Reproductive Medicine

Our Research Studies

Merrion Fertility Clinical - 200 x 108

Transcriptional Signatures of Endometrial Receptivity

Failed embryo implantation is a critical factor in infertility, early miscarriage and IVF failure. Successful implantation requires a competent embryo and a receptive endometrium.  As embryo quality is increasingly being evaluated, there is an acute need for a greater understanding of the endometrial factors associated with successful implantation. 

The goal of this MD project, a collaborative research endeavour between UCD, MFC and NMH, is to define how dysregulation of inflammatory pathways affect embryo implantation and pregnancy, using next-generation sequencing and real-time PCR. Dr. David Crosby, Clinical Research Fellow and Specialist Registrar Obstetrics & Gynaecology, MFC and NMH, was recently awarded a highly competitive research grant by the UCD and SFI-HRB-Wellcome Trust Biomedical Research Partnership fund for this work.

Collaborators: Prof Fionnuala McAuliffe, Prof Donal Brennan and Prof Brendan Loftus

Natural Killer Cells and Infertility

The role of natural killer (NK) immune cells in infertility is the subject of much controversy in reproductive medicine. It is important to note that circulating blood NK cells and NK cells found in the uterus have very different profiles and functions. Scientific studies in animals indicate that NK cells are in fact essential for pregnancy and development of the placental blood supply.

A recent collaborative study between Merrion Fertility Clinic and Trinity College Dublin found more immature uNK cells in uterine tissue from women with endometriosis as compared to healthy patients. Further analysis of these endometrial tissue samples revealed reduced levels of a growth factor called SCF in women with endometriosis, which may underlie the impaired maturation of uNK cells.

Collaborator: Prof C O’Farrelly

Follicular Environment and Oocyte Competence

This collaborative study with Dr Lynne O’Shea, UCD, investigates functional, biochemical and molecular factors in follicular fluid and granulosa cells which may predict oocyte quality and competence. Follicular fluid is collected from women undergoing IVF/ICSI treatment at MFC.

Work to date has demonstrated differences in follicular fluid AMH and P4 concentrations between fertilized oocytes that developed successfully to blastocyst stage and those which failed to do so. This research is ongoing.

Collaborator: Dr Lynne O'Shea

Attitudes Towards Fertility Testing and Fertility Preservation

Research in this area by Dr Yvonne O’Brien has focused on several topical issues in the area of fertility awareness, testing and fertility preservation. These include:

  • the attitudes of women in the general population towards ovarian reserve screening and whether they would prioritise life goals if informed and empowered with knowledge of their individual ovarian reserve
  • women’s attitudes towards oocyte vitrification for non-medical reasons in an effort to avoid unintended childlessness due to delayed childbearing
  • the emotional responses of women to being informed of their AMH result and coping mechanisms that were beneficial
  • knowledge and desire for fertility preservation options in a transgender population  imaginations of parenthood

Collaborators: Prof Donal O'Shea, Prof Cecily Kelleher

Other Studies

  • Development of a sperm friendly vaginal lubricant
  • Out-patient hysteroscopy – cost analysis
  • Clinical trial involving a device for hysteroscopic tubal occlusion (Altaseal ®)

For more information visit https://merrionfertility.ie/about/research-teaching/

Research Team

Professor Mary Wingfield , MD, FRCOG

Clinical Director, Merrion Fertility Clinic

Consultant Obstetrician Gynaecologist, National Maternity Hospital and St Michael’s Hospital

Associate Clinical Professor, Obstetrics & Gynaecology, University College Dublin

Adjunct Professor, School of Medicine, Trinity College, Dublin 

Dr Louise Glover, PhD

Research Officer, Merrion Fertility Clinic

Professor Cathy Allen

Consultant Obstetrician Gynaecologist

Merrion Fertility Clinic, National Maternity Hospital and St Michael’s Hospital

Assistant Clinical Professor, Women's & Children's Health, UCD School of Medicine

