Thyroid Treatment Did Not Improve IVF Miscarriage Rate in Women With Thyroid Antibodies But Normal Thyroid Function

MedicalResearch.com Interview with:
Professor Tianpei Hong, MD, PhD
Of behalf of Prof. Jie Qiao and all the coauthors,
Director, Department of Endocrinology & Metabolism
Director, Department of Laboratory Medicine
Peking University Third Hospital
Beijing, China

MedicalResearch.com: What is the background for this study?

  • Ÿ           Women who test positive for thyroid autoantibodies have been reported to be at 2- to 3-fold higher risk of spontaneous miscarriage than those who test negative. However, the effect of levothyroxine on miscarriage among women with positive thyroid autoantibodies and normal thyroid function has been documented in limited studies with conflicting results.
  • Ÿ           Given the substantial difficulty achieving successful pregnancy among infertile women, identifying optimal treatment for infertile women who test positive for thyroid autoantibodies is particularly important. There are a few randomized clinical trials showing a beneficial effect of levothyroxine treatment on pregnancy outcomes among women undergoing in vitro fertilization and embryo transfer (IVF-ET). However, the sample size of those trials was rather small which may weaken the quality of the evidence.
  • Ÿ           Therefore, the Pregnancy Outcomes Study in euthyroid women with Thyroid Autoimmunity after Levothyroxine (POSTAL) study was conducted in Peking University Third Hospital to evaluate whether levothyroxine treatment initiated before IVF-ET could decrease the miscarriage rate and improve the live birth rate in infertile women who tested positive for antithyroperoxidase antibody but had normal thyroid function.

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IVF Linked To Increased Risk of Congenital Heart Defects

MedicalResearch.com Interview with:
“2010 Nobel Prize in Medicine - development of the in vitro fertilization procedure” by Solis Invicti is licensed under CC BY 2.0
Paolo Cavoretto MD PhD
San Raffaele Scientific Centre
Obstetrics and Gynaecology Department
Milan Italy

MedicalResearch.com: What is the background for this study?

Response: Congenital heart defects (CHD) are the most common forms of congenital disorders and a relevant cause of perinatal morbidity and mortality involving about 0.8% of pregnancies. IVF pregnancies are very common nowadays with increasing rates in the developed countries worldwide. There is no consensus in current practice guidelines whether IVF/ICSI conception represents an indication for performing a fetal echocardiogram according to different eminent scientific societies due to differences in the estimations of the risk for CHD in the available literature.

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Uterine Fibroid Embolization Helps Restore Fertility

MedicalResearch.com Interview with:
Prof. Dr. João Martins Pisco MD PhD Radiologia de Intervenção Hospital Saint Louis - Rua Luz Soriano Portugal
Prof. Dr. João Martins Pisco MD PhD
Radiologia de Intervenção
Hospital Saint Louis – Rua Luz Soriano
Portugal

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The background for the study is the good results I started to check in patients with uterine fibroids who could conceive a successful pregnancy with live birth following embolization.

MedicalResearch.com: What should readers take away from your report?

Response: The readers should know that fertility can be restored following embolization of uterine fibroids, particularly if the embolization is partial. The wish of conception in patients with uterine fibroids is not a contraindication for fibroids embolization.

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Fetal Reduction in Multifetal Pregnancies Results in Fewer Preterm Births and Deaths

MedicalResearch.com Interview with:

Neda Razaz, PhD, MPH Postdoctoral Fellow Reproductive Epidemiology Unit Karolinska Institutet

Dr. Razaz

Neda Razaz, PhD, MPH
Postdoctoral Fellow
Reproductive Epidemiology Unit
Karolinska Institutet

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Multiple births of twins and triplets – and the associated health risks – have increased in many high-income countries, with a respective two-fold and three-fold increase in recent decades.

In Canada, triplet births or higher have increased from 52.2 per 100 000 live births to 83.5 between 1991 and 2009, mainly because of an increase in fertility treatments for older women of child-bearing age. In this study we found that among twin and triplet pregnancies that were reduced to singleton or twin pregnancies, there was a substantial reduction in complications such as preterm birth and very preterm birth. Although rates of death and serious illness were not lower among all multifetal pregnancies that were reduced, pregnancies that resulted from fertility treatments did show a significant reduction in rates of death or serious illness following fetal reduction.

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Omega-3 Fatty Acid Supplementation Improves Luteal Function in Obese Women

MedicalResearch.com Interview with:

Alex J. Polotsky, MD Associate Professor of Obstetrics and Gynecology University of Colorado Denver Practice homepage

Dr. Polotsky

Alex J. Polotsky, MD
Associate Professor of Obstetrics and Gynecology
University of Colorado Denver
Practice homepage

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: It has been well established that profound dietary changes occurred over the past 100 years. The type and amount of fat consumed has changed quite a bit over the course of 20th century. Intake of omega-3 polyunsaturated fatty acids (PUFAs), previously consumed in large quantities by humans from vegetable and fish sources, has dropped significantly. The typical Western diet (sometimes also called the typical American diet) provides an omega-6 to omega-3 fatty acid ratio of as high as 25:1, which is quite different from what it used to up until about the 19th century (believed to be about 1:1 ratio).

In animal studies, diets enriched with omega-3 PUFA enhance early embryonic development and boost progesterone secretion. Obesity is well known to be associated with decreased progesterone production in women (even if a obese woman ovulates). The reasons for this are not clear. Obesity is also a state of low-grade chronic inflammation. Omega-3 fatty acids are well known to have anti-inflammatory properties.

We sought to test whether dietary supplementation with omega-3 PUFA favorably affects reproductive hormones in women and whether this effect includes normalization of progesterone production in obesity.

All women in the study tolerated supplementation well, and had significantly decreased their omega-6 to omega-3 ratios (they were normalized much closer to a 1:1 ratio). Omega-3 supplementation resulted in a trend for increased progesterone in obese women, thus enhancing ovulatory function. A 16 to 22 percent increase was observed. Additionally, the supplementation resulted in reduced systemic inflammation.

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Women With Health Insurance for IVF More Likely To Have Successful Live Birth

MedicalResearch.com Interview with:

Emily S. Jungheim, MD, MSCI Assistant Professor, Obstetrics and Gynecology Division of Reproductive Endocrinology and Infertility Washington University St. Louis, Missouri

Dr. Jungheim

Emily S. Jungheim, MD, MSCI
Assistant Professor, Obstetrics and Gynecology
Division of Reproductive Endocrinology and Infertility
Washington University
St. Louis, Missouri

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Many women with health insurance lack coverage for fertility treatment so they end up being self-pay for fertility treatments which can be expensive and limit access to care.

