About

Mark V. Sauer, M.D. is a faculty affiliate in bioethics and a professor and chair of the Department of Obstetrics, Gynecology and Reproductive Sciences at Rutgers Robert Wood Johnson Medical School. He has been a pioneer in the field of donor oocyte and embryo transfer, achieving the world's first donor egg pregnancies in menopausal women. Sauer is the director of the Division of Reproductive Endocrinology and the program director at the Center for Women’s Reproductive Care. His research and published works include topics such as payment of egg donors in stem cell research, reprogramming somatic cells to a pluripotent state using human oocytes, and extending reproductive potential to women over forty through oocyte donation. He received his medical degree from the University of Illinois School of Medicine, completed his residency in obstetrics and gynecology at the University of Illinois Hospital, and completed his fellowship in reproductive endocrinology at the University of California at Los Angeles.

Research topics

• Medicine
• Gynecology
• Obstetrics
• Andrology
• Internal medicine

Selected publications

• INCREASED STILLBIRTH RISK IN WOMEN UNDERGOING INFERTILITY TREATMENT AND ART; A POPULATION-BASED CROSS-SECTIONAL STUDY IN THE UNITED STATES, 2016-2023

  Fertility and Sterility · 2025-12-01

  article
  PublisherDOI

• Risks of Placental Abruption and Preterm Delivery in Patients Undergoing Assisted Reproduction

  JAMA Network Open · 2024-07-10 · 8 citations

  articleOpen access

  Importance: Patients using assisted reproductive technology (ART) may need additional counseling about the increased risks of placental abruption and preterm delivery. Further investigation into the potential additive risk of ART and placental abruption is needed. Objective: To ascertain the risk of placental abruption in patients who conceived with ART and to evaluate if placental abruption and ART conception are associated with an increased risk of preterm delivery (<37 weeks' gestation) over and above the risks conferred by each factor alone. Design, Setting, and Participants: This cross-sectional study used data from the National Inpatient Sample, which includes data from all-payer hospital inpatient discharges from 48 states across the US. Participants included women aged 15 to 54 years who delivered from 2000 through 2019. Data were analyzed from January 17 to April 18, 2024. Exposures: Pregnancies conceived with ART. Main Outcomes and Measures: Risks of placental abruption and preterm delivery in ART conception compared with spontaneous conceptions. Associations were expressed as odds ratios (ORs) and 95% CIs derived from weighted logistic regression models before and after adjusting for confounders. The relative excess risk due to interaction (RERI) of the risk of preterm delivery based on ART conception and placental abruption was also assessed. Results: Of 78 901 058 deliveries, the mean (SD) maternal age was 27.9 (6.0) years, and 9 212 117 patients (11.7%) were Black individuals, 14 878 539 (18.9%) were Hispanic individuals, 34 899 594 (44.2%) were White individuals, and 19 910 807 (25.2%) were individuals of other races and ethnicities. Of the total hospital deliveries, 98.2% were singleton pregnancies, 68.8% were vaginal deliveries, and 52.1% were covered by private insurance. The risks of placental abruption among spontaneous and ART conceptions were 11 and 17 per 1000 hospital discharges, respectively. After adjusting for confounders, the adjusted OR (AOR) of placental abruption was 1.42 (95% CI, 1.34-1.51) in ART pregnancies compared with spontaneous conceptions, with increased odds in White women (AOR, 1.42; 95% CI, 1.31-1.53) compared with Black women (AOR, 1.16; 95% CI, 0.93-1.44). The odds of preterm delivery were significantly higher in pregnancies conceived by ART compared with spontaneous conceptions (AOR, 1.46; 95% CI, 1.42-1.51). The risk of preterm delivery increased when patients had both ART conception and placental abruption (RERI, 2.0; 95% CI, 0.5-3.5). Conclusions and Relevance: In this cross-sectional study, patients who conceived using ART and developed placental abruption had a greater risk of preterm delivery compared with spontaneous conception without placental abruption. These findings have implications for counseling patients who seek infertility treatment and obstetrical management of ART pregnancies.

