Fertility Research

Explore All Women & Infants Research

Our Fertility Research Leads to the Most Up-To-Date Infertility Treatments for Patients

Conducting clinical research while treating patients is the ultimate combination to ensure the most up-to-date care for infertility patients. The fellows and physicians at Women & Infants Fertility Center share their findings and perspectives with each other so each patient ultimately receives input from a team of learned providers.

The REI Fellowship Program is a member of the National Resident Matching Program (NRMP) and complies with and follows the NRMP guidelines. Applicants should be registered with the NRMP, have a state medical license, and meet ABOG eligibility requirements.

Women & Infants Fertility Center is part of Women & Infants Hospital, one of the country’s most prestigious research hospitals for obstetrics, gynecology, and newborn pediatrics. All of our providers are also on staff at the Warren Alpert Medical School of Brown University.

In addition to seeing patients, our physicians prioritize their research work. Not only are they the authors of numerous studies related to fertility, they have also played historic roles in the development of reproductive medicine, such as delivering the first baby conceived through donor embryo transplant. Many of our physicians also work across disciplines to develop useful tools based on their research, such as apps and medical devices.

Our Research Philosophy

Intelligent questions lead
to better answers.

We know that there can be a big difference in the perceptions of outcomes, even successful ones, and the truth. Only by critically evaluating interventions and treatments can we truly know what really happens. We use research to examine if interventions can benefit patients and, importantly, to make sure that they are not detrimental. By taking a closer look at the way we approach treatment, we can improve our own processes and the processes within our field.

The future of treatment
starts with an idea.

Reproductive endocrinology and infertility is a relatively new field. Rapid advancements in technology and science continually change the way we practice, but our research keeps us at the forefront. Because of research, we can also be a part of developing the next cutting-edge interventions.

Research informs better
patient care. 

We see a close link between the work we perform in the lab and the work we perform in the clinic. There is nothing more gratifying than helping a person or couple build their family, and we believe our research allows us to get closer to making sure that every one of our patients has the opportunity to have a baby.

Our work extends beyond
the here and now.

Our discoveries in the field of education research allow us to prepare the next generation of physicians. By working with students at the Warren Alpert Medical School at Brown University, we have the opportunity to give back and prepare them for their future careers.

Current Fertility Research Roundup

Fertility research on chemo, stress, and resting female eggs

Dr. Meghan Ozcan is in her research year of her fellowship at our clinic. Her research interests include epigenetics (heritable changes in gene activation/deactivation), specifically the impact environmental stressors and diet can have on fertility and sub fertility. Currently she’s working on three research projects.

  • Cancer and fertility. Preserving fertility in the face of cancer is a mission and a passion for Women & Infants Fertility Center. Some women are diagnosed before pregnancy, and unfortunately, some are diagnosed during pregnancy. These patients have to make tough decisions that can affect their health, their future fertility and the health of the unborn child.

Dr. Ozcan is using a mouse model to test the impact of the most common chemotherapy agents and regimens on the number and quality of eggs in the ovaries of the fetus. Her goal is to use her findings to empower patients and take fertility preservation into the next generation.

  • Resting eggs. Dr. Ozcan is also investigating a novel gene and protein that is expressed in the inactive eggs in a girl’s ovaries from birth through her reproductive years. “We are born with all the eggs we’ll have for the rest of our lives, but the process of maintaining them is still poorly understood,” Dr. Ozcan explains.

She is exploring in mice whether any changes in the gene’s functionality affect a female’s long-term ovarian reserve. “I hope the findings will eventually translate into insights for our patients,” she says.

  • Stress and infertility. Dr. Ozcan invites new patients to join her study of the use of an online stress management and counseling tool to minimize stress caused by infertility. “The stress of infertility is significant,” she says. “We want to know if an online tool helps improve the quality of life for patients suffering with infertility.”

