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Fertility experts present the latest research at reproductive medicine meeting

NEW YORK (Nov. 7, 2008) -- Leading fertility experts at NewYork-Presbyterian Hospital/Columbia University Medical Center are presenting new research findings at the 64th annual American Society of Reproductive Medicine (ASRM) meeting in San Francisco, Nov. 8. Highlights include the following:

  • Dr. Mark V. Sauer is chairing the invited symposia, "Management of the HIV-Discordant Couple Seeking Fertility Care." He will speak on "Clinical Paradigms Gained From 10 Years of Experience."
  • Dr. Rogerio A. Lobo is chairing a plenary session on infertility in polycystic ovary syndrome (PCOS). He will speak on "Management of Infertility in PCOS."
  • Successful Fertility Treatment for HIV Women. "A Systematic, Multidisciplinary Approach to Address the Reproductive Needs of HIV-Seropositive Women" by Drs. Nataki C. Douglas, Bo Yu, Jeffrey Wang, Sreedhar Gaddipati, Michael Guarnaccia and Mark V. Sauer.
    Nearly 130,000 American women are HIV-positive. Most are of reproductive age and many desire children. The researchers sought to establish a comprehensive program to address their fertility needs in order to minimize infectious, medical and reproductive risks to prospective patients. They found that by using a multidisciplinary approach to care, HIV-seropositive women may be successfully managed in a program of assisted reproduction. Of 17 HIV-positive women undergoing IVF, there were seven pregnancies, and five singletons and two sets of twins were delivered by Caesarean section. Throughout the pregnancies, maternal HIV-1 RNA levels remained undetectable and CD4 counts were stable. All infants, tested at birth and at 3 and 6 months of age, remained HIV-negative.
  • SC Ovidrel Can Be Reliably Used for Egg-Cell Donation. "Lower Serum hCG Levels After Ovidrel Administration Do Not Reflect Compromised Oocyte Maturation in Donor Oocyte IVF Cycles," by Drs. Nataki C. Douglas, Bo Yu, Jeffrey Wang, Gary Nakhuda, Mark V. Sauer and Melvin Thornton II.
    Human chorionic gonadotropin (hCG) is used to promote final oocyte (egg cell) maturation for IVF. For ease of administration and improved patient tolerance, use of subcutaneous (SC) Ovidrel instead of intramuscular (IM) u-hCG has been used in women undergoing egg retrieval for oocyte donation. However, a decrease in serum hCG levels, a measure of patient compliance with the drug therapy, was noted after Ovidrel self-administration. The researchers conducted a retrospective cohort study to determine if the lower hCG levels associated with Ovidrel were associated with any measurable detrimental effects on the oocytes or resulting embryos. They found that Ovidrel injection resulted in significantly lower serum hCG levels compared to u-hCG and these levels did not correlate with BMI. And, despite lower serum hCG levels, all clinical outcome parameters were statistically identical. Thus, SC Ovidrel can be reliably used for oocyte donation.
  • Good News for Female Cancer Patients Seeking to Save Their Eggs. "Favorable Clinical Outcomes Attained in Young Cancer Patients Undergoing Oncofertility Treatments" by Drs. Bo Yu, Nataki C. Douglas, Janet Choi and Mark V. Sauer.
    Cancer is commonly diagnosed in women of reproductive age who may desire to freeze (cryopreserve) their eggs or embryos prior to undergoing chemotherapy, radiation or extirpative surgery. The researchers compared the clinical outcomes of cancer patients undergoing egg retrieval with age-matched controls, in order to ascertain if their underlying illness affected their reproductive performance. They found that cancer patients experienced a reasonable response to ovulation induction and as a result, had similar mature oocytes harvested as age-matched controls. The fertilization rate was comparable to controls and all patients successfully achieved embryos or oocytes for cryopreservation despite their illness and the requisite expedited approach to care. Therefore, female patients with cancer should be encouraged to have MIS (Mllerian Inhibiting Substance) assessment, and when their reproductive profile is favorable, be considered for embryo or oocyte cryopreservation in order to maximize opportunity for future fertility before undergoing gonadotoxic treatments.
  • Pregnancy Possible in Breast Cancer Patients After Chemotherapy. "Dissociation of Mllerian Inhibiting Substance (MIS) and Estradiol (E2) Levels After Chemotherapy in Young Women With Breast Cancer" by Drs. Bo Yu, Dawn L. Hershman, Michel J. Ferin, Nataki Douglas, Gary S. Nakhuda and Rogerio A. Lobo.
    The goal of the study was to evaluate the effect of chemotherapy on ovarian function in young women with breast cancer, assessing a marker of ovarian reserve, MIS, as well as E2, Follicle Stimulating Hormone (FSH) and menstrual status. Chemotherapy decreases ovarian reserve rapidly and dramatically as reflected by levels of MIS. After chemotherapy, although E2 levels recover quickly, with 58 percent of women regaining menstrual function by 52 weeks, all MIS levels remain below the normal range of age-matched fertile women. In spite of the concern of reduced fertility six months after chemotherapy, reflected by very low MIS levels, researchers have documented that pregnancy can occur.

Contact: Belinda Mager
New York- Presbyterian Hospital/Columbia University Medical Center

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