Physician-scientists from Shady Grove Fertility presented new information that helps to improve treatment outcomes for the one in eight couples who face infertility at this year’s premier education and research meeting for reproductive medicine. Held from October 12 to 16, 2019, in Philadelphia, PA, the theme of this year’s Scientific Congress of the American Society for Reproductive Medicine was “Celebrating 75 Years of History and Innovation.” The program featured scientific, postgraduate, and video presentations as well as plenary lectures addressing the most pressing clinical and basic-science issues in reproductive medicine. The meeting drew nearly 10,000 attendees from 94 countries to share their clinical research and study findings from the past year.
For the past 28 years, the physicians at SGF have placed a high value on conducting clinical research and remain a leader in the field. It is one of only a few private practice fertility centers in the country to employ a full-time dedicated research team who perform under the direction of Director of Research, Kate Devine, M.D., board certified reproductive endocrinologist who sees patients in SGF’s Washington, D.C., K Street location.
“This conference offers physicians in our field from around the world a unique opportunity to collaborate and learn from each other,” explained Dr. Devine. “With a common goal of improving treatment outcomes for patients across the globe, SGF is able to share its findings so that others can benefit. Learning from each another’s research stirs innovation and helps us sow seeds that turn into new ideas for next year’s research endeavors,” Devine added.
Among the findings SGF presented this year, two of the most notable included a new study that evaluated the optimal oral medication type (letrozole compared to clomiphene citrate, or clomid) and dose in controlled ovarian hyperstimulation/intrauterine insemination (COH / IUI) cycles to increase clinical pregnancy rates (CPR) while lowering risk of multiple gestation, i.e., twins or triplets.
The data suggested that in ovulatory women, a starting dose of 50mg of clomid provides a greater chance of a singleton gestation than a higher starting dose. Simply put, more medication doesn’t always mean better success rates, and a higher dose increases a woman’s risk of multiples.
The data also showed, in the overall population, clinical pregnancy rates were comparable between patients who received letrozole and women given clomid. However, in women who are anovulatory (do not ovulate) specifically, there was a lower chance of a multiple pregnancy when given letrozole compared to clomid. In women who are ovulatory, neither medication showed a higher risk of multiples or a higher clinical pregnancy rate than the other.
“To maximize clinical pregnancy rates while minimizing the chance of multiples in oral ovulation induction/intrauterine insemination cycles, medication and dose should be chosen carefully. Our research sheds an important light on this popular treatment approach, making it safer for women by lowering their chances of high-risk, multiple gestation pregnancies while optimizing pregnancy rates,” said Devine.
This retrospective study evaluated 8,911 patients who underwent 15,453 oral ovulation induction-IUI (OI-IUI) cycles from 2004-2018 at SGF.
In the second, highly notable study, SGF’s physician scientists showed women with endometriosis achieve equal success rates when using euploid blastocysts during frozen embryo transfers compared to couples with other diagnoses—a significant finding as this challenges decades of fertility myth that suggested women with endometriosis don’t have the same success using fertility treatments.
Conducted in partnership with the National Institutes of Health’s (NIH) National Institute of Child Health and Human Development (NICHD), SGF’s research gives hope to the nearly 10% of women who have endometriosis.
“We wanted to understand whether endometriosis, which may decrease a couple’s chances of conceiving naturally, also decreases their chances of having a baby from IVF, as many believe. Furthermore, we wanted to understand ‘why’. Was it that these women didn’t have the same rate of genetically normal embryos? Or that they have impaired endometrial receptivity preventing them from achieving or keeping a pregnancy?” explained Dr. Devine.
This retrospective study looked at 472 frozen embryo transfers in SGF patients using chromosomally normal blastocysts (as shown by preimplantation genetic testing for aneuploidy [PGT-A]). Three subsets of patients were included: women with surgically proven endometriosis, patients with isolated male factor infertility, and non-infertile patients electing genetic testing for a single gene disorder. The male factor infertility and single gene groups of patients were selected for comparison, as they typically yield strong pregnancy and delivery rates using IVF and because neither egg nor uterine infertility factors were likely to be present.
The results from the study showed that women with endometriosis had statistically similar rates of pregnancy and live birth compared to the other groups. Further, when patients with endometriosis were compared to each control group, there was no difference in the number and frequency of chromosomally normal blastocysts with PGT-A.
“We are excited to see that even though women with endometriosis may have impaired fertility, their diagnosis is not limiting them in their success with IVF treatment,” explained Devine.
“Patients can be reassured that their chances of a live birth are good when a euploid blastocyst is available. I’m encouraged for women and what this means for how we treat endometriosis. Along with advancements that we continue to make across the board, this study should encourage women with endometriosis that it’s very possible to build their family with the right treatment and timely care,” added Devine.
To learn more about ongoing research being conducted at SGF, visit http://www.shadygrovefertility.com/research
To learn more about these studies, or to schedule an appointment with one of our physicians, please call our New Patient Center at 888-971-7755 or complete this brief online form.