Dr. Norber Gleicher explains in this new video the benefits, risks, and chances of a successful pregnancy with our affordable egg donation program, called EcoDEP (Eco Donor Egg Program). For more information about our frozen donor egg program please visit the EcoDEP webpage.

A very recent CHR Grandrounds speaker, Shoukhrat Mitalipov, PhD, has been in the media spotlight in the last 24 hours, for a groundbreaking human cloning paper that was just published in one of the leading scientific journals, Cell¹,describing the technique of creating human embryonic stem cells via somatic cell nuclear transfer (SCNT). The clinical idea behind this research is then to use these stem cells for therapeutic purposes.

Dr. Mitalipov’s group at Oregon National Primate Research Center removed the nucleus from a donated oocyte, and fused this oocyte with a skin cell from a sick baby, who needed a stem cell transplant. Utilizing SCNT, the group was able to create an embryo with the baby’s own DNA. Implanting these stem cells into the baby would not cause a rejection reaction by the baby’s immune system.

Previous attempts at creating such “autologous” embryonic stem cells through SCNT had failed, because embryos did not develop normally in culture. The Oregon group was, however, able to overcome this problem. Embryos could be culture long enough to harvest embryonic stem cells to treat the baby.

Scientists have been trying to create human embryonic stem cells through cloning for more than a decade. Since embryonic stem cells are pluripotent (they can develop into any kind of cells), they can be converted into many different tissue cell types in the laboratory. Moreover, these cells, genetically identical to the patient in need of treatment, do not pose a threat of rejection when implanted, offering a real potential breakthrough for future stem cell therapies.

In a more controversial clinical application, this research, however, also potentially points towards the possibility of creating human embryos for infertility treatments in this way. While current U.S. law prohibits human cloning for reproductive purposes, laws, can, of course, change over time, should the safety of this cloning process be established.

Most of the findings reported by Dr. Mitalipov’ group in the Cell article were previewed at the March Grandrounds for CHR’s physician-scientist audience. A recording of Dr. Mitalipov’s presentation is available on CHR’s Infertility University website.

Congratulation, Dr. Mitalipov and colleagues, and thank you for sharing your exiting research with us at CHR’s Grandrounds.

¹Tachibana et al. Human embryonic stem cells derived by somatic cell nuclear transfer. Cell 2013. doi:10.1016/j.cell.2013.05.006

CHR’s David H. Barad MD (Clinical Director of Assisted Reproductive Technology and Senior Scientist at CHR) and Norbert Gleicher MD (Medical Director and Chief Scientist at CHR), along with other leading infertility specialists, authored a study just published in the medical journal Reproductive Biology and Endocrinology, titled “Does hormonal contraception prior to in vitro fertilization (IVF) negatively affect oocyte yields? – A pilot study.”

The study investigated what effects taking oral contraceptives prior to IVF treatment has on a woman’s oocyte (egg) numbers. Many IVF centers routinely prescribe hormonal contraceptives in order to help regulate a woman’s menstrual cycle prior to treatment. However, the findings in the study suggests that oral contraceptives could affect a women’s oocyte numbers negatively, especially if they are taking androgenic oral contraceptives.

The results may be particularly important for women with diminished ovarian reserve, who already, in the best of circumstances, only produce a small number of eggs.

This study, which is the first of its kind, will certainly question the routine practice of using of hormonal oral contraception leading up to IVF cycles.

To read the full study report, please visit:
www.centerforhumanreprod.com/news_oral_contraceptives_reduce_IVF_pregnancy_chances.html

Visiting an infertility center for the first time can be a little daunting. In order to help ease nerves and familiarize you with our facility and staff, our new virtual facility tour video (available on the CHR YouTube Channel) will walk you through what to expect on your first in-office consultation at CHR. (And for those of you who are our long-distance patients, the video will give you an idea of what our facility and staff look like, before you come here for egg retrieval and/or embryo transfer!)