Dr Fiona Martyn, MRCOG

Consultant Obstetrician Gynaecologist

Merrion Fertility Clinic and National Maternity Hospital

Dr David Crosby, MRCOG

Clinical Fellow, Merrion Fertility Clinic

Dr Yvonne O’Brien, MRCOG

Clinical Fellow, Merrion Fertility Clinic

Dr Lucia Hartigan

Clinical Fellow, Merrion Fertility Clinic

Publications

  1. Wallace M., Cottell E., Gibney M.J., McAuliffe F.M., Wingfield M., Brennan L. An investigation into the relationship between the metabolic profile of follicular fluid, oocyte developmental potential, and implantation outcome. Fertil Steril. 2012 May; 97(5):1078-84 Epub 2012 Feb 22
  2.  Naasan M., Waterstone J., Johnston M.M., Nolan A., Egan D., Shamoun O., Thompson W., Roopnarinesingh R., Wingfield M., Harrison R.F., Mocanu E.  Assisted reproductive technology treatment outcomes. Ir Med J. 2012 May; 105(5):136-9.
  3.  McMenamin M., Lysakova-Devine T., Wingfield M., O'Herlihy C., O'Farrelly C. Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells. Reprod Biomed Online. 2012 Sep; 25(3):322-8. Epub 2012 May 23.
  4. Wong L.F., Wingfield M. Pre-operative testing for pregnancy in Dublin day surgery units.  Ir J Med Sci. 2013 Jun; 182(2):231-5.
  5.  O'Gorman A., Wallace M., Cottell E., Gibney M.J., McAuliffe F.M., Wingfield M., Brennan L.  Metabolic profiling of human follicular fluid identifies potential biomarkers of oocyte developmental competence.  Reproduction. 2013 Aug; 46(4):389-95
  6.  Wallace M., Cottell E., Cullinane J., McAuliffe F.M., Wingfield M., Brennan L. NMR based metabolic profiling of day 2 spent embryo media correlates with implantation potential. Syst Biol Reprod Med. 2014 Feb; 60(1):58-63.
  7.  Martyn F., McAuliffe F.M., Wingfield M. The role of the cervix in fertility: is it time for a reappraisal? Hum Reprod 2014 Oct; 29(10):2092-98.
  8.  Wingfield M, McMenamin M.  Preoperative pregnancy testing.  Br J Surg 2014 Nov; 101(12):1488-90
  9.  Martyn FM, McAuliffe FM, Beggan C, Downey P, Flannelly G, Wingfield MB. Excisional treatments of the cervix and effect on subsequent fertility: a retrospective cohort study.  Eur J Obstet Gynecol Reprod Bio. 2015 Feb; 185:114-20
  10.  Thiruchelvam U, Wingfield M, O'Farrelly C. Natural Killer Cells: Key Players in Endometriosis. Am J Reprod Immunol. 2015 Oct; 74(4):291-301
  11.  Thiruchelvam U, Wingfield M, O'Farrelly C. Increased uNK Progenitor Cells in Women With Endometriosis and Infertility are Associated With Low Levels of Endometrial Stem Cell Factor. Am J Reprod Immunol. 2016 Apr; 75(4):493-502
  12.  Glover LE, Fennimore B, Wingfield M. Inflammatory Bowel Disease: Influence and Implications in Reproduction. Inflamm Bowel Dis. 2016; 22(11):2724-2732.
  13.  Neville G, Martyn F, Kilbane M, O'Riordan M, Wingfield M, McKenna M, McAuliffe FM. Vitamin D status and fertility outcomes during winter among couples undergoing in vitro fertilization/intracytoplasmic sperm injection. Int J Gynaecol Obstet. 2016 Nov;135(2):172-176.
  14.  O'Brien YM, Ryan M, Martyn F, Wingfield MB. A retrospective study of the effect of increasing age on success rates of assisted reproductive technology. Int J Gynaecol Obstet. 2017 Jul;138(1):42-46.
  15. Martyn F, O'Brien YM, Wingfield M. Review of clinical indicators, including serum anti-Müllerian hormone levels, for identification of women who should consider egg freezing. Int J Gynaecol Obstet. 2017 Jul;138(1):37-41.
  16. O’Brien Y, Martyn F, Glover LE, Wingfield M. What women want?  A scoping survey on women's knowledge, attitudes and behaviours towards ovarian reserve testing and egg freezing. Eur J Obstet Gynecol Reprod Biol. 2017 Oct;217:71-76.