IVF NewsNews: IVF women prefer risky pregnancy to no pregnancy
Ailsa Taylor 26 August 2007
Women with fertility problems would rather take the risks associated with multiple pregnancies than risk not becoming pregnant at all, reveals research published in BJOG: An International Journal of Obstetrics and Gynaecology (BJOG) this month. Researchers from the University of Aberdeen surveyed a total of 74 women who were awaiting IVF treatment to find out their preference for having children with the severe disabilities associated with multiple births, including physical impairments, mental impairments, visual impairments, stillbirth or death in early infancy and premature birth, compared to not becoming pregnant at all.
'Today a growing proportion of women conceive via assisted reproduction, yet there is limited appreciation amongst the general population regarding the risks involved with multiple births for both mother and child', said Professor Philip Steer, BJOG editor-in-chief. He added: 'This study reveals that a significant number of prospective parents value the experience of parenthood ahead of the risk of significant disability to their child'. The UK 'postcode lottery' for heath care extends into fertility treatment. While UK guidelines recommend funding three cycles of IVF for women younger than 40, limited resources mean that many women are only offered a single try. 'A more appropriate way to minimise risks without risking poor outcomes would be to encourage uptake of single embryo transfer in a climate which permits a greater number of funded treatments to couples', suggests lead researcher Graham Scotland, Research Fellow of the University of Aberdeen. However, he admits that limited resources may make this recommendation hard to put into practice. Two or more embryos are transferred into some women undergoing IVF, depending on guidelines issued under the HFEA's existing Code of Practice. However, the Authority launched a consultation in April this year aimed at finding the best way to reduce problems experienced by IVF children arising from multiple births and is expected to make a policy decision on the basis of the evidence and the consultation responses sometime in autumn 2007. The HFEA last reviewed its guidelines on how many embryos can be transferred during IVF treatments in July 2005. At the time, over 90 per cent of IVF cycles in the UK involved the transfer of two or three embryos. Current guidelines say that clinics can transfer up to two embryos per cycle for women under 40 and up to three for women over 40. Transferring multiple embryos means women are 20 times more likely to have twins and 400 times more likely to have triplets, compared to natural conception. As well as representing a significant risk of mortality to mother and child, this pronounced increased in multiple births puts added pressure on an already stretched National Health Service. Preliminary results from European research suggests that transferring single embryos may be as effective as transferring of two or more embryos, raising the question of whether this decision should be made by the doctor or by the patient. Regardless of who decides, good information is the key, say the researchers. 'Our results suggest that, at the present time, information on the risks associated with twin pregnancy may not be enough to deter some women in the UK from choosing double embryo transfer, given their perception that it will improve their chances of a live birth', said Scotland. [ Full Article ] News: British undercover journalists referred abroad for illegal sex selection
Heidi Nicholl 15 November 2006
According to the UK's Sunday Times newspaper last week, clinics in the UK are offering couples the chance to choose the sex of their child, a practice that is illegal in Britain unless done to avoid a serious genetic disorder in the resulting child, by referring them to clinics abroad. An undercover reporter from the newspaper approached a leading fertility specialist in London and was offered IVF with preimplantation genetic diagnosis (PGD) to choose the gender of a resulting baby - despite having no fertility problems - for the price of ?12,000. [ Full Article ] News: US guidelines restrict number of embryos transferred during IVF
Antony Blackburn-Starza 29 October 2006
The American Society for Reproductive Medicine (ASRM) and the US Society for Assisted Reproductive Technology (SART) have issued new guidelines limiting embryo transfer during IVF procedures to reduce the occurrence of multiple births. Announced at the annual ASRM meeting, held in New Orleans last week, the revised guidelines recommend that no more than two embryos should be transferred to women under 35 during a single cycle of IVF treatment, and that clinics should consider the possibility of transferring only one. For older women the recommended number of embryos increases, but to no more than five. The guidelines state that for women aged between 35 and 37, up to three embryos should be transferred, with up to four recommended for women aged between 37 and 40, and no more than five for women over 40. [ Full Article ] News: PhD Programme in Clinical Embryology, Reproductive Genetics and Stem Cell Biology
Dr. S. S. Muthiah. PhD 12 September 2014
Institute of Bio-Medical Research (DSIR Recognized) in association with SRM University (India's No.1 Private University) invites applications to pursue PhD Programme in the fields of Clinical Embryology, Reproductive Genetics, Stem Cell Biology and Regenerative Medicine. Kanmani Fertility Centre Pvt Ltd is one of the leading and pioneer fertility centres in Tamilnadu. It was established in the year 1996 by Dr. S.S. Muthiah, an Eminent Embryologist with 25 yrs of experience in the field of Human Embryology. Now the centre has successfully completed its 18 years of service with excellence in the field of human reproduction. To proceed with academic and research activities, Kanmani Fertility Centre Pvt Ltd has established a separate R&D wing ‘Institute of Biomedical Research’ in the year 2010 at T. Nagar, Chennai. ‘Institute of Biomedical Research’ has been recognized by the Department of Scientific and Industrial Research (DSIR), Ministry of Science and Technology, Government of India to carry out research in the emerging fields of biomedical sciences with special reference to human reproduction. In addition, the institute is also recognized and enrolled under National Registry of ART Clinics and Banks in India by Indian Council of Medical Research. Essential Educational Qualification MD - Obs&Gyn/Microbiology/ Biochemistry MS - Urology M Tech - Biotechnology M Sc - Life Sciences Desirable Candidates with Fellowship from CSIR / ICMR Resumes should be sent to [ Full Article ] Announcement: Clinical Fellowship in Andrology and Reproductive Medicine
Dr.N.Pandiyan 20 December 2008
Clinical Fellowship in Andrology and Reproductive Medicine.
