Published Work
Chapters, Abstracts, and Peer-Reviewed Journal Articles
Published Book Chapters
2016
Human Embryo Vitrification
Juergen Liebermann, Ph.D.
Cryopreservation is one of the keystones in clinical infertility treatment. In particular, vitrification has become a well-established and widely used routine procedure. The technology may even be used to eliminate fresh embryo transfers for reasons of convenience, uterine receptivity, fertility preservation, preimplantation genetic diagnosis or emergency management.
Cryopreservation of Mammalian Gametes and Embryos: Methods and Protocols edited by Ashok Agarwal, Zsolt Peter Nagy, and Alex Varghese, Springer AG 2016
2015
Vitrification of Human Blastocysts: Clinical Realities and Neonatal Outcomes
Juergen Liebermann, Ph.D.
More than a million children have been born worldwide after the transfer of embryos following cryostorage. In particular, vitrification has become a well-established and widely used routine procedure that has allowed important expansion of therapeutic strategies when IVF is used to treat infertility. Vitrification involves the use of highly concentrated aqueous solutions as cryoprotectants to prevent ice crystal formation during exceedingly fast cooling. Vitrification of human blastocysts allows us to maximize the potential for conception from any single in vitro fertilization cycle and prevents wastage of embryos. This goes even further towards the best utilization of a patient’s supernumerary oocytes after retrieval, maximizing the use of embryos from a single stimulation cycle. The technology may even be used to eliminate fresh embryo transfers for reasons of convenience, uterine receptivity, fertility preservation, preimplantation genetic diagnosis or emergency management. In this chapter, the application of vitrification technology for cryopreserving human blastocyst will be revealed through step-by-step protocols. The results that are presented using the described protocols underscore the robustness of the vitrification technology for embryo cryopreservation.
Vitrification in Assisted Reproduction (2nd. Edition), Chapter 19, pp. 163-173, 2015 Eds. Michael J Tucker, Juergen Liebermann, Informa Healthcare, London, UK.
The Vitrification Component: An Integral Part of a Successful eSET Program
Juergen Liebermann, Ph.D.
IVF today was never so successful in regards to implantation rate and live birth rate since its introduction in 1978. A part of this is improvements in culture systems, culture media but also in training and proficiency of embryologists. It was common to transfer two or even more embryos per patient regardless of age or embryo quality. As a result of these high-order multiples, including twin pregnancy, were on the rise. Multiple gestations are high-risk pregnancies that should be avoided more a couple of reasons. The only truly effective means to avoid multiple gestations is transferring one embryo at a time. The patient’s autonomy represents a particular challenge, especially an overwhelming desire for twin pregnancies after IVF. Therefore patient education is vital for encouraging patients to take an elective single embryo transfer (eSET). Supportive in their decision making can be being aware of a successful cryopreservation program of supernumerary embryos which will help to maintain high pregnancy rates while increasing the health of the resulting live births by performing eSET in good prognosis patients.
Transferring the Single Euploid Embryo—Molecular Genetics in Reproductive Medicine, ed. Scott Sills Springer AG 2015
2014
Vitrification: A Simple and Successful Method for Cryostorage of Human Blastocysts
Juergen Liebermann, Ph.D.
Vitrification of human blastocysts allows us to maximize the potential for conception from anyone undergoing in vitro fertilization cycle and prevents wastage of embryos. This goes even further towards to best utilize a patient’s supernumerary oocytes after retrieval, maximizing the use of embryos from a single stimulation cycle.
Willem F. Wolkers and Harriëtte Oldenhof (eds.), Cryopreservation and Freeze-Drying Protocols, Methods in Molecular Biology, vol. 1257 Springer 2014
2013
Vitrification of Human Oocytes and Embryos: An Overview
Juergen Liebermann, Ph.D.
Successful cryopreservation of gametes in animal reproduction has a track record of over 60 years. In human IVF, interest in cryobiology increased dramatically in 1983 following the first successful pregnancy after the transfer of a human embryo. Currently, controlled ovarian hyper-stimulation protocols commonly provide embryos in excess of those needed for fresh transfer. Therefore, techniques have been developed to store these surplus embryos in liquid nitrogen (referred to as cryopreservation) for an indefinite period of time without a significant compromise in their quality. Embryo cryopreservation and cryostorage is now a routine part of services offered at clinics treating infertility worldwide. With improvements in cryopreservation techniques and methods over the last three decades, the process has increasingly become an important part of the IVF process. By improving the cumulative pregnancy rate per oocyte retrieval, and by reducing the number of embryos transferred, thereby reducing the risk of multiple pregnancies, the technology brings two extremely important contributions to the field.
Biennial Review of Infertility (eds: P. Schlegel, B. Frauser, D. Carrell, C. Racowsky). Chapter 15; pp. 189-202; 2013. Springer New York, Heidelberg, Dordrecht, London.
Artificial Collapse Prior Blastocyst Vitrification: Improvement of Clinical Outcome
Juergen Liebermann, Ph.D., Joe Conaghan, Ph.D.
By mastering blastocyst vitrification, the IVF lab has gained the ability to encourage physicians and patients to consider reducing the number of fresh embryos transferred through cryo-storage of sibling embryos. The technology involved has changed little in principle over time other than in the availability of carrier devices and in preference for closed systems instead of open systems. With the ever-increasing production of mid-to-fully expanded and hatched blastocysts on the 5th, 6th and 7th day of embryo culture, an important part of the success in Assisted Reproductive Technologies (ART) lies in a well-working cryopreservation program for blastocysts. In this article, we focus on possibilities for improving an already successful blastocysts vitrification program in a clinical setting.
The Journal of Clinical Embryology, Vol. 16, issue 1
2012
Chapter 57: Fertility Preservation in Patients with Endometrioma
Jennifer E. Hirshfeld-Cytron, M.D., Tingen C, TK Woodruff
Discussed the impacts of various benign ovarian pathology on the function of the remaining ovary. In particular impacts to women’s fertility who have these lesions.
Endometriosis: Science and Practice. Editors: L Giudice, JLH Evers, and D Healy. Blackwell Publishing Ltd. Oxford, UK.
Elective Single-Embryo Transfers: A Paradigm Between Risks of Multiple Pregnancies, Patient’s Expectations and Demands, and a Patient-Centric Autonomic Environment
Juergen Liebermann, Ph.D.
The data in this article show that successful implementation of eSETs for clinical application can be achieved by using basic embryonic knowledge rather than relying on expensive equipment and complex technology that is still under scientific development. Also, beside a wider acceptance of eSET in the IVF patient population, as well as among physicians and embryologists39, an active and effective cryopreservation program is essential for implementing eSET successfully and for effectively reducing the rate of multiple gestations associated with ART. In general, based on the data achieved at FCI, eSET has been demonstrated to be a valuable tool, not to maximize but rather to optimize pregnancy rates.
The Journal of Clinical Embryology, Vol. 15, issue 2.
Embryo Cryopreservation: Relevance in Human Assisted Reproduction
Matthew VerMilyea, Ph.D., Juergen Liebermann, Ph.D., Michael Tucker, Ph.D.
