Scholars@Duke
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Kelly S Acharya

Kelly S Acharya

Assistant Professor of Obstetrics and Gynecology
Obstetrics and Gynecology, Reproductive Endocrinology & Infertility
kelly.acharya@duke.edu
5601 Arringdon Park Dr, Suite 210, Morrisville, NC 27560

Selected Publications

Success rates with preimplantation genetic testing for aneuploidy in good prognosis patients are dependent on age.

Journal Article Fertil Steril · March 2025 OBJECTIVE: To evaluate cumulative live birth after preimplantation genetic testing for aneuploidy (PGT-A) with next generation sequencing (NGS) compared with morphology alone among patients aged 21-40 years undergoing single blastocyst transfer. DESIGN: Re ... Full text Link to item Cite

Unmet Reproductive Health Care Information Needs of Female Young Adult Survivors of Childhood Cancer: Oncology Providers' Perspectives.

Journal Article J Adolesc Young Adult Oncol · February 2025 This study aimed to characterize unmet reproductive health needs of female young adult survivors of childhood cancer (YASCC), as understood by oncology providers (N = 10) caring for this patient population. Providers completed brief online questionnaires a ... Full text Link to item Cite

Adoption as an Alternative Family-Building Strategy: Perceptions of Female, Young Adult Cancer Survivors Receiving Gonadotoxic Treatments.

Journal Article J Adolesc Young Adult Oncol · August 2024 Female survivors of young adult (YA) cancers are at risk of fertility impacts following cancer treatment. For these women, fertility-related distress is both prevalent and persistent. Yet there is little research regarding survivors' perspectives on altern ... Full text Link to item Cite

Impact of Financial Costs on Patients' Fertility Preservation Decisions: An Examination of Qualitative Data from Female Young Adults with Cancer and Oncology Providers.

Journal Article J Adolesc Young Adult Oncol · June 2024 Purpose: To examine the impact of financial costs on fertility preservation decisions among female young adults (YAs) with cancer. Methods: Female YAs (N = 18; aged 21-36) with a history of cancer and oncology providers (N = 12) were recruited from an Nati ... Full text Link to item Cite

The #IVF journey: content analysis of IVF videos on TikTok.

Journal Article Reprod Biomed Online · December 2023 RESEARCH QUESTION: What patient populations and outcomes are depicted on IVF videos on the short-form video-sharing application 'TikTok'? DESIGN: This cross-sectional study investigated the 100 most-viewed videos utilizing the #IVF hashtag on TikTok. Only ... Full text Link to item Cite

Body mass index is negatively associated with a good perinatal outcome after in vitro fertilization among patients with polycystic ovary syndrome: a national study.

Journal Article F S Rep · March 2023 OBJECTIVE: To evaluate the association between body mass index (BMI) and good perinatal outcomes after in vitro fertilization (IVF) among women with polycystic ovary syndrome (PCOS). DESIGN: Retrospective cohort study using 2012-2015 Society for Assisted R ... Full text Link to item Cite

Oncofertility research pitfall? Recall bias in young adult cancer survivors.

Journal Article F S Rep · March 2023 OBJECTIVE: To assess recall bias by evaluating how well female cancer survivors remember details regarding their cancer diagnosis, treatment, and fertility preservation (FP) counseling.Oncofertility literature cites recall bias as a pitfall of retrospectiv ... Full text Link to item Cite

Well-Woman Care for the Female Cancer Survivor

Journal Article Topics in Obstetrics and Gynecology · January 2023 Open Access Cite

Impact of increasing antimüllerian hormone level on in vitro fertilization fresh transfer and live birth rate.

Journal Article F S Rep · September 2022 OBJECTIVE: The objective of our study was to assess the association between AMH and live birth among women with elevated AMH undergoing first fresh IVF. Serum antimüllerian hormone (AMH) correlates with oocyte yield during in vitro fertilization (IVF). How ... Full text Link to item Cite

Can high antimüllerian hormone mitigate some of the age-related decline in live birth rates? The association between antimüllerian hormone and live birth among women over 40 undergoing in vitro fertilization.

Journal Article F S Rep · December 2021 OBJECTIVE: To examine the association between serum antimüllerian hormone (AMH) and live birth among women aged ≥41 years undergoing in vitro fertilization (IVF). DESIGN: Retrospective cohort study using the 2012-2014 Society for Assisted Reproductive Tech ... Full text Link to item Cite

Development of a fertility risk calculator to predict individualized chance of ovarian failure after chemotherapy.

Journal Article J Assist Reprod Genet · November 2021 PURPOSE: To develop an innovative machine learning (ML) model that predicts personalized risk of primary ovarian insufficiency (POI) after chemotherapy for reproductive-aged women. Currently, individualized prediction of a patient's risk of POI is challeng ... Full text Link to item Cite

Addressing Barriers to Fertility Preservation for Cancer Patients: The Role of Oncofertility Patient Navigation.

