Monash IVF

Clayton, Australia

Monash IVF

Clayton, Australia
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News Article | May 18, 2017
Site: www.eurekalert.org

Findings from new research led by the Monash Biomedicine Discovery Institute (BDI) and University College London may finally resolve, and potentially provide answers, as to why older women have higher incidences of miscarriage and have babies with chromosomal abnormalities. Female fertility declines rapidly after the age of 37 -- with women over 42 having only a five per cent chance of having a baby without fertility treatment. The problem is that as a woman ages, her eggs also age -- increasing the chances of chromosomal abnormalities. This leads to an increase in conditions such as Down's syndrome, where the egg has three copies of chromosome 21. However most chromosomal abnormalities in eggs lead to embryos that either fail to implant in the womb, or miscarry soon after implantation. In women over 40 most miscarriages are caused by the wrong number of chromosomes being present in the egg. In a paper published today in Nature Communications, Professor John Carroll from the Monash BDI, together with an international team of collaborators, reveal a fault in how the egg controls the levels of a protein called securin. In the final stages of egg development just before ovulation, it undergoes two specialised cell divisions known as meiosis I and meiosis II. Securin is important for both divisions but in old eggs, it appears that there is insufficient securin remaining to ensure meiosis II takes place normally. Most chromosome abnormalities occur in the first egg division (meiosis I) but it is known that a substantial number of abnormalities also occur during meiosis II. Dr Ibtissem Nabti and Professor Carroll's experiments help explain why things go wrong in this second division. In these older women the chromosomes in their eggs start to fall apart because there is insufficient securin to control the process. Dr Nabti, formerly from University College London, is currently at the Abu Dhabi campus of New York University. The discovery opens the way to improving an older woman's chances of having eggs with fewer chromosomal abnormalities through regulating the processes that control securin levels in the two divisions of the egg or controlling the protein that securin regulates (a protein called separase). According to Professor Carroll, new therapeutic approaches to improving egg quality in older women is very important at a time when the age at which women are having their first baby is increasing. "It is immensely challenging because any treatments need to be safe for the egg and subseqents embryo and would usually need to be applied while the egg is in the ovary," Professor Carroll said. "It may one day be possible to perform treatments in-vitro (in the laboratory) but human in-vitro egg maturation is not yet very successful." The research team is working with Monash IVF to improve in vitro maturation and identify new targets that may be able to better control prevent the degradation of Securin, according to Professor Carroll. "Now that we have an idea of at least one of the causes of the increased incidence of chromosomal abnormalities and miscarriages in older women, we can attempt to find ways to prevent this happening," Professor Carroll said. Committed to making the discoveries that will relieve the future burden of disease, the newly established Monash Biomedicine Discovery Institute at Monash University brings together more than 120 internationally-renowned research teams. Our researchers are supported by world-class technology and infrastructure, and partner with industry, clinicians and researchers internationally to enhance lives through discovery.


News Article | May 18, 2017
Site: www.sciencedaily.com

Findings from new research led by the Monash Biomedicine Discovery Institute (BDI) and University College London may finally resolve, and potentially provide answers, as to why older women have higher incidences of miscarriage and have babies with chromosomal abnormalities. Female fertility declines rapidly after the age of 37 -- with women over 42 having only a five per cent chance of having a baby without fertility treatment. The problem is that as a woman ages, her eggs also age -- increasing the chances of chromosomal abnormalities. This leads to an increase in conditions such as Down's syndrome, where the egg has three copies of chromosome 21. However most chromosomal abnormalities in eggs lead to embryos that either fail to implant in the womb, or miscarry soon after implantation. In women over 40 most miscarriages are caused by the wrong number of chromosomes being present in the egg. In a paper published today in Nature Communications, Professor John Carroll from the Monash BDI, together with an international team of collaborators, reveal a fault in how the egg controls the levels of a protein called securin. In the final stages of egg development just before ovulation, it undergoes two specialised cell divisions known as meiosis I and meiosis II. Securin is important for both divisions but in old eggs, it appears that there is insufficient securin remaining to ensure meiosis II takes place normally. Most chromosome abnormalities occur in the first egg division (meiosis I) but it is known that a substantial number of abnormalities also occur during meiosis II. Dr Ibtissem Nabti and Professor Carroll's experiments help explain why things go wrong in this second division. In these older women the chromosomes in their eggs start to fall apart because there is insufficient securin to control the process. Dr Nabti, formerly from University College London, is currently at the Abu Dhabi campus of New York University. The discovery opens the way to improving an older woman's chances of having eggs with fewer chromosomal abnormalities through regulating the processes that control securin levels in the two divisions of the egg or controlling the protein that securin regulates (a protein called separase). According to Professor Carroll, new therapeutic approaches to improving egg quality in older women is very important at a time when the age at which women are having their first baby is increasing. "It is immensely challenging because any treatments need to be safe for the egg and subseqents embryo and would usually need to be applied while the egg is in the ovary," Professor Carroll said. "It may one day be possible to perform treatments in-vitro (in the laboratory) but human in-vitro egg maturation is not yet very successful." The research team is working with Monash IVF to improve in vitro maturation and identify new targets that may be able to better control prevent the degradation of Securin, according to Professor Carroll. "Now that we have an idea of at least one of the causes of the increased incidence of chromosomal abnormalities and miscarriages in older women, we can attempt to find ways to prevent this happening," Professor Carroll said.


