StartART Nursing Congress

On August 1st, I went to Baltimore to attend the StartART Nursing Congress. My fellow attendees were primarily nurses who work in reproductive health and IVF clinics. The presenters were MD’s (reproductive endocrinologists), geneticists, and ethicists from Harvard, Stanford, Weill Cornell, Yale, Vanderbilt and other prestigious centers.

Way too many words and stats appeared on their Power Point slides, but I would like to share some highlights, based on common questions from my patients. 

  • Letrazole appears to be more successful than Clomid in women with poly cystic ovaries but not for those with unexplained infertility.  Adding Metformin may help pregnancy rates and lower miscarriage rates. 
  • Inositol (a member of the Vitamin B family) can help ovulation. No solid data on whether it increases pregnancy rates.
  • Weight gain can induce the development of Polycystic Ovaries. This association was seen when college women who were studied after gaining weight after starting college. From the lecture of Dr. Elizabeth Ginzburg, Harvard Medical School

Embryos with evidence of mosaic cells (chromosomally abnormal cells) can become normal babies. However, the higher the percentage of mosaic cells, the more likely there is to be a problem. From the lecture of Marcus Hughes, Clinical Molecular Geneticist

  • There is a higher miscarriage rate for women who consumed over 4 or 5 drinks per week, during the months leading up to pregnancy.
  • There is some evidence that Progesterone is helpful in recurrent pregnancy loss.
  • In the event of a second miscarriage, a woman should try to preserve some of the “products of conception” to have them tested.  Dr. Kutteh stated that 95% of the time, the reasons for recurrent pregnancy loss can be determined.
  • There is NOT good evidence that treating the MTHFR, Protein Z, or Factor V , is at all helpful unless a woman or a lot of her first degree relatives have had a history of blood clots. From the lecture of Dr. William Kutteh, Reproductive Endocrinologist, Vanderbilt University.

What the future may hold:

Making eggs and sperm from a person’s skin cells will probably be possible in 15 to 30 years, or 20 to 40 years, depending on which researcher you talk to.  It is already being done successfully in mice. From the lecture of Henry T.  Greely, Professor of Law and Genetics, Stanford University.

Cells for genetic testing of embryos will be able to be taken from the culture medium that the embryo is living in rather than the embryo itself, which will be less invasive for the embryo. From the lecture of Marcus Hughes, Clinical Molecular Geneticist.

Stem cells from bone marrow or embryonic stem cells can help women who have a history of a thin endometrial lining. They migrate to the uterus and help it proliferate. From the lecture of Dr.Hugh Taylor, MD, Professor of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine.

If you choose to ask your doctor about this research or any information you find on the internet, remember that one study does not mean that protocols or standard treatments should be changed. Results can change when studies are repeated. In addition to this , not everyone agrees with the interpretation of data from a given study. And know that when medical journalists profile a study or research they extracted from a journal and published in the mainstream media, they sometimes “distill” the information in a way that may be misleading, or incomplete. There are some fine medical journalists out there, but be aware.

I enjoy bringing my patients information about current research and what things may help them in the future. I am hoping to attend the American Society of Reproductive Medicine Conference in October, and will plan to bring you some of the “pearls” from that.

Jane