Close to three decades of experience with human embryo cryopreservation has accrued since its first clinical application. The technology involved has changed little in principle in this time other than a slow but inexorable swing away from a preference for ‘slow-freezing’ to the ultra-rapid ‘ice-free’ approach of vitrification. Embryo cryopreservation, as it relates to IVF therapy, has become an essential adjunct to improve clinical outcomes both in terms of cumulative pregnancy rate per oocyte retrieval and as a strategy to encourage a reduction of the number of fresh embryos transferred through cryo-storage of sibling embryos. The technology may even be used to eliminate fresh embryo transfers for reasons of convenience, uterine receptivity, fertility preservation, preimplantation genetic diagnosis or emergency management. In this chapter, the breadth of the application of this technology, its shortcomings, and burgeoning benefits are considered.
In Vitro Fertilization: A Comprehensive Guide. Eds, E. Ginsburg & C. Racowsky. Chapter 9, pp. 145-160, 2012). Springer New York Dordrecht Heidelberg London.
Vitrification of Embryos
Juergen Liebermann, Ph.D., Joe Conaghan, Ph.D., Peter Nagy, Ph.D., Michael Tucker, Ph.D.
Since mid 80th that time the impact of cryopreservation on the growth and improved efficiency of assisted reproduction in humans has become increasingly appreciated. Methods and protocols for cryopreservation have been developed such that ice crystals formation and growth inside the cells or tissues must either be eliminated or massively suppressed. One recent hotly debated topic in the area of reproductive cryobiology is whether slow-cooling or rapid-cooling protocols both satisfy the fundamental cryo-biological principles for reduction of damage by ice crystal formation during cooling and warming and which approach is better. It is the case nonetheless, that both methods of cryopreservation of biological material include 6 steps: 1) Initial exposure to cryoprotectant; 2) Cooling (slow/rapid) to subzero temperatures; 3) Low-temperature storage; 4) Thawing/warming; 5) Dilution and removal of the cryoprotective agent, and 6) Return to a physiological environment.
Practical Manual of In Vitro Fertilization: Advanced Methods and Novel Devices” (Chapter 59). Springer New York Dordrecht Heidelberg London.
Vitrification of Oocytes and Embryos
Juergen Liebermann, Ph.D.
Currently, controlled ovarian hyperstimulation protocols commonly provide embryos in excess of those needed for fresh transfer. Therefore, techniques have been developed to store these surplus embryos in liquid nitrogen (referred to as cryopreservation) for an indefinite period of time without significant compromise of their quality. Based on data from the Centers for Disease Control and Prevention (CDC) from 2001 to 2004, about 18% of all IVF cycles in the USA used frozen embryos for transfer. In addition, data from the same registry compared live births per transfer using frozen and fresh embryos (25% versus 34% respectively) clearly showing that cryopreservation is an important adjunct to maximize the efficiency of every single patient’s oocyte retrieval. The fundamental objectives for successful cryostorage of cells in liquid nitrogen at -196°C can be summarized as follows: 1) arresting the metabolism reversibly, 2) maintaining structural and genetic integrity, 3) achieving acceptable survival rates after thawing, 4) maintain of developmental competence post-thaw and, 5) the technique has to be reliable and repeatable.
Current Frontiers in Cryobiology” (Chapter 6). Ed. I.Katkov. InTech http://www.intechweb.org/; pp. 169-184, 2012.
2011
Cryopreservation of Human Oocytes and the Evolution of Vitrification Technology for this Purpose
Michael Tucker, Ph.D., Juergen Liebermann, Ph.D.
In principle the aims we expect from a cryopreservation technique that allows us to store a biological material at the low temperature of liquid nitrogen (-196°C) with the tissue free of any crystalline structure, and with arrest of all molecular diffusion and chemical processes which would otherwise precipitate degradation and aging. In this chapter, we shall consider the evolution of the practical application of cryopreservation technology to achieve consistently acceptable levels of cryosurvival of this highly cryosensitive gamete while retaining its inherent competency.
Principles and Practice of Fertility Preservation (Chapter 24). Eds. Jacques Donnez and S. Samuel Kim. Cambridge University Press pp. 295-306, 2011.
2011
Vitrification of Oocytes and Embryos
Juergen Liebermann, Ph.D.
Juergen Liebermann, Ph.D., CC, HCLD (ABB) has authored many papers in the area of reproductive science. Dr. Liebermann has contributed his research in Vitrification. In addition to his own published book on Vitrification in 2007, he has recently contributed an updated overview of Oocyte and Embryo vitrification to a new textbook, “Current Frontiers in Cryopreservation” which discusses new cryobiological ideas and introduces the recently emerged protocols for cryopreservation. This chapter reviews data accrued at Fertility Centers of Illinois.
Current Frontiers in Cryobiology, ISBN: 978-953-51-0191-8
Published Abstracts
2022
Fertility knowledge and views on egg freezing and family planning among surgical specialty trainees
Karine Matevossian, DO, Anne Rivelli, MA, MPH, Meike L. Uhler, MD
AJOG Global Reports, November 2022
Opinions of Transgender, Gender nonconforming, and Non-binary People on Value of Fertility Preservation: A Cross-Sectional Survey
Jawaria Amir, MD, Sara Twiehaus, DO, Monica Dholakia, BS, Maria Amir, BS, Sloane L. York, MD MPH, Jennifer Hirshfeld-Cytron, MD
ASRM Congress & Scientific Expo - October 2o22
The Impact of COVID-19 on Burnout in Healthcare Workers: A Cross-Sectional Survey
Amir J, Gupta S, Namath A, Burks C, Hirshfeld-Cytron J. (2022 October 22-26). Jawaria Amir, MD, Sonali Gupta, MD, Amalia Namath, M.D., Channing Burks, MD, Jennifer Hirshfeld-Cytron, MD
ASRM Congress & Scientific Expo - October 2o22
2020
Fertility Knowledge and Views on Egg Freezing and Family Planning among Surgical Specialty Trainees
Karine Matevossian, D.O., Anne Rivelli, M.A., M.P.H., Meike L. Uhler M.D.
ASRM Congress & Scientific Expo - October 2o20
2019
Preimplantation genetic testing for aneuploidy versus morphology as selection criteria for single frozen-thawed embryo transfer in good-prognosis patients: a multicenter randomized clinical trial
Santiago Munné, Ph.D., Brian Kaplan, M.D., John L. Frattarelli, M.D., H.C.L.D., Tim Child, M.D., Gary Nakhuda, M.D., F. Nicholas Shamma, M.D., Kaylen Silverberg, M.D., Tasha Kalista, M.A., Alan H. Handyside, Ph.D., Mandy Katz-Jaffe, M.D., Dagan Wells, Ph.D., Tony Gordon, Ph.D., Sharyn Stock-Myer, Ph.D., Susan Willman, M.D.
