Virtus Health invests a great deal of time and resources into clinical research - in fact, we are involved in more active research projects than any other fertility group in Australia. This ensures we give our patients access to the most advanced science, and supports our clinicians’ training, development, and career opportunities.
We are proud of our leadership within the fertility profession, and our clinicians, nurses and scientists are all committed to the future of fertility treatment. Many projects involve collaboration between states, and we expect this to increase over the coming years.
Here’s an overview of some of our current research:
Melbourne IVF Current Projects
Nifedipine for improving Implantation and Pregnancy rates in ART Trial (NIPA)
Implantation failure is the main factor affecting the success rate of IVF procedures. Excessive uterine contractions have been described as a potential mechanism for reduced implantation rates in IVF cycles. Uterine contractions are stimulated by the embryo transfer procedure and by ovarian stimulation itself. It is thought that contractile activity of the uterus could move the implanted embryo towards the Fallopian tubes or cervix/vagina, or the embryo might even be expelled out of the uterus. It is thought that such contractions could play a role in IVF patients who have undergone several cycles that failed to result in pregnancy. Therefore, a reduction in contractions in the uterus on the day of embryo transfer may increase the chance of pregnancy in IVF patients. The entry of calcium is critical for the transfer of the electrical signal that passes from muscle cell to muscle cell, and signals the cells to contract. Calcium channel blockers are drugs that block the entry of calcium into the muscle cells, thereby reducing muscle contractility. Find out more about current Melbourne IVF research projects...
The 'POP Study' (Pregnancy Outcomes after Pre-conception weight loss)
Research has shown women who carry excess weight prior to pregnancy are more likely to have trouble conceiving. Once pregnant, these women have higher rates of gestational diabetes and gestational hypertension/pre-eclampsia. They are also more likely to deliver by Caesarean section. Babies born to women carrying excess weight are at an increased risk of premature delivery and being born either small or large for gestational age. They are also more likely to require additional care after delivery.
If you are keen to lose weight prior to pregnancy, you are invited to consider participation in a clinical trial being conducted by the University of Melbourne. The ‘POP Study’ aims to explore how much weight loss is required by an obese woman in order to optimise pregnancy outcomes for mother and baby. Women who participate in this study will be randomized to one of two different weight loss programs. These programs will occur under the supervision of medical doctors, dieticians and nurses with vast experience in weight management.Women will then be observed during the pre-pregnancy, pregnancy and early post-natal stages of pregnancy and information about the health of mother and baby will be collected. Find out more about current Melbourne IVF research projects...
Acupuncture Trial – Melbourne IVF currently recruiting patients
Acupuncture is one of the most commonly used complementary therapies for women trying to get pregnant either naturally or through fertility treatment. As such, acupuncture is an area of interest to Melbourne IVF as we would like to see evidence of the effectiveness of claims made in previous studies. We are participating in a national multi-centre randomised controlled acupuncture trial to determine if acupuncture improves live birth rates for women undergoing IVF. For more information visit the Melbourne IVF website...
A study of Fertility Management in Australia - Having children when you want them
Melbourne IVF is collaborating with the Jean Hailes Research Unit and Monash University on a study aimed to help Australians have children when they want them, and to avoid pregnancy when they don’t. The study is looking for men and women aged 18 to 50. For more information visit the Melbourne IVF website...
The LIGHT study: Assessing the effect of recombinant human growth hormone (r-hGH) on live birth rates in women who are poor responders undergoing an IVF/ICSI cycle.
The aim of this study is to determine the influence of growth hormone treatment as an adjunct to stimulation with the maximal dose of FSH stimulation in the unexpected poor responding IVF patient - patients requiring maximal dose of stimulation despite being under 41 years of age. This is a randomised, double blind placebo controlled study.
