b enchmark Media, LLC. March 2021 • Volume 27 No. 2
PRESIDENT/CEO Darwin Oordt doordt@benchmarkmediallc.com DIRECTOR OF OPERATIONS Christina Heintzelman cheintzelman@benchmarkmediallc.com EDITOR Deborah Lynch dlynch@harrisburgmagazine.com GRAPHIC DESIGNER Laura Reich lreich@benchmarkmediallc.com DIRECTOR OF SALES AND MARKETING Mike Jurosky mjurosky@harrisburgmagazine.com ACCOUNT EXECUTIVE Jo Ann Shover jshover@benchmarkmediallc.com
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If you want a perfect smile that's guaranteed for life, look no further than ISOIMPLANTS™. Why Implants? Implants are the safest and most effective treatment for missing or broken teeth, with a 96% thirty year survival rate. In the past, providers tried to do everything possible to try and save a compromised tooth. But, more times than not, this approach means weakening other teeth requiring additional treatments or procedures in later years. In today’s world, that is just not necessary. Technology has led us to better, stronger and safer solutions. With implants, we can keep a one tooth problem – a one tooth solution. What is an implant system? Every implant is comprised of three parts; the fixture, the abutment and the crown. The fixture and the abutment are the most critical. The fixture is the anchor that is embedded in the jawbone; the new root if you will. The abutment screws into the fixture and creates the base for the crown to be attached. The abutment holds the crown in place. The crown is the most visible part of an implant but endures the least amount of stress among the three components. The fixture and the abutment take on the most force and that is why it is so important that these components are made by the same manufacturers so the fit and stability can be assured and guaranteed for life.
Are there different types of implants? Yes - 90% of dental implants done today restore the tooth using parts that may not work well together and cause problems down the road. That is why the ISOIMPLANT™ quality assurance certification process is so valuable. ISOIMPLANT™ certified implants are guaranteed for life because the components are milled to the highest standards. This certification provides quality and assurance and puts the PATIENT FIRST. ISOIMPLANT™ dental implants are manufactured by two of the most respected and largest implant manufacturers in the world: Noble Biocare and Astra Tech. What happens if my provider uses knock-off components for my implant surgery? Unfortunately, there are many knock-off implants and components on the market today. These implants are less safe, less durable and can lead to significant issues including bone damage, fractures and
infections. The ISOIMPLANT™ quality assurance certification was created by professionals who had treated hundreds of patients whose implants were failing and needed to be replaced. No patient should have to endure the discomfort and the financial cost of a second surgery due to faulty parts. Is implant surgery more expensive than other options, such as bridge work or a root canal? No. In fact, over a patient’s life, implant surgery is much more cost effective. It is important to note that insurance plans and options vary, but the bottom line is that an ISOIMPLANT™ is the most cost-effective option available. A single ISOIMPLANT™ solution; implant, abutment, and crown that is guaranteed for life, can cost about $3,000 while a bridge can cost anywhere from $2,400 to $3,000 and a root canal with crown build up and crown on a single tooth can cost as much as $2,700. Crowns and bridges will also require additional treatments in future years and additional costs. A bridge, for instance, typically lasts on average 7.2 years. How can I determine if my provider is ISOIMPLANT™ approved? Check www.ISOIMPLANTS.com to see who is ISOIMPLANT™ approved in your area. Make sure they guarantee that they use an ISOIMPLANT™ certified lab – where your implant will be designed – as well as an ISOIMPLANT™ implant manufacturer. This way you will be guaranteeing your investment in your oral health. About ISOIMPLANTS™? Dr. Robert Myers pioneered the ISOIMPLANT™ in early 2018 from his practice, Wood & Myers OMS, in Central Pennsylvania. The ISOIMPLANT™ trumps other dental implants that are less durable and that create underlying issues such as bone damage, fractures and infections. ISOIMPLANT™ certification guarantees the dental implant and restoration for life, because all our partners, including the manufacturers, your dentist and other providers and the dental labs have earned the ISOIMPLANT™ approval. With ISOIMPLANT™ dental implants, all the parts are guaranteed to work together for flawless, durable performance. When you use ISO-certified implants, everybody becomes part of the warranty equation – patient, surgical specialist, and dental lab Quite simply, ISOIMPLANTS™ provide the best quality and value in dental implants today. When problems arise, secure your smile by insisting on an ISOIMPLANT™ and an ISOIMPLANT™ certified professional. WWW.ISOIMPLANTS.COM.
