Your San Diego fertility center: Reproductive Sciences Center & Genetics Institute

Fertility Research at Reproductive Sciences Center

Although our primary mission is to assist our patients in successfully achieving a pregnancy, we also feel a strong responsibility to infertility patients around the world that are unable to receive treatment at Reproductive Sciences Center in San Diego . Thus, on a regular basis, we release our latest research findings in the hope that other fertility centers can utilize that information to help their patients.

Below are summaries of our important scientific research projects. To read detailed information about any of them, click on the title.

Early Administration of Additional Vaginal Progesterone Support has a Detrimental Effect on Implantation Rates in Embryo Recipient Cycles.
Research presented at the American Society for Reproductive Medicine (ASRM), Washington, D.C., 2007.

Relationship Between Sperm Survival Assay Results Performed for Quality Control (QC) Testing of Plastic Cultureware and IVF Outcome.
Award-winning research presented at the Pacific Coast Fertility Society, 2007.

Paternal Factors, Specifically Low Sperm Motility and High Levels of Moderate DNA Damage, Predict Increased Rates of Aneuploidy in Embryos from Egg Donor Cycles.
Research presented at the Pacific Coast Fertility Society, 2007.

Efficient Derivation of Xeno-free Human Embryonic Stem Cell Lines from Fresh Embryos Following Preimplantation Genetic Diagnosis (PGD). Research presented at the International Society for Stem Cell Research (ISSCR), Cairns, Australia, 2007.

Attitudes of Reproductive Oocyte Donors Towards Donating Oocytes for Embryonic Stem Cell Research. Research presented at the International Society for Stem Cell Research (ISSCR), Cairns, Australia, 2007.

Use of GnRH Antagonists in Egg Donation Cycles is Associated with Reduced Serum Estradiol and LH Levels Compared to Agonist Cycles with and without LH Supplementation, But Has No Effect on Implantation or Pregnancy Rates.
Research presented at the American Society for Reproductive Medicine (ASRM), New Orleans, 2006.

Aneuploidy Rates In Young Egg Donors Are Highly Variable And May Be Related To The Presence of a Male Factor, But Are Not Predictive of Cycle Outcome.
Research presented at the American Society for Reproductive Medicine (ASRM), New Orleans, 2006.

Characterization of four sperm cell populations resolved and flow cytometry sorted by the Sperm Chromatin Structure Assay (SCSA®). Research presented at the American Society for Reproductive Medicine (ASRM), New Orleans, 2006.

No Deleterious Effect of IVF on Singleton Birth Weight and Pre-term Delivery Rate in Oocyte Donation Cycles for Either Infertile Recipients or Fertile Gestational Surrogates.
Research presented at the American Society for Reproductive Medicine (ASRM), Montreal, 2005.

Sperm DNA Damage as Measured by the Sperm Chromatin Structure Assay (SCSA) Does Not Predict Sperm Survival Rate.
R esearch presented at the American Society for Reproductive Medicine (ASRM), Montreal, 2005.

Response to Controlled Ovarian Hyperstimulation (COH), as Measured by Peak Estradiol Levels and Number of Follicles, Does not Correlate with Singleton Birth Weight in Oocyte Donation Cycles.
Research presented at the American Society for Reproductive Medicine (ASRM), Montreal, 2005.

High, But Not Moderate, Levels of Sperm DNA Fragmentation are Predictive of Poor Outcome in Egg Donation Cycles.
Research presented at the American Society for Reproductive Medicine (ASRM), Philadelphia, 2004.

It has been proposed that young healthy eggs like those from egg donors might have the ability to “heal” or at least overcome the negative effects of damaged sperm. In this study we looked at the outcome of egg donation cycles in men with low, moderate, and high levels of sperm DNA damage as measured by the DNA Fragmentation Index (DFI), a part of the Sperm Chromatin Structure Assay (SCSA). If there was no beneficial effect of the donor eggs, we have expected to find that the pregnancy rates would have progressive fallen as the level of sperm damage increased from low to moderate to severe. Instead, we found that only high levels of sperm damage appeared to negatively effect pregnancy rates, suggesting it is possible that donor eggs can overcome the ill effects of sperm damage, but that this capacity is limited.

Effect of Medications on Semen Analysis and Sperm Chromatin Structure Sssay (SCSA) Parameters.
Award-winning research presented at the American Association of Bioanalysts (AAB), Los Vegas, 2004.

Little is known of the effects of common taken medications on male fertility. In this preliminary study, we looked at the relationship between one of the most sensitive measures of sperm damage, the Sperm Chromatin Structure Assay (SCSA) and several classes of medications: cholesterol lowering agents, hair loss reduction products (5-alpha-reductase inhibitors), antihypertensives, psychoactive agents, antiulcer agents and antihistamines. We found that men taking cholesterol lowering agents or anti-ulcer medications had significantly elevated levels of sperm damage as compared to men taking no medications. More research needs to be done before we can conclude that these classes of medications actually cause male infertility, but we have seen several cases in which sperm quality improves after discontinuing them. Obviously, no one should ever stop a medication without discussing with their physician first.

Cryopreservation Has No Detrimental Effect on Implantation and Pregnancy Rates in Egg Donation Cycles
Research presented at the Alpha Society Scientific Meeting, Antwerp, Belgium, 2003.

