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Alper, Michael

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Alper

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Michael

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Alper, Michael
Author's Publications: search.filters.isAuthorOfPublication.883949fa-0be9-4c56-8001-fc95cba957ce

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    Impracticality of Egg Donor Recruitment in the Absence of Compensation
    (Elsevier BV, 2011) Egli, Dieter; Chen, Alice E.; Saphier, Genevieve; Powers, Douglas; Alper, Michael; Katz, Karin; Berger, Brian; Goland, Robin; Leibel, Rudolph L.; Melton, Douglas; Eggan, Kevin
    Unfertilized oocytes of many mammalian species can reprogram somatic cells to a pluripotent state. Human oocytes might therefore be useful for producing patient-derived pluripotent stem cells. Because they would carry the patient's genotype, these stem cells may be useful for the production of autologous transplants. Such cells could also be used to determine whether the epigenetic (Lister et al., 2011) and genetic (Gore et al., 2011) changes detected in induced pluripotent stem cells (iPSCs) are universally found in reprogrammed cell lines or instead are unique to iPSCs.
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    Ovarian Hyperstimulation Syndrome: Current Views on Pathophysiology, Risk Factors, Prevention, and Management
    (The Sims Institute Press Ltd., 2009) Alper, Michael; Smith, Laura; Sills, Eric Scott
    Objective: To summarize current views on the pathophysiology, risk factors, prevention, clinical features, and management of Ovarian Hyperstimulation Syndrome (OHSS). Design: Literature review. Results: OHSS is a condition characterized by increased capillary permeability, and experimental evidence has identified a provocative link to pathologic vasoactive cytokine actions. Although the ultimate physiologic mechanism of OHSS is not yet known, there are well-known risk factors that must be considered during the administration of medications to treat infertility. Clinical features are consequences of third-spaced intravascular fluid, and OHSS may become life-threatening secondary to thromboembolism or compromised pulmonary or cardiovascular function. Cornerstones of prevention have historically included cycle cancellation, coasting, decreased dosing of human chorionic gonadotropin (hCG) trigger, use of an agonist trigger, and cryopreservation of all embryos. Newer methods of prevention include the administration of a dopamine agonist medication. Management options for OHSS include outpatient transvaginal paracentesis, outpatient transabdominal paracentesis, and inpatient hospitalization with or without paracentesis. Conclusions: OHSS continues to be a serious complication of assisted reproductive therapy (ART), with no universally agreed upon best method of prevention. Coasting and cryopreservation of all embryos are the most commonly used approaches in the literature, but cycle cancellation is the only method that can completely prevent the development of OHSS. Dopamine agonists are currently being investigated to both prevent and improve the clinical course in OHSS. Recent publications suggest that outpatient paracentesis both prevents the need for inpatient hospitalization and is a cost-effective strategy.