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Even if you think your doctor is the smartest and most thoughtful provider you’ve ever had, doctors can still offer solutions you don’t agree with. In addition, different providers can have varying treatment approaches, recommendations, and findings. Due to all these factors, it never hurts to seek out a second...
In vitro fertilization (IVF) is an assistive reproductive technology used to help you expand your family. It involves taking eggs from a woman’s ovaries and fertilizing them with sperm outside the body to make an embryo. This embryo can then be transferred to the woman’s uterus. This process can be...
Cortisol is one of several hormones produced by the adrenal glands, sitting on top of both kidneys. Adrenals produce several families of hormones under regulation of a pituitary hormone called adrenocorticotropic hormone (ACTH). These groups of hormones are derived from three so-called zonae and an area called he hilus of...
Contrary to widely held beliefs, the history of IVF did not start with the world’s first reported IVF birth in the United Kingdom on July 25, 1978.3 This birth was, indeed, preceded by years of research and failed attempts by Patrick Steptoe, MD, and Robert Edwards, PhD, who in 1978...
Since this is the “American Heart Month,” we felt it was time to address the fact that cardiovascular diseases are the most frequent cause of maternal death in pregnancy. Because ever older women are now conceiving, often with donated eggs from younger women, we have started to see cardiovascular diseases...
In several consecutive formats, for over 20 years PGT-A, in association with in vitro fertilization (IVF), representing the testing of human embryos for chromosomal abnormalities (aneuploid cells) prior to transfer into the uterus, has been used to deselect “abnormal” embryos. As of 2022, it is assumed that over half of...
And now to a much more practical subject: have you heard about “PCOS diets”? They suddenly have become a hot topic all over the Internet. But looking a little closer into the wisdom that is being offered, it quickly becomes apparent that practically nobody is addressing the immunological HH-PCOS. Universal...
The COVID-19 pandemic has triggered dramatic changes throughout everyday life — and in the medical community as well. Not only are providers across the country postponing elective procedures, but many are also encouraging people to avoid in-office appointments to reduce their risk of exposure to this highly contagious coronavirus.But what...
In this section we attempt to draw attention to science papers we perceive as potentially important for the basic understanding of reproductive biology and, therefore, may have translational relevance to infertility practice at some future point. We already discussed in CHR’s recent publication list the study in Nature Cell Biology...
Millions of people who until only a few decades ago had no chance of genetic parenthood, now have children of their own. Even for professionals in the field, the progress achieved in the understanding of basic physiological processes relating to female and male infertility and basic human embryology over the...
New York City and a big part of the country are quickly coming back to almost normal, as case numbers, hospitalizations and deaths from COVID-19 are quickly dropping. There is still some fear mongering going on, especially when it comes to the so-called new strains of the virus, which are...
Most of the COVID-19 news these days is positive: new infections in the U.S. and countries, like Israel, have been declining rapidly and, with its deaths from the disease. At the same time, the news in big parts of the world, especially Europe and Brazil, is not that favorable. Especially...
The appropriate role of profit incentives on medical practice has been, and will remain for some time to come, the central theme in every discussion of national health care, - whatever the system. One would assume that profit motives in private systems would be more dominant than in more socialist...
Are plastics and pesticides making us sterile? Alarming news about declining sperm counts have recently made headlines in medical literature as well as lay media. That sperm counts have been declining has been known for decades; but the trend appears to accelerate, with a recent study reporting an approximately 50%...
New experimental models for human blastocyst-stage embryos (“blastoids”) Nature magazine just published two exiting papers,[1,2] with two similar ones from other investigators, as the magazine also reports, on the way and posted ahead of peer review on bioRxiv.[3,4] All of this is about the fact that research involving human embryos,...
Is there a place for DHEA and CoQ10 in women undergoing “planned” egg-freezing? At CHR, women undergoing egg-freeing cycles undergo a very similar diagnostic work-up before cycle start as women who are in regular IVF cycles. Therefore, the kind of ovarian stimulation a woman undergoing egg-freezing will receive, is equally...
Two prominent voices in the fertility field known as longstanding supporters of mild ovarian stimulation were at it once again (Nargund and Fauser, Reprod Biomed Online 2020;41:569-571) when publishing an editorial with the rather astonishing title: “Mild ovarian stimulation for IVF is the smartest way forward.” The first question that comes to mind...
DOES THE BRITISH STRAIN B.1.1.7 INCREASE MORTALITY OVER D614G? A just published study by British investigators claims that not only infectivity of the “new” British B.1.1.7 SARS-CoV-2 strain, B.1.1.7, is higher than that of previously dominant strains, including D614G, but also mortality. A case-controlled study suggests a significant increase in deaths [1.64 (955 CI,...
Letter to President Biden and Secretary Designate of HHS, Xavier Becerra In a published letter (_Santoro et al Reprod Sciences 2021; https:/doi.org/10.1007/s43032-021-00491-_9), a small group of prominent physicians, scientists, and ethicists in reproductive medicine urged the new administration to reverse a decision made by the Human Fetal Tissue Ethics Advisory Board. This...
On the Cryopreservation of gametes and embryos It is 42 years from the birth of the first IVF offspring and the world is now already approaching 10 million IVF births. There are few, if any, new medical treatments that can point toward such enormous success. But to a degree, IFV...
ACCESS TO FERTILITY COVERAGE EXPANDED BY NEW YORK STATE FOR SAME SEX COUPLES AS PART OF 2021 WOMEN’S AGENDA and NEW YORK CHILD PARENT SECURITY ACT (CPSA) WENT INTO EFFECT On February 11, 2021, Governor Cuomo directed the Department of Financial Service to ensure that insurers immediately begin covering fertility services for same sex...
In this issue, we continue to offer what we consider the most important news relating to the infertility field and/or reproductive biology in the preceding month. We in this issue, however, also are responding to two requests we received from our readers: The first was a request for brief “case...
Important new observations about placental physiology, protecting offspring from viral infections Investigators from Duke University and New York’s Mount Sinai just published a very interesting mouse study in SCIENCE. The matter is somewhat complicated, but we will attempt to explain: Our bodies produce three types of interferons (IFNs), alpha, beta and gamma. They have...
Does obstructive sleep apnea cause male infertility? For some time, obstructive sleep apnea (OSA) has in the literature been considered a risk factor for male infertility; but up to this point it was not very clear whether this was a real, potentially causally related association, or was only secondarily connected through,...
No question in IVF has been as thoroughly investigated as this question and the repeated answer has practically always been the same: there is no evidence that even large numbers of repeat IVF cycles increase cancer risks! Only one study years ago suggested that one kind of ovarian cancer may occur more...
Why it has become so difficult to believe experts That the World Health Organization (WHO) needs help, has been rather obvious for some time. Whether its disastrous performance at the beginning of the COVID-19 pandemic was professional incompetence or political corruption, has remained in dispute; but what happened in the last week...
Based on feedback from our readers, each month we will be highlighting what we consider the most important news for fertility patients and professionals working in the field. Do you have a topic you would love covered in next month’s VOICE? We would love to hear your feedback by emailing ldellere@thechr.com...
New York has been only one of three states (the other two being Louisiana and Michigan) without surrogacy law. As of February 15, 2021, the state will join the majority, facilitating legal arrangement of paid surrogacy in New York state and conducting clinical surrogacy in the state within an existing framework that defines the...
Too many Cesarean sections? It appears that roughly every 10 years somebody notices that, especially in the developed world, too many Cesarean sections (CS) are being performed. According to CDC, CS rates in U.S. states range between 17.7% and 31%. In other countries like Brazil, the rate is even higher....
Statements of professional organizations In December, *ASRM issued the first clinical recommendation from its COVID-19 Task Force which “did not recommend withholding the (anti-COVID-19) vaccine from patients who are planning to conceive, who are currently pregnant or who are lactating.”* On December 13, ACOG followed by announcing that, “pregnant women should be given a...
First class-action lawsuit because of PGT-A One could argue that a class-action lawsuit regarding preimplantation genetic testing for aneuploidy (PGT-A) had to happen sooner or later. If something is surprising, then it is that it happened in Australia, and not in the U.S. Monash IVF in Melbourne, one of the...
