Fertility Education: IVF Plano Newsletters Cover Topics that Matter to Fertility Families
IVF Preimplantation Genetic Diagnosis: A New Approach, But Is It Improved?
by James W. Douglas, MD – November 2011 Newsletter
Until recently, preimplantation genetic diagnosis (PGD) was conducted on day three of the IVF cycle when embryos reach eight cells. A single cell could then be removed for analysis and tested for the six to 10 most commonly abnormal chromosomes (aneuploidy) that lead to inheritable genetic diseases. PGD was thought to increase pregnancy rates due to an increased likelihood of transferring a higher percentage of genetically ‘normal’ embryos back to the uterus. Read More>
Live birth outcome with trophectoderm biopsy, blastocyst vitrification, and single-nucleotide polymorphism microarray- based comprehensive chromosome screening in infertile patients.
by W. Schoolcraft, MD, N. Treff, PhD, J. Stevens, BSc, K. Ferry, BSc, M. Katz-Jaffe, PhD, and R. Scott, MD – June 2011 Newsletter
Embryo assessment is a crucial component to the success of in vitro fertilization (IVF). Current selection methods are based on detailed embryo morphology with the highest implantation rates observed with the use of optimal morphologic characteristics 1, 2. Although this information contributes to the prediction of reproductive competence and is relatively successful in improving pregnancy rates and reducing multiple gestations, morphology is not absolute, with >70% of embryos created in vitro failing to implant. This failure is likely due to both the absence of developmentally competent embryos as well as our inability to select the most viable embryo in the cohort. Read More >
Breast cancer and fertility preservation options
by James W. Douglas, MD – June 2011 Newsletter
One out of twenty breast cancers occur in women under the age of 40 and at least half of these women still desire to protect future fertility. Yet less than 10 percent of women have a child after diagnosis and treatment for breast cancer. The cytotoxic chemotherapy utilized to treat the cancer creates the biggest issues, resulting in a low birth rate and decreased fertility. Read More >
Breast cancer and fertility preservation
by S. Samuel Kim, M.D.,a Jennifer Klemp, Ph.D.,b and Carol Fabian, M.D. – June 2011 Newsletter
Most women who develop invasive breast cancer under age 40 will be advised to undergo adjuvant chemotherapy with or without extended antihormonal therapy to reduce the risk of recurrence and death from breast cancer. Adjuvant chemotherapy particularly with alkylating agents such as cyclophosphamide is gonadotoxic and markedly accelerates the rate of age-related ovarian follicle loss. Although loss of fertility is an important issue for young cancer survivors, there is often little discussion about fertility preservation before initiation of adjuvant therapy. Greater familiarity with prognosis and effects of different types of adjuvant therapy on the part of infertility specialists and fertility preservation options. Read More >
Use of Femara to Shrink Fibroids Instead Of Depo-Lupron
by James W. Douglas, MD – March 2011 Newsletter
Femara (letrozole), an aromatase inhibitor, blocks the conversion of testosterone to estrogen. Often, doctors use Femara in women who have had breast cancer that was positive for estrogen receptors. In our infertility practice, we use Femara as an ovulation induction agent that works similarly to Clomid. Read More >
A randomized, controlled clinical trial comparing the effects of aromatase inhibitor (letrozole) and gonadotropin-releasing hormone agonist (triptorelin) on uterine leiomyoma volume and hormonal status
By Mohammad Ebrahim Parsanezhad, M.D.,a Mina Azmoon,a Saeed Alborzi, M.D.,a Abdoreza Rajaeefard,b Afsun Zarei, M.D.,a Talieh Kazerooni, M.D.,a Vivian Frank, M.D.,c and Ernst Hienrich Schmidt, M.D.c – March 2011 Newsletter
Uterine leiomyomas are the most common benign tumors of the uterus (1). These tumors are estrogen (E) dependent, develop during the reproductive period, and are suppressed with menopause (2). Receptors for both E and P have been identified in leiomyomata (3). In addition to ovarian E, some investigators have shown that leiomyoma tissues are a source of E. Leiomyoma cells express an E synthetase as well as aromatase and convert circulating androgens to E (4–9). Estrogen secreted by leiomyomata tissue may reach a sufficient concentration within the local compartment to support its own growth, allowing independence from ovarian E (10). Read More >
Protocol for Birth Control Pills Following Surgery for Endometriomas
by James W. Douglas, MD – November 2010 Newsletter
Advanced stage endometriosis with an endometrioma is very difficult to treat in the long term because of how rapidly these cysts normally reoccur. Extended treatment with Lupron or letrozole can have significant side effects, including bone loss. Birth control pills have been advocated to help slow the growth of endometriosis, but many physicians wonder how they should be given, in a cyclic or continuous dose. The question also arises about whether birth control pill treatment prolongs the endometrioma free interval and reduces the need for surgery. A recent randomized controlled study starts to address these issues. In summary, the study compared three groups of women: no birth controls pills, cyclic birth control pills, and continuous birth control pills. Ultrasounds were used to measure endometrioma recurrence, the size of the recurrent endometriomas, and the growth rate during at least two years of follow up. Read More >
Long-term cyclic and continuous oral contraceptive therapy and endometrioma recurrence: a randomized controlled trial
By Renato Seracchioli, M.D. et al. Fertility & Sterility :Vol. 93, No. 1, January 2010 – November 2010 Newsletter
Ovarian endometrioma is one of the most common endometriotic lesions, affecting approximately 55% of patients with endometriosis (1). There is general agreement that conservative surgery by laparoscopy is the treatment of choice for ovarian endometriotic cysts (2, 3), because medical treatment alone is inadequate (4). However, a frustrating aspect of laparoscopic excision is cyst recurrence after surgery, with a cumulative rate of endometrioma recurrence after 2 to 5 years of follow-up of 12% to 30% (5–7). Therefore, many authors recently have studied adjuvant therapeutic modalities that may reduce the rate of postoperative recurrence. Read More >
What is the First Line Treatment for Polycystic Ovary Syndrome (PCOS), Clomid or metformin?
by James W. Douglas, MD – June 2010 Newsletter
As a reproductive endocrinologist, I see cases of polycystic ovary syndrome (PCOS) on a daily basis. One of the most common female endocrine disorders, conservative estimates suggest that PCOS affects approximately five to ten percent of women who are of childbearing age. My ob-gyn colleagues have often asked whether Clomid or metformin is the preferred therapy for PCOS when patients are trying to conceive. Read More >
Comparison of clomiphene citrate, metformin, or the combination of both for first-line ovulation induction, achievement of pregnancy, and live birth in Asian women with polycystic ovary syndrome: a randomized controlled trial
By Murizah Mohd Zain, M.D., M.Med. (O&G),a,c Ridzuan Jamaluddin, M.D.,b Adibah Ibrahim, M.D., M.Med. (O&G),b and Robert J. Norman, M.D., F.R.A.N.Z.C.O.G., F.R.C.O.G., F.R.C.P.A.c Read More >