Patients of Women & Infants Fertility Center can join the study by contacting the office for the online study link. That link will take users to a scheduler to set up a time for the clinic to call for consent and enrollment.

Investigating immune regulatory T-cells in the endometrium

Dr. May-Tal Sauerbrun-Cutler was a fellow at our clinic before becoming our newest reproductive endocrinologist on staff. As an academic fellow, she split her time between treating fertility patients and researching how immune cells affect infertility.

Some of Dr. Sauerbrun-Cutler’s research focused on a type of immune cell called a regulatory T-cell that lives in the innermost lining of the uterus, known as the endometrium. “Immune cells contain factors that could help determine which women will conceive and which won’t,” she says. One of her studies revealed that a woman’s pregnancy rate could decrease if there are too few regulatory T-cells in the endometrium prior to embryo transfer.

While her findings are preliminary, Dr. Sauerbrun-Cutler says her research provides perspective that reproductive immunology could play a role in some fertility disorders. “That’s important,” she says. “I can share this perspective with my patients, especially those who have recurring implantation failures and haven’t found a source for these failures.”

Insights into ICSI, egg donation & IVF success rates

Dr. Jennifer Eatons research has focused on using national data to examine factors that influence a woman’s odds of achieving a “good perinatal outcome,” defined as a full-term birth of a single infant with normal birthweight. Dr. Eaton is the chair of the research committee of the Society for Assisted Reproductive Technology (SART), which reports data for over 90% of fertility clinics in the United States. As such, she is nationally renowned for her expertise in assisted reproductive technology (ART).

Her research has previously demonstrated that the use of intracytoplasmic sperm injection (ICSI) does not influence the risk of prematurity or low birth weight. Her work has also shown that the chance of a good perinatal outcome is slightly lower with frozen donor eggs as compared with fresh donor eggs.

Dr. Eaton currently has several ongoing projects using national data to determine the impact of various other factors on IVF success rates and birth outcomes.

Improving care and fertility treatment for the next generation

While a lot of research is meant to ultimately benefit the patient, some studies are done for the benefit of doctors. For instance, Dr. Carol Wheeler enlisted the residents at Women & Infants Hospital in a multi-center trial to see how effective an online, self-paced education module would be to teach pediatric and adolescent gynecology to medical residents.

Most OB-GYN residents receive very little education in the field of pediatric and adolescent gynecology. Dr. Wheeler and her cohorts set out to determine whether the availability of the online module would improve OB-GYN residents’ knowledge about pre-pubertal vaginal bleeding, how to perform a pre-pubertal genital exam, vaginal culture collection and other skills.

Ninety-seven residents enrolled in the study. Nearly half were randomly selected as a control group; the others were placed in an interventional group, meaning they were required to take the online training.

The study found that the group that underwent the interventional training scored significantly higher on their final assessments than the control group

“The findings from this research will ultimately benefit infertility patient care by enabling more physicians to be better trained in how to talk to, diagnose and treat girls with gynecologic problems,” Dr. Wheeler says. Gynecologic issues such as developmental anomalies can alter a girl’s future reproductive potential, and managing them properly from the beginning is critical. As academic physicians, we are always teaching our residents and students how to care for women of all ages. This study helps us learn the best teaching methods.

Why is clinical fertility research important for infertility treatment?

Seeking care at a world-class academic center like Women & Infants Hospital means you’ll receive the latest treatments available. One main reason is that research studies and the collection of comprehensive clinical data from multiple doctors are integral parts of the operating missions of both the hospital and our Fertility Center.

When it comes to infertility treatments, it behooves patients to consider a fertility center at which research is a core value. Reputable providers follow evidence-based medicine and guidelines to ensure patients receive the highest quality care.

At our clinic, academic fellows and physicians practice medicine while continually conducting studies and reviewing literature. Their fertility treatment recommendations are based on properly performed trials with data to support the intended outcomes.