15 states have responded with mandates for employers to include fertility coverage in their employee insurance benefits, and 5 of these have comprehensive mandates that include IVF. Illinois is one of these states. Washington University is located on the border between Illinois and Missouri so our fertility center treats a number of women with coverage for fertility treatment and a large number of women who are self-pay for fertility treatment. We suspected that women requiring IVF to conceive were more likely to follow through with treatments if they had coverage so we decided to look at our data.

Ultimately we confirmed our suspicions. Women with coverage were more likely to come back for additional cycles of IVF if they didn’t conceive. Ultimately this ability to come back for additional treatment cycles led to a higher chance of live birth.

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Newly Recognized Connection Between Immune System and Sperm Opens Window to Some Male Infertility and Cancer Vaccine Failures

MedicalResearch.com Interview with:
Kenneth S. K. Tung, M.D.
Professor of Pathology and Microbiology
Director of UVA Research Histology Core
Beirne B. Carter Center for Immunology Research
University of Virginia

MedicalResearch.com: What is the background for this study?

Response: The immune system needs to see tissue antigens to avoid responding to them in order to prevent autoimmune disease development. The current dogma, stated in all Immunology and Reproductive Biology textbooks, considers the sperm antigens in the testis to be exempted from this process. They are considered totally hidden behind a tissue barrier, and are invisible to the immune system.

Because sperm antigens are treated as foreign molecules, they should stimulate strong immune response when employed in cancer vaccines against antigens common to sperm and cancers. It is also believed that sperm molecules are protected by local factors that inhibit inflammation, whereas systemic mechanisms such as regulatory T cells would not exist.

The paradigm has restrained ongoing research on systemic tolerance to sperm, and the need to understanding systemic regulation in infertility research

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Oral Dydrogesterone May Become Preferred Treatment Option for IVF

MedicalResearch.com Interview with:
Matthias Straub
Senior Director, Clinical Development
Abbott

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Lotus I study provides clinical evidence that oral dydrogesterone is a treatment option for women who undergo in vitro fertilization (IVF) treatment. The current standard of care for IVF globally is micronized vaginal progesterone (MPV), which is administered vaginally.

The Lotus I study concludes that oral dydrogesterone is similarly well-tolerated and efficacious compared to MVP, while being easier to administer than MVP.

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Failed Fertility Therapy Linked To Increased Risk of Heart Disease

MedicalResearch.com Interview with:

Jacob A. Udell MD MPH FRCPC Cardiovascular Division Women's College Hospital Toronto General Hospital University of Toronto

Dr. Jacob Udell

Jacob A. Udell MD MPH FRCPC
Cardiovascular Division
Women’s College Hospital
Toronto General Hospital
University of Toronto 

MedicalResearch.com: What is the background for this study?

Response: We’ve noticed for a long time that fertility drug treatment can cause short-term complications such as high blood pressure or diabetes in pregnancy. We recently started wondering whether there may be long term consequences for these women years after a baby was or was not born.  To do this, we looked at all women who were treated with fertility therapy in Ontario for the last 20 years, from what we could determine this amounted to more than 28,000 women. We then followed up years later to examine every woman’s cardiovascular health.

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Almost 40% of Assisted Reproductive Infants Are Multiple Births

MedicalResearch.com Interview with:
Saswati Sunderam, PhD

Division of Reproductive Health
National Center for Chronic Disease Prevention and Health Promotion
CDC.

MedicalResearch.com: What is the background for this study?

Response: Assisted Reproductive Technology Surveillance – United States, 2014, the surveillance summary published this week in CDC’s Morbidity and Mortality Weekly Report (MMWR), presents state-specific data on assisted reproductive technology (ART) use and outcomes.

The report compares ART infant outcome data with outcomes for all infants born in the U.S. in 2014, and provides data on the contributions of  Assisted Reproductive Technology to total infants born, multiple birth infants, low birth weight infants, and preterm infants for each U.S. state, the District of Columbia, and Puerto Rico.

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Does IVF Raise Risk of Malignancies in Offspring?

MedicalResearch.com Interview with:
Tamar Wainstock, PhD

Department of Public Health; Faculty of Health Sciences
Ben-Gurion University of the Negev
ISRAEL

MedicalResearch.com: What is the background for this study?

Response: There is a controversy in the medical literature regarding the possible association between infertility or infertility treatments, and the long-term offspring neoplasm risk: while some studies have found such an association, others have not.
Since the number of offspring conceived following treatments are growing, and as they age, it is critical to clarify this possible association.

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National Trends and Outcomes of Embryo Donation

Jennifer F. Kawwass, MD, FACOG Assistant Professor, Emory Reproductive Center Director of Third Party Reproduction, Emory Reproductive Center

Dr. Jennifer F. Kawwass

MedicalResearch.com Interview with:
Jennifer F. Kawwass, MD, FACOG

Assistant Professor, Emory Reproductive Center
Director of Third Party Reproduction, Emory Reproductive Center

MedicalResearch.com: What is the background for this study?

Response: With the increasing use of assisted reproductive technology (ART), the number of cryopreserved embryos in storage has increased, as residual viable embryos from an in vitro fertilization (IVF) cycle may be frozen for future use. Each embryo maintains attributes reflective of the age of the female at time of the original oocyte retrieval. Embryo donation, a form of third-party reproduction, involves donation without compensation of previously formed embryos to another couple for implantation.

Limited published data exist detailing outcomes of donor embryo cycles. Patients and clinicians would benefit from information specific to donor embryo cycles to inform fertility treatment options, counselling, and clinical decision-making. We sought to quantify trends in donor embryo cycles in the United States, to characterize donor embryo recipients, and to report transfer, pregnancy, and birth outcomes of donor embryo transfers.

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New Online Fertility Calculators Predict Chance of IVF Success

MedicalResearch.com Interview with:

David McLernon PhD MPhil BSc Research Fellow in Medical Statistics Medical Statistics Team Institute of Applied Health Sciences University of Aberdeen Foresterhill Aberdeen

Dr. David McLernon

David McLernon PhD MPhil BSc
Research Fellow in Medical Statistics
Medical Statistics Team
Institute of Applied Health Sciences
University of Aberdeen
Foresterhill Aberdeen

MedicalResearch.com: What is the background for this study?

Response: Normally when a couple attend a fertility clinic to begin IVF treatment they are only informed about their chances of having a baby for the first attempt of IVF. In actual fact the first treatment is often unsuccessful and many couples will go on to have several complete cycles of the treatment– each involving the transfer of one or two fresh embryos potentially followed by one or more frozen embryo transfers. We felt that a prediction model that could calculate the chances of having a baby over the complete package of treatment would provide better information for couples.

