What’s New

How The Fertility Centers Of New England Selects Embryos For Transfer

Read Dr. Scott's Blog

Military Discount

We offer a 10% discount on all services to active duty military personnel who do not have coverage for infertility.

Elective Single Embryo Transfer (eSET): Achieving One Healthy Baby Per Pregnancy – Tuesday, July 27, 2010 from 6:30-8:30 pm

With Dr. Danielle Vitiello and Lynette A. Scott, PhD., Fertility Centers of New England

A multiple pregnancy may feel like a welcome relief after the struggles of infertility. But with the recent bad publicity about multiple births after IVF, and concerns about exploding health care costs, elective single embryo transfer (eSET) is attracting close attention and is viewed as a viable option for a number of women. Many fertility centers now offer eSET in order to reduce multiple births and achieve the goal of one healthy baby per pregnancy. Why should you consider this technique?

Fertility treatment cycles are responsible for 50% of twin births and 75% of higher order births. It is important to be aware that there are significant risks and that poor health outcomes can be associated with this type of pregnancy, to both mother and fetus/child. For example, the major problem with twin pregnancies is prematurity, and the more premature the delivery, the greater the risks of complications both at birth and beyond. For the mother, risks include conditions such as high blood pressure and gestational diabetes, as well as the psychological stresses of raising several children at once.

This program will cover the success rates of the eSET technique, along with information about how the embryology lab can select the best quality embryos for the highest rates of success. The presenters will explain who is a good candidate for this technique, and how it achieves the goal of healthier outcomes for both mother and baby. There will be plenty of time for Q&A.
Fees: Resolve members: $10 per person. Non members: $20 per person.
Where: The Walker Center, 171 Grove St, Newton, MA 02466, in the Living Room

Directions to the Walker Center
BY SUBWAY:
Take the Green Line. Riverside car (D) to MBTA Riverside Station. At the exit, turn left and walk left onto Grove Street. Go about 1/4 mile to the top of the small hill. Walker is at the intersection of Grove and Hancock Streets. (From Riverside Station, Walker is a six-minute walk.)
BY CAR:
FROM BOSTON: Take the Mass Pike to exit 16; go west on Route 16 toward Wellesley. After it crosses Commonwealth Ave (Rt. 30), look for Woodland Rd on the right. Take Woodland to the flashing light; turn left up the hill. Walker is on the right after the elementary school.
FROM THE NORTH OR SOUTH: Take Rt. 128 (US 95) to exit 22, Grove St./MBTA Station. After you exit 128/95, go past the Holiday Inn and the Riverside T station. At the top of the small hill as Grove Street bears right, the Walker Center will be on the left; watch for the sign.
FROM THE WEST: Take the Mass Pike to exit 14. Go south on Rt. 128/95, and take exit 22. Then follow NORTH/SOUTH directions.

Air Travel During Pregnancy

Read Dr. Hill's New Blog Entry, Titled "Air Travel During Pregnancy"

Patients Choice Award

We are pleased to announce that Dr. R. Ian Hardy is the recipient of the Patients Choice Award!

Every month more than 60,000 patients across the US provide online reviews about personal experiences with their doctors. Dr. Hardy has received this outstanding distinction for 2009.

Fertility Drugs and Ovarian Cancer

Read Dr. Hill’s blog on fertility drugs and ovarian cancer

Egg Freezing

We are pleased to announce the first pregnancy in Northern New England using a previously frozen egg. Read about egg freezing.

Read Dr. Hardy’s new blog entry on Universal Genetic Testing!

Ready the story on our blog!

Now Offering Universal Genetic Testing

The Fertility Centers of New England is now offering universal genetic testing for all new patients as part of the standard evaluation. This genetic test, performed by Counsyl (www.counsyl.com) , screens for over 100 single gene disorders. Historically, patients were routinely tested for cystic fibrosis carrier status and those patients at risk were tested for Tay-Sachs and sickle cell disease. Routine screening for other genetic disorders was not routinely performed due to low incidence and increased cost. Recent advances in DNA microarray chip technology have enabled a 600-fold decrease in cost, thus enabling a more thorough genetic screening process. 80% of children born with genetic disorders had no known family history of the disorder. Further information can be seen on our blog.

Take Control of Your Fertility - Boston!

