Pietro Bortoletto

Reproductive Medicine, Weill Cornell Medicine - Center for Reproductive Medicine
  • Weill Cornell Medicine - Center for Reproductive Medicine
  • United States of America

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Recent Comments

Dec 31, 2021

This is great - what a wonderful way to capture the magic and energy of the dawn of reproductive surgery with people who where in the room doing the work. Cannot wait to see how the rest of the series turns out. Love that we have this recorded oral history for posterity!

Mar 18, 2020

Very strong statement -created/reviewed/approved in record time. I eagerly await the next update and hope that the Task Force has started to think about the criteria for "re-starting" infertility care.

Feb 26, 2020

Great interview, Dr. Hoyos!

Feb 21, 2020

An AMH value in isolation can be incredibly falsely reassuring ( or even falsely alarming) re: a woman's reproductive potential. A mail out AMH is not a fertility assessment unless it is accompanied by a physician consult and a hollistic evaluation of a woman's reproductive potential. In the same way a 23andMe test would not be enough for a genetic counselor to make any true assessment of your genetic risk - a single screening test does not tell the whole story. 

Jan 03, 2019
Replying to Micah J Hill

Great debate again by expert authors!  I voted for the IVF side.  I just think the burden of proof in this debate is on surgery to demonstrates it improves live birth outcomes, especially given the risks of surgery, published numbers needed to treat to get an additional live birth (as high as 40), and known decrease in ovarian reserve.  I would want to see level 1 evidence demonstrating better reproductive results from surgery before it became my first line treatment.

I love this debate because it is a very real one faced by patients and providers alike. I guess the answer, to me, lies in what the presenting complaint is.  An infertile but asymptomatic patient presenting with an incidentally found endometrioma should have IVF -> treat the presenting complaint. However, the minute the patient reports symptoms, this is becomes a little trickier.I think surgery serves several purposes: 1) diagnosis, 2) treatment, and 3)  improvement in IVF outcomes (maybe). The importance of diagnosis cannot be understated as it can validate a woman's symptoms and provides a  clear treatment algorithm for management outside of fertility treatment/pregnancy.

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