Where Motherhood Can Be Possible

Dr. Louis R. Manara

Novel IVF Stimulation Protocol

Nov 27, 2014 — by manara99
Tags: Improving Ivf Success Improving Fertility Potential

One of the most important factors in achieving successful in-vitro fertilization is the ovarian stimulation.  Over the years, many stimulation protocols have been utilized in an attempt to achieve the  “ideal” controlled ovarian hyperstimulation protocol.  A recent publication in Fertility and Sterility, November 2015 presents an excellent protocol with some distinct advantages.

When Is Ovarian Stimulation With Intrauterine Insemination A Futile Treatment?


In the course of caring for infertile couples, various treatment options are often available.  Well-controlled randomized trials designed to evaluate treatment outcomes for specific groups of patients provide the data needed to counsel patients properly as to which treatment offers the best prognosis given their specific situation.  A study published in Fertility and Sterility in November 2014 from Harvard University provides important data concerning treatment with clomid or gonadotropin stimulation in conjunction with intrauterine insemination (IUI).  The study seeks to help identify patients who have poor treatment outcomes with ovarian stimulation in conjunction with intrauterine insemination. 

Premature Ovarian Failure – A Review

Nov 13, 2014 — by manara99
Tags: Infertility Anovulation Ovarian Failure

Premature ovarian failure (POF) is the loss of ovarian function before the age of 40.  Usually a woman’s ovaries supply eggs and hormones until the age of 51, which is the natural age of menopause.   However, with premature ovarian failure, complete loss of ovarian function can occur from the teenage years through age 40.  This condition is associated with infertility and often occurs before the traditional age of child bearing.

Successful IVF: How Important Is Endometrial Thickness?

Several publications have demonstrated that thin endometrial lining, as measured by transvaginal ultrasound, results in decreased prospects for successful embryonic implantation, while thicker endometrial development results in higher implantation rates.  A recent large study out of Shanghai Jiaotong University looked at the association between endometrial thickness and in-vitro fertilization outcomes in 2106 patients.  Patients with the thinnest endometria had the poorest outcomes.

Does Ovarian Stimulation For IVF Adversely Effect Embryo Implantation?

Oct 25, 2014 — by manara99
Tags: Improved Infertility Care Improved Ivf

It has long been suspected among clinicians that stimulation of the ovaries in standard IVF treatment creates an environment that is not ideal for embryo implantation.  A large study out of Duke University published in the August 2014 issue of Fertility and Sterility, compared pregnancy rates among donor egg cycles to IVF treatment cycles in which the intended mother used her own (autologous) eggs. In egg donor cycles there is no stimulation of the recipient's ovaries, while in autologous IVF cycles the ovaries are stimulated and the embryos are transferred later in that same cycle. Other studies have looked at this question by comparing fresh IVF treatment with frozen embryo transfer.  

Is it Time to Consider Chromosomal Analysis of All Embryos Before Embryo Transfer?

The quest to achieve the best possible outcomes with in-vitro fertilization has led to the use of embryo biopsy to determine the genetic makeup of an embryo before it is transferred to the uterus.  Performing embryo biopsies on the 5th day of embryonic life and application of new technologies that allow 24-chromosome evaluation, have led to improved outcomes.

Novel Therapy For Uterine Fibroids

Sep 17, 2014 — by manara99
Tags: Non Surgical Treatment Uterine Fibroids

Uterine fibroids are very common, occurring in one out of every four women during their reproductive years.  These benign tumors may cause excessive uterine bleeding, pain, pressure symptoms, and infertility.  Other than surgery, the options for long term treatment of fibroids are limited.  Progesterone antagonists sometimes referred to as selective progesterone receptor modulators (SPRMs) are an exciting group of compounds that hold great promise for long term non-surgical treatment of uterine fibroids.

Vitamin D Deficiency and Infertility

Sep 4, 2014 — by manara99
Tags: Nutrition And Infertility Vitamin D And Infertility

While the complete relationship between Vitamin D and infertility has yet to be completely understood, gathering evidence suggests that having higher blood levels of this vitamin is associated with improved fertility treatment outcomes.  A recent paper published in the August, 2014 issue of Clinical Endocrinology and Metabolism, suggests that higher blood levels of 25-hydroxy-vitaminD was associated with improved clinical pregnancy rates in patients undergoing IVF.

Does Regular Menstruation Assure Regular Ovulation?

Patients with infertility often inquire about whether they are ovulating with certainty.  Physicians and patients tend to equate regular predictable menstruation with regular ovulation.  A recent paper from the National Institute of Child Health and Human Development (NIH), published in Fertility and Sterility August 2014 found that 5.5%-12.8% of cycles in healthy women who were menstruating regularly were anovulatory.

Birth Control Pills and Ovarian Reserve Indicators – Important Information!

Aug 3, 2014 — by manara99
Tags: Ovarian Aging Fertility Assessment

Assessment of egg quality is a standard part of the evaluation of the infertility evaluation.  A recent Danish study suggests caution when interpreting two of the tests commonly used to evaluate egg quality in women who are taking oral contraceptives.

Voorhees, New Jersey

Dr. Louis R. Manara


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