News Article | April 18, 2017
Site: marketersmedia.com

— Infertility is the failure to achieve pregnancy after 12 months of unprotected intercourse. Infertility occurs due to the abnormal functioning of the female and male reproductive system. It can be treated with infertility drugs and through procedures such as artificial insemination, in-vitro fertilization, and surrogacy. Read more details of the report at Orbis Research The report covers the present scenario and the growth prospects of the infertility services market in US for 2017-2021. To calculate the market size, the report considers the services carried out during treatment via infertility drugs and assisted reproductive technology (ART) services. Research report, Infertility Services Market in US 2017-2021, has been prepared based on an in-depth market analysis with inputs from industry experts. The report covers the market landscape and its growth prospects over the coming years. The report also includes a discussion of the key vendors operating in this market. Request sample copy of the report at: http://www.orbisresearch.com/contacts/request-sample/244699 Other prominent vendors • AbbVie • Apricus Biosciences • AstraZeneca • Auxogyn • Eli Lilly • EMD Serono • IKS International • InVitro Care • INVO Bioscience • Irvine Scientific • LifeGlobal • MedITEX • NMC Health • OB GYN Associates • OvaScience • Pantec Biosolutions • Reproductive Medicine Associates of New Jersey • The Sims Clinic • TriHealth • Virtus Health • Xytex Cryo International Market driver • Rising success rate of infertility treatments. • For a full, detailed list, view our report Market challenge • Limited reimbursements and lack of strict regulatory oversight. • For a full, detailed list, view our report Market trend • Upsurge in mergers and acquisitions. • For a full, detailed list, view our report Key questions answered in this report • What will the market size be in 2021 and what will the growth rate be? • What are the key market trends? • What is driving this market? • What are the challenges to market growth? • Who are the key vendors in this market space? • What are the market opportunities and threats faced by the key vendors? • What are the strengths and weaknesses of the key vendors? You can request one free hour of our analyst’s time when you purchase this market report. Details are provided within the report. CARE facility, CooperSurgical, Ferring Pharmaceuticals, Monash IVF, Merck, Vitrolife, AbbVie, Apricus Biosciences, AstraZeneca, Auxogyn, Eli Lilly, EMD Serono, IKS International, InVitro Care, INVO Bioscience, Irvine Scientific, LifeGlobal, MedITEX, NMC Health, OB GYN Associates, OvaScience, Pantec Biosolutions, Reproductive Medicine Associates of New Jersey, The Sims Clinic, TriHealth, Virtus Health, Xytex Cryo International. Enquire more details of the report at: http://www.orbisresearch.com/contact/purchase/244699 About Us: Orbis Research (orbisresearch.com) is a single point aid for all your market research requirements. We have vast database of reports from the leading publishers and authors across the globe. We specialize in delivering customized reports as per the requirements of our clients. We have complete information about our publishers and hence are sure about the accuracy of the industries and verticals of their specialization. This helps our clients to map their needs and we produce the perfect required market research study for our clients. For more information, please visit http://www.orbisresearch.com/reports/index/infertility-services-market-in-us-2017-2021


Coughlan C.,Royal Hallamshire Hospital | Ledger W.,Royal Hospital for Women | Wang Q.,Sun Yat Sen University | Liu F.,Women and Children Hospital of Guangdong Province | And 6 more authors.
Reproductive BioMedicine Online | Year: 2014

Recurrent implantation failure refers to failure to achieve a clinical pregnancy after transfer of at least four good-quality embryos in a minimum of three fresh or frozen cycles in a woman under the age of 40 years. The failure to implant may be a consequence of embryo or uterine factors. Thorough investigations should be carried out to ascertain whether there is any underlying cause of the condition. Ovarian function should be assessed by measurement of antral follicle count, FSH and anti-Müllerian hormone. Increased sperm DNA fragmentation may be a contributory cause. Various uterine pathology including fibroids, endometrial polyps, congenital anomalies and intrauterine adhesions should be excluded by ultrasonography and hysteroscopy. Hydrosalpinges are a recognized cause of implantation failure and should be excluded by hysterosalpingogram; if necessary, laparoscopy should be performed to confirm or refute the diagnosis. Treatment offered should be evidence based, aimed at improving embryo quality or endometrial receptivity. Gamete donation or surrogacy may be necessary if there is no realistic chance of success with further IVF attempts. Recurrent implantation failure is an important cause of repeated IVF failure. It is estimated that approximately 10% of women seeking IVF treatment will experience this particular problem. It is a distressing condition for patients and frustrating for clinicians and scientists. In this review, we have discussed the definition and management of the possible underlying causes of recurrent implantation failure.


Evans J.,Prince Henrys Institute of Medical Research | Evans J.,Monash University | Hannan N.J.,Prince Henrys Institute of Medical Research | Hannan N.J.,University of Melbourne | And 10 more authors.
Human Reproduction Update | Year: 2014

Background: Improvements in vitrification now make frozen embryo transfers (FETs) a viable alternative to fresh embryo transfer, with reports fromobservational studies and randomized controlled trials suggesting that: (i) the endometrium in stimulated cycles is not optimally prepared for implantation; (ii) pregnancy rates are increased following FET and (iii) perinatal outcomes are less affected after FET. methods: This review integrates and discusses the available clinical and scientific evidence supporting embryo transfer in a natural cycle. results: Laboratory-based studies demonstrate morphological and molecular changes to the endometrium and reduced responsiveness of the endometriumtohCG, resulting fromcontrolledovarian stimulation.Theliteraturedemonstrates reducedendometrial receptivity incontrolledovarian stimulation cycles and supports the clinical observations that FET reduces the risk of ovarian hyperstimulation syndrome and improves outcomes for both the mother and baby. conclusions: This review provides the basis for an evidence-based approach towards changes in routine IVF, which may ultimately result in higher delivery rates of healthier term babies. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.


Fernando D.,Monash University | Halliday J.L.,Murdoch Childrens Research Institute | Breheny S.,Monash IVF | Healy D.L.,Monash University
Fertility and Sterility | Year: 2012

Objective: To compare obstetric and perinatal outcomes of singleton births after assisted reproductive technology (ART) with blastocyst transfer (days 5 to 6) versus nonblastocyst transfer (days 2 to 4). Design: Retrospective cohort study. Setting: Monash IVF. Patient(s): 4,202 women who conceived using in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) between 2004 and 2009. Intervention(s): Records analysis of fresh and frozen-thawed embryo transfers resulting in singleton births of at least 20 weeks' gestation. Main Outcome Measure(s): Perinatal outcomes: preterm birth, low birthweight, very low birthweight, small for gestational age, large for gestational age, preeclampsia, antepartum hemorrhage, placental abruption, placenta previa, and postpartum hemorrhage; and covariates: maternal age, year of birth of the baby, private health insurance status, maternal body mass index, smoking status, parity, gender of baby, and variations in treatment procedures. Result(s): Multivariate analysis found no statistically significant difference between transfers on days 5 and 6 and days 2 and 4 for all maternal and perinatal outcomes. There were modest increases in the adjusted odds ratios for preeclampsia (adjusted odds ratio 1.72, 99% confidence interval 0.93-3.20) and placenta previa (1.65, 0.92-2.98). Conclusion(s): Obstetric and perinatal outcomes after blastocyst transfer on days 5 to 6 are similar when compared with embryo cleavage-stage transfers on days 2 to 4. © 2012 American Society for Reproductive Medicine, Published by Elsevier Inc.