BABY BOOM: Fertility specialists’ high success rates offer patients hope in becoming parents By Deborah Lynch
dlynch@harrisburgmagazine.com
F
orty-two years ago, the world was transfixed by science. The birth of the world’s first “test-tube baby” in England seemed like something out of an H.G. Wells novel or an old sci-fi movie. On July 25, 1978, Louise Brown gained worldwide fame as the first child born who was conceived by in vitro fertilization (IVF). People were astounded that a baby could be produced outside the human body. What next, they wondered? Four years later, her parents used in vitro fertilization treatments to conceive her sister Natalie, then the world’s 40th IVF baby. When Louise turned 40 in 2018, more than 8 million babies had been conceived through IVF treatments. Dr. Matthew Connell, a fertility specialist at Shady Grove Fertility (SGF) in Mechanicsburg, met Louise Brown at a medical conference, where she recounted her experiences from the book she wrote on the occasion of her 40th birthday. Today, Dr. Connell is helping men and women locally to achieve parenthood through a variety of assisted reproductive technology treatments and protocols. With infertility rates as high as one in eight couples, his clinical expertise and success rates are in high demand. For every couple that walks in through the door for a fertility evaluation, Dr. Connell said that infertility can be attributed to a male factor 40 percent of the time, a female factor 40 percent of the time, and to either both or unexplained 20 percent of the time. Since Dr. Connell joined SGF in late 2019, he estimates that he has helped achieve 30 to 40 pregnancies among couples, and single men and women. “I kind of feel like every time someone gets pregnant and we get to graduate them, that’s a victory,” he said. “So, it is very special every time.” Since SGF first opened its doors in 1991 with its flagship Rockville, MD, office — which is located on Shady Grove Road — more than 85,000 babies have been born, averaging 12 babies every day. The milestone has been made possible with SGF’s expanding offices, including 37 practices along the East Coast, of which 18 offer full-service fertility care. Pennsylvania residents do not have to search far for care with SGF’s five locations across the state. Dr. Connell currently sees patients 6 HARRISBURG MAGAZINE MARCH 2021
Connor Weigand and Clairen Percival knew from day one that having children would be a long fertility journey — after four years, they are due to have their first child in June. Photo by Mary Elizabeth Carson for Clairen Percival
at SGF’s Lancaster and Mechanicsburg (fullservice) locations. In Mechanicsburg, providers see patients from around the state including patients from State College and Pittsburgh.
“... every time someone gets pregnant and we get to graduate them, that’s a victory.” – Dr. Matthew Connell, Shady Grove Fertility physician A State College area couple, Clairen Percival and Connor Weigand, both in their 30s, knew from the onset that if they wanted children, they would either need to adopt or seek the help of a fertility clinic. In 2009, Percival was 22 and attending graduate school at the University of British Columbia when she got a bad case of strep throat that would not go away despite being on antibiotics. Finally, she went to the hospital where a bone marrow biopsy revealed she had Acute Lymphoblastic Leukemia. After a long road to recovery
that included chemotherapy and cranial radiation, it was discovered that she also had a chromosome abnormality, which put her at high risk of relapse. The best treatment was a stem cell transplant, so when her brother Ryland matched, she got his stem cells in March 2010. Percival’s infertility was a result of the chemotherapy. “My fertility was not something that was discussed at the onset of my treatment… possibly out of necessity to begin treatment immediately,” she noted. “After the induction phase of chemotherapy, I did seek treatment from a fertility clinic in Toronto, but at that point, it was too late.” Percival and Weigand first started their fertility journey four years ago. After consulting multiple health-care providers, Shady Grove emerged as a good fit for the couple, who decided to seek an egg donor. SGF’s Donor Egg Program is the largest in the nation and is one of only a few centers that recruits, selects, and medically, psychologically, and genetically prescreens its own ready-to-cycle egg donors prior to making them available on their donor egg registry.