Where: Bella Santé Spa - Newbury Street, Boston
Date: Sunday, October 4, 2009
Time: 6:30-8pm

Meet Dr. Joseph Hill from Fertility Centers of New England, Extend Fertility’s newest partner center. Enjoy an evening of education and refreshments in the luxurious setting of the Bella Santé Spa on Newbury Street. Bella Santé’s intimate environment provides the perfect setting for a personal discussion on fertility. The focus of the discussion will be on the biological clock and the latest advances in assisted reproductive technology including fertility preservation and egg freezing. The panelists include: Dr. Joseph Hill, a board certified reproductive endocrinologist from Fertility Centers of New England; Stacie Baker, a licensed clinical social worker and Extend Fertility client educator; and Cheryl Ball, an Extend Fertility client.

The event is free, but reservations are required. To register, contact 800-841-7197 or info@extendfertility.com

Dr. Hill to serve on the Medical Advisory Board of EXTEND FERTILITY

We are pleased to announce that Dr. Joseph A. Hill has been nominated to serve on the Medical Advisory Board of Extend Fertility. Extend Fertility is a national egg-freezing service offering women through their Partner Centers the ability to store their eggs for use later in life. The members of Extend Fertility’s Advisory Boards are world-renown leaders and pioneers in the field of egg freezing and infertility.

The FERTILITY CENTERS OF NEW ENGLAND selected as a PARTNER CENTER for EXTEND FERTILITY

The Fertility Centers of New England is proud to announce their being selected as a Partner Center for Extend Fertility.

Extend Fertility is a national egg-freezing service offering women through their Partner Centers across the country the unprecedented opportunity to preserve their fertility and thereby take control of their reproductive health.

Freezing eggs enables women planning to have children after the age of 35 the chance to extend their ‘biological clock’ by storing their eggs during their reproductive prime for use later in life when they wish to start or expand their families.

2009 BEST DOCTORS IN AMERICA AWARD

The Fertility Centers of New England is proud to report that Dr. Hardy, Dr. Hill and Dr. Weiss have been selected by their peers to be included in the 2009 Best Doctors in America. A peer review survey by thousands of doctors is used to identify who are the most respected doctors in different medical specialties. In the survey, doctors are asked, “If you or a loved one needed a doctor in your specialty, to whom would you refer?” Best Doctors in America reports that “doctors have unique inside perspective about who’s at the top of their profession and who’s up on the latest advances in their field.” Only 5 % of physicians nationwide are selected for inclusion on the Best Doctor List. The accumulated database is used worldwide for patients to access medical advice. We are proud to have our best doctors for you right here in New England.

DR. HARDY GIVEN THE 2008 PATIENTS’ CHOICE AWARD

We are pleased to announce that Dr. Ian Hardy has been awarded the 2008 Patients’ Choice Award. More than 400,000 patient reviews and ratings were gathered, and Dr. Hardy was chosen as a patient favorite. Patients took the time to compliment Dr. Hardy in areas such as: bedside manner, the amount of time spent with them, the courtesy of the office staff, appropriate follow-up, and their overall opinion of Dr. Hardy as a physician.

NEW SEMINAR IN JUNE

We have a seminar scheduled for June 30 at our Reading, MA location. Please join us to meet the team and learn about some exciting new services!

NEW PORTSMOUTH, NH OFFICE

Our Portsmouth office has moved to 875 Greenland Road, Building C, Unit 1, in Portsmouth, NH!

WHAT’S NEW IN OUR LAB WITH DR. SCOTT AND HER EMBRYOLOGY TEAM.

The FCNE is recognized both Nationally and Internationally for the innovative approaches it takes to embryo scoring and transfer. At the FCNE we treat all embryos individually and develop pedigrees for each, over a 2-3 day course, so that when we select an embryo for transfer, the selection is based on multiple parameters and not just a snap shot look at one point in time.

Dr Scott has been recognized for this approach and invited to many meetings to share and teach the technique and concept. She will be speaking at 4 upcoming meetings in Europe on Sequential Embryo Selection and Selecting the Day for Embryo Transfer.

The laboratory is also involved in Cutting Edge research, looking for ways to select embryos other than by “how nice do they look”. Something every living thing needs to do to create energy is breathe. Oocytes and embryos also breathe or respire. The FCNE is working closely with a company that is developing a system that can measure the respiration of single oocytes and embryos, without harming them in any way. The goal is to be able to use this tool for oocyte and embryo selection in the future. Again, this work is recognized Internationally and Dr Scott will be presenting some of her recent data at an upcoming special meeting of The European Society for Human Reproduction and Embryology, specifically convened to discuss and investigate new methods of embryos selection. Dr Scott is 1 of the only 2 scientists from the USA who have been invited to participate in this forum, with a total of 15 presenters from all over the world.

