Lasers, Robots, and a Cast of Thousands

Posted by Brigham and Women's Hospital January 4, 2013

Dr. Gargiulo demonstrates his robotic technique to an audience of more than 1,000 surgeons.

Dr. Antonio Gargiulo, Medical Director of Robotic Surgery at the Brigham and Women’s Hospital (BWH), has performed hundreds of computer-assisted laparoscopic surgeries, but the one he performed on October 22, 2012, was very special.

The surgery, a robotic myomectomy to remove a uterine fibroid tumor in a 29-year-old patient, was beamed live from Brigham and Women’s Faulkner Hospital (BWFH) to an audience of more than 1000 fertility surgeons attending the 68th Annual Meeting of the American Society for Reproductive Medicine (ASRM) meeting in San Diego, California. Over the course of two hours, Dr. Gargiulo narrated the ongoing surgery while answering a steady stream of questions from the audience via three moderators.

Dr. Gargiulo and members of the robotic team at the Center for Infertility and Reproductive Surgery (CIRS)  were chosen by ASRM to broadcast the procedure based on their innovative work in robotic reproductive surgery, such as performing the first single incision robotic myomectomy in 2012.

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New Research Sheds Light on Link Between Obesity and Fertility in Women

Posted by Brigham and Women's Hospital November 1, 2012

Obese women are more likely to have egg abnormalities associated with infertility.

Modern reproductive science has unlocked the key to a vast array of fertility problems, and researchers at Brigham and Women’s Hospital have now discovered a possible link between obesity and egg quality.

Obesity has long been associated with poor reproductive outcomes, but the reason has largely been unknown. With one-third of all American women of childbearing age battling obesity, it is a major barrier for many wishing to grow their family.

A new study released earlier this month shows that severely obese women are more likely to have abnormalities in their eggs that can make it impossible for them to be fertilized normally. The abnormalities involve the spindle, a critical egg structure responsible for normal arrangement of the chromosomes. A normal egg must have one spindle organized in a very specific way, with the chromosomes lined up correctly. The study showed that severely obese women have a much greater chance of having eggs with multiple spindles and disorganized chromosomes.

“This study is the first to shed light on how BMI (body mass index) might adversely affect egg quality in women,” said study lead, Catherine Racowsky, PhD, Director of the Assisted Reproductive Technologies Laboratory at Brigham and Women’s Hospital.

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Cancer Treatment and Fertility: Planning for the Future

Posted by Brigham and Women's Hospital September 25, 2012

Planning ahead can help preserve fertility in young cancer patients.

Imagine being 22 and having your two biggest fears come true: You have cancer, and your treatment may leave you unable to have children in the future.

While you’re still coming to terms with the diagnosis, you now have to make some major life decisions. Do you want to freeze your eggs? Or should you choose a sperm donor and freeze fertilized eggs instead? Don’t forget to consider your husband’s feelings — even though he isn’t even in your life yet.

“It was so overwhelming,” says Arieana Carcieri, who found herself facing this scenario last year after being diagnosed with Hodgkin lymphoma. “I come from a big family and always wanted at least three kids. The cancer diagnosis alone was all-consuming — I didn’t anticipate the decisions I’d have to make about a future family.”

When Arieana learned that her cancer treatment could impact her ability to have children, she turned to Dr. Sara Barton, a fertility specialist at Brigham and Women’s Hospital who collaborates with Dana-Farber/Children’s Hospital Cancer Center. Dr. Barton sees many young women between the ages of 16 and 21 who are preparing for cancer treatment.

“These aren’t issues women typically think about in their early 20s, especially without a partner,” she said. “We’re asking them to make very mature, complicated decisions that are going to have a big impact on their life trajectory. A lot of girls think yes, I want kids, I want to do it. But then we have to talk about the reality of the situation and the financial cost.”

Cancer treatment can increase the rate at which a woman’s supply of eggs is depleted. Some chemotherapy accelerates the aging of a 20-something’s ovaries to that of a 35- or 40-year-old. Radiation can damage both the ovaries and the cells the uterus needs to regenerate each month, which are important to carry a healthy pregnancy.

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