- Age-specific anti-Müllerian hormone values determined for US women of reproductive age who present to fertility centers. from Endocrine Today Click Here for website
Seifer DB. Fertil Steril. 2011;95:747-750.
From ages 24 to 50 years, anti-Müllerian hormone levels steadily diminish. Researchers for a new study have suggested that although a normal range of reference values have been available for women of reproductive age, age-specific values could potentially be of greater clinical use.
“What has been used in clinical practice has been a range of normal values for women in general without any reference to age,” researcher David B. Seifer, MD, of Genesis Fertility and Reproductive Medicine at Maimonides Medical Center and New York University School of Medicine, told Endocrine Today.
Between 2007 and 2010, Seifer and colleagues determined single-year interval median and mean anti-Müllerian hormone values for 17,120 unselected women aged 24 to 50 years. All women presented to US fertility clinics in 37 states.
The researchers used single-year intervals to evaluate median and mean anti-Müllerian hormone levels. Results demonstrated a continual linear decrease as women’s ages increased, with the average annual decline in median serum anti-Müllerian hormone values reaching 0.2 ng/mL by age 35 years. This number, however, stabilized at 0.1 ng/mL for each year thereafter. Additionally, the yearly rate of decrease in mean anti-Müllerian hormone levels was 0.2 ng/mL until age 40 years before subsequently decreasing to 0.1 ng/mL.
“Given the increasing utility and frequency of use of [anti-Müllerian hormone] in clinical evaluations of fertility, trends in age-specific reference values for [anti-Müllerian hormone] may provide added perspective for clinicians and couples who are considering fertility treatment options,” the researchers wrote in the study.
Most studies investigating anti-Müllerian hormone levels historically come from Europe because anti-Müllerian hormone levels are used more frequently outside of the United States, according to Seifer. “The value of this study lies in its design because it yields useful information on age-specific anti-Müllerian hormone levels in US women,” he said.
The researchers said the anti-Müllerian hormone reference values “cannot be used in isolation to provide counseling about a woman’s chance for a successful ovulation induction or ability to have a child.” They noted, however, that anti-Müllerian hormone reference values may be used as one component during evaluation of reproductive potential and treatment options to conceive. Results of this study may further aid patients and physicians in determining which treatment options may be preferred. For example, if a woman’s anti-Müllerian hormone level is much lower than anticipated for her age, she and her physician may want to approach treatment more aggressively, Seifer said.
The data provide greater insight intoa woman’s remaining egg supply at a specific age, he added.
“Clinical scenarios where age-specific anti-Müllerian hormone values may be informative include women presenting with a history of infertility trying to decide between different therapeutic options; women with newly diagnosed cancer who will to assess their options for Fertility Preservation prior to undergoing chemotherapy or to assess the return of ovarian function after receiving chemotherapy; and women who may be questioning the timing of the onset of menopause,” he said. – by Melissa Foster
- Dr, Richard Grazi - listed in TopDocamerica.com http://www.topdocamerica.com/richard-v-grazi.
- One Embryo Better Than Two in In Vitro Fertilization - ABC NEWS
- Female Athletes Are Too Fit To Get Pregnant - ABC NEWS
- Heavy women's miscarriage risk higher after IVF - ABC NEWS
- Dr. Kris Bevilacua discusses male infertility / fertility with Dawn Davenport on a web radio show.
Click Here to listen.
- New article online at the UMDNJ website featuring David Seifer and the extensive research he has performed in the field of Reproductive Endocrinology. Click Here
- GENESIS FERTILITY & REPRODUCTIVE MEDICINE NAMED “CLINICAL CENTER OF EXCELLENCE”
The Maimonides Program Is Cited Among Best in the Nation
BROOKLYN, NY (January 14, 2010) – GENESIS Fertility & Reproductive Medicine, the program for infertility and assisted reproduction at Maimonides Medical Center, has been named one of America’s “Centers of Excellence” in the field of infertility by Contemporary OB/GYN, a peer-reviewed journal for practicing obstetrician/gynecologists. GENESIS is listed among the most elite fertility centers in the nation, including The Cleveland Clinic, Brigham and Women’s Hospital in Boston and the Yale Fertility Center.