Should Day 2, 3 or 5 Embryo Transfer be performed in first time IVF patients, repeat failure patients and low responders? When should we transfer embryos?

Lynette Scott, PHD
Fertility Centers of New England, Reading, MA, USA

Over the years in ART/IVF the day of embryo transfer has moved from Day 2, to Day3 and then Day 5 and is now in debate. During this time the media used for embryo development improved, and embryologists developed a better understanding of the human fertilized oocyte and day 2 and 3 embryos, and how their morphology affected development. The increased pregnancy rates with each additional day of culture were met with the overall assumption that later transfers give better results, which they did initially. However, over time it has become clear that Day 5 transfers generally only benefit high prognosis patients. The concept of differential in vitro development of human embryos is real and seen on a regular basis in ART laboratories and the question ”Would a human embryo that did not develop beyond the 4-cell stage in vitro, on day 2, with the new improved culture systems, also arrested in vivo? Would the patient who's embryos always slow down and/or arrest in vitro between day 2 and day 3 or 3 and 5 also have suffered this fate if the embryos were developing in vivo? Would the patient who has repeated IVF failure do better if the embryos were not subjected to many days of in vitro-culture conditions and would having an old-fashioned early transfer benefit pregnancy rates?“

At the Fertility Centers of New England we approach the problem of “which day to transfer embryos” from a laboratory or embryo perspective: Using our empiric data we allow the embryos to dictate the Day of ET, based on certain key morphological criteria (Scott et al., 2007) and not the published (supposed) literature. To bring this concept into the clinical practice we first needed to test the concept in a controlled randomized trial, asking: “which is the appropriate day to transfer embryos in repeat failure patients”. If this could be answered, using key embryological morphologic criteria, we would be able to answer the larger question, When should an embryo transfer be performed?

A study was initiated using repeat failure patients who were randomly assigned to a day 2 or day 3 ET if they met inclusion criteria for the study. The study was prospective and under IRB with informed consent. Inclusion criteria included, no major female pathology, no severe male factor, no previous conception and at least 2 previous failed ART attempts. To be effective we were looking for at least an increase of 10% Fetal Heart Beat rate and >5% Implantation Rate. The results of this study indicated that a day 2 transfer resulted in a 2-fold increase in pregnancy rates compared to Day 3 transfers in this group of patients.

Another group of patients that have benefited from this approach are those with known arrest in in vitro development. In these patients a Day 2 ET should be considered as a means of reducing detrimental in vitro effects (Scott, 2000). Day 2 embryo morphology has been shown to be very effective for embryo selection, even when performing single embryo transfer. In fact when day 2 morphology is used in conjunction with Day1 and day 3 scoring systems for sequential embryo selection (SES), implantation and pregnancy rates are increased (Scott et al 2007).

It is therefore more important to select the day of embryo transfer by the characteristics of the embryos rather than a protocol or unit plan, since not all embryos are the same and clearly some will benefit from an early removal from culture. In first time patients, it is most beneficial to grow to at least the 8-cell stage unless there are very few of them, but a Day 5 transfer should only be considered when embryos are all growing well, from day 1 to day 2 to day 3 and meet all the morphological criteria on each day. Repeat failure patients may benefit from early transfer, as will patients with poor embryo quality.

Is there a way to choose the best embryo?

Lynette Scott, PHD
Fertility Centers of New England, Reading, MA, USA

One of the most important steps in an ART laboratory is choosing the right embryo for transfer. Currently the only tool available is the morphology of the embryos on various days (1, 2, 3, and 5) with wide variations in reported correlations of certain morphology features and outcome. Selection through developmental arrest by extended culture has proven marginally successful in all but high prognosis patients. To compensate for the low selection-success to implantation rates multiple embryos have traditionally been used in embryo transfer. What is needed is a better, more rigorous method of using morphology in selection in order to improve outcome but at the same time use fewer embryos in transfer. By setting up a strict Sequential Embryo Selection system (SES), with multiple points of scoring, where the parameters being used are based on biology and not appearance, the most viable embryos can be selected for transfer. Using SES, embryos are scored on Day1 and Day 2, and 3. The 2 most important days of scoring are Day 1 and Day 2, with Day 2 scoring having the highest impact on outcome, early loss and PGS results. Only if there are sufficient embryos passing all criteria on each day would a day 5 transfer be considered. On any day of transfer, Day 2, 3 or 5, embryos should be selected based on pedigree and not only the morphology on that day.