Use of transdermal testosterone cream in IVF pre-treatment and its effect on controlled ovarian stimulation and IVF outcome in poor responder IVF patients: a randomised placebo-controlled trial
Poor ovarian response to ovarian stimulation usually indicates a reduction in follicular response, resulting in a reduced number of retrieved oocytes (eggs). Consequentially, poor ovarian response results in fewer embryos, reduced implantation rate, decreased pregnancy rates and high cycle cancellation rates. Although several approaches have been considered for the management of poor responders, this remains a challenging issue.
Ovarian follicular fluid Melatonin levels and ovarian reserve
Melatonin is made by the ovary, in addition to other organs. It is thought that the melatonin level in ovarian follicular fluid drops with increasing age and decreasing ovarian reserve. As a pilot study, we aim to establish a relationship between lower follicular fluid melatonin and increasing age, as well as ovarian reserve and egg quality
Preservation of Spermatogonia in mature human testicular tissue
Since pre-pubertal boys cannot benefit from sperm banking, a potential alternative for preservation of their fertility involves storage of testicular tissue in the hope that future technologies will allow its safe utilisation.
Automated semen analysis in the prediction of human fertility (SHAMAS)
Sperm morphology assessment is a critical component of standard semen analysis and evaluation of male fertility. Computer automated image analysis enables efficient, objective and reproducible analysis of sperm morphology. As well as providing the conventional assessment of “percent normal”, computer analysis provides morphometry parameters of individual sperm that can be used to define new assessments of semen quality based on physiological endpoints.
This study will therefore aim to use the endpoint of fertilization rate in standard IVF to provide a new clinical assessment of sperm morphology using an in-house, Sperm Head Automated Morphometry Analysis System (SHAMAS).
Identification of Genomic Determinants of Uterine Receptivity
Successful establishment of pregnancy requires a viable embryo and a receptive uterus. Over the past 30 years there have been many IVF-related advances in embryology that have resulted in significant improvements in embryo viability and overall success rates. However, over the same time, understanding of uterine receptivity in humans has advanced little. We are therefore undertaking a prospective, controlled study which will aim to identify determinants of uterine receptivity by studying the gene expression of the human endometrium at the time of embryo implantation. With our collaborator Grant Montgomery from the QLD Institute of Medical Research, genes showing evidence for a functional role in uterine receptivity will be identified.
Banking on the future: Establishing evidence for policy, protocols and patient care relating to storage of reproductive material before treatment for cancer.
In recent decades, there have been rapid technological advances in cryopreserving sperm, oocytes (eggs), embryos, and ovarian tissue as a means of enabling future genetic parenthood for cancer survivors. Simultaneously, increasing survival after cancer in childhood and young adulthood means that demand for cryopreservation and subsequent fertility treatment is growing. This project aims to investigate and describe the development of expert practice in fertility preservation associated with cancer treatment to inform Australian guidelines and policies. It is the hope that these will inform recommendations for national policy development and service strengthening. The case study will demonstrate our position as a leading organisation not only in techniques and practices, but also as a public-spirited contributor to national guidelines and policies.
Health and development of young adults born with and without assisted conception.
The first IVF birth worldwide was in 1978, therefore the oldest IVF children are now adults. Will they have the same health outcomes as those spontaneously conceived? This study, involving interviewing Melbourne IVF mothers and young adults, investigates the physical and mental health, including education and social development, of young adults conceived through IVF. This project involves collaboration with the Murdoch Children’s Research Institute, University of Melbourne and is co-funded by the National Research and Medical Council.
Follow-up of children conceived through use of donor sperm.
A questionnaire based study, the project aims to assess the physical, psychosocial and development of children conceived through use of donor sperm, between 2004 and 2007. Analysis will be over the period 2004 -2007 as that is within the school age of those who accessed donor sperm and conceived in 2000 (when medical donor sperm was granted).
Health and well-being of PGD children at school age compared with IVF conceived and spontaneously conceived children of the same age.