Tarlatzis B.C.,Aristotle University of Thessaloniki | Griesinger G.,University of Lübeck | Leader A.,University of Ottawa | Rombauts L.,Monash IVF | And 2 more authors.
Reproductive BioMedicine Online | Year: 2012

Corifollitropin alfa is a novel recombinant gonadotrophin with sustained follicle-stimulating activity. A single injection can replace seven daily injections of recombinant follicle-stimulating hormone (rFSH) during the first week of ovarian stimulation. All cases of ovarian hyperstimulation syndrome (OHSS) with corifollitropin alfa intervention in a gonadotrophin-releasing hormone antagonist protocol have been assessed in three large trials: Engage, Ensure and Trust. Overall, 1705 patients received corifollitropin alfa and 5.6% experienced mild, moderate or severe OHSS. In the randomized controlled trials, Engage and Ensure, the pooled incidence of OHSS with corifollitropin alfa was 6.9% (71/1023 patients) compared with 6.0% (53/880 patients) in the rFSH group. Adjusted for trial, the odds ratio for OHSS was 1.18 (95% CI 0.81-1.71) indicating that the risk of OHSS for corifollitropin alfa was similar to that for rFSH. The incidence of mild, moderate and severe OHSS was 3.0%, 2.2% and 1.8%, respectively, with corifollitropin alfa, with 1.9% requiring hospitalization, and 3.5%, 1.3% and 1.3%, respectively, in the rFSH arms, with 0.9% requiring hospitalization. Despite a higher ovarian response with corifollitropin alfa compared with rFSH for the first 7 days of ovarian stimulation, the incidence of OHSS was similar. Corifollitropin alfa is a new agent used in ovarian stimulation treatment for IVF fertilization. One injection of corifollitropin alfa can replace seven injections of recombinant FSH (rFSH). In three studies of corifollitropin alfa treatment, we assessed all cases of ovarian hyperstimulation syndrome (OHSS), a potentially serious complication of ovarian stimulation treatment. Overall, 5.6% of the patients (95/1701) experienced OHSS. Two of the trials compared corifollitropin alfa versus rFSH. Because OHSS is relatively rare, we pooled the results of these trials to give a more reliable estimate of the incidence of OHSS. In the pooled analysis, 6.9% (71/1023) of patients receiving corifollitropin alfa had signs or symptoms of OHSS, compared with 6.0% in the rFSH group (53/880). The risk of OHSS with corifollitropin alfa treatment was similar to the risk of OHSS in patients who received rFSH: the incidence of mild, moderate and severe OHSS was 3.0%, 2.2% and 1.8%, respectively, in patients in the corifollitropin alfa treatment groups, with 1.9% requiring hospitalisation, and 3.5%, 1.3% and 1.3%, respectively, in patients in the rFSH treatment groups, with 0.9% requiring hospitalization. Although the ovaries respond more to corifollitropin alfa than to rFSH for the first 7 days of ovarian stimulation, neither treatment regimen was significantly more likely to cause OHSS. © 2012, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.


Kovacs G.T.,Monash IVF | Morgan G.,Roy Morgan Research Center Pty Ltd. | Levine M.,Roy Morgan Research Center Pty Ltd. | McCrann J.,Roy Morgan Research Center Pty Ltd.
Australian and New Zealand Journal of Obstetrics and Gynaecology | Year: 2012

Fifteen Australia-wide interview surveys between July 1981 and February 2011 on the community's attitudes to in vitro fertilisation (IVF) were carried out as part of regular Morgan polls. Each survey involved between 650 and 1000 respondents in urban and rural locations. The proportion of respondents who 'approved' or 'disapproved' of various aspects of IVF treatment were determined. Support for IVF to help infertile married couples increased from 77% in 1981 to 91% in 2011. Approval for IVF procedures being supported by Medicare funding rose from 70% in 1981 to 79% in 2000 and was unchanged in 2011. There has also been a marked increase in the support for single women and lesbians using donor sperm. © 2012 The Authors ANZJOG © 2012 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.


