About

Sara Sinha Morelli, PHD, MD, is a professor at Rutgers New Jersey Medical School in the Department of Obstetrics, Gynecology and Reproductive Health. She serves as the Vice Chair of the department, Director of the Division of Reproductive Endocrinology and Infertility, and Director of the Reproductive Endocrinology and Infertility Fellowship Program. Her educational background includes a Bachelor of Science in Biology and Society from Cornell University, an MD with Distinction in Research from Mount Sinai School of Medicine, and a PhD in Biomedical Sciences from Rutgers Graduate School of Biomedical Sciences. She completed her residency in Obstetrics and Gynecology at NYU School of Medicine and a fellowship in Reproductive Endocrinology and Infertility at New Jersey Medical School. Her research interests focus on disorders of the endometrium and their contributions to reproductive success and failure. She has developed a mouse model to study the role of bone marrow-derived cells in the endometrium and has published extensively on topics such as endometrial aging, receptivity, and the impact of assisted reproductive technologies.

Research topics

• Gynecology
• Internal medicine
• Medicine
• Biology
• Obstetrics
• Genetics

Selected publications

• Association Between Post-Trigger Hormones and <i>In Vitro</i> Fertilization Cycle Outcomes

  Journal of Clinical Gynecology and Obstetrics · 2026-02-08

  articleOpen accessSenior author

  Background: Numerous studies have evaluated the association between estradiol and progesterone levels on the day of trigger administration and cycle outcomes; however, less is known about serum hormone levels following trigger and whether they are associated with cycle outcomes. This study was conducted to assess the association between serum steroid hormone parameters on the day after oocyte maturation trigger and ovarian stimulation cycle outcomes. Methods: This was a retrospective cohort study. All patients undergoing ovarian stimulation with the use of gonadotropins between September 2018 and September 2020 were assessed for inclusion. Chart review was performed to collect demographic information, cycle and trigger type, pre- and post-treatment serum hormone levels (estradiol, progesterone), and cycle outcomes. The primary outcomes were oocyte recovery rate, oocyte maturity rate, oocyte fertilization rate, and blastulation rate. Results: A total of 320 cycles were included in the study from 245 unique patients; 19% of cycles utilized a gonadotropin-releasing hormone (GnRH) agonist stimulation protocol and 81% utilized a GnRH antagonist stimulation protocol. Post-trigger progesterone level was associated with poor oocyte recovery, but not with oocyte maturity, fertilization, or blastulation rates. Post-trigger estradiol levels were not associated with oocyte recovery rate, oocyte maturity rate, fertilization rate, or blastulation rate. Conclusions: This is one of few studies evaluating the association between estradiol and progesterone levels on the day after trigger injection and oocyte stimulation cycle outcomes. Our findings suggest that the association between post-trigger progesterone levels and poor oocyte recovery rate may be small but meaningful.

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• Co-occurrence of a Mullerian anomaly and Kallmann syndrome: A case report

  Case Reports in Women s Health · 2025-02-04

  articleOpen accessSenior author

  The evaluation of primary amenorrhea requires a thoughtful assessment for hormonal, structural and/or genetic causes. Although most cases of primary amenorrhea are caused by a single pathology, rarely multiple pathologies may be uncovered. We present the case of a 33-year-old woman with a history of pubertal failure and primary amenorrhea due to Kallmann syndrome. She reported previous short-term use of hormone replacement therapy, with onset of severe pelvic pain and vaginal bleeding following its discontinuation. Her workup revealed concern for uterine didelphys with OHVIRA syndrome on MRI. Surgical exploration revealed a normal-appearing vagina and cervix communicating with the left uterine horn and fallopian tube, a separate, contralateral, obstructed, and engorged right uterine horn with cervix and obstructed vagina, and normal ovaries bilaterally. She underwent laparoscopic resection of the obstructed right hemiuterus with right salpingectomy. Estrogen replacement therapy was initiated postoperatively with cyclic progestins, and she experienced complete resolution of her pain. In the workup of primary amenorrhea, it is important to consider that more than one pathology may be present. A thorough endocrine, genetic, and anatomic evaluation is imperative prior to confirming the diagnosis and initiating treatment. Kallmann syndrome has rarely been reported with Mullerian anomalies; in this case it represents a scenario in which the induction of puberty and menses brought an obstructive anomaly to light. The possibility of co-occurring pathologies should always be considered to provide optimal care to the patient.

