Fertility Centers of New England - What's New

4.1.08	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.
12.10.07	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.
11.15.07	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?
7.27.07	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.
7.03.07	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."
11.06.06	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.
11.01.06	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.
11.01.06	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.
10.01.06	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).
5.26.06	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.
3.01.06	Dr. Robert M. Weiss, M.D. FCNE welcomes board-certified reproductive endocrinologist Robert Weiss, MD to the staff.
2.01.06	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.