As part of SGF’s Donor Egg Program, patients have the choice to elect a shared egg donor, which is the method Percival and Weigand chose. This helps to make the treatment more affordable by offering patients the opportunity to split a cycle of eggs from a single donor between two to three anonymous recipients. “Choosing an egg donor was a strange process for us,” Percival said. “Shady Grove had a wonderful database of candidates, but for us, it felt kind of like we were on a dating app… Shady Grove also does a genetic screening to look for possible high-risk pairings. It took us some time to figure out what we were looking at for a donor, but we are happy with the decision we made and are excited for the future.” Percival and Weigand conceived and their baby is due in June. Years earlier, a Harrisburg-area couple turned to Shady Grove for treatments after going through six IVF treatments at a Baltimore clinic that never offered them other options. This woman had started fertility treatments when she was 33, but wasn’t able to conceive until she found SGF, which agreed that her eggs were the root of her infertility, and that a donor egg was the solution. At 39, she finally conceived. All egg and sperm donors are de-identified. This means that while prospective parents can see a few photos and review family medical history and background such as educational history about donors, they don’t get birth dates and other specific identifying details. Today, however, total anonymity no longer exists with the advent of Ancestry.com, 23andMe, and other genetic testing labs that have made it possible for donor-conceived people to find both their donors and possible half-siblings. A Donor Sibling Registry also can connect people by donor number. “We picked a donor who looked like me when I was 5,” the Harrisburg-area mother said of getting to see photos of potential egg donors from when they were 5 years old. She conceived on the first try, she said, but unfortunately, miscarried at five weeks. They had frozen eggs from the first donation to try again. This time she conceived and bore her son, and later a daughter through the same donor batch. Even though she lost the first baby, the experience at Shady Grove gave her hope. It was the first time she’d ever been able to get pregnant. “I had no problems going back. When we switched [from Baltimore to SGF], it was a much better outcome and more positive… . Shady Grove was more open to different treatments. They knew what we had gone through,” she said. “Having a single miscarriage is rather common,” said Dr. Connell, who researched recurrent pregnancy loss during his fellowship in Endocrinology and Infertility at the National Institutes for Health. “... up to 20 percent of patients have multiple pregnancy loss. “The number of tries are different for everybody,” Dr. Connell said of the treatment
process. “Almost everyone can be successful, but sometimes that road to success is going to be different than what we intended it to be.” The cost of fertility Cost is still the biggest barrier to fertility treatments. That’s why Percival and Weigand’s fertility journey took four years — first they had to save for it. The average cost of a single IVF cycle is $10,500 plus cost of medications, and many must pay that fully out of pocket. While insurances might cover the full cost in some states, Pennsylvania is not a mandated state, which means that some people, depending on their employers, might get full coverage, but many others won’t. This is why
SGF acknowledges that the fertility journey is expensive and takes the philosophy that it is important to offer patients some type of financial program. Those programs include its Shared Risk 100% Refund Program, which is offered to qualified self-pay patients without insurance coverage. Women must be 40 upon completion of the IVF cycles to participate in the refund program although women 41 and older can participate if using donor eggs. The program includes up to six fresh IVF or donor egg cycles (and unlimited frozen embryo transfer cycles from those fresh cycles) — patients take home a baby or receive a refund. The SGF website claims that 82 percent of participants
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What causes infertility and how can it be treated? By Deborah Lynch
dlynch@harrisburgmagazine.com
