Research

Research is a vital aspect of modern medicine, and is necessary for keeping a practice current.

Through research and clinical trials, the practice of IVF has become safer, more efficient, and more successful.

The Fertility Center of Las Vegas performed two clinical trials, both presented and published in 2011, that compared transfers of thawed embryos to fresh embryo transfers. We concluded that the fresh transfer was impaired by the residual effects of ovarian stimulation on the uterine lining, reducing its receptivity to embryos.

After presenting these findings in Stockholm, Dr. Shapiro was told, “Many people have been working on this problem for a long time. You broke it wide open. Congratulations.” IVF pioneer Jacques Cohen, Editor-in-Chief of the Journal Reproductive Biomedicine Online, referred to our two research studies as “two of the most important trials in the past 10 years”.

In 2015 (the latest data available as this is written), the number of infants born from frozen embryo transfers outnumbered those from fresh embryo transfers for the first time. In that year, there were 4 live births from frozen embryos for every 3 fresh embryos, or a ratio of 1.33. That ratio had tripled in just three years. If that rapid shift has continued, as this is written, live births from frozen embryos should be about 3x those from fresh transfers in 2017. We shall see when the national reports for 2017 are released.

That rapid paradigm shift was due to greater implantation rates and live birth rates with frozen embryos in every age group. This can be seen in US national averages, at most US centers, and in the clinical trials performed in the US.

Today, modern centers freeze all embryos at the blastocyst stage, perform genetic testing as needed, and transfer one thawed blastocyst into each patient, and most of these transfers will achieve a live birth, even in patients over 40 years of age. With modern practice, ovarian hyperstimulation (OHSS) has been nearly eliminated, as has the risk of multiple pregnancies. Multiple pregnancies (twins, triplets, etc.) are associated with greatly increased risks of prematurity and very low birth weight, so the transfer of a single blastocyst in all patients was a vital improvement.

The need for further research is evident because fertility medicine is still not able to give every patient a healthy baby. With IVF, we are still occasionally unable to get viable embryos, especially in older patients. Some transferred embryos fail to implant in the uterine lining, even in frozen embryo transfers. In rare cases, the mother has pregnancy complications or the infant is not as healthy as we’d like. Continuing research will focus on getting more women to produce viable embryos, getting embryos to implant more reliably, and further improving safety.

Patients participating in clinical trials can benefit future patients by helping to identify better methods. They might benefit themselves through discounted fertility medications, free medications, discounted IVF cycles, or even free IVF cycles in some cases, and, of course, by achieving their goal of having a healthy baby.