A pilot study of premature ovarian senescence: I. Correlation of triple CGG repeats on the FMR1 gene to ovarian reserve parameters FSH and anti-Müllerian hormone.

Objective: To assess whether the number of triple CGG expansion of the FMR1 (fragile X) gene, known to correlate at premutation (55-200 repeats) and full mutation (>200 repeats) ranges with risk toward premature ovarian failure (POF), also correlates with milder forms of premature ovarian senescence.

Design: Retrospective, controlled cohort study.

Setting: Academically affiliated, private fertility center.

Preimplantation genetic screening: "established" and ready for prime time?

Unless attempts to improve pregnancy rates and/or diminish miscarriage rates through preimplantation genetic screening (PGS) are applied to only carefully selected patients, they will fail. Because specific PGS indications have remained undefined, PGS should be considered an experimental procedure.

The impact of LH-containing gonadotropins on diploidy rates in preimplantation embryos: long protocol stimulation.

Background: The aim of this study was to evaluate the effect of ovarian stimulation with LH-containing gonadotropins (human menopausal gonadotropin, hMG), on ploidy of human cleavage-stage-embryos.

Methods: A total of 104 women, at ages 27-43 years, undergoing one cycle of controlled ovarian hyperstimulation for IVF in combination with preimplantation genetic diagnosis, were eligible for enrollment in this retrospective, controlled cohort study. Ovarian stimulation included down-regulation with long agonist and stimulation with either recombinant FSH or hMG.

Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function.

Objective: We assessed the role of DHEA supplementation on pregnancy rates in women with diminished ovarian function.

Design: This is a case control study of 190 women with diminished ovarian function. The study group includes 89 patients who used supplementation with 75 mg daily of oral, micronized DHEA for up to 4 months prior to entry into in vitro fertilization (IVF).

Too old for IVF: are we discriminating against older women?

In vitro fertilization (IVF) in women of advanced age (>42 years) represents only 5%, a comparatively minute part, of the national IVF experience in the United States (US). In view of evolving population dynamics, it, however, also represents proportionally a rather quickly expanding patient need. Because of access restrictions at many IVF programs, this market does not live up to its potential.

Functional autoantibodies, a new paradigm in autoimmunity?

The recent detection of stimulatory autoantibodies as a characteristic feature of systemic sclerosis (scleroderma), established the presence of such autoantibodies as a characteristic pathophysiologic finding in a second classical autoimmune disease after autoimmune thyroid disease. This observation raises the possibility of a new paradigm in abnormal autoimmune function, the presence of stimulatory (and suppressive), functional autoantibodies as characteristic features of abnormal autoimmune function. The assumption of such a paradigm opens interesting new research avenues within rheumatology and in other medical specialty areas.

Differences in ovarian function parameters between Chinese and Caucasian oocyte donors: do they offer an explanation for lower IVF pregnancy rates in Chinese women?

Background: IVF outcomes in Chinese women are inferior to those of Caucasian patients. Reflecting prematurely diminished ovarian function, women with elevated age-specific baseline (b-) FSH levels are designated to suffer from premature ovarian aging (POA). We investigated if the prevalence of POA differs between these two ethnic populations.

Postpartum depression, an autoimmune disease?

Medical conditions with known etiology and typical peripartal/postpartal disease exacerbations are now, without exception, considered autoimmune in etiology. Postpartum psychiatric conditions, and especially postpartum depression, currently, however, are still not understood in their etiology. This paper suggests that the typical postpartum flare pattern, and other clinical characteristics, point towards an autoimmune etiology for (postpartum) depression.

The choice of gender: is elective gender selection, indeed, sexist?

Background: Like a number of international organizations before them, the American College of Obstetricians and Gynecologists (ACOG) recently issued an ethics opinion, which condemned all indications of elective gender selection as devaluatory to women and sexist and, therefore, given the choice, assumed automatic preference for male gender selection in all populations. This study intended to investigate this notion for accuracy.