Objectives: Train postgraduate students to establish and run an efficient, cost effective and ethical reproductive medicine unit. At the end of the course, candidates will 1.be able to handle reproductive medical problems both in the male and female. 2.have good working knowledge in the field of infertility and reproductive laboratory services Eligibility: Postgraduate Degree or Diploma in Obstetrics and Gynecology, General surgery,urology and general medicine. Duration: 1 year Mode of Teaching: Lectures, Power point presentations and interactive sessions Practical demonstrations Hands on – wherever applicable Journal club every month Frequent examinations conducted throughout the course. MCQ’s, Short notes and Essay type Questions. The students will not receive any stipend or any other form of financial support from the institution. However they may utilize the existing infrastructure in the department and institution. Fellows enrolled will not be on call in the hospital in any other department. [ Full Article ] News: Discovered: The starting pistil for sperm
Rose Palmer 09 February 2010
Scientists from the University of California in San Francisco have identified the mechanism by which sperm start swimming towards the egg when they enter the female reproductive system. The discovery could lead to drugs that boost male fertility and new forms of contraceptives. The finding was reported in Cell. It has been known for a while that a sperm's level of activity is affected by a change in internal pH, but the exact mechanism that regulates swimming was unknown. To investigate, Dr Yuriy Kirichok and his team used a technique called patch clamping to record proton movement across the cell membrane of sperm. They discovered that there was an abundance of Hv1 proton channels in the tails of the sperm. These act as a pore in the outer membrane of the sperm cell, extrude protons and are responsive to changes in the levels of zinc and pH outside of the cell. The uterus has a pH concentration one thousand times higher than semen, and this triggers the Hv1 channels to open. Extrusion of protons makes the environment within the sperm more alkaline and this, in turn, causes the sperm to start swimming. High concentrations of zinc, as found in semen, inhibit the Hv1 channels, preventing them from opening too soon. The levels of zinc are lower in the fallopian tubes and this may trigger an extra spurt of swimming power as the sperm nears the egg. Dr Kirichok said: 'What we're very excited about is that we've found the molecule that elevates sperm intracellular pH and we've found how that molecule is activated'. The researchers found that a compound called anandamide, which is found in high levels near the egg, also causes the channels to open. The compound is similar to the active ingredient in cannabis and it is possible the drug may mimic the effect. This could explain the link between cannabis use and poor fertility in males. The finding could lead to new forms of contraception. Dr Kirichok said the channel could be exploited by a drug which hampers proton release, leaving the sperm unable to swim. He said: 'All of these events are essential to fertilisation - you can imagine now that we know the molecule responsible we could block it to prevent activation and fertilisation as a kind of male contraception'. It may now also be possible to find a way to improve the sperm mobility of men who have fertility problems. [ Full Article ] Article: Egg donors need long-term follow-up: Recommendations from a retrospective study of oocyte donors in the US
Jennifer Schneider, MD, PhD Arizona Community Physicians, and Wendy Kramer, BA, Director, Donor Sibling Registry. 19 January 2009
More than 100,000 young women in the US have been recruited to become egg donors (1) with the offer of large sums of money, typically $8-15,000 per egg retrieval cycle, but at times up to $100,000. The US is also a destination for European women seeking to sell their eggs. Additionally, many couples seeking egg donors are from Europe, where paying for such services is illegal and waits can stretch for years (2). [ Full Article ] News: Divorced couple battle for 'custody' of their frozen embryos
Danielle Hamm 05 June 2007
A divorced couple have applied to the Texas Supreme Court for rights over frozen embryos, created using each of their gametes whilst they were still married. Randy and Augusta Roman underwent fertility treatment together before they separated in 2002. On the eve of the day the embryos were due to be implanted, Randy is reported to have withdrawn his consent to the procedure. The couple subsequently divorced and they have been fighting for 'custody' of the embryos ever since.
