Today we discussed a patient with good quality expanding blastocysts who, unexpectedly, is not getting pregnant following implantation.
At Sims IVF, we were delighted to welcome the renowned nutritional biologist and author Dr Marilyn Glenville to the Clinic today for a talk on male Infertility and nutritional interventions.
G-CSF (granulocyte colony stimulating factor) is a natural cytokine (chemical messenger) which is normally found in the body, and neupogen (filgrastim) is a synthetic (recombinant) form of G-CSF . Higher levels of natural G-CSF seem to be found in follicles which go on to produce healthy eggs compared to follicles which produce poor eggs. Higher levels of G-CSF are expressed in healthy embryos and in healthy placenta, so it is a marker of embryonic/placental viability that seems to have a role in communicating with the endometrium to allow implantation. It is suggested that it may improve lining thickness and egg quality (although the number of patients he has tried it out on for egg quality is apparently very small), as well as placental growth and may permit a successful live birth for ladies who have failed to respond to IVIG. For patients who respond well to it, he believes it can replace IVIG.
Today Dr Bart gave a general lecture on the role of natural killer cells in pregnancy and recurrent miscarriage. Needless to say this is a very complex area involving diverse HLA receptors, adhesion molecules & cytokines. We are developing new modalities to address these – we will bring you further news on these developments as soon as we can.
Today the medical team were joined by a visiting physician from INVIMED in Poland. Our discussions focussed on the recent ESHRE meeting, which took place in London over the last few days.
Today marked the celebration of the first baby in Ireland born to Elonva compliments of our very own Dr Lyuda. Elonva or Corifollitropin alfa is a long acting gonadotrophin which aims to remove the burden of daily injections from suitable patients.
This week, our team has discussed new guidelines for the management of miscarriage and ectopic pregnancies. Thankfully ectopic pregnancies are a relatively rare occurrence, but they do require swift and decisive action. We discussed the case of a patient with multiple failed cycles, two at Sims and two elsewhere. Our new FMR 1 test showed up a low, norm allele ratio on the fragile X gene so we can now counsel this patient that she needs a specifically modified protocol (with more embryos transferred), to match the normal chances of successful pregnancy. In addition, her stress markers were high, so a three month break with DHEA supplementation was recommended. Dr. David Walsh, MRCOGSims IVF
Sims IVF installed the Eeva™ (Early embryo viability assessment) test which involves time lapse technology in January 2013.
Preliminary audit of the first cases of time lapse selection tool utilising the Eeva system at Sims IVF has confirmed recently published results from a British study (below).Our audit of Eeva completed this year confirms the major benefits of Eeva in selecting viable embryos. 55% of our patients who had one or more embryos with high implantation potential by Eeva achieved a pregnancy.The British study focused on the transfer of blastocyst embryos, and quite remarkably in the Irish population, all of our Sims patients with one or more either high implantation Eeva embryos transferred at the blastocyst stage achieved a pregnancy.This preliminary assessment in an Irish population confirms the major benefits of Eeva selection in identifying those patients with the best chances of achieving pregnancy and maximising their chance of conceiving.The message for us as clinicians at Sims is that we need to be much more proactive in combining the structural benefits of assessment at the blastocyst stage with the functional assessments of the genetic potential of the embryo with the Eeva timelapse selection tool.This combination of technologies in our hands results in an extremely high chance of pregnancy. We are continuing further investigations to further establish the benefits of Eva selection in routine IVF practice.
Ann Bracken, Mind/Body Programme facilitator and Fertility Counsellor featured in Modern Medicine - The Irish Journal of Clinical Medicine.
Ann Bracken, Mind/Body Programme facilitator and Fertility Counsellor featured in November 2011 issue of Irish Tatler Magazine.
Ann Bracken, Mind/Body Programme facilitator and Fertility Counsellor discusses the benefits of taking an integrative approach to managing stress in fertility treatment in Easy Parenting Magazine