Children of school age are being recruited from three groups: those conceived through IVF (without PGD), those conceived through IVF (with PGD), and those spontaneously conceived.This project aims to investigate the health and well-being of children conceived following PGD.
Evaluation of written information and a decision tool for deciding what to do with unused embryos.
Many people who have excess embryos in storage often struggle to make a decision about what the fate of the embryos should be once their storage life has expired. Existing evidence shows that deciding what to do with unused frozen embryos can be very difficult and that patients want clinics to provide them with information and support through the process of arriving at a decision. This project therefore aims to develop a tool which can be applied to assist people in clarifying their thoughts about the available embryo disposition options, and to reach a decision that is best for them.
A multi-clinic prospective study of participants engaging in a Victorian altruistic surrogacy program.
In January 2010 the legislation allowed for altruistic surrogacy arrangements to be offered in accredited IVF units. To ensure our approach to this program is holistic, supportive and addresses the concerns of all parties involved, we have initiated a study where, from the initiation of the surrogacy arrangement, with all parties involved – commissioning woman and commissioning man, surrogate and her partner (if applicable) and egg donor (if applicable) – until the infant is six months, we will aim to better understand attachment styles, how relationships are affected, as well as relinquishment issues for surrogates and commissioning couples.
In vitro maturation of immature oocytes
Approximately 20% of oocytes recovered from stimulated cycles are immature. Although some will mature in vitro, extremely high proportions show evidence of inappropriate maturation and poor subsequent development rendering them unsuitable for clinical use. The aim of this study is to improve the maturation rate and the normality of resulting mature oocytes.
Xenografting of human ovarian tissue as a model for clinical auto grafting
For almost 10 years we have been offering women with malignant disease the option to cryopreserve ovarian tissue prior to commencing cytotoxic therapy which may render them infertile. In parallel with a small number of groups around the world, we have now started to graft frozen tissue back into selected patients. Although some early reports of positive outcomes have appeared, there is little knowledge regarding the factors critical for successful autografting.
The aim of this study is to investigate the early events which occur following grafting using a xenografting model and to determine whether manipulation of the grafting environment can restrict cell or tissue loss.
Vitrification of human oocytes
A number of recent studies have achieved encouraging results with vitrification of human oocytes. One component of vitrification solutions has been shown to elevate intracellular levels of calcium; a known activator of cell processes. The aim of this study is to compare results obtained using this vitrification method with vitrification using other components to determine the level of activation which results. Failed fertilised and immature oocytes are used for the study.
Assisted activation for couples with chronic low fertilisation following ICSI
Several previous studies have suggested a defect in oocyte activation to be one of the major causes of fertilisation failure following intracytoplasmic sperm injection (ICSI).
Find out more about research at Melbourne IVF...
Queensland Fertility Group
Non-Invasive Embryo Selection.
The technical objective is to establish whether alternative morphological criteria in pronuclear and cleavage stage embryos offer a higher predictive potential for implantation and whether embryo cleavage criteria offer a higher predictive potential for implantation.
Embryo & Oocyte Vitrification.
The technical objective is to establish the most efficient vitrification system for embryos, blastocysts and oocytes and to determine its efficacy compared with current slow freezing protocols.
Sperm Aneuploidy Detection Using FISH.
The technical objective is to establish the following:
- Techniques to identify the numerical chromosomes using FISH.
- Using these techniques identify whether aneuploidies exist in the sperm of men with chromosomal translocations.
- The incidence of sperm chromosomal aneuploidies in the male partners of infertile couples related to aetiology of infertility.
Sperm DNA Integrity in Oncology Patients
The technical objective is to establish whether different malignancies (particularly testicular and systemic malignancies) and disease processes are associated with increased levels of damaged sperm DNA and whether any such disease groups would benefit from alternative collection protocols prior to cryopreservation.
Artificial Oocyte Activation using Calcium Ionophore in ICSI Cycles.
