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Reproductive Immunology Initiative at CHR: Announcement

Center for Human Reproduction’s Dr. Norbert Gleicher announces the new Reproductive Immunology Initiative, aiming to refine the understanding of immunological factors involved in infertility and revolutionize the clinical treatments available to women with immune-related infertility problems.

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This month’s newsletter includes the announcement of a new initiative at CHR. This is only the second time in the history of CHR that our institution has taken such a step. The first time, about 15 years ago, was the initiative that made us concentrate on the “older” ovary at the Center, in both research, as well as clinical care. 15 years ago, when we made this decision we were motivated by the hypothesis, by the thought, by the idea that older women were increasing in our patient population in general. That women above age 40 represent now, in the United States for a good number of years, the age group that the quickest increases in size and having children.

In other words, women above age 40 are today practically the only age group where pregnancies and deliveries are still rising. You know, at all other ages deliveries in the United States have been declining and a similar pattern can be seen throughout developed countries around the globe. Recognizing then that older women will become more prevalent in infertility centers, we felt that it was time to concentrate our efforts on this subject and the announcement of that initiative 15 years ago, led to CHR concentrating a big part of its financial resources, when it came to research, but also to clinical care on the older ovary.

We have been exceptionally successful in this effort. It was well-timed and we believe very logical because if anything, they increase in age of women needing fertility care proceeded even at a quicker pace than than we had anticipated. CHR is probably at the extreme. CHR has by far the oldest patient population, reporting to CDC and ASRM but we see no end to this trend as our patient population Year by year is quite significantly aging in 2016 indeed. Our patients mean age for the first time past 42.

So we have been extremely successful by being able in parallel, over those 15 years, to advance our pregnancy rates in these older patients. Best documented elsewhere reported in this month’s newsletter by the recent birth of what is likely the oldest woman ever giving birth to a child with use of her own eggs after IVF at age practically 48. She was only two months short of 48 at the time we transferred her embryos.

We now are announcing a similar initiative in the field of reproductive immunology. Like 15 years ago, when we decided to concentrate our efforts on the older ovaries. We feel that the time now is ripe for this initiative. Reproductive immunology has gotten somewhat of a bad name over the last 20 to 25 years because a lot of people entered the field and made pronouncement and promises that were really not based on solid data. CHR has had a prominent position in the field of reproductive immunology for many years, though we have remained relatively quiet. I personally was involved in the formation of the American Society for Reproductive Immunology, Indeed I was the society’s first elected vice president. I was also the founding editor in chief of the American Journal of Reproductive Immunology, which was founded in parallel with the creation of the society and in the early days there was a lot of enthusiasm about the field of reproductive immunology, and then unfortunately, interests in general in medicine dissipated about immunology.

But particularly in the reproductive immunology, some exaggerated statements from colleagues rightly made many other colleagues in the specialty question the seriousness of some of the published reports and especially of some of the clinical practices that started entering the field. We now feel that considering the advances that have been made in immunology and other areas of medicine, particularly in oncology, in the organ transplantation and to a large degree in basic biology and genetics. This is the time to get back into reproductive immunology.

After all, pregnancy is a transplant situation. The fetus is 50% a foreign body that is tolerated by the maternal immune system. What this means is that without the immune system reprogramming itself to tolerate that parasite called a fetus, there would be no pregnancies. That describes how important reproductive immunology is to reproductive success.

Like 15 years ago with the aging ovary, we now believe that the time is right to start an initiative in reproductive immunology. New tools, new knowledge have made this the time to aggressively to re-enter the field and we therefore are extremely pleased to announce the new reproductive immunology initiative at CHR, which will be concentrating both on basic research. As well as, clinical care of patients with reproductive immunology problems in a very similar fashion to how we developed our knowledge and our expertise about the aging ovary. We’re looking forward to seeing you if you have reproductive immunology problems, just call us. We learn every day from our patients. You