Needle Free! Boston Fertility Doctors Develop Saliva Test

A typical in vitro fertilization (IVF) cycle requires hormone therapy to stimulate production of eggs, and daily blood tests to monitor hormone levels and a patient's response to therapy. These daily blood draws for up to seven days can be one of the most unpleasant parts of fertility treatment — leaving a woman feeling stressed and even a little bit like a voodoo doll.

But a Boston fertility clinic is eliminating that stress. Following two years of research, Boston IVF fertility doctors have developed the first needle-free saliva test that will replace the daily blood tests to monitor infertility treatment. They have proven that the hormone estradiol, traditionally measured in the blood, can also be accurately measured in saliva, which virtually eliminates the need for daily blood testing during a patient's treatment cycle.

"Patients undergoing IVF or other stimulation cycles feel like pin cushions," says Michael M. Alper, MD, medical director of Boston IVF. "I have always worried about this intrusive aspect of IVF. Drawing blood once can be tolerated by most people. But try it four to eight times in a row! It is painful and stressful, especially when combined with the need to take injectable medications as well."

Research conducted at the fertility clinic demonstrated that hormone levels found in saliva correlate with the hormone levels in the blood. "We recognized several years ago that certain hormones, such as cortisol, can be measured in saliva," Dr. Alper says. "So it made sense for us to determine if other hormones could be measured in saliva as well. As a consequence, we developed a method to detect hormones such as estradiol in the saliva and construct an algorithm to predict the levels in the blood. The research occurred over a two-year period. To our delight, the correlation was excellent."

Boston IVF further developed laboratory procedures, assays and the collection process for this diagnostic breakthrough. Patients collect their spit at home and drop off their sample for analysis each morning. Results from saliva testing are available the same day.

"We know that stress and any inconvenience reduces the likelihood that couples will continue with fertility treatments," Dr. Alper says. "If they don’t continue, we can't help them so we regard this discovery as a very important step in the advancement of fertility treatments."