I have just returned from Orlando, Florida. No, not from Disney World but from the 57th Annual Scientific Meeting of the Society for Gynecologic Investigation (SGI). This is the regular convention of academicians doing research in women’s health, and since all the doctors at USC Fertility are full-time faculty members of the University of Southern California, it ranks as one of our most important yearly events.
The conference attracts about a thousand researchers (MDs and Ph.D.s) from all over the world, and is oriented toward basic reproductive science. This means that most of the research is quite removed from the “real world” of medicine. As is the case with most medical gatherings, the best (and most useful) information is often obtained from conversations in the hallways, and at the “poster session” where research results are posted on 3-foot by 5-foot “posters” and the authors stand next to them to answer questions.
Our group presented the results of our measurements of Anti-Muellerian Hormone (AMH) and outcome of IVF in women over 40. We found that AMH levels were related to age and FSH levels, but not to pregnancy outcome. In fact, live births were found in women with very low AMH levels. We concluded that AMH measurements have limited value in predicting pregnancy success with IVF. These results seem to contradict recent reports suggesting that AMH levels could predict whether or not women could conceive with IVF. We have had many patients ask if this test is worthwhile, and we have been skeptical. Now we have data that supports our skepticism.
We also reported our experience with nausea during pregnancy after fertility treatment. (A big THANK YOU to all the patients who patiently filled out our surveys.) I had been convinced after 25 years of practice that nausea of pregnancy starts earlier in women whose ovaries were stimulated as part of fertility treatment (as opposed to recipients of egg donation or women who receive frozen embryo transfers, whose ovaries are not stimulated). However, our data do not seem to bear this out (or at least not yet).
Interestingly, our report was the first to address nausea during pregnancy after ovarian stimulation. We feel strongly that there is still much that we need to learn about pregnancy after fertility treatment, and with our patients’ help, we hope to continue to expand the knowledge base in this very important area.
While I was in Florida, my automatic computer update brought me research results that had nothing to do with the SGI meeting but that rather had just appeared in “Fertility and Sterility,” the main scientific journal of fertility specialists (for which I serve as the deputy editor). A study conducted in the Netherlands found an association between a pre-conceptual Mediterranean diet and higher pregnancy rates with IVF. The study was quoted by Reuters: http://www.reuters.com/article/idUSTRE62I2RA20100319. Patients are frequently asking about diet and other things they can do to maximize the chances of success. Whereas this type of “association” study should not be construed as implying a cause-and-effect relationship, it certainly appears that a healthy diet is at least not a bad idea!
I am always glad to come back from a meeting and see my patients again, and to return to the reality of practical medicine. But conventions like the SGI 57th Annual Scientific Meeting help me remember that as physician-scientists, we must focus not just on good patient care, but also on making a contribution to the field. Only in this way will infertility treatment improve and only in this way will be get closer to the eventual goal of eliminating infertility as a disease.