A leading Southern California Fertility center esteemed for their excellent IVF success rates and national reputation was recently selected as a participant in a national, multi-center study exploring new progesterone delivery systems to replace intramuscular injections. Patients going through in vitro fertilization (IVF) often describe the progesterone injections as the most difficult and painful part of the IVF cycle. For more than 30 years doctors have been seeking effective alternatives to these painful injections.
The study compares an FDA-approved vaginal progesterone, Endometrin, with a new formulation which is administered subcutaneously, similar to the relatively painless fertility drug injections. Patients will be randomized to receive either the vaginal or subcutaneous progesterone until the pregnancy test and then until about 10 weeks of pregnancy. In case of unacceptable side effects the patient will be offered an alternative medication. Side effects are usually local reactions and mild.
Benefits to patients include free progesterone medications as well as a $1,500 (INR 72,000) honorarium for participating and completing the study questionnaires.
Participating patients will be IVF candidates, including those undergoing ICSI, Blastocyst and PGD, who are age 18-42 who have had less than three prior IVF cycles and an FSH less than 15IU/L and estradiol less than 80 pg/mL. Other exclusion criteria exist.
Wednesday, January 14, 2009
Folate receptor blockade may compromise fertility
Treatment of impaired folate metabolism caused by an autoimmune response might improve the chances of conception among certain women with fertility problems, research suggests.
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
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