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High Cortisol Levels in Hair May Be Linked To Lower IVF Success

MedicalResearch.com Interview with:

Kavita Vedhara FAcSS Professor of Health Psychology Division of Primary Care School of Medicine University Park,N ottingham

Prof. Kavita Vedhara

Kavita Vedhara FAcSS  
Professor of Health Psychology
Division of Primary Care
School of Medicine
University Park,Nottingham

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a longstanding interest in the role of the hormone cortisol in fertility, because of its potential to affect the functioning of the biological systems that influence both conception and pregnancy.

This interest has extended to IVF, with researchers exploring the relationship between levels of the hormone and pregnancy since the advent of the treatment in the late 1970s.

However, a recent review showed that the relationship between cortisol and pregnancy in IVF was unclear. A number of reasons were highlighted for this, including that all of the studies to date had relied on short-term measures of the hormone measured in blood, saliva, urine and sometimes follicular fluid. Such measures can only capture hormone levels over a matter of minutes and hours. Such ‘snapshots’ are unable to give us an accurate picture of the levels of hormone over longer periods of time. This is important because any clinically relevant effects of cortisol on fertility are only likely to occur in the context of long-term changes in the hormone.

In recent years it has become possible to measure long-term levels of cortisol in hair. Cortisol is deposited in the hair shaft and because human hair grows, on average, 1cm per month, a 3cm sample of hair closest to the scalp can tell us about levels of cortisol in the previous 3 months.

We used the development of this technique to examine whether long term levels of cortisol (as measured in hair), or short term levels of cortisol (as measured in saliva) could predict whether or not women going through IVF would become pregnant.

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Chemical Sunscreens May Reduce Male Fertility

MedicalResearch.com Interview with:
Anders Rehfeld MD, PhD Student
Faculty of Health and Medical Sciences
Department of Cellular and Molecular Medicine
University of Copenhagen
Copenhagen Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Human fertility is declining in many areas of the world and the reason is largely unknown. Our study shows that 44% of the tested chemical UV filters can induce calcium signals in human sperm cells, thereby mimicking the effect of progesterone. Progesterone-induced calcium signals, and the sperm functions it triggers, is absolutely essential for the human sperm cell to normally fertilise the human egg.

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Step Closer To Treating Mitochondrial Diseases by Understanding How Embryos Digest Sperm

MedicalResearch.com Interview with:

Peter Sutovsky PhD Professor of Animal Science in the College of Agriculture, Food and Natural Resources University of Missouri Professor of Obstetrics, Gynecology and Women’s Health at the School of Medicine University of Missouri Health System

Dr. Peter Sutovsky

Peter Sutovsky PhD
Professor of Animal Science in the College of Agriculture, Food and Natural Resources
University of Missouri
Professor of Obstetrics, Gynecology and Women’s Health at the School of Medicine
University of Missouri Health System

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Strictly maternal inheritance of mitochondria, the cellular power stations, and mitochondrial genes that mitochondria harbor, is a major biological paradigm in mammals. Propagation of paternal, sperm-contributed mitochondrial genes, resulting in a condition called heteroplasmy, is seldom observed in mammals, due to post-fertilization elimination sperm mitochondria, referred to as “sperm mitophagy.” Our and others’ recent results suggest that this process is mediated by the synergy of ubiquitin–proteasome system (UPS) pathway that recycles outlived cellular proteins one molecule at a time, and autophagic pathway capable of engulfing and digesting an entire mitochondrion.

Here we demonstrate that the co-inhibition of the ubiquitin-binding autophagy receptor proteins SQSTM1, GABARAP, and UPS, and the UPS protein VCP dependent pathways delayed the digestion of sperm mitochondria inside the fertilized pig egg. By manipulating said proteins, we created heteroplasmic pig embryos with both the paternal and maternal mitochondrial genes. Such animal embryos that could be used as a biomedical model to research and alleviate certain forms of mitochondrial disease.

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Is There an Increased Risk of Breast Cancer in Women Who Have IVF?

MedicalResearch.com Interview with:

Alexandra W. van den Belt-Dusebout, PhD Department of Epidemiology The Netherlands Cancer Institute The Netherlands

Dr. Alexandra van den Belt-Dusebout

Alexandra W. van den Belt-Dusebout, PhD
Department of Epidemiology
The Netherlands Cancer Institute
The Netherlands

MedicalResearch.com: What is the background for this study?

Response: In vitro fertilization (IVF) is commonly used, but because of the relatively recent use of IVF, long-term breast cancer risk is not yet known. Female sex hormones have been shown to affect breast cancer risk. Because sex hormone levels during hormonal stimulation of the ovaries for IVF are up to 10 times higher than in natural cycles, IVF was expected to increase breast cancer risk.
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Co-infection with HPV and Chlamydia Can Be Asymptomatic and Lead to Infertility

MedicalResearch.com Interview with:

Dejan R. Nonato, MD, PhD Institute of Tropical Pathology and Public Health School of Medicine Federal University of Goiás Goiânia, GO, Brazil

Dr. Dejan Nonato

Dejan R. Nonato, MD, PhD
Institute of Tropical Pathology and Public Health
School of Medicine
Federal University of Goiás
Goiânia, GO, Brazil

MedicalResearch.com: What is the background for this study?

Response: Human papillomavirus (HPV) and Chlamydia trachomatis (CT) share the same route of sexual transmission and possess similar risk factors, indicating that co-infection may act synergistically in the induction of epithelial cell abnormalities.

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Little Known Herpes Virus Linked To Some Unexplained Fertility

MedicalResearch.com Interview with:

Roberta Rizzo PhD Department of Medical Sciences Section of Microbiology University of Ferrara Ferrara, Italy

Dr. Roberto Rizzo

Roberta Rizzo PhD
Department of Medical Sciences
Section of Microbiology
University of Ferrara
Ferrara, Italy

MedicalResearch.com: What is the background for this study?

Response: Infertility affects approximately 6% of 15-44 year old women or 1.5 million women in the US, according to the CDC. Approximately 25% of female infertility cases are unexplained, leaving women with few options other than expensive fertility treatments. Researchers are trying to identify factors and mechanisms at the basis of this condition.
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Depression More Common In Women (But Not Men) Who Experience Infertility

MedicalResearch.com Interview with:

Jessica Datta Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine London

Jessica Datta

Jessica Datta
Department of Social & Environmental Health Research
London School of Hygiene & Tropical Medicine
London

MedicalResearch.com: What is the background for this study?

Response: The paper presents an analysis of data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 is a survey of more than 15,000 women and men aged 16-74 resident in Britain, conducted in 2010-2012, which includes a wide range of questions about sexual relationships and behaviour and reproductive history.

