Overview of Clinical Areas of Strength

In Vitro Fertilization

We have a long history of a highly successful in vitro fertilization program. We pride ourselves on innovations in in vitro fertilization as well as providing highly ethical and effective clinical care. We are doing approximately 300 IVF retrievals per year. We also have active oocyte and embryo donation programs. Our program has always emphasized obtaining high clinical pregnancy rates while transferring as few embryos as possible to avoid high order multiple births.

Our Embryologist, Amy Sparks, PhD, is a recognized leader in the field of clinical embryology. Dr. Sparks has her High Complexity Lab Director Certification. Our lab is College of American Pathologists (CAP) certified and she serves as a CAP inspector. Her laboratory performs the full range of standard IVF procedures including ICSI, assisted hatching, blastocyst culture, embryo cryopreservation, and PGD. Through her laboratory, fellows would be exposed to embryology as it relates to in vitro fertilization and to proper laboratory quality control and techniques to maintain excellent results with IVF.

Gynecologic Ultrasonography

Within our division, we have a fully accredited ultrasound unit which performs all of the gynecologic ultrasonography for our department and hospital. Last year, our unit performed nearly 4,000 ultrasounds. We have 2 full-time sonographers at this time. Our sonographers are involved in teaching ultrasound skills to residents. They would also instruct fellows in the art. Thus, fellows would not be responsible for doing all of these scans themselves but rather would learn from a moderate number of ultrasound exams. We feel that experience in ultrasonography is essential in evaluating reproductive tract abnormalities in REI conditions and in the performance of high quality IVF.

Not only do we provide top quality gynecologic ultrasonography, but we have used this experience to perform clinical investigation. We have performed and published some of the initial observations regarding gynecological ultrasonography and its use in detecting abnormalities of the reproductive tract. In particular, we published the first series of saline infusion sonography (SIS) in the United States and also published the initial observations on ovarian volume and its use in predicting ovarian stimulation and pregnancy following IVF. We published the first observation that color Doppler studies can be used to aid in the diagnosis ovarian torsion following ovarian hyperstimulation and that uterine diverticula observed after caesarian sections could be a source of abnormal uterine bleeding. Finally, we are prospectively following women over time to better understand the natural history of benign uterine conditions including fibroids and polyps. This experience has also been recently published and is ongoing as an area of active clinical investigation.

Reproductive Endocrinology Surgery

Fellows in our program would have a superior exposure to surgical procedures in reproductive endocrinology. As a referral center, we see a number of difficult surgical cases including severe endometriosis, müllerian abnormalities and uterine fibroids. Although laparoscopic surgical procedures are decreasing in reproductive endocrinology due to improving success rates with IVF, we still perform an adequate number of these cases to allow fellows to have good exposure to this area. We have state of the art laparoscopic and hysteroscopic equipment for the performance of difficult endoscopic surgery. All of our staff members are fully trained in endoscopic surgery and perform the bulk of the endoscopic surgery in our department. As such, fellows would be expected to become excellent endoscopic surgeons during their training.

General Center for Advanced Reproductive Care

Fellows will have the advantage of seeing a large patient volume while they are on clinical rotations. Last year we saw over 1,000 new patients and over 6,000 return patients in our Reproductive Endocrinology Clinic.

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