Fertility Research at CHR

Driving Force behind CHR’s Clinical Success

CHR is a rare private fertility center that combines clinical fertility care with a robust clinical and laboratory research program. In over 30 years since its inception, CHR researchers have published hundreds of research papers, many in prestigious medical journals like Journal of the American Medical Association (JAMA) and New England Journal of Medicine (NEJM). CHR’s medical journal publications are listed below.

Some of CHR’s original research findings brought revolutionary new approaches to the field of reproductive endocrinology and infertility. Involvement of autoimmunity in endometriosis is one; the now-routine transvaginal egg retrieval is another; and the most recent example is the introduction of DHEA supplementation into the treatment of women with diminished ovarian reserve.

CHR Explains

CHR’s focus has been the mechanism and treatment of diminished ovarian reserve for over a decade now, and many of our research publications are in this area. In the past few years, CHR has also expanded its laboratory research division significantly with 3 PhD-level scientists to conduct translational research in molecular biology and genetics. CHR’s Medical Director and Chief Scientist, Dr. Norbert Gleicher, emphasizes rigorous translational research because research is what drives innovation in fertility treatment at CHR, and our patients benefit directly from our research findings, which are “translated” into our clinical care program.

Infertility Clinical Trials

Clinical trials are considered the gold standard of research, and at any given time, CHR is likely to have more than one ongoing clinical trials. Some clinical trials recruit participants, while others may be open by invitation only.

CHR’s Medical Journal Publications

How the FMR1 gene became relevant to female fertility and reproductive medicine

A comprehensive overview of the FMR1 gene’s effects on ovarian function and follicle maturation, and its potential role as an important diagnostic tool for functional ovarian reserve.

Citation Page #: 5;284.
Journal: Frontiers Genetics
Author Publication: Gleicher N, Kushnir VA, Weghofer A, Barad DH.
Link: View Publication
Date: 2014

Categories: Diminished Ovarian Reserve, FMR1

Effects of inter-cycle interval on oocyte production in humans in the presence of the weak androgen DHEA and follicle stimulating hormone: a case-control study

Repeat exposures to androgens like DHEA and FSH in short intervals improves functional ovarian reserve and increase pregnancy chances in humans, confirming the results of prior animal studies.

Citation Page #: 12:68.
Journal: Reprod Biol Endocrinol
Author Publication: Barad DH, Kushnir VA, Lee H-J, Lazzaroni-Tealdi E, Gleicher N.
Link: View Publication
Date: 2014

Categories: DHEA

Letter to the Editor: Poor responders and androgen adjuvant treatment: “Still haven’t found what I’m looking for …”

The paper offers a concise summary of rationale for androgen supplementation in women with LFOR to maximize pregnancy chances, in response to uninformed skepticism.

Citation Page #: 29(5):650-2.
Journal: Reprod Biomed Online
Author Publication: Gleicher N, Barad DH, Kushnir VA, Sen A, Weghofer A.
Link: View Publication
Date: 2014

Categories: DHEA, Ovarian Reserve

The "graying" of infertility services: an impending revolution nobody is ready for

Revolutionary change in infertility practice looms large with more older women seeking ART. Medical practice will have to adapt as women in their 50s and 60s start conceiving.

Citation Page #: 12:63.
Journal: Reprod Biol Endocrinol
Author Publication: Gleicher N, Kushnir VA, Weghofer A, Barad DH.
Link: View Publication
Date: 2014

Categories: Ovarian Reserve, Pregnacy After 40

Absence of BRCA/FMR1 correlations in women with ovarian cancers.

Study of BRCA1/2 mutation did not show correlation between low FMR1 alleles and BRCA-positive ovarian cancer patients.

Citation Page #: 9(7): e102370.
Journal: PLoS ONE
Author Publication: Gleicher N, McAlpine JN, Gilks CB, Kushnir VA, Lee H-J, Wu Y-G, Lazzaroni-Tealdi E, Barad DH.
Link: View Publication
Date: 2014

Categories: FMR1, Testing & Diagnostics

Ovarian reserve screening prior to contraception?

Hormonal contraceptives can deter detection of POF. The study proposes risk screenings before women begin taking contraceptives.

Citation Page #: In press.
Journal: Reprod Biomed Online
Author Publication: Kushnir VA, Barad DH, Gleicher N.
Link: View Publication
Date: 2014

Categories: Anti-Müllerian Hormone, Fertility Preservation, Premature Ovarian Failure, Testing & Diagnostics

Utilizing FMR1 gene mutations as predictors of treatment success in human in vitro fertilization.

