Uterine polyps may be discovered during preparation for IVF when the uterus is evaluated by hysterosalpingogram or during routine vaginal ultrasound monitoring.  The question of whether these polyps should be surgically removed prior to in-vitro fertilization treatment has been controversial.  Many reproductive specialists have recommended removal based on data suggesting improved implantation rates following surgical polypectomy.  Several papers have suggested removing only polyps which are greater than 1cm in diameter.  A recent Turkish paper (in press) suggests that removal of polyps measuring less than 1.5cm offers no advantage in terms of pregnancy or live birth rates.  

Because fertility decreases with advancing age it is imperative that the most effective therapies be offered to couples as early in the treatment process as possible.  Physicians who care for infertile couples must make the most of each month to assure that fertility potential is maximized.  Toward this end, data evaluating age specific expectation for successful pregnancy for the various commonly used treatments is essential.  An article in press at this time suggests that in-vitro fertilization is far superior to ovarian stimulation combined with intrauterine insemination.  Live birth rates in this study were more than five times greater for IVF versus ovarian stimulation with intrauterine insemination. 

There have been several publications in recent years suggesting that minor trauma to the uterine lining in the menstrual cycle preceding an IVF treatment cycle results in a significant improvement in embryo implantation.  A recent study suggests that obtaining a biopsy from a precise location within the uterine cavity during the IVF treatment cycle significantly improved the prospect of embryo implantation. This study is the first to indicate that location and timing of the biopsy may impact favorably the chances for pregnancy in patients who have had repeated failure of healthy appearing embryos to implant.  

In vitro fertilization (IVF) is a great way for many couples who cannot conceive a child on their own begin the great adventure of having a family. Let’s look at who the best candidates for IVF are and what the procedure entails.

Because of the large number of follicles often present in patients with polycystic ovarian syndrome (PCOS) as well as the usually observed excellent ovarian response to stimulation with fertility medications in this group of patients, the question arises as to whether reduction in fertility which is known to occur with aging proceeds at a slower rate in PCOS patients.  A recent study from Norway suggests that fertility potential is maintained between the ages of 22 and 41 in a group of PCOS patients compared to a group of non-PCOS patients.

In this blog post, Dr. Louis Manara, the director of our New Jersey fertility clinic, reviews the PGD procedure and its uses.