Where Motherhood Can Be Possible

Dr. Louis R. Manara

IVF – Sooner Rather Than Later?

In-vitro fertilization is the most effective treatment available to treat infertile couples.  Over the past three decades IVF technology has undergone numerous modifications and improvements.  It now represents the treatment of choice for infertility caused by severe tubal disease and severe male factor infertility.  The authors of a recently published article suggest that it is time to consider IVF the first treatment of choice for the majority of infertile couples, including those with unexplained infertility, women of advanced age (40 or older), and for patients with polycystic ovarian syndrome who fail to conceive with clomid therapy.

The Case For DHEA Supplementation In Patients With Diminished Ovarian Reserve!


Those of us who provide care to couples with diminished ovarian reserve related to advancing age are in a continuous search for treatments that improve pregnancy chances.  There is evidence that dehydroepiandrosterone (DHEA) improves egg and embryo quality and quantity, as well as prospects for successful pregnancy.  DHEA has also been demonstrated to decrease miscarriage rates. This review looks at DHEA supplementation and explores possible explanations for some of the observed benefits of DHEA supplementation.

Should We Be Monitoring Vitamin D Levels In Our Infertile Patients?

Feb 12, 2014 — by manara99
Tags: Improving Ivf Success Rates

A recent study suggests that IVF pregnancy rates are significantly higher when serum vitamin D levels are above 30 ng/ml compared with rates below 20 ng/ml.  The IVF pregnancy rate in patients with high vitamin D levels was 74% compared with 35% in patients with the lowest levels.

What is Ovarian Reserve and How Do We Evaluate It?

In the course of an infertility evaluation, we often come to the conclusion that there is an issue with egg quality and/or quantity, and describe the underlying problem as “diminished ovarian reserve”.   It is essential that multiple indicators of ovarian reserve be evaluated before arriving at this conclusion. Often, the choice of therapy is dictated by ovarian reserve status. Patient counseling regarding prospects for successful treatment should reflect the findings of ovarian reserve testing.  A discussion of ovarian reserve follows.

Voorhees, New Jersey

Dr. Louis R. Manara


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