“We are certainly pleased that our colleagues have included us in the same category of excellence as some of the best known reproductive medicine centers in the country,” said David Seifer, MD, co-director of GENESIS and scientific director of the Division of Reproductive Endocrinology at Maimonides. “Of course, our patients’ satisfaction is, by far, our most important measure of success.”
GENESIS offers the full range of services for couples with infertility – from the simplest treatment options to the most advanced, including in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI) and pre-implantation genetic diagnosis (PGD) – in a single setting. It has consistently produced pregnancy rates that are well above national rates, while keeping high order multiple rates significantly below national levels.
“We believe this recognition reflects the exceptional care and outstanding results we deliver for our patients,” added Richard Grazi, MD, co-director of GENESIS and director of the Division of Reproductive Endocrinology at Maimonides. “Our team of talented and highly caring professionals provides comprehensive services to couples with infertility, tailored very specifically to their needs.”
The infertility centers highlighted as Centers of Excellence in a recent issue of Contemporary OB/GYN are “programs offering comprehensive infertility testing, diagnosis, and treatment complemented by participation in evolving infertility and genetic research arenas.” They were selected based on a survey of the journal’s readers: more than 40,000 obstetrician/gynecologists from across the country. Each center provided patient statistics, research protocols, funding information, areas of concentration and detailed information on services offered.
GENESIS Fertility & Reproductive Medicine has offices at 1355 84th Street in Brooklyn and 1855 Richmond Avenue in Staten Island. For more information about the services at GENESIS, please call (718) 283-8600 or log-on to www.maimonidesmed.org/genesis.
Race, ethnicity may influence reproductive life
Last Updated: 2009-12-25 13:00:35 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Race and ethnicity may be important factors in women's reproductive lives, from the timing of the first menstrual period to the severity of menopausal symptoms, a new research review finds.
A growing number of studies in recent years have found racial and ethnic disparities in women's reproductive health, but the reasons remain unclear.
In the new review, published in the journal Fertility and Sterility, researchers found that in general, race and ethnicity affected the timing of puberty, the odds of successfully becoming pregnant through fertility treatment and the transition into menopause.
Compared with white women, black and Hispanic women typically started menstruating at an earlier age, while Asian women tended to start later -- though the data on that last finding are conflicting.
Several large U.S. studies suggest that black girls start to show signs of puberty about one year earlier, on average, than white girls -- around age 9, versus age 10 -- and start menstruating close to a year earlier. Hispanic girls tend to fall somewhere in between.
A few reports suggest that Asian girls typically hit puberty later than white and Hispanic girls. One U.S. study, however, found that girls of Asian descent began menstruating at a slightly earlier age than white girls.
The reasons for these racial and ethnic differences are not certain, according to Dr. Samantha F. Butts, of the University of Pennsylvania in Philadelphia, and Dr. David B. Seifer, of Mt. Sinai School of Medicine in New York.
One possibility, they write, is the difference in rates of childhood obesity, since greater fat mass may spur earlier puberty. On the other hand, there is evidence that earlier puberty contributes to excessive weight gain thereafter. It remains unclear which comes first, according to Butts and Seifer.
When it comes to assisted reproduction, a number of studies -- though not all -- have found that black women have lower success rates than white women. In one U.S. study, for example, the birth rate among black women undergoing their first cycle of fertility treatment between 2004 and 2006 was 22 percent; that figure was 32 percent among white women.
Few studies on assisted-reproduction outcomes have included Hispanic and Asian women, but some suggest that these women also have a lower success rate than white women.
Again, Butts and Seifer write, the reasons for these findings are unknown. One possibility is that minority women have less access to fertility treatment, and may have longer-standing infertility by the time they do get help. Differences in the underlying cause of the infertility, lifestyle habits or genetics could also be at work, the researchers note.
Finally, when the investigators looked at menopausal symptoms, they found that black women were generally more likely than white women to suffer symptoms like hot flashes, night sweats and vaginal dryness, while rates tended to be lowest among Asian women.
Obesity may, again, be a factor, since body fat levels affect hormone balance. However, Butts and Seifer write, studies suggest that even when body fat is taken into account, race itself seems to influence menopausal symptoms.