Journal Article J Oncol Navig Surviv · October 2021 BACKGROUND: Infertility is a common late effect for cancer survivors. Whereas assisted reproductive technology has made it possible for survivors to take steps to preserve fertility before starting treatment, only a minority of patients proceed with preser ... Link to item Cite

Sexual and Reproductive Health Concerns

Chapter · September 15, 2021 This book provides a clinically useful resource for evaluation and management of the symptoms and issues that burden survivors of breast cancer. ... Link to item Cite

Oocyte cryopreservation versus ovarian tissue cryopreservation for adult female oncofertility patients: a cost-effectiveness study.

Journal Article J Assist Reprod Genet · September 2021 PURPOSE: In December 2019, the American Society for Reproductive Medicine designated ovarian tissue cryopreservation (OTC) as no longer experimental and an alternative to oocyte cryopreservation (OC) for women receiving gonadotoxic therapy. Anticipating in ... Full text Link to item Cite

A View from the past into our collective future: the oncofertility consortium vision statement.

Journal Article J Assist Reprod Genet · January 2021 PURPOSE: Today, male and female adult and pediatric cancer patients, individuals transitioning between gender identities, and other individuals facing health extending but fertility limiting treatments can look forward to a fertile future. This is, in part ... Full text Link to item Cite

Epigenetic alterations in cytochrome P450 oxidoreductase (Por) in sperm of rats exposed to tetrahydrocannabinol (THC)

Journal Article Scientific Reports · December 1, 2020 As marijuana legalization is increasing, research regarding possible long-term risks for users and their offspring is needed. Little data exists on effects of paternal tetrahydrocannabinol (THC) exposure prior to reproduction. This study determined if chro ... Full text Open Access Cite

Single blastocyst transfer yields similar pregnancy rates compared with multiple cleavage embryo transfer, with reduced twin rate, in patients with low number of fertilized oocytes

Journal Article Middle East Fertility Society Journal · December 1, 2020 Background: In patients with low numbers of embryos, there is not yet consensus on whether to extend culture to the blastocyst stage, especially due to the risk that some or all of the embryos will not make it to the blastocyst stage. The objective of our ... Full text Cite

Sperm DNA methylation altered by THC and nicotine: Vulnerability of neurodevelopmental genes with bivalent chromatin.

Journal Article Sci Rep · September 29, 2020 Men consume the most nicotine and cannabis products but impacts on sperm epigenetics are poorly characterized. Evidence suggests that preconception exposure to these drugs alters offspring neurodevelopment. Epigenetics may in part facilitate heritability. ... Full text Open Access Link to item Cite

Total follicle stimulating hormone dose is negatively correlated with live births in a donor/recipient model with fresh transfer: an analysis of 8,627 cycles from the Society for Assisted Reproductive Technology Registry.

Journal Article Fertil Steril · September 2020 OBJECTIVE: Oocyte donation has optimized our understanding of ovarian stimulation. Increasing the follicle-stimulating hormone (FSH) dose has been shown to adversely affect live birth rates in autologous cycles. Our objective is to assess whether this rela ... Full text Link to item Cite

Data from: Cannabinoid exposure and altered DNA methylation in rat and human sperm

Dataset · August 25, 2020 This dataset contains the raw sequencing data files for reduced representation bisulfite sequencing. Abstract: Little is known about the reproductive effects of paternal cannabis exposure. We evaluated associations between cannabis or tetrahydrocannabinol ... Full text Cite

Epigenetic alterations in cytochrome P450 oxidoreductase (Por) in sperm of rats exposed to tetrahydrocannabinol (THC).

Journal Article Sci Rep · July 23, 2020 As marijuana legalization is increasing, research regarding possible long-term risks for users and their offspring is needed. Little data exists on effects of paternal tetrahydrocannabinol (THC) exposure prior to reproduction. This study determined if chro ... Full text Open Access Link to item Cite

Preconception Evaluation Before In Vitro Fertilization.

Journal Article Obstet Gynecol Surv · June 2020 IMPORTANCE: Infertility poses a substantial public health problem for women of reproductive age, in the United States and globally. Infertility can be overcome with a variety of emerging assisted reproductive technologies (ARTs). In vitro fertilization (IV ... Full text Link to item Cite

Cannabis use is associated with potentially heritable widespread changes in autism candidate gene DLGAP2 DNA methylation in sperm.

Journal Article Epigenetics · 2020 Parental cannabis use has been associated with adverse neurodevelopmental outcomes in offspring, but how such phenotypes are transmitted is largely unknown. Using reduced representation bisulphite sequencing (RRBS), we recently demonstrated that cannabis u ... Full text Open Access Link to item Cite

Patient and in vitro fertilization (IVF) cycle characteristics associated with variable blastulation rates: a retrospective study from the Duke Fertility Center (2013–2017)

Journal Article Middle East Fertility Society Journal · December 1, 2019 Background: To evaluate the association of patient and IVF cycle characteristics with blastulation rate and formation of high-quality blastocysts Results: We analyzed autologous blastocyst cycles from 2013 to 2017. Cycles were subdivided into low (< 33%), ... Full text Open Access Cite

Clinical pregnancy and live birth increase significantly with every additional blastocyst up to five and decline after that: an analysis of 16,666 first fresh single-blastocyst transfers from the Society for Assisted Reproductive Technology registry.

