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419


WHAT IS A NORMAL THYROID STIMULATING HORMONE (TSH) LEVEL? EFFECTS OF STRICTER TSH THRESHOLDS ON PREGNANCY OUTCOMES AFTER IVF [Meeting Abstract]

Reh, A.; Danoff, A.; Grifo, J.
ISI:000281441000641
ISSN: 0015-0282
CID: 113772

EFFECT OF AUTOIMMUNE THYROID DISEASE (AITD) IN OLDER, EUTHYROID INFERTILE WOMEN UNDERGOING IN VITRO FERTILIZATION (IVF) [Meeting Abstract]

Reh, A.; Im, S.; Amarosa, A.; Rolnitzky, L.; Grifo, J.; Danoff, A.
ISI:000281441000647
ISSN: 0015-0282
CID: 113773

ESTRADIOL (E2), PROGESTERONE (P), AND HUMAN CHORIONIC GONADOTROPIN (hCG) AS PREDICTORS OF PREGNANCY OUTCOME IN IN-VITRO FERTILIZATION (IVF) [Meeting Abstract]

Weinerman, R. S.; Mullin, C.; Grifo, J. A.
ISI:000281441000887
ISSN: 0015-0282
CID: 113774

Oocyte cryopreservation: a feasible fertility preservation option for reproductive age cancer survivors

Noyes, Nicole; Labella, Patty Ann; Grifo, James; Knopman, Jaime M
PURPOSE: To compare oocyte cryopreservation cycles performed in cancer patients to those of infertile women. METHODS: Cancer patients referred for fertility preservation underwent counseling in compliance with the ASRM; those electing oocyte cryopreservation were included. Ovarian stimulation was achieved with injectable gonadotropins and freezing was performed using slow-cooling and vitrification methods. RESULTS: Fifty cancer patients (mean age 31 y) underwent oocyte cryopreservation; adequate ovarian stimulation was achieved in 10 +/- 0.3 days. The outcome from these cycles included a mean peak estradiol of 2,376 pg/ml and an average of 19 oocytes retrieved (15 mature oocytes were cryopreserved/cycle). All patients tolerated ovarian hyperstimulation. There were no significant differences noted between cryopreservation cycles performed in cancer patients and in women without malignancy. CONCLUSIONS: Oocyte cryopreservation appears to be a feasible fertility preservation method for reproductive-age women diagnosed with cancer. This modality is not only effective but also, providing a multidiscipline effort, can be completed in timely fashion
PMCID:2941585
PMID: 20480389
ISSN: 1573-7330
CID: 112546

Cryopreserved oocytes can serve as the treatment for secondary infertility: a novel model for egg donation [Case Report]

Knopman, Jaime M; Noyes, Nicole; Grifo, James A
OBJECTIVE: To report the use of previously cryopreserved oocytes for the treatment of secondary infertility. DESIGN: Case report. SETTING: University-based IVF program. PATIENT(S): A 41-year-old woman with 18 months of secondary infertility and a previous history (age 38) of elective oocyte cryopreservation. INTERVENTION(S): Previously cryopreserved oocytes. MAIN OUTCOME MEASURE(S): Fertilization, embryo development, pregnancy, and outcome. RESULT(S): The patient achieved pregnancy and delivery following thaw of oocytes electively cryopreserved 39 months before use. Before thawing the oocyte, the patient attempted pregnancy naturally for 12 months, followed by two unsuccessful clomiphene citrate ovulation induction cycles with intrauterine insemination and one fresh IVF cycle resulting in a chromosomally abnormal twin gestation that aborted. CONCLUSION(S): Although oocyte cryopreservation is still labeled an experimental procedure, this case demonstrates that oocyte cryopreservation used for electively deferred reproduction can subsequently serve in the treatment for secondary infertility when the patient becomes her own oocyte donor
PMID: 20097336
ISSN: 0015-0282
CID: 107365

Surviving childhood and reproductive-age malignancy: effects on fertility and future parenthood

Knopman, Jaime M; Papadopoulos, Esperenza B; Grifo, James A; Fino, M Elizabeth; Noyes, Nicole
Annually, more than 50 000 cancer diagnoses are made in the USA in patients under the age of 35 years. Despite this staggering statistic, medical advancements have substantially improved survival rates. Thus, for both male and female patients with cancer, quality-of-life issues, such as fertility preservation and parenthood, have become an essential component of treatment. Unfortunately, many of the treatments to eradicate malignant processes can also compromise reproductive function. In these cases, fertility preservation should be discussed and initiated with early treatment planning, to allow the best chance for future parenthood, when appropriate. The effects of cancer and cancer treatments on fertility and future parenthood, including health risks for patients, their gametes, and offspring are discussed
PMID: 20153978
ISSN: 1470-2045
CID: 107364

Comparison of pregnancy outcomes in elective single blastocyst transfer versus double blastocyst transfer stratified by age