Our tour shows you who you meet on your first day, what exams to expect, explains the roles of our clinical co-coordinators and takes you through the IVF treatment process.

So, simply play the video below and let us welcome you to our first class facility in New York City!

Ovarian hyperstimulation syndrome—especially in its more severe forms—is a rare complication of fertility treatments. Women can develop this condition after taking ovarian stimulation drugs; however, it is possible for this condition to develop even without evidence of over-stimulation.

Risk of developing OHSS increases with:

• High follicle count
• High levels of estradiol, a female hormone released by the follicles
• Pregnancy and resulting hormone, hCG

Although these risks can be indicators that women may develop OHSS, sometimes women can develop OHSS with a small follicle count and modest levels of estradiol.

Severity of OHSS can range from mild, to moderate, to severe. In mild cases, women may just experience slight abdominal discomfort, which is caused by a fluid collection in the abdomen. In moderate cases, this fluid may be more painful and disabling. When in experienced hands, these cases can usually be managed on an outpatient basis.

Severe cases of OHSS, luckily, are extremely rare and hospitalization for management is usually necessary. With severe OHSS, women experience extreme pain in the abdomen and often have difficulty breathing.

Diagnosing OHSS can be difficult, as diagnosis is based on the presentation of symptoms, and pain thresholds differ between different people. Also, as we have already mentioned, some women may lack the typical “warning signs” for developing OHSS.

Another reason OHSS diagnosis can be difficult relates to the simple fact that women in or just after fertility treatments can develop other abdominal conditions that present with similar symptoms; just because a woman was recently in fertility treatments and is presenting with OHSS-like symptoms doesn’t mean that she doesn’t have these other abdominal conditions.

Because physicians outside of reproductive endocrinology and infertility can be unfamiliar with OHSS, women who go to the emergency room with OHSS can often be subjected to unnecessary investigations, such as exploratory surgery, when surgery is not indicated in OHSS.

So, this is what we tell all our patients: If you are undergoing treatment at the CHR (egg donors included), and develop any unusual symptoms, please contact us before considering the emergency room. We are available 7 days a week, 24 hours a day (with the help of our answering service). If you cannot contact us and go to the emergency room, please tell the treating physician that you are under our care. The physician can then contact us before any unnecessary and avoidable interventions.

We are very happy to announce that construction to expand our facility has begun.

Projected to be finished in 2014, the construction process will be completed in four phases, the first of which has already started!

Phase 1: Our basement, which has been just a storage facility, will become space for administrative and research facility for the laboratory staff, where some portion of the center’s significant research activities will take place. The basement will also be expanded to the full length of the courtyard.

Phase 2: We are planning to build a three-floor structure above the expanded basement in the courtyard. If all goes well, we expect for this structure to be finished later this year.

Phase 3: Interior work on our new structure will take place, including a brand-new IVF unit located on the ground floor, just off the waiting room.

The office of our Chief Operating Officer (COO), Jolanta Tapper, will be moved to the 3^rd floor of the new structure. Her new office will be larger and much more visitor friendly.

Part of the 2^nd floor will be another office, for our clinical coordinators and a conference room, which can easily be converted into a small lecture room. This will be of great use for the CHR, as we regularly host seminars with scientists from all over the world, discussing the newest research projects and practices for infertility treatment.

Phase 4: The last phase will see a complete rebuilding of our 4^th floor. At the moment, we have a satellite office on Madison Avenue, in which a number of activities are carried out (such as management of our monthly medical education events, editorial activities, management of our websites, and other communication and marketing functions). With this new space, these activities will return “home” to our parent office, which will improve our internal communication.

Construction activities will become very visible soon, and this alone can be somewhat disruptive. For this, we apologize in advance. That said, by planning out the building process in minute detail, we are trying our best to limit disruption of our day-to-day clinical activities. In addition, every effort has been made to ensure that patient records, as well as eggs, sperm and embryos, will remain secure.

However, if you are concerned at any given point, please do not hesitate to contact us at the CHR. Our COO, Ms. Jolanta Tapper, or our Medical Director, Dr. Norbert Gleicher, MD, can be reached at any time by calling (212)-944-4400.

