Dr. Laura Londra presented new infertility research at ASRM
This year’s Annual Meeting of the American Society of Reproductive Medicine (ASRM) was held in Baltimore, Maryland. Dr Laura Londra, MD, FACOG, a fertility specialist at Ohio Reproductive Medicine, presented her latest research, which looked at differences in pregnancy outcomes after in vitro fertilization according to the type of ovarian stimulation protocol used in patients with different infertility diagnosis. Dr. Londra teamed up with researchers from the world-renown Johns Hopkins Bloomberg School of Public Health to analyze data from the Society of Assisted Reproductive Technologies (SART) database. This registry collects information from more than 90% of infertility practices across the United States and it is a great resource for the study of many aspects of the process of in vitro fertilization. It is known that the uterine hormonal environment is modified as a consequence of the high hormonal levels that ovarian stimulation produces. In certain cases, this particular environment may not be conducive to a normal implantation of the embryo and additional measures such as freezing of the embryos and replacement of them in another cycle is an option, or reducing the number of embryos transferred in the fresh cycle while freezing the rest for another cycle are options to improve the outcome of pregnancies after IVF.
Dr. Londra and her fellow authors also found differences in treatment results according to the race or ethnicity of the patient, according to the main cause of infertility (i.e., problems with the fallopian tubes or endometriosis as opposed to male factor or lack of ovulation), and according to the type of medications received and the ovarian response during the treatment. This new study raises questions about the options that we offer patients at the time of embryo transfer, since it is now possible to expect similar or even better pregnancy outcomes in what we call a ‘ frozen cycle’. Although this may not be the best option for all patients, we are now learning that for certain patients, it might be best to ‘freeze all’ and wait to transfer the embryo in a more ‘normal’ hormonal environment, i.e., in a next cycle, specially prepared for the embryo implantation.
Overall, this study shows that ‘one size fits all’ clearly does not apply for IVF procedures, and that treatments should be tailored according to multiple factors in order to achieve good outcomes for IVF pregnancies. This is particularly important because even if we take the financial aspects of treatments aside, the emotional burden of not achieving the desired outcome after repeated embryo transfers is a big factor in discouraging couples in their pursuit of building their families.
This research was published in the official journal of ASRM, Fertility and Sterility, and can be accessed online in their official website.
The Jones Lecture at Johns Hopkins, October 2014
ASRM and Dr. Londra Remember IVF Pioneer Dr. Howard Jones, MD
This year ASRM 2015 was affectionately dedicated to the memory of Dr. Howard Jones, who died at the age of 104 this past July (2015). I was privileged to have had the opportunity to meet Dr. Jones at least once a year at our traditional “Jones Day” meeting during my fellowship training at Johns Hopkins (see photo). At those meetings we had the privilege of presenting cases and discussing topics with Dr. Jones. He was one of those physicians that appreciated humanity way beyond medicine. I especially remember his fondness of poetry, as he introduced Frost poems into scientific discussions with the ease of someone who was clearly knowledgeable about many aspects of life beyond medicine.
I have been very fortunate to have met many of the pioneers of IVF and Reproductive Medicine during fellowship and at national meetings. I will remember and treasure their stories of the long journey they underwent toward the first IVF pregnancy in the US. Dr. Jones and his wife Dr. Georgeanna Seegar Jones had the drive and the faith to continue despite many disappointments and obstacles. Dr. Howard was sharp, down to earth and fun to be around until his last time with us, he was truly an amazing individual. Click here for more about Dr. Jones.