Lucky Sekhon, M.D.

The underlying mechanism for an ectopic pregnancy (EP) following an intrauterine embryo transfer is not fully understood. While ectopic pregnancies result from alterations in the tubal environment in most natural cycles, endometrial receptivity is the primary concern following in vitro fertilization (IVF). Elevations in estradiol and progesterone levels during controlled ovarian stimulation (COS) are associated with morphological changes in the endometrium that may augment or interfere with… Show more

The underlying mechanism for an ectopic pregnancy (EP) following an intrauterine embryo transfer is not fully understood. While ectopic pregnancies result from alterations in the tubal environment in most natural cycles, endometrial receptivity is the primary concern following in vitro fertilization (IVF). Elevations in estradiol and progesterone levels during controlled ovarian stimulation (COS) are associated with morphological changes in the endometrium that may augment or interfere with normal implantation. Perhaps as a result of the exaggerated hormonal environment resulting from IVF stimulation, the risk of EP has been shown to be greater during a fresh compared to frozen embryo transfer (ET) cycle. However, despite lower steroid hormone levels in a frozen ET cycle, ectopic risk is still higher than in natural cycles. This study aimed to determine whether estradiol (E2) and progesterone (P4) levels during a frozen, blastocyst ET cycles are associated with EP risk. Show less

Data are conflicting regarding the impact of a patient’s race on assisted reproductive technology treatment success. A study published by Dhillon et al. observed lower IVF pregnancy rates in African American (AA) and Asian women as compared to Caucasian women; however, these findings were limited to cycles involving transfer of fresh, unscreened embryos. The current study sought to determine differences in pregnancy outcomes in women of different racial groups who undergo a single, euploid… Show more

Data are conflicting regarding the impact of a patient’s race on assisted reproductive technology treatment success. A study published by Dhillon et al. observed lower IVF pregnancy rates in African American (AA) and Asian women as compared to Caucasian women; however, these findings were limited to cycles involving transfer of fresh, unscreened embryos. The current study sought to determine differences in pregnancy outcomes in women of different racial groups who undergo a single, euploid frozen embryo transfer (FET). Show less

BRCA1 and BRCA2 mutation carriers are at increased risk for breast and ovarian cancer, with lifetime risks approximately 49-72% for breast cancer and 17-59% for ovarian cancer. The National Cancer comprehensive Network recommends routine screening as well as a risk-reducing surgery to remove the fallopian tubes and ovaries for BRCA carriers between ages 35 to 40 or after the completion of childbearing. Since many women have not completed childbearing by age 40, they have the option of… Show more

BRCA1 and BRCA2 mutation carriers are at increased risk for breast and ovarian cancer, with lifetime risks approximately 49-72% for breast cancer and 17-59% for ovarian cancer. The National Cancer comprehensive Network recommends routine screening as well as a risk-reducing surgery to remove the fallopian tubes and ovaries for BRCA carriers between ages 35 to 40 or after the completion of childbearing. Since many women have not completed childbearing by age 40, they have the option of undergoing fertility preservation prior to undergoing this risk-reducing surgery. Additionally, use of Preimplantation Genetic Diagnosis (PGD) allows couples to prevent transmission to their offspring. BRCA carriers may be at greater risk for diminished ovarian reserve, yet studies regarding the effect of BRCA carrier status on fertility remain inconsistent in their conclusions. To date, researchers have demonstrated that infertility treatment is safe in BRCA carriers. BRCA carriers are faced with complex challenges and will benefit from consultation with a fertility specialist to discuss options for fertility preservation to safely build the family they desire. Show less

Does vitrification and warming affect live birth rate, infant birth weight and timing of delivery?

Controlled ovarian hyperstimulation (COH) promotes multifollicular growth, increasing the chance of
obtaining euploid embryos that will successfully implant. Whether aneuploidy is increased from COH with exogenous gonadotropins interfering with natural selection of dominant follicles is a concern. This study evaluates the association between gonadotropin exposure and aneuploidy.