Initially, the district court ruled that Augusta had a constitutional right to the use of the embryos. The decision was later reversed by the Texas first Court of Appeal that ruled that the couple had made a contractual and binding agreement to destroy the embryos if they divorced. The case has now been referred to the Texas Supreme Court; which is not expected to decide whether it will hear the case until later this year. The case has ignited debate in America because of its potential implications for the legal status of the embryo. The ability to store embryos has created new legal questions over rights to these embryos in the event of subsequent disagreement between couples. There is currently no federal precedent and this is the first time such a case has come before the Texas Supreme Court. Similar cases have gone to the Supreme Courts in six states in America and the general trend has been to prevent implantation on the basis that one spouses' right not to implant the embryos overrules the other spouses right for them to be implanted. Some fear that if the case ends up in the Federal Supreme court, then the increasing conservative Court may use it as a vehicle for reconsidering the legal status of the embryo. In the landmark Roe v Wade ruling, which effectively made abortion legal in America, the Court ruled that because the unborn do not have constitutional rights, the woman's rights over her own body take precedent. If the unborn are considered to have a constitutional right to life, the legality of abortion will be thrown into question.
A similar case has recently gone through the European Court of Human Rights (ECHR). Natallie Evans fought for the right to use frozen embryos, created with her former partner, after he had withdrawn his consent to their use. The Court's final ruling was that Evan's right to become a parent should not be afforded more weight than her ex-partner's right not to become a parent.
News: Vitamin supplements help fertility in women
Laura Bell 30 October 2006
A Harvard Medical school study involving 18,000 women has shown that taking multivitamins, particularly folic acid, can improve chances of pregnancy in couples having difficulty conceiving. [ Full Article ] News: Lying down after artificial insemination improves pregnancy rates, study shows
Antony Blackburn-Starza 04 November 2009
A study in the Netherlands has shown that lying down following artificial insemination, also known as intrauterine insemination (IUI), increases the chances of pregnancy by 50 per cent. The findings, published in the British Medical Journal (BMJ) last week, revealed that 27 per cent of women who remained in a supine position following treatment for 15 minutes achieved a live birth, compared with only 17 per cent of those who got up and moved around. In total, 391 couples aged between 18 and 43 took part in the study, which took place across several hospitals in the Netherlands. Each couple received up to three cycles of insemination and were split into two groups - one remained immobilised immediately after treatment and the other, the control group, were asked to walk around. Lead author Dr Inge Custers, from the Academic Medical Center in Amsterdam, said that the pregnancy rate for the immobilised group was 'significantly higher'. He explained that 'immediate mobilisation might cause leakage [of the sperm]', which may take longer to reach the fallopian tubes if the woman is moving around. 'As immobilisation is easily done and carries very little cost, we suggest incorporating immobilisation as a standard procedure in intrauterine insemination treatment', said Custers, adding that clinics in the Netherlands were already adopting the method. However, there is concern that extending the period each bed is used in clinics could mean that clinics treat fewer patients. Custers said that improving the success rate of IUI will be more economical for patients. 'Although immobilisation takes more time and occupies more space in busy rooms, the intervention will be economic in the long run, as pregnant patients will not return in subsequent cycles,' he said. In an editorial piece which accompanied Custer's publication in the BMJ, Professor William Ledger, from the Academic Unit of Reproductive and Developmental Medicine at the University of Sheffield, said that there remain many unexplained factors that need to be explored, such as the optimal length of time a woman should remain immobile following treatment to achieve pregnancy. He also noted that it was not clear what proportion of women in the study were given drugs to stimulate their ovaries to produce eggs and expressed some doubt over the benefits of remaining immobile. 'Such postcoital positioning was advocated in the United States many years ago but did not seem to improve conception rates after sex,' he said. He also warned that the overall pregnancy rate achieved in the study is somewhat lower than can be expected in Britain. Ledger said that clinics should perform their own studies in the 'real world' to test Custers' findings. If further studies confirm the findings of the Netherlands team then he agreed that some couples will be spared the cost of IVF (in-vitro fertilisation). Artificial insemination is cheaper than IVF and requires minimal drug treatment. It is often used prior to IVF and success rates vary from 5-70 per cent, according to Ledger. [ Full Article ] |