Fertility and Sterility 2019; Volume 112, Issue 6, Pages 1071–1079
2018
Differential Rate in Decline in Ovarian Reserve Markers in Women with Polycystic Ovary Syndrome Compared with Control Subjects: Results of a Longitudinal Study
Asima K. Ahmad, M.D., M.P.H., Chia-Ning Kao, B.S., M.S., Molly Quinn, M.D., Nikolaus Lenhart, B.S., Mitchell Rosen, M.D., Marcelle I. Cedars, M.D., Heather Huddleston, M.D.
Fertility and Sterility 2018; Volume 109, Issue 3, Pages 526-531
2016
Analytical Validation of Novel Next-Generation Screening Technology
Gole, J., Mullen, T., Celia, G., Colleen Wagner-Coughlin, Brian R. Kaplan, M.D., Katz-Jaffe, M., Schoolcraft, W., Umbarger, M.
Fertility and Sterility 2016; 105, no. 2 Supplement. (Prize paper at 64th Annual Pacific Coast Reproductive Society Meeting)
Impact of a Structured Yoga Program on Anxiety in Infertility Patients: A Feasibility Study
Sona Jasani, Beth Heller, Sue Jasulaitis, Marie Davidson, Ph. D., and Jennifer E. Hirshfeld-Cytron, M.D.
One of the largest prospective cohort studies to date demonstrating the improvement in stress levels in infertility patients undergoing a structured yoga program. Collaborative with Pulling Down the Moon.
Journal of Fertilization: In Vitro – IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biology 2016: 4: 183.
Understanding Young Women’s Reasons for Accepting or Declining Fertility Preservation Treatment Following a Cancer Diagnosis
Hershberger, P.E., Sipsma, H., Finnegan, L., and Jennifer E. Hirshfeld-Cytron, M.D.
Exploring the decision making of young women with cancer as they decide whether or not to pursue fertility preservation.
Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2016 Jan-Feb;45(1):123-34.
2015
Elective Single Versus Double Blastocyst Transfers in Gestational Carriers Using Fresh Anonymous Donor Oocytes
Sue Jasulaitis, Brian R. Kaplan, M.D., Colleen Wagner-Coughlin, and Juergen Liebermann, Ph.D.
Fertility and Sterility 2015; 102, no. 3.
Egg Donor Aneuploidy Rates Significantly Differ Between Fertility Centers
Munne, S., Alikani, M., Barritt, J., Hesla, J., Brian R. Kaplan, M.D., Alper, M., and McCulloh, D.
Fertility and Sterility 2015; 102, no 3.
Psychological Counseling of Female Fertility Preservation Patients
Lawson AK, Klock SC, Pavone ME, Jennifer E. Hirshfeld-Cytron, M.D., Smith KN, Kazer RR.
Study demonstrating the benefit of fertility preservation patients seeking psychological counseling on stress/ anxiety during the fertility preservation process.
Journal of Psychosocial Oncology 2015;33(4):333-53.
2014
Next-Generation DNA Sequencing: Improving the Accuracy of Routine Carrier Screening
Davie, J., Hallam, S. and Greger, V.
Fertility and Sterility 2014; 101, no. 2.
Fertility Preservation Outcomes May Differ by Cancer Diagnosis
Pavone ME, Jennifer E. Hirshfeld-Cytron, M.D.
This study suggesting that a patient’s cancer diagnosis can impact her individual response to gonadotropins in a fertility preservation/ IVF cycle.
Journal of Human Reproductive Sciences 2014 Apr;7(2):111-8.
A Prospective Study of Depression and Anxiety in Female Fertility Preservation and Infertility Patients.
Lawson AK, Klock SC, Pavone ME, Jennifer E. Hirshfeld-Cytron, M.D., Smith KN, Kazer RR.
This study shows that cancer patients have higher baseline stress/anxiety than infertility patient but they demonstrate a decrease with time in treatment. Infertility patients actually have a significant increase in stress during the treatment process.
Fertility Sterility 2014 Nov;102(5):1377-84.
Human Ovarian Tissue Cortex Surrounding Benign and Malignant Lesions
Pavone ME, Jennifer E. Hirshfeld-Cytron, M.D., Tingen C, Thomas C, Thomas J, Lowe MP, Schink JC, Woodruff TK.
Ovarian follicle counts of archived pathological specimens show that cancer patients have significantly decreased ovarian reserve BRCA patients also demonstrated a significant decrease number of available follicles compared to benign. Thus, patients with cancer or BRCA may not benefit from ovarian tissue cryopreservation.
Journal of Human Reproductive Sciences 2014 May;21(5):582-9.
Elective Single versus Double Blastocyst Transfers in Fresh Anonymous Oocyte Recipient Cycles.
Allison K. Rodgers, M.D., Marcia Hilse, and Juergen Liebermann, Ph.D.
The objective was to describe clinical pregnancy, live birth, and multiple gestation rates resulting from blastocyst transfers in fresh anonymous oocyte recipient cycles. While pregnancy rates and live birth rates are less in the elective single embryo transfer (eSET) group compared to the double embryo transfer ( DET), they are not significantly decreased. A 40.4% multiple gestation live birth rate in the DET group is clinically important. The average age in these oocyte recipients is greater than 40, and previous literature has reported that obstetrical complications are increased with singleton pregnancies and even higher risk with multiple gestations with increasing age. Interestingly, approximately 80% of cases still underwent DET. This can be hypothesized to be related to financial or emotional factors facing patients utilizing anonymous donor oocytes. The dramatically high multiples rate should be considered when determining eSET versus DET in this at-risk population.
Fertility and Sterility 2014; 102 (3) e337. Poster Presentation: American Society of Reproductive Medicine, 2014.
Elective Single versus Double Blastocyst Transfers in Gestational Carriers Using Fresh Anonymous Donor Oocytes.
Allison K. Rodgers, M.D., Sue Jasulaitus R.N., M.S., Colleen Wagner-Coughlin, and Juergen Liebermann, Ph.D.
Gestational carriers utilizing anonymous donor oocytes have both excellent prognosis embryos as well as an optimal uterine environment. Both clinical pregnancy rates and live birth rates are less in the elective single embryo transfer (eSET) group compared to the double embryo transfer (DET). However, a 48.1% multiple gestation rate in the DET group is clinically important. Interestingly, approximately 78% of cases still underwent DET. The dramatically high multiples rate should be considered when determining eSET versus DET in this population with an excellent prognosis.
Fertility and Sterility 2014; 102 (3) e340. Poster Presentation: American Society of Reproductive Medicine, 2014.
2013
Choosing the Optimal IVF Protocol for Patients 40 Years and Older
Brian R. Kaplan, M.D., Edward L. Marut, M.D., Jane M. Nani, M.D., Sullivan, C.M., and Johnson, H.
Fertility and Sterility 2013; 100, no. 3.
A Paradigm of Maximum Efficiency in the Utilization of Cryopreserved Embryos
Colleen Wagner-Coughlin, Brian R. Kaplan, M.D., Maravilla, A., Escudero, T., Munne, S.
Fertility and Sterility 2013; 100, no. 3.
