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Marie
 
Posted By Marie
August 20, 2012

CHR begins a study on diminished ovarian reserveAugust 20, 2012 (New York, NY) – Center for Human Reproduction (CHR), a leading fertility research and treatment center in New York City, has announced a new prospectively randomized controlled clinical trial to investigate the effects of testosterone supplementation in women with diminished ovarian reserve (DOR).

The study is designed to determine whether transdermal (applied through the skin) supplementation with testosterone in women with DOR may (i) objectively improve ovarian reserve parameters, (ii) improve egg quality and embryo quality, and (iii) improve IVF pregnancy rates if testosterone levels have remained low after six weeks of dehydroepiandrosterone (DHEA) supplementation.

CHR introduced DHEA supplementation for women with DOR to the infertility field in 2004, and this treatment is now utilized worldwide. More recently, CHR investigators were able to produce evidence that the efficacy of DHEA is very likely mediated by the male hormone testosterone, to which DHEA is mostly converted in the body. The new randomized controlled trial will investigate whether women whose testosterone levels do not rise well after DHEA supplementation may benefit from direct testosterone administration.

“This study took longer than usual to get off the ground after approval by our center’s Institutional Review Board,” noted David H. Barad, MD, one of the principal investigators and Director of the Center’s Clinical Assisted Reproduction Program. “Since testosterone in this country is considered a controlled substance, we had to obtain permits from the State of New York and the Federal Government first.”

Norbert Gleicher, MD, another principal investigator and Medical Director of CHR, adds: “Androgens, like DHEA, are becoming increasingly important tools in treating women of all ages with poor ovarian reserve. We are now on track to determine how this is best done most effectively and individualized to each patient.”

 

About Center for Human Reproduction

The Center for Human Reproduction (CHR, http://www.centerforhumanreprod.com/), located in New York City, is one of the world’s leading fertility centers. Because of its worldwide reputation as “fertility center of last resort,” CHR has a worldwide patient following among women with DOR, whether due to advanced age, or due to premature ovarian aging (POA). Dr. Barad and Dr. Gleicher are available for further comments.

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Marie
 
Posted By Marie
March 19, 2012

March 19, 2012 (New York, NY) – A genotype of the FMR1 (fragile X mental retardation) gene preserves a woman’s ability to produce CHReggs (oocytes) well into the 40s, according to an ovarian aging study just published in the medical journal PLoS One1.

Conducted at the Center for Human Reproduction (CHR), a fertility center in New York City specializing in fertility treatments for older women, the study compared egg yields during in vitro fertilization (IVF) in women above age 40 with varying FMR1 genotypes and sub-genotypes.

In women with very poor ovarian reserve (i.e., women with the poorest ovarian function), the FMR1 sub-genotype het-norm/high (normal CGG repeat count on one allele, abnormally high count on the other) produced significantly more eggs than other genotypes and sub-genotypes. This observation suggests that the het-norm/high FMR1 sub-genotype preserves a woman’s ability to produce a good number of eggs at older ages even if the ovarian reserve is severely reduced.

“From our previous research, we knew that the het-norm/high sub-genotype was responsible for slow recruitment of eggs into maturation process at younger ages than other genotypes and sub-genotypes,” explains Norbert Gleicher, MD, lead author of the study and Medical Director of CHR. “Because these women ‘use up’ fewer eggs from their egg reserve, we suspected that they may have more eggs left when older. This study confirmed this hypothesis, demonstrating that women with this sub-genotype performed better in IVF cycles than even women with normal FMR1 genotype.”

These findings further enhance the understanding of genetic control over the process of ovarian aging, and further refine prognostication in older women undergoing fertility treatments. Given that oocyte yields in IVF cycles usually correlate with pregnancy chances, older women with extremely low ovarian reserve, therefore, appear to have better chances of success if their FMR1 sub-genotype is het-norm/high.

 

1Gleicher N et al. The impact in older women of ovarian FMR1 genotypes and sub-genotypes on ovarian reserve. PLoS One 2012:e33638. [http://dx.plos.org/10.1371/journal.pone.0033638]

 

About Center for Human Reproduction

Center for Human Reproduction, or CHR (http://www.centerforhumanreprod.com), is a leading fertility center in the United States with a worldwide reputation as a “fertility center of last resort,” specializing in treatment of infertility in women with diminished ovarian reserve, including younger women with premature ovarian aging (POA) and older women with physiological ovarian aging. Dr. Gleicher is available for additional comments.

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