Human growth hormone (HGH) has over the last decade returned to popularity in IVF cycles and is increasingly utilized at many IVF centers, including at CHR. The costs of HGH for patients are, however, significant, especially if used correctly, which here at CHR is believed to mean that supplementation must...
The VOICE is getting an upgrade! Based on feedback from our readers, each month we will be highlighting what we consider the most important news for fertility patients and professionals working in the field. Do you have a topic you would love covered in next month's VOICE? We would love...
Embryos Available in Our Embryo Donation Program CHR's embryo donation program utilizes embryos donated anonymously by infertile patients/couples for such a purpose. The availability of embryos is usually limited and embryo donation does not offer the wide variety of choices that egg donation and sperm donation allows. Below is a list of embryos currently...
Prominent physicians and scientists criticize continued utilization of Preimplantation Genetic Testing for Aneuploidy (PGT-A) in IVF and warn about a new fourth generation test For immediate release January 12, 2021 (New York, NY) - Three prominent physicians and scientists from three prestigious institutions criticized in an opinion paper just published in the...
Dr. Gleicher joins two prominent colleagues in warning against the widespread utilization of PGT-A, in an opinion paper just published in Trends in Molecular Medicine. Learn more in our press release here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief...
Affordable Frozen Donor Egg Program at CHR EcoDEP, CHR's frozen donor egg program that offers a lower-cost alternative to traditional (fresh) egg donor program, has a limited number of donor eggs immediately available to recipients. The table below lists the donors whose frozen eggs are currently available in this program....
Following the FDA approval this past weekend, vaccinations against the SARS-CoV-2 virus have begun in the U.S. Priority has been correctly assigned to health care providers, first responders and older individuals (males over females) with the highest mortality risk from COVID-19. While many infertility patients will not be included in...
As we head into the holiday season many of us find ourselves, as we have for some time, ready for the year to end, hoping for a more normal 2021. But what a year 2020 has been! Beginning this year enjoying the best economy and lowest unemployment in this county’s...
Non-Invasive Preimplantation Genetic Testing for Aneuploidy (PGT-A 4.0): Hard to believe, but IVF centers really use it! Yes, believe it or not, but several IVF centers, including at least two in NYC we know about, have initiated in association with routine IVF cycles so-called non-invasive preimplantation genetic testing for aneuploid (PGT-A). Since...
Norbert Gleicher, MD I arrived in New York City (NYC) to start my residency at Mount Sinai Medical Center roughly 46 years ago. A highly rewarding professional career in academia, research, private medicine and business behind me, I was expecting a few more good years of the same, when 2020...
Norbert Gleicher, MD In this article, CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, shares his personal experience with COVID-19. His encounter with the virus adds to the growing body of evidence that points to the existence of non-specific immunity that protects against a range of similar viruses. Here...
Photo by Tanaphong Toochinda on Unsplash One of the most frequently asked question in, likely, every fertility center is this: Doctor, should I change my diet? For the longest time there was really no good answer to this question because there were, simply, no reliable studies in the literature that address the connection between diet...
As we are finalizing this issue of The VOICE, the country has established a new president-elect who will be inaugurated in January. By that time, it also appears increasingly likely, that the first anti-COVID-19 vaccines will come to the market and, hopefully, allow the country to return to some balance and...
Photo by Nynne Schrøder on Unsplash A question that only recently seemed to have gained popularity is, what does it mean if an IVF center reports high miscarriage rates? The honest answer is not very much! The principal reason why that mere fact, alone, does not mean very much is because high miscarriage rates may...
Photo by Hira Sundus on Unsplash The SARS-CoV-2 virus, causing the current COVID-19 pandemic, is now almost 8 months among us. It has changed everything almost everywhere in the world. With millions of people infected and, in the U.S. alone, almost 250,000 deaths linked to the pandemic, this is only the beginning of the story. Unexpected...
We still have not figured out why, but CHR sees increasing numbers of women who, even at advanced ages, still produce unusually good numbers of eggs. These eggs, however, lead to surprisingly few good quality embryos. Though one, of course, cannot generalize simply based on these two points of observation, most of...
Harvard University's Petrie-Flom Center is hosing a webinar on IVF add-ons on November 10, 2020 at noon EST. Dr. Gleicher is a panelist on the webinar. Follow along as Petrie-Flom Center live-Tweet the event [here](http://IVF Add-Ons: Scientific, Ethical, Regulatory, and Legal Considerations)! Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads...
Photo by Karolina Badzmierowska via Unsplash Since our September issue was completely dedicated to COVID-19, here is, for all practical purposes, our first regular issue of the VOICE in the 2020/2021 academic year, and what an academic year it promises to be: At the time of this writing New York City has for...
Platelet (center), shown with red and white blood cells. CHR recently announced and registered a third PRP trial. For those who do not recall our prior discussions of PRP (platelet-rich plasma) in these pages, here is a quick reminder: PRP is a fraction of our blood which in many medical fields has been...
The coronavirus that our readers must be quite familiar with at this point. Mostly unnoticed and/or unmentioned by media, because of what has been happening in many countries to national health care systems (the U.S. included), brought on by the COVID-19 pandemic, the practice of medicine is undergoing likely the...
After a failed IVF cycle, ask these questions to figure out what to do next. Photo by Marina Shatskih via Unsplash The chance of pregnancy in an IVF cycle, of course, depend on many factors. Two often related factors, however, dominate: female age and functional ovarian reserve. Age is by far the most...
CHR is please do announce that Mia Yang, PhD, Junior Scientist at CHR and Postdoctoral Associate in the Laboratory of Stem Cell Biology and Molecular Embryology at the Rockefeller University, won the SRBT Basic Science Award for her abstract accepted to this year’s ASRM meeting. Awarded by the Society of Reproductive Biologists and Technologists, SRBT Basic Science Award...
One of CHR's abstracts accepted to this year's ASRM meeting won the prestigious SRBT Basic Science Award. Read about Dr. Yang's abstract on early-stage embryos' ability to correct errors in chromosomes here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned...
Study in NYC suggests that the city, likely, has already reached an adequate level of herd immunity to prevent a significant second wave of COVID-19 in the fall For immediate release New York, NY (August 21, 2020) - In a still unreviewed preprint available here, and based on an analysis of...
After a two-month break, we are very pleased to offer here the first issue for the 2020/2021 academic year of CHR’s VOICE. Because after almost half a year the COVID-19 pandemic, still, represents the _central issue this country and most of the world is facing, we are completely dedicating this issue of...
The COVID-19 pandemic through eyes of a NYC fertility center: A unique learning experience with often unexpected results This preprint has not gone through Peer-ReviewInitially Published on August 20, 2020 Norbert Gleicher, MD The Center for Human Reproduction, New York, N.Y., USA; The Foundation for Reproductive Medicine, New York, N.Y.,...
The COVID-19 pandemic through eyes of a NYC fertility center: A unique learning experience with often unexpected results This preprint has not gone through Peer-ReviewInitially Published on August 20, 2020 Norbert Gleicher, MD The Center for Human Reproduction, New York, N.Y., USA; The Foundation for Reproductive Medicine, New York, N.Y.,...
[This article deals with a continuously evolving situation, and is updated frequently to reflect new developments. It was last reviewed and updated on November 13, 2020. For further updates and links to other COVID-related articles, please scroll down to the bottom.] Fertility Treatment at CHR during COVID-19, at a Glance...
Evolving understanding of COVID-19 immunity, notable articles in the medical literature and the media, and more. Read the 7/6/2020 COVID-19 Bulletin from CHR here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr....
News you, likely, will not find in the media [This article deals with a constantly evolving situation. It was written by Norbert Gleicher, MD, on July 5, 2020 and published on July 6, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] Over the long July 4th...
In this month's CHR VOICE, we discuss what it means to "follow science" and continue our series on fertility treatments for women with low functional ovarian reserve. Read the June 2020 CHR VOICE here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist....
New study suggests a lower immunity level in the community than the typically quoted 60%, gauged by antibody tests, may be sufficient to protect everyone from COVID-19, as new case numbers surge in southwestern US states. Read the bulletin here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical...
Rapidly increasing COVID-19 case numbers in the Southwestern U.S. states [This article deals with a constantly evolving situation. It was written by Norbert Gleicher, MD, on June 27, 2020 and published on June 29, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] Not at all unexpected,...
A second wave of COVID-19? [This article deals with a constantly evolving situation. It was written by Norbert Gleicher, MD, on June 20, 2020 and published on June 22, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] Media reports from all over the world suggest that...
As New York City enters the Phase II of reopening, are we witnessing the 2nd wave of COVID-19 infections? Read the June 22 COVID-19 bulletin from CHR here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist...
WHO was wrong about asymptomatic patients being contagious, and other COVID-19 fake news to watch out for. Read CHR's 6/10/2020 COVID-19 bulletin here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher...
Image by Eric Mclean via Unsplash. ASYMPTOMTIC COVID-19 PATIENTS ARE HARDLY EVER CONTAGIOUS AND WHAT THAT MEANS [This article deals with a constantly evolving situation. It was written by Norbert Gleicher, MD, on June 9, 2020 and published on June 10, 2020. For a list of all COVID-19 Bulletins, scroll...
[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on June 8, 2020 and published on June 9, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] While many fertility centers closed down in the first few months of COVID-19 outbreak...
3 prominent fertility specialists urge the IVF field to focus on improving autologous IVF pregnancy rates for women over 40, in a newly published paper. Read the press release here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A...
Prominent fertility experts challenge current IVF practice in older women that automatically resorts to third-party egg donation For release on June 9, 2020 June 9, 2020 (New York, NY) - The U.S. is suffering from a number of unprecedented trends in national reproduction: Except for older women over age 38 in...
We here continue the series on how to individualize fertility treatments in women with low functional ovarian reserved (LFOR), often also called diminished ovarian reserve (DOR). In the May issue of the VOICE, we offered a general introduction to the subject and explained some of the terminology used. We then described how follicle mature after...
The June issue of this newsletter traditionally is the last before a summer hiatus for the VOICE in July and August. The year 2019 was, however, the only year in recent memory when we were able to stick to this plan. In all other years, we had to issue the newsletter in...
Largely deserted Grand Central Station with signs advising that passengers wear masks at all times. Image by Yucel Moran via Unsplash. Sad to acknowledge but necessary to recognize, even the political discourse surrounding the continuous management of the COVID-19 virus has in the U.S. become a political football. Considering the...
International Do No Harm Group in IVF (IDNHG-IVF), consisting of prominent physicians and basic scientists in reproductive medicine, including CHR physicians, just published a Position Statement on the dangers and utilization of PGT-A in the medical journal Reproductive Biology and Endocrinology. Read the press release here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher,...
International Group of Prominent Reproductive Physicians and Scientists Releases Position Statement on Chromosomal Testing of Human Embryos Prior to Embryo Transfer For immediate release June 1, 2020 (New York, NY) - Preimplantation genetic testing for aneuploidy (PGT-A), previously known as PGS (preimplantation genetic screening), has in recent years become an increasingly...
What we now know about COVID-19 and what it means for mitigation strategies going forward. Read CHR's May 22 COVID-19 Bulletin here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has...
CHR tries to combat misinformation about COVID-19 through these periodic COVID-19 Bulletins. Image by United Nations COVID-19 Response via Unsplash. [This article deals with an evolving situation with many unknowns. It was written by Norbert Gleicher, MD, on May 21, 2020 and published on May 22, 2020. For a list...
While COVID-19 still continues to dominate our psyche, we look forward with a first article in a series on DOR/LFOR. Read the May 2020 CHR VOICE here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology,...
#1 in a series on DOR/LFOR With CHR, likely being an extreme example (median age 43 years), patient populations in many fertility centers are aging, leading to surges in donor egg cycles, in most IVF centers, unfortunately, pretty automatically considered _the _remedy of choice for age above 42-43 years. Though pregnancy chances...
The amount of information distributed in print, social media, Internet and television on the COVID-19 crisis is, likely, unprecedented. Indeed, almost everything regarding this virus is unprecedented, from how murky its origins are even today (even intelligence agencies are investigating); its unpredictable but extremely high infectivity; its completely erratic disease...
CHR has a new informed consent, informing patients on the potential risks of COVID-19 infection during fertility treatment and pregnancy. Image by Christian Bowen via Unsplash. We have repeatedly, and in detail, laid out in these pages and in CHR’s intermittent COVID-19 Bulletins why CHR made the decision to remain open, while...
Dr. Gleicher's live webinar on DHEA was attended by over 4,000 viewers. May 2020 CHR VOICE Digest During April, the coronavirus and COVID-19, in all spheres of life, continued to dominate the nation’s existence. That, of course, also applies here at CHR. We are, however, very pleased to report that so-far only...
[This article deals with a continuously evolving situation. It was written by Norbert Gleicher, MD, on May 7, 2020 and published on the same day. For a list of all COVID-19 Bulletins, scroll to the bottom.] As the country is slowly “reopening” it economy, the President’s COVID-19 Task Forece is...
ASRM and SART release guidelines on reopening IVF centers that have closed to prevent the spread of COVID-19. CHR has implemented most of the recommended policies as we've remained open. Read the second 4/29/2020 COVID-19 bulletin here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts...
Availability of PPE will be just one part of the reopening considerations for IVF centers that closed to prevent the spread of COVID-19. Image by Jon Tyson via Unsplash. [This article deals with a continuously developing situation. It was written by Norbert Gleicher, MD, on April 28, 2020 and published...
[This article deals with a continuously developing situation. It was written by Norbert Gleicher, MD, on April 28, 2020 and published on April 29, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] Chasing bad and ignoring good science One of the major problems why COVID-19 is...
[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 24, 2020 and published on April 27, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] In an article on April 23 the Daily Beast expanded on the information we provide in CHR’s...
[This article deals with a continuously developing situation. It was written by Norbert Gleicher, MD, on April 22, 2020 and published on April 22, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] We have not published a Bulletin for almost a week because there has not...
How can fertility patients decide when to restart their treatments after the current spread of COVID-19 slows down? CHR has some answers here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher...
Some IVF centers recommend embryo freezing rather than IVF during COVID-19 outbreak. Is this a reasonable approach? Read CHR's take here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published...
Fertility patients rightly wonder how IVF centers would reopen once the spread of COVID-19 slows down. Image by Evgeni Tcherkasski via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 16, 2020 and published on April 17, 2020. For a list...
When to restart IVF after COVID-19 is a clinical, logistical and emotional decision each patient must make. Image by DrKontogianniIVF via Wikimedia Commons, under Creative Commons Zero license. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 16, 2020 and published on...
Freezing embryos for later FETs because of the current COVID-19 outbreak may not make sense for everyone. Image by Irina Murza via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 16, 2020 and published on April 17, 2020. For a...
[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 11, 2020 and published on April 13, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] As expected, death rates from COVID-19 in the New York Tristate Area have reached...
Fertility Providers' Alliance issues new letter attempting to reframe ASRM's reaffirmation of guidelines on COVID-19 and fertility treatment as FPA's victory. Read the second COVID-19 bulletin of 4/6/2020 here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned...
CHR's COVID-19 Bulletin, April 6, 2020 #2 [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on April 5, 2020 and published on April 6, 2020. For a list of all COVID-19 Bulletins, scroll to the bottom.] To fully understand the significance of this...
At CHR, we appreciated the genuine, honest and valuable contribution that Dr. Reed's petition has made to the discussion on what IVF centers should do during the COVID-19 outbreak. Image by Omar Lopez via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD,...
[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 31, 2020 and published on April 2, 2020. For a list of all COVID-19 articles, scroll to the bottom.] Should fertility centers be open during COVID-19 pandemic? We hope our readers have been...
IVF Investor Interest and COVID-19, Advice for Fertility Patients Sheltered in Place & More: April CHR VOICE Digest We are entering the third month of COVID-19-induced restrictions to infertility practice and our daily lives. Even though, in an attempt to minimize risks to patients as well as staff, we are...
[This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 31, 2020 and published on April 2, 2020. For a list of all COVID-19 articles, scroll to the bottom.] "What can I do while waiting for my IVF center to reopen?" This is...
As pregnant women worry over COVID-19's effects on their pregnancies, deliveries and babies, Columbia University releases preliminary data. Read the COVID-19 bulletin here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher...
Data on COVID-19's effects on pregnant mothers, deliveries and babies are still scarce. Image by Jonathan Borba, via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 31, 2020 and published on April 1, 2020. For a list of all COVID-19...
Contrary to the previous understanding of the disease, COVID-19 may be passed to the fetus, studies in JAMA suggest. Image by Sharon McCutcheon via Unsplash. We have previously noted in these Bulletins and in our monthly newsletter, the VOICE, that early Chinese data suggested that COVID-19 demonstrates fewer adverse effects on pregnancy...
Spring flowers add much-needed brightness to life during the COVID-19 crisis. Image by Sergee Bee via Unsplash. [This article deals with rapidly evolving circumstances. It was written by Norbert Gleicher, MD, on March 25, 2020 and published on March 26, 2020. For a list of all COVID-19 Bulletins, please scroll...
CHR's front desk will follow this process to screen for COVID-19. Figure adapted from Northwell Network Emergency Management. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020. Our COVID-19 safety precautions have evolved with...
COVID-19 could result in not just having to work from home but disruptions in your IVF cycle. Image by Avel Chuklanov via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020. For information...
The novel coronavirus that causes COVID-19. Public domain image by NIAID-RML. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020.] This is another possibility that must be considered and prepared for under current COVID-19...
As of March 12, 2020, the novel coronavirus that causes COVID-19 does not appear to negatively affect pregnancies. Image by Christian Bowen via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020.] The COVID-19...
CHR's "telemedicine" system that eases the burden of long-distance fertility treatment. With the COVID-19 outbreak, this long-standing system has started providing additional safety layer to our patients and staff. Coronavirus outbreak highlights the benefits of CHR's remote care capabilities--over a decade in the making--to advise patients and manage individualized fertility...
The March issue of the CHR VOICE is running a few days late because we knew that we had to address the CORONA virus and how CHR is responding to the public health crisis to protect the safety of our patients, staff and everyone in the community. But whenever we set down to write...
Artificially colored electron micrograph of blood cells, including the platelet in the middle. Public domain image from Wikimedia Commons. Platelet-rich plasma (PRP) entered the medical field in the 1970 when hematologists discovered this plasma fraction that demonstrates higher platelet counts than peripheral blood. It was initially used as a transfusion medium...
Currently, the novel coronavirus that causes COVID-19 does not appear to affect fertility positively or negatively. Image by Tanaka Pendeke via Unsplash. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020.] Once again, we...
CHR has a large number of long-distance patients, including international IVF patients. [This article deals with a rapidly developing situation. It was written by Norbert Gleicher, MD, on March 12, 2020 and published on March 13, 2020.] Almost a third of CHR patients travel to our center from out of...
Many brands of myo-inositol are on the market, some marketed specifically for female fertility. Myo-inositol is one of the most widely advertised and used over-the-counter supplements in female infertility. Yet, as we on previous occasions have pointed out in the VOICE, it is, unfortunately, frequently used inappropriately. Widely advertised by manufacturers as “supportive...
Embryos deemed "abnormal" after PGT-A may have real potential to become a healthy baby. Image by Irina Murza via Unsplash. There still must be a large number of presumably “chromosomaly abnormal” embryos, either “mosaic” and/or “aneuploid,” out there in cryopreservation tanks of IVF centers. These centers may not be advising...
Detecting negative SEO campaign and taking steps to protect our website is time-consuming. Image by Charles via Unsplash. Having one’s intellectual property illegally appropriated, in a strange way, can be viewed as an ultimate compliment. Similarly, one could argue that competitors or other adversaries viciously attacking your web presence by...
Female fertility is a multifaceted process that can't be assessed with just a few blood tests. Image by Anna Pritchard via Unsplash. What is female fertility, to begin with? Something interesting is going on in cyberspace when it comes to female fertility: quite a number of new start-up companies offer...
HGH (human growth hormone) may have beneficial effects on egg quality and quantity, but not many well-conducted studies exist. Image by Minnie Zhou via Unsplash. Human growth hormone (HGH) increasingly appears to be yet another “fashion of the moment,” as more and more IVF centers use it almost as a routine....
Testosterone patches can be used to raise androgen levels in the ovaries of women with low ovarian reserve, but DHEA supplementation is usually preferred. Image by Marvin Lewis via Unsplash. That the Androderm patch has suddenly become a topic of conversation on blogs, forums and social media is, for a number of...
Evidence is accumulating that untested IVF add-ons don't deliver on their promises and reduce patients' chance of pregnancy in many cases. Image via Unsplash, by Aditya Romansa. OPINIONS 012: 1/9/2020 Introduction Add-ons to IVF are finally attracting more attention in the medical literature as well as the lay press. It seems...
It is with much refreshed energy that we are welcoming you, our readers, to a new year and a new decade. Despite a seemingly somewhat rudderless world, there is reason for optimism: The economy is performing remarkably well, which significantly impacts fertility practice since, at least in the U.S., studies...
Image via Unsplash If not, it may be time to familiarize yourself with the term because it may just have become a favorite new legal theory, very actively pursued by the plaintiff bar. The American Society for Reproductive Medicine (ASRM) in a recent mailing offered an update on the subject to its...
Image by Amanda Jones via Unsplash The sad news is that there is no time to treat a chemical pregnancy. Most women don’t even know when they experience a chemical pregnancy, with the only potentially recognizable sign being a heavier than usual menses and/or a slightly delayed period, by a few days....
Like so many times in medicine, the one thing one should never do, is to generalize things. In this case this means that the meaning of a chemical pregnancy is not always the same and, therefore, must be appropriately interpreted: For a young and healthy woman in her 20s who just started trying to...
Chemical pregnancies are believed to be as much as 33% of all pregnancy losses. Earlier, we explained that a chemical pregnancy is, in principle, just a very early miscarriage. Consequently, causes of chemical pregnancies are believed to be no different from causes of all other later-occurring miscarriages. But this is an...
A chemical pregnancy is first suspected if the hCG level on the first pregnancy test is positive but too low. A frequent second sign of chemical pregnancy is when the hCG level does not double within two days. Once hCG levels plummet, it becomes very clear that the pregnancy is not...
Image by Wutthichai Charoenburi, licensed under Creative Commons Attribution 2.0 Generic license. Terminology is important: An embryo is the result of the fertilization of an egg by one spermatozoon. Only once an embryo implants in the endometrial lining of the uterine cavity, does a pregnancy exist. In other words, the definition of...
Young Investigator Award ceremony, lecture hall, exhibition hall and final group shot from FRM 2019. The second half of November at CHR, as in recent years, was again significantly affected by the annual Foundation for Reproductive Medicine Conference (FRMC), covering reproductive biology and clinical reproductive endocrinology subjects with potential translational opportunities...
As the year is coming to its end, it is quite apparent that the year 2019, in almost all spheres of life and in all corners of the world, has been quite disruptive. Disruptions are also happening in medicine; it is, indeed, quite remarkable how quickly medicine in the U.S....
When it comes to visitors at CHR from all around the world, the fall season until Thanksgiving is usually the busiest part of the year. We call this time our “traffic jam,” not too dissimilar from what happens to midtown Manhattan during the annual United Nations General Assembly in September....
Does vaping lower your fertility? Photo by Thomas Stephan via Unsplash. Whether vaping impact male and female fertility may be a moot point, given the serious health risks vaping appears to have Vaping (the use of e-cigarettes) has over the last few years not only created a new multi-billion dollar...
Marijuana plant. Photo by Rick Proctor via Unsplash. The question of how marijuana affects fertility in men and women is becoming more important as state-level legalization spreads. It is, of course, well established that cigarette-smoking is bad for fertility, especially female fertility. It is also bad for babies, resulting in...
CHR is considering opening up a fertility center in Europe for patients in Europe, Russia, Middle East and more. Photo by Kelly Sikkema via Unsplash. CHR is contemplating opening a center in Europe, to serve patients in Europe, Russia and the Middle East with difficult-to-treat infertility cases. As a reader...
A recent paper by a major proponent of PGS/PGT-A ironically may be the last straw on the genetic testing saga (we hope) No subject in fertility practice has likely more often been a subject of these pages, a lead article or just a mention in regard to other issues in...
When the exogenous hormones are stopped, the body's own hormones seem to kick in, causing some women to "rebound" after no response to the fertility drugs. Image via Unsplash Since a paper has been submitted reporting on here described so-called rebound effect, we cannot go too much into detail in...
CHR received a good number of calls and messages following a report on NPR’s Health News on August 22, 2019 by Rob Stein that investigators at Weill-Cornell Medicine are attempting to use CRISPR/Cas-9 to alter genes in human sperm. The report was something of a surprise, considering how sensitive an issue genetic germline editing in...
Electron microscopic image of a human lymphocyte. Image source: Public domain image via Wikimedia Commons The term “lymphocyte immunization” is rarely heard since 2002, when the _Food and Drug Administration (FDA) _prohibited this treatment in the U.S. outside of clinical trials. Up to that point, immunomodulation of the maternal immune...
The shocking news highlights uncomfortable, if less obvious, developments surrounding third-party gamete donations It was this time _The New York Time_s that, in two articles within a few days, featured the subject of fertility providers, secretly, using their own semen, rather than third-party-donor semen, in treating their infertility patients. This...
Treatments to prevent early miscarriages (miscarriages at 6 weeks to 8 weeks) depend on what the root cause of the miscarriage is. At CHR, a thorough testing round helps our physicians pinpoint miscarriage treatments at its precise cause for each patient. Putting in place preventative steps before a pregnancy happens...
Early miscarriages at 6-8 weeks have different causes than miscarriages that happen later in the pregnancy. That means testing for early miscarriage risks and treatments for miscarriages at 6-8 weeks have to be tailored to evaluate and target these causes. Frequent cause of miscarriages at 6-8 weeks: chromosomal abnormality Miscarriages are a frequent and...
While not all miscarriages require testing and treatment, identifying women who are at risk of multiple early miscarriages at 6-8 weeks is an important step toward prevention. At CHR, we pay particular attention to the medical history and run a battery of test for early miscarriages to help women overcome...
Harper's Bazaar quotes Dr. Gleicher extensively on the positive effects of DHEA on women's sexual wellbeing. Read the article here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds...
Norbert Gleicher, MD, CHR's Medical Director and Chief Scientist, responds to a Modern Love column in which the author outlines the broken promise of "egg freezing as reproductive insurance." Reading Ruthie Ackerman’s recent article in The New York Times on her egg-freezing experience, two thoughts come immediately to mind: First, how difficult it...
Image by Derek Thomson, via Unsplash The June issue of Fertility & Sterility, the official journal of the ASRM, was dedicated to exactly that question and various contributors offered review articles. Overall reaffirming the safety of IVF, these articles, nevertheless, summarized in detail some of the associations, known for some time. Those...
Image courtesy of Picsea via Unsplash In over 40 years of IVF practice, likely no question has been investigated more thoroughly than this: Does IVF in any way adversely affects the lives of IVF offspring? The general answer of a large number of studies has usually been that, with very few exceptions, there...
When you are told you are too fat to get pregnant, New York Times Magazine Ignorance and profit motif deprive obese women of access to fertility treatments Learning that a considerable number of fertility clinics “refuse to treat prospective mothers they consider too large,” Virginia Sole-Smith asked exactly the question in the...
Because of a study that was just published in a highly prestigious scientific journal, the lead article in this issue of the _VOICE _once again addresses what now is widely called preimplantation genetic testing for aneuploidy (PGT-A). The reason is simple: Considering the increasing pressure that has been building in...
Image courtesy of Markus Spiske via Unsplash Pursuing evidence that examining embryos prior to transfer for chromosomal abnormalities and excluding from transfer those demonstrated to be chromosomal abnormal has now been going on for over 20 years. Yet, in over two decades, not a single properly conducted study has been...
In a recent article, physicians at Yale Fertility Center questioned the increasingly aggressive marketing push for egg freezing "for everyone." Read it here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher...
What are the signs of immunological infertility and immune-related pregnancy loss? Diagnostic challenges of immune-related infertility Please note that the question addressed here is _not _when to suspect an autoimmune problem or when to suspect any other immune system-related problems. This is on purpose because we, again and again, want to stress...
Immune system of the mother has to reprogram itself to tolerate the implanting embryo in order for the embryo to survive and thrive. Image by Suhyeon Choi via Unsplash. One of the most basic questions in human biology still remains mostly unanswered After a long journey down the fallopian tube,...
Treating immunological problems in the fertility context require a proactive approach We again point out that the question here is not how to treat autoimmune problems in infertility. The reason is that we do not just treat immune system hyperactivity due to autoimmunity. There are conditions beyond autoimmunity that are associated with...
Broadening the issue from simply "autoimmune infertility" Once again, please note that the question we are asking is _not _how to test for an autoimmune problem in the fertility context. Though we are testing for certain autoimmune abnormalities, like anti-nuclear antibodies and anti-phospholipid antibodies, the purpose is not to find a...
We mourn the premature passing of Jeffrey J, Braverman, MD, 59, an in many ways truly unique colleague, with whom especially CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, had the opportunity to collaborate on a number of occasions over many decades. He passed away peacefully on Monday, April 29, 2019...
CONFLICT STATEMENT: Readers of this article should be aware that CHR and CHR investigators have applied for an U.S. patent, claiming here described effects of DHEA and of other androgens on female sexual dysfunction in premenopausal women. If awarded, the patent will be exclusively licensed to Fertility Nutraceuticals, LLC, the...
There is - for once - good news for New Yorkers: New York state is the 10th state to now mandate insurance coverage for IVF. As the 6th state to do so, NY state is also mandating insurance coverage for fertility preservation in young cancer patients. Both are welcome developments, as...
In late March, Lisa Rapaport interviewed Dr. Gleicher for her article on _Reuters _about the reported higher risk of cancer among children born from IVF. Dr. Gleicher pointed out that this may be a result of chromosomal instabilities related to maternal age rather than a direct effect of IVF and patients should not...
Sometimes one ovary is inexplicably resistant to stimulation, but it doesn't affect fertility too much Unilateral ovarian response to IVF stimulation is not infrequent and can have different causes, from a missing ovary, to a vascular-compromised ovary (usually after surgery) or an ovary compromised by infiltrating endometriosis. All of these causes can...
DHEA has few serious side effects Already a number of years ago, a worldwide survey of IVF centers revealed that approximately half were supplementing selected patients with dehydroepiandrosterone (DHEA). The number must be even bigger by now. Though studies on how widely DHEA is used in fertility practice are lacking, anecdotal...
Overselling without proper education leads to abuse of patients With our understanding of how our genes are working having made truly remarkable progress over the last two decades (see also a related article on “epigenetics” in this month's newsletter), and with diagnostic testing capabilities often leapfrogging even that advanced understanding, we...
Egg donation gains a layer of nuance as our understanding of epigenetics, once an esoteric subject, evolves What is epigenetics? If you have not heard yet about “epigenetics,” you will probably be surprised, as its evolution also surprised many of the scientists who discovered this new layer of genetic activity...
Abuse of the genetic testing industry, when only one ovary responds to stimulation, and more: April 2019 CHR VOICE Digest Reflecting the increasing importance of genetics in all areas of medicine, reproductive medicine of course included, this issue of the _VOICE _contains two major articles pertaining to genetics. In our...
Age-specific normal AMH levels and FSH levels change as women age. A question we hear quite frequently from patients is whether follicle stimulating hormone (FSH), anti-Müllerian hormone (AMH)or both are predictive of pregnancy chances with IVF. Though on first impulse the answer appears to be a simple YES, reality is much more...
In a Reuters _article, Dr. Gleicher explained the possible reason behind the elevated cancer risks in IVF offspring. Noting the extremely low absolute risk and risk-benefit analysis, Dr. Gleicher advised against foregoing IVF. Read [the Reuters_ article here](https://www.reuters.com/article/us-health-ivf-cancer/ivf-tied-to-slight-increased-risk-of-rare-childhood-cancers-idUSKCN1RD365), and our recap here. Norbert Gleicher, MD, FACOG, FACS Norbert Gleicher, MD, leads CHR’s clinical...
Reuters' writer Lisa Rapaport reported on a recent study that found elevated risks of certain very rare childhood cancers in children conceived via IVF. Authors of the study, published in JAMA Pediatrics, explained that the absolute risks were still extremely low and parents shouldn't lose sleep over the possibility or avoid fertility treatments...
What is the connection between thyroid function and fertility problems? Once again, there is no simple answer to this frequently asked question. In principle, there is little, if any, direct connection between female infertility and hypothyroidism(usually Hashimoto’s thyroiditis), reflected in abnormally high TSH levels, or hyperthyroidism(Grave’s disease), characterized by abnormally low TSH levels. Yet the...
Amenorrhea Definition: What is Amenorrhea? The term “amenorrhea” describes a prolonged time period without menstruations during reproductive years, when regular menstruations should be the norm in women. Though menstruations are supposed to follow a regular pattern, every woman experiences some irregularities on some occasions. These irregularities are reflections of the...
Two major trends have been pervading fertility treatments over the last 20 years: the rapid aging of the fertility patient population and an almost equally rapid increase in numbers of women who seek fertility treatments as single parents. We have addressed the “graying” of fertility services on repeated occasions; here, for the first time,...
What is myo-inositol? Myo-inositol is often used to improve egg quality in IVF, but only _some _infertility patients reap the myo-inositol egg quality benefits. Myo-inositolused to be considered a vitamin within the vitamin B family but no longer has this designation. It is increasingly prescribed within the fertility field under...
Whether PCOS negatively affects egg quality is a complex question, in part due to the diversity within a PCOS diagnosis Whether PCOS adversely affects egg quality in IVF has remained a highly controversial issue, with many authors claiming yes and similar numbers of investigators claiming no. The reason for this discrepancy is,...
Single motherhood, PCOS' effects on egg quality, TSH and fertility, and more - March 2019 CHR VOICE Digest February and running into March has been a very busy month at CHR clinically and in terms of international visitors. Because the annual conference “Best of ASRM and ESHRE” this year took...
A study by Boston investigators, published in Human Reproduction, recently received some media attention when it suggested no adverse effects on semen parameters from exposure to marijuana. Indeed, sperm counts were higher in pot smokers than controls. In reviewing this paper for HealthDay, a health-related website, Dennis Thomson interviewed some experts, including Norbert...
LH stands for luteinizing hormone. Like the follicle-stimulating hormone, FSH (and others), LH is produced by specialized cells in the pituitary gland. Its principal function lies in inducing ovulation. Following a sudden spike in LH production, one or more follicles will ovulate (i.e., release an egg). This function of LH is...
Changes in the ovaries during gender transition taught us about androgens' role in female fertility This is, indeed, a very interesting question because the medical experience with females transitioning to males taught us a lot about the effects of male hormones (androgens) on ovaries. One of the very early stages...
New York State, currently without legal definition of surrogacy, should recognize this reproductive arrangement at last According to a report in the New York Post on February 2, 2019, Governor Cuomo is, finally, proposing a “surrogacy law” for New York state. At present, New York is one of only a handful of...
How do you know you need egg freezing? Hint: Not by going to egg freezing parties! It started with egg freezing parties in private homes or private back rooms of restaurants and bars and now it has reached the streets of major metropolitan areas, where food truck-like contraptions on wheels,...
With hopefully the last arctic vortex behind us, an early spring would be very welcome this year. CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, will, indeed, do even better than that since, on a 10-day long lecture tour of Australia, he will definitely not suffer from cold weather...
"Dr. Norbert Gleicher, the Go-To IVF Specialist" in New York Lifestyle magazine The December 2018 issue of the New York Lifestyle magazine ran a biographical sketch of Norbert Gleicher, MD, CHR's Medical Director and Chief Scientist. The piece chronicled Dr. Gleicher's professional trajectory over his four decades of medical practice and research, ending with a...
Does mild stimulation perform better than regular IVF? The answer to this question is a clear no, and here is why: Like every sphere of life, medical practice is, at times, being “taken over” by myths. Nobody knows where they came from, but in most instances the source can be found in prominent...
How times have changed from when insured patients could see practically any physician of their choice! This was the time when over 90 percent of CHR’s new patients were referred to us by a physician. Then insurance companies started the concept of provider networks, and patients, for the first time,...
In collaboration with researchers from The Salk Institute for Biological Studies in La Jolla, CA, CHR is seeking women with established mitochondrial diseases who are interested in participating in a study, which is seeking to develop treatments that prevent transmission of mitochondrial diseases into next-generation offspring. This fully funded study will cover all IVF...
Good-quality embryos from poor-quality eggs don't have the same IVF outcomes as embryos from good-quality eggs Every IVF program in the world carefully assesses in every cycle the “quality” of obtained embryos. Whether the plan is to transfer those embryos at cleavage stage (day-3 after fertilization) or blastocyst stage (days 5-6),...
Medical journals are in a crisis of credibility The term “fake news,” suddenly a widely used and discussed acronym, is by no means only restricted to political discourses. With the ascent of social media and the opportunity they offer to spread highly subjective information quickly and unhindered to large numbers...
So, it finally happened: the genome of human embryos was modified and children with such modifications allegedly were born and will pass those edits on to future generations. The world is outraged, pretending to be surprised, when nobody really should be. According to press reports, suddenly, the World Health Organization (WHO) announced creation...
The Holiday Season is once again upon us, and we want to take this opportunity to wish all of our readers, whether patients, colleagues or friends, a Festive Chanukah, a Merry Christmas and a Delightful Kwanzaa. All denominations we wish a Healthy, Happy and Prosperous New Year 2019, and our active patients in treatment...
Yet another "innovation" cannot overcome fundamental fallacy of PGS/PGT-A It is hard to believe but, as Ellie Kincaid, an Assistant Editor at Forbes, in the last issue of the magazine reported, what we here at CHR have only been joking about, has in fact happened: The 4th consecutive version of PGS/PGT-A (PGS/PGT-A 4.0)...
Our lead article this month is dedicated to the annual Foundation for Reproductive Medicine Conference (FRMC), which CHR for the third year in a row proudly co-sponsors here in New York City. Likely because in comparison to most other U.S. cities the organization of conferences in NYC is much costlier, FRMC is now...
With outside financing pouring in, commercialization of IVF practice continues in the New York region, with implications on patient care We previously reported in the pages of the VOICE that the infertility industry all over the world is in a race toward consolidation. The concept of establishing nationwide medical practice networks actually first...
We are very pleased to announce that CHR’s website received the eHealthcare Leadership Award, a recognition shared with such mammoth health care providers as Cleveland Clinic, Mayo Clinic and others. This represents a truly remarkable accomplishment for a relatively small private fertility center and is a reflection of the years-long efforts...
This is one of the most frequently asked questions at CHR since almost all of our center’s patients present with high FSH. And the answer in an overwhelming majority of cases is, no, it is not worthwhile to attempt to reduce FSH levels. Some colleagues believe that IVF cycles with lower FSH...
Over the last few years some colleagues have started to propagate the so-called all-freeze protocol for most, if not all, IVF cycles. What they mean by that is embryos should practically never be transferred in a fresh cycle because, based on their hypothesis, the endometrium in stimulated cycles is much...
Evelyn Telfer, PhD, professor and Personal Chair in Reproductive Biology at University of Edinburgh, a close research collaborator of David F. Albertini, PhD, CHR's Senior Visiting Scientist, was recently recognized as one of Porter's magazine's Incredible Women of 2018. The annual award celebrates women who inspire others through their actions. The work recognized by...
Elsewhere in this issue of the VOICE, we discuss that a prominent IVF center through an article in Forbes magazine recently announced a new method of testing for chromosomal abnormalities in blastocyst-stage embryos (PGS/PGT-A 4.0). The new PGS/PGT-A relies on testing of embryonic DNA in spent media, in which embryos were incubated....
“There is nothing more that I can do for you. The only way you have a chance of getting pregnant is with using donor eggs.” Thinking about the day these words were said to my husband and I still brings tears to my eyes. But that is all they are:...
If there is a “craziest” month in the year for CHR, then for the last three years November clearly qualified. It is now the third year in a row that CHR co-sponsors with the Foundation for Reproductive Medicine (and this year for the first time also with the New Hope Fertility Center in NYC) an...