A variety of factors can affect fertility. Causes of infertility include hormonal and thyroid issues (including among men, causing sperm issues), polycystic ovary syndrome (PCOS), and endometriosis. PCOS causes higher-than-normal amounts of male hormones in a woman, which in turn causes missed menstrual periods. It means a woman doesn’t release an egg in a predictable fashion. It can be treated with a pill to release an egg. Endometriosis can affect the tubes and ovaries or uterus, and can require surgery or hormonal management to fix. An infertility diagnosis is likely for a couple when a woman is 35 or younger and having regular unprotected intercourse for a year without achieving a pregnancy. If a woman is 35-39, that time frame drops to six months without success, and for women over 40, a consultation is recommended immediately. If infertility also includes other problems, such as a woman who is not menstruating or those who suffered two or more miscarriages, for example, doctors recommend seeking a fertility evaluation sooner. Although treatment success is less likely for a woman over 40 using her own eggs, some treatment options still exist. Women produce all of their eggs before they are even born, and over time, their reserve decreases in quantity along with the quality of the eggs. Similarly, although men continue to produce sperm, the quality also drops with age. Shady Grove Fertility will not use donor eggs for patients over 50. SGF offers a variety of treatments. The basic treatments include timed intercourse, ovulation induction, and intrauterine insemination (IUI). Advanced treatments include in vitro fertilization and donor egg treatment, and egg freezing (fertility preservation). Other services include andrology services for male fertility issues, financial counseling, LGBTQ+ family building, and more. Part of a fertility consultation includes discussion of family medical history and patient history for high blood pressure, diabetes, and weight concerns. These must all be under control before treatments can begin, and SGF's Dr. Matthew Connell says they often work together with other specialists to help patients achieve this. A fertility evaluation starts with a detailed history of the patient(s) looking for any potential causes of infertility. Doctors look at egg issues, uterus or tube issues, and sperm. “About 30 percent of the time, a couple will fall into unexplained,” Dr. Connell said, which means “we’ve done all the testing and haven’t found any abnormalities. With unexplained infertility, we talk about different treatments.” Connell explains that SGF always uses a stair-step approach to treatment. That means they try more low-tech or basic treatments before progressing to higher tech or advanced treatments. The basic treatments of ovulation induction (trying to help a woman release two or three eggs a month rather than the usual one), intrauterine insemination (placing sperm into the uterus), and timed intercourse work 50 percent of the time, Dr. Connell said. “If that’s not successful -- we step up to the next treatment, which would be IVF. From there, we would look at a donor egg or donor sperm,” he said. IVF involves giving female patients medications to help them produce eggs. Then, an egg retrieval is done and the eggs are fertilized in the lab with sperm to make embryos, which are then placed back in the uterus (think Louise Brown). 7
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using their own eggs take home a baby, and 85 percent of patients using a donor egg take home a baby. The rest receive a refund. SGF also offers discount programs (such as a military discount), egg-freezing programs, medication discounts, financing, grants, and clinical trial programs. “At other clinics, it’s pay as you go, so you keep paying more. Once in our guaranteed program, you are in and it helps people who otherwise might not be able to do treatment,” Dr. Connell said, noting that the Mechanicsburg office sees a diverse clientele with people originally from all over the world coming to them for help. A popular media story about fertility procedures features those of multiple births from IVF like with Central Pennsylvania’s former reality star Kate Gosselin (Jon & Kate Plus 8 and Kate Plus 8) and the Octomom, Nadya Suleman, who gave birth to octuplets in January 2009. Those are rare cases, and another thing that sets SGF apart – along with being the nation’s largest fertility practice network – is its low rate of multiple births. “We’re very proud of our twin rate with IVF – it is in the single digits percentage-wise,” Dr. Connell said. “We pride ourselves on very high pregnancy rates, and very low twin and triplet rates.” That’s because SGF generally uses a single embryo transfer. SGF has been given a distinction as a Center of Excellence not only for high success rates, but also for low multiple birth rates. SGF also offers counseling and psychological services and makes a psychological consult a requirement for all third-party services, meaning the use of donor egg, sperm, embryo, or gestational surrogacy. Percival and Weigand feel they could use more guidance, but wonder if Covid affected that for them since their process was ramping up just as Covid hit. All of that comes back to initial consultations and a philosophy of patient autonomy. “My approach to patients is very collaborative, meaning that I’m really here to figure out what’s going on. I really just want to give them the information to help guide them with their choices,” Dr. Connell said. “I like to give them options and pick how we best move forward. I really like to work together to find what best suits patients.”
