Tag Archives: infertility

Endometriosis Tissue Bank to Identify Key Biomarkers for the Disease

Timothy Deimling, M.D., Obstetrics and Gynecology, is in the final stages of obtaining institutional review board approval to launch a prospective database and tissue bank for endometriosis research. The primary purpose is to identify biomarkers for less invasive diagnosis, in addition to identifying targets for treatment of endometriosis. “Most women with pelvic pain and infertility obtain definitive diagnosis of endometriosis after a long history of problems; the delay in diagnosis is in large part due to the fact that it requires surgery,” notes Dr. Deimling. The tissue bank is being established according to guidelines set by the supporting World Endometriosis Research Foundation (WERF), and is planned to include multiple centers in the U.S. and internationally.

Pathology slide of endometriosis and picture of an endometriosis lesion

Pathology slide of endometriosis, as well as an intra-operative picture of an endometriosis legion.

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New Study Explores Pre-Treatment Lifestyle Modification for Obese Women with Unexplained Infertility

Obesity in women is associated with a negative impact on ovulation, delayed time to conception, increased pregnancy loss, and an increased risk of serious adverse maternal pregnancy and neonatal outcomes.1 A new randomized controlled trial recently began enrolling patients, aimed at evaluating the impact of two varying 16-week lifestyle modification interventions (see chart) on the frequency of healthy births (e.g., live birth at 37 or more weeks gestation with no major congenital anomaly, birth weight between 2500g to 4000g). To achieve a weight loss of approximately 7 percent of total body weight, the intensive intervention promotes increased physical activity combined with calorie restriction and a weight loss medication. The other standard intervention group promotes activity alone. Richard Legro, M.D., Penn State Hershey Obstetrics and Gynecology (lead study site), the lead investigator of this nationwide study explains, “Although the epidemiology of obesity and adverse fertility outcomes is well established, there is no evidence that losing weight or achieving fitness prior to pregnancy improves fertility. In fact, there are studies that show excessive weight loss or activity can harm the chances for pregnancy. We are doing this study to answer the question of what is safe and best for women seeking pregnancy.” Continue reading

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Letrozole: New Oral Fertility Option for Women with Polycystic Ovary Syndrome (PCOS)

Letrozole: New Oral Fertility Option for Women with Polycystic Ovary Syndrome

Data were analyzed based on the intent-to-treat population. P values were calculated with the use of the chi-square test or Fisher’s exact test for categorical data.

In the Pregnancy in Polycystic Ovary Syndrome II (PPCOS II)¹ clinical trial, the aromatase inhibitor letrozole (Femara) demonstrated significantly greater rates of ovulation, conception, pregnancy, and live birth, compared with the selective estrogen receptor modulator clomiphene citrate (Clomid) when given for up to five menstrual cycles in women with PCOS (Figure). The main findings of PPCOS II were published in the New England Journal of Medicine last summer (2014).¹ The trial, initiated and led by Richard Legro, M.D., of Penn State Hershey Obstetrics and Gynecology, sought to identify and compare safer, more cost-effective, oral infertility treatments that could be used as first-line options for women with PCOS. Both treatments were fairly well tolerated; the most common adverse events were hot flushes (clomiphene), dizziness, and fatigue (letrozole). Continue reading

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Welcome to the OB/GYN Report

John T. Repke, M.D., F.A.C.O.G.

John T. Repke, M.D., F.A.C.O.G.

Greetings from Penn State Hershey! I am pleased to share with you the first issue of the OB/GYN Medical Report from the Department of Obstetrics and Gynecology of the Penn State College of Medicine and Penn State Milton S. Hershey Medical Center.

We recognize the importance of collaboration among our peer physicians, and regularly work with other academic medical schools to propel our field forward through new research discoveries, better patient care, and educating new physicians. Our hope is that this publication helps inform physicians like yourself of some of this important work, and that you find it to be a valuable resource.

In the coming year, this publication will feature Penn State Hershey clinicians and researchers who are helping to raise current standards of patient care and shape the future of OB/GYN practice. Our department features five divisions – General OB/GYN, Maternal-Fetal Medicine (MFM), Reproductive Endocrinology and Infertility (REI), Gynecologic Oncology, and Urogynecology/ Minimally Invasive Gynecologic Surgery. Continue reading

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Advancing Safer, More Cost-effective Fertility Treatment Options for Women with Polycystic Ovary Syndrome (PCOS) and Couples with Unexplained Infertility

For infertile women with polycystic ovary syndrome (PCOS) or couples with unexplained infertility who wish to become pregnant, fertility treatment is often expensive and invasive, and holds greater risks. Increasingly, couples are being advised to consider in vitro fertilization (IVF) as a front line treatment. “Even though we have effective strategies for inducing ovulation and achieving pregnancy in women with PCOS or unexplained infertility, going straight to IVF for infertility treatment results in high cost and in risky multiple gestation pregnancies,“ explains Richard Legro, M.D., Penn State Hershey Obstetrics and Gynecology. Multiple gestation pregnancies are associated with risks to the mother, as well as the infant, including preterm labor and delivery, infant morbidity, and ensuing financial and personal burden to the parents. Worldwide, rates of twin pregnancies have increased nearly 60 percent, and rates of higher-order multiple pregnancies have increased a staggering 400 percent since 1980, largely ascribed to infertility therapy, including injectable gonadotropins and IVF. Gonadotropin regimens are also associated with increased risk of ovarian hyperstimulation syndrome which can be life-threatening. Continue reading

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