  PublisherOA PDFDOI

• Infertility treatment is associated with increased risk of postpartum hospitalization due to heart disease

  Journal of Internal Medicine · 2024-02-25 · 6 citations

  articleOpen access

  BACKGROUND: Cardiovascular disease is a major cause of maternal mortality, but the extent to which infertility treatment is implicated in heart disease remains unclear. OBJECTIVE: To evaluate the association between infertility treatment and postpartum heart disease. METHODS: We designed a retrospective cohort study of patients who delivered in the United States between 2010 and 2018. The primary outcome was hospitalization within 12-month post-delivery due to heart disease (including ischemic heart disease, atherosclerotic heart disease, cardiomyopathy, hypertensive disease, heart failure, and cardiac dysrhythmias). We estimated the rate difference (RD) of hospitalizations among patients who conceived with infertility treatment and those who conceived spontaneously. Associations were expressed as hazard ratios (HRs) and 95% confidence intervals (CIs), derived from Cox proportional hazards regression after adjustment for potential confounders. RESULTS: Infertility treatment was recorded in 0.9% (n = 287,813) of 31,339,991 deliveries. Rates of heart disease hospitalizations with infertility treatment and with spontaneous conception were 550 and 355 per 100,000, respectively (RD 195, 95% CI: 143-247; adjusted HR 1.99, 95% CI: 1.80-2.20). The most important increase in risk was observed for hypertensive disease (adjusted HR 2.16, 95% CI: 1.92-2.42). This increased risk was apparent as early as 30-day post-delivery (HR 1.61, 95% CI: 1.39-1.86), with progressively increasing risk up to a year. CONCLUSIONS: Although the absolute risk of postpartum heart disease hospitalization is low, infertility treatment is associated with an increased risk, especially for hypertensive disease. These findings highlight the importance of timely postpartum follow-ups in patients who received infertility treatment.

  PublisherOA PDFDOI

• Does Proposed Anti-Abortion Legislation Affect Access to Abortion Care? A State-by-State Comparison [ID: 1371679]

  Obstetrics and Gynecology · 2023-05-01

  articleSenior author

  INTRODUCTION: Concerns over unhindered access to abortion have heightened because of newly proposed state legislation designed to restrict care in the United States. This study examines the effect of such measures on abortion access within each state prior to the 2022 Dobbs v Jackson ruling. METHODS: Proposed anti-abortion measures from 2015 to 2019 were collected from Guttmacher Institute databases, and sorted by state and legislative progress. Rates of abortions during that period were collected from Centers for Disease Control Vital Statistics reports, and similarly sorted by state. Basic statistical analyses were used to compare data. RESULTS: The average ratio of introduced to enacted anti-abortion legislation in the United States was 0.176, with North Dakota having the highest ratio of 1. Average overall abortion rates did not significantly change during this time (9.70 versus 9.44 per 1,000, P =.79). However, the correlation coefficient of state data comparing enacted legislation to overall abortion rates grew in magnitude from −0.189 in 2015 to −0.350 in 2019. The overall percent change in abortion rate per enacted legislation was −0.0089%, with Washington, DC, having the largest at −0.14%. CONCLUSION: Prior to the overturning of Roe v Wade , most state-introduced anti-abortion bills failed to be enacted into law. However, in states legislating restriction, women were disproportionately affected by lack of access to abortion locally. Patients and physicians alike should remain vigilant to the danger posed by anti-abortion legislation that would further hinder access to the reproductive health care of women.