Strategy for Euploid Embryo Banking
Dlugi, A., Grifo, J., Brian R. Kaplan, M.D., Hesla, J., Anderson, S., and Munne, S.
Fertility and Sterility 2013; 100, no. 3.
Toward Theoretical Understanding of the Fertility Preservation Decision-Making Process: Examining Information Processing Among Young Woman with Cancer
Hershberger P, L Finnegan, S Altfeld, S Lake and Jennifer E. Hirshfeld-Cytron, M.D.
Exploring the factors that help patients make clinical decision making in the context of fertility preservation.
Research and Theory for Nursing Practice. 2013; 27(4): 257-275.
Laparoscopic Tubal Reanastomosis versus In Vitro Fertilization: Cost-Based Decision Analysis
Jennifer E. Hirshfeld-Cytron, M.D. and J Winter.
LSC tubal reanastomosis is more cost-effective than IVF. This is due to the costs associated with multiple births.
American Journal of Obstetrics & Gynecology 2013 Jul;209(1):56.e1-6.
IGF-I Signaling is Essential for FSH Stimulation of AKT and Steroidogenic Genes in Granulosa Cells
Zhou P, Baumgarten SC, Wu Y, Bennett J, Winston N, Jennifer E. Hirshfeld-Cytron, M.D., Stocco C.
Basic science study exploring the pathway important in folliculogenesis and oocyte maturation.
2013; 27(3):511-23.
Role of Complementary and Alternative Medicine to Achieve Fertility in Uninsured Patients
T Perry and Jennifer E. Hirshfeld-Cytron, M.D.
Although there is limited data to support complementary and alternative medicine for fertility; patients, even those without insurance, still pursue these treatments.
Obstetrical & Gynecological Survey 2013 Apr;68(4):305-11.
Cost Implications to Society of Delaying Childbearing
Jennifer E. Hirshfeld-Cytron, M.D.
Expert Review of Obstetrics & Gynecology 2013; 8 (1):9-14.
2012
Pregnancy Outcome After the Biopsy with Fresh Transfer or Vitrification
Munne, S., Smotrich, D., Hill, D., Brian R. Kaplan, M.D., Grifo, J., and Anderson, S.
Fertility and Sterility 2012; 98, no. 3.
Results of Array Comparative Genomic Hybridization (aCGH) Combined with Multiplex PCR for Preimplantation Genetic Diagnosis (PGD) of both Single Gene Disorders and Aneuploidy
Prates, R., Kung, A., Fischer, J.M., Grifo, J., Brian R. Kaplan, M.D., Escudero, T.
Fertility and Sterility 2012; 98, no. 3.
Cost-Effective Analysis of Oocyte Cryopreservation: Stunning Similarities but Differences remain
Jennifer E. Hirshfeld-Cytron, M.D., van Loendersloot LL, Mol BW, Goddijn M, Grobman WA, Moolenaar LM, Milad MP.
Collaborative cost-effectiveness with European group suggesting that the reports oocyte success rates dictate if the strategy is cost-effective.
Human Reproduction 2012;27(12):3639.
Fertility Preservation for Social Indications: A Cost-Based Decision Analysis
Jennifer E. Hirshfeld-Cytron, M.D., WA Grobman, MP Milad
Fertility Sterility 2012;97(3):665-70.
Uterine Artery Embolization Immediately Preceding Laparoscopic Myomectomy
KN Goldman, Jennifer E. Hirshfeld-Cytron, M.D., ME Pavone, AP Thomas, RL Vogelzang, MP Milad
International Journal of Gynecology & Obstetrics 2012 Feb;116(2):105-8.
2011
Management of Recurrent Pregnancy Loss Associated with a Parental Carrier of a Reciprocal Translocation: A Systematic Review
Jennifer E. Hirshfeld-Cytron, M.D., M Sugiura-Ogasawara, MD Stephenson
Seminars in Reproductive Medicine 2011 Nov;29(6):470-81.
Animal Age, Weight, and Estrus Cycle Stage Impact the Quality of In Vitro Grown Follicles
Jennifer E. Hirshfeld-Cytron, M.D., FE Duncan, M Xu, JK Jozefik, LD Shea, TK Woodruff
Human Reproduction 2011 Sep;26(9):2473-85.
Non-malignant Diseases and Treatments Associated with Primary Ovarian Failure: An Expanded Role for Fertility Preservation
Jennifer E. Hirshfeld-Cytron, M.D., C Gracia, TK Woodruff
Journal of Women’s Health 2011 Oct;20(10):1467-77.
Comparing Thaw Survival, Implantation and Live Birth Rates from Cryopreserved Zygotes, Embryos, and Blastocysts
ME Pavone, J Innes, Jennifer E. Hirshfeld-Cytron, M.D., R Kazer, J Zhang
Journal of Human Reproductive Sciences 2011;4(1):23-8.
The Progressive Simplification of the Infertility Evaluation.
Jennifer E. Hirshfeld-Cytron, M.D., ME Pavone, RR Kazer
Obstetrical & Gynecological Survey 2011 Jan;66(1):31-41.
Correlation Between Depression, Anxiety and Nausea and Vomiting during Pregnancy in IVF Population – A Pilot Study
F Jahangiri, Jennifer E. Hirshfeld-Cytron, M.D., K Goldman, ME Pavone, S Gerber, S Klock
Journal of Psychosomatic Obstetrics & Gynecology 2011 Sep;32(3):113-8.
The Gynecologist has a Unique Role in Providing Oncofertilty Care to Young Cancer Patients
FE Duncan, JK Jozefik, AM Kim, Jennifer E. Hirshfeld-Cytron, M.D., TK Woodruff
US Obstetrics & Gynecology (Volume 5). 2011;6(1):24-34
A Unique Pathology Associated with Pelvic Pain and Adnexal Mass
C Lim, Jennifer E. Hirshfeld-Cytron, M.D., C McCarthy, Z-M Chen, and M Milad
Fertility Sterility 2011 Jun;95(7):2432.e9-11.
Metabolic Syndrome and Oocyte Quality
E Cardozo E, ME Pavone ME, Jennifer E. Hirshfeld-Cytron, M.D.
Trends in Endocrinology & Metabolism 2011;22(3):103-9.
In Vitro Oocyte Maturation and Preantral Follicle Culture from the Luteal Phase Baboon Ovary Produce Mature Oocytes.
M Xu, AT Fazleabas, A Shikanov, E Jackson E, SL Barrett, Jennifer E. Hirshfeld-Cytron, M.D., SE Kiesewetter, LD Shea, TK Woodruff
Biology of Reproduction 2011;84(4):689-97.
Implantation of Euploid Blastocysts, Assessed by Array Comparative Genomic Hybridization (aCGH), in Unstimulated Cycles is not Correlated with Maternal Age
Gary Harton, M.D., Mark Surrey, M.D., Jamie Grifo, M.D., Ph.D., Brian Kaplan, M.D., Peter Ahlering, M.D., and Jacques Cohen, Ph.D.
