CHR Update

The following articles represent an update on CHR activities. If you want further information on any of these articles, please contact us. CHR is a comprehensive fertility center in New York, NY.

April 2012

Interesting things are happening in the world of reproductive endocrinology and infertility, and CHR investigators are getting increasing recognitions for their work in some of the most challenging areas. This is well documented by their rather busy travel schedules, the result of many invitations to present talks at meetings all around the world.

David H. Barad, MD, Senior Scientist at CHR and its Director of Clinical IVF, just returned from a European symposium in Budapest, Hungary, where he was asked to speak about differences in reproductive function between races.

Those who follow CHR's research efforts, either through these pages, our newsletter or the center's website, know that these differences have been a major point of interest for researchers at CHR for years, and have been the subject of a good number of published papers. This is such an important topic because many research centers, including CHR, have reported different IVF outcomes between races but nobody has been able to understand why these differences occur.

Through our work on the FMR1 gene, we now believe to be coming closer and closer to an answer. We already know that different races present with distinctively different distributions of ovarian genotypes and sub-genotypes of the FMR1 gene, first described here at CHR. These differences undoubtedly contribute to reported outcome differences in IVF. The remaining question is only, by how much?

For the coming September, Dr. Barad was invited to present a keynote lecture at the 58th Annual Meeting of the Canadian Fertility and Andrology Society (CFAS), the Canadian counterpart to the American Society for Reproductive Medicine (ASRM). This time Dr. Barad was asked to address another main area of research at CHR, ovarian reserve (OR), and its impact on oocytes.

OR, of course, has been a central theme of all research at CHR for the last 10 years. The number of published papers on this subject is almost too large to remember. CHR's special research and clinical expertise on this subject is now recognized worldwide.

Norbert Gleicher, MD, CHR's Chief Scientist and Medical Director, was in Canada just last month, addressing the Greater Toronto Reproductive Medicine Rounds in a lecture specifically dedicated to the FMR1 gene. At the beginning of May, he will be addressing a conference in Barcelona, Spain, on Granulocyte-Colony Stimulating Factor (G-CSF) use in women with treatment-resistant thin endometrium, also a new treatment first developed and reported in the medical literature at CHR. As a rather unusual honor, he was then invited to give a keynote lecture in association with the Annual Congress of Clinical Rheumatology in Chicago on chromosomes and autoimmunity, likely consequence of a paper that just appeared in the Journal of Autoimmunity by Dr. Gleicher and colleagues, describing the relevance of the FMR1 gene for autoimmunity as well as reproductive success [Gleicher et al., Cutting edge assessment of the impact of autoimmunity on female reproductive success. J Autoimmunity 2012;38:74-80].

He then continues straight from Chicago to Berlin, Germany, where he was asked to cover another area of his special expertise, cardiac problems in pregnancy, at a congress for cardiologist. As more and more women of more and more advanced ages are going through pregnancy, cardiac problems arise more frequently and require close prophylactic attention in infertility practice. After all, we do not only want to help establish pregnancies, but we want pregnancies to end with healthy mothers and babies!

And in early July, Dr. Gleicher is off to the Annual Asian COGI Congress, this year in Singapore, where he has been a permanent faculty member for years. This year, he is to present four talks, covering in vitro maturation of (immature) oocytes, preimplantation genetic screening (PGS), diminished ovarian reserve (DOR) and a more theoretical subject close to his heart, evidence-based medicine. In practically all of these areas, CHR has extensively published, and is known for its special expertise.

The Annual ESHRE Meeting and Related Issues

Steady readers of the UPDATE may have noticed that in both physicians' upcoming travel schedule the Annual Meeting of the European Society for Human Reproduction and Embryology (ESHRE) does not appear this year. This is not an accident because the meeting, this year, is scheduled in Istanbul, Turkey. Though Istanbul is one of Dr. Gleicher's favorite cities in Europe, he decided to skip his annual participation at the ESHRE meeting at advice of legal counsel.

Why at advice of legal counsel, you may ask? The answer is simple: In 2011, Turkey passed a law, which made the process of egg donation a criminal act. Moreover, the law threatened prosecution of Turkish patients and of all health care providers who participate in egg donation treatments of Turkish patients.

CHR serves a good number of Turkish patients every year, some of whom undergoing egg donation. Therefore, any health care provider at CHR, under this new law, at least theoretically, could be subject to prosecution in Turkey. Would you under these circumstances attend ESHRE? Remember the prison in Midnight Express?

So, for the first time in many years, CHR will have no representation at ESHRE. Maybe ESHRE should consider more carefully where to schedule future Annual Meetings. Aside from the obvious legal threat this new law represents to members of ESHRE, one really has to wonder why a major international infertility society would reward a country with the honor of an Annual Meeting the year after the country's government passes such a restrictive and rather ridiculous law. We are puzzled!

Another Ridiculous Government Activity Related to IVF

But unfortunately ridiculousness is not restricted to the Turkish government. Our government, here in the U.S., is also following some rather strange policies. Michelle Chabin reported last month in USA Today that a U.S. citizen from Chicago, who gave birth to twins in Israel, entered "regulatory hell" when she applied for U.S. citizenship for her twins at the U. S. embassy in Tel Aviv.