In this paper we analysed responses to the questions: ‘Have you ever had a time, lasting 12 months or longer, when you and a partner were trying for a pregnancy but it didn’t happen?’ and ‘Have you (or a partner) ever sought medical or professional help about infertility?’. As well as calculating the prevalence of experience of infertility and help seeking, we looked at associated factors e.g. education, employment, relationship status.

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Majority of Women with Endometriosis Do Not Experience Infertility

MedicalResearch.com Interview with:

Stacey A. Missmer, ScD Associate Professor of Obstetrics, Gynecology, and Reproductive Biology Director of Epidemiologic Research, Division of Reproductive Medicine Scientific Director, Boston Center for Endometriosis Brigham and Women’s Hospital and Harvard Medical School Associate Professor in Epidemiology Harvard T.H. Chan School of Public Health

Dr. Stacey Missmer

Stacey A. Missmer, ScD
Associate Professor of Obstetrics, Gynecology, and Reproductive Biology
Director of Epidemiologic Research, Division of Reproductive Medicine
Scientific Director, Boston Center for Endometriosis
Brigham and Women’s Hospital and Harvard Medical School
Associate Professor in Epidemiology
Harvard T.H. Chan School of Public Health

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Missmer: As we’ve known for many years, women with endometriosis are at greater risk for infertility compared to women without endometriosis.

What this new study confirms, however, is that endometriosis and infertility should not be conflated.

MedicalResearch.com: What should readers take away from your report?

Dr. Missmer:The majority of women with endometriosis do not experience infertility and the majority do become pregnant and are able to build the families that they desire.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Missmer: The majority of women with endometriosis do not experience infertility and the majority do become pregnant and are able to build the families that they desire.

MedicalResearch.com: Is there anything else you would like to add?

Dr. Missmer: The key next step in endometriosis discovery is identifying that minority of women with endometriosis who ARE at higher risk of infertility. We can then target treatments directly to the biology causing infertility in women with endometriosis. We can also attempt to identify the women at risk early so that they can access fertility treatment and perhaps fertility preservation early.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

J. Prescott, L.V. Farland, D.K. Tobias, A.J. Gaskins, D. Spiegelman, J.E. Chavarro, J.W. Rich-Edwards, R.L. Barbieri, and S.A. Missmer
A prospective cohort study of endometriosis and subsequent risk of infertilityHum. Reprod. first published online May 1, 2016 doi:10.1093/humrep/dew085

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.
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IVF: More Embryos Transferred Means More Costs and Worse Outcomes

MedicalResearch.com Interview with:

Dr. Scott Sills MD, PhD Medical Director at the Center for Advanced Genetics an IVF program based in Carlsbad, California

Dr. E. Scott Sills

Dr. Scott Sills MD, PhD
Medical Director at the Center for Advanced Genetics
an IVF program based in Carlsbad, California 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Sills: Often regarded as a miracle procedure by many infertile couples, in vitro fertilization (IVF) can be financially difficult for those without insurance coverage for the treatment. This prohibitive cost leads many would-be parents who pursue IVF to transfer multiple embryos at once, to increase their chances of getting a baby and minimize the need for additional attempts.

This new study now reports that the economic impact of IVF deserves a closer look. As corresponding author E. Scott Sills, MD PhD noted, rates of cesarean-section deliveries, premature births, and low birth weight of babies are all greater with two or more embryos transferred to the mother at once, compared to a lower risk, single-embryo pregnancy.

The data derived from a comprehensive analysis of all IVF cases in Vermont (UVM) and was recently published in the journal Applied Health Economics & Health Policy. It is believed to be the first effort to calculate the difference in infant hospital costs based on the number of embryos transferred. Sills and his team had access to UVM Medical Center records of patients who conceived through IVF and delivered at least 20 weeks into their pregnancies between 2007 and 2011.

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Mouse Study Suggests Marijuana May Affect Male Fertility

MedicalResearch.com Interview with:

Paola Grimaldi, PhD Associate Professor of Anatomy Department of Biomedicine and Prevention, School of Medicine, University of Rome Tor Vergata Rome, Italy

Dr. Paola Grimaldi

Paola Grimaldi, PhD
Associate Professor of Anatomy
Department of Biomedicine and Prevention,
School of Medicine, University of Rome Tor Vergata
Rome, Italy

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Grimaldi: Our previous studies reported that mouse mitotic germ cells, spermatogonia, express type 2 cannabinoid receptor (CB2) and its stimulation promoted differentiation and meiotic entry of these cells in vitro. In this study we demonstrate that CB2 plays a role of in regulating the correct progression of spermatogenesis in vivo and we found that the use of exogenous agonist or antagonist of this receptor disrupts the normal differentiation of germ cells. This suggests that a basal and finely regulated level of endocannabinoids in male germ cells activate CB2, thus maintaining the homeostasis of spermatogenesis.

Another important novelty of our study is that CB2 activation in developing germ cells determines the appearance of modifications in DNA-bound proteins, which are known to impact on gene expression and inheritance of specific traits in developing germ cells. An exciting idea could be that these modifications might be maintained in the mature spermatozoa and transmitted to the offspring.

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More Birth Defects In Children Born Through Assisted Reproductive Technology

MedicalResearch.com Interview with:

Sheree L. Boulet, DrPH, MPH Division of Reproductive Health Centers for Disease Control and Prevention Atlanta, Georgia

Dr. Sheree Boulet

Sheree L. Boulet, DrPH, MPH
Division of Reproductive Health
Centers for Disease Control and Prevention
Atlanta, Georgia

MedicalResearch.com: What is the background for this study?

Dr. Boulet: Findings from some studies have suggested that children conceived with assisted reproductive technology (ART) have increased risks of birth defects compared with spontaneously conceived children. Many of these studies were limited by a small sample size and were unable to assess risks associated with specific ART procedures.

MedicalResearch.com: What are the main findings?

Dr. Boulet: We found that singleton infants conceived using assisted reproductive technology were 1.4 times more likely to have a non-chromosomal birth defect compared with other infants, and the risks were highest for gastrointestinal and musculoskeletal defects. However, when our study was restricted to only ART-conceived infants, no single procedure substantially increased the risk for birth defects. This suggests that the higher risk of birth defects may be due to underlying issues related to infertility, rather than to ART itself.

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Chemical UV Filters May Impair Fertility By Interfering With Progesterone Signaling

MedicalResearch.com Interview with:
Anders Rehfeld MD, PhD Student
University of Copenhagen
Faculty of Health and Medical Sciences
Department of Cellular and Molecular Medicine
Copenhagen, Denmark

MedicalResearch.com: What is the background for this study? What are the main findings?

DrRehfeld: Human fertility is declining in many areas of the world and the reason is largely unknown.

