Help for Older Moms-to-Be

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As more women delay pregnancy into their late 30's and beyond, reproductive specialists are working to fine tune treatment protocols in an effort to keep pace with their patients' needs. One area of fertility treatment that warrants an expert's judgement is the use of medication for ovulation stimulation.

In California, the Reproductive Science Center of the San Francisco Bay Area is conducting research to look at improving ovulation stimulation and related IVF outcomes for women in their late 30's and early 40's. The study compares one drug protocol (the microdose Lupron® flare protocol) that is currently believed to be optimal for women in this age group with a protocol using the GnRH antagonist called Cetrotide®.

So far, the results are promising. RSC's Dr. Louis Weckstein says that they're seeing an increase in the clinical pregnancy rate per transfer with the patients who are being administered the Cetrotide protocol. Still, more study participants are needed in order to arrive at a final conclusion.

The choice of drug therapy for each fertility patient is highly individualized, but some generalizations can be made by expert physicians.

"While there are always clues from initial evaluations," explains Dr. Weckstein, "such as a woman's age and her FSH [follicle stimulating hormone] level, that can give us an idea of how a patient may benefit from a given drug therapy, statistics have shown us that women in this age range [late 30's to early 40's] do not respond as well to the most commonly-used protocol, most likely because Lupron overly suppresses their ovaries."

Weckstein theorizes that Cetrotide, a GnRH antagonist, may be superior to Lupron, a GnRH agonist, for several reasons. The use of Cetrotide requires fewer injections, a shorter duration overall of medication, and most likely, related cost savings to the patient. If those benefits can be achieved along with increased pregnancy rates, fertility specialists will be that much closer to being able to help older women become mothers. To Weckstein's knowledge, no well-done comparison studies have been done to date; hence, the present RSC research.

Study participants receive a significant discount on the cost of medications. Weckstein emphasizes that none of the drugs being used in this research are experimental, and that all participants will be administered fertility medications. Also, the study is not evaluating the drug protocol's use with patients who are "poor responders" to ovulation stimulation.

Patients who participate must be age 39 to 42 years old, have a normal FSH level (that is, less than 11), and must not have gone through a previous IVF stimulation. People who are interested in being involved in the RSC study should contact the research coordinator directly at 925-973-5012.

Dr. Weckstein will be presenting the latest findings from this study at the October 2004 meeting of the American Society for Reproductive Medicine.

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