The first question she was asked, apparently, was whether she conceived through infertility treatment. When she honestly responded yes, she was informed that her two children would not receive U.S. citizenship unless she could prove that egg or sperm came from an American citizen!

Does anybody believe that OUR government would behave in such a way?

Chabin pointed out in her report the very obvious and "glaring inequity" in citizenship requirements between overseas adoptions and overseas infertility treatments, demonstrated by this case. The most remarkable fact about all of this to us, however, is that the above noted Turkish law makes very similar statements about Turkish citizenship, and lists the possibility of "foreign" sperm or egg donors as a reason for the criminalization of egg and sperm donations. How proud can we be to find ourselves in such good company!

This Chicago citizen, a single mother of advanced age, has given up on seeking U.S. citizenships for her twins, according to Chabin's article. Had she given birth in the U.S., the twins would, of course, have had citizenship automatically.

What an invasion of privacy! And what an absolutely stupid rule! One sometimes wonders about the people in the U.S. Department of State who make up these rules. Maybe we could use them to staff our growing embassy in Turkey!

Joking aside, this case, of course, should serve as a serious warning to patients who travel overseas for fertility treatments. If the U.S. embassy in Israel follows these rules, it is reasonable to assume that U.S. embassies in other countries will as well. But, then, who knows, considering the demonstrated wisdom of our government in this realm!

CHR in the News

March turned out to be another busy month for CHR's media appearances. FertilityAuthority.com interviewed Dr. Gleicher on various infertility-related topics, including a CHR publication on a FMR1 gene sub-genotype that may preserve a woman's ability to produce eggs well into her 40s. A French-language Quebec newspaper Le Devoir interviewed Dr. Gleicher extensively on the pitfalls of Quebec's mandatory single embryo transfer policy. In addition, a publisher of college-level psychology textbook visited our Manhattan office to film an expert commentary on the psychological impact of infertility.

For a list of CHR's media appearances, please visit our press page.

News from CHR's Division of Laboratories

With the principal goal of increasing the scientific research output, CHR has, over the last two years, been proactively rebuilding its laboratory division. We are now very pleased to report that we, finally, have reached our long-searched-for goals. CHR's Division of Laboratories has now three full-time staff members with Ph.D. degrees, one full time member currently working on her M.S., and one laboratory technologist. The division is further backed up by a part-time senior embryologist with an M.S.

This represents more than a doubling of the center's laboratory staff from only a year ago, and a tripling of the number of Ph.D.-level scientists.

The Director of the Division, with academic title of Senior Scientist, is Ho-Joon Lee, Ph.D., who recently joined CHR, after working for a number of years as a research scientist at Massachusetts General Hospital of Harvard Medical School in Boston, MA. Before coming to Boston, Dr. Lee was the laboratory director of South Korea's largest and most prominent IVF program.

Dr. Lee is extensively published in the field, and his research interests over the last years very well match with the direction CHR's research has taken.

Also new to the division is Tamar Michaeli, Ph.D., who joined CHR as an Associate Scientist from a position as Associate Professor of Developmental and Molecular Physiology at Albert Einstein College of Medicine. Dr. Michaeli, who originally is from Israel, was brought on board because of her well-recognized expertise in molecular biology.

Aya Shohat-Tal, Ph.D., also originally from Israel, is a recent graduate of City University of New York Graduate Center, and joined CHR as a Junior Scientist. Despite her young age, she already has a published paper under her belt, pointing towards a sharp and inquisitive research mind.

Emanuela Lazzaroni, B.S., joined CHR in late 2011 from another NYC-based IVF program. As a highly competent clinical embryologist, she has been striving to advance her academic career, and has been enrolled in a master's program in embryology and clinical andrology at Eastern Virginia Medical School in Norfolk, VA. She is currently in the process of completing her master's thesis at CHR.


Finally, we recently had the opportunity to welcome Aritro Sen, Ph.D., at CHR for a staff seminar. Dr. Sen, currently Research Assistant Professor at the University of Rochester School of Medicine and Dentistry in Rochester, NY, is the first author of one of the most important scientific papers published in our field in recent years. In this paper (published with his division head in medical endocrinology, Stephen Hammes, MD, Ph.D.), the authors were, for the first time, able to demonstrate in a unique mouse model, beyond reasonable doubt, that androgens were essential for normal follicle maturation, offering a strong theoretical basic science underpinning for CHR's clinical DHEA work.

We are now hopeful to establish in the very near future a formal collaborative arrangement between CHR and Dr. Sen, which will give CHR investigators access to the unique laboratory set up Dr. Sen has at his disposal in Rochester, NY, will allow him on a regular basis to come for visits to CHR in NYC, and will give him, in turn, access to CHR's clinical research opportunities. Stay tuned for more to come in a, potentially, mutually very beneficial research collaboration!

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If you have any questions or comments, please contact us.

-The CHR

Last Updated: March 29, 2012