New Advancements In Improving IVF Success
The new era of comprehensive chromosome screening has ushered a paradigm shift in IVF. Trophectoderm biopsy and 24 chromosome screening, coupled with vitrification and frozen embryo transfer, allows confident selection of a single embryo at any age, dramatically improving live birth rates, reducing miscarriage rates, and minimizing complications from multiple pregnancies. Yet despite this significant leap forward, 30% of euploid, morphologically normal embryos will not implant. While the reasons for implantation failure are not certain, it is likely that the significant contributing factors include a) embryonic challenges belied by normal chromosomes and b) endometrial receptivity issues.
Objectives:
1) Understand the advantages and limitations of comprehensive chromosome screening.
2) Review embryonic and maternal causes of implantation failure of a euploid embryo.
3) Discuss new diagnostic and therapeutic modalities to address these issues.
Dr Nakhuda is co-director of Olive Fertility Centre.
Dr Nakhuda graduated from New York Medical College and spent the next 12 years at New York's Columbia University Medical Center. There he completed a residency in obstetrics and gynecology, which he followed up with a fellowship in reproductive endocrinology and infertility. Dr Nakhuda also served on faculty at the Center for Women's Reproductive Care. During his time at Columbia University, he was active in both basic science and clinical research, publishing over 20 research articles and text book chapters. He repeatedly received the “Patients Choice Award” for outstanding clinical care. Married to a BC native, he moved to Vancouver in 2011, delighted to work with Drs. Yuzpe, Taylor, Hitkari, & Fluker at the Olive Fertilty Centre.
Dr Nakhuda's special interests include polycystic ovarian syndrome, fertility preservation, recurrent pregnancy loss, and embryology laboratory technology. He is board-certified in both ob-gyn and reproductive endocrinolgy and infertility by the American Board of Obstetrics & Gynecology.
DR GARY NAKHUDA - PUBLICATIONS
Nakhuda GS, Douglas NC, Thornton MH, Guarnaccia MM, Lobo R, Sauer MV, Anti-Müllerian hormone testing is useful for individualization of stimulation protocols in oocyte donors. Reprod Biomed Online, February 2011 22 Suppl 1:S88-93. doi: 10.1016/S1472-6483(11)60014-X
read more: http://www.ncbi.nlm.nih.gov/pubmed/21575855
Yu B, Douglas N, Ferin MJ, Nakhuda GS, Crew K, Lobo RA, Hershman DL, Changes in markers of ovarian reserve and endocrine function in young women with breast cancer undergoing adjuvant chemotherapy. Cancer, May 2010116(9):2099-105. doi: 10.1002/cncr.25037
read more: http://www.ncbi.nlm.nih.gov/pubmed/20187091
Nakhuda GS, The role of mullerian inhibiting substance in female reproduction. Curr Opin Obstet Gyneco, June 2008 257-64. doi: 10.1097/GCO.0b013e3282fe99f2. Review
read more: http://www.ncbi.nlm.nih.gov/pubmed/18460940
Nakhuda GS, Sauer MV, Wang JG, Ferin M, Lobo RA, Müllerian inhibiting substance is an accurate marker of ovarian response in women of advanced reproductive age undergoing IVF. Reprod Biomed Online, April 2007 14(4):450-4
read more: http://www.ncbi.nlm.nih.gov/pubmed/17425826
Nakhuda GS, Chu MC, Wang JG, Sauer MV, Lobo RA, Elevated serum müllerian-inhibiting substance may be a marker for ovarian hyperstimulation syndrome in normal women undergoing in vitro fertilization. Fertil Steril, May 200685(5):1541-3. Epub 2006 Mar 29
read more: http://www.ncbi.nlm.nih.gov/pubmed/16566934