David R. Meldrum, MD

“The measure of intelligence is the ability to change.” - Albert Einstein. If you’re not changing, you’re not growing.

IVF has been one of the most rapidly developing disciplines in medicine. Over the 34 years that I directed the University of California Comprehensive Course on In vitro Fertilization and Embryo Transfer our primary focus during three full days of lectures was to impart every clinical detail from beginning to end. However, certain “Mega-trends” gradually impacted the interest in and need for that focus. The most prominent has been the consolidation of IVF into large groups, spurred on by venture capital investments and the interest of older originators of small IVF practices to recoup their substantial investments needed to develop those smaller practices. Consequently those coming out of training have been content with simply following group protocols and saving any free time for their families (which I can hardly fault having missed so much time with our family while developing my practice). Further mega-trends have been the decision by organizations to not give out email lists to protect their members’ privacy, and improved blocking of potentially unwanted emails by servers. As time passed from those changes more and more of the younger trainees who would be more interested in attending such a course were no longer getting notices of courses such as ours. Yes, we could have struggled to regroup and tried to change course content, but 34 years was a very good run and there is a lot to be said for accepting change and stopping the course at its peak, rather than trying to make it into something entirely new. Having now finally retired, this website is also changing its focus. Claudia and I realized that we have had a unique number and variety of experiences and adventures and together with my passion for photography we have written an eBook entitled:

“Lessons From a Lifetime of Adventures” - 1 ½ pilots, 2 divers, and a healthy gourmet cook.

This autobiography will appeal most to pilots and wannabe pilots, but virtually everyone is fascinated with flight and many who fly are also intrigued with diving because of its many parallels with flight. With both one enters a fascinating realm.  This is also an intimate story of two people from very different backgrounds, one from a small town in Canada and one from a small harbor town in Southern California, who somehow found each other, fell in love, and pursued a lifetime of adventure, flying, diving and travel. They discuss their adventures visiting over 60 countries and living in Madrid for 6 months and Melbourne for 3 months. Dave being a physician and Claudia becoming a master of healthy cooking, they both developed an interest in healthy lifestyle, adding further lessons, guidance and Claudia’s favorite recipes to the book. In part due to Claudia’s lack of ovulation, Dave decided to become a gynecologist and entered the field of In Vitro Fertilization almost at its inception. He then combined that passion with travel to learn as much as possible but also to teach nascent programs around the world, including helping to achieve the first IVF birth in China. Their personal experience with infertility led to the Meldrum quadruplets, who got to share some of their parents’ travel, including a safari in Kenya. Most autobiographies are rendered on paper, usually with old photographs in the center of the book, but with eBooks and Dave’s passion for photography, having almost 300 photos throughout brings it to life in a way not possible with a standard book. Even our cover got a lot of piz zazz from a selection of our book photos. We have enjoyed reading books on our Iphones, and our book presents itself and reads very well on smarphones.

We hope you will enjoy our book, now on Amazon and other ebook sites, and that you can benefit from some or all its lessons, perspectives and information to enrich your lives. We know that even just writing it has strengthened our relationship and has increased our ability to get the most out of life. Enjoy! David and Claudia Meldrum

For questions regarding prior courses, contact:

Amy Hart; a1hart@health.ucsd.edu 

*click (ONCE) to enlarge personal images

Most people feel more comfortable with their physicians if they know a lot about them. Certainly you want to know their education and qualifications, but you may also like to know their personal interests, or research, or their most cherished accomplishments during their career. At the very least it gives you something to talk about, particularly if the person is on the quiet side, like yours truly. Above all, don't equate being quiet with lack of interest. One thing you can be sure of is that I will always be thinking of how to provide you with the best chance of success with the least expense (part of my Scottish background) and risk.

Education and training
I'm originally Canadian, brought up in the prairies in Regina, Saskatchewan. I was fortunate to earn a scholarship to do a combined science and medicine course at McGill University, where I received a bachelor of science with great distinction and graduated first in my class for my MD. Incidentally that wasn't something I was really trying to do. I just love the process of learning and I did something quite unusual in never taking any notes. I figured that anything that was really important I would hear at least a half dozen times and if my mind set was learning it instead of writing it down to learn it later, it would be mine. Needless to say my classmates thought I was nuts, but it worked well, and "the proof is in the pudding".

When I finished my medical training there was a lot of political unrest in French Canada where McGill is located. I had developed a travel bug by doing externships in Jamaica and Florida, so I set off for an internship in Los Angeles at Harbor-UCLA, which was reputed to be one of the top in the U.S. There I met and married Claudia, who is a native Californian. I had enjoyed doing obstetrics so I then applied to UCLA and completed my OB/GYN residency there in Westwood.

My interest in infertility arose very much out of our difficulty conceiving. When I finished my residency a vacancy on the faculty in infertility opened up and I became the principal person doing infertility surgery at UCLA for the next dozen years. Claudia didn't ovulate with clomid and fertility specialists were just beginning to use gonadotropins. However, we did not have ultrasound or estrogen levels for monitoring. After 5 failed cycles of Pergonal (like menopur today) we took a relaxing 6 months doing research in Madrid and the first cycle on our return resulted in the Meldrum quadruplets (see “quads”)! I've always thought the lack of stress made a difference, but she did also gain a little weight.

