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Goals Interface with Clinical Investigation Special Expertise in Ovulation Induction
Staffing and Patient Volume

Nationally Accredited Ultrasound Practice

Teaching Role
For women with irregular menstrual cycles

Goals
The Reproductive Endocrine Associates Group Practice was established to provide the highest quality reproductive medical care to both men and women, while providing our patients the benefits of the most recent scientific and technological advances resulting from the ongoing basic and clinical investigations within our Unit. Examples of such novel therapies, which have resulted from our research program and are available in this practice, are outlined above and include pulsatile GnRH for ovulation induction and the use of potent GnRH agonists for the treatment of precocious puberty, both of which have now been FDA approved on the basis of studies performed in our Unit.

In addition, we have pioneered the use of pulsatile GnRH for induction of puberty and spermatogenesis in men with GnRH deficiency. While ongoing research projects are extremely important, patient care and quality physician-patient relationships are our highest priorities. The success and uniqueness of the Reproductive Endocrine Unit's practice was recently highlighted by an invitation to publish it as a model of an academic/clinical investigative practice in the Journal of Clinical Endocrinology and Metabolism.

Interface with Clinical Investigation
The practice consists of seven adult endocrinologists (Drs. Crowley, Hall, Hayes, Martin, Pitteloud, Seminara & Welt), all of whom have expertise in clinical investigation as well as clinical practice. We provide comprehensive services for patients with reproductive endocrine problems--including menstrual cycle abnormalities, polycystic ovarian syndrome, menopause and hormone replacement therapy, male and female infertility, premature ovarian failure, Kallmann's Syndrome, and pubertal disorders. Services are also available for a wide spectrum of reproductive disorders not included in this list. In addition, as part of the National Center for Infertility Research, ongoing clinical and basic research projects within the Unit continuously provide new information on these disorders, providing patients with access to new and innovative clinical investigation protocols.

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Special Expertise in Ovulation Induction

The practice also offers a comprehensive program of ovulation induction, with on-site transvaginal ultrasound and serum estradiol monitoring during the administration of clomiphene citrate, human recombinant FSH, and pulsatile GnRH. We have one of the world's largest clinical experiences using pulsatile GnRH for anovulatory infertility and continue to serve as a major referral site for this therapy, both nationally and internationally. Through the National Center for Infertility Research, we continue to develop novel clinical protocols to improve both ovulatory and conception rates for anovulatory patients, but also to pursue both physiologic investigation of the normal menstrual cycle and the genetic basis of reproductive disorders.

We also have extensive experience with exogenous gonadotropins, both human menopausal and more recently, recombinant gonadotropins, and have the lowest reported rate of multiple gestation when compared to other large series in the literature (Martin 1993). The economic impact of multiple gestations has also been reported by investigators in our Unit (Callahan), and emphasizes the critical importance of minimizing multiple gestation rates, both for patient safety and reduction of health care costs.

Staffing and Patient Volume

Dr. Kathryn Martin and Dr. Stephanie Seminara are co-Directors of the practice. Dr. Martin sees patients two sessions per week, and she oversees the ovulation induction program, which manages approximately 150-200 cycles per year. Drs. Stephanie Seminara, Corrine Welt, and Frances Hayes see patients 1 session per week, and Drs. Crowley and Hall see patients for one session every other week.

Ultrasound

Accreditation: Since 2004, the Reproductive Endocrine Associates practice has been accredited by the American Institute of Ultrasound in Medicine in recognition of excellence in patient care and meeting or exceeding national standards. As there are no state or federal laws overseeing diagnostic ultrasound, we believe that voluntarily maintaining this rigorous accreditation is yet another way we demonstrate our ongoing commitment to excellence in practice.

Judith Adams, D.M.U., an internationally recognized expert in pelvic ultrasonography, has been our staff ultrasonographer since 1987. In addition to playing a critical role in the ovulation induction program, she also has an active role in a variety of ongoing clinical research protocols. Judy is a widely sought expert for ultrasonography of complex pediatric endocrine cases, including precocious and delayed puberty, as well as intersex disorders.

Teaching Role
The Reproductive Endocrine Associates serves as a vehicle for training for the first year endocrine fellows as well as MGH housestaff and medical students rotating through the Clinical Endocrinology Service. Fellows and residents see patients under the supervision of individual staff members, and participate in all longitudinal care, including ovulation induction.

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