Mullin, Christine M; Fino, M Elizabeth; Talebian, Sheeva; Krey, Lewis C; Licciardi, Frederick; Grifo, Jamie A
OBJECTIVE: To determine whether there is a difference in pregnancy outcomes, stratified by age, between women undergoing elective single blastocyst transfer (eSBT) versus those undergoing double blastocyst transfer (2BT). DESIGN: Retrospective analysis. SETTING: University IVF center. PATIENT(S): A total of 1,141 nondonor IVF cycles in women aged <40 years from January 2004-March 2007. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Eggs retrieved, embryos cryopreserved, implantation rates, clinical pregnancy rates (PR), live birth rates (LBR), spontaneous abortion rates (SAB). RESULT(S): Pregnancy outcomes in 52 cycles of women <40 years of age who underwent eSBT were compared with 1,086 cycles of women who underwent 2BT in fresh IVF cycles from January 2004-March 2007. Overall, the eSBT was associated with a statistically significant 92% reduction in the twinning rate (from 25%-2%) while maintaining a high clinical PR (63% in the eSBT group vs. 61% in the 2BT group). CONCLUSION(S): Women who are <40 years of age undergoing nondonor fresh IVF cycles can electively choose to transfer a single blastocyst for the purpose of significantly reducing their risk of multiples without compromising their PR
PMID: 19249756
ISSN: 1556-5653
CID: 95765

Optimizing embryo selection with day 5 transfer

Reh, Andrea; Fino, Elizabeth; Krey, Lewis; Berkeley, Alan; Noyes, Nicole; Grifo, James
OBJECTIVE: To compare rates of implantation, pregnancy, miscarriage, multiple gestation, and selective reduction between patients undergoing day 5 (d5) and day 3 (d3) ETs. DESIGN: Retrospective cohort study. SETTING: University-based IVF center. PATIENT(S): The first d5 ET cycle of patients 42 years of age from 2003 to 2006 was compared with a historical control of first cycle d3 ET patients 42 years of age from 1996 to 1999 who would have met current d5 ET criteria. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Rates of implantation, clinical pregnancy, miscarriage, live birth, high order multiple pregnancy (HOMP), and selective reduction. RESULT(S): D5 ET patients had higher implantation rates (39% vs. 30%), with no difference in the no-transfer rate. D5 ET patients had lower rates of HOMP (2.5% vs. 11%) and HOMP delivery (0.7% vs. 3.5%), multiple pregnancy (27% vs. 33%), multiple delivery (19% vs. 26%), and twin delivery (18% vs. 23%). There were fewer selective reductions of HOMP with d5 ET (1.7% vs. 3.8%). CONCLUSION(S): Extended culture improves embryo selection through increased implantation, facilitating fewer embryos per transfer, which lowers multiple gestation rates and the need for HOMP reduction
PMID: 19368915
ISSN: 1556-5653
CID: 99204

Delivery rate using cryopreserved oocytes is comparable to conventional in vitro fertilization using fresh oocytes: potential fertility preservation for female cancer patients

Grifo, James A; Noyes, Nicole
OBJECTIVE: To explore the use of oocyte cryopreservation as a fertility-conserving option. Cancer treatments administered during the reproductive and adolescent years can result in sterility. Previous fertility preservation efforts focused on embryo rather than oocyte storage because the latter was deemed inefficient. Recently, several large reports of healthy births resulting from the transfer of embryos derived from frozen/thawed oocytes have been published. We sought to establish an oocyte cryopreservation program at our center. DESIGN: Twenty-three oocyte cryopreservation cycles were performed. Collected oocytes were cryopreserved by either the slow or the vitrification method. Approximately 1-4 months later, a programmed cycle of thawing/warming, fertilization with intracytoplasmic sperm injection, and ET was performed; cycle and pregnancy outcomes were assessed. SETTING: University-based fertility center. PATIENT(S): Twenty-two infertile women. INTERVENTION(S): Oocyte cryopreservation. MAIN OUTCOME MEASURE(S): Oocyte survival, embryo development, pregnancy outcomes. RESULT(S): Oocyte survival, 2-pronuclei fertilization, and blastocyst formation rates were 92%, 79%, and 43%, respectively. Fourteen women became pregnant; one miscarried; 10 have delivered 13 viable infants, and three pregnancies are ongoing for an ongoing/delivered pregnancy rate of 57%. This result was not statistically different from cycles performed consecutively in age-matched controls using fresh, nonfrozen autologous or donor oocytes during a similar time period. CONCLUSION(S): Oocyte cryopreservation appears to be a viable option for fertility preservation in some centers
PMID: 19439285
ISSN: 1556-5653
CID: 99203

Comparison of pregnancy outcomes in anonymous shared versus exclusive donor oocyte in vitro fertilization cycles

Mullin, Christine M; Fino, M Elizabeth; Talebian, Sheeva; Keegan, Debbra; Grifo, Jamie A; Licciardi, Frederick
OBJECTIVE: To determine whether there is a difference in pregnancy outcomes between women undergoing a shared versus exclusive donor oocyte cycle. DESIGN: Retrospective analysis. SETTING: University IVF center. PATIENT(S): Women undergoing either a shared (n=656 cycles), exclusive (n=225 cycles), or shared converted to exclusive (n=22 cycles) donor oocyte cycle from January 2000-December 2005. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Number of eggs retrieved, eggs fertilized, embryos transferred, embryos cryopreserved, clinical pregnancy rates (PR), live birth rates, spontaneous abortion rates. RESULT(S): Pregnancy outcomes in 656 shared cycles were compared with 225 exclusive cycles and 22 shared converted to exclusive donor oocyte cycles. Overall, there was no difference in the clinical PR among the three groups; however, the exclusive group did have a significantly greater number of embryos cryopreserved and this event occurred more frequently in such a cycle. CONCLUSION(S): Women undergoing a donor oocyte IVF cycle can choose to share the donor's oocytes with another recipient without compromising their PR; however, the probability of cryopreservation in such a shared donor oocyte cycle is significantly reduced. Therefore, the recipient must weigh the financial burden of an exclusive cycle with the desires for cryopreservation in an IVF cycle
PMID: 19815192
ISSN: 1556-5653
CID: 114626