Austin Fertility and Reproductive Medicine Westlake IVF

Earth, TX, United States

Austin Fertility and Reproductive Medicine Westlake IVF

Earth, TX, United States
SEARCH FILTERS
Time filter
Source Type

Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF | Lim C.S.,University of Michigan | Skinner B.D.,University of Michigan | Lebovic D.I.,Center for Reproductive Medicine | As-Sanie S.,University of Michigan
Current Opinion in Obstetrics and Gynecology | Year: 2016

Purpose of review Endometriosis is a common gynecologic condition estimated to affect 10-15% of reproductive-aged women, 30% of women with subfertility, and 80% of women with chronic pelvic pain. Although mainstays of diagnosis and treatment are still commonly applied, there have been various advances in the modalities of diagnosis and management of this complex condition. This article provides an updated review of novel findings regarding the diagnosis and management of this challenging disease. Recent findings Despite an abundance of studies on noninvasive diagnostic markers for endometriosis, there is no single imaging study, biomarker or panel of biomarkers that has been validated for clinical diagnosis. New technologies, such as use of indocyanine green and fluorescence, which visualize neovascularization often associated with endometriosis may improve diagnostic detection of endometriosis at the time surgery, but have not been demonstrated to improve pain outcomes after surgery. Hormone suppression remains the mainstay therapy prior to and following surgery. Although most methods demonstrate similar efficacy in reducing endometriosis-associated pain, newer pharmacologic agents that may prove advantageous include oral gonadotropin receptor antagonists, selective progesterone receptor modulators, and angiogenesis inhibitors. Summary Although there have been some advances in the study of noninvasive imaging and biomarkers, more investigation into effective modalities are being conducted and are needed. © 2016 Wolters Kluwer Health, Inc. All rights reserved.


Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF | Kavoussi K.M.,Austin Fertility and Reproductive Medicine Westlake IVF | Lebovic D.I.,University of Wisconsin - Milwaukee
US Obstetrics and Gynecology | Year: 2012

There has been great interest in researching the enigmatic disease known as endometriosis, which has been found in many women who have pelvic pain and/or infertility. Recent advances in endometriosis-related research have been made and these investigations have added to the solid foundation of literature that has already been established. This update first provides insight into these findings, which have aided in understanding the incidence and pathogenesis of endometriosis. Next, medical therapies that have been long-standing, those that have been recently applied or developed, and other novel modalities that are potentially on the horizon are reviewed. The focus of the article then shifts to the association between endometriosis and infertility as well as treatment options such as surgery and assisted reproductive technologies. © 2012 Touch Briefings.


Lebovic D.I.,University of Wisconsin - Madison | Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF | Lee J.,Texas A&M University | Banu S.K.,Texas A&M University | Arosh J.A.,Texas A&M University
Endocrinology | Year: 2013

Endometriosis is a chronic inflammatory disease of reproductive age women leading to chronic pelvic pain and infertility. Current antiestrogen therapies are temporizing measures, and endometriosis often recurs. Potential nonestrogenic or nonsteroidal targets are needed for treating endometriosis. Peroxisome proliferator-activated receptor (PPAR)γ, a nuclear receptor, is activated by thiazolidinediones (TZDs). In experimental endometriosis, TZDs inhibit growth of endometriosis. Clinical data suggest potential use of TZDs for treating pain and fertility concurrently in endometriosis patients. Study objectives were to 1) determine the effects of PPARγ action on growth and survival of human endometriotic epithelial and stromal cells and 2) identify the underlying molecular links between PPARγ activation and cell cycle regulation, apoptosis, estrogen biosynthesis, and prostaglandin E2 biosynthesis and signaling in human endometriotic epithelial and stromal cells. Results indicate that activation of PPARγ by TZD ciglitazone 1) inhibits growth of endometriotic epithelial cells 12Z up to 35% and growth of endometriotic stromal cells 22B up to 70% through altered cell cycle regulation and intrinsic apoptosis, 2) decreases expression of PGE2 receptors (EP)2 and EP4 mRNAs in 12Z and 22B cells, and 3) inhibits expression and function of P450 aromatasemRNAand protein and estrone production in 12Z and 22B cells through EP2 and EP4 in a stromal-epithelial cell-specific manner. Collectively, these results indicate that PGE2 receptors EP2 and EP4 mediate actions of PPARγ by incorporating multiple cell signaling pathways. Activation of PPARγ combined with inhibition of EP2 and EP4 may emerge as novel nonsteroidal therapeutic targets for endometriosis-associated pain and infertility, if clinically proven safe and efficacious. Copyright © 2013 by The Endocrine Society.


Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF | Kavoussi K.M.,Austin Fertility and Reproductive Medicine Westlake IVF | Lebovic D.I.,University of Wisconsin - Madison | Lebovic D.I.,GenerationS
Journal of Robotic Surgery | Year: 2014

The da Vinci® robotic surgical system has been used more often in recent years for tubal anastomosis (TA) and has been reported to have an increased operative time. A one-stitch technique has been used for the reanastomosis step in laparoscopic TA. To date, publications on robotically-assisted TA (RATA) describe an anastomotic step with multiple (usually four) sutures placed. This retrospective case series reports tubal patency data on patients who underwent RATA with the one-stitch technique; tubal patency was the outcome measure. Eighteen women (ages 27-39) underwent RATA with the one-stitch anastomotic technique in tertiary care medical centers between February 2009 and May 2012. Tubal patency was demonstrated in 16/17 patients (94.1 %), as evidenced by postoperative hysterosalpingogram (HSG) and/or subsequent pregnancies. We report the first case series which shows that RATA with a single stitch for the reanastomotic step is effective in achieving tubal patency as evidenced by postoperative HSG and/or pregnancies. © 2013 Springer-Verlag London.


Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF
Seminars in Reproductive Medicine | Year: 2013

Superovulation (SO)/Intrauterine insemination (IUI) has been used as a treatment approach for endometriosis-associated infertility. The existing medical literature regarding SO in endometriosis patients is composed of heterogeneous studies that differ in terms of study design, SO protocols, the addition of IUI, and comparison groups. There is a need for more well-designed studies to further investigate the efficacy of SO in women with endometriosis-associated infertility. Although in vitro fertilization (IVF) is most effective and is significantly superior to other treatments in endometriosis patients, most of the existing studies suggest some benefit of SO/IUI in infertility patients with early-stage disease. Therefore, SO/IUI is a reasonable early fertility treatment option for women with endometriosis who desire a short trial of potentially more cost-effective treatment options prior to pursuing an IVF cycle and those for whom IVF is not a feasible or desirable option. It appears that gonadotropins are most effective for SO in this patient population even though more head-to-head comparisons are needed. © 2013 by Thieme Medical Publishers, Inc.


Kavoussi S.K.,Austin Fertility and Reproductive Medicine Westlake IVF | Odenwald K.C.,Austin Fertility and Reproductive Medicine Westlake IVF | Boehnlein L.M.,University of Wisconsin - Madison | Summers-Colquitt R.B.,Austin Fertility and Reproductive Medicine Westlake IVF | And 5 more authors.
Fertility and Sterility | Year: 2015

Objective To determine whether antimüllerian hormone (AMH) levels predict the availability of good-quality supernumerary blastocysts for cryopreservation. Design Retrospective study. Setting Two fertility centers. Patient(s) First fresh IVF cycles (n = 247) grouped as follows: 40 women <35 year old with AMH <1 ng/mL and 77 women with AMH 1-4 ng/mL; 62 women ≥35 year old with AMH <1 ng/mL, and 68 women with AMH 1-4 ng/mL. Intervention(s) AMH level measured before IVF with ovarian stimulation protocols based on patient age and AMH level, including short gonadotropin-releasing hormone (GnRH) agonist, GnRH antagonist, or GnRH agonist microdose flare; supernumerary good-quality blastocysts cryopreserved on days 5 or 6 after retrieval. Main Outcome Measures(s) Supernumerary good-quality blastocysts for cryopreservation in relation to AMH levels. Result(s) Among women <35 years of age, there was a statistically significant difference in the number of patients with supernumerary good-quality blastocysts for cryopreservation between the groups with AMH <1 ng/mL and AMH 1-4 ng/mL (30.0% vs. 58.4%) when adjusted for age. Among women ≥35 years of age, there was a statistically significant difference in the number of patients with supernumerary good-quality blastocyst cryopreservation between groups with AMH <1 ng/mL and AMH 1-4 ng/mL (16.1% vs. 42.6%), when adjusted for age. Conclusion(s) Low AMH levels are associated with a statistically significantly lower likelihood of blastocysts for cryopreservation as compared with higher AMH levels. This effect was seen among women both <35 and ≥35 years of age. Patient counseling should include realistic expectations for the probability of good-quality supernumerary blastocysts available for cryopreservation. © 2015 American Society for Reproductive Medicine.


PubMed | Austin Fertility and Reproductive Medicine Westlake IVF and University of Wisconsin - Madison
Type: Journal Article | Journal: Journal of robotic surgery | Year: 2016

The da Vinci() robotic surgical system has been used more often in recent years for tubal anastomosis (TA) and has been reported to have an increased operative time. A one-stitch technique has been used for the reanastomosis step in laparoscopic TA. To date, publications on robotically-assisted TA (RATA) describe an anastomotic step with multiple (usually four) sutures placed. This retrospective case series reports tubal patency data on patients who underwent RATA with the one-stitch technique; tubal patency was the outcome measure. Eighteen women (ages 27-39) underwent RATA with the one-stitch anastomotic technique in tertiary care medical centers between February 2009 and May 2012. Tubal patency was demonstrated in 16/17 patients (94.1%), as evidenced by postoperative hysterosalpingogram (HSG) and/or subsequent pregnancies. We report the first case series which shows that RATA with a single stitch for the reanastomotic step is effective in achieving tubal patency as evidenced by postoperative HSG and/or pregnancies.


PubMed | Austin Fertility and Reproductive Medicine Westlake IVF
Type: Journal Article | Journal: Seminars in reproductive medicine | Year: 2013

Superovulation (SO)/Intrauterine insemination (IUI) has been used as a treatment approach for endometriosis-associated infertility. The existing medical literature regarding SO in endometriosis patients is composed of heterogeneous studies that differ in terms of study design, SO protocols, the addition of IUI, and comparison groups. There is a need for more well-designed studies to further investigate the efficacy of SO in women with endometriosis-associated infertility. Although in vitro fertilization (IVF) is most effective and is significantly superior to other treatments in endometriosis patients, most of the existing studies suggest some benefit of SO/IUI in infertility patients with early-stage disease. Therefore, SO/IUI is a reasonable early fertility treatment option for women with endometriosis who desire a short trial of potentially more cost-effective treatment options prior to pursuing an IVF cycle and those for whom IVF is not a feasible or desirable option. It appears that gonadotropins are most effective for SO in this patient population even though more head-to-head comparisons are needed.

Loading Austin Fertility and Reproductive Medicine Westlake IVF collaborators
Loading Austin Fertility and Reproductive Medicine Westlake IVF collaborators