  PublisherDOI

• Obesity Epidemic and Its Impact on Female Fertility: Current Understanding and Future Directions

  Cureus · 2025-07-04 · 2 citations

  reviewOpen accessSenior author

  Obesity is a global epidemic with profound implications for fertility in women of reproductive age. This review summarizes how obesity affects fertility by disrupting the hypothalamic-pituitary-ovarian (HPO) axis, affecting oocyte quality and reserve, and compromising endometrial receptivity. The combination of these disruptions leads to reduced fertility rates, decreased success with assisted reproductive technologies (ARTs), and increased risk for adverse pregnancy outcomes. This review also examines the impact of interventions for weight loss, including lifestyle modifications, medications, and surgery, on female fertility. Overall, these interventions show promise in anovulatory cycles; however, their impact on live birth rates (LBRs) remains variable. Newer therapies, such as glucagon-like peptide 1 receptor agonists (GLP-1 RAs), have expanded the armamentarium of options for obesity management. Emerging data suggest potential roles for GLP-1 RAs in ovarian and endometrial function, suggesting broader applications in reproductive health. Given the complexity of obesity's impact on reproduction, a multidisciplinary approach incorporating lifestyle modification, pharmacotherapy, and, if necessary, surgery offers the most significant potential to optimize reproductive success.

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• Dynamic expression of endometrial adhesion G protein-coupled receptors during the menstrual cycle and early mouse pregnancy: modulation by ovarian stimulation

  F&S Science · 2025-05-16 · 2 citations

  articleOpen access

  OBJECTIVE: To characterize the expression of adhesion G protein-coupled receptors (ADGR) in the human endometrium and early mouse pregnancy. DESIGN: An in silico analysis was performed using a retrospective data set comprised endometrial samples across normo-ovulatory menstrual cycles. Gene expression was then validated using quantitative reverse transcription polymerase chain reaction and mRNA sequencing (mRNA-seq) in prospectively collected endometrial biopsies in the periovulatory and midsecretory stages of natural cycles. Gene expression was also investigated under ovarian stimulation (OS) conditions using mRNA-seq. Early pregnancy mouse models were used to investigate whether trends of dynamic ADGR expression are also conserved in the mouse. SUBJECTS: Twenty-four women aged 21-42 years. EXPOSURE: Ovulatory menstrual cycle or OS cycle. MAIN OUTCOME MEASURES: Gene expression in endometrial biopsies and pregnant mouse uterus. RESULTS: Fifteen women, aged 21-33 years, were recruited in natural cycles during the proliferative phase (cycle days 10-13; n = 4), periovulatory (luteinizing hormone + 12-24 hours; n = 6) period, and midsecretory (luteinizing hormone + 8-9 days; n = 5) phase. Nine women aged 31-42 years old undergoing in vitro fertilization (without fresh embryo transfer) or oocyte cryopreservation using a gonadotropin releasing hormone antagonist protocol were recruited for the OS cohort in either the periovulatory phase (human chorionic gonadotropin + 2; n = 5) or midsecretory phase (human chorionic gonadotropin + 9; n = 4). The in silico analysis revealed dynamic expression for many ADGRs across the menstrual cycle. Differential gene expression was also seen in the prospective analysis within the menstrual cycle phases and between natural cycle and OS conditions. Within early mouse pregnancy, expression was also found to be altered across several Adgr subfamilies. CONCLUSION: The differential gene expression observed between the proliferative and secretory phases of the menstrual cycle, along with changes in expression seen in OS and early mouse pregnancy suggest that ADGR expression is hormonally regulated by estradiol and progesterone.

  PublisherDOI

• Effect of powder morphology on tribological performance of HVAF-sprayed WC-CoCr coatings

  Surface and Coatings Technology · 2025-03-28 · 14 citations

  articleOpen access

  This study investigates the tribological behavior of WC-CoCr coatings deposited using High-Velocity Air Fuel (HVAF) thermal spraying. Three distinct types of feedstock powders were employed to examine the influence of powder morphology on coating performance: a dense, angular fused-and-crushed powder; a spherical, porous agglomerated-and-sintered powder, and a newly developed powder with intermediate features. All powders had analogous particle size distribution approximately in the range of 7–20 μm. Two coating thicknesses were deposited with each powder (50 μm and 150 μm), additionally aiming to verify the possibility of depositing thin hardmetal coatings. The coatings microstructure was characterized, their hardness and porosity were measured and their tribological properties were evaluated by means of ball-on-disk sliding tests and dry jet erosion tests at various impact angles. The results demonstrated that powder morphology significantly affects deposition efficiency. The newly developed powder offers notable advantages, such as higher deposition efficiency, which accelerates the spraying process and boosts production productivity, along with reduced sensitivity to parameter variations. In fact, the newly developed powder exhibited more consistent deposition rates across varying process conditions. Coatings derived from the new manufacturing route powder also showed improved cohesion and hardness due to stronger interparticle bonding and peening effects. On the other hand, surface roughness was unaffected by the powder type, and the coatings produced from the three powders had comparable wear resistance under erosion and sliding conditions. Coating thickness, rather than powder morphology, appeared to play a greater role in determining wear performance. The thicker coatings demonstrated superior resistance under both test conditions, due to reduced substrate influence. • Influence of powder morphology on WC-CoCr coating deposition by HVAF is investigated • WC-CoCr powder with rounded yet dense particles induces higher deposition efficiency • Coatings from this type of powder feedstock are more cohesive and harder • Hardness also increases with coating thickness because of enhanced peening effects • Thicker coatings exhibit better erosion and sliding wear resistance regardless of powder type