“Patients should want the best treatment based on trials,” says Dr. May-Tal Sauerbrun-Cutler, who is board certified in reproductive endocrinology & infertility (REI) at Women & Infants Fertility Center. “There’s so much misinformation out there about fertility treatments, a lot of it about new interventions. But those may not be helpful and possibly could be harmful.” 

Notable publications and presentations by our doctors

Jennifer L. Eaton, MD, MSCI
  • Gender and functional outcome after coronary artery bypass. Surgery 1999; 126:184-90. PMID: 104558822.
  •  Assessment of day-3 morphology and euploidy for individual chromosomes in embryos that develop to the blastocyst stage. Fertil Steril 2009; 91(6):2432-6. PMID: 18440522.
  • Influence of patient age on the relationship between euploidy and day-3 embryo morphology. Fertil Steril 2010; 94(1):365-7. PMID: 20004892.
  • Influence of embryo sex on development to the blastocyst stage and euploidy. Fertil Steril 2011; 95(3):936-9. PMID: 20688326.
  • Amniocytes can serve a dual function as a source of IPS cells and feeder layers. Hum Mol Genet 2011; 20(5):962-74. PMID: 21156717.
  • A large network of interconnected signaling pathways in human ovarian follicles is supported by the gene expression activity of the granulosa cells. Reprod Sci 2011; 18(5):476-84. PMID: 21558463.
  • Embryo culture media and neonatal birthweight following IVF. Hum Reprod 2012; 27(2):375-9. PMID: 22128298.
  • Increased AKT or MEK1/2 activity influences progesterone receptor levels and localization in endometriosis. JCEM 2013; 98(12):E1871-9. PMID: 24064688.
  • Embryo transfer by reproductive endocrinology fellows versus attending physicians: are live birth rates comparable? AJOG 2014; 211:494.e1-5. PMID: 24881830.
  • Pregnancy outcomes after myomectomy with polytetrafluoroethylene placement. JSLS 2014; 18(3): e2014.00013. PMID: 25392651.
  • Pax6- and Six3-mediated induction of lens cell fate in mouse and human ES cells. PLoS One 2014; 9(12):e115106. PMID: 25517354.
  • Ectopic pregnancy rate increases with the number of retrieved oocytes in autologous IVF with non-tubal infertility but not donor/recipient cycles: an analysis of 109,140 clinical pregnancies from the SART registry. Fertil Steril 2015; 104(4):873-8. PMID: 26171996.
  • Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry. Fertil Steril 2016; 105(3): 663-9. PMID: 26627120.
  • Pregnancy outcomes decline with increasing recipient body mass index: an analysis of 22,317 fresh donor/recipient cycles from the 2008-2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry. Fertil Steril 2016; 105(2): 364-8. PMID: 26523329.
  • First-trimester bleeding and twin pregnancy outcomes after in vitro fertilization. Fertil Steril 2016; 106(1):140-3. PMID: 27060729.
  • State insurance mandates and multiple birth rates after in vitro fertilization. Obstet Gynecol 2016; 128(6): 1205-14. PMID: 27824752.
  • Supplemental project to assess the transparency of reporting for trials evaluating treatment for infertility. AHRQ Methods for Effective Healthcare 2017; Report No. 17-EHC022-EF. https://doi.org/10.23970/AHRQEPCMETH4.
  • An embryonic and induced pluripotent stem cell model for ovarian granulosa cell development and steroidogenesis. Reprod Sci 2018; 25(5):712-26. PMID: 28854867.
  • Preterm delivery and low birth weight among infants conceived with intracytoplasmic sperm injection versus conventional in vitro fertilization. Obstet Gynecol 2018; 131(2):262-8. PMID: 29324596.
  • Does information from ClinicalTrials.gov increase transparency and reduce bias? Results from a five-report case series. Syst Rev 2018; 7(1):59. PMID: 29661214.
  • Management of Infertility. AHRQ 2019; Comparative Effectiveness Review No. 217, Publication No. 19-EHC014-EF. https://doi.org/10.23970/AHRQEPCCER217.
  • Prevalence of a good perinatal outcome with cryopreserved versus fresh donor oocytes. Obstet Gynecol 2020; 135(3):709-16. PMID: 32028490.
  • Serum peak estradiol and neonatal birth weight following in vitro fertilization. In press, J Reprod Med.
  • Decision on mandating coverage for ART must begin with accurate data. Virtual Mentor 2014; 16(4): 304-7. PMID: 24735582.
  • Fertility and infertility in rheumatoid arthritis. Curr Opin Rheumatol 2014; 26(3):308-14. PMID: 24663108.
  • Luteinizing hormone deficiency. Medscape, updated November 4, 2016.
  • Toward a standard definition of polycystic ovarian morphology. Fertil Steril 2019; 112(5): 823-4. PMID: 31594632.
  • Does low dose aspirin use influence the menstrual cycle? A hypothetical risk gets debunked. In press, Fertil Steril.