FERTILITY CENTERS THREE PHYSICIANS SELECTED AS AMONG TOP 5% MD'S IN AMERICA.

The Fertility Centers of New England is proud to announce that Drs. Hill, Hardy, and Weiss have been selected by their peers as Best MD's in America for 2007-2008 honoring them among the top 5% of the MD's in the country. They have been recognized in the November 7th issue of Boston Magazine in addition to articles in various hospital and provider newsletters.

American Society for Reproductive Medicine Meeting

More than 4000 reproductive clinicians and scientists recently attended the American Society for Reproductive Medicine's annual meeting in Washington DC. This event is a unique opportunity for staff at FCNE to observe state-of-the-art techniques and protocols to further benefit our patients in New England. It was also an opportunity to share our work here at the Center with scientists from around the world. The Fertility Centers of New England was privileged to present five clinical papers at this international meeting.

Presented papers included:

• SHOULD PREIMPLANTATION GENETIC DIAGNOSIS FOR ANEUPLOIDY SCREENING BE USED FOR POOR PROGNOSIS PATIENTS?
• RESPIRATION MEASUREMENTS OF HUMAN OOCYTES CORRELATE WITH OOCYTE COMPETENCE.
• OOCYTE COMPETENCY IS PROGRESSIVELY ACQUIRED FOLLOWING FIRST POLAR BODY EXTRUSION.
• DOES DAY 1 EARLY CLEAVAGE SCORING PROVIDE MORE INFORMATION FOR EMBRYO SELECTION THAN SEQUENTIAL SELECTION ON DAYS 1, 2 AND 3?
• ARE IVF PATIENTS WITH AN INCREASED BODY MASS INDEX LESS LIKELY TO HAVE GOOD QUALITY EMBRYOS?

Sex Selection for Family Balancing Now Available

The Fertility Centers of New England now offer sex selection for family balancing. Click here to learn more about this new service that we offer.

Dr. Lynette Scott Recently Published

Research performed by Lynette Scott PhD HCLD, ART Laboratory Director at the Fertility Centers of New England, and her staff was recently accepted for publication in the international journal Human Reproduction. Human Reproduction features full-length, peer-reviewed papers reporting original research, clinical case histories, as well as opinions and debates on topical issues. The Centers’ publication is entitled “Morphologic parameters of early cleavage-stage embryos that correlate with fetal development and delivery: prospective and applied data for increased pregnancy rates.” The authors conclude that early embryo morphologic parameters are stronger positive predictors of implantation than day 3 morphology or the ability to achieve the blastocyst stage of development. The complete manuscript can be seen at http://humrep.oxfordjournals.org/.

Kate Johnson, RN Joins the Fertility Centers Team

The Fertility Centers of New England is pleased to announce the recent hiring of Kate Johnson, RN. Kate joins the Center having previously worked at Beverly Hospital as a charge nurse on the medical surgical unit. She is a graduate of Salem State College where she received her Bachelors degree of science in nursing. She is “thrilled to be a part of the Fertility Centers of New England.”

Annual Infertility Conference

Please join us at the Annual Infertility Conference being held at the Best Western Royal Plaza Hotel in Marlborough, MA on November 12th.

RESOLVE of the Bay State’s Annual Infertility conference Achieving Parenthood: The Road to Resolution is coming on Sunday, November 12th 8:45 am-4:45 pm. This all-day conference has over 40 workshops featuring topics such as the latest in infertility treatments and also covers the emotional issues and decision-making aspects of infertility treatment. The conference also offers many workshops on other family building options such as donor egg and adoption.

Fertility Centers of New England's featured speakers are: R. Ian Hardy, M.D., Ph.D, Robert Weiss, M.D., Lynette Scott, Ph.D and Nancy Doctor, RNCS

Please go to www.resolveofthebaystate.org for information about this conference.

