Robert D. Nachtigall, M.D.

Robert Nachtigall

Email: Robert.Nachtigall@ucsf.edu
Telephone: (415) 476-3786

Dr.
Nachtigall is Adjunct Professor at the Institute for Health & Aging,
Clinical Professor of Obstetrics, Gynecology and Reproductive Sciences
at UCSF, and Director of Reproductive Endocrinology and Infertility at
San Francisco General Hospital. He completed medical school, internship,
and residency in Obstetrics and Gynecology at the New York University
School of Medicine and came to UCSF as an ACOG post-doctoral Fellow in
Reproductive Endocrinology. Dr. Nachtigall has had an active career in
the sub-specialty of reproductive endocrinology with a broad range of
interests including teaching, writing, research, and clinical practice.

Dr. Nachtigall’s research career has been committed to the study of the
social and emotional aspects of infertility with particular emphasis on
the medical, ethical, and psychological issues involved in the practice
of gamete donation. Over the past decade, a series of research projects
have been undertaken in collaboration with Gay Becker, Ph.D., a medical
anthropologist at UCSF. This research has been funded by the National
Institutes of Health, the University of California Academic Senate, and
the California Pacific Medical Center.

The purpose of the early research was to address how women and men
experienced and sought to resolve their infertility. These studies were
the first to clearly establish that women and men respond differently to
infertility, and that there are also differences among men which, in
turn, affect the marital relationship and the decisions that people make
in the course of medical treatment. This exposure to the issues of
gender and stigma sensitized the investigators to a controversial,
unresolved issue in the practice of infertility of whether or not the
offspring of children conceived with donor eggs or donor sperm should be
told of the true nature of their conception. Dr. Nachtigall is currently
involved in a NIH-sponsored qualitative research project that will
describe the process that parents of children conceived with donor
gametes engage in as they address the “disclosure decision.” His other
ongoing NIH-sponsored research studies include (a) the investigation of
how infertile couples who have undergone in-vitro fertilization decide
what to do with their surplus frozen embryos, and (b) an ethnographic
qualitative description of the infertility experiences of low-income
Latino women.

Recent Projects

Title:
Disposition Decisions by Couples with Frozen Embryos

Project Period: 07/01/04-06/30/08

Funding Agency: National Institutes of Health

Description:
The goal of this qualitative research is to better understand how
infertile couples who have undergone in-vitro fertilization decide what
to do with their surplus frozen embryos.

Title: Infertility in Low-Income Latinos (Principal Investigator)

Project Period: 5/01/03-4/30/08
Funding Agency: National Institute of Health
Description: A qualitative
ethnographic description of the infertility experiences of low income
Latino women.

Title: The Disclosure Decision After the Use of Donor Gametes
Project Period: 09/01/01-08/31/05
Funding Agency: National Institutes of Health and Child Development
Description: The goal of this research is to better understand how parents of
children conceived through the use of donor gametes make their decision
about whether or not to tell their children of the true biologic nature
of their conception, i.e., the disclosure decision. Because cultural
assumptions and perceptions exert a powerful influence on the meaning of
parenthood and family, we are specifically interested in how stigma,
gender, and ethical issues influence the process of making a decision
about disclosure.

Title: Stigma and Secrecy in Donor Insemination: A Study of Family Functioning
Project Period: 1993-97
Funding Agency: UCSF Academic Senate, California Pacific Medical Center

Description: This study addressed whether the decision to tell or
not to tell donor-sperm-conceived offspring about their conception
affected their parents’ marital satisfaction, marital intimacy,
involvement with the child, parental warmth, parental fostering of
independence, parental strictness, or parental aggravation. The findings
indicated that although most donor insemination parents come to a
clear-cut and apparently united disclosure decision that reflects and
supports their beliefs in what is best for the child and the family
unit, they continue to grapple with a broad range of issues and concerns
that interact in complex and subtle ways.

Title: Gender and the Disruption of Life Course Structure
Project Period: 1991-95 (Gay Becker P.I./R. Nachtigall Co-P.I.)
Funding Agency: National Institute on Aging
Description: In-depth interviews illustrate how disclosure
decisions are embedded in a much larger complex of issues about gender,
the parent-child relationship, becoming parents, adjusting to
parenthood, reconsolidation of the couple relationship within the
context of the nuclear family, and the changing perspectives of new
parents.

Publications

Harrington J, Becker G,
Nachtigall RD. Non-reproductive technologies: Re-mediating kin structure
with donor gametes. Science, Technology, and Human Values: The Journal
of the Society for Social Studies of Science 2007. In Press.

Shehab D,
Duff J, Pasch L, MacDougall K, Scheib JE, Nachtigall RD. How parents
whose children have been conceived with donor gametes make their
disclosure decision: contexts, influences, and couple dynamics. Fertil
Steril 2007. In Press.

MacDougall K, Becker G, Scheib J, Nachtigall RD. Strategies for
disclosure: How parents approach telling their children that they were
conceived with donor gametes. Fertil Steril 2007;87:524-33.

Friese C, Becker G, Nachtigall RD.
Rethinking the biological clock: eleventh hour moms, miracle moms and
meanings of age-related infertility. Soc Sci Med 2006;63:1550-60.