Briggs R.,University of Edinburgh | Kovacs G.,Monash IVF | MacLachlan V.,Monash IVF | Motteram C.,Monash IVF | Gordon Baker H.W.,University of Melbourne
Human Reproduction | Year: 2015

STUDY QUESTION Does the chance of pregnancy keep improving with increasing number of oocytes, or can you collect too many? SUMMARY ANSWER Clinical pregnancy (CP) and live birth (LB) rates per embryo transfer varied from 10.2 and 9.2% following one oocyte collected to 37.7 and 31.3% when >16 oocytes were collected. Regression modelling indicated success rates increased or at least stayed the same with number of oocytes collected. WHAT IS KNOWN ALREADY It has been suggested that if >15 oocytes are collected, the success rate for fresh embryo transfers decreases. As this is counterintuitive, as more oocytes should result in more embryos, with a better choice of quality embryos, we decided to analyse the recent experience in a busy IVF unit. STUDY DESIGN, SIZE DURATION A retrospective analysis of clinical pregnancy and live birth outcome, with respect to number of oocytes collected at Monash IVF for the 2-year period between August 2010 and July 2012, where patients under the age of 45 years underwent a fresh embryo transfer. This included 7697 stimulated cycles for IVF and ICSI. PARTICIPANT/MATERIALS, SETTING, METHODS Statistical analysis involved data tables and graphs comparing oocyte number with outcome. Results of women who had their first oocyte collection with an embryo transfer within the reference period were analysed by logistic regression analysis including other covariates that might influence pregnancy outcome. Analysis was also carried out of all the 7679 oocyte collections undertaken, resulting in fresh embryo transfers by generalized estimating equations to allow for the within subject correlation in outcomes for repeated treatments. MAIN RESULTS AND THE ROLE OF CHANCE The number of oocytes collected varied from 1 to 48. Clinical pregnancy and live birth rates per embryo transfer varied from 10.2 and 9.2% when only one oocyte was collected to 37.7 and 31.3% when >16 oocytes were collected. Regression modelling indicated success rates increased or at least stayed the same or with the number of oocytes collected. The percentage of women with embryos cryopreserved increased from under 20% with <4 oocytes collected to over 70% with >16 oocytes collected. There was a slight increase (from 18 to 22%) in oocyte immaturity and a more marked increase (from 0 to 3%) in cancelling fresh transfers to prevent Ovarian Hyperstimulation Syndrome (OHSS) with increase in number of oocytes collected above 16. The results of this study suggest that you cannot collect too many oocytes as both clinical pregnancy and live birth rates do not decrease with high numbers of oocytes collected. However, once >15 oocytes are collected, everything gets quite uncertain. LIMITATIONS, REASONS FOR CAUTION As the data become sparse above 15 oocytes, we could not demonstrate a significant increase in pregnancy rates above this number. Larger studies would be required to answer the question whether there is a plateau, or rates continue to increase. The negative of aggressive stimulation to produce many oocytes is that the risk of OHSS increases, and this is the most serious complication of ovarian stimulation. STUDY FUNDING/COMPLETING OF INTEREST(S) No funding was required. There is no conflict of interest, except that G.K., V.M. and C.M. are shareholders in Monash IVF Pty Ltd. © 2014 © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved.


Hope N.,Monash IVF | Rombauts L.,Monash IVF
Fertility and Sterility | Year: 2010

Objective: To assess whether provision of an educational DVD was more effective in increasing the uptake of elective single embryo transfers (eSET) than an educational brochure in an IVF population. Design: Randomized controlled trial. Setting: Private IVF clinic. Patient(s): One hundred thirty-one couples starting their first cycle of IVF were randomized to receive either an educational DVD or brochure. Intervention(s): Sixty-four couples received the DVD and 67 couples received the brochure. Both provided identical factual information on outcomes and risks of twin pregnancies. The DVD also included two short interviews with mothers of twins. Main Outcome Measure(s): Preference for eSET after the intervention. Result(s): There were no significant differences in fertility history or demographics. After the interventions, both groups demonstrated significantly improved knowledge. Patients in the DVD group were significantly more likely to prefer eSET compared with patients who read the brochure (82.6% vs. 66.7%). Conclusion(s): Patients exposed to the educational DVD were significantly more likely to prefer eSET. Provision of an educational DVD, such as the one used in the present study, may provide an affordable and more effective means of delivering health risk information. © 2010 American Society for Reproductive Medicine.

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