Highlights of the 16th Annual In Vitro Fertilization and Embryo Transfer-A Comprehensive Update-2003 Meeting, Santa Barbara, California (Part II)
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Highlights of the 16th Annual In Vitro Fertilization and Embryo Transfer-A
Comprehensive Update-2003 Meeting, Santa Barbara, California (Part I)
By David R. Meldrum, M. D.
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By David R. Meldrum, M. D.

The 15th Annual In Vitro Fertilization and Embryo Transfer Comprehensive Update, July 14-17 2002 was again a huge success with well over 200 attendees from around the U.S. and the world.  Reproductive Partners’ Dr. David Meldrum has directed this postgraduate course in conjunction with the Office of Continuing Medical Education, UCLA School of Medicine each year since 1987.  The course owes its success to the large number of top-quality speakers, each an authority in his or her particular field.  Most IVF programs in the U.S. make a point of having someone attend at least every couple of years.  Since each year some applications are turned away, the conference is limited to those actively working in the field.
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Highlights of the 15th Annual In Vitro Fertilization and Embryo Transfer-A
Comprehensive Update-2002 Meeting, Santa Barbara, California (Part I)
By David R. Meldrum, M. D.
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By V. Gabriel Garzo M. D., Medical Director
Reproductive Partners-UCSD Regional Fertility Center
La Jolla, California
Assistant Clinical Professor, Department of Reproductive Medicine
University of California-San Diego
La Jolla, California

Gestational surrogacy is yet another example of how the development of the techniques of in-vitro fertilization have allowed us to help infertile couples that never expected to become parents of their own genetic child.
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Because of the overwhelming response to our website, we are introducing Reproductive Partners Worldwide (RPWW). The purpose of RPWW is to make the programs and facilities of Reproductive Partners available to couples throughout the United States and around the globe.

Our interactive bulletin board and e-mail communications show that there are unmet needs for couples in many parts of the U. S. as well as in the rest of the world. Until now we have tried to meet some of the educational needs through our website and books. In addition to consultations and telephone consultations, we can now also make IVF cycles more accessible for couples from other locations.
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By I. Lane Wong, M. D., F.A.C.O.G., Reproductive Partners Medical Group, Fountain Valley and Long Beach, California

Introduction: A key step in the high tech Assisted Reproductive Technologies (ART) such as In Vitro Fertilization (IVF) and Gamete IntraFallopian Transfer (GIFT) is the recruitment and development of several follicles that will yield a cohort of eggs.

This process is called Controlled Ovarian Hyperstimulation (COH). The usual goal is to recruit a cohort of around 5-12 follicles that will produce a similar number of eggs. In a natural cycle, several follicles are recruited and initiate development. However, as estrogen levels increase, negative feedback occurs and the brain (anterior pituitary gland) releases less Follicle Stimulating Hormone (FSH). This causes all but the strongest follicle to cease maturation. Thus, in a natural cycle, generally only the one “dominant” follicle ovulates, releasing one egg. COH is accomplished by administering injections of gonadotropins, either FSH and Luteinizing Hormone (LH), or FSH alone. This prevents the drop in FSH levels allowing not just a single follicle, but a cohort of follicles to continue to develop. The result is the availability of several eggs for ART.
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By Gregory Rosen, M. D.

The success rates of IVF and GIFT are related to many factors, but two very important factors are the age of the woman and the number of mature eggs and high quality embryos that are harvested/created. Because of these observations, many tests have been developed to attempt to assess who might be a better candidate for these procedures, i.e., who would be more likely to ripen more eggs, before starting an attempt at IVF or GIFT.
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Antagon – A New and Simpler Alternative to Lupron
by David R. Meldrum, M. D.

GnRH agonists have been routinely used for IVF cycles since they prevent ovulation before egg retrieval, improve the ovarian response, and increase the success rate approximately two-fold over IVF cycles without use of a GnRH agonist. These benefits are produced by suppression of luteinizing hormone (LH). Leuprolide acetate (Lupron) has been the most common GnRH agonist used for IVF, although Synarel (a form given by nasal spray) has been tried with similar success. Lupron is given by injections under the skin, sometimes overlapping with an oral contraceptive, but often given starting about one week after ovulation.
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