conceiving.
Each attempt at in-vitro fertilization can cost $7,000 to $11,000, according to one estimate, and most couples will have to undergo several attempts before achieving a successful pregnancy.
Hospital-based fertility programs have been available in Maryland since the mid-1980s, at Union Memorial, GBMC, Johns Hopkins Hospital, Sinai Hospital and the University of Maryland Medical System.
Joyce Zeitz, publicity director for the American Fertility Society, in Birmingham, Ala., said there are now at least 251 fertility centers, both hospital-based and free-standing, in the U.S. That is almost twice the number that existed in 1987.
When he left GBMC, Dr. Padilla took with him Kimberly J. Dugan, who was the senior in-vitro technologist at GBMC. Joining them is Vicki Maruschak, a registered nurse who was a clinical surgical nurse and surgical technician in GBMC's in-vitro program for two years. Even so, hospital spokeswoman Vivienne Stearns-Elliott said, GBMC's in-vitro program has been expanded since Dr. Padilla's departure, and its waiting list has been eliminated.
Dr. Padilla was replaced by Dr. Marian Damewood, former director of the in-vitro fertilization program at Johns Hopkins Hospital. In addition, the program has hired Dr. Eugene Katz, former director of the in-vitro program at University Hospital, as a staff physician.
GBMC's in-vitro program is headed by Dr. Jairo E. Garcia. He recently reported that 870 babies have been born to couples who received in-vitro fertilization at GBMC since the program there began in 1985. It is the largest such program in Maryland and among the three largest in the nation. It is also among the most successful, hospital officials say.
On average, each attempt at in-vitro fertilization at GBMC has had about a 21 percent chance of producing a live birth, what Stearns-Elliott calls a "take-home baby." The national average is about 15 percent.
Dr. Padilla said the advantage of a comprehensive private fertility clinic like his is primarily one of convenience.
"The hospital is decentralized," he said. "In a private center we have all the services in the same place."
Ms. Stearns-Elliott said the labs, surgery suite and other fertility services at GBMC are not particularly inconvenient for patients. But they are due to be consolidated in a new facility next year.
Like most comprehensive fertility centers, Dr. Padilla's will offer couples a semen laboratory for determining the husband's potential for fertility; hormonal evaluation, to identify and treat abnormalities that might prevent ovulation and pregnancy; ultrasound services to monitor ovulation; and cryo-preservation -- frozen storage -- of live embryos for later transplant.
The center also will perform several types of surgical procedures, in which either the egg and sperm, or an egg fertilized in the laboratory, are collected and implanted in the woman's fallopian tubes.
Laser laparoscopy, in which a surgeon removes scar tissue that is preventing pregnancy, also will be available. And couples will be offered in-office educational programs and psychological support services.