Each has its aim of optimising a particular factor, as the complexity of reproduction means that standard protocols will deliver an ‘average’ rather than ‘best’ outcome. Taking account of as many factors as possible is likely to produce the ‘best possible’ outcome. Examples of these are below.

Acupuncture in the assessment and management of infertility, IVF and miscarriage

  • Foreword to book by Jane Lyttleton: Treatment of infertility with Chinese Medicine, 2nd ed, Churchill Livingstone 2013. Download the PDF
  • Supervised student project at UNSW (2011): Interest and experience in the role of acupuncture in in-vitro fertilisation. Read

Sperm quality association with miscarriage

Sperm and miscarriage study Abstract of study presented at Fertility Society of Australia, Sydney 2013. 

Ovarian reserve (AMH) association with egg quality

  • Abstract submitted to Asian Pacific Initiative on Reproduction (Aspire) Congress, Brisbane 2014. Read the abstract

Surgical correction of pelvic factors for optimising natural conception and IVF

  • Reconstruction, destruction and IVF: dilemmas in the art of tubal surgery – published in BJOG. Read the abstract

Natural killer cell activity as an indicator of immunological causes of unexplained infertility and miscarriage

  • Natural Killer Cell Analysis. Read the book chapter
  • NK Cells in Peripheral Blood and the Endometrium. Read the book chapter
  • Detailed analysis of peripheral blood natural killer cells in women with repeated IVF failure – published in the American Journal of Reproductive Immunology. Read the article
  • Detailed analysis of peripheral blood natural killer (NK) cells in women with recurrent miscarriage – published in Human Reproduction. Read the article
  • The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure. Read the article
  • Prednisolone for repeated implantation failure associated with high natural killer cell levels: Case Report and Risk-Benefit analysis. Read the report
  • Holding On – Newspaper Article. Read the article

Introduction of a new blood clotting assay for better targeting potential anti-clotting therapy in IVF and miscarriage

  •  Internal jugular vein thrombosis following ovarian hyper stimulation syndrome – published in Australian and New Zealand Journal of Obstetrics and Gynaecology. Read the article
  • Supervised student project UNSW 2011: Presented at Fertility Society of Australia meeting, Melbourne 2011. Read the project
  • Presentation to Fertility Society of Australia, Melbourne 2011. Read the abstract

Development of more user-friendly protocols for IVF

  • Measuring how patients use a web-based personal health record and tools to manage in-vitro fertilization. Read the article
  • The ease of use of a redesigned pen device to deliver recombinant human follicle-stimulating hormone (follitropin alfa) for assisted reproductive technology treatment. Read the article

Development of a cost effective immune therapy protocol for IVF and miscarriage (the Bondi protocol)

Targeting patients for additional hormone (LH) during IVF stimulation

Genetic quality of embryos is a key factor for IVF success, but not the only one

  • A significant success of aneuploidy screening: identification of a new research arena for implantation failure. Read the abstract

Progesterone assessment in the luteal phase of IVF cycles

  • Day 14 maternal serum progesterone levels predict pregnancy outcome in IVF/ICSI treatment cycles: a prospective study – published in Human Reproduction. Read the article

Understanding that pregnancy is an inflammatory condition from the beginning

  • Maternal C-reactive protein levels in patients undergoing frozen embryo replacement cycles: a prospective study – published in Fertility and Sterility. Read the abstract
  • Maternal C-reactive protein levels are raised at 4 weeks gestation – published in Human Reproduction. Read the article

Successful implantation and formation of the placenta has implications, via the immune system for the whole pregnancy

  • Systemic inflammatory priming in normal pregnancy and preeclampsia: the role of circulating syncytiotrophoblast micro particles – published in The Journal of Immunology. Read the article
  • An innate view of human pregnancy – published in Immunology Today. Read the abstract
  • Flow cytometric measurement of intracellular Th1 and Th2 cytokine production by human villous and extravillous cytotrophoblast – published in Placenta. Read the abstract
  • Monocytes are primed to produce the Th1 type cytokine IL-12 in normal human pregnancy: an intracellular flow cytometric analysis of peripheral blood mononuclear cells – published in Clinical and Experimental Immunology. Read the abstract
  • Preeclampsia: an excessive maternal inflammatory response to pregnancy – published in the American Journal of Obstetrics and Gynecology. Read the abstract

