IVF NewsNews: Postcode lottery rages on as IVF funding lacks continuity
Sarah Guy 12 January 2009
Only one in five primary care trusts (PCTs) in England is providing the recommended number of NHS-funded IVF cycles, it was revealed at a fertility conference in Edinburgh last week. [ Full Article ] News: Daily sex helps to reduce sperm DNA damage and improve fertility
ESHRE 30 June 2009
Amsterdam, The Netherlands: Daily sex (or ejaculating daily) for seven days improves men’s sperm quality by reducing the amount of DNA damage, according to an Australian study presented today (Tuesday) to the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam. Until now there has been no evidence-based consensus amongst fertility specialists as to whether or not men should refrain from sex for a few days before attempting to conceive with their partner, either spontaneously or via assisted reproduction. Dr David Greening, an obstetrician and gynaecologist with sub specialist training in reproductive endocrinology and infertility at Sydney IVF, Wollongong, Australia, said: “All that we knew was that intercourse on the day of ovulation offered the highest chance of pregnancy, but we did not know what was the best advice for the period leading up to ovulation or egg retrieval for IVF. “I thought that frequent ejaculation might be a physiological mechanism to improve sperm DNA damage, while maintaining semen levels within the normal, fertile range.” To investigate this hypothesis, Dr Greening studied 118 men who had higher than normal sperm DNA damage as indicated by a DNA Fragmentation Index (DFI). Men who had a more than 15% of their sperm (DFI >15%) damaged were eligible for the trial. At Sydney IVF, sperm DNA damage is defined as less than 15% DFI for excellent quality sperm, 15-24% DFI for good, 25-29% DFI for fair and more than 29% DFI for poor quality; but other laboratories can have slightly different ranges. The men were instructed to ejaculate daily for seven days, and no other treatment or lifestyle changes were suggested. Before they started, levels of DNA damage ranged between 15% and 98% DFI, with an average 34% DFI when measured after three days’ abstinence. When the men’s sperm was re-assessed on the seventh day, Dr Greening found that 96 men (81%) had an average 12% decrease in their sperm DNA damage, while 22 men (19%) and an average increase in damage of nearly 10%. The average for the whole group dropped to 26% DFI. Dr Greening said: “Although the mean average was 26% which is in the ‘fair’ range for sperm quality, this included 18% of men whose sperm DNA damage increased as well as those whose DNA damage decreased. Amongst the men whose damage decreased, their average dropped by 12% to just under 23% DFI, which puts them in the ‘good’ range. Also, more men moved into the ‘good’ range and out of the ‘poor’ or ‘fair’ range. These changes were substantial and statistically highly significant. “In addition, we found that although frequent ejaculation decreased semen volume and sperm concentrations, it did not compromise sperm motility and, in fact, this rose slightly but significantly. “Further research is required to see whether the improvement in these men’s sperm quality translates into better pregnancy rates, but other, previous studies have shown the relationship between sperm DNA damage and pregnancy rates. “The optimal number of days of ejaculation might be more or less than seven days, but a week appears manageable and favourable. It seems safe to conclude that couples with relatively normal semen parameters should have sex daily for up to a week before the ovulation date. In the context of assisted reproduction, this simple treatment may assist in improving sperm quality and ultimately achieving a pregnancy. In addition, these results may mean that men play a greater role in infertility than previously suspected, and that ejaculatory frequency is important for improving sperm quality, especially as men age and during assisted reproduction cycles.” Dr Greening said he thought the reason why sperm quality improved with frequent ejaculation was because the sperm had a shorter exposure in the testicular ducts and epididymis to reactive oxygen species – very small molecules, high levels of which can damage cells. “The remainder of the men who had an increase in DFI might have a different explanation for their sperm DNA damage,” he concluded.
