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Capturing the "rebound" effect after poor response to IVF medications

Posted on Sep 23, 2019

Since a paper has been submitted reporting on here described so-called rebound effect, we cannot go too much into detail in describing this phenomenon. However, because we feel that this discovery again offers one of those incremental additions to CHR’s armamentarium in battling the challenges of “older” ovaries, we want to make sure our patients know about it.

What we have come to call the "rebound" effect was initially an accidental finding. Because it, on rare instances, appeared to help some patients to respond to ovarian stimulation, CHR’s physicians over a few years started integrating it into daily routine practice: When gonadotropin stimulation was interrupted for a few days, some women, who completely failed to respond to even maximal ovarian stimulation with exogenous gonadotropins, suddenly, responded with at least some follicle growth.

sergee bee NaaiDPPlXwk unsplash 1024x679 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

Though this recognition was integrated into CHR’s treatment of such unfavorable patients, the impression was that this kind of "rebound" was rare, maybe affecting 15-20% of patients who did not respond at all to ovarian stimulation. When Assoc. Prof. Andrea Weghofer, MD, PhD, MS, MBA, a senior visiting scientist from the _Medical University of Vienn_a in Vienna, Austria, came to CHR in April of 2018, she decided to investigate this observation in more detail.

Utilizing CHR's electronic research data bank, she made the discovery that successful rebound effects in patients otherwise resistant to ovarian stimulation were, actually, much more frequent than CHR’s impression had been. This observation then led to a study, encompassing an even larger number of patients, which confirmed her initial results and, as noted above, was just submitted for publication.

Though an important observation, the rebound effect is, of course, not a revolutionary finding. It, is, however, yet another small step in what CHR sees its main obligation as a research, as well as a clinical, infertility center: to incrementally enhance pregnancy chances for the worst-prognosis patients who, are not even given a chance to try for pregnancy with their own eggs in most fertility centers and automatically referred into third-party egg donation.

This is a part of the September 2019 CHR VOICE.

Norbert Gleicher, MD, FACOG, FACS

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 of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.

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