  PublisherDOI

• Risk of Stroke Hospitalization After Infertility Treatment

  JAMA Network Open · 2023-08-30 · 25 citations

  articleOpen access

  Importance: Stroke accounts for 7% of pregnancy-related deaths in the US. As the use of infertility treatment is increasing, many studies have sought to characterize the association of infertility treatment with the risk of stroke with mixed results. Objective: To evaluate the risk of hospitalization from hemorrhagic and ischemic strokes in patients who underwent infertility treatment. Design, Setting, and Participants: This population-based, retrospective cohort study used data abstracted from the Nationwide Readmissions Database, which stores data from all-payer hospital inpatient stays from 28 states across the US, from 2010 and 2018. Eligible participants included individuals aged 15 to 54 who had a hospital delivery from January to November in a given calendar year, and any subsequent hospitalizations from January to December in the same calendar year of delivery during the study period. Statistical analysis was performed between November 2022 and April 2023. Exposure: Hospital delivery after infertility treatment (ie, intrauterine insemination, assisted reproductive technology, fertility preservation procedures, or use of a gestational carrier) or after spontaneous conception. Main Outcomes and Measures: The primary outcome was hospitalization for nonfatal stroke (either ischemic or hemorrhagic stroke) within the first calendar year after delivery. Secondary outcomes included risk of stroke hospitalization at less than 30 days, less than 60 days, less than 90 days, and less than 180 days post partum. Cox proportional hazards regression models were used to estimate associations, which were expressed as hazard ratios (HRs), adjusted for confounders. Effect size estimates were corrected for biases due to exposure misclassification, selection, and unmeasured confounding through a probabilistic bias analysis. Results: Of 31 339 991 patients, 287 813 (0.9%; median [IQR] age, 32.1 [28.5-35.8] years) underwent infertility treatment and 31 052 178 (99.1%; median [IQR] age, 27.7 [23.1-32.0] years) delivered after spontaneous conception. The rate of stroke hospitalization within 12 months of delivery was 37 hospitalizations per 100 000 people (105 patients) among those who received infertility treatment and 29 hospitalizations per 100 000 people (9027 patients) among those who delivered after spontaneous conception (rate difference, 8 hospitalizations per 100 000 people; 95% CI, -6 to 21 hospitalizations per 100 000 people; HR, 1.66; 95% CI, 1.17 to 2.35). The risk of hospitalization for hemorrhagic stroke (adjusted HR, 2.02; 95% CI, 1.13 to 3.61) was greater than that for ischemic stroke (adjusted HR, 1.55; 95% CI, 1.01 to 2.39). The risk of stroke hospitalization increased as the time between delivery and hospitalization for stroke increased, particularly for hemorrhagic strokes. In general, these associations became larger for hemorrhagic stroke and smaller for ischemic stroke following correction for biases. Conclusions and Relevance: In this cohort study, infertility treatment was associated with an increased risk of stroke-related hospitalization within 12 months of delivery; this risk was evident as early as 30 days after delivery. Timely follow-up in the immediate days post partum and continued long-term follow-up should be considered to mitigate stroke risk.

  PublisherOA PDFDOI

• Egg and Embryo Donation

  2023-12-04 · 2 citations

  book-chapter1st authorCorresponding

  Human egg (oocyte) and embryo donation has evolved into a relatively common procedure that addresses a variety of reproductive disorders. In the United States, more than 22,000 procedures involving fresh or frozen embryos procured through oocyte donation or embryo donation were reported to the Centers for Disease Control and Prevention in 2018. Oocyte donation to treat infertility in women with physiological menopause is an established and very effective method to achieve pregnancy in patients who have reached the end of their reproductive years. In today's ART clinic, donor eggs are frequently obtained from “egg banks,” which store oocytes from young, healthy donors who were paid to undergo stimulation and oocyte retrieval. Recipients of donated eggs experience implantation and pregnancy rates similar to those normally seen in young women undergoing IVF. However, providers and patients should be aware that pregnancies conceived via oocyte donation are at increased risk of certain obstetrical and neonatal complications, including pre-eclampsia, preterm delivery, and low birthweight. Individuals in the LGBTQ community commonly seek fertility care to build their families. For such patients, the use of oocyte donation and/or gestational carriers may be necessary, and use of these services has continued to increase.

  PublisherDOI

• Gestational diabetes mellitus in pregnancies conceived after infertility treatment: a population-based study in the United States, 2015–2020