Our study shows that 44% tested chemical UV filters can induce calcium signals in human sperm cells, thereby mimicking the effect of progesterone and possibly interfering with the fertilizing ability of human sperm cells. Progesterone-induced calcium signaling, and the sperm functions it triggers, is absolutely essential for the human sperm cell to normally fertilize the human egg.

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Infertility Risk after Chemotherapy For Pediatric Cancers Varies Between Men and Women

MedicalResearch.com Interview with:

Eric J. Chow, MD, MPH Hematology-Oncology Attending physician, Seattle Childrens Hospital Assistant professor of Pediatrics, University of Washington School of Medicine Member of the Clinical Research and Public Health Sciences Divisions Fred Hutchinson Cancer Research Center

Dr. Eric Chow

Eric J. Chow, MD, MPH
Hematology-Oncology
Attending physician, Seattle Childrens Hospital
Assistant professor of Pediatrics, University of Washington School of Medicine
Member of the Clinical Research and Public Health Sciences Divisions
Fred Hutchinson Cancer Research Center 

MedicalResearch.com: What is the background for this study?

Dr. Chow: Adverse effects on reproductive health including fertility is a known side effect of cancer therapy, particularly among survivors of childhood cancer. However, much of this risk has been linked to radiation exposure and less is known about the effects of chemotherapy treatment alone, particularly newer drugs now being used more widely. We used data from over 10,000 survivors of childhood cancer (plus nearly 4000 siblings) who are part of the Childhood Cancer Survivor Study (CCSS) which tracks people who were diagnosed with the most common types of childhood cancer before the age of 21 and treated at 27 institutions across the US and Canada between 1970 and 1999, and who had survived at least 5 years after diagnosis. The CCSS is a resource study open to all investigators and funded by the US National Cancer Institute (ccss.stjude.org). We specifically examined the effect of various doses of 14 commonly used chemotherapy drugs on pregnancy and livebirth and excluded survivors who received any radiotherapy to the pelvis or the brain.

MedicalResearch.com:  What are the main findings?

Dr. Chow: We found that among male cancer survivors, the chance of pregnancy by age 45 was only around 50%, compared to 80% for siblings. However, among female cancer survivors, the chance of pregnancy by age 45 was approximately 70%, compared to over 80% for siblings. In male survivors, the likelihood of fathering a child generally decreased as cumulative exposure to alkylating drugs increased. High cumulative doses of several alkylating drugs (cyclophosphamide, ifosfamide, procarbazine) and cisplatin were linked with a significantly reduced likelihood of fathering a child.

In female survivors, only busulfan and high doses of lomustine were directly linked with lower likelihood of pregnancy. Overall, female survivors were still less likely to conceive compared to siblings but the effect was much smaller compared to men. However, in women, the difference was more pronounced for those who delayed pregnancy until they were aged 30 or older.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Chow: This is one of the largest studies of pregnancy and livebirth in cancer survivors of any age who were not exposed to radiation to the pelvis or brain (both of which can affect fertility). Importantly, our study features a broad range of commonly used chemotherapy drugs, given at varying doses, which allowed us to establish more precise dose thresholds associated with reduced likelihood of having (female) or fathering (male) a pregnancy for survivors of childhood cancer. Our findings showed an association between risk and exposure to cisplatin among male survivors, a finding not consistently reported in survivors of childhood cancer previously. Female survivors can be reassured by the result that chemotherapy-specific effects in women who did not receive any radiotherapy to the pelvis or brain were generally few in relation to these reproductive outcomes, except with exposure to the highest cumulative doses.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Chow: The association of risk with cisplatin exposure among male survivors should be investigated further, given the increase in use of that drug in many contemporary pediatric treatment protocols. 

MedicalResearch.com: Is there anything else you would like to add?

Dr. Chow: Counseling of patients and families about fertility preservation before initiation of cancer therapy is important. In particular, sperm banking should be encouraged for all newly diagnosed pubertal men, since this is a proven method of fertility preservation.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Pregnancy after chemotherapy in male and female survivors of childhood cancer treated between 1970 and 1999: a report from the Childhood Cancer Survivor Study cohort

Chow, Eric J et al.

The Lancet Oncology , Volume 0 , Issue 0 ,
DOI: http://dx.doi.org/10.1016/S1470-2045(16)00086-3

Published 22 March 2016

 

 

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Dr. Eric Chow (2016). Infertility Risk after Chemotherapy For Pediatric Cancers Varies Between Men and Women MedicalResearch.com

Steroid Signal That Makes Sperm React Quickly Identified

MedicalResearch.com Interview with:
Melissa Miller, PhD
Postdoctoral fellow at both UC Berkeley and UC San Francisco 

MedicalResearch.com: What is the background for this study? What are the main findings?

Dr. Miller: This work builds on years of observed, but unexplained, phenomena within sperm cells which respond almost instantaneously to the presence of the steroid hormone progesterone. Typically, steroid signaling occurs through a long, slow process that involves the modification of gene amount within a cell. However, there is an alternative mechanism that is not well understood that works differently and is termed non-genomic progesterone signaling. We found that progesterone in human sperm cells binds to a protein called ABHD2 and activates its activity to clear the cell of the endogenous cannabinoid 2AG.  2AG is an inhibitor of sperm activation and its removal from the cellular membrane allows the sperm cells to change its motility so that it may reach and fertilize the egg. Men who’s sperm is unable to undergo this progesterone activated motility change are infertile.

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Miscarriage Risk Reduced by Daily Multivitamins Before and After Conception

MedicalResearch.com Interview with:

Germaine M. Buck Louis, Ph.D., M.S. Office of the Director, Division of Intramural Population Health Research Eunice Kennedy Shriver National Institute of Child Health and Human Development Rockville, Maryland 20852.

Dr-Germaine M. Buck-Louis

Germaine M. Buck Louis, Ph.D., M.S.
Office of the Director
Division of Intramural Population Health Research
Eunice Kennedy Shriver National Institute of Child Health and Human Development
Rockville, Maryland 20852.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: To understand the association between couples’ lifestyles and risk of pregnancy loss.  Couples were recruited upon discontinuing contraception to try for pregnancy and followed daily for up to one year of trying or until pregnancy.  Pregnant women were followed daily for 7 weeks following conception then monthly.

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Cryopreservation and Transplantation Of Ovarian Tissue In Cancer Patients Helps Preserve Fertility

Kutluk Oktay, MD, PhD. Professor of Obstetrics & Gynecology, Medicine, and Cell Biology & Anatomy Director, Division of Reproductive Medicine & Institute for Fertility Preservation Innovation Institute for Fertility and In Vitro Fertilization New York Medical College, Valhalla, NY

Dr. Oktay

MedicalResearch.com Interview with:
Kutluk Oktay, MD, PhD
.
Professor of Obstetrics & Gynecology, Medicine, and Cell Biology & Anatomy
Director, Division of Reproductive Medicine & Institute for Fertility Preservation
Innovation Institute for Fertility and In Vitro Fertilization
New York Medical College, Valhalla, NY

Medical Research: What is the background for this study? What are the main findings?