“Once in our guaranteed program, you are in and it helps people who otherwise might not be able to do treatment.” – Dr. Matthew Connell, Shady Grove Fertility physician SGF is also the preferred fertility provider for UPMC Pinnacle. Other fertility clinics in central Pennsylvania include Penn Fertility at Lancaster General Health in Lancaster, The Fertility Center of Lancaster and York, Geisinger in State College, and Penn State Health. 7
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How does your garden grow?
Master Gardeners plant seeds of knowledge for novices and pros alike By Christina Heintzelman
cheintzelman@benchmarkmediallc.com
S
pring is in the air, buds are beginning to pop, and crocuses and snowdrops are peeking their tiny heads out of the dark earth eager to pay homage to the returning warmth of the sun. Here in Pennsylvania, gardeners are also beginning to plan their gardens of flowers, herbs, fruits, and vegetables with an eye toward a new year of outdoor gardening activity, which is great for the wallet, health, and happiness. Whether someone is brand new to gardening or has several cultivating years under the belt, Dauphin County Master Gardeners Program can help with gardening plans. This program is part of the Outreach Program of the U.S. Department of Agriculture, which funds State Departments of Agriculture throughout the country. The Pennsylvania State Department of Agriculture then funds the Pennsylvania Land Grant University, which is Penn State University. Catherine Scott, Extension Educator/Horticulture Master Gardener Coordinator, is the head of the program for Dauphin County through the Penn State Extension Program. “This is a way for home gardeners to get expert advice,” she said, adding she’s had questions ranging from “why are there weevils in my bathroom?” to “why are my spruce trees dying?” to “why are there no goldfinches in my backyard? I guess you could say we handle everything from bathtubs to birds.” 10 HARRISBURG MAGAZINE MARCH 2021
This crew of experienced master gardeners is equipped to make recommendations for garden design, provide conifer identification to home gardeners, and assist with seasonal garden tips. They also can aid community gardens and other community gardening projects. In addition to their in-person assistance, they offer a garden question hotline, and an email
Office Gardens Photo by Shawna Raymond
site to assist with plants and insect samples for identification and diagnosis. The Dauphin County Master Gardeners Program is peripherally involved with many local projects. One is The Five Senses Gardens, located on the Capital Area Green Belt in Harrisburg, designed to enhance all of the senses. A personal connection to nature and a sense of tranquility is fostered by visiting this garden with its many different types of flowers, trees, sculptures, and butterflies. Visitors can sit on one of the many benches and take in nature while relaxing. Master Gardeners have been maintaining the garden with the help of many volunteers from surrounding communities. During this time of social distancing, working in this beautiful garden has been both safe and therapeutic for the volunteers. In addition, the Master Gardener Program has aided The Harrisburg Cemetery, the oldest and largest in the city and the final resting place of noted individuals of national, state, and local importance, such as war dead from all American wars including the Revolutionary War and Civil War. The Master Gardeners joined with Mayor Eric Papenfuse and volunteers from the board and staff of Harrisburg Cemetery to plant tree seedlings to begin the creation of a beautiful arboretum during the 2015 Earth Day celebration. The plans for this started more than five years earlier while the gardeners were volunteering with a clean-up of the cemetery and noticed that many of the trees and various plants were not healthy. They began thinking about new plantings emphasizing native species. Now the cemetery is a beautiful historic place with an astonishing variety of plantings and the feel of a lovely suburban park. The Master Gardener Program has also assisted with the Hershey Community Garden on the campus of Penn State Health Milton S. Hershey Medical Center, which offers a venue for community networking on 234 plots, 220 for community residents to garden, and 14 to raise produce to donate to organizations that distribute it to those in need. In 2020, more than 3,000 pounds of produce were donated to local groups like Hershey Food Bank, Palmyra Food Bank, Middletown Food Bank, and CocoaPacks, benefiting more than 1,000 families. The garden was completed in 2014 with 123 plots, but expanded in 2018. Generally, about 50 community members are on a waitlist for plots. Gardeners do not have to live in Derry Township to be eligible for a plot. Other features of the Hershey garden are sections allocated for children with hands-
Hunger Garden midseason Photo by Shawna Raymond
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Five Senses Garden bike trail