I was fortunate to be able to take a fellowship in reproductive endocrinology and infertility while I was a faculty member (I was already doing essentially only infertility clinically and for my research). I then received my subspecialty board accreditation shortly thereafter.

My interest in IVF arose directly out of my involvement in tubal surgery (there had to be a better way than trying to repair badly damaged fallopian tubes), but it was also spurred by a patient whose ovaries had failed to develop. I remember that we had to remove her ovaries because of their risk for tumors. It was a couple of years before the first IVF success in 1978 in Great Britain (Louise Brown) but I was aware of the work being done. I did not remove my patient's uterus and recall being roundly criticized by my fellow faculty members when we presented the case at grand rounds. When I told them that some day she would have children from donated eggs they looked at me like I was from another planet. She subsequently had two successful pregnancies and I saw her for many years for hormone replacement.

Research interests

Although my initial research interest while on full time faculty at UCLA was related mainly to menopause, I was intrigued by a new class of drugs called GnRH agonists. Together with the Salk Institute (above) I was first to publish the use of an agonist in women with endometriosis. That work of course developed into the use of Lupron as a new treatment for endometriosis, but it also led to my interest in using GnRH agonists as adjuncts for ovulation induction. I was subsequently one of the first to investigate the use of Lupron for IVF and was the first to suggest its routine use (the benefits for synchronized growth of the follicles and for preventing ovulation before the eggs could be retrieved were very large). Even so, it took a few years until virtually all IVF programs were using an agonist initially for all patients. Throughout my career I have maintained ovulation induction as one of my main research interests (see publications).

More recently I have developed an interest in the effects of lifestyle and nutrition on IVF results, which is becoming an area of major interest (see "Lifestyle and fertility" and www.lifechoicesandfertility.com). Studies have also shown that sexual dysfunction is common in infertility patients, and I have recently published on erectile function and its relationship to vascular health in general. Together with Lou Ignarro, PhD, who is a UCLA researcher who shared the 1998 Nobel Prize for discovering the role of nitric oxide in erectile and vascular health, and researchers in Naples, Italy who have also done excellent work in this area, I have published 4 major reviews on this topic. Infertile couples experiencing sexual dysfunction will find our book, "Survival Of The Firmest" very helpful. It is available on Amazon/kindle or itunes.

Accomplishments
I have always enjoyed the development of knowledge, which of course stems from individual, well-designed studies. I've served as an ad-hoc reviewer for several journals and as an editorial board member for Fertility and Sterility for 22 years. For seven years I was an editorial editor, which allowed me to be involved in writing and editing review articles. Most people don't realize how important review articles are. There is always a long delay between publication of definitive research and when new treatments are widely adopted in practice. For example, at the Mayo Clinic a study was done showing that a short course of antibiotics was equally effective for bladder infections compared with 10 days of treatment, but it took about 10 years until they uniformly applied their own research in care of their patients. That finally resulted from review articles that gave practitioners "permission" to change their care. Another example in our field is the use of growth hormone for poor responders. The research is quite definitive and the benefit appears to be large, yet less than half of IVF practitioners use it. It is hoped that articles such as one I did with colleagues around the world discussing "orphan adjuncts" and a review article which I co-authored with colleagues in Europe on the value of growth hormone supplements in ART will encourage others to adopt this highly effective treatment.

I was fortunate to serve as the first commissioner for reproductive lab accreditation, which is now a highly effective program helping to standardize IVF lab quality across the U.S. I also have served as president of the Society for Assisted Reproductive Technology and the Pacific Coast Reproductive Society.

 

Perhaps the professional accomplishment I am most proud of is my 34 years organizing and directing the UC comprehensive postgraduate course on IVF, which took place each July, initially in Santa Barbara and then on Coronado Island in San Diego. It is widely recognized as the top postgraduate course in IVF, and because it was so well attended, I was able to invite a large number of highly respected speakers from around the world. I remember several years ago it was even attended by people who had originally been involved in my training in Australia before setting up the UCLA IVF program (see "Australia to UCLA").

I would also have to list being involved in achieving the first IVF success in China, following an extended visit by a team in Beijing while I was at UCLA (see "China").

One of my proudest accomplishments is the people I have trained. At the top of that list are Dr. Gabe Garzo, who runs our La Jolla facility, and Dr. William Schoolcraft, who runs the Colorado Center for Reproductive Medicine. Those two programs have some of the best results in the nation. I could list numerous others, but Gabe and Bill have become truly stellar IVF clinicians and Bill has published numerous excellent IVF papers.

Not everyone is fortunate enough to be widely recognized for his/her achievements. At the 2019 ASRM meeting I was presented with their "lifetime achievement Award", only the second year it had been given. I am greatful to one of my UCLA fellows and very good friends, Joe Gambone, for proposing me for it and for his wonderful letter sumarizing my contributions to the specialty. We took our grown children and grandchildren to the presentation and to a Gala dinner the night before to support research in IVF. The grandkids had never dressed up like that before and were really cute in their suits and dress. I will forever cherrish those days and the award.

Of course like any father my greatest accomplishment has been helping Claudia to raise our four kids, who are each successful in their chosen fields and who all have big hearts. My passion for flying (see "Angel Flight") allowed us to see Erik and Tiffany in northern California and we enjoy getting together each year for their birthday (now also with 3 grand kids and 2 grand dogs)!