UAMS fertility clinic in LR folding up shop
Posted on Friday, July 4, 2008
The University of Arkansas for Medical Sciences Fertility Center stopped accepting new patients in April and is closing its in vitro fertilization clinic in Little Rock.
The move to shut down the center comes after 12 months of discussions with doctors at the private Arkansas Fertility & Gynecology Associates at 9101 Kanis Road, said Dr. Curtis Lowery, director of maternal-fetal medicine at UAMS.
While other doctors in the state do some fertility procedures, the west Little Rock private clinic is now the only facility in the state that offers in vitro fertilization, a procedure in which doctors combine an egg and a sperm in a laboratory and plant the resulting embryo or embryos in a woman’s uterus.
UAMS officials decided to close the university clinic after four years of losing patients to the private facility. Dr. Dean Moutos and Dr. Michael Miller left UAMS to start Arkansas Fertility & Gynecology in May 2004 with Dr. Francisco Batres. They took many of their patients with them.
“Little Rock’s just not big enough for two [in vitro fertilization ] programs to be financially sound,” said Moutos, medical director of the private clinic. “We decided it really wasn’t in either of our best interest to have two competing programs.” About 7. 3 million, or 12 percent, of women in the United States ages 15-44 had difficulty getting pregnant or carrying a baby to term in 2002, according to the latest figures from the National Center for Health Statistics.
It’s not the first time a university-based fertility clinic has closed in favor of a private practice.
The University of Washington closed its Seattle clinic after four of its doctors left to go into private practice in 2004. The University of Wisconsin-Madison threatened to close its fertility clinic in June 2006 but decided to keep it open and compete with two other clinics in the city after an outcry from patients and politicians.
“There are plenty of examples where this has happened in other parts of the country,” Moutos said. “What somebody has to realize is that it’s expensive to maintain an IVF program. It’s labor intensive, it’s high capital investment. Your overhead is very high. If you’re not doing enough patients or enough cycles a year, financially you’re just not going to make it.” Ken Mosesian, acting executive director of the American Fertility Association, said he’s not aware of a “trend” of educational institutions closing fertility clinics because of competition from private-practice clinics.
“How well a particular clinic does is in large part due to the success rates of the physicians and how well they are respected and sought after in the community,” Mosesian said.
Lowery said the UAMS center had an annual operating budget of about $ 1. 3 million and had been losing money since 2004. The average number of patients seeking in vitro fertilization treatments has dropped at UAMS from about 200 to 40 annually over the past four years.
“The market’s not very big here,” Lowery said. “Based on population, there are only a certain number of people who need fertility services.... It’s just not cost effective in this market to have more than one program.” Moutos said his clinic has about 200 patients seeking treatment a year.
“We can easily absorb those patients from UAMS,” he said.
Opened in 1988, the UAMS clinic was the first and only facility offering in vitro fertilization in Arkansas for several years. Now all that remains of the clinic are the frozen embryos and sperm still in storage. All of the staff has either left or moved into other positions at UAMS.
The embryos and sperm will be transferred to Arkansas Fertility & Gynecology within the next few weeks.
For the past six months, the staff at both clinics has been calling and mailing letters to notify patients of the change, Moutos said.
“The embryos are not in any danger,” Moutos said. “We’ve been working on this for six months in anticipation of this. We will be taking over the storage and the maintenance of those embryos for the patients that want them.” In a relationship formalized Tuesday, UAMS is also partnering with Moutos, Miller and Batres to provide training for medical-school residents in reproductive endocrinology and fertility. UAMS residents spend three months training at the private clinic, assisting with surgeries and other procedures, Moutos said.
“We are affiliating with them, and they’re training the residents,” said Leslie Taylor, UAMS spokesman. “We have a great relationship with them, and it just makes sense to work with them.” Since he’s been practicing in Arkansas, Moutos said demand for in vitro fertilization has grown. Many women are waiting later in life to have children and encounter more fertility problems and seek treatment as a result, he said. Insurance coverage for infertility diagnoses and some treatment has also improved, although most insurers still do not cover in vitro fertilization, Moutos said. “There’s also more we can offer — problems that 15 years ago we had no hope for, we can now offer treatment,” Moutos said. Moutos said he and Miller had been at UAMS for more than a decade each and were ready for a change. “We were just ready to try something different,” Moutos said.
The doctors had built up a large enough patient and referral base to go into private practice, Moutos said. “It’s sad that we had to shut down, but I think in the end you had to do what’s the right thing for the community,” Lowery said.
FEEDBACK:
Something to say about this topic? Submit a Letter to the Editor online