Journal Article Fertil Steril · November 2019 OBJECTIVE: To study the association between the number of blastocysts available and pregnancy outcomes in first fresh autologous single blastocyst transfer cycles. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): Patients from the S ... Full text Link to item Cite

Clinical pregnancy (CP) and live birth (LB) increase significantly with each additional fertilized oocyte up to nine, and CP and LB decline after that: an analysis of 15,803 first fresh in vitro fertilization cycles from the Society for Assisted Reproductive Technology registry.

Journal Article Fertil Steril · September 2019 OBJECTIVE: To study the association between the total number of fertilized oocytes available and pregnancy outcomes in first fresh IVF cycles with a single blastocyst transfer. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): A tota ... Full text Link to item Cite

Does a freeze-all policy lead to better IVF outcomes in first autologous cycles?

Journal Article Middle East Fertility Society Journal · December 1, 2018 Full text Cite

Freezing of all embryos in in vitro fertilization is beneficial in high responders, but not intermediate and low responders: an analysis of 82,935 cycles from the Society for Assisted Reproductive Technology registry.

Journal Article Fertil Steril · October 2018 OBJECTIVE: To assess in vitro fertilization (IVF) and pregnancy outcomes in patients having their first frozen embryo transfer (FET) after a freeze-all cycle versus similar patients having their first fresh embryo transfer (ET). DESIGN: Retrospective cohor ... Full text Link to item Cite

Cannabinoid exposure and altered DNA methylation in rat and human sperm.

Journal Article Epigenetics · 2018 Little is known about the reproductive effects of paternal cannabis exposure. We evaluated associations between cannabis or tetrahydrocannabinol (THC) exposure and altered DNA methylation in sperm from humans and rats, respectively. DNA methylation, measur ... Full text Open Access Link to item Cite

Do donor oocyte cycles comply with ASRM/SART embryo transfer guidelines? An analysis of 13,393 donor cycles from the SART registry.

Journal Article Fertil Steril · September 1, 2016 OBJECTIVE: To analyze donor oocyte cycles in the Society for Assisted Reproductive Technology (SART) registry to determine: 1) how many cycles complied with the 2009 American Society for Reproductive Medicine/SART embryo transfer guidelines; and 2) cycle o ... Full text Link to item Cite

How compliant are in vitro fertilization member clinics in following embryo transfer guidelines? An analysis of 59,689 fresh first in vitro fertilization autologous cycles from 2011 to 2012.

Journal Article Fertil Steril · September 1, 2016 OBJECTIVE: To determine whether IVF clinics are compliant with American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology (SART) (ASRM/SART) guidelines and assess the multiple pregnancy outcomes according to the numb ... Full text Link to item Cite

Pregnancy outcomes decline with increasing body mass index: analysis of 239,127 fresh autologous in vitro fertilization cycles from the 2008-2010 Society for Assisted Reproductive Technology registry.

Journal Article Fertil Steril · March 2016 OBJECTIVE: To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): A total of 239,127 fresh IVF cycles from the 2008-2010 Society for Assisted Repro ... Full text Link to item Cite

Pregnancy outcomes decline with increasing recipient body mass index: an analysis of 22,317 fresh donor/recipient cycles from the 2008-2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry.

Journal Article Fertil Steril · February 2016 OBJECTIVE: To examine the effect of recipient body mass index (BMI) on IVF outcomes in fresh donor oocyte cycles. DESIGN: Retrospective cohort study. SETTING: Not applicable. PATIENT(S): A total of 22,317 donor oocyte cycles from the 2008-2010 Society for ... Full text Link to item Cite

Ectopic pregnancy rate increases with the number of retrieved oocytes in autologous in vitro fertilization with non-tubal infertility but not donor/recipient cycles: an analysis of 109,140 clinical pregnancies from the Society for Assisted Reproductive Technology registry.

Journal Article Fertil Steril · October 2015 OBJECTIVE: To study the impact of controlled ovarian stimulation on ectopic pregnancy (EP) rate as a function of the number of oocytes retrieved, using donor IVF cycles as a control. DESIGN: Retrospective cohort study using a large national database. SETTI ... Full text Link to item Cite

Ectopic pregnancy rates in frozen versus fresh embryo transfer in in vitro fertilization: A systematic review and meta-analysis

Journal Article Middle East Fertility Society Journal · December 1, 2014 Objective To evaluate whether the rate of ectopic pregnancy differs between fresh and frozen embryo transfers.Design Systematic review and meta-analysis.Setting Centers for reproductive care.Materials and methods An electronic literature search in MEDLINE ... Full text Cite