Recent Abstracts

Reduced spontaneous abortion and increased live birth rate after PGD for advanced maternal age

 

S. Munne, Ph.D., J. Garrisi, F. Barnes, L. Werlin, W. Schoolcraft. M.D., Brian Kaplan, M.D.

 

Summary:  The data suggest that PGD can significantly increase the chance of pregnancy to term in multiple IVF programs, while reducing the risk of miscarriage in women age 38-42.  Inter-clinic variations indicates that PGD is more effective in some IVF centers compared to others, suggesting that patient selection, follicular stimulation, culture systems, and biopsy may play important roles. 

 

Fertility and Sterility 2007:88, Suppl 1: S85-86.

 

 

Repeated IVF failures followed by successful donor oocyte cycle

 

Meredith K. Martin-Johnston, D.O., Angeline N. Beltsos, M.D., Meike L. Uhler, M.D. and H. Edward Grotjan, Ph.D

 

Summary:  In patients undergoing repeated failed IVF cycles, there is a significant increase in pregnancy rates by altering the treatment method to a donor oocyte cycle.  For patients undergoing repeated IVF cycles two and three resulting in failure, donor oocyte should strongly be considered.

 

Fertility and Sterility 2007:88, Suppl 1: S127.

 

 

Clinical response of successful donor cycles

 

Cerise J. Bush, M.D., Angeline N. Beltsos, M.D., Kelli L. Sasada, M.D., Meredith K. Martin-Johnston, D.O., Meike L. Uhler, M.D. and Juergen Liebermann, Ph.D.

 

Summary:  When looking at donor oocyte IVF cycles, no clinical parameter of the donor influenced pregnancy rates except blastocyst development.  Blastocyst transfer was highly predictive of a successful donor oocyte cycle with pregnancy rates of 69% versus 46% for cleavage stage day 3 embryo transfers.

 

Fertility and Sterility 2007:88, Suppl 1: S141-142.

 

 

Does luteinizing hormone activity in the form of low-dose hCG or HMG produce better outcomes for GnRH antagonist ART cycles stimulated with rFSH? 

 

J. Fratarrelli, M.D., B.T. Miller, M.D., Brian Kaplan, M.D., E. Widra, M.D. R. T Scott, M.D.

 

Summary:  It appears that low dose- hCG and the traditional mixed protocol provide little benefit for controlled ovarian hyperstimulation ART cycles. The study design and small sample size preclude drawing any definite conclusions regarding implantation or pregnancy rates. 

 

 Fertility and Sterility 2007:88, Suppl 1: S132.

 

 

BMI:  Impact on IVF success appears age-related.

 

Megan L. Sneed, M.D., Meike L. Uhler, M.D., H. Edward Grotjan, Ph.D., John J. Rapisarda, M.D., Kevin J. Lederer, M.D., and Angeline N. Beltsos, M.D.

 

Summary:  In younger patients undergoing IVF, BMI has a significant negative impact; however, as patients reach their mid thirties, the effects of age appear to be stronger than those of BMI.  It seems appropriate to recommend pretreatment weight loss to patients under age 36, whereas in patients over age 36, a more aggressive approach to infertility treatment may be warranted.

 

Fertility and Sterility 2006: 86, Suppl 2: S69-70.

 

 

Lower chance of pregnancy with repeated cycles with in vitro fertilization.

 

Meredith K. Martin-Johnston, D.O., Angeline N. Beltsos, M.D., Jane M. Nani, M.D., H. Edward Grotjan, Ph.D., Aaron S. Lifchez, M.D., and Meike L. Uhler, M.D. 

 

Summary:  The probability of a successful outcome declined with each additional treatment cycle. The most notable decrease in pregnancy and clinical pregnancy rates occurred between the second and third cycle.  Patients who fail to conceive after two cycles of IVF should be counseled to begin considering other options. 

 

Fertility and Sterility 2006: 86, Suppl 2: S183.

 

 

Clinical benefit from in vitro matured metaphase I oocytes?

 

Juergen Liebermann, Ph.D., Elissa Pelts, Jill Matthews, Amanda Erman, Sara Sanchez, and Andrew Barker.

 

Summary:  There was a reasonable fertilization rate and blastocyst formation rate with over 1000 in vitro matured oocytes analyzed.  In situations where only a limited number of embryos is available, embryos derived from in vitro mature oocytes should be considered to be included in the embryo transfer cohort because they can result in pregnancy.

 

Fertility and Sterility 2006: 86, Suppl 2: S388.

 

 

Differential frequency of aneuploidy among chromosomes detected by preimplantation genetic diagnosis of day 3 embryos.

 

R. Pen, Juergen Liebermann, Ph.D., K. Richter, Jill Matthews, E. Widra and William Kearns, Ph.D.

 

Summary:  Results of this study suggest that the primary aneuploidy rate differs among chromosomes.  Possible explanations are offered, and more research is needed to further elucidate the causes of this observed variation.