As for the timing of menopause, there is some evidence that black women begin menopause earlier than white women. However, there is not enough research to draw firm conclusions yet, according to the report.
More studies, Butts and Seifer write, are needed to tease out the various reasons for racial and ethnic differences in reproductive function -- and to, when possible, improve minority women's fertility treatment outcomes and management of menopausal symptoms.
SOURCE: Fertility and Sterility, online November 24, 2009.
- Dr. David Seifer Quoted in Wall Street Journal Health Blog on Drug Scandal of Major League Baseball Player Manny Ramirez - Women who have used home pregnancy tests may be familiar with HCG, the substance that got Los Angeles Dodgers slugger Manny Ramirez banned from baseball for 50 games. HCG, or human chorionic gonadotropin, is a hormone produced during pregnancy and is what pregnancy test strips detect if they determine a woman is expecting, as this patient-information sheet from JAMA explains. HCG appears in a woman’s blood or urine as early as 10 days after conception, the NIH says. The body also secretes HCG during certain kinds of cancers. Brand names for the drug include Chorex, Novarel, Ovidrel, Pregnyl and Profasi, according to this page from Mayo Clinic. It is used by women to who are having fertility problems. And it helps men produce male hormones such as testosterone, which helps increase the production of sperm, the site says. Men with fertility problems — which can be a side effect of steroid use — may have HCG prescribed, the New York Times notes. “Often infertile men will take it because it’s believed that it might increase the quantity and the quality of their sperm,” David Seifer, co-director of Genesis Fertility & Reproductive Medicine in Brooklyn, N.Y., and a professor at Mount Sinai School of Medicine, tells the Health Blog. “By doing that, it will increase the testosterone as well.” Gary Wadler, chairman of the prohibited list and methods committee of the World Anti-Doping Agency, said steroid users often take HCG when they are coming off a round of steroids, which shut down the body’s natural production of testosterone, the WSJ explains. Men sometimes take HCG if they have had problems with their testicular or pituitary glands, WSJ adds. By Sarah Rubenstein LINK to WSJ
- Dr. David Seifer Quoted in Wall Street Journal Article - "A New measure in Fertility Testing - Doctors Say Hormone Gauge Gives an Accurate Egg Count; Still Awaiting FDA
Clearance" SOURCE: Wall Street Journal April 22, 2008. Link to Article
- April 1, 2009 - New Location Opening in Staten Island - Genesis is opening a new location on Staten Island to better serve the patients of Genesis. Click for More
- Fox News NEW YORK — African-American women who undergo in vitro fertilization (IVF) are less likely to ultimately have a baby than are their white counterparts, a new U.S. study suggests. Using data for more than 70,000 IVF treatment cycles performed nationally, researchers found that black women who underwent IVF using their own unfrozen eggs were less likely to become pregnant and more likely to miscarry than white women having the same procedure. The birth rate per treatment cycle was about 19 percent among black women, versus 26 percent among white women. There was, however, no racial disparity among women who underwent IVF using frozen embryos, with birth rates of 16 percent for white women and 16.5 percent for black women. The researchers, led by Dr. David B. Seifer of Maimonides Medical Center in Brooklyn, New York, report the findings in the journal Fertility and Sterility. Some previous studies examined the racial differences in IVF success rates, but have come to conflicting conclusions. To try to resolve the question, Seifer's team used data from a federal registry that collects information from fertility clinics nationwide; the researchers focused on 72,273 IVF treatment cycles performed between 1999 and 2000. The majority were performed in white women, with African-American women accounting for about 3,700 of the treatment cycles. The reasons for the lower success rate among black women are not clear, but the data suggest some possibilities, according to Seifer and his colleagues. Black women, they note, tended to have more abnormalities of the pelvic structures, which can lower the likelihood of pregnancy and increase the risk of miscarriage. Black women also tended to be older when they first sought IVF treatment and had fertility problems for a longer time — two more factors that dim the chances of success. More studies are needed to understand why racial disparities in IVF success exist, according to the researchers. This is especially important, they note, in light of recent research showing that while infertility is becoming less common among white U.S. women, it is on the rise among African Americans.
- Genesis featured on News 12 Long Island : Cancer and Infertility