A multicenter comparative study was conducted to assess the relationship between maternal age and implantation after preimplantation genetic diagnosis with array comparative genomic hybridization following blastomere biopsy on day 3, or trophectoderm biopsy on day 5. Data suggests that day 5 biopsy produced better outcomes that day 3 biopsy across all ages. Implantation rates for euploid blastocysts were not significantly different between young and old patients, however, implantation rates from day 3 biopsy declined with advanced maternal age.
Fertility and Sterility 2011: 96(3), Suppl: S55.
Endometrin as Luteal Phase Support in Assisted Reproduction
Eve Feinberg, M.D., Elitsa Nicolaou, B.S., Edward Marut, M.D., Meike Uhler, M.D.
To determine optimal treatment options for luteal phase support, a retrospective analysis of 1075 treatment cycles was conducted. These cycles represented autologous fresh IVF cycles (IVF), autologous frozen embryo transfer cycles (FET), and oocyte donation cycles (OD). This analysis demonstrated that Endometrin monotherapy was sufficient for luteal phase support and provided high pregnancy rates in both autologous IVF and OD cycles. The combination of Endometrin and PIO was superior to Endometrin monotherapy in autologous FET cycles, potentially reflecting the fact that lesser quality embryos are transferred in FET cycles, and more intense progesterone support is required for comparable pregnancy rates.
Fertility Sterility 2011: 96(3), Suppl: S280.
Embryo Cohort Size Does Not Affect Euploidy
Brian Kaplan, M.D., Hal Danzer, M.D., Michael Glassner, M.D., Michael Opsahl, M.D., Jacques Cohen, Ph.D., and Santiago Munne, Ph.D.
A correlation between follicular response and cohort size could indicate that ovarian reserve related to egg/ embryo quality and euploidy. In this analysis, the study results do not support the notion that larger cohorts of embryos or aggressive stimulation regimes produce chromosomally inferior embryos. Furthermore, a smaller cohort of embryos reduces the absolute number of normal embryos available for fresh/frozen-thawed transfers while reducing the cumulative chances of pregnancy. Increasing the cohort size, when possible, combined with comprehensive chromosome assessment and embryo selection followed by high yield freezing or vitrification procedures may optimize single embryo transfer and increase cumulative pregnancy rates.
Fertility Sterility 2011: 96(3), Suppl: S83-84.
Significant Decrease in Miscarriage Rates after Preimplantation Genetic Diagnosis (PGD) for Recurrent Pregnancy Loss Using Array Comparative Genome Hybridization (Array CGH)
Jamie Grifo, M.D. Ph.D., Shahin Ghadir, M.D., Brian Kaplan, M.D., Carl Laskin, M.D., Michael Glassner, M.D., and Santiago Munne, Ph.D.
In evaluating the frequency of euploidy in both cleaved embryos and blastocysts across maternal age groups (according to cohort size), 177 cycles (1517 embryos) of couples diagnosed with idiopathic RPL (defined as 3 or more miscarriages) were evaluated utilizing aCGH technology. The results indicated a significant decrease in the miscarriage rates of this population. Previous PGD results using FISH demonstrated a significant reduction in miscarriage rated from 26% to 10% in patients younger than 35, and from 39% to 13% in older patients. For the aCHG cycles, miscarriages were reduced from an expected rate of 35% to 6% (p<0.001). This data suggests that aCGH further improves the results previously obtained by FISH. Furthermore, this evaluation confirms that idiopathic recurrent miscarriage is mostly caused by embryonic chromosome abnormalities.
Fertility Sterility 2011: 96(3), Suppl: S23.
Implantation and Miscarriage Rates Following Array CGH Analysis at the Cleavage and Blastocyst Stages
Gary Harton, M.D., Mark Surrey, M.D., Jamie Grifo, M.D., Ph.D., Brian Kaplan, M.D., and Santiago Munne, Ph.D.
A multi-center, retrospective, comparative study was conducted to assess the effects of maternal age on implantation after PGD with comparative genomic hybridization (CGH). Comparison between day-3 (cleavage) and day-5 (blastocysts) biopsy was performed. There were fewer abnormal embryos when biopsied at the blastocysts stage compared with embryos biopsied at the cleavage stage, suggesting selection against aneuploidy during extended culture. However, blastocysts aneuploidy rates remained high and increased with advancing maternal age.
Fertility and Sterility 2011: 95(4), Suppl: S7.
2010
First Clinical Results with Preimplantation Genetic Diagnosis using Array Comparative Genome Hybridization
Santiago Munne, Ph.D., Colleen Coughlin Wagner, M.S., Pere Colls, Ph.D., Klaus Wiemer, Ph.D., Jill Fischer, M.S., David Hill, Ph.D., Brian Kaplan, M.D., Hal Danzer, M.D., Mark Surrey, M.D., and Michael S. Opsahl, M.D.
The first pregnancies in the US are reported with array CGH of cleavage stage embryos. The amplification method proved to be very efficient in amplifying single cells. The implantation and pregnancy rates were superior to FISH results but inferior to those reported by day 5 biopsy CGH results, indicating that day 5 may be a better stage to biopsy embryos.
Fertility and Sterility 2010: 93(5), Suppl 1: S7.
2009
Comparison of Luteal Phase Support with Endometrin vs. Progesterone in Oil in Donor Oocyte Cycles
Erica Herndon, M.D., L. Sue Jasulaitis, R.N., M.S., Kevin J. Lederer, M.D., Michael Byers, Ph.D. and Meike L. Uhler, M.D.
In donor oocyte cycles, luteal phase support with Endometrin appears to have similar clinical pregnancy outcomes when compared to progesterone in oil. Endometrin provides a valuable alternate progesterone vaginal preparation thus avoiding intramuscular injections for the patient.
Fertility and Sterility 2009: 92(3), Suppl: S76-77.
Comparison of Clinical Pregnancy Rates in Programmed Frozen Embryo Transfer Cycles between Endometrin and Progesterone in Oil
Eve C. Feinberg, M.D., Megan Graber, M.D., Sue Jasulaitis, R.N., M.S., Laurence A. Jacobs, M.D., Michael Byers, Ph.D.
As the ovary is unstimulated during programmed FET cycles, the choice of luteal support may be more critical than in fresh cycles. In this retrospective analysis, when confounding factors such as age and number of embryos transferred were controlled, progesterone in oil had a positive impact on clinical pregnancy rates.
Fertility and Sterility 2009: 92(3), Suppl: S157-158.
2008
Is There a Benefit to Biopsy 4-Cell Embryos on Day 3?
Juergen Lieberman, Ph.D., HCLD, Jill Mathews, B.S., T.S., Andrew Barker, Sara Sanchez, B.S., T.S., Amanda Erman, and Elissa Pelts, B.S., T.S.
Although biopsy results in the 4-cell embryo group demonstrated a surprisingly high percentage of chromosomal normality, the biopsied embryos displayed poor rates of blastocyst development, clinical pregnancies or live births. Based on these outcomes, we do not recommend PGD embryo biopsy on 4 cell, cleavage stage embryos.