The technical objective is to establish whether published techniques of AOA using Ca ionophores in ICSI cycles improve fertilisation, cleavage, embryo quality and implantation rates in patients with a history of poor ICSI fertilisation.
Embryo Media Comparison
The technical objective is to perform a comparative study of Cook and Vitrolife culture media and compare results with those previously achieved with Sage medium.
SCSA & Hyaluronan Binding Assay Study
The technical objective is to test sperm selected by hyaluronan binding with an assay for sperm DNA integrity and to compare that with the measured sperm DNA integrity for the whole specimen.
Establishment of FMR1 Testing
The technical objective is to fully assess the merits of offering the PCR screen for FMR1 to all future QFG couples.
Early Embryo Cleavage & Embryo Polarity
Effect of Embryo Cryostorage Above the Glass Transition Temperature
The technical objective is to determine whether reproductive material, frozen in liquid nitrogen, is affected by a period of storage at the temperature of dry ice, -80 °C, which is above the glass transition temperature.
Hyaluronan Sperm Selection for ICSI
The technical objective is to identify specific patient populations that benefit the greatest from the use of HA-ICSI.
Sperm Preparation Using ProInsert System
The technical objective is to determine whether the system minimises the viral load in the final preparation of semen from infectious disease discordant couples.
Effectiveness of Group vs Single Embryo Culture
The technical objective is to compare the outcome from embryos cultured singly and in groups.
Find out more about research at Queensland Fertility Group...
IVFAustralia's current research work falls into three categories:
1) Refining the treatments that we give our patients
- Studying the role of a hormone supplement, recombinant Luteinising Hormone (LH), in patients who have been shown to have a deficiency in LH during their IVF/ICSI treatment.
- Studying the effect of an elevated progesterone concentration at the time of egg collection on the success rate from IVF.
- Studying the effects of acupuncture on IVF. In a randomised controlled trial, in collaboration with Professor Smith of the University of NSW, the effects of acupuncture on both the immune processes associated with successful implantation as well as the success rate itself are being studied.
- Assessing the novel possibility that disrupting the lining of the uterus (the endometrium) in the cycle before IVF may increase the success rate of IVF.
- Assessment of the acceptability of a new improved form of pen for administration of FSH during IVF.
- Studying the significance of the egg number test (AMH) in predicting the response to IVF.
2) Developing new technologies to assist our patients
- Further development of the technology for digital high magnification of sperm. Our initial research has found that this is a very effective technique for identifying the healthiest sperm for injection during the IVF process. Our ongoing work will focus on identifying which men will benefit most from this technology.
- Development of sophisticated technology to study the genetic health of an oocyte prior to injection of the sperm. Using the latest “Oosight” technology, we can study the genetic material inside the egg using polarised light and gain many useful insights into why some eggs work and others do not.
- Genetic study of the embryo. In association with our partners at Melbourne IVF, we now have access to the latest rapid ArrayPGD technology for study of the genetic makeup of the embryo. Recently, techniques have been developed to assist couples where the cause of their infertility is a chromosomal rearrangement in one or other partner.
- Understanding the immune processes involved in implantation. Through study of the “natural killer” cells in the lining of the uterus, we have been able to identify that some women have disordered function of these cells and we are currently carrying out trials of therapy that may help these couples.
3) Understanding the long-term consequences of infertility for our patients
- A long-term study in association with Professor Cathy McMahon of Macquarie University in the effects of parental age, the mode of conception and the transition to parenthood. In this research, that has been supported by an Australian Research Council grant, the biological, psychological and social consequences of delayed parenthood are being studies.
- Collaborative studies of Infertility, body weight, eating and exercise disorders.
- Study of the economic implications of ARTprogrammes for both the nation and patients. In association with Dr Georgina Chambers at the University of NSW, we have an ongoing collaboration that is supported by the Australian Research Council to carry out detailed econometric studies.
Find out more about research at IVF Australia...