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

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

Some more on preventing congenital heart block

Overall lack of evidence leaves most treatments of congenital heart block only experimental, even those recommended by rheumatologists.

Citation Page #: Epub ahead of print
Journal: Autoimmunity Reviews
Author Publication: Gleicher N, Elkayam U.
Link: View Publication
Date: 2013

Categories: Autoimmune Disease

Defining assisted reproductive technology success.

Citation Page #: Epub ahead of print
Journal: Fertil Steril
Author Publication: Kushnir VA, Barad DH, Gleicher N.
Link: View Publication
Date: 2013

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Reply of the authors.

Citation Page #: 100(3);e18
Journal: Fertil Steril
Author Publication: Kushnir VA, Vidali A, Barad DH, Gleicher N.
Link: View Publication
Date: 2013

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Reply of the authors.

Citation Page #: Epub ahead of print
Journal: Fertil Steril
Author Publication: Kushnir VA, Barad DH, Gleicher N, Vidali A.
Link: View Publication
Date: 2013

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Association of abnormal ovarian reserve parameters with a higher incidence of aneuploid blastocysts (In reply)

Studies of abnormal ovarian reserve must control for age in order to be valid, according to CHR physicians in this letter to the editor.

Citation Page #: 121(6);1361
Journal: Obstet Gynecol
Author Publication: Kushnir VA, Barad DH, Gleicher N.
Link: View Publication
Date: 2013

Categories: Egg Quality, Ovarian Reserve

Age at menarche: a predictor of diminished ovarian function?

Early onset of menstruation was associated with higher risks for low functional ovarian reserve later in life, making age at menarche a potential diagnostic tool for FOR.

Citation Page #: Epub ahead of print
Journal: Fertil Steril
Author Publication: Weghofer A, Kim A, Barad DH, Gleicher N.
Link: View Publication
Date: 2013

Categories: Ovarian Reserve, Testing & Diagnostics

Is androgen production in association with immune system activation potential evidence for existence of a functional adrenal/ovarian autoimmune system in women?

Existence of an immune system-derived androgen-production factor (APF) hints at an unknown functional adrenal autoimmune system.

Citation Page #: 11;58
Journal: Reprod Biol Endocrinol
Author Publication: Gleicher N, Weghofer A, Kushnir VA, Shohat-Tal A, Lazzaroni E, Lee HJ, Barad DH.
Link: View Publication
Date: 2013

Categories: Autoimmune Disease, Diminished Ovarian Reserve

The status of public reporting of clinical outcomes in assisted reproductive technology.

Controversial paper lays out the ways in which some IVF centers manipulate IVF success rates reported to and published by SART/CDC.

Citation Page #: Epub ahead of print.
Journal: Fertil Steril
Author Publication: Kushnir VK, Vidali A, Barad DH, Gleicher N.
Link: View Publication
Date: 2013

Categories: IVF Success Rates

Preventing congenital neonatal heart block in offspring of mothers with anti-SSA/Ro and SSB/La antibodies: a review of published literature and registered clinical trials.

Use of hydroxychloroquine to prevent congenital heart block in children of women with anti-SSA/Ro – SSB/La antibodies lacks evidence.

Citation Page #: 12(11);1039-45
Journal: Autoimmune Rev
Author Publication: Gleicher N, Elkayam U.
Link: View Publication
Date: 2013

Categories: Autoimmune Disease

Clinical relevance of combined FSH and AMH observations in infertile women.

Combination of high FSH and high AMH levels was predictive of almost twice the pregnancy rates with IVF than other combinations.

Citation Page #: 98(5):2136-2145.
Journal: J Clin Endocrinol Metabol
Author Publication: Gleicher N, et al.
Link: View Publication
Date: 2013

Categories: Anti-Müllerian Hormone, High FSH, IVF Success Rates, Testing & Diagnostics

Mistaken advocacy against twin pregnancies following IVF.

Single embryo transfer (SET) is not cost effective and patient friendly; the paper points out that advocates of SET are incorrectly interpreting the statistical risk data.

Citation Page #: 30(4):575-9.
Journal: J Assist Reprod Genet
Author Publication: Gleicher N, Barad DH.
Link: View Publication
Date: 2013

Categories: IVF & Twins

Does hormonal contraception prior to in vitro fertilization (IVF) negatively affect oocyte yields? A pilot study.

Oral contraceptives (OC) suppress ovarian reserve and egg quality, according to preliminary findings, suggesting that the common practice of using OCs before IVF must be reevaluated.

Citation Page #: 11:28.
Journal: Reprod Biol Endocrinol
Author Publication: Barad DH, et al
Link: View Publication
Date: 2013

Categories: IVF

IVF

A pilot trial of large versus small diameter needles for oocyte retrieval.

Needle diameter does not affect the effectiveness of egg retrieval, though thinner needles seem to significantly prolong operation time.

Citation Page #: 11:22.
Journal: Reprod Biol Endocrinol
Author Publication: Kushnir VA, et al
Link: View Publication
Date: 2013

Categories: IVF

IVF

Hypoandrogenism in association with diminished functional ovarian reserve.

Groundbreaking study found that diminished ovarian reserve is associated with low androgen levels, which may be the cause of poor egg quality and yield.

Citation Page #: 28(4):1084-91.
Journal: Hum Reprod
Author Publication: Gleicher N, et al
Link: View Publication
Date: 2013

Categories: DHEA, Ovarian Reserve

Avoiding currently unavoidable conflicts of interest in medical publishing by transparent peer review.

Changes to the current process of peer review in medical publishing are needed in order to make the process transparent and to avoid potential conflicts of interest.

Citation Page #: 26(5):411-5.
Journal: Reprod Biomed Online
Author Publication: Gleicher N
Link: View Publication
Date: 2013

Categories: Research

Starting and resulting testosterone levels after androgen supplementation determine at all ages in vitro fertilization (IVF) pregnancy rates in women with diminished ovarian reserve (DOR).

Women with DOR whose androgens rose after DHEA supplementation saw higher pregnancy chances with IVF than those whose androgen levels remained unchanged before and after supplementation.

Citation Page #: 30(1):49-62.
Journal: J Assist Reprod Genet
Author Publication: Gleicher N, et al
Link: View Publication
Date: 2013

Categories: DHEA, Ovarian Reserve

Why are reproductive cancers more common in nulliparous women?

It has been known for decades that nulliparity is associated with an increased risk for certain reproductive malignancies, including breast, ovarian and uterine cancers. In response to a commentary in The Lancet that related the age-related increase in reproductive cancers in nulliparous women to the number of ovulatory cycles, this commentary postulates other possible primary mechanisms.

Citation Page #: 26(5):416-9.
Journal: Reprod Biomed Online
Author Publication: Gleicher N
Link: View Publication
Date: 2013

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A pilot cohort study of granulocyte colony-stimulating factor in the treatment of unresponsive thin endometrium resistant to standard therapies

A follow-up to an original pioneering case report from CHR, this study of 21 women confirmed that direct uterine perfusion with G-CSF improves the thickness of uterine lining that did not respond to conventional treatments. After G-CSF perfusions, women in this study expanded their endometrium to approximately 9.3 mm on average, from an inadequate 6.4 mm, enabling them to proceed to embryo transfer.

Citation Page #: 28(1):172-7.
Journal: Hum Reprod
Author Publication: Gleicher N, et al.
Link: View Publication
Date: 2013 (Epub 2012)

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