[ Full Article ] News: IVF and ICSI children grow up healthy
Dr. Kirsty Horsey 19 May 2024
Children conceived using IVF and intracytoplasmic sperm injection (ICSI) techniques have the same intellectual and movement abilities as naturally conceived children, a new European study shows. Researchers based at University College Medical School in London tested the developmental skills of around 1000 five-year old children conceived using IVF and ICSI. No differences were found between these children and those conceived naturally, say the scientists, who published their findings in the journal Pediatrics. [ Full Article ] News: Experts criticise lack of NHS funding for PGD
Ailsa Taylor 03 May 2009
British couples at risk from passing on a serious genetic disorder to their children are being refused National Health Service (NHS) funding for treatment which could allow them to have a healthy child, medical experts have warned this week. The procedure, known as pre-implantation genetic diagnosis (PGD), involves creating embryos through conventional IVF, testing them for a particular condition, and only implanting those free from that condition into the woman's womb. In the absence of this procedure, many couples wishing to have children are forced to conceive naturally and face the prospect of either having an affected child, or of terminating any pregnancies which test positive for the condition. [ Full Article ] News: British couples can choose baby's sex in US clinic
Sarah Guy 06 September 2009
A fertility clinic in the USA has revealed that it provides sex selection to many British couples who pay large amounts of money to travel and receive the service. Jeffrey Steinberg opened his clinic in Manhattan, New York, in January of this year and claims that over half of the embryos currently undergoing pre-implantation genetic diagnosis (PGD) for ‘family balancing', as it has become known, are British. ‘Britain were the innovators but now they've got handcuffs on. From a medical standpoint, it's a travesty' says Steinberg. The procedure is currently banned in the UK except for use in screening for genetic diseases such as muscular dystrophy and haemophilia, which usually only affect boys. Each proposed use of PGD must be granted by the British regulatory body, the Human Fertilisation and Embryology Authority (HFEA). Using PGD for this purpose was banned in the 2008 Human Fertilisation and Embryology Act after a public consultation in 2003 revealed 80 per cent of the British public objected to the idea. The HFEA have warned couples thinking of travelling abroad to receive this service to take time to explore the implications. ‘In the US there is no official regulator. Those who go overseas should make themselves aware of the laws and what impact there may be on any child that is born', said a spokesperson. The procedure involves the extraction of a single cell from embryos created by in vitro fertilisation (IVF). The sex chromosomes in the cell are then found and examined to reveal whether the embryo is male or female. The desired sex of embryo is then implanted into the womb. Pro-life groups in the USA have condemned the destruction of the embryos found not to be the desired sex. The cost of receiving PGD in the USA is a big boost for the medical business; it has been estimated at £20,000 after procedures, travel and hotels. David Karabinns of ‘The Genetics and IVF Institute' in Virginia, USA, who were among the first clinics to offer PGD for family balancing, said: ‘Just as there was an overreaction about IVF, there will be a gradual acceptance as we prove it's safe'. Most US clinics will only treat parents who already have a child of the opposite sex. Critics of family balancing fear that it will lead to a cultural bias toward one gender and earlier this year the Pope attacked what he called, ‘the obsessive search for the perfect child'. [ Full Article ] Article: Donor conception: what to do about birth certificates?
Eric Blyth, Professor of Social Work 18 December 2007
One of the questions facing legislators considering changes to UK legislation regulating the provision of assisted conception procedures is the extent to which formal measures may increase the likelihood of donor-conceived people being informed about their origins.
The background to these considerations includes the 2005 legislative change enabling a donor-conceived person to learn the identity of his or her donor and research evidence indicating that relatively few parents of donor-conceived children (and, in particular, heterosexual parents using donor insemination) inform their children about their conception. Evidence from Sweden, where donor anonymity was abolished in 1985, suggests that the level of parental disclosure increases over time (1). However, key questions remaining are whether the 'natural' pace of change is quick enough, and whether those parents who left to their own devices remain unlikely to tell their children can be encouraged to do so. Annotation of the birth certificates of donor-conceived people has been proposed as a possible means of ensuring that more donor-conceived people learn of their status (2-4). The government has indicated its preference for educational rather than legislative measures to promote disclosure (5). However, in response to peers' concerns, it has offered further discussions before the Human Fertilisation and Embryology Bill reaches the Report stage in the House of Lords. Any measure in this direction seeking serious consideration must ensure that individual privacy is not compromised and that additional bureaucracy and public expense are proportionate. Furthermore it must recognise the involvement of two state agencies when a child is born as a result of a donor procedure: the HFEA (through its register of information) and one of the UK's three General Register Offices (GROs) (England and Wales, Northern Ireland, Scotland). Currently there are no provisions for ensuring co-ordination of information between the HFEA and GROs. Doing so seems to offer a way of achieving, to a large extent, the objective of ensuring that more donor-conceived people become aware of their conception, while recognising that no system can guarantee total compliance (since one thing we can be sure of is that wherever there are rules someone will break them). A possible model can be suggested, and outlined as follows: " the HFEA notifies the relevant GRO of all donor-conceived births; " the GRO records a link between its own birth registration and the HFEA records; " when an application for a birth record is made to a GRO and it is satisfied that the applicant is either the individual to whom the registration relates or his or her legal parent - and those persons only - the 'full' birth certificate that is provided will indicate that the HFEA Register contains information regarding the individual to whom the certificate relates. (This could be achieved by means of an appendix to the certificate which may be detached if the certificate is subsequently required for purposes such as a passport application). As now, an un-annotated birth certificate will be provided by GRO to any other applicant; " if the individual chooses to contact the HFEA, existing measures with regard to applications to the HFEA Register of Information will come into operation; " information and advice concerning birth registration should be provided to people undergoing a donor procedure as part of the information, counselling and other preparation provided by a licensed treatment centre to persons undergoing a donor procedure. This should be mandatory and specified as such in the HFEA Code of Practice. Ongoing information, advice and support should also be made available to the family following the birth of a child. The registration of a child's birth is likely to precede the formal linking of HFEA and GRO data, and so remains reliant on parental veracity. However, non-compliance should be greatly minimised by the provision of information and advice as outlined above; coupled with the knowledge of the future co-ordination of HFEA and GRO records and the knowledge that if the donor-conceived person requests a birth certificate from GRO, this will indicate his or her status. This proposal not only safeguards individuals' privacy, so that the donor-conceived person or his or her legal parents only will be able to access information disclosing the donor-conceived person's status, but also would not establish any provisions different from those currently regulating public access to birth records that would alert any other enquirer to the possibility of donor-conception. It also avoids establishing a completely separate registration system for donor-conceived births. The downside is that it would involve additional resources insofar as GROs and the HFEA will have to establish systems for the recording of this information. However, since the state legitimises donor conception, it seems perfectly reasonable that it should accept the responsibility this entails. In any event, the limited numbers of individuals involved indicate that any such resource requirements are proportionate. A more radical version of this model, but which could ultimately reduce bureaucracy, would transfer responsibility for the HFEA Register to the GROs - a model adopted for New Zealand's Human Assisted Reproductive Technology (HART) Register (6). A persuasive case could probably be made for this also. The GROs' current responsibilities and track record for safeguarding sensitive data relating to the Adopted Children, Parental Order, Stillbirth and Gender Recognition Registers indicate that this information would be in safe hands (a not-insignificant consideration at the present time).
References:
1. Lalos, A., Gottlieb, C. and Lalos, O. (2007) Legislated right for donor-insemination children to know their genetic origin: a study of parental thinking. Human Reproduction 22(6): 1759-1768. 2. Department of Health and Social Security (1984) Report of the Committee of Inquiry into Human Fertilisation and Embryology (The Warnock Report), Cmnd. 9314 London: HMSO: 4.25 3. House of Lords and House of Commons (2007) Joint Committee on the Human Tissue and Embryos (Draft) Bill Vol 1: Report: 276 http://www.publications.parliament.uk/pa/jt200607/jtselect/jtembryos/169/169.pdf 4. House of Lords (2007) Official Debates 10 December: Cols 91-108 http://www.publications.parliament.uk/pa/ld200708/ldhansrd/text/71210-0013.htm 5. Department of Health (2007) Government Response to the Report from the Joint Committee on the Human Tissue and Embryos (Draft) Bill. CM 7209 8 October. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/dh_079127 6. Human Assisted Reproductive Technology (HART) Register. http://www.dia.govt.nz/diawebsite.nsf/wpg_URL/Services-Births-Deaths-and-Marriages-Human-Assisted-Reproductive-Technology-(HART)-Register?OpenDocument
Acknowledgements: In accepting full responsibility for the ideas contained in this Commentary, I wish to thank Lucy Frith and Caroline Jones for their invaluable advice in helping me to develop and refine them. [ Full Article ] News: Italy's fertility laws face referendum
Dr. Kirsty Horsey 18 January 2005
Italy's highest court has approved a series of referendums on whether parts of its controversial new fertility law should be overhauled. However, the constitutional court rejected calls for a referendum on completely scrapping the law, instead allowing a public vote on some of its elements. These will include rules limiting fertility treatment to heterosexual couples, and those governing embryo research. The country's anti-clerical Radical Party, which collected the 500,000 signatures needed to call for the referendