UAB Magazine Online Archive
UAB Fertility Advances Bring Help and Hope
By Julie Hall Bosché
Sometimes it takes a little science to help fulfill a dream. At least that’s what it often feels like for people who turn to UAB’s Division of Reproductive Endocrinology and Infertility for answers, help, and hope.
Now more of those dreams are coming true. In less than 10 years, UAB’s success rate for in vitro fertilization (IVF) has more than doubled. Division director G. Wright Bates, M.D., credits much of the success to refinements in IVF techniques. “We have come a long way in treatment cycles,” he says. “Back in 2002, less than one in four women with a good prognosis got pregnant within a month. Now we often exceed 50 percent in a month with IVF.” He adds that increased awareness of infertility issues—and more widespread information on potential solutions—also has helped educate the public and encouraged more patients to learn about their options.
Increasing the Chances
Today, the division, which provides individualized care to both women and men, continues to investigate new advances in fertility treatment that will increase the chances of conceiving and carrying healthy babies. One avenue of research is the multicenter PCOS-II Trial, sponsored by the National Institutes of Health (NIH), which is testing two oral medications, clomiphene citrate (Clomid) and letrozole (Femara), to determine which is the most effective in inducing ovulation and enhancing fertility in women who have irregular cycles, don’t ovulate regularly, or exhibit signs of hormone imbalance.
WATCH: Infertility: 35 is the new 25
Wright Bates discusses the latest science in fertility treatment in this video presentation.
“We’re thrilled to be part of this group,” Bates says. “There is no other center in the Southeast participating, and we think it’s a great way for us to improve our treatment options, and better serve the women of Alabama.”
The trial covers basic fertility testing for both women and men and provides four months of treatment. Patients interested in enrolling in the trial can call study coordinator Susan Mason at (205) 801-8207 for more information and a phone screening.
Another revolutionary development, Bates says, is pre-implantation genetic screening, which examines embryos for disease and potential developmental problems. “This doesn’t mean designer babies, or choosing hair color and eye color,” Bates explains. “We’re talking about ensuring a normal chromosomal number and avoiding major developmental issues to enhance the chances of producing a normal, healthy offspring.”
Bates is quick to underscore the division’s emphasis on healthy pregnancies. UAB is committed to avoiding high-order multiples—triplets or more—that can pose a threat to both the woman and the fetuses, he says.
UAB Alumni Cook Up New Flavors for Cancer Patients
By Susannah Felts
A brief bout with nausea or stomach flu is enough to remind most of us that enjoying food is a wonderful thing. For people struggling with cancer and many other long-term medical conditions, a changed relationship with food can be one of the most troubling outcomes.
Chemotherapy and radiation treatment, in particular, wreak havoc on taste, smell, and digestion, leaving patients with little appetite and difficulty consuming meats and hot or crunchy foods. Both treatments damage salivary glands and taste receptors in the mouth and nose. They also create a wide range of gastrointestinal problems, along with mouth inflammation, ulcers, and dryness.
In his Birmingham oncology practice, Luis Pineda, M.D., observed many patients turning down meals and meal-replacement shakes. Those skipped meals ultimately translate to “poor nutrition and, eventually, poor outcomes,” notes Pineda, who completed a fellowship at the UAB School of Medicine in 1982 and was one of the original members of UAB’s bone marrow transplant program.
A lifelong food-lover, Pineda decided to address the problem. So he enrolled in Birmingham’s Culinard cooking school to explore how to make food that was more palatable for cancer patients.
A Free-flowing Conversation with UAB’s Dr. Gridlock
By Matt Windsor
Everyone likes to complain about traffic. UAB transportation expert Virginia Sisiopiku, Ph.D., is actually doing something about it. Sisiopiku, an associate professor in the Department of Civil, Construction, and Environmental Engineering, is following several parallel lanes of traffic-related research that could lead to a quicker, happier, healthier commute for the rest of us—without years of paralyzing construction.
"In the past, the answer to traffic was to build new roads and add new lanes, but we have come to the conclusion that this does not work,” she says. “Eventually, your money and available space run out, and the traffic is still clogged. We are looking at ways to reduce traffic congestion and the consequences—everything from increased travel times to pollution—without building more infrastructure.”
Here is a quick spin through the science of traffic research—and four potential solutions being pursued by Sisiopiku and other researchers at the UAB School of Engineering.
New Techniques Could Accelerate Drug Discovery
By Matt Windsor
If you could look inside the lungs of a child with cystic fibrosis, you would see a layer of thick, sticky gunk coating every surface, providing a rich haven for bacteria and making it very hard to breathe. If you could look into the child’s future, the view wouldn’t be pretty, either. Every day, her parents will have to pound on her back in order to break up the accumulated mucus and allow her to cough it out. While previous generations of patients with cystic fibrosis often died in their teens, this child will at least have a good chance of living into her 30s. However, her lung disease will have worsened to the point that she will become disabled and, eventually, die.
Medications have played a major role in extending the lifespan of patients with cystic fibrosis. Antibiotics help prevent serious lung and sinus infections, inhaled medicines open the airways, and enzyme therapies can thin mucus. But the root of the problem, revealed in 1989 in part by UAB scientists, lies in a single defective gene. And at the moment doctors don’t have anything that can touch it.
The gene produces a protein called the cystic fibrosis transmembrane conductance regulator (CFTR). When CFTR is functioning normally, it shuttles chloride and thiocyanate ions through cell membranes, which helps keep mucus thin and flowing freely. But when CFTR is defective, the channels can become partially or completely blocked, or they may never become embedded in the cell wall in the first place.