The effect of methotrexate injection for treatment of an ectopic pregnancy on ovarian reserve

7 01 2014

To the Editor:

We read with great interest the paper “Does methotrexate administration for ectopic pregnancy after in vitro fertilization (IVF) impact ovarian reserve or ovarian responsiveness?” by Boots et al. (1). In the article, the authors evaluated the effects of methotrexate (MTX) on the future fertility of women undergoing IVF by comparing markers of ovarian reserve (day 3 FSH, antral follicle count), measures of ovarian responsiveness (duration of stimulation, peak E2 level, total dose of gonadotropins, number of oocytes retrieved, fertilization rate), and time from MTX administration to subsequent IVF cycle, in the IVF cycle before and after an ectopic pregnancy (EP) treated with MTX. They concluded that MTX treatment of an EP does not compromise ovarian reserve or ovarian responsiveness in subsequent cycles. However, other studies have demonstrated that when gonadotropin stimulation dose remains unchanged, fewer oocytes may be collected after MTX is taken as management of an ectopic pregnancy, suggesting a decrease in ovarian reserve (2). Read the rest of this entry »


Concerning “The use of recombinant luteinizing hormone in patients undergoing assisted reproductive techniques with advanced reproductive age: a systematic review and meta-analysis”

30 04 2012

To the Editor:

With great interest we read the article by Hill et al. (1) on the use of recombinant luteinizing hormone (r-LH) in patients of 35 years and older undergoing assisted reproductive techniques. The use of r-LH supplementation during ovarian stimulation as part of assisted reproduction treatment is controversial and literature shows conflicting results in women of 35 years and older. The available evidence does not support the hypothesis that the addition of r-LH increases the pregnancy rate in unselected patients treated in an IVF/ICSI protocol with recombinant FSH and a GnRH agonist or antagonist. But there might be a potential benefit of the use of r-LH supplementation during ovarian stimulation in women with a poor response and women of advanced age (2). An update and systematic review and meta-analysis focused on women of 35 years and older is therefore timely and of great value with regard to possibilities to individualize treatments to improve outcomes. Read the rest of this entry »

Acupuncture: when classical meets modern

10 03 2011

To the Editor:

We read with great interest the recent article by Moy, et al. (1)

After its mysterious origination over 2500 years ago, acupuncture had spread rapidly through Asia, and been applied in Europe since the early seventeenth century. (2) Based on controlled clinical trials, extensive data about the efficacy of acupuncture have been gathered over the past three decades, providing valuable insight into the experience-based practice. We have the following concerns about the present study: Read the rest of this entry »

Endometrioma and in vitro fertilization

8 03 2011

To the Editor:

We read the article by Almog et al. (1) with interest. Similar to what we showed on a smaller scale (2), and in contrast to what showed by Somigliana et al. (3), they found that the number of oocytes retrieved from a cohort of patients bearing endometrioma and undergoing in vitro fertilization (IVF) is similar to that retrieved from unaffected patients, and that the presence of unilateral endometriomas has no impact of the number of oocytes retrieved. The straightforward recommendation was that one should proceed to IVF without preliminary removal of endometrioma (1). This is similar to what was suggested by Garcia-Velasco et al (4). Read the rest of this entry »

Leveling the playing field for grandfather’s sperm

29 05 2009

To the Editor:

A recent publication by Frattarelli et al., found that sperm from males age 50 or over resulted in a lower percentage of live deliveries, even when using a donor oocyte model to negate the adverse effect of maternal oocyte age (1). These data reached a different conclusion compared to an earlier publication by another group using the donor oocyte model Read the rest of this entry »

Risk of birth defects increased in pregnancies conceived by AHR

26 02 2009

To the Editor:

In a recent publication, using the Niday Perinatal Database from 82 primary and tertiary centers in Ontario for 2005, El-Chaar et al found that assisted human reproduction (AHR) procedures increase the risk of birth defects in a retrospective cohort design (1).   Read the rest of this entry »

Evidence of absence or absence of evidence? A reanalysis of the effects of low-dose aspirin in in-vitro fertilization

21 11 2008

To the Editor:

We read with respect the article by Ruopp et al. (1) that has questioned the methodological approach of our previously published review (2) on the use of aspirin in in vitro fertilization cycles. We disagree with the authors in that random-effects models should only be used in the absence of inter-study heterogeneity. With fixed-effects models, it is assumed that there is a sole common effect estimates for all studies, i.e., the true effect of treatment, in both magnitude and direction, is the same value in every study. Read the rest of this entry »