The annual meeting of the American Society for Reproductive Medicine was held from Oct. 15 to 19 in Salt Lake City and attracted approximately 5,000 participants from around the world, including physicians, researchers, nurses, technicians, and other health care professionals associated with reproductive medicine. The conference featured more than 1,000 abstracts focusing on reproductive biology.
In one study, Michael Eisenberg, M.D., of Stanford University in California, and colleagues found associations between certain antihypertensive medications and the rate of male infertility diagnoses and evaluations.
“Based on our data, there may be some medications used to treat hypertension that may impact male fertility. Given the rising age of paternity in the country, more men trying to conceive are now on medications. Thus, this type of data may be more relevant,” Eisenberg said. “At this point, the data are hypothesis generating. Certainly, further research is necessary to examine the impact of a wider array of medications on male fertility.”
In another study, Ronald F. Feinberg M.D., Ph.D., of Reproductive Associates of Delaware in Newark, and colleagues found that minimal in vitro fertilization (mini-IVF), when combined with single embryo transfer, improves access to IVF care through significant cost savings, but without sacrificing overall success rates.
“Our study combined several important cost-saving strategies in patients considered to have a good prognosis for IVF success: (1) the use of milder ovarian stimulation initially with clomiphene, followed by more expensive but lower-dose follicle stimulating hormone (FSH); (2) culturing of fewer eggs and embryos in the IVF lab; and (3) universal use of single embryo transfer, both in the study and control groups,” Feinberg said. “The mini-IVF study group utilized significantly less FSH than the traditional IVF control group, which did result in obtaining fewer eggs and embryos. However, the blastocyst embryos obtained from the mini-IVF study group yielded equal potential for achieving pregnancy when compared to the control group. This resulted in equivalent and high pregnancy rates for the two groups, whether calculated as a ‘per transfer’ rate or cumulatively.”
After just one ovarian stimulation and with single embryo transfer, the investigators found that 78 percent of the mini-IVF group had an ongoing pregnancy and live birth, compared to 85 percent in the traditional IVF group, which was statistically equivalent. Both groups had cryopreserved embryos available for future use. When the investigators calculated cost savings, the mini-IVF group was calculated to cost 28 percent less than the traditional IVF group, or over $5,000 in reduced costs.
“Single embryo transfer, whether with fresh or frozen embryos, yields ongoing pregnancy implantation rates of 62 to 66 percent in good prognosis patients, and should be adopted universally as a key strategy for dramatically reducing high-risk multiple gestations,” Feinberg said. “Women’s health care providers should advise their patients that IVF is no longer a ‘last resort’ for overcoming infertility, and that high-risk pregnancies can be dramatically reduced by IVF practitioners who utilize single embryo transfer. Furthermore, as we demonstrated in this study, single embryo transfers can be combined with significantly less aggressive ovarian stimulation protocols to yield a 78 percent cumulative chance of a successful and safe pregnancy outcome.”
Biren Patel, M.D., of the University of Utah in Salt Lake City, and colleagues found that attention-deficit/hyperactivity disorder (ADHD) medications can affect sperm analysis parameters.
“The key results are that medication can affect sperm parameters and that we as a medical community need to be more aware of the effects. Stimulant medications cause a decrease in all semen analysis parameters. More work will need to be done to make a clinical recommendation,” Patel said. “Since this was a retrospective study, we cannot make any recommendations at this time. More work will need to be done to determine if there is a clinical application.”
In a retrospective medical records study, Yefim Sheynkin, M.D., of the State University of New York at Stony Brook, and colleagues did not observe a higher rate of medical comorbidities, including hypertension, diabetes, hyperlipidemia, thyroid disease, coronary artery disease, autoimmune disease, asthma, or cancer, in infertile men as compared to fertile men.
“Patients with male factor infertility do not have a higher prevalence of medical comorbidities than fertile men. Additional multi-center studies of reliable individual data are necessary to further evaluate the association between male reproductive health and general health. Ultimately, we are in a great need of a dedicated national male infertility database,” Sheynkin said. “Infertility diagnosis and treatment are psychologically distressing for many men. The results of this study may be useful in counseling patients who are often concerned with the additional health-related issues possibly associated with male infertility.”
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