Joelle Klein

Milk does an embryo good. Or, rather, calcium can improve embryo outcome and quality.

 Annual Meeting of the American Society for Reproductive Medicine in Honolulu, HI, showed that higher calcium intake results in better reproductive outcomes than lower dairy consumption.

Dairy Intake in Women and In Vitro Fertilization Outcomes

 – reported a correlation between higher live birth rates and high dairy consumption for IVF patients.

In the study, conducted at Massachusetts General Hospital Fertility Center, women in subfertile couples had their diets assessed using a food frequency questionnaire prior to undergoing IVF.  Outcomes for fertilization rates, embryo quality, implantation, pregnancy and live birth rates were reported for patients who completed their cycles within 18 months of the questionnaire.

When outcomes were correlated with patients’ dietary information, the researchers found that the women consuming the highest amounts of dairy  (more than three servings per day) had a 21% greater chance of having a live birth than those consuming the least dairy (less than 1.34 servings per day).

High Fat Butter Ameliorates the Impaired Embryo Implantation of Female Rats Exposed to Dietary Bisphenol-A

, conducted at the University of Cincinnati and the Cincinnati Veterans Affairs Hospital on rats showed that a maternal diet rich in butterfat can ameliorate some of the harmful effects of bisphenol-A (BPA) exposure on embryos.

In the study, female rats were placed on various diets incorporating different amounts of butterfat and different concentrations of BPA. After the rats were mated, embryo implantation and quality were checked. The researchers found that the rats on the high butterfat diet without BPA produced the largest embryos, while rats who had been exposed to BPA in their diet without addition of butterfat, produced the smallest embryos, which also lacked trophoblasts and were incapable of implantation. However, including high butterfat in a diet containing BPA enabled the rats to produce embryos larger than those from the BPA-only group and without developmental deficiencies. For rats that were not exposed to BPA, a diet in which butterfat accounted for 40% of calories resulted in better embryo development than a diet with only 4% of calories from butterfat.

Kurt Barnhart, MD, President of the Society for Reproductive Endocrinology and Infertility noted, “These studies point us in an interesting direction for future research into the nutrients found in dairy which may promote embryo growth and development.”

Articles

Women with high dairy diets have higher live birth rates after IVF; maternal diets high in butterfat can ameliorate effects of BPA exposure on embryos in rats.

High Dairy Intake Improves Reproductive Outcomes

An alternative technology to incubating embryos in a laboratory during an IVF (in vitro fertilization) cycle, with and without ICSI (intracytoplasmic sperm injection), has been found to be safe and effective and may reduce the high price tag of IVF.

 Annual Meeting of the American Society for Reproductive Medicine in Honolulu, HI, two studies were presented demonstrating that the use of the INVOcell vaginal culture device to incubate embryos resulted in embryos that were of comparable quality and pregnancy rates as those that were cultured in laboratory incubators.

“In vitro fertilization is the most effective treatment for infertility and the only one that is suitable for many. IVF is also resource intensive and its expense can put it out of reach of many patients who would benefit from it,” noted Charles Coddington, MD, President of the Society for Assisted Reproductive Technology.

A Randomized Prospective Controlled Trial Confirms the Safety and Efficacy of Extended Intravaginal Culture of Embryos with INVOcell Compared to Laboratory Incubators

 -- at the Center for Assisted Reproduction in Bedford, TX, 33 women between the ages of 18 and 38 undergoing IVF were randomly divided into two groups. One group’s embryos were incubated in the INVOcell device and the other group’s embryos were cultured in a laboratory.

After egg retrieval, each patient’s eggs were conventionally co-incubated with sperm for two to four hours. Then, up to 10 eggs were placed in the INVOcell device or moved to a laboratory incubator. After five days of culture, patients from both groups had one or two embryos transferred to their uteruses. Ten of the 16 women from the incubator culture group and 10 of the 17 women from the INVOcell group reported ongoing pregnancies.

INVO and ICSO: A Pioneer Idea and a Real Alternative for ART

 -- at the Columbian Fertility and Sterility Center in Bogota, couples went through 172 cycles of IVF in which their eggs were fertilized through ICSI and then placed in the INVOcell device and incubated vaginally for 72 hours. The patients incubated, on average, four or five eggs per cycle, 53% of which divided, with an average of two embryos transferred per cycle. Sixty-five resulted in pregnancies at a rate of 38% per cycle and 40% per embryo transfer.

“These studies show how innovative technology may be able to reduce some of the laboratory costs and lead to wider availability of treatment,” said Coddington.

The use of an intravaginal incubation device in IVF is found to be a safe and effective alternative to lab incubation of embryos, and it may reduce costs.

Novel IVF Technology: Safe and Effective, May Cut Costs

The pressure of trying to conceive after many months of failing to conceive can take its toll on the male partner in infertile couples.