Occasionally during the course of planning or conducting an egg donation cycle, it becomes clear that performing an embryo transfer during that cycle is either inadvisable (e.g., the uterine lining is too thin) or impractical (e.g., the recipient has a family emergency and will not be available). In cases like this, the question always arises: Should the cycle be cancelled and restarted when a “fresh transfer” is possible or should the eggs be removed, fertilized, and frozen as embryos, then transferred in a future frozen embryo transfer (FET) cycle? In this study, we compared the outcome of cycles in which a fresh transfer was performed with those in which the embryos were electively frozen and transferred later in an FET cycle. The results were quite interesting. Ninety percent of the embryos in the FET cycles successfully survived the thaw with a subsequent clinical pregnancy rate of 90%, which compared favorably to the 83% pregnancy rate seen in fresh cycles. Thus it appears that in the vast majority of cases, continuing the egg donation cycle and freezing the embryos for a future transfer is the best strategy because it eliminates the extra time and expense that results from cancelling and restating an egg donation cycle.

Gestational Surrogacy Enhances Implanatation Rates in Egg Donation Cases
(Presented at the American Society for Reproductive Medicine (ASRM), 2003)

Although it widely accepted that the most important female factor in successfully acheiving a pregnancy is egg (oocyte) quality, the role of uterine "stickiness" (in the absence of obvious uterine abnormalities) is controversial. The aim of this study was to assess the contribution of a possible uterine factor on implantation by comparing embryo transfers into surrogate and non-surrogate recipients. By looking only at egg donation cycles, any effect of egg quality was controlled. We looked at all cases performed over a five year period (1997-2002) to make sure our results were consistent. We found that surrogates had a higher implantation rate (the chance that any one embryo will implant) than non-surrogates in both fresh (42% vs. 33%) and frozen embryo transfer (28% vs. 15%) cycles, with pregnancy rates being much higher in surrogates (74%) than non-surrogates (43%) in FET cycles and somewhat higher (73% vs 65%) in fresh embryo transfer cycles. These results strongly suggests that uterine "stickiness" plays an important role in acheiving a successful pregnancy in addition to any effects of egg quality. It also supports the use of a gestational surrogate for patients with repeated pregnancy failure using egg donation or their own eggs.

Intracytoplasmic Injection of Testicular Sperm Results in Higher Fertilization Rates than Ejaculated Sperm from Oligoteratozoospermic Males
(Presented at the American Society for Reproductive Medicine (ASRM), 2000)

For patients with no sperm in the ejaculate, ICSI combined with testicular sperm extraction may enable them to achieve a pregnancy using the male partners sperm. Unlike previous studies, we had observed that in the majority of our ICSI cases using testicular sperm (TESE cases) we were able to achieve higher fertilization rates than with the male-factor non-TESE cases, thus having more embryos to select from. We were interested to determine whether this was a significant difference and, if so, whether this was due to different laboratory techniques, or the type of infertility patient receiving the TESE procedure. Our study indicated that a significantly higher fertilization rate was achieved with the testicular sperm, and that this was probably due to the fact that the majority of TESE patients had an obstruction causing the infertility and therefore normal sperm formation, whereas the majority of ICSI cases using ejaculated sperm were on men with defective sperm development.

Activation of Human Oocytes using Calcium Ionophore After ICSI Increases Fertilization and Number of Embryos for Couples with a History of Low ICSI Fertilization Rate.
(Presented at the European Society of Human Reproduction and Embryology (ESHRE), 1999)

ICSI is a highly successful procedure for overcoming male infertility, however, there are some patients who even with ICSI are unable to achieve fertilization, or only achieve such low fertilization rates that they have too few embryos to achieve a pregnancy. Using a special chemical called an "ionophore' we were able to increase fertilization rates for some patients with a history of low ICSI fertilization, without observing any detrimental effects on embryo quality, and achieve successful pregnancies. The ionophore acts by briefly increasing calcium levels within the egg resulting in "activation" or triggering of the fertilization process.

Immediate Insemination of Human Oocytes by IVF or ICSI does not Reduce Fertilization Rates.
(Presented at the Pacific Coast Fertility Society, 1999)

Procedures for insemination of eggs (both IVF and ICSI) have usually incorporated a preincubation period of several hours to allow eggs to complete the maturation process. The optimal length of this incubation period may vary from patient to patient depending on the maturity and quality of the eggs. In an attempt to determine whether higher fertilization rates and better quality embryos could be obtained by reducing or expanding the preincubation period, a study was undertaken comparing the outcomes from cases with different preincubation periods. The results showed that the preincubation period did not appear to increase fertilization rates for IVF or ICSI, and that pregnancy rates with IVF may actually be higher when eggs are inseminated soon after retrieval.

Gestational Surrogacy Greatly Enhances Pregnancy and Implantation Rates in Both Fresh and Frozen Embryo Transfers
(Presented at the Pacific Coast Fertility Society, 1999)

We observed that overall higher pregnancy rates are achieved with gestational surrogacy compared to non-surrogate cycles. In an attempt to improve implantation rates for patients, we evaluated our results from a series of fresh and frozen surrogate and non-surrogate cases to determine whether this was a result of a more optimal uterine environment due to the hormonal status of the patient (stimulated versus a non-stimulated) or other unknown aspects of uterine receptivity. Our results suggested that surrogacy may benefit patients with unexplained infertility who have failed multiple ART cycles.

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