Each program has pros and cons, but the benefit of rigorous egg donor selection processes at IVF centers cannot be overstated Egg donor agencies vs. egg donor programs at IVF centers Something dramatic and new has been happening over the last decade: IVF centers in the U.S. have progressively given...
With summer behind us, and the Holiday Season quickly approaching, CHR is entering what, every year, in different aspects represents the busiest quarter in all three major activity areas: clinical care, research and education. Clinically, the last quarter is always the busiest. Everybody still wants to conceive before the new...
Being informed about different types of genetic testing and their efficacy grows in importance as genetic testing becomes commonplace A brief history of genetic testing It is almost impossible to open a newspaper or magazine these days without seeing articles about various forms of genetic testing. Considering how much genetic...
Genetic testing during IVF for eye color is frivolous and still very much a snake oil In a recent article in The Wall Street Journal (October 3, 2018, pA11) Amy Dockser Marcus once again, rightly, raised the question “whether it is ethical to choose a baby’s eye color?” The VOICE addressed this issue before, and...
Don't let misconceptions about embryo transfer and the "2WW" stress you out during the most stressful time in IVF cycles Most centers explain well what happens in IVF cycles up to egg retrieval, but relatively little is explained for the period between retrieval, embryo transfer and first pregnancy test. This...
Intralipid or intravenous gamma-globulin (IV-Ig) for implantation failures and repeated miscarriages? Maternal immune system sometimes needs help with implantation failures or miscarriages, but which kind? Patients who come to CHR for second opinion consultations frequently have previously identified immune problems, for which various treatments have been recommended by our colleagues. CHR has...
Donor egg IVF has much higher success rates than IVF with patients' own eggs, but it's still not 100% A couple’s success with fertility treatments primarily depends on the female partner’s fertility, since male-factor infertility can be remedied in almost all cases via intracytoplasmic sperm injection, ICSI. Donor egg cycles, therefore,...
Receive free flu vaccination at CHR and help us study its potentially beneficial effects on implantation and miscarriage prevention! The Centers for Disease Control and Prevention (CDC) recently published death rates from Influenza in 2017 and concluded that the country experienced the highest death rate in many years. Over 80,000 people died...
Welcome back to the CHR VOICE for the fall semester of 2018. For the first time in a decade, the summer months, July and August, passed without us seeing a reason to break the VOICE’s scheduled hiatus during these two months. Here we now are, well rested and ready with a plethora of...
Proper treatment for "implantation failure" can start only when underlying causes are identified What is implantation failure? How is implantation failure diagnosed? Whether implantation failure is a real diagnosis remains to be determined. While scientific papers on the subject are published almost daily, nobody really knows what implantation failure really is and/or...
As risks of pregnancy in 40s and 50s are higher, proactive management becomes key Pregnancies in 40s and 50s are becoming more common Just before the summer break, the news media were filled with reports about record low birth rates in the U.S., especially over the last decade. One of...
PGS/PGT-A debate degenerates as its proponent drifts away from science So here is a little background on this piece: Santiago Munné, PhD, initially came to the attention of the IVF community as a talented geneticist who closely worked with one of the pioneering clinical embryologists in IVF, Jacques Cohen, PhD, in the...
Advancing age usually means declining chances of pregnancy, but too many women are pushed into egg donation prematurely Female age, fertility and egg quantity/quality The honest truth is that nobody fully understands why age is by far the most important predictor of pregnancy success, whether women attempt pregnancies with or...
The best way to improve the chance of IVF pregnancy is to live your normal life and relax, say CHR experts Patients play an important role in determining the success of fertility treatments Likely the most frequently asked question from our patients is this: “What can I do to improve...
Link between NK cells and implantation of embryos may be overblown Natural killer (NK) cells are an important subgroup of lymphocytes (a subgroup of white blood cells) which have a large variety of functions, from killing cancer cells to, potentially, also killing the “invading” (i.e., implanting) embryo if the immune system sees the...
Endometrial scratching has limited evidence of efficacy Endometrial scratching was first described in 2003 as treatment for suspected implantation failure by Israeli investigators (Barash et al., Fertil Steril 2203;79:1317-1322). The procedure has remained controversial ever since, though its utilization has increased worldwide. Dekel et al in 2010 offered evidence that endometrial injury in...
Endometrial receptivity testing (ERT) is a recently introduced fertility test that claims to identify the optimal "window" for embryo transfer, when the the lining of the uterus is ready to welcome the implanting embryo. In an endometrial receptivity test, a small sample of endometrium is taken via an endometrial biopsy, and...
Birth control pills can be a bad idea for IVF patients with low ovarian reserve Almost since the very inception of IVF, oral contraceptive pills (OCPs), or birth control pills, have been routinely used to prepare patient for IVF cycles. They, indeed, are perfect tools to control the timing of cycle starts....
The June issue of the VOICE is traditionally the last before a summer hiatus in July and August, unless, of course, important news must be immediately conveyed to our readership. In recent years, this meant that we never really succeeded in breaking publication of this newsletter for both months. At best, we...
Recently identified form of PCOS has implications on fertility treatment strategies and outcomes PCOS is a widely known and extensively studied medical diagnosis, closely associated with female infertility but also later in life with the so-called metabolic syndrome, characterized by significantly increased risks for type II diabetes mellitus, hypertension and...
Consider size, track record and management before success rates A quite frequent question patients ask our center’s staff is, how do we know CHR is the right fertility center for us? Recognized by peers worldwide as one of the world’s leading fertility centers, the answer is usually not difficult for...
Photo by Brooke Lark, via Unsplash The lay media suddenly discovered the ultimate cure for infertility: healthy food! A plethora of articles in newspapers and on the web discovered the value of healthy eating for women as well as men. Both sexes are alleged to be more fertile if they...
As new technologies become more prevalent, parents' decisions around telling or not telling their children about their conception become more complicated Out of approximately 8 million IVF children presumed to have been born worldwide, likely at least 2 million can be expected to be the result of gamete and embryo donation cycles,...
A moving piece in JAMA boosts our pride in the profession It does not happen too often that reading an article in JAMA touches one’s heart and, at the same time, increases one’s pride in the profession. But that is exactly what happens to, likely, most professional readers of “On the Origin of...
Women over 40 are experiencing an increase in birth rates as they delay childbearing for the right partner We recently discussed in the VOICE on a number of occasions this country’s declining birth rates but the subject suddenly made headlines in May, with practically all news outlets reporting on the subject. The...
Study reports egg freezing patients are more likely to experience regret if they were not given full information about future chance of pregnancy We are almost sorry for bringing up this subject once again after having discussed it extensively only recently, but a paper in one of our specialty’s leading...
Continued promotion of PGT-A/PGS still lead to loss of many healthy human embryos, even with incontrovertible evidence against its value It happened barely a few months ago on March 3 and 4 on both sides of the country, eerily on the same days: Cryopreservation tanks at two highly reputable major...
Immuno-suppressive biologics may be on the horizon Steady readers of the VOICE, of course, know by now that, when assessing new patients and when initiating treatments, CHR takes the immune system very seriously, if autoimmune abnormalities were diagnosed during initial diagnostic evaluations. This is a very specific feature that differentiates CHR from many, if...
A thoughtful New York Times piece affirms CHR's belief in patient autonomy When first confronted with the article under this heading by Nick Bhasin in The New York Times, we initially thought that here is, once again, one of those very difficult to read stories of somebody over and over trying to conceive...
We've discussed our concerns over the commercialization of social or elective egg freezing in the last few years. A few patients have contacted us since then, looking for advice on how to select the best egg freezing center where their chance of success is the highest. So, here's a list...
Choosing the right fertility center makes all the difference Under the title, “Glamorizing egg freezing can have devastating consequences,” Angela Lawson, PhD, a clinical psychologist and associate clinical professor in Obstetrics and Gynecology as well as Psychiatry at Northwestern University Feinberg School of Medicine in Chicago, Illinois, recently wrote a...
The term “stem cell” has become a buzzword, a phenomenon, a presumed future treatment for everything from toe to head, from injuries, over cancer to Alzheimer’s. A huge industry has grown up around this term, with hundreds of so-called stem cell clinics offering treatments alleged to involve the use of...