According to research presented at the 70

 Annual Meeting of the American Society for Reproductive Medicine in Honolulu, HI, it’s not uncommon for men to experience acute stress and sexual dysfunction during the partner’s fertile period.

South Korean researchers interviewed the male partners of 236 couples seeking infertility care or evaluation about their sexual function, use of erectile dysfunction (ED) drugs and their stress levels related to timed intercourse during the partner’s fertile period. They also had a physical examination, a semen analysis and a hormone profile. Men that had no sperm, low testosterone levels, an underlying chronic disease or that were exposed to gonadotoxins were excluded from the study.

The researchers reported that about half the men in the study experienced some degree of erectile dysfunction (42% reported mild ED and 9% reported mild-to-moderate ED) and that sexual relationship stress scores were significantly higher during the fertile period as compared to the non-fertile period. Only 6% reported using drugs for ED treatment during the fertile period.

Paul J. Turek, MD, FACS, President for the Society for Male Reproduction and Urology, commented that this research was the start of quantifying this “well-recognized phenomenon” in men.

“Men can feel a lot of pressure to perform when sex is ‘scheduled’ during fertile periods. And this stress is compounded by the underlying stress of infertility and the recurring disappointment of trying and failing to conceive month after month. Men should be reassured that it’s normal to feel stressed under these circumstances and there is nothing wrong with taking drugs to address erectile dysfunction,” said Turek.

New research: it’s common for the male partner in infertile couples to experience stress and sexual dysfunction during their partner’s fertile period.

Trying to Conceive Can Stress Men Out

In June 2014, the FDA's Oncologic Drugs Advisory Committee voted against offering accelerated approval of olaparib, a poly ADP ribose polymerase (PARP) inhibitor, for maintenance treatment of platinum-sensitive relapsed ovarian cancer with germline 

 mutation that completely or partially responded to platinum-based chemotherapy. Instead, the agency recommended waiting until the results of the phase III trial are available in 2015 before the committee made a decision.

However, the results of an investigational study evaluating the tablet form of olaparib have recently been presented and, although in very early stages, seem promising. In this new study, the oral tablet form of olaparib, given in combination with chemotherapy, was found to be safe and effective in treating advanced relapsed ovarian cancer patients, especially those with 

 mutations. This phase Ib clinical trial data was presented last month at the Marsha Rivkin Center for Ovarian Cancer Research–American Association for Cancer Research 10th Biennial Ovarian Cancer Research Symposium.

The purpose of this research was to determine the maximum tolerated dose of olaparib tablets and to evaluate dose-limiting toxicities and response to a combination therapy of carboplatin/paclitaxal and olaparib. According to researcher Saul Rivkin, MD, founder and chairman of the Marsha Rivkin Center for Ovarian Cancer Research, and a research scientist at the Swedish Cancer Institute, this was one of the first studies using olaparib tablets as opposed to the capsule form. The tablets pack a higher dosage in a smaller package than the hard-to-swallow olaparib capsules.

“The outlook for ovarian cancer patients with advanced disease is not equivalent to that of breast cancer, and a lot of work needs to be done to improve the cure rate," Rivkin said.

A study from 2013 led by researchers at The Institute of Cancer Research in London and The Royal Marsden NHS Foundation Trust also found that olaparib and chemotherapy can, together, be effective in helping women with 

-mutated ovarian cancer live longer than they would if treated with chemotherapy alone.

Rivkin and colleagues enrolled 14 heavily pretreated ovarian cancer patients (from three to eight prior therapies). The patients, aged between 42 and 77 years, received paclitaxel and carboplatin weekly, three weeks out of four, with increasing doses of olaparib. The maximum tolerated dose of olaparib was found to be 150 mg twice daily for three consecutive days of each week of each cycle.

Of the 12 evaluable patients, four had a complete response, four had a partial response, two had stable disease, and two had disease progression.

Three patients with a complete response, three with a partial response, one with stable disease, and one with disease progression had 

The most common side effects of the combination treatment included neutropenia, leukopenia, lymphopenia, and anemia. There was no evidence of GI, cardiac, hepatic, pulmonary, or dermatologic toxicities in any of the patients.

"This treatment regimen provided a response rate of 66% in heavily pretreated ovarian cancer patients. It was surprisingly tolerable with no grade 4 toxicities," said Rivkin.

The investigators plan to recruit up to 40 additional patients in the phase II extension of this protocol.

The tablet form of olaparib, given with chemotherapy, is promising in pretreated ovarian cancer patients with BRCA mutations, an investigational study finds.

Joelle Klein

Articles

High Dairy Intake Improves Reproductive Outcomes

Novel IVF Technology: Safe and Effective, May Cut Costs

Trying to Conceive Can Stress Men Out

Olaparib Tablet Safe in Relapsed Ovarian Cancer Patients