"... the garden serves as a tangible reminder to those who walk by it to do business in the Capitol that some of our neighbors experience food insecurity every day.” — Sen. Elder Vogel who leads Hunger Garden project
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on educational programs and several raised garden plots that are designed for those who cannot bend to ground level. Hershey Community Garden is also taking part in a study sponsored by Penn State Health with collaboration from Dauphin County and two adjoining counties, Lebanon and Lancaster. The study is being conducted by dietitian Susan Veldheer, DEd, RD, who is an assistant professor for Family and Community Medicine and Public Health Sciences, Penn State College of Medicine. The goal of the study is to introduce new gardeners to starting and tending a garden throughout the season while realizing another goal by introducing them to the link between healthy eating and gardening, which can result in improved health. “Gardening is the fourth most common physical activity in the country, so the idea is to go with that momentum and link it to a great way to access fresh and healthy fruits and vegetables while improving one's physical and mental health, and helping the environment,” Veldheer said. She also noted that gardening has increased in popularity during COVID. The study will be done online because of potential health uncertainties this spring due to COVID. There will be links to videos and online materials timed to what should be happening in the garden in real time. Also, Zoom meetings will be held with a Master Gardener presenting information on a gardening topic. Participants will have homework to do in their garden and will be able to present their questions or concerns to the Master Gardener at the end of the Zoom presentations. In addition to the Hershey Garden project, the Dauphin County Master Gardener Program has aided the Capitol Hunger Garden in Harrisburg. This 1,000-square-foot garden first broke ground in an area between the Main Capitol Building and the Ryan Office Building in 2008 with the goals of creating a garden that would provide healthy food for those in need and serving as a valuable tool to raise awareness of hunger issues in Pennsylvania. Since its inception, the garden annually yields nearly 800 pounds of produce for local food banks, pantries, and soup kitchens. It is maintained by volunteer master gardeners — and sometimes lawmakers. “Since 2008 the Legislative Hunger Garden has served as an ever-present reminder of the struggle many face each day just to put fresh food on the table,” Senate President Pro Tempore, Jake Corman (R-34) said. “In the midst of a global pandemic that caused all-time highs in unemployment, it is even more
important to highlight the importance of working together to ensure that not one Pennsylvania resident goes without food. I am pleased Senator Vogel [Senate Deputy President Pro Tempore Elder Vogel (R-47)] has agreed to spearhead this effort for us this year.” A fourth-generation dairy farmer, Vogel agreed that “[i]t is important that we carry on the mission of the Hunger Garden because of the fresh, nutritious foods it provides to Pennsylvanians. At the same time, the garden serves as a tangible reminder to those who walk by it to do business in the Capitol that some of our neighbors experience food insecurity every day.” For those who already are comfortable with their gardening skills, studying to become a Master Gardener volunteer is an option. Scott recommends it as a pastime for people who love dealing with new people and enjoy learning new things. “And while we are learning, we realize just how much more we have to learn,” she said. The Penn State Extension Master Gardener basic training program is open to individuals interested in becoming volunteers and sharing gardening knowledge with the public through community outreach. The horticultural training is taught by Penn State Extension educators and university professors. Master Gardener trainees are required to participate in a minimum of 40 hours of classroom training, score 80 percent on the final exam, and fulfill 50 hours of volunteer service. The training class schedules are varied based on location within the state and include the following topics: botany, plant propagation, soil health and fertilizer management, composting, controlling pests safely, entomology, plant diseases, indoor plants, vegetables, lawn care, pruning, woody ornamentals, herbaceous plants, native plants, weeds, and invasive plants. Those interested in studying to become a Master Gardener can contact the county Extension office in their area for an updated schedule of classes and program cost. Financial aid may be available through the local Extension office. Basic training for Master Gardeners is not offered annually in every county. You can also visit the website: https://extension.psu.edu/programs/mastergardener/join. For assistance or questions regarding a home garden, or assistance wwith a community project, call the extension helpline at 717-921-8803, or send an email to dauphinmg@psu.edu. 7
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