Women under 40 with POF/POI are needed for the study CHR is very pleased to announce that the center’s Institutional Review Board (IRB) approved on March 22, 2018 the proposed study, which will involve injection of the patient’s own platelet-rich plasma (PRP) into one of her two ovaries, with the other ovary...
ASRM's Practice Committee Opinion finally puts an official question mark on PGS, but the genetic testing industry still refuses to take responsibility for 2 decades of abuse It took quite some time (many, indeed, believe too much time) for the American Society for Reproductive Medicine (ASRM) to, finally, publish an updated opinion...
When we are writing these words, the first quarter of 2018 is not even fully over yet, and CHR’s investigators have already seen 10 peer reviewed papers published according to PubMed. CHR is very obviously again looking at another record year in its research activities. We are particularly excited about...
Most fertility supplements lack scientific evidence of efficacy. CHR recommends just a few, depending on each patient's needs. So, you are trying to conceive, and your girlfriend told you about all those supplements you immediately should start taking; a long list of at least 10 different ones. Just thinking about...
New report of PRP use requires cautious interpretation Elsewhere in this issue of the VOICE we report on the IRB approval of CHR’s PRP study for the purpose of Ovarian Rejuvenation in women with POF/POI. We also in last month’s VOICE noted that PRP has been in clinical use in Europe and in a number...
New York Times reports on an alarming decline in birth rates among young Americans The New York Times recently published an interesting, yet disturbing article by Lyman Stone, “American women are having fewer children than they'd like.” He noted that American fecundity (he called it fertility, not realizing the difference in...
Dear Dr. Gleicher, Dr. Kushnir & the staff at CHR, We are so happy to announce the arrival of our daughter! She surprised us and made her grand entrance a month early and arrived via C-section in January. After a week in the NICU, she was able to come home...
AI or not, embryo selection is still a flawed concept A Scientific American blog recently suggested that artificial intelligence (AI) may be able to flag the most viable embryos “far better than humans.” Quoting yet another start-up, we, once again, are offered the promise of “embryo selection.” The VOICE has repeatedly discussed the concept of...
SELF Magazine recently raised the question whether flying while pregnant may induce labor? Though we are unaware of specific studies, CHR agrees with the “experts” quoted in the article that there is no evidence that flying increases risks of premature labor and/or any other risks to pregnancy. But we also agree with...
We noted elsewhere in this newsletter that CHR investigators just published an update [_J Ovarian Res 2018;11(1):2] to their 2015 study in the prestigious medical journal JAMA [2015;314(6):623-624_], which at that time received considerable media attention since it demonstrated that cryopreserved (frozen) donor eggs produced lower pregnancy and live birth rates than fresh...
In the February issue of the VOICE, CHR announced Initiation of a new Ovarian Rejuvenation Research Study. Natalie Rahhal from the British DailyMail.com picked up on the announcement, and published a full-length article titled, “Hope for pregnancy after menopause with ‘ovarian rejuvenation’ which involves poking the organs with needles.” In this...
CHR’s Medical Director and Chief Scientist, Norbert Gleicher, MD, was extensively quoted in an ABC News article that addresses the fact that increasingly older women are conceiving and having children. This piece by Grace Wong, entitled “Why more women are having babies at 50 and beyond,” was motivated by Sen. Tammy Duckworth, D-Ill,...
As noted in the introduction of this newsletter, February was an unusual month when it came to media exposure because so much was happening. Indeed, quite a number of media encounters by CHR’s staff have not reached print yet and, therefore, will be presented in next month’s issue of the VOICE....
Age and functional ovarian reserve of patients Here are CHR’s cumulative 2017 IVF cycle characteristics and outcomes. We reported already in the January issue of the VOICE the unprecedented rise in the age of CHR’s patient population during 2017, increasing the median age between 2016 and 2017 by a full year,...
Literally on the same day, two prominent IVF centers lost large numbers of cryopreserved embryos in one or more tanks. Though details have not been released yet, and causes as of this moment are still unclear, events like this are every embryologist’s ultimate nightmare. Fortunately, these events are so rare...
Making your own decision, based on accurate information Egg donation has been a routine procedure at most fertility centers for decades. CHR, indeed, believes that the procedure has become too routine; that is, patients are often prematurely “pushed” toward the use of donor eggs. How do we know that this is...
When it comes to CHR’s media exposure, February was a truly remarkable month. CHR was all over the world mentioned in print media in conjunction with a paper that announced the first successful in vitro culture of primordial oocytes to maturity. CHR’s Director of Laboratories and Senior Scientist, David F. Albertini,...
For immediate release February 9, 2018 (New York, NY) - Norbert Gleicher, MD, Medical Director and Chief Scientist of New York's Center for Human Reproduction (CHR), and Arthur Caplan, PhD, the William F. and Virginia Connolly Mitty Professor of Bioethics at New York University's Langone Medical Center (NYULMC), and founding director of NYULMC's Division of...
You may have heard the news that a mostly British team of researchers were able to culture immature human eggs to full maturity in the lab. CHR's Director of the Division of Laboratories, Dr. David F. Albertini, who has been collaborating with the British team for a long time, explains the significance...
Quite a number of media organizations recently reported on the cloning of 2 surviving Macaque monkeys at the Chinese Academy of Sciences in Shanghai, China. Two other cloned monkeys in the same experiment expired immediately after birth. The difference between surviving and expired monkeys was the source of their nuclear...
Quite a number of media organizations a few weeks ago reported on what, likely, represented the "oldest" frozen embryo ever to lead to pregnancy. The embryo had been cryopreserved for 24 years before being, finally, transferred. As an interesting side note, the woman who had this embryo transferred was, herself,...
Journalists critically examine egg freezing with more nuance It is reaffirming to see that CHR is no longer alone in expressing discomfort with what is going on in the commercial egg freezing world. After an initial rather enthusiastic bout of commentaries in the lay media after major social media and...
The median age of IVF patients at CHR jumps to 43 It is now for quite some years that CHR has been serving the by far oldest patient population of any IVF center in the U.S. that is reporting annual outcomes to either the Centers for Disease Control and Prevention...
Two NEJM papers on the question require cautious interpretation In recent years, a number of colleagues have been pushing the concept of so-called all-freeze IVF cycles. They have been arguing that pregnancy chances are better if embryos are not transferred in fresh cycle, as has been routine IVF practice for over 30 years,...
Along with Highly Individualized Egg Retrieval (HIER), a new laboratory procedure for immature eggs gives poor-prognosis patients their best chance of pregnancy with IVF CHR investigators in 2016 published a paper, where they coined the term rescue in vitro maturation (R-IVM). It describes a circumstance usually encountered in poor prognosis patients who produce small...
Uniformly, the whole staff at CHR enjoys those moments when, usually unannounced, former patients bring by their CHR babies to present to coordinators, embryologists and physicians the results of their combined efforts. Usually this happens sometimes during the first year of the child’s life, sometimes a little later. Only very...
CHR to investigate ovarian rejuvenation via platelet rich plasma (PRP) Updated June 2019: CHR is currently recruiting participants for two clinical trials on ovarian rejuvenation using platelet-rich plasma (PRP). One study is for patients with a diagnosis of premature ovarian insufficiency (POI) and the other is for women over 40 with age-related decline in ovarian reserve....
Our image this month is an example of the new technology scientists at the CHR are employing to make the best eggs possible for our patients. Shown here is a human egg that has not yet completed the process of maturation needed before it can be fertilized. Many human eggs...
Highly individualized egg retrieval (HIER), unquestionably, is CHR’s most important recent innovation brought to the practice of IVF, and we are absolutely convinced that, like many other CHR contributions to IVF before, it will quickly be picked up by IVF centers all around the world. HIER started a number of...
We recently in the VOICE announced CHR’s new Reproductive Immunology Initiative, pointing out that recent research in other areas of medicine induced CHR to make reproductive immunology, once again, a priority of the center’s research and clinical practice since many findings in other areas of medicine had potential clinical implications for reproductive biology...
Now that most of us have made our annual New Year's resolutions, we also have to acknowledge that most are, unfortunately, as quickly forgotten as they were made. Since the start of a new year often involves decisions surrounding family planning, we in this first 2018 issue of the VOICE want to...