  • Overweight and obesity among women undergoing intrauterine insemination: does body mass index (BMI) matter? In press, Fertil Steril.
  • Polycystic ovary syndrome: reproductive and psychological implications. In E Stevenson (Ed), Fertility and Assisted Reproductive Technology (ART): Theory, Research, Policy, and Practice for Health Care Practitioners. New York: Springer International Publishing 2016.
  • An 8 cm subserosal fibroid in a 37-year-old patient with unexplained infertility. In N Moawad (Ed), Uterine Fibroids: A Clinical Casebook. New York: Springer International Publishing 2017.
  • Thyroid disease and reproduction: a clinical guide to diagnosis and management. Eaton JL (Ed). New York: Springer International Publishing 2018.
  • Thyroid autoimmunity and Miscarriage. In JL Eaton (Ed), Thyroid disease and reproduction: a clinical guide to diagnosis and management. New York: Springer International Publishing 2018.
  • Postpartum thyroiditis. In JL Eaton (Ed), Thyroid disease and reproduction: a clinical guide to diagnosis and management. New York: Springer International Publishing 2018.
Gary Frishman, MD
  • Counseling women about lubricants and intercourse. Published in BJOG, April 2018.
  • So what do cesarean section scar diverticula and intraligamental fibroids have in common? Published in Journal of Minimally Invasive Gynecology, August 2016.
  • “Navigating Collegial Professionalism in Fellowship Training: Frameworks for Setting Boundaries in Tight Communities,” breakout session, APGO/CREOG Annual Meeting, New Harbor MD, March 1-3, 2018.
  • “Office Hysteroscopy: Tips from Masters for a Roadmap to Success,” session leader and lecturer, Joint ACOG/AAGL Session, ACOG Annual Clinical and Scientific Meeting, Austin TX, April 28, 2018.
  • “Hysteroscopy evidence-based approach and revolving treatment options,” AAGL (American Association of Gynecologic Laparoscopists) 14th International Conference of Gynecologic Minimally Invasive Surgery of AAGL/8th Global Congress of Gynecologic Minimally Invasive Surgery of COGA (Chinese Obstetric Gynecologic Association), Beijing, China, September 16, 2018
  • “The State of the Art in Office Procedures (including Hysteroscopy),” Harvard University Generalist Course/Annual Ob/Gyn Update Course, Boston MA, March 20, 2018.
  • “Hysteroscopy: Tips and Tricks,” Harvard University Generalist Course/Annual Ob/Gyn Update Course, Boston MA, March 20, 2018.
  • Beyond Gynecologic Surgery conference, Clermont-Ferrand, France, April 4-6, 2018.
    • Scientific Program Committee
    • Co-Chair/Moderator: Teaching and simulation in surgery in 2018 session
    • Lecture: “Burnout and post-traumatic stress among surgery residents and surgeons, do we need to teach resilience?”
    • Keynote Lecture: “The Future of Surgery and of Endoscopic Surgery”
  • Led AAGL International Board of Directors Meeting, New York NY,  February 24-25, 2018
  • Presented “Show me the numbers: a guide to statistics and paper analysis,” Australasian Gynaecological Endoscopy & Surgery (AGES) Society Annual Scientific Meeting, Melbourne, Australia, March 8-10, 2018.
  • Attended APGO/CREOG Annual Meeting, New Harbor MD, March 1-3, 2018.
    • Board Member Meeting: COFTOG business meeting
    • Presenter at breakout session: “Navigating Collegial Professionalism in Fellowship Training: Frameworks for Setting Boundaries in Tight Communities”
  • Led AAGL (American Association of Gynecologic Laparoscopists) Executive Board Meeting, Providence RI, August 3-5, 2018 with board members from the United States, Canada, Italy, India and South America participating.
  • Co-chaired AAGL (American Association of Gynecologic Laparoscopists) 14th International Conference of Gynecologic Minimally Invasive Surgery of AAGL/8th Global Congress of Gynecologic Minimally Invasive Surgery of COGA (Chinese Obstetric Gynecologic Association), Beijing, China, September 11-16, 2018.
    • Presented “Hysteroscopy evidence-based approach and revolving treatment options,” September 16, 2018.
  • IVF Clinic Websites: Buyer Beware the System Is Broken, presented at the American Society for Reproductive Medicine (ASRM) 2019 Scientific Congress & Expo, Philadelphia, PA, October 12-16, 2019.
Richard Hackett, MS
  • From Fertilization To Blastocyst: A Comparative Study Of Testicular To Ejaculated Sperm In Intracytoplasmic Sperm Injection (ICSI) Treatment Cycles, presented at the American Society for Reproductive Medicine (ASRM) 2019 Scientific Congress & Expo, Philadelphia, PA, October 12-16, 2019.
Warren J. Huber III, MD, PhD
Virginia Mensah, MD
May-Tal Sauerbrun-Cutler, MD