Fertility and Sterility 2008: 90, Suppl 1: S297.
Vitrification: What is the Outcome using an FDA Cleared “Closed” Carrier System?
Juergen Lieberman, Ph.D., HCLD, Jill Mathews, B.S., T.S., Amanda Erman, Sara Sanchez, B.S., T.S., Yuri Wagner, B.S., and Elissa Pelts, B.S., T.S.
Based on the results of 162 FET embryos, the closed carrier system for embryo vitrification demonstrated acceptable rates for blastocyst thawing, implantation, and pregnancy. In addition, the closed carrier system provides the additional benefit of eliminating the potential risk of contamination of human embryos.
Fertility and Sterility 2008: 90, Suppl 1: S276.
Oocyte Maturity: Does it Predict IVF Outcome? A Review of a Large IVF Program
Juergen Lieberman, Ph.D., HCLD, Elissa Pelts, B.S., T.S., Jill Mathews, B.S., T.S., Meike Uhler, M.D., and Diego Ezcurra, Ph.D.
Based on data derived from 1538 retrievals, when the total number of oocytes retrieved increased, the number of mature oocytes decreased. However, there was an increase in blastocyst development as well as clinical pregnancy rates. Therefore, maturity does not appear to be a reliable predictor of IVF outcomes.
Fertility and Sterility 2008: 90, Suppl 1: S228.
Four Years of Vitrifying Blastocysts: What is the Verdict?
Juergen Lieberman, Ph.D., HCLD, Jill Mathews, B.S., T.S., Yuri Wagner, B.S., Rebecca Brohammer, B.S., T.S., Andrew Barker, Sara Sanchez, B.S., T.S., Amanda Erman, and Elissa Pelts, B.S., T.S.
Vitrification of blastocysts provides significant clinical improvement in FET outcomes. Although clinical pregnancy rates per transfer and implantation rates were higher in the day 5 compared to the day 6 blastocyst group, there was no significant difference in pregnancy outcomes between the two groups.
Fertility and Sterility 2008: 90, Suppl 1: S297.
Transfer of Compacting Embryos or Early Blastocysts on Day 5: What We Can Expect in Terms of Outcome?
Juergen Lieberman, Ph.D., HCLD, Jill Mathews, B.S., T.S., Andrew Barker, Rebecca Brohammer, B.S., T.S., Yuri Wagner, B.S., and Elissa Pelts, B.S., T.S.,
When comparing underdeveloped, suboptimal day 5 embryos (either compacting or early blastocysts), early blastocyst embryos have a 50% higher potential for implantation, as well as a 50% higher pregnancy rate. If only compacting embryos are available, it is recommended that the embryo transfer be moved to day 6 to improve the selection of available embryos.
Fertility and Sterility 2008: 90, Suppl 1: S369.
1-Year Experience with Elective Single Embryo Transfers (eSET): Is it Worth it?
Juergen Liebermann, Ph.D., HCLD, Jill Matthews, B.S., T.S., Amanda Erman, Rebecca Brohammer, B.S.,T.S., Andrew Barker, and Elissa Pelts, B.S., T.S.
For patients with good pregnancy prognosis (age < 35, no prior IVF failure, availability of one or more high-quality blastocysts, and additional embryos suitable for Cryopreservation), elective single embryo transfer (eSET) was recommended. High blastocyst formation rates (49.6%) and pregnancy rates (68.8%) were achieved in the eSET patients.
Fertility and Sterility 2008: 90, Suppl 1: S369.
Preimplantation Genetic (PGS) Screening on 2291 Embryos from a Large IVF Center.
Juergen Liebermann, Ph.D., HCLD, Elissa Pelts, B.S., T.S., R. Pen, Meike Uhler, M.D., and William Kearns, Ph.D.
A total of 373 PGS cycles were retrospectively analyzed. Couples with 3-4 embryos available for biopsy had a lower chance of embryo transfer (55%) due to Aneuploidy, compared to those with 5 or more available embryos (80%). Approximately 70% of all tested embryos were abnormal for aneuploidy screening regardless of age. Although there was a significant increase in aneuploidy in patients with a maternal age >40, a high pregnancy rate was seen in this population, suggesting that PGS may improve clinical outcomes in this population.
Fertility and Sterility, 2008: 90, Suppl 1: S303-304.
Preimplantation Genetic Screening (PGS) in Donor Egg Cycles: Evidence for a Beneficial Effect?
Colleen Wagner-Coughlin, M.S., Brian Kaplan, M.D., Al Maravilla, B.S., and Edward Marut, M.D.
When retrospectively comparing PGS and non-PGS donor groups, maturation, fertilization rate, implantation rate, loss rate, and pregnancy rate statically were the same. Early pregnancy loss was notably reduced in the PGS group (13.2% vs. 6.6%), but this difference was not statistically significant. PGS is not detrimental to pregnancy rates in donor egg recipients and may reduce the rate of early pregnancy loss.
Fertility and Sterility 2008: 90, Suppl 1: S308.
High Viability of Biopsied Embryos using a New Method of Vitrification.
Colleen Wagner-Coughlin, M.S., J. Stachecki, Ph.D., A. Maravilla, B.S., Brian Kaplan, M.D., Edward Marut, M.D. and Jacques Cohen, Ph.D.
In this retrospective study, 28 cyro-transfers of embryos vitrified during preimplantation genetic screening cycles using the S3 vitrification method were examined. The results indicate good embryo viability, with embryo thaw rates at 94%, and clinical pregnancy rates of 57%. These findings clearly demonstrate good embryo viability after utilizing S3-vitrification.
Fertility and Sterility 2008: 90, Suppl 1: S308.
Using Gonadotropins with hCG Activity Improves Controlled Response in PCOS Patients Undergoing IVF Compared to Cycles Using FSH Alone.
Christopher Sipe, M.D., Marcia Hilse, R.N., M.S.N., Meike Uhler, M.D., Meredith Martin-Johnson, M.D., Kelli L. Sasada, M.D.
In this retrospective study, 64 PCOS patients were stimulated with hMG and FSH, compared with 46 PCOS patients stimulated with FSH only. This study demonstrates that although Stimulation with hMG produced cycles with a higher total gonadotropins use, patients had shorter cycles and demonstrated a much lower cancellation rate (3.6% hMG vs. 20% with FSH alone) due to hyper-response.
Fertility and Sterility 2008: 90, Suppl 1: S132-133.
Luteal Phase Support with Endometrin vs. Progesterone in Oil in IVF Cycles.
A. Robinson, Meredith Martin-Johnston, D.O., Kevin Lederer, M.D., Kelli L. Sasada, M.D., and Michael Byers, Ph.D.
A new vaginal progesterone insert was compared with the standard progesterone in oil (PIO) for IVF luteal phase support. No differences were seen in pregnancy rates, indicating the vaginal insert may be as effective as PIO. In addition, vaginal progesterone seems to provide adequate support of the early pregnancy as compared to the classic PIO. The vaginal insert seems to be a valuable alternative to PIO due to its ease of use and patient-friendly approach.