  F&S Reports · 2023-11-17 · 4 citations

  articleOpen access

  Objective: To evaluate the risk of gestational diabetes mellitus (GDM) in singleton pregnancies conceived using infertility treatment and examine the influence of race and ethnicity as well as prepregnancy body mass index (BMI). Design: Cross-sectional study using the US vital records data of women that delivered singleton births. Setting: United States, 2015-2020. Interventions: Any infertility treatment was divided into two groups: those that used fertility-enhancing drugs, artificial insemination, or intrauterine insemination, and those that used assisted reproductive technology (ART). Main Outcome Measuress: Gestational diabetes mellitus, defined as a diagnosis of diabetes mellitus during pregnancy, includes both diet-controlled GDM and medication-controlled GDM in singleton pregnancies conceived with infertility treatment or spontaneously and delivered between 20- and 44-weeks' gestation. We also examined whether the infertility treatment-GDM association was modified by maternal race and ethnicity as well as prepregnancy BMI. Associations were expressed as a rate ratio (RR) and 95% confidence interval (CI), derived from log-linear models after adjustment for potential confounders. Results: A total of 21,943,384 singleton births were included, with 1.5% (n = 318,086) undergoing infertility treatment. Rates of GDM among women undergoing infertility treatment and those who conceived spontaneously were 11.0% (n = 34,946) and 6.5% (n = 1,398,613), respectively (adjusted RR 1.24, 95% CI 1.23, 1.26). The RRs were adjusted for maternal age, parity, education, race and ethnicity, smoking, BMI, chronic hypertension, and year of delivery. The risk of GDM was modestly increased for those using fertility-enhancing drugs (adjusted RR 1.28, 95% CI 1.27, 1.30) compared with ART (adjusted RR 1.18, 95% CI 1.17, 1.20), and this risk was especially apparent for non-Hispanic White women (adjusted RR 1.29, 95% CI 1.26, 1.31) and Hispanic women (adjusted RR 1.35, 95% CI 1.29, 1.41). The number of women who needed to be exposed to infertility treatment to diagnose one case of GDM was 46. Prepregnancy BMI did not modify the infertility treatment-GDM association overall and within strata of race and ethnicity. These general patterns were stronger after potential corrections for misclassification of infertility treatment and unmeasured confounding. Conclusions: Infertility treatment, among those who received fertility-enhancing drugs, is associated with an increased GDM risk. The persistently higher risk of GDM among women who seek infertility treatment, irrespective of prepregnancy weight classification, deserves attention. Infertility specialists must be vigilant with preconception counseling and ensure that all patients, regardless of race and ethnicity or BMI, are adequately tested for GDM early in pregnancy using a fasting blood glucose level or a traditional 50-g oral glucose tolerance test. Testing may be completed by the infertility specialist or deferred to the primary prenatal care provider at the first prenatal visit.

  PublisherOA PDFDOI

• INFERTILITY TREATMENT AND THE RISK OF HEART DISEASE WITHIN A YEAR FOLLOWING DELIVERY: A COHORT STUDY IN THE UNITED STATES

  Fertility and Sterility · 2023-10-01

  articleOpen access
  PublisherOA PDFDOI

• Cancellation of Postpartum Tubal Ligations During COVID-19 and Alternative Contraceptive Methods in Women With Public Insurance: A 2-Year Update [ID: 1373829]

  Obstetrics and Gynecology · 2023-05-01

  articleSenior author

  INTRODUCTION: During the COVID-19 pandemic, postpartum bilateral tubal ligations (ppBTLs) were deemed “elective” and cancelled from March through June 2020. For patients with public insurance, the postpartum represents a brief interval in which contraception is covered and access to surgery is readily available. METHODS: We reviewed publicly insured patients who consented for ppBTLs after vaginal deliveries at our institution from March to June 2020 in whom procedures were cancelled. We analyzed alternative contraception chosen at discharge and up to 6 months postpartum. Two years later, we reviewed the same patients to evaluate contraceptive practice and pregnancy outcomes. RESULTS: After 275 vaginal deliveries, 25 ppBTLs were cancelled. Subsequently, 12 (48%) women were discharged without contraception. Seven (28%) and 14 (56%) women were not using contraception 6 weeks and 6 months postpartum, respectively. Two years later, six (24%) women returned pregnant; three without contraception, one using oral contraceptive pills, one using condoms, and one with a perforated intrauterine device (IUD). Two are currently pregnant and one underwent abortion with IUD placement. Three experienced uncomplicated vaginal deliveries, after which two received ppBTLs and one did not return for follow-up. CONCLUSION: As a result of pandemic policy, many women were unable to access ppBTLs and failed alternative means of contraception. As a result, nearly one-quarter of these patients became pregnant. Obstetrician–gynecologists should ensure that contraception counseling and pregnancy intention are addressed at each prenatal appointment. Physicians must also lobby for an expansion of postpartum insurance coverage and better advocate for services that provide women reproductive autonomy.

  PublisherDOI

• Trocar site hernia after laparoscopy: Early recognition prevents catastrophic sequelae

  Journal of Emergency Medicine · 2022-10-28 · 2 citations

  articleSenior author
  PublisherDOI

Frequent coauthors

• Richard J. Paulson

  116 shared

• Rogerio A. Løbo

  Columbia University

  101 shared

• John E. Buster

  Brown University

  66 shared

• Cande V. Ananth

  Rutgers, The State University of New Jersey

  60 shared

• Melvin H. Thornton

  57 shared

• Gary S. Nakhuda

  54 shared

• Michael M. Guarnaccia

  50 shared

• Joseph E. Peña

  Yale University

  49 shared

Labs

• Reproductive Endocrinology at Columbia UniversityPI

Education

• MS, Bioethics

  Columbia University

  2017

• MD

  University of Illinois at Chicago

  1980

• AB Biology

  Washington University in Saint Louis

  1976