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REI at the University of Illinois Hospital & Health Sciences System, located in Chicago, is constantly striving to improve patient care at an individual level. To achieve this we have analyzed the data from completed IVF treatment cycles in several ways in order to ensure that the best care and treatment approach is being offered to every patient. The results from our studies have been selected for presentation at national meetings and have led us to make important changes to patient treatment such as selection of ovarian stimulation protocols, requirement for the use of aspirin, number of embryos to transfer and regulation of thyroid hormone levels during IVF treatment and pregnancy. Please find below a list of our current research projects approved by the UIC IRB:
Optimization of Fertility Treatment for Women Who Have a Poor Response to Fertility Drugs
As part of our efforts to optimize pregnancy outcomes in our IVF program, we have evaluated women who have poor response to fertility drugs while undergoing treatment. We have found several strategies which improve our live-birth rates in these patients, including a short GnRH agonist protocol to prevent spontaneous ovulation & withholding baby-aspirin administration. Other strategies which we plan to study to improve live-birth rates in these poor responder patients are: mixed ovulation induction protocols, luteal choriogonadotropin boosters, & DHEA ovarian priming.
Impact of Thyroid Function on IVF Outcomes
In our preliminary study, we found that hypothyroid patients on levothyroxine supplementation undergoing IVF have significantly decreased implantation & pregnancy rates compared to patients without hypothyroidism. We found no differences in the clinical miscarriage rates. Based on these results, we now plan a larger prospective study to confirm these findings, & to determine the optimal level of thyroid hormone supplementation prior to and during an IVF cycle.
National Cancer Institute (NCI) Collaborative Study on the long term effects of fertility drugs in Infertile Women
We are studying a group of 12,000 women who underwent fertility therapy between 1965 and 1988. To date, this is the largest epidemiologic study of infertile patients treated with ovulation inducing agents, with follow-up stretching up to 20 years. We studied the effect of fertility drugs on ovarian and breast cancer and found reassuring results regarding the effects of ovulation-stimulating drugs on cancer risk. We now plan to extend our observations in these 12,000 women to the next ten years after exposure to fertility drugs to assess the long term impact after 30 years.
National Physicians Cooperative (NPC) to Preserve Fertility for Women with Cancer
This project is sponsored by the "Oncofertility Consortium" with the intent to study fertility preservation in women with cancer before they undergo chemotherapy or radiation. The objective of this study is to achieve long-term cryopreservation (freezing) of ovarian tissue & develop in vitro techniques that will allow maturation of oocytes (eggs) from frozen ovarian tissue. We are one of 20 institutions that will recruit suitable patients with a cancer diagnosis. Women will provide one ovary for these research studies. Patients will have 80% of this one ovary frozen for their future reproductive use after they are in cancer remission. The remaining 20% of the ovary will be used for cryopreservation and in vitro maturation studies.
Impact of Endometrial "Scratching" and Chronic Endometritis in IVF Outcomes
We are studying the effect of "scratching" the lining of the uterus in patients going through IVF to determine whether there is any impact on pregnancy rates. We are also evaluating the impact of inflammatory cells on subsequent pregnancy rates. This is a research collaboration with Duke University in North Carolina and the goal is to recruit a total of 150 patients.