Fertility and Sterility 2008: 90, Suppl 1, S459.
IVF Cycles with 3 or Less Mature Oocytes: What Should the Patient Expect in Terms of Outcome?
Juergen Liebermann, Ph.D., HCLD, Jill Mathews, B.S., T.S., Amanda Erman, Sara Sanchez, B.S., T.S., Andrew Baker, and Elissa Pelts, B.S., T.S.,
Our retrospective analysis indicates that cycles with 3 or less mature oocytes provide good embryonic development, but also display the following suboptimal characteristics: (1) low chance of developing to blastocyst stage (2) a higher chance of embryo transfer cancellation (3) a low chance of having embryos available for cryopreservation, and (4) an outcome that is unsatisfactory considering the average age of these patients. Overall, patients with a low number of eggs at the time of Egg Retrieval have a much lower chance to achieve pregnancy than normally responding patients in matched age groups.
Fertility and Sterility 2008: 90, Suppl 1, S395-396.
GnRH Antagonist vs. Microdose Flare Agonist Treatment in Older Patients Undergoing ART.
Meike Uhler, M.D., and Diego Ezcurra, Ph.D.
Controlled ovarian hyperstimulation protocols for IVF in older patients taking GnRH antagonists in combination with recombinant FSH and/or LH utilized significantly less total gonadotropins over fewer days of treatment and produced less fertilized oocytes than microdose flare agonist protocol. When transferring a similar number of embryos, pregnancy rates are similar between these two protocols for stimulation.
Fertility and Sterility 2008: 90, Suppl 1, S237.
2007
Does Leutinizing Hormone Activity in the Form of Low-Dose hCG or HMG Produce Better Outcomes for GnRH Antagonist ART Cycles Stimulated with rFSH?
Frattarelli, J.L., Miller, B.T., Brian R. Kaplan, M.D., Widra, E., and Scott, R.T.
Fertility and Sterility 2007; 88.
Reduced Spontaneous Abortion and Increased Live Birth Rate After PGD for Advanced Maternal Age
Santiago Munne, Ph.D., J. Garrisi, Ph.D., F. Barnes, Ph.D., L. Werlin, M.D., William Schoolcraft. M.D., and Brian Kaplan, M.D.
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 indicate 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., Meike L. Uhler, M.D. and H. Edward Grotjan, Ph.D.
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., Kelli L. Sasada, M.D., Meredith K. Martin-Johnston, D.O., Meike L. Uhler, M.D. and Juergen Liebermann, Ph.D.
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?
John Fratarrelli, M.D., B.T. Miller, M.D., Brian Kaplan, M.D., Eric Widra, M.D., Richard T. Scott, M.D.
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.
2006
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.
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 IVF
Meredith K. Martin-Johnston, D.O., Jane M. Nani, M.D., H. Edward Grotjan, Ph.D., Aaron S. Lifchez, M.D., and Meike L. Uhler, M.D.
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., HCLD, Elissa Pelts, B.S., T.S., Jill Matthews, B.S., T.S., Amanda Erman, Sara Sanchez, B.S., T.S., and Andrew Barker
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 are available, embryos derived from in vitro matured 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., HCLD, Kevin Richter, Ph.D., Jill Matthews, Eric Widra, M.D., and William Kearns, Ph.D.
The 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 Ciopsied Embryos on Day 3.
Juergen Liebermann, Ph.D., HCLD, Elissa Knopoff, B.S., T.S., Jill Matthews, B.S., T.S., Michael Tucker, Ph.D., K. Richter, Ph.D., and William Kearns, Ph.D.
The data presented in this study confirm that significant differences in the percentage of aneuploid chromosomes between different age groups exist. Based on the 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.
2005
Severe Teratospermia Does Not Affect Fertilization or Pregnancies in IVF Patients Undergoing Intracytoplasmic Sperm Injection
Meike L. Uhler, M.D., Ramaa P. Rao, M.D., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.
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 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., Meike L. Uhler, M.D., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.
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., H. Edward Grotjan, Ph.D., and Aaron S. Lifchez, M.D.
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, Ph.D., HCLD, Elissa Knopoff, B.S., T.S., Jill Matthews, B.S., T.S., Amanda Erman, Sara Sanchez, B.S., T.S., and Michael Tucker, Ph.D.
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, Ph.D., HCLD, Elissa Knopoff, B.S., T.S., Jill Matthews, B.S., T.S., Amanda Erman, Sara Sanchez, B.S., T.S., Andrew Barker, and Michael Tucker, Ph.D.
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, Ph.D., HCLD, Elissa Knopoff, B.S., T.S., Jill Matthews, B.S., T.S., Yuri Wagner, B.S., Rebecca Brohammer, B.S., T.S., and Michael Tucker, Ph.D.
Our data confirm 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, Ph.D., HCLD, Elissa Knopoff, B.S., T.S., Jill Matthews, B.S., T.S., Amanda Erman, and Michael Tucker, Ph.D.
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.
2003
Embryologic and Clinical Outcomes of Donor Oocyte IVF Cycles using Ovidrel (rhCG) versus profasi (uhCG) for Follicular Triggering after a Standard Downregulation Protocol
Edward L. Marut, M.D., Brian R. Kaplan, M.D., and Colleen Wagner-Coughlin
Fertility and Sterility 2003; 80.
Published Peer-Reviewed Journal Articles
2015
Diminished Ovarian Reserve is Not Observed in Infertility Patients with High Normal CGG Repeats on the Fragile X Mental Retardation I (FMRI) Gene
Ann Schufreider, M.D., Dana B. McQueen, M.D., Sang Mee Lee, Ph.D., Rachel Allon, M.D., Meike L. Uhler, M.D., Jocelyn Davie, M.S., CGC, and Eve C. Feinberg, M.D.
This large data set demonstrated that a high normal number of CGG repeats (35-54 repeats) on FMR I gene was not significantly correlated with diminished ovarian reserve.
Human Reproduction Vol. 30, No. 1, pp 2686-2692, September 2015. ©2015 by The Author. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology.
Racial Disparities in In Vitro Fertilization Outcomes
Dana B. McQueen, M.D., M.A.S., Ann Schufreider, M.D., Sang Mee Lee, Ph.D., Eve C. Feinberg, M.D., and Meike L. Uhler, M.D.
Black and Asian women had lower odds of clinical intrauterine pregnancy and live birth and higher rates of spontaneous abortion compared with white women. Further research is needed to better characterize the mechanisms associated with this racial disparity and to improve treatment options for black and Asian women.
Fertility and Sterility® Vol. 104, No. 2, pp 398-402, August 2015. ©2015 by American Society for Reproductive Medicine. Published by Elsevier, Inc.
2013
Diminished Effect of Maternal Age on Implantation After Preimplantation Genetic Diagnosis with Array Comparative Genomic Hybridization.
