Comparison of Luteal Phase support with Endometrin vs. Progesterone in oil in donor Oocyte cycles
Angeline N. Beltsos, MD, Erica Herndon, MD, L. Sue Jasulaitis, RN, MS, Kevin J. Lederer, M.D., Michael Byers, Ph.D. and Meike L. Uhler, MD.
Summary: 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, MD, L. Sue Jasulaitis, RN, MS, Laurence A. Jacobs, M.D., Michael Byers, Ph.D. and Angeline N. Beltsos, MD.
Summary: 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.
Is there a benefit to biopsy 4-cell embryos on day 3?
Juergen Lieberman, Ph.D., Jill Mathews, Andrew Barker, Sara Sanchez, Amanda Erman, and Elissa Pelts
Summary: 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 a FDA cleared “closed” carrier system?
Juergen Lieberman, Ph.D., Jill Mathews, Amanda Erman, Sara Sanchez, Yuri Wagner, and Elissa Pelts
Summary: 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., Angeline Beltsos, M.D., Elissa Pelts, Jill Mathews, Meike Uhler, M.D., Diego Ezcurra, Ph.D.
Summary: 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.
4-years of vitrifying blastocysts: What is the verdict?
Juergen Lieberman, Ph.D., Jill Mathews, Yuri Wagner, Rebecca Brohammer, Andrew Barker, Sara Sanchez, Amanda Erman, and Elissa Pelts
Summary: 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., Jill Mathews, Andrew Barker, Rebecca Brohammer, Yuri Wagner, and Elissa Pelts
Summary: 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., Jill Matthews, Amanda Erman, Rebecca Brohammer, Andrew Barker, and Elissa Pelts
Summary: 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., Elissa Pelts, R. Pen, Angeline Beltsos, M.D., Meike Uhler, M.D., and William Kearns, Ph.D.
Summary: 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, Brian Kaplan, M.D., Al Maravilla, and Edward Marut, M.D.
Summary: 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, J. Stachecki, A. Maravilla, Brian Kaplan, M.D., Edward Marut, M.D. and Jacques Cohen, Ph.D.
Summary: 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 were 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, MD, Marcia Hilse, RN MSN, Meike Uhler, MD, Meredith Martin-Johnson, MD, Kelli Sasada, MD, Angeline N Beltsos, MD
Summary: 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.
Angeline Beltsos, M.D., A. Robinson, Meredith Martin-Johnston, D.O., Kevin Lederer, M.D., K. Sasada, and Michael Byers, Ph.D.
Summary: 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., Jill Mathews, Amanda Erman, Sara Sanchez, Andrew Baker, and Elissa Pelts
Summary: Our retrospective analysis indicates that cycles with 3 or less mature oocytes provides 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.
Angeline Beltsos, M.D., Meike Uhler, M.D., and Diego Ezcurra, Ph.D.
Summary: Controlled ovarian hyperstimulation protocols for IVF in older patients taking GnRH antagonist 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 similar number of embryos, pregnancy rates are similar between these two protocols for stimulation.
Fertility and Sterility 2008: 90, Suppl 1, S237.
Serum progesterone levels with Endometrin compared to progesterone in oil and associated pregnancy outcomes in a large IVF center.
Angeline Beltsos, M.D., Meredith Martin-Johnson, D.O., K. Sasada, and Michael Byers, Ph.D.
Summary: In this analysis of pregnant IVF patients, the mean initial serum progesterone levels on Endometrin appear to be similar to those on progesterone in oil. Furthermore, pregnancy rates per transfer and clinical pregnancy rates appear to be the same between the groups. This data suggests that Endometrin may be an acceptable, patient-friendly alternative to progesterone in oil.
Fertility and Sterility 2008: 90, Suppl 1, S366.
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.
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.
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