Original publications in peer-reviewed journals

  • Novel predictive and therapeutic options for better pregnancy outcome in frozen embryo transfer cycles. Accepted for publication in American Journal of Reproductive Immunology.
  • SART advertising guidelines: How are member clinics doing? Accepted for publication in Fertility and Sterility.
  • Is intracytoplasmic sperm (ICSI) better than traditional in vitro fertilization (IVF): confirmation of higher blastocyst rates per oocyte using a split insemination design. J Assist Reprod Genet. 2020.
  • Short- and long-term impact of gonadotropin-releasing hormone analogue treatment on bone loss and fracture. Fertility and Sterility. 2019 Nov;112(5):799-803.
  • Day three biopsy and blastulation rates. J Reprod Med. 2016 Aug; 61(4):336-340.
  • Antibiotics for asymptomatic bacteriuria. Cochrane Database Syst Rev. 2015 Apr 8;4.
  • Oocyte zona pellucida dysmorphology is associated with diminished in-vitro fertilization success.
    J Ovarian Res. 2015 Feb 27;8(1):5.
  • In Vitro Maturation (IVM) and its role in ART. Obstet Gynecol Surv. 2015 Jan;70(1):45-57.
  •  Do In utero events contribute to current health disparities in reproductive medicine? Semin Reprod Med 2013 Sep;31(5):325-32.
  • Positive chlamydia trachomatis serology in infertility is a negative prognosticator for intrauterine pregnancy. Sexually Transmitted Diseases. 2013 Nov;40(11):842-5.
  • Managing poor responders in IVF. Expert Rev Obstet Gynecol. 2013 Mar;8(2);121-134.
  • Pseudoaneurysm after abdominal myomectomy: a rare but catastrophic complication. Open J Obstet Gynecol. 2013 Jan;3(1):123-5.
  • Chlamydia trachomatis serology screening in reproductive medicine: a comprehensive review. Expert Rev Obstet Gynecol. 2012 May;7(3):205-11.