Gary L. Harton, B.S., Santiago Munné, Ph.D., Mark Surrey, M.D., Jamie Grifo, M.D., Ph.D., Brian Kaplan, M.D., David H. McCulloh, Ph.D., H.C.L.D., Darren K. Griffin, Ph.D., Dagan Wells, Ph.D., PGD Practitioners Group
Aneuploidy rates increase significantly with advanced maternal age as confirmed by both day 3 and day 5 embryo biopsy and aCGH testing. Implantation rates for euploid embryos did not decrease after PGD for women ages 42. Selective transfer of euploid embryos showed that implantation and pregnancy rates for euploid embryos were not significantly differenced between reproductively younger and older patients up to age 42 years.
Fertility and Sterility, Volume 100, Issue 6, Pages 1695-1703, December 2013
http://www.sciencedirect.com/science/article/pii/S0015028213028112
http://www.fertstert.org/article/S0015-0282(13)02811-2/fulltext
Toward Theoretical Understanding of the Fertility Preservation Decision-Making Process: Examining Information Processing Among Young Women with Cancer.
Hershberger, P.E., Finnegan, L., Altfeld, S., Lake, S., & Hirshfeld-Cytron, J.
Young women with cancer now face the complex decision about whether to undergo fertility preservation, yet little is known about how these women process information involved in making this decision. A better understanding of theoretical underpinnings surrounding women’s information processes can facilitate decision support and improve clinical care.
Research and Theory for Nursing Practice, 27(4), 257-275. DOI: 10.1891/1541-6577.27.4.257. PMCID
http://www.ncbi.nlm.nih.gov/pubmed/24552086?tool=MedlinePlus
2012
Idiopathic Recurrent Miscarriage is Caused Mostly by Aneuploid Embryos
Brian Kaplan, M.D., Brook Hodes-Wertz, M.D., Jamie Grifo, M.D., Shahin Ghadir, M.D., Carl Laskin, M.D., Michael Glassner, M.D., and Santiago Munne, Ph.D.
Miscarriage rates of idiopathic RPL patients following PGS were found to be 6.9%, compared to the expected rate of 33.5% in the RPL control group and 23.7% in an infertile control population. Current PGS results utilizing aCGH indicate a significant decrease in the miscarriage rate of idiopathic RPL patients and high pregnancy rates, suggesting that idiopathic recurrent miscarriage is mostly caused by chromosomal abnormalities in embryos.
Fertility and Sterility 2012: 98(4): 675-680
2011
Vitrification of Oocytes and Embryos
Juergen Liebermann, PhD., HCLD, CC, (ABB) Director of Laboratories, Fertility Centers of Illinois, Chicago, IL USA
Juergen Liebermann, PhD., CC, HCLD (ABB) has authored many papers in the area of reproductive science. Dr. Liebermann has contributed his research in Vitrification. In addition to his own published book on Vitrification in 2007, he has recently contributed an updated overview of Oocyte and Embryo vitrification to a new textbook, “Current Frontiers in Cryopreservation” which discusses new cryobiological ideas and introduces the recently emerged protocols for cryopreservation. This chapter reviews data accrued at Fertility Centers of Illinois. Read
Current Frontiers in Cryobiology, ISBN: 978-953-51-0191-8
2009
Vitrification of Human Blastocysts: An Update
Juergen Liebermann, Ph.D., HCLD.
Vitrification of human blastocysts is a viable and feasible alternative to traditional slow-freezing methods. Transfer of blastocyst-stage embryos has been shown to increase pregnancy rates while allowing for improved selection of potentially viable embryos. At this late stage of development, lower numbers of embryos can be transferred, resulting in less high order multiple pregnancies and increased implantation rates.
Reproductive Biomedicine Online 2009: 19 Suppl 4: 4328.
Lower Chance of Pregnancy with Repeated Cycles with IVF
Meredith K. Martin-Johnston, D.O., Meike L. Uhler, M.D., H. Edward Grotjan, Ph.D., Aaron S. Lifchez, M.D., Jane M. Nani, M.D.
The likelihood of a successful outcome declined with each additional treatment cycle The most notable decrease in clinical pregnancy rates occurred after the third cycle. Patients who fail to conceive after three cycles of IVF should be counseled to consider other options such as third-party reproduction, particularly when age is a consideration.
Journal of Reproductive Medicine 2009: 54: 67-72.
2008
Body Mass Index: 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.
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.
Human Reproduction 2008: 23:1835-1839.
Long-Term Economic Benefits Attributed to IVF-Conceived Children: A Lifetime Tax Calculation.
Mark Connolly, MHE, Michael Pollard, Ph.D., Stijn Hoorens, MSc., Brian Kaplan, M.D., Selwyn Oskowitz, M.D., and Sherman J. Silber, M.D.
The aim of this research was to compare the public cost of providing fertility treatment vs. the future lifetime tax revenue derived from the ART conceived child. An accounting model was applied to determine if this future revenue potential would justify public subsidy of fertility treatment costs. It was determined that the future taxes paid by an ART conceived child outweigh the cost of providing treatment by 700%, thus justifying the elimination of the legislative barriers that currently exist to providing fertility treatment.
American Journal of Managed Care 2008: 14: 598-604.
2007
Adding Human Menopausal Gonadotropin to Antagonist Protocols-Is There a Benefit?
Meredith K. Martin-Johnston, D.O., H. Edward Grotjan, Ph.D., and Meike L. Uhler, M.D.
Regardless of age, adding HMG to recombinant FSH was not beneficial in patients using a GnRH antagonist protocol in a large group practice using a single IVF laboratory.
Reproductive Biomedicine Online 2007: 15: 161-168.
2006
Comparison of Vitrification and Conventional Cryopreservation of Day-5 and Day-6 Blastocysts during Clinical Application.
Juergen Liebermann, Ph.D., HCLD and Michael J. Tucker, Ph.D.
Vitrification technique yields the same implantation and pregnancy rate as slow-frozen blastocyst transfers. Slow growing embryos can be cryopreserved on day 6 because they yield a satisfactory survival, implantation, and pregnancy rate.
Fertility and Sterility 2006: 86: 20-26.
Age-Matched Comparison of Recombinant and Urinary hCG for Final Follicular Maturation.
Meike L. Uhler, M.D., H. Edward Grotjan, Ph.D., Kevin J. Lederer, M.D., and Aaron S. Lifchez, M.D.
Pregnancy (46 versus 45.2%) and clinical pregnancy rates (38.1 versus 36.8%) were similar for recombinant and urinary hCG. Recombinant hCG was as effective as urinary hCG for final follicular maturation in IVF cycles.
Reproductive Biomedicine Online 2006: 13: 315-320.
2005
Vitrification: A Successful Techniques for Cryopreserving Human Cells in ART.
Juergen Liebermann, Ph.D., HCLD and Michael J. Tucker, Ph.D.
The benefits and potential problems associated with vitrification as a method of choice for embryo cryopreservation in clinical embryology are discussed. Based on the available data, it is clear that vitrification procedures have become increasingly successful and maybe a better method than slow cooling for embryo freezing.
Alpha Scientists in Reproductive Medicine: 2005: 32: 4-9.