In this study, low FMR1 alleles lowered IVF pregnancy rates by reducing egg and embryo quality.

Citation Page #: 9(7): e102274.
Journal: PLoS ONE
Author Publication: Kushnir VA, Yu Y, Barad DH, Weghofer A, Himaya E, Lee H-J, Wu Y-G, Shohat-Tal A, Lazzaroni-Tealdi E, Gleicher N.
Link: View Publication
Date: 2014

Categories: Egg Quality, FMR1, Ovarian Reserve, Testing & Diagnostics

Preimplantation genetic screening (PGS) still in search of a clinical application: a systematic review.

Newly updated “PGS#2” faces a multitude of issues, chief among them appropriate patient selection. With its efficacy still unproven, the technique should be offered only on an experimental basis.

Citation Page #: 12:22.
Journal: Reprod Biol Endocrinol
Author Publication: Gleicher N, Kushnir VA, Barad DH.
Link: View Publication
Date: 2014

Categories: PGD

PGD

Fertility treatments and multiple births in the United States.

Focus for multiple birth prevention should be on IUI, not IVF, given IUI’s much higher risk of high-order multiples and complications.

Citation Page #: 370:1069-1071.
Journal: NEJM
Author Publication: Gleicher N, Kushnir VA, Barad DH.
Link: View Publication
Date: 2014

Categories: IVF, IVF & Twins

Maternal autoimmunity and adverse pregnancy outcomes.

This study explores the poorly understood mechanisms of autoimmune diseases like preeclampsia negatively affecting pregnancy outcomes.

Citation Page #: 50:83-89.
Journal: Journal of Autoimmunity
Author Publication: Gleicher N.
Link: View Publication
Date: 2014

Categories: Autoimmune Disease

A randomized clinical trial of endometrial perfusion with granulocyte colony-stimulating factor in in vitro fertilization cycles: impact on endometrial thickness and clinical pregnancy rates

In normal, older IVF patients, G-CSF does not affect endometrial thickness, implantation rates, or clinical pregnancy rates.

Citation Page #: 101(3):710-715.
Journal: Fertility & Sterility
Author Publication: Barad DH, Yu Y, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Gleicher N.
Link: View Publication
Date: 2014

Categories: Failed IVF, IVF, Pregnacy After 40

What misguided campaign against SET?

CHR physicians argue against the supposed efficacy of single embryo transfer, based on cost-benefit analysis and statistical comparison of risks between twins and singletons.

Citation Page #: In press.
Journal: Human Reproduction
Author Publication: Gleicher N, Kushnir VA, Barad DH.
Date: 2014

Categories: IVF Success Rates

Preimplantation genetic screening is alive and very well: Really?

Though preimplantation genetic screening (PGS) was proven ineffective and costly for patients in a previous iteration, it is still marketed aggressively.

Citation Page #: e36.
Journal: Fertility & Sterility
Author Publication: Gleicher N, Kushnir VA, Barad DH.
Link: View Publication
Date: 2013

Categories: PGD

PGD

Do BRCA1/2 mutations and low FMR1 alleles interact or not?

Current evidence does not support the possibility of interplay between the BRCA mutation and the FMR1 gene; further exploration of this connection is necessary.

Citation Page #: Epub ahead of print

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Therapeutic interventions into early stages of follicle maturation: a new treatment paradigm after over 50 years of modern infertility therapy.

Infertility treatment of the 21st century will center on saving and maturing ovarian follicles, with androgen supplementation for DOR and tamoxifen protection during radiotherapy being two examples.

Citation Page #: 3498-501
Journal: Endocrinology
Author Publication: Gleicher N, Kushnir VA, Barad DH.
Link: View Publication
Date: 2013

Categories: DHEA, Ovarian Reserve, Pregnacy After 40

FMR1-dependent variability of ovarian aging patterns is already apparent in young oocyte donors

FMR1 gene already affects ovarian function at young ages; FMR1 may be an effective prospective POA screening tool.

Citation Page #: 11:80
Journal: Reprod Biol Endocrinol
Author Publication: Gleicher N, Kim A, Barad DH, Shohat-Tal A, Lazzaroni E, Michaeli T, Lee Ho-Joon, Kushnir VA, Weghofer A.
Link: View Publication
Date: 2013

Categories: Egg Donation, FMR1, Testing & Diagnostics