Dr. Oktay: Cancer treatments cause infertility and early menopause in a growing number of young women around the world and US. One of the strategies to preserve fertility, which was developed by our team, is to cryopreserve ovarian tissue before chemotherapy and later transplant it back to the patient when they are cured of the cancer and ready to have children. However, success of ovarian transplantation has been limited due to limitation in blood flow to grafts. In this study we described a new approach which seems to improve graft function. The utility of an extracellular tissue matrix and robotic surgery seems to enhance graft function. With this approach both patients conceived with frozen embryos to spare and one has already delivered.

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“What’s My Fertility” Screening Allows Early Detection of Premature Ovarian Aging

Dr. Norbert Gleicher, MD, FACOG, FACS Founder, Center for Human Reproduction

Dr. Gleicher

MedicalResearch.com Interview with
Dr. Norbert Gleicher, MD, FACOG, FACS
Founder, Center for Human Reproduction

Background: What’s My Fertility and the Center for Human Reproduction in New York, have announced the first screening for Premature Ovarian Aging (POA) in young women, based on new research that the FMR1 gene can be predictive of POA.

Medical Research:   What is Premature Ovarian Aging (POA)?

How does POA differ from Premature Ovarian Failure?

Dr. Gleicher: Premature Ovarian Aging (POA) is a condition that causes a young woman’s ovaries to age faster than normal. It affects roughly 10% of all women, regardless of race or ethnic background. POA typically causes no symptoms until the ovarian reserve is already very low.

Women are born with all their egg cells (called oocytes). Scientists refer to this as a woman’s original “ovarian reserve.” From birth on, significant numbers of these eggs are constantly lost until menopause. As women age, their ovarian reserve, therefore, depletes and fertility declines.

In most women, fertility begins to decline around age 35 – but for women at risk for POA, fertility declines can begin as early as in their teens or 20s. POA in early stages typically has no symptoms. Most women until now, therefore, are usually only diagnosed after troubles conceiving become apparent, which brings them to a fertility specialist. At that point, most require stressful and costly infertility treatment to have children.

Premature Ovarian Failure (POF), sometimes also called premature menopause of primary ovarian insufficiency (POI) is the end stage of POA, when women reach menopause under age 40. Fortunately, this happens only to 10% of the 10% of women with Premature Ovarian Aging, – which means to 1% of the total female population. In those unfortunate few, even routine IVF can usually no longer help, and most of these women will only conceive with use of young donor eggs.  Continue reading

PCOS: Exercise and Weight Loss Can Improve Fertility

Richard S. Legro, MD Vice Chair of Research and Professor of Obstetrics and Gynecology and Public Health Sciences Penn State College of MedicineMedicalResearch.com Interview with:
Richard S. Legro, MD
Vice Chair of Research and Professor of Obstetrics and Gynecology and Public Health Sciences Penn State College of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Legro: Weight loss is recommended for obese women with PCOS, but there are no randomized studies to show that it improves fertility outcomes.

Both Lifestyle modification and oral contraceptives are also recommended for chronic treatment of women with PCOS so that this study has relevance to all obese women with PCOS.

We designed this study to prospectively examine the effects of these common treatments on reproductive, metabolic and quality of life parameters, as well as on fertility in women seeking pregnancy.

The main findings are summarized in the abstract and conclusion to the study.  I would repeat those here.  I would highlight that quality of life improved in all treatment groups, but the group that had both oral contraceptives and lifestyle modification had a significant improvement in their physical well-being compared to the oral contraceptive group.

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Folic Acid and B12 May Improve Assisted Reproductive Technology Results

Audrey J. Gaskins, Sc.D. Postdoctoral Fellow Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MA 02115
MedicalResearch.com Interview with:
Audrey J. Gaskins, Sc.D.  Postdoctoral Fellow
Department  of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA 02115

 

 

Medical Research: What is the background for this study? What are the main findings?

Dr. Gaskins: Infertility, defined as the inability to conceive after 12 months of unprotected intercourse, is a common reproductive disorder affecting ~15% of couples who attempt to become pregnant. Assisted reproductive technologies (ART), which include in vitro fertilization (IVF) and intra-cytoplasmic sperm injection (ICSI), have become the main treatment modalities for couples facing infertility. Pre-conceptional folate and vitamin B12 have been linked to many beneficial early pregnancy outcomes among couples undergoing assisted reproductive technologies treatment in Europe but mixed results have been found in regards to clinical pregnancy and live birth rates. Therefore, we sought to investigate whether higher levels of serum folate and vitamin B12 could increase reproductive success in a cohort of women undergoing assisted reproductive technologies at an academic medial center in the United States.

We found that high concentrations of folate and vitamin B12 in serum are associated with increased chance of live birth following assisted reproduction. Moreover, women with higher concentrations of both serum folate and vitamin B12 had the greatest likelihood of reproductive success. Analysis of intermediate endpoints suggests that folate and vitamin B12 may exert their favorable effects on pregnancy maintenance following implantation.

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Depression Risk Not Raised After Unsuccessful Fertility Treatments

MedicalResearch.com Interview with:
Camilla Sandal Sejbaek PhD
Department of Public Health
University of Copenhagen

Medical Research: What is the background for this study? What are the main findings?

Response: Previous literature have shown ambiguous results when investigating the association between becoming a mother and depression among women in fertility treatment. Small questionnaire-based studies with self-reported depression have shown that women in unsuccessful fertility treatment had a higher risk of depressive symptoms compared to women in successful fertility treatment. Two larger register-based studies using clinical depression (depression diagnosed at the psychiatric hospitals) have shown that women becoming a mother are at increased risk of clinical depression.

Our findings, from a large register-based study with about 41,000 women in assisted reproductive technology (ART) treatment, showed that women WHO became mothers had a higher risk of clinical depression compared to women in ART treatment WHO did not become mothers. The risk of clinical depression were more than five-fold higher within the first 6 weeks after becoming a mother to a live-born child.

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Fresh Donor Eggs Result In More Live Births Than Frozen

Vitaly A Kushnir MD The Center for Human Reproduction New York, NY 10021MedicalResearch.com Interview with:
Vitaly A Kushnir MD
The Center for Human Reproduction
New York, NY 10021

Medical Research: What is the background for this study? What are the main findings?

