An ovarian pioneer

Long before she helped create the first artificial ovary, Sandra Carson, MD, was a child growing up in 1960s Pittsburgh when the steel mills were still bustling. Carson was filled with curiosity about the world around her; a curiosity that ended up serving her well in her career as a doctor and researcher.

Carson, professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine and director of the Reproductive Endocrinology and Infertility (REI) section benefited from the strong local programs in the arts and sciences, many of which were funded by the steel magnate and philanthropist Andrew Carnegie. Carson was also influenced by Fred Rogers, whose “Mister Rogers’ Neighborhood” television show was filmed in Pittsburgh. “He talked about taking care of your neighborhood, and that theme of being caring was always something I carried with me,” says Carson.

After a stint in nursing school while still in high school, Carson was convinced that medicine was the right path, says Carson. Following college, she graduated from Northwestern University Feinberg School of Medicine in Chicago in 1977. Women were just 15% of her class.

Initially, she set her path toward anesthesiology. “I liked that anesthesiologists make people very comfortable and take away pain, and they do it with chemistry, which I also loved. I wanted to go into pharmacologic research,” she explains.

That all changed in the fall of 1975 when Carson delivered her first baby as a medical student. “I never had another five-year plan. It was such an honor and has always been an honor for all of my career to be the one chosen by a family to deliver their child,” says Carson, whose office window sill is crowded with framed photos of her two sons and three young grandchildren.

Before in vitro fertilization (IVF), reproductive endocrinology was largely a surgical subspecialty. Carson felt drawn to the delicate technique required for reproductive surgery and the biochemical dimension of endocrinology. After faculty and leadership positions at the University of Chicago’s Pritzker School of Medicine and the University of Tennessee’s College of Medicine in Memphis in the ’80s and ’90s, Carson joined Baylor College of Medicine in Houston as the director of the Assisted Reproductive Technology Program in 1994. A longhorn skull and horns, which Carson named Bob, is mounted on her office wall to remind her of her 13 years in the Lone Star State. It was in Texas that she became interested in fertility preservation, given the medical school’s proximity to MD Anderson Cancer Center, where patients receive treatments that can diminish fertility.

Carson continued to focus on fertility preservation at the Warren Alpert Medical School of Brown University, where she became director of REI in 2007. There, Carson received a grant to develop an artificial ovary that could mature a woman’s immature eggs outside the womb. The purpose, she explains, was to study ovarian function in the lab and serve as a testing ground for the effects of toxins and medications on egg maturation. The artificial ovary would also allow doctors to harvest immature eggs from women about to start cancer treatment, and bring them to maturity in an artificial ovary to preserve future fertility. At the time, egg freezing was in its infancy.

Carson led a team that developed a 3D model of an ovary—developed in a specially designed mold—which could bring them to maturity. “We needed a system to mature eggs better, and this also allowed us to look at the physiological process of how the ovary works,” she says of the project, which was chosen by “Time” magazine as one of the top 10 medical breakthroughs of 2010. Today, the artificial ovary she worked on is used to study the effects of environmental toxins on egg maturation and health.

Next, Carson moved to the American College of Obstetricians and Gynecologists (ACOG) in Washington, D.C., where she served as vice president for education from 2013 to 2019. “I had a wonderful career as an Ob/Gyn and loved it, but there were a number of challenges facing the field, especially in education,” Carson says of her career move. During her tenure, she changed the format of the organization’s educational meeting, organized a summit for women’s health, addressed the meaning of specialization within the field, and updated the core curriculum for residency training among other goals.

How did she end up in New Haven? According to Carson, she missed seeing patients, as well as the intellectual stimulation of working at a university. “I also missed New England, which is home, and I was really happy to be part of a terrific team here at Yale,” says Carson.

Meanwhile, she continues her research. Carson is co-inventor of a catheter that flushes embryos out of women before they implant. “This way, we can do genetic testing on [an embryo] and return it without a woman needing to do IVF,” she says. This project is currently moving into Phase III clinical trials with the U.S. Food and Drug Administration (FDA).

The catheter project is one of many for Carson, who holds 14 patents for devices used in fertility and surgery, and has authored or co-authored more than 140 peer-reviewed publications. She served as a principal investigator in the Reproductive Medicine Network of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, among other high-profile research roles. She has also provided expert advice on the national level, including serving on and chairing the FDA’s Fertility and Maternal Health Drugs Advisory Committee.

None of her many roles as an Ob/Gyn, research-scientist, educator, and leader have ever been a “job” to Carson. “I’ve been so happy that I’ve never felt like I had to go to work. Instead, it’s been like a day-to-day calling, working on something vital and interesting,” she says. “A lot of that has to do with those around me. Ob/Gyns are a wonderful group of people.”