Methods: We investigated the desired gender in 92 couples who had undergone between January 2004 and December 2006 first in vitro fertilization (IVF) cycles in attempts at gender selection for family balancing purposes.

Age-specific levels for basal follicle-stimulating hormone assessment of ovarian function.

Objective: Traditionally, the most important measurement in the assessment of ovarian function has been age-independent baseline follicle-stimulating hormone (FSH) levels. The objective of this study was to characterize the continuum of ovarian function based on age-specific categories of baseline FSH.

Methods: In a cross-sectional historical cohort study we evaluated records of 434 patients with baseline FSH levels of less than 12 milli international units/mL that underwent ovulation induction for in vitro fertilization (IVF) with long gonadotropin-releasing hormone (GnRH) antagonist or GnRH agonist suppression and modal gonadotropin stimulation of 300 units of gonadotropins per day.

The impact of luteinizing hormone in assisted reproduction: a review.

Purpose Of Review: Although the key role of luteinizing hormone in ovarian function, the promotion of follicular growth and maturation, is widely acknowledged, its usefulness as a predictor of ovarian status, and as a supplement during fertility treatment, remains controversial.

Recent Findings: Luteinizing hormone alone is not an effective predictor of ovarian function. In combination with follicle-stimulating hormone, as the so-called follicle-stimulating hormone: luteinizing hormone ratio, it serves as a useful marker of ovarian status.

Lack of association between polycystic ovary syndrome and embryonic aneuploidy.

Objective: To determine whether women with polycystic ovary syndrome (PCOS) are at increased risk for embryonic aneuploidy.

Design: Retrospective cohort study.

Setting: Academic teaching department, privately owned preimplantation genetics laboratory, and academically affiliated, private infertility center.

Update on the comparison of assisted reproduction outcomes between Europe and the USA: the 2002 data.

Objective: In follow-up to an earlier study of in vitro fertilization (IVF) outcomes in Europe and the U.S. for the year 2001, the present study reports on 2002 outcomes in an attempt to determine diverging practice trends.

Aneuploidy rates in embryos from women with prematurely declining ovarian function: a pilot study.

Objective: Prematurely declining ovarian function (PDOF) affects approximately 10% of infertile females, and has been suggested to represent a shift of the normal ovarian aging curve toward younger age. Whether women with PDOF demonstrate an increased level of aneuploidy in their embryos, based on increasing aneuploidy rates with advancing female age, is unknown, and was the subject of this study.

Design: Retrospective, case-control study.

Gender as risk factor for autoimmune diseases.

Most autoimmune diseases occur significantly more frequently in women than men. This female preponderance for abnormal autoimmune function has largely gone unexplained. Many investigations have concentrated on the effects of female and male sex hormones on immune function, by suggesting that estrogens favor the antibody production-enhancing Th2 response and, by doing so, possibly, increase the risk towards abnormal autoimmune function.

Why much of the pathophysiology of preeclampsia-eclampsia must be of an autoimmune nature.

Preeclampsia-eclampsia (PE-E) is a poorly understood condition of human pregnancy, which can affect multiple organs and is a leading cause of maternal deaths worldwide. The etiology and pathophysiology remain enigmas, however, which hampers progress in prevention, diagnosis, and treatment of this condition. PE-E is characterized by many features typically seen in autoimmune diseases, or in association with autoimmune reactions.

"Ovarian age-based" stimulation of young women with diminished ovarian reserve results in excellent pregnancy rates with in vitro fertilization.

Objective: To determine whether pregnancy outcome can be positively affected if the ovarian stimulation in women with diminished ovarian reserve (DOR) is changed.

Design: Case control study.

Setting: Medical school-affiliated private infertility center.

The impact of abnormal autoimmune function on reproduction: maternal and fetal consequences.

The impact of abnormal autoimmune function on reproductive success has remained a highly controversial issue. This is, at least partially, due to the relative lack of demographic data from women with established autoimmune diseases. We, therefore, investigated 163 women with proven autoimmune diseases and 73 controls in a demographic study of reproductive success and impact of abnormal autoimmunity on pregnancy and offspring.