Dr. Kushnir: In January 2013, the American Society for Reproductive Medicine declared the technique of oocyte cryopreservation no longer experimental, although they body did call for further study.

Vitaly A. Kushnir, M.D., of the Center for Human Reproduction, and colleagues used 2013 data from 380 U.S fertility centers to compare live birth and cycle cancellation rates using either fresh or cryopreserved donor oocytes.

The study found roughly 20 percent of donor cycles used cryopreserved oocytes and 80 percent fresh oocytes. Of those embryos transferred, 56 percent that started as fresh oocytes resulted in live births compared to just 47 percent of those that started as cryopreserved oocytes. Continue reading

Long Work Week, Heavy Lifting Linked To Decreased Fertility in Nurses

Dr. Audrey J Gaskins Department of Nutrition Harvard T.H. Chan School of Public Health Boston, MAMedicalResearch.com Interview with:
Dr. Audrey J Gaskins
Department of Nutrition
Harvard T.H. Chan School of Public Health
Boston, MA

Medical Research: What is the background for this study? What are the main findings?

Dr. Gaskins: Previous studies have linked shift work, long working hours, and physical factors to an increased risk of menstrual cycle disturbances, spontaneous abortion, preterm birth, and low birth weight; however the association with fecundity is inconsistent. Several papers have also reviewed the occupational exposures of health care workers and concluded that reproductive health issues are a concern. Therefore we sought to determine the extent to which work schedules and physical factors were associated with fecundity in a large cohort of nurses.

Our main findings were that that working >40 hours per week and moving or lifting a heavy load >15 times per day (including repositioning or transferring patients) were associated with reduced fecundity in our cohort of female nurses planning pregnancy. However, all other factors such as frequency of night work, duration of rotating and non-rotating night shifts, and time spent walking or standing at work were not significantly associated with fecundity in this cohort.

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Protein Link Between Brain/Heart Function and Fertility

Carmen J. Williams, M.D., Ph.D. Principal Investigator National Institute of Environmental HealthMedicalResearch.com Interview with:
Carmen J. Williams, M.D., Ph.D.
Principal Investigator
National Institute of Environmental Health

Medical Research: What is the background for this study?

Dr. Williams: G-protein coupled receptors are used by almost all cells to receive signals from the outside of the cell and transduce these signals into actions within the cell. There are hundreds of these receptors, but many of them link to a protein named Gq to transmit their signals to other cellular proteins. Gq is found in most cells, including eggs, and activating Gq protein is one way to artificially activate the egg to begin developing into an embryo, even though it is not the way sperm normally do this. In fact, if the egg is activated before the sperm arrives it prevents the sperm from binding and fusing with the egg, so fertilization cannot take place. As a result, we thought that a mechanism might be in place within eggs to prevent them from being activated prematurely by signals that could activate Gq by triggering G-protein coupled receptors. RGS2 was a good candidate for this function because it binds to Gq in a way that prevents Gq from transmitting signals to other cellular proteins.

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RNA in Sperm Could Be Biomarkers of Male Fertility

Stephen A. Krawetz, Ph.D. Associate Director C.S. Mott Center for Human Growth and Development, Charlotte B. Failing Professor of Fetal Therapy and Diagnosis, Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, MI, 48201MedicalResearch.com Interview with:
Stephen A. Krawetz, Ph.D.
Associate Director C.S. Mott Center for Human Growth and Development,
Charlotte B. Failing Professor of Fetal Therapy and Diagnosis,
Department of Obstetrics and Gynecology,
Center for Molecular Medicine and Genetics,
Wayne State University School of Medicine,
Detroit, MI, 48201

Medical Research: What is the background for this study? What are the main findings?

Dr. Krawetz: The current study developed over approximately the past 20 years of work in my laboratory.  In the mid 1990s, along with David Miller, we independently discovered that sperm contain RNA.  This was followed by our joint publication in The Lancet that began to describe the RNAs in normal fertile males along with our paper in Nature that showed that RNA was delivered to the oocyte at fertilization.  Following these studies we assessed the ability of RNAs to be used as markers of morphologically abnormal sperm (teratozoospermia).  My laboratory then had the opportunity to explore the complexity of the population of sperm RNAs using Next Generation Sequencing.   We recently began the translation of this work from the bench to bedside which takes us to the current paper in Science Translational Medicine that was a multi-institutional collaborative effort.  Members of the team include Dr. Meritxell Jodar, Edward Sendler, Robert Goodrich, from my laboratory, along with Dr. Clifford L. Librach, Dr. Sergey I. Moskovtsev, and Sonja Swanson – CReATe Fertility Center, University of Toronto; Dr. Russ Hauser -Harvard University and Dr. Michael P. Diamond, Georgia Regents University. Here we tackled the issue of idiopathic infertility, that is, unknown infertility, since the couple appears normal in all respects.  We specifically framed our study as the contribution of the male and female as a couple towards the birth of a healthy child focusing on male idiopathic infertility within the setting of a Reproductive Clinic.  Representative publications from my laboratory that outline this part of my research program appear below.

1)            Jodar, M., Sendler, E., Moskovtsev, S. Librach, C., Goodrich, R., Swanson, S., Hauser, R., Diamond, M. and Krawetz, S.A. (2015) Absence of sperm RNA elements correlates with idiopathic male infertility. Science Translational Medicine, 7(295):295re6.

2)            Sendler, E., Johnson, G.D., Mao, S., Goodrich, R.J., Diamond, M.P., Hauser, R., and Krawetz, S.A. (2013) Stability, Delivery and Functions of Human Sperm RNAs at Fertilization.  Nucleic Acids Research 41:4104-4117. PMID: 23471003

3)            Platts, A.E., Dix, D. J., Chemes, H.E., Thompson, K.E., Goodrich, R., Rockett, J. C., Rawe, V.Y., Quintana, S., Diamond, M.P., Strader, L.F. and Krawetz, S.A. (2007)  Success and failure in human spermatogenesis as revealed by teratozoospermic RNAs.  Human Molecular Genetics. 16:763-773.  PMID: 17327269

4)            Ostermeier, G.C., Miller, D., Huntriss, J.D., Diamond, M.P. and Krawetz, S.A. (2004) Delivering spermatozoan RNA to the oocyte.  Nature 429:154.  PMID: 15141202

5)            Ostermeier, G.C., Dix, D.J., Miller, D., Khatri, P. and Krawetz, S.A. (2002) Spermatozoal RNA profiles of normal fertile men. The Lancet. 360:773-777.  PMID: 12241836

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Decreasing Financial Burden Of IVF May Encourage Single Embryo Transfers, Reduce Multiple Births

Dmitry Kissin, MD Health scientist CDC Division of Reproductive HealthMedicalResearch.com Interview with:
Dmitry Kissin, MD
Health scientist
CDC Division of Reproductive Health

Medical Research: What is the background for this study?