Getting pregnant is only part of the problem – many couples suffer repeated miscarriages

  • Recurrent Miscarriage, Investigating the potential causes – published in Medicine Today – Read the article
  • Recurrent miscarriage: pathophysiology and outcome – published in Current Opinion on Obstetrics and Gynecology – Read the abstract
  • My Child Magazine Article – Read the article

Natural Killer Cells

  • The question of whether elevated NK cell levels are a cause of infertility and pregnancy loss, and whether they provide a potential target for therapy to improve reproductive outcomes, lacks a definitive answer. Read Full Article 
  • Natural killer cell testing is currently practised widely, and there are studies indicating potential benefit in terms of targeting women with repeated reproductive failure for immune therapy. This may be a better approach than empirical immune therapy without any investigation. More and better studies are needed before such an approach can be fully endorsed. Read the full article
  • Women with unexplained repeated IVF failure present a considerable challenge. Some cases are believed to be due to immunological dysfunction preventing effective embryo implantation. As data are still being collected, doctors are faced with the dilemma of treating patients (or not) in the absence of randomised control trial evidence. This review explores a pragmatic approach in using natural killer cell analysis as a means of targeting suitable patients who might attempt treatment with additional immunosuppressive therapy. Read the full article

Reproductive immunology: the relevance of laboratory research to clinical practice (and vice versa)

  • In this issue of Human Reproduction, the paper by Gu et al. represents a landmark in reproductive immunology research. A new mechanism for evasion of maternal immune attack is described, one which explains an older theory but also itself represents part of a newer understanding of the maternal – fetal relationship.

Read the full article

Single-arm, observational study of the ease of use of a redesigned pen device to deliver recombinant human follicle-stimulating hormone (follitropin alfa) for assisted reproductive technology treatment

  • Evaluation of patients’ ease of use of the redesigned, disposable, ready-to-use ­follitropin alfa pen during controlled ovarian stimulation for assisted reproductive technology. Read the full article

Asynchronous glands in the endometrium of women with recurrent reproductive failure.

  • Of 969 non-consecutive endometrial biopsies performed for investigation of recurrent reproductive failure, 20 cases (2.1%) showed the striking presence of retarded or asynchronous endometrial glands in otherwise unremarkable mid or late secretory endometrium. Read the full article

Metformin and PCOS: Potential benefit to reduce miscarriage risk.

  • Polycystic ovary syndrome (PCOS) is associated with an increased risk of miscarriage, occurring in 30% of pregnancies. Although the mechanism is unclear, several interrelated factors appear to increase the risk of spontaneous miscarriages, including higher luteinising hormone levels, obesity, hyperandrogenisation, insulin resistance and infertility treatments. Read the full article

LH Supplementation for Low LH Levels during Antagonist IVF Cycles Improves Live Birth Rates.

  • Luteinizing hormone (LH) supplementation in IVF cycles has been a debated topic for many years [1-4]. Whilst follicle stimulating hormone (FSH) alone achieves adequate ovarian stimulation it is still possible that, in some circumstances, better results could be achieved with a combined approach. Read the full article

Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage.

  • In this retrospective study, between 2008 and 2013, couples with a history of recurrent miscarriage (≥3 first trimester miscarriages) were investigated comprehensively for known causes (karyotype, uterine, antiphospholipid syndrome, thrombophilia) and also by semen analysis, including DNA fragmentation [sperm chromatin structure analysis (SCSA)]. Statistical analysis was performed on SPSS software with significance taken as P < 0.05. Read the full article

The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure. III: Further observations and reference ranges.

  • Abnormally functioning immunocompetent cells in the endometrium are thought to be responsible for at least some cases of recurrent reproductive failure [recurrent miscarriage or recurrent in vitro fertilisation (IVF) failure], but their detailed investigation has been hampered by a lack of a standardised protocol of counting such cells in study or control patients. The purpose of this study is to use a standardised protocol for the assessment of immune cells in the endometrial biopsies of a large cohort of women with recurrent reproductive failure and establish relevant reference ranges. Read the full article

Reproductive Outcomes and General Health in Women with High Natural Killer Cell Levels

  • Journal of Allergy and Immunology. The role of natural killer (NK) cells in reproductive failure has been investigated extensively, but the topic remains controversial and poorly understood. Download Journal