News from the Laboratory

Over the last two and one-half years the embryology laboratory has been studying the impact of early embryo scoring on the potential of an embryo to both implant and result in a successful delivery. From this data the Fertility Centers of New England have developed a very strict “gated embryo scoring” technique that enables us to select embryos on both day one and 2 of culture that have the highest potential for implantation.

The scoring techniques are those developed by Dr Scott. These data have been published in the leading clinical journal (Human Reproduction) and are being used internationally to enhance implantation, while also reducing the multiple pregnancy rate.

Once we had elucidated the key parameters that contribute to delivery and we implemented this across the whole program, we were able to increase the implantation and delivery rates by as much as 15% in some couples. This has also been with reduced numbers of embryos used in transfer, thus negating the complications of triplet pregnancies for our patients. By treating every embryo as an individual and developing a profile of each embryo, we are better able to select those with the highest potential for implantation and therefore better serve the couples we are treating with infertility.

Our current In Vitro Fertilization (IVF) statistics can be found by clicking here to go to the Statistics section of this website.

Research News

In a granted research project the laboratory is also investigating new methods of identifying oocyte quality and health by looking how the embryos are “breathing” or respiring. Our findings have shown that oocytes do indeed have different respiration rates and that this may be a very good indicator of their ability to continue developing after fertilization and form viable embryos. As this project moves forward we hope to begin clinical trials and again, aid more of our couples in achieving a healthy baby.

New Locations for Family Acupuncture & Herbs

We are pleased to announce that Family Acupuncture & Herbs, formerly Natural Healing Acupuncture & Herbs, have opened two new locations to better serve patients for Fertility Centers of New England. The first location which opened in July is just down the hall from FCNE’s main location in Reading, and the second, which opened in September, is 1 minute down the street from FCNE’s location in Portsmouth, NH. Both Family Acupuncture offices provide a full range of services in the areas of women’s health and fertility and their new locations make them ideally suited to provide acupuncture in conjunction with patients’ conventional fertility treatments. These types of coordinated acupuncture treatments have been shown in several recent studies to dramatically increase the success of conventional fertility treatments.

Betsy Campbell Learner, L. Ac., Adam Learner, L. Ac., and Jose Ruiz, L.Ac., the three acupuncturists with Family Acupuncture & Herbs, all specialize in the treatment of women’s health issues and infertility. They have extensive experience in this area and are very comfortable working with patients undergoing treatment with IUI, IVF, and other Assisted Reproductive Technologies. They currently have offices in Portsmouth and Somersworth, NH and Reading, MA.

To book an appointment or for more information please call 603-969-2229 in NH or 781-944-5443 in MA, or visit their website at www.acufamily.com.

Neighborhood Health Plan

We are excited to announce that as of October 1, 2006 the Fertility Centers of New England will be accepting patients with Neighborhood Health Plan Insurance. Patients are welcome to call and schedule an initial consult at 877-FCNEIVF (877-326-3483).

What’s New? Appointments Made Easier for You!

The Fertility Centers of New England realizes that your work schedule may make it difficult to schedule a consult during the normal 9-5 workday. That's why we're excited to announce that as of June, 2006 we will be offering some Saturday and evening appointments for initial consults.

Please contact us at 877-FCNE-IVF to schedule a Saturday or evening appointment today.

Dr. Robert M. Weiss, M.D.

FCNE welcomes board-certified reproductive endocrinologist Robert Weiss, MD to the staff.

Natural Healing Acupuncture & Herbs

We are pleased to announce that practitioners from Natural Healing Acupuncture & Herbs have begun to see patients at the Fertility Centers of New England. Acupuncture and Chinese herbal medicine have been used to effectively treat infertility for over 2000 years, and recent research has begun to validate its beneficial effects. (Fertility And Sterility Vol. 77, No. 4, April 2002)

Betsy Campbell Learner, L. Ac. and Adam Learner, L. Ac., the two acupuncturists with Natural Healing, specialize in the treatment of women’s health issues and infertility. Both have extensive experience in this area and are comfortable working with patients undergoing treatment with IUI, IVF, and other Assisted Reproductive Technologies. They currently have two offices in Stratham and Somersworth, NH that serve the Seacoast area, and will begin seeing patients in Fertility Centers’ Bedford location in January. They will start seeing patients in Fertility Centers’ Reading location later this spring.

To book an appointment, or for more information please call 603-969-2229 or visit their website at www.NaturalHealingNH.com.