Dr. Kissin: Due to the frequent transfer of more than one embryo during assisted reproductive technology (ART) treatments, such as in vitro fertilization (IVF), many ART-conceived children are born as multiples (twins, triplets and higher order). Multiple births, even twins, carry increased risk for both mothers and children. In the U.S., the practice guidelines published by the American Society for Reproductive Medicine (ASRM) and the Society for Assisted Reproductive Technology (SART) provide recommendations on how many embryos to transfer in order to balance safety with the effectiveness of assisted reproductive technology. In an effort to reduce multiple births and associated complications, it is important to evaluate embryo transfer practices that contribute to these outcomes.

Medical Research: What are the main findings?

Dr. Kissin: Using data from the CDC’s National ART Surveillance System (NASS), we found that the majority of ART-related multiple births in the U.S. resulted from assisted reproductive technology cycles practiced in accordance with ASRM/SART guidelines and involved the transfer of two embryos. Almost half of ART-related multiple births resulted from transferring two fresh blastocysts (embryos cultured for 5/6 days) to favorable- or average-prognosis patients less than 35 years and donor-egg recipients, or two frozen/thawed embryos to patients less than 35 years.

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Male Occupation and Health Can Affect Fertility

Michael L. Eisenberg, M.D. Director, Male Reproductive Medicine and Surgery Assistant Professor Department of Urology Stanford University School of MedicineMedicalResearch.com Interview with:
Michael L. Eisenberg, M.D.
Director, Male Reproductive Medicine and Surgery
Assistant Professor
Department of Urology
Stanford University School of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Eisenberg: There has been growing data that a man’s overall health may impact his fertility. As such, we wanted to explore this link using the NICHD LIFE Study which has the unique ability to account for both health and work exposure in men with both normal and abnormal fertility. We found that certain aspects of a man’s work and health can impact his semen parameters.

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Scientists Complete First Steps Toward Making Sperm and Eggs From Skin Stem Cells

Jacob (Yaqub) Hanna  M.D. Ph.D. Kimmel Investigator | NYSCF Robertson Investigator The Department of Molecular Genetics Weizmann Institute of Science, IsraelMedicalResearch.com Interview with:
Jacob (Yaqub) Hanna  M.D. Ph.D.
Kimmel Investigator | NYSCF Robertson Investigator
The Department of Molecular Genetics
Weizmann Institute of Science, Israel

MedicalResearch: Could this be helpful for any individual with infertility problems? 

Dr Hanna: Our research is focused on taking skin cell samples and converting them into embryonic-like stem cells (iPS cells) via direct reprogramming and without using embryo derived stem cell lines. Then we are focusing in differentiating these male or female iPS lines into sperm cells or oocytes, respectively. We have succeeded in the first and most important step of the process, where we succeed in reaching the progenitor cell state for sperm and egg (we have not achieved mature sperm and eggs ….Very important to emphasize!). So we are now focusing on completing the second half of this process. Once that is achieved this may become useful for any individual with fertility problems.

MedicalResearch: Could this be a viable option ALSO for same-sex couples?  What are the prospects for letting gay or lesbian couples produce progenitor cell state cells from their skin cells? For example, is it conceivable that the “second half” of the protocol could some day also be done in vitro (making fully mature sperm and eggs), so that men could produce egg cells and women sperm cells?
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Link Between Stress and Fertility Examined

Anna Geraghty Department of Integrative Biology University of California, Berkeley, Berkeley,MedicalResearch.com Interview with:
Anna Geraghty

Department of Integrative Biology
University of California, Berkeley, Berkeley,

Medical Research: What is the background for this study? What are the main findings?

Response: RFRP3 in mammals has been well characterized as a negative regulator of the hormonal reproductive axis. It shuts down release of gonadotropins necessary for successful reproduction, similar to how stress inhibits reproduction. Our lab has previously shown that stress can directly regulate RFRP3 levels in males-both acute and chronic stress lead to an upregulation of RFRP3 levels in the male rat. As a followup to that study, we were interested in looking at whether this response was similar in females, and how that may affect long term fertility. We found that chronic (18 days) of stress led to an increase in RFRP3 levels all all stages of the estrous cycle. This increase was also sustained for at least 4 days, or one whole estrous cycle, after the stress ended- the equivalent to a month menstrual cycle in humans. In rats that were stressed and then allowed to recover for 4 days, animals that were stressed were significantly less successful at reproducing- 76% success rate in controls compared to 21% in the stressed animals. This was a result of a combination of deficits in the mating process- less stressed animals successfully copulated, those that did successfully mate had fewer pregnancies, and gave birth to smaller litters. However, utilizing an inducible virus to knockdown RFRP levels in the hypothalamus specifically during the stress period prevented all of these problems- stressed animals without stress-induced RFRP3 increases looked indistinguishable to controls.

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Infertility in Men Linked to Mortality

Michael Eisenberg, MD, PhD Director, Male Reproductive Medicine and Surgery Assistant Professor, Department of Urology Assistant Professor, Department of Obstetrics and GynecologyMedicalResearch. com Interview with:
Michael Eisenberg, MD, PhD
Director, Male Reproductive Medicine and Surgery
Assistant Professor, Department of Urology
Assistant Professor, Department of Obstetrics and Gynecology
Stanford School of Medicine

MedicalResearch:   What are the main findings of the study?

Dr. Eisenberg: There is an inverse relationship between semen quality and mortality so that as semen quality declines the likliehood of death increases.
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Number, Success of Donor Egg Cycles Increase over Decade

Dr. Jennifer Fay Kawwaas MD Department of Gynecology and Obstetrics Emory University School of Medicine, Atlanta, GA, USAMedicalResearch.com Interview with:
Dr. Jennifer Fay Kawwaas MD
Department of Gynecology and Obstetrics
Emory University School of Medicine, Atlanta, GA, USA


MedicalResearch.com: What are the main findings of the study?

Dr. Kawwaas: Using CDC National ART Surveillance System (NASS) data, we found an increasing trend from 2000 to 2010 in the number of donor egg cycles performed annually and in the percentage of donor cycles that resulted in a good outcome, defined as delivery of a full term infant weighing more than 5.5lbs. Donor and recipient ages remained relatively stable at 28 and 41, respectively, over the 11-year period.

Elective single embryo transfer is recommended when the donor is under 35 years old, regardless of recipient’s age; transfer of a single day 5 embryo was associated with an increased chance of good perinatal outcome.

Tubal or uterine factor infertility and non-Hispanic Black race were associated with a lower chance of good perinatal outcome.
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