  PublisherDOI

• Age does not affect maximal endometrial thickness achieved in frozen embryo transfer cycles: a SARTCORS study

  Reproductive Biology and Endocrinology · 2025-08-02

  articleOpen accessSenior author

  BACKGROUND: Age is known to affect the success of assisted reproductive technology (ART) treatment. While significant research efforts have been directed at investigating the effects of aging on oocytes, few studies have examined the effect of aging on the endometrium. We sought to assess whether age negatively impacts peak endometrial thickness achieved in frozen embryo transfer (FET) cycles. METHODS: This was a retrospective cohort study utilizing the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) database between 2016 and 2020. Young (< 35) and older (≥35yo) non-identified oocyte donor (NOD) recipients were included to assess the impact of age on endometrial thickness; young and older gestational carriers (GCs) served as the respective controls for these two groups. The primary outcome was peak endometrial thickness achieved in an FET cycle; additional outcomes included cycle cancellation rate, clinical pregnancy rate and live birth rate. RESULTS: We observed a weak association between age and endometrial thickness in both NOD recipient and GC cycles. Though pregnancy rates were slightly lower at endometrial thicknesses < 8 mm, we observed no difference in clinical pregnancy rate with endometrial thicknesses between 8 and 18 mm. We found a significantly higher clinical pregnancy rate in GCs compared to NOD recipients in both the young and older age groups, and noted a decreasing clinical pregnancy rate with age in all groups. CONCLUSION: Our data suggest an age-related decline in pregnancy rates in donor oocyte recipients and gestational carrier cycles, in which an endometrial factor would not necessarily be anticipated; this endometrial factor does not appear to be related to endometrial thickness. Therefore, our data support the existence of an endometrial factor that cannot be assessed by measurements of thickness, but nevertheless plays a crucial role in the success of an embryo implantation. CLINICAL TRIAL NUMBER: Not applicable.

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• Update on Diagnosis and Management of Recurrent Early Pregnancy Loss

  Topics in Obstetrics & Gynecology · 2024-08-16

  articleSenior author
  PublisherDOI

• Impaired receptivity of thin endometrium: therapeutic potential of mesenchymal stem cells

  Frontiers in Endocrinology · 2024-01-25 · 28 citations

  articleOpen accessSenior authorCorresponding

  The endometrium is a resilient and highly dynamic tissue, undergoing cyclic renewal in preparation for embryo implantation. Cyclic endometrial regeneration depends on the intact function of several cell types, including parenchymal, endothelial, and immune cells, as well as adult stem cells that can arise from endometrial or extrauterine sources. The ability of the endometrium to undergo rapid, repeated regeneration without scarring is unique to this tissue. However, if this tissue renewal process is disrupted or dysfunctional, women may present clinically with infertility due to endometrial scarring or persistent atrophic/thin endometrium. Such disorders are rate-limiting in the treatment of female infertility and in the success of in vitro fertilization because of a dearth of treatment options specifically targeting the endometrium. A growing number of studies have explored the potential of adult stem cells, including mesenchymal stem cells (MSCs), to treat women with disorders of endometrial regeneration. MSCs are multipotent adult stem cells with capacity to differentiate into cells such as adipocytes, chondrocytes, and osteoblasts. In addition to their differentiation capacity, MSCs migrate toward injured sites where they secrete bioactive factors (e.g. cytokines, chemokines, growth factors, proteins and extracellular vesicles) to aid in tissue repair. These factors modulate biological processes critical for tissue regeneration, such as angiogenesis, cell migration and immunomodulation. The MSC secretome has therefore attracted significant attention for its therapeutic potential. In the uterus, studies utilizing rodent models and limited human trials have shown a potential benefit of MSCs and the MSC secretome in treatment of endometrial infertility. This review will explore the potential of MSCs to treat women with impaired endometrial receptivity due to a thin endometrium or endometrial scarring. We will provide context supporting leveraging MSCs for this purpose by including a review of mechanisms by which the MSC secretome promotes regeneration and repair of nonreproductive tissues.

