Exclusive Interview: Dr.Juliet Skinner, Coping with infertility

After being awarded the Barbados scholarship, Dr. Juliet Skinner completed her undergraduate medical training at Trinity College Dublin, Ireland. Women’s health was always of special interest to her from early on in her training and she specialized in Obstetrics and Gynaecology. Juliet worked in the Coombe Women’s Hospital and was at that time the youngest doctor to ever be appointed the position of Assistant Master of this prestigious Dublin maternity hospital. After completing her specialization in Dublin she continued as Perinatal Research Fellow.

During this time she developed and evaluated a number of ultrasound diagnostic tests both for fertility and for obstetrics. In 1999 she returned home to Barbados where she dedicated her time to expanding the medical care options to women on the island and within the Caribbean. Fertility and IVF then became the main focus of her interest. Dr. Skinner was instrumental in developing the Barbados Fertility Centre from a start-up unit with the goal of becoming one of the best in the world. From the beginning, the mission was to create a center, which would maximize each and every couple’s chance of success by offering the latest technology and the best facilities and by ensuring attention to every detail. Dr. Skinner is a Consultant Gynaecologist who leads the team at Barbados Fertility Centre.

Many couples can try for years to have a child, but to their disappointment, they cannot conceive. Some of them may give up trying or chose to adopt. However, there is a solution for many with assisted reproduction. So what should you do if you can’t conceive? Firstly, both the male and female partners need to consult a doctor and establish if there is a medical reason why they are not conceiving. A variety of different tests will determine the best course of action to increase this couple’s chance of a successful pregnancy. We have interviewed Dr. Juliet Skinner, Consultant Gynaecologist, and Head Clinician at Barbados Fertility Centre for a more detailed explanation of infertility treatments available for couples who are trying to conceive.

Dr. Skinner: There are many reasons why a couple may not be able to conceive, this could be female factor or malefactor, a combination of both, or there may be no obvious medical reason at all, this is called unexplained infertility. Whatever the reason for infertility, if a couple has tried for 12 months with no successful outcome then they must seek medical intervention. Depending on the diagnosis then it may be necessary to try IUI (Intra-Uterine Insemination) or a full IVF (In Vitro Fertilization) cycle. Each couple we treat is individual and no two couples are the same. We take a detailed medical history from both the male and female partners and ask for tests to determine the cause of their infertility.

Dr.S.: Male infertility is very common and affects about one in twenty men. We would analyze the male partner’s semen for its motility, which shows how well the sperm can swim. We would analyze the morphology, this is the shape of the sperm. Female infertility is far more complex and there are certain diseases such as Poly Cystic Ovarian Syndrome, Endometriosis, and Fibroids, which will all, affect a woman’s ability to conceive. Age plays a huge part in female infertility, as unlike men women are born with all of their eggs and after 35 there is a marked decrease in ovulation. We also specialize in reproductive immunology and advanced fertility treatments such as hysteroscopy and laparoscopy. We take in to account all the many factors and determine the best course of action for each individual patient.

Dr. S.: IUI is the introduction of prepared sperm into the uterus in order to improve the chances of pregnancy. IUI can be used when the female partner has open fallopian tubes and the male partner has normal semen parameters. IVF refers to the procedure where the embryo is fertilized outside of the body, so the female eggs are retrieved and are placed in a glass with the male partners prepared sperm. When these fertilize and become embryos these are then transferred back to the uterus.

Dr. S.: A couple can only try IUI if the female has open fallopian tubes, and this procedure starts at 375USD for the procedure. A full IVF cycle is 5750USD. But as we treat each couple based on their individual medical history, costs can vary depending on the medication that they need to prepare for treatment. We work hard to keep our costs down and have not increased our prices since 2007. This makes us a very attractive option for couples in Europe and the US, as our costs can be as much as half the cost.

Dr.S.: We would prepare the sperm so that we use the male partners’ best quality of sperm, we can also take sperm directly from the testis if necessary to find sperm that is strong enough to fertilize the egg. And if necessary we can also use donor sperm.

Dr.S.: Clomid is used to stimulate the ovaries and in turn release eggs from the ovaries.

Dr.S.: Clomid increases the number of eggs that we retrieve and in turn means we can end up with more than one good grade of the embryo that has a good chance of survival. The decision of how many embryos we transfer back to the uterus is taken in consultation with the couple and very much depends on their medical history.

Dr.S.: We offer our patients individualized care, we do everything we can to increase every couple’s chance of success, even if that is only 1%, that 1% could mean a baby! We combine cutting edge treatment with holistic therapy at our on-site spa, The Life Wellness Centre, meaning our patients are at their optimum of relaxation to undergo treatment. We have a very high success rate of 80% on women under 35% and offer very low-cost treatment compared to our international competitors. Finally, we are JCI accredited, assuring our patients of the best practices upheld at BFC. We are listed in the elite group of clinics that hold JCI accreditation and of this, we are very proud.

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