Published abstracts and scientific presentations

  • Fluoroscopically Guided Hysteroscopic Tubal Cannulation: A Novel Procedure for Unilateral or Bilateral Proximal Tubal Obstruction Promptly Resolves Tubal Infertility,” Accepted for scientific paper presentation at Minimally Invasive Surgery(MIS) Week 2020.
  • IVF clinic websites: Buyer Beware the System is Broken. Oral presentation at the Annual Meeting of American Society of Human Reproduction Medicine, October 2019; Philadelphia.
  • Natural Killer Cell-Based Predictive Assay for Pregnancy Outcome in Frozen Embryo Transfer Cycles. Poster presentation at the Annual Meeting of American Society of Human Reproduction Medicine, October 2019; Philadelphia.
  • 3-D Ultrasound is Accurate for Follicular Monitoring but Does Not Reduce Time to Perform. Poster presentation at ACOG clinical and scientific meeting, May 2019; Nashville.
  • IVF insemination provides higher blastulation rates compared to ICSI-a sibling oocyte study. Poster presentation at the Annual Meeting of American Society of Human Reproduction Medicine, October 2018; Denver.
  • Polycystic Ovary Syndrome (PCOS) protects against the natural decline in Fertility with advancing reproductive age: findings of a large retrospective cohort analysis. Poster presentation at the Annual Meeting of American Society of Human Reproduction Medicine, October 2018; Denver.
  • Does PICSI offer an advantage over ICSI in ART for patients with male factor. Poster presentation at the Conjoint Meeting of the International
    Federation of Fertility Societies and the American Society for Reproduction Medicine, October 2013; Boston.
  • Comparative genomic hybridization (CGH) after day 3 blastomere biopsy results in lower multiple pregnancy and miscarriage rates, as well as improved clinical and ongoing pregnancy rates in fresh IVF. Poster presentation at the SGI 60th Annual Scientific Meeting, March 2013; Orlando.
  • Serum anti-mullerian hormone levels decrease after metformin administration in women with polycystic ovary syndrome more in patients with lean PCOS despite their normal levels of Insulin resistance. Poster presentation at the SGI 60th Annual Scientific Meeting, March 2013; Orlando.
  • Serum anti-mullerian hormone levels (AMH) decrease after metformin administration in women with both lean and overweight polycystic ovary syndrome (PCOS). Poster presentation at the 68th Annual Meeting of American Society of Human Reproduction Medicine, October 2012; San Diego.
  • Oocyte dysmorphology is associated with both poor IVF outcome and pelvic endometriosis, yet recent treatment had no effect on subsequent IVF outcome. Poster presentation at the 67th Annual Meeting of the American Society for Reproductive Medicine, October 2011; Orlando.
  • Oocyte zona pellucida dysmorphology is associated with both poorer IVF outcomes and laparoscopically confirmed pelvic endometriosis. Poster presentation at the 27th Annual Meeting of the European Society of Human Reproduction and Embryology, July 2011; Stockholm, Sweden.

Book chapters

  • Uterine Fibroids, The Health Care Costs of Uterine Fibroids, CRC press, In press.
  • Survivors of Childhood Cancer and Cancer Treatments, Abnormal Female Puberty: A Clinical Casebook, Edited by Appelbaum H, Springer International, 241-259, 2016.

Ongoing research and scholarly activity

    • Developing a prediction model for oocyte maturity based on follicular size: Medical record review and data abstraction ongoing.
    • Developing an assay to predict pregnancy success using Natural killer and T-regulatory cells. Research ongoing.
    • Breast cancer fertility preservation outcomes in a mandated state- A pilot study evaluating a new intervention utilizing telehealth consults. Constance A Howes Grant submitted June 2020.
Victoria Snegovskikh, MD