 

Fertility and Sterility 2006:86, Suppl 2: S474-5.

 

 

Effect of the maternal age on the percentage of aneuploid chromosomes in biopsied embryos on day 3.

 

Juergen Liebermann, PhD., Elissa Knopoff, Jill Matthews, Michael Tucker, Ph.D., K. Richter, and William Kearns, Ph. D

 

Summary:  The data presented in this study confirm that significant differences in the percentage of aneuploid chromosomes between different age groups exist.  Based on linear regression model, the percentage of aneuploid chromosomes increases by almost 0.6% for each additional year of age.

 

Fertility and Sterility 2006: 86, Suppl 2: S484.

 

 

Severe teratospermia does not affect fertilization or pregnancies in IVF patients undergoing intracytoplasmic sperm injection

 

Meike L. Uhler, M.D., Angeline N. Beltsos, M.D., Ramaa P. Rao, M.D., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.

 

Summary:  Fertilization and pregnancy rates were not affected by severe teratospermia in IVF patients when ICSI is the primary fertilization method.  Intracytoplasmic sperm injection can overcome the negative influence of severe teratospermia to produce fertilization and pregnancy rates comparable to those patients with normal sperm morphology. 

 

Fertility and Sterility 2005: 84, Suppl 1: S208.

 

 

A comparison of recombinant follicle stimulating hormone (Rec FSH) to combination Rec FSH plus human menopausal gonadotropin (HMG) in gonadotropin releasing hormone (GnRH) antagonist in IVF cycles.

 

Meredith K. Martin-Johnston, D.O., Angeline N. Beltsos, M.D., Meike L. Uhler, M.D., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.

 

Summary:  Rec FSH treatment yielded more oocytes, better embryo development and tended to increase pregnancy rates compared to treatment with Rec FSH in combination with hMG. Although both FSH and LH are obligatory for follicular development in humans, exogenous hMG does not appear to be required or beneficial in most IVF patients given GnRH antagonist to block endogenous LH surges.

 

Fertility and Sterility 2005: 84, Suppl 1: S425.

 

 

Intercycle variability of day 3 FSH levels is useful for predicting ovarian responses but not pregnancy outcomes in IVF.

 

Meike L. Uhler, M.D., Ramaa P. Rao, M.D., Angeline N. Beltsos, M.D., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.

 

Summary:  High day 3 FSH variability can effectively be used to identify patients that are likely to have diminished ovarian responses to treatment.  However, these patients still have a reasonable chance of establishing a pregnancy. 

 

Fertility and Sterility 2005:  84, Suppl 1: S265.

 

 

Blastocyst cryopreservation: To slow-freeze or to vitrify?

 

Juergen Liebermann, PhD., Elissa Knopoff, Jill Matthews, Amanda Erman, Sara Sanchez, and Michael Tucker, Ph.D.

 

Summary:  Vitrification is now our standard protocol for cryopreservation of human blastocysts within our program.  With much shorter procedural protocols, vitrification can be undertaken on a more flexible basis by laboratory staff and reduces personnel time commitment.

 

Fertility and Sterility 2005:  84: S182

 

 

Early cleavage of embryos as a rigorous and efficient tool to predict the implantation competence of a human embryo:  still a good diagnostic tool?

 

Juergen Liebermann, PhD., Elissa Knopoff, Jill Matthews, Amanda Erman, Sara Sanchez, Andrew Barker, and Michael Tucker, Ph.D.

 

Summary:  Based on strong statistical significance in clinical improvement, it is evident that early cleavage is a strong diagnostic tool yielding useful information regarding the implantation potential of the human embryo.

 

Fertility and Sterility 2005: 84, Suppl 1: S285.

 

 

Developmental potential of early-cleaved embryos associated with higher rates of blastocyst formation and utilization for cryopreservation.

 

Juergen Liebermann, PhD., Elissa Knopoff, Jill Matthews, Yuri Wagner, Rebecca Brohammer, and Michael Tucker, Ph.D.

 

Summary:  Our data confirms significant differences in embryo quality between early and non early-cleaved embryos.  Furthermore, early-cleaved embryos progressed to the blastocyst stage at a higher rate, and formed higher quality blastocysts suitable for cryopreservation.

 

Fertility and Sterility 2005:  84, Suppl 1: S289.

 

 

Vitrification ready for reproductive medicine:  blastocyst vitrification versus conventional cryopreservation.

 

Juergen Liebermann, PhD., Elissa Knopoff, Jill Matthews, Amanda Erman, and Michael Tucker, Ph.D .

 

Summary:  Cryosurvival was improved with vitrification compared to conventional cryopreservation.  Clinical outcomes were notably improved but did not quite reach statistical significance.  Nonetheless, vitrification improves patient management with embryo transfer being almost certain to occur.

 

Biology of Reproduction 2005: Special Issue; 228.