CHR Blog

The Latest on Fertility Research and Treatment

Posts Tagged ‘infertility treatment’

CHR announces research agreement to further study effectiveness of DHEA

CHR is proud to announce a research collaboration agreement with University of Rochester School of Medicine and Dentistry (URSMD), to better understand how dehydroepiandrosterone (DHEA) improves female fertility.

The team plans to explore the process of follicle maturation, and especially the role of androgens in female reproduction.

Lead investigators are Aritro Sen, PhD, Research Assistant Professor, and Stephen R. Hammes, MD, PhD, Professor, both in the Division of Endocrinology and Metabolism at URSMD, who have published pioneering work on the subject in a rodent model.

They are joined by two other lead investigators: Norbert Gleicher, MD, CHR’s Chief Scientist, and David H. Barad, MD, MS, Senior Scientist at CHR, who revolutionized infertility treatment for women with low ovarian reserve worldwide through the introduction of DHEA.

“The goal of this research collaboration is to combine complementary animal and laboratory expertise at URSMD with clinical expertise at CHR,” explains Dr. Gleicher. “By combining research in URSMD’s unique animal model and CHR’s large clinical human experience, we aim to better understand how DHEA, as well as other androgens, improve female fertility.”

“This is a very exciting development,” adds Dr. Barad. “We have known for years now that DHEA improves pregnancy chances but only very recently learned that this very likely occurs through conversion of DHEA to testosterone. For all practical purposes, this means that the process very likely involves the androgen receptor (AR) on granulosa cells.” Dr. Barad continues: “For this kind of work our colleagues at URSMD have the ideal mouse model.”

Dr. Sen, who will become a Visiting Assistant Scientist at CHR, adds: “we are very much looking forward to this collaboration, which should be very beneficial for both institutions.”

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Few cancer patients seek fertility preservation options, according to new research study

Fertility PreservationAccording to a new research study, only a few percent of women in reproductive age with breast cancer take steps to preserve their eggs before going through chemotherapy and radiation treatments. These cancer treatments pose a significant risk of infertility if appropriate steps for fertility preservation are not taken in advance.

“Patients are understandably overwhelmed by the diagnosis, and might want to focus on the immediate treatment for cancer,” explains Norbert Gleicher, MD, Medical Director of CHR and the Director of the center’s Fertility Preservation Program. “Furthermore, the counseling cancer patients receive may not be timely enough.”

Dr. Gleicher continues: “Cancer patients who do not have timely access to a properly equipped fertility center may lose the chance for fertility preservation before their cancer treatments start. At CHR, all fertility preservation patients are given priority as medical emergencies, and receive same-day or next-day appointments.”

Egg freezing remains the predominant method of fertility preservation for cancer patients, but freezing of embryos can also be an infertility treatment option. Worldwide experience with embryo freezing is much larger than with egg freezing, and available data are, therefore, more extensive and reliable. However, embryo freezing may not be an option for patients without a partner. The only additional alternative to egg and embryo freezing is the freezing of whole ovaries.

“At CHR, we see a considerable increase in ‘social’ fertility preservation in women who are not ready to have children yet, but want to extend their fertility into the future,” adds Dr. Gleicher. “Fertility preservation for cancer patients remains, as the study suggests, a medical service with quite limited demand.”

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U.S. citizenship requirement may pose threats to patients seeking infertility treatments overseas

According to a recent USA Today report by Michelle Chabin, 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. (What an invasion of privacy!) When she honestly responded yes, she was informed that her two children would not receive U.S. citizenship unless she could prove that the egg or sperm came from an American citizen!

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. While children adopted overseas are granted U.S. citizenship, children born overseas to U.S. parents from donor eggs and/or sperm from non-U.S. citizens may not be.

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

What an absolutely stupid rule! Outrage aside, however, this case 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.

 

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Dr. Gleicher Weighs In on Low-Intensity IVF Treatment

CHR’s founder and medical director, Norbert Gleicher, MD, provided expert commentary regarding a controversial new IVF treatment which was recently featured in the St. Louis, MO-based newspaper, St. Louis Post-Dispatch.

The infertility treatment, known as low-intensity IVF or “Mini-IVF,” is a variation of standard in vitro fertilization (IVF) but uses a less intense regimen of medications, with the aim of reducing monitoring needs, smaller numbers of eggs and lower costs.

The article was generated in St. Louis because a local IVF center has been very actively promoting this procedure, with its medical director claiming to “get better quality eggs, and almost every single one of these eggs forming into a beautiful embryo.”

Dr. Gleicher was interviewed for this article because he was the lead author of a recent critical “commentary” in the medical journal Reproductive Medicine Online, regarding the data reported about “Mini-IVF” by the St. Louis group. In this commentary, titled “Low-intensity IVF: real progress?” the authors from CHR questioned the integrity of reported results and concluded that “Mini-IVF,” considering the lack of credible data on its outcome, should, as of this point, still be considered an experimental procedure, and only be offered under study conditions, and with appropriate informed consents. (Reprod Biomed Online 2011;23(3):274-8).

“I’m not against the idea, but what I am against is when patients are deprived of expected pregnancy chances without them even knowing about it,” Dr. Gleicher was quoted in the Post-Dispatch article.

Preliminary research on the subject at CHR, which was recently accepted for publication in the same journal, indeed, was unable to confirm the claims made by the St. Louis group: pregnancy rates with low-intensity IVF were significantly lower than with standard IVF procedures, and because of much lower pregnancy chances, there was also no cost advantage to “Mini-IVF” if a correct end point of live birth was chosen, rather than simple cycle costs. (Gleicher et al, A case control pilot study of low-intensity IVF in good-prognosis patients. Reprod Biomed Online 2012; In Press).

In the article Dr. Gleicher’s views were shared by another commentator, Dr. Randall Odem, chief of the reproductive endocrinology division at Washington University School of Medicine.

For the full article please go to www.stltoday.com.

 

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