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• One Result, Many Eyes: Creating a Results Safety Net in a University Hospital-Based Reproductive Endocrinology and Infertility Clinic

  American Journal of Medical Quality · 2024-05-01

  articleSenior author

  Vessa, Blake MD; Malhotra, Radhika MD; Chemerinski, Anat MD; Howard, David MD, PhD; Morelli, Sara MD, PhD Author Information

  PublisherDOI

• The impact of ovarian stimulation on the human endometrial microenvironment

  Human Reproduction · 2024-03-20 · 15 citations

  articleOpen access

  STUDY QUESTION: How does ovarian stimulation (OS), which is used to mature multiple oocytes for ART procedures, impact the principal cellular compartments and transcriptome of the human endometrium in the periovulatory and mid-secretory phases? SUMMARY ANSWER: During the mid-secretory window of implantation, OS alters the abundance of endometrial immune cells, whereas during the periovulatory period, OS substantially changes the endometrial transcriptome and impacts both endometrial glandular and immune cells. WHAT IS KNOWN ALREADY: Pregnancies conceived in an OS cycle are at risk of complications reflective of abnormal placentation and placental function. OS can alter endometrial gene expression and immune cell populations. How OS impacts the glandular, stromal, immune, and vascular compartments of the endometrium, in the periovulatory period as compared to the window of implantation, is unknown. STUDY DESIGN, SIZE, DURATION: This prospective cohort study carried out between 2020 and 2022 included 25 subjects undergoing OS and 25 subjects in natural menstrual cycles. Endometrial biopsies were performed in the proliferative, periovulatory, and mid-secretory phases. PARTICIPANTS/MATERIALS, SETTING, METHODS: Blood samples were processed to determine serum estradiol and progesterone levels. Both the endometrial transcriptome and the principal cellular compartments of the endometrium, including glands, stroma, immune, and vasculature, were evaluated by examining endometrial dating, differential gene expression, protein expression, cell populations, and the three-dimensional structure in endometrial tissue. Mann-Whitney U tests, unpaired t-tests or one-way ANOVA and pairwise multiple comparison tests were used to statistically evaluate differences. MAIN RESULTS AND THE ROLE OF CHANCE: In the periovulatory period, OS induced high levels of differential gene expression, glandular-stromal dyssynchrony, and an increase in both glandular epithelial volume and the frequency of endometrial monocytes/macrophages. In the window of implantation during the mid-secretory phase, OS induced changes in endometrial immune cells, with a greater frequency of B cells and a lower frequency of CD4 effector T cells. LARGE SCALE DATA: The data underlying this article have been uploaded to the Genome Expression Omnibus/National Center for Biotechnology Information with accession number GSE220044. LIMITATIONS, REASONS FOR CAUTION: A limited number of subjects were included in this study, although the subjects within each group, natural cycle or OS, were homogenous in their clinical characteristics. The number of subjects utilized was sufficient to identify significant differences; however, with a larger number of subjects and additional power, we may detect additional differences. Another limitation of the study is that proliferative phase biopsies were collected in natural cycles, but not in OS cycles. Given that the OS cycle subjects did not have known endometrial factor infertility, and the comparisons involved subjects who had a similar and robust response to stimulation, the findings are generalizable to women with a normal response to OS. WIDER IMPLICATIONS OF THE FINDINGS: OS substantially altered the periovulatory phase endometrium, with fewer transcriptomic and cell type-specific changes in the mid-secretory phase. Our findings show that after OS, the endometrial microenvironment in the window of implantation possesses many more similarities to that of a natural cycle than does the periovulatory endometrium. Further investigation of the immune compartment and the functional significance of this cellular compartment under OS conditions is warranted. STUDY FUNDING/COMPETING INTERESTS: Research reported in this publication was supported by the National Institute of Allergy and Infectious Diseases (R01AI148695 to A.M.B. and N.C.D.), Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD109152 to R.A.), and the March of Dimes (5-FY20-209 to R.A.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or March of Dimes. All authors declare no conflict of interest.

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Frequent coauthors

• Peter G. McGovern

  224 shared

• Nicole M. Marchetto

  Rutgers New Jersey Medical School

  88 shared

• Amy S. Dhesi

  83 shared

• E.C. Holden

  Rutgers New Jersey Medical School

  58 shared

• Nataki C. Douglas

  Rutgers, The State University of New Jersey

  52 shared

• Sangita Jindal

  42 shared

• Anat Chemerinski

  University Reproductive Associates

  38 shared

• Qingshi Zhao

  37 shared

Education

• B.S., Biology and Society

  Cornell University

  1999

• M.D.

  Mount Sinai School of Medicine

  2003

• Ph.D., Biomedical Sciences

  Rutgers Graduate School of Biomedical Sciences

  2017

Awards & honors

• Scholar of the American Association of Obstetricians and Gyn…