CHR Update August 2006

THE ECO-IVF PROGRAM

As of July 1, 2006 we are pleased to offer an economic, new low-cost IVF program. Under this program, women, who qualify medically, will be given the option to pursue a “minimum frills” IVF program at the unprecedented total cycle cost of only $4,950, including all medications and including of ICSI, if required. At this price, we believe, this IVF cycle cost represents the lowest, all inclusive, cycle fee offered anywhere in the Tristate area.

Qualified women will receive so-called minimal ovarian stimulation, which in a number of studies, over the last two years, has been shown to be very effective in carefully selected patients. Since the stimulation is mild, monitoring requirements are reduced, as are other routine activities in comparison to traditional IVF cycle stimulation. The resultant cost-savings can then be passed on to patients and result in the above noted, extraordinarily low cycle costs.

This kind of stimulation, in our opinion, is not well suited for women with diminished ovarian reserve and we, therefore, will carefully evaluate patients before making a recommendation about participation in this program. The program is, however, open to everybody who chooses to participate.

For further information on ECO-IVF, please contact us here or by calling
212-994 4400 and mention that you are calling about ECO-IVF.

THE MENOPAUSE RESEARCH INSTITUTE (MRI)

MRI has now been functioning for a couple of month and we are seeing increasing interest in MRI’s consulting services. We want, however, to point out, one more time, that the clinical consultation services of MRI are primarily meant as sub-specialty services. They and are not replacement for routine menopause care.

Like with CHR’s infertility services, we also welcome direct inquiries from our colleagues, who will be immediately answered, whether they are received by telephone or by e-mail. Such inquiries should be directed to MRI’s Medical Director, David Barad, MD at 212-434 7055.

DHEA UPDATE

We, of course, previously have reported extensively on the various DHEA studies we conducted at CHR. Those who have followed our progress will recall that we initially reported that DHEA increases egg and embryo numbers to a statistically significant degree. Subsequently, we were also able to prove that DHEA also significantly improves egg and embryo quality and, later, pregnancy rates, as well as time to pregnancy. [Those who seek confirmation are referred to our publications: Fertil Steril 2005;84:756.e1-3; Fertil Steril 2005;84(Suppl 1):S42(abstract); Hum Reprod 2006:21(Suppl 1):i69; (abstract); Barad and Gleicher, Human Reprod, In press;].

What we were, however, only able to suggest, but not able to prove statistically, was that DHEA, to a statistically significant degree, reduces chromosomal abnormalities in embryos (i.e. the aneuploidy rate). As Dr. Gleicher, for the first time, was able to report at last month’s ESHRE Meeting in Prague, Czech Republic,
our data on the impact of DHEA on aneuploidy rates have now also reached statistical significance. Therefore, we are now, for the first time, in a position to state with a level of statistical confidence that one of the mechanisms by which DHEA appears to improve fertility outcomes is the reduction in chromosomal abnormalities in embryos.

While these data have reached statistical significance, our numbers are still quite small and we, therefore, are viewing them still with some caution. The overall picture, however, fits, and it makes logical sense that “better” embryos would also show less aneuploidy.

We are in the process of preparing a manuscript on this topic and will, of course, report further updates as we develop new, and additional, data.

ESHRE, Prague, Czech Republic, June 18-21 2006

As already noted above, Dr. Gleicher presented to great acclaim an update of CHR’s DHEA work in an oral presentation at the Annual Meeting of the European Society of Human Reproduction and Embryology. Following his presentation, a large circle of physicians and reporters formed around him outside the lecture room, who continued for a good half hour to ask questions.

What also has become apparent is that the use of DHEA in women with diminished ovarian reserve has become world wide practice.

A day earlier, Dr. Weghofer had presented, equally successfully, CHR’s data on aneuploidy rates in IVF cycles of women with prematurely aging ovaries (POA)[Hum Reprod 2006;21(Suppl 1):i8(abstract)]. As we already reported in a previous Update, POA patients do not show an increase in aneuploidy, as one would expect in prematurely aging ovaries, if properly stimulated. She, too, received a large number of questions from a very interested audience.

ASRM, New Orleans, October 23-25, 2006

At this year’s meeting of the American Society for Reproductive Medicine (ASRM), in New Orleans, Louisiana, CHR will also show considerable presence. In unprecedented fashion, all six abstracts, we had submitted for presentation, have been accepted. We will, thus, have three oral and three poster presentations.

The topics covered by these presentations will, of course, once again, include a DHEA update. In addition, however, we will present papers on chromosomal abnormalities in embryos from women with POA and polycystic ovaries (PCO), a paper which, we believe, will attract considerable attention, on the prevalence of chromosomal abnormalities in embryos, based on the mode of ovarian stimulation, and another very important study, in which we propose a new method of diagnosing POA in timely fashion.

In addition, Dr. Barad was asked to chair the menopause session of the meeting and Dr. Gleicher was asked to present a Roundtable on the topic of hysterosalpingography.

We will, of course, further report on our activities at the upcoming ASRM meeting. Since this will be everybody’s first visit to New Orleans since the hurricane devastated the city, we are all looking forward to this event with great anticipation.

These are exiting times at CHR, and we thank you for your interest in our work.

Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned reproductive endocrinologist, 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.