We hope that you will join us at our formal reception opening in 2014 to celebrate our new space!

We are pleased to present our first infographic, which we hope will help spread awareness about unexplained infertility.  You can spread the word too by sharing our infographic via social media or by using the embed code below to publish it on your website or blog!

Embed code

Just copy and paste the code below into your blog or website to help spread the word about unexplained infertility.

<iframe style=”border: 0; height: 1110px; overflow: hidden;width: 630px;” src=”https://www.centerforhumanreprod.com/embed.html“frameborder=”0″ scrolling=”no” width=”630″ height=”1110″></iframe>

The popular online fertility site, FertilityAuthority.com, sat down and interviewed CHR’s Medical Director, Norbert Gleicher, MD, about his recent research which suggests that low androgen levels are associated with diminished functional ovarian reserve (DFOR) in women of all ages.

Currently, androgen levels are not a part of routine testing for fertility patients. However, in light of these research findings, Dr. Gleicher suggests that women with DFOR should be tested for these hormone levels. And, if the levels are in the lower one-third of the normal range, the doctor should provide appropriate hormone supplementation.

Read the full article on FertilityAuthority.com : Low Androgen Levels Associated with Diminished Functional Ovarian Reserve

One of the most widely used methods of measuring the function of a woman’s ovarian reserve is the assessment of FSH (follicle-stimulating hormone) levels. However, despite the fact that it has been proven that the FSH levels rise with advancing age, many fertility centers still rely on universal cut-off values for FSH, meaning that they refuse treatment to women whose FSH levels are above one “normal range” for women of all ages, or consider every woman as having normal ovarian function, whose FHS levels are below such a universal “normal”.

What is a normal FSH level?

We have demonstrated that the true normal level of FSH in a woman falls within certain parameters, depending on her age. These age-specific parameters look like this:

33 year or less = less than 7.0mlU/mL

33-37 years = less than 7.9 mlU/mL

38-40 years = less than 8.4 mlU/mL

41 years = less than 8.5 mlU/mL

In other words, the older a woman gets, the higher we expect her FSH levels to be. This sliding scale is important because the fertility centers that enforce universal cut-off measures for FHS are probably refusing treatment to many women who actually have appropriate FSH levels for their age. Another reason for the importance of age-specific FSH levels is that they allow fertility specialists to identify women whose ovarian reserve is prematurely being depleted, even when their FSH levels are “normal” on a universal scale.

It is important to note that FSH is NOT the only measure of ovarian function (and nor is it as specific as we once thought) and other factors, including the anti-Müllerian hormone levels and as has become increasingly apparent, the testosterone levels, need to be taken into consideration in order to accurately assess a woman’s ovarian function and probability of conception.

For more information about FHS, high FSH levels, and FHS infertility please view our High FSH information page.

CHR’s Dr. Norbert Gleicher recently spoke out against the findings of a 2012 Finnish study which promoted the use of elective single embryo transfer (eSET) in women between the ages of 40-44. Dr. Gleicher wrote a counter-response piece to the study which was published in the journal Human Reproduction last year.

In recent years, eSET, which is the practice of transferring only one embryo, instead of two, during an IVF treatment cycle, has received considerable attention in the reproductive community. Supporters of this practice argue that by transferring only one embryo, the risk for twins and subsequent complications is theoretically reduced.

However, Dr. Gleicher and his colleagues at CHR disagree.

“Is it really ethically acceptable to urge 40- to 44-year-old women to reduce their immediate pregnancy chances [by transferring only one embryo]? Is it ethically acceptable to do this to even younger women?… No patient can ever be guaranteed that she will be given a second chance to conceive, once she decides to split the initial 2ET chance into two consecutive eSET cycles.”

Dr. Gleicher’s comments caught the eye of the editor at Human Reproduction, Professor Hans Evers, who featured it a February highlight in the prestigious medical journal.