David Seifer, MD
Professor of Obstetrics, Gynecology & Reproductive SciencesCards
About
Research
Overview
The major focus of my research effort has been ovarian follicular aging. This effort has been directed to developing new, novel diagnostic methods and treatment. For the last two decades, I focused on the discovery of novel granulosa cell proteins and defining their respective roles in the function of the normal aging human preovulatory follicle. This research led to two translational advances. The first has been a better understanding of the aging granulosa cell and in turn, the aging ovarian follicle responsible for diminished reproductive function. This fundamental information has allowed greater insight into cellular and molecular events that precede the perimenopausal transition. The second advancement has been the clinical use of granulosa cell proteins as serum markers (specifically, inhibin-b and anti-Mullerian hormone (AMH), which provide patients and clinicians with an assessment of a woman’s real-time egg count prior to choosing an infertility treatment. Over time AMH moved from a scientific curiosity to a daily diagnostic test, to becoming utilized in a therapeutic fashion to help determine a physician's choice of initial and ongoing fertility treatment. In addition, AMH is now being used to anticipate the onset of menopause, is clinically useful in making the diagnosis of polycystic ovarian syndrome and is a diagnostic marker in a number of other clinically important areas of reproductive medicine including oncofertility, fertility preservation and family planning. Interest is now being directed to exploring the production of AMH analogues for potential therapeutic applications.
I have also worked with collaborators investigating a family of ovarian growth factors, known as neurotrophins, that we discovered to be present in the adult human preovulatory follicle. The family of neurotrophins include brain-derived neurotrophic factor (BDNF), neurotrophin-4/5 (NT-4/5), neurotrophin-3 (NT-3), and nerve growth factor (NGF). We have utilized both human and mouse models to investigate the neurotrophin site of secretion and potential function in promoting oocyte maturation as well as their basic roles in ovarian physiology. These studies indicate that neurotrophins, if not obligatory, facilitate regulation of oocyte physiology, including oocyte development within the preovulatory follicle. Our basic research shows promise of translational applications in both in vitro maturation of immature oocytes and in pathophysiologic conditions such as polycystic ovary syndrome. These findings may eventually lead to new opportunities for treatment of infertility and to improved methods contraception.
I have also been privileged to participate in health outcomes research for the last 10 years, studying health care disparities as it relates to IVF success. Initial studies were directed at investigating if there were differences in outcomes based on ethnicity/race. We found that race and ethnicity are important correlates of IVF outcomes. Follow up studies examined if there were real trends in these disparities over time. Further investigation was directed to trying to understand possible reasons for such differences. The relative contributions of several presumptive reasons were explored. They included biological (pathology, genetic, AMH, BMI), environmental (vitamin D deficiency, smoking, toxins) and socio-cultural reasons. This has also lead to studying the impact of race and ethnicity on female reproductive aging. Our ultimate goal of identifying racial disparities in reproductive outcomes is to isolate the basic determinants of these disparities and formulate strategies to improve outcomes.
Another area of sustained interest has been in the role vitamin D impacts female reproduction. Focusing on the mechanisms by which vitamin D levels may influence folliculogenesis in the context of specific types of infertility.
Academic Achievements & Community Involvement
Clinical Care
Overview
As a reproductive endocrinologist and infertility specialist, David B. Seifer, MD, sees himself as a liaison. His goal is to help his patients choose the right medical approach, while respecting their personal values.
“When I first meet with a couple or an individual, we talk. Over the course of an hour, I get an idea of their world view, how they envision their future and their hopes for a family,” Dr. Seifer says. “I then figure out how to apply the technology we have at our disposal to their individual needs. That might mean egg freezing for women who are concerned about future fertility but aren’t ready to conceive now. We also have egg donor and surrogate options for women of advanced maternal age or for same-sex couples.”
Dr. Seifer says he was drawn to the field of obstetrics and gynecology in medical school. “It was an epiphany when I realized how appreciative patients were,” he says. “To have someone let you into their life during such an important time, and to be able to make an impact, is such a joy.”
The dawn of in vitro fertilization (IVF) was occurring around the time Dr. Seifer completed his medical degree. “There was such excitement, like science fiction becoming a reality,” he says. “It’s a convergence of technology and biology, and I was excited to practice it and help build families.”
Plus, he enjoys working with patients who are as motivated as he is to reach a successful outcome. “Everybody is moving in the same direction,” says Dr. Seifer, who primarily sees patients in Yale Fertility Center’s Orange office, which he describes as a comfortable, calming place. “We take care of everything that may seem daunting in an efficient, relaxed way.”
Dr. Seifer’s research include the mechanisms of reproductive aging. In fact, his research led to a simple blood test used worldwide today that helps determine the health of a woman’s ovaries and a rough estimate of her egg count. He is also a past president of the Society for Assisted Reproductive Technology (SART), the primary, national organization that sets clinical and laboratory guidelines and standards for safety and quality metrics for the practice of IVF.
Clinical Specialties
Fact Sheets
In Vitro Fertilization (IVF)
Learn More on Yale MedicineSurrogacy
Learn More on Yale MedicineFemale Infertility
Learn More on Yale MedicineOvulation Induction and Intrauterine Insemination
Learn More on Yale Medicine
Board Certifications
Reproductive Endocrinology & Infertility
- Certification Organization
- AB of Obstetrics & Gynecology
- Latest Certification Date
- 2020
- Original Certification Date
- 1994
Obstetrics & Gynecology
- Certification Organization
- AB of Obstetrics & Gynecology
- Latest Certification Date
- 2020
- Original Certification Date
- 1989
Yale Medicine News
News
News
- May 02, 2024
15 Yale Ob/Gyn Physicians Named "Top Doctors" For 2024
- October 01, 2019Source: Yale Medicine Magazine
Overcoming Infertility
- September 24, 2019
Overcoming infertility
- September 24, 2019
A grand challenge: slowing the biological clock