Levy S, Brizendine
L, Nachtigall RD. How to treat depression, stress associated with
infertility treatment. Current Psychiatry 2006;5(10):65-74.

Becker G, Castrillo M,
Jackson R, Nachtigall RD. Infertility among low-income Latinos. Fertil
Steril 2006;85:882-7.

Nachtigall RD.
International Disparities in Access to Infertility Services. Fertil
Steril 2006;85:871-5.

Nachtigall RD,
Becker G, Friese C, Butler A, MacDougall K. Parents’ conceptualization
of their frozen embryos complicates the disposition decision. Fertil
Steril 2005;84:431-4.

Becker G, Butler A,
Nachtigall RD. Resemblance talk: A challenge for parents whose children
were conceived with donor gametes in the U.S. Soc Sci Med
2005;61(6):1300-9.

Nachtigall RD,
Becker G, Friese C, Butler A, MacDougall K. Parents’ conceptualization
of their frozen embryos complicates the disposition decision. Fertil
Steril 2005;84:431-4.

Katz P, Nachtigall R,
Showstack J. The economic impact of the assisted reproductive
technologies. Nat Cell Biol 2002 Oct;4 Suppl:s29-32.

Nachtigall RD,
Becker G, Szkupinski-Quiroga SS, Tschann JM. The disclosure decision:
concerns and issues of parents of children conceived through donor
insemination. Am J Obstet Gynecol 1998;178:1165-70.

Nachtigall RD, Tschann JM, Pitcher L, Szkupinski-Quiroga SS, Becker G.
Stigma, disclosure, and family functioning among parents of children
conceived through donor insemination. Fertil Steril 1997;68:83-9.

Kiprov DD, Nachtigall RD, Weaver RC, Jacobson A, Main EK, Garovoy MR.
The use of intravenous immunoglobulin in recurrent spontaneous
abortions associated with combined alloimmune and autoimmune
abnormalities. Am J Repro Immun, 1996;36:228.

Nachtigall RD. Human immunodeficiency virus and donor insemination: a
risk/benefit analysis. Am J Obstet Gynecol, 1994;170:1692.

Becker G, Nachtigall RD. “Born to be a mother”: the cultural
construction of risk in infertility treatment in the U.S. Soc Sci Med,
1994;39:507.

Nachtigall RD. Secrecy: an unresolved issue in the practice of donor
insemination. Am J Obstet Gynecol,1993;168:1846.

Nachtigall RD, Becker G, Wozny M. The effects of gender-specific
diagnosis on men’s and women’s response to infertility. Fertil Steril,
1992;57:113.

Becker G, Nachtigall RD. Eager for medicalisation: the social production
of infertility as a disease. Soc Health Ilness, 1992;14:456.

Nachtigall MJ, Smilen SW, Nachtigall RD, Nachtigall RH, Nachtigall LE.
Incidence of breast cancer in a 22-year study of women receiving
estrogen – progestin replacement therapy. Obstet Gynecol,
1992;80:827.

Becker G, Nachtigall RD. Ambiguous responsibility in the doctor-patient
relationship: the case of infertility. Soc Sci Med, 1991;32:875.

Hahn RG, Nachtigall RD, Davies TC. Compliance difficulties with progestin-supplemented estrogen
replacement therapy. J Fam Pract, 1984;18:411.

Nachtigall RD, Monroe SE, Wilson CB, Jaffe RB. Prolactin secreting
pituitary adenomas in women V. Absence of demonstrable adenomas in
patients with altered menstrual function and abnormal sellar
polytomography. Am J Obstet Gynecol, 1981;140:303.

Reviews

Nachtigall RD.
Intracytoplasmic sperm injection. Western J Med 1996;165(6):373.

Nachtigall RD. Age
related infertility. Practice guideline of the American Society for Reproductive Medicine. 1995.

Arpels J, Nachtigall
RD. Gonadal hormones and breast cancer risk: the estrogen window
hypothesis revisited. Menopause 1994;1:49.

Nachtigall RD.
Assessing fecundity after age 40. Contemp OB/GYN 1991;36:11.

Nachtigall RD.
Infertility. Technical Bulletin of the American College of Obstetrics
and Gynecology 1989.

Nachtigall RD. Artificial insemination: current concepts. In: Tanagho
EA, McClure RD,

Lue TF, eds.
Contemporary Management of Impotence and Infertility. Baltimore:
Williams and Wilkins, 1988.

Nachtigall RD. AIH – Indications, techniques and success rates. Seminars
in Repro Endo 1987;5:5.

Nachtigall LE, Nachtigall RD. Evaluating the newly menopausal woman.
Contemp OB/GYN 1985;30:68.

Nachtigall RD, Faure N, Glass RH. Artificial insemination of husband’s
sperm. Fertil Steril 1979;32:14.

Books and Monographs

Nachtigall LE,
Nachtigall RD., and J. Heilman: What Every Woman Should Know:Staying
Healthy After Forty. New York: Time/Warner. 1995.

Nachtigall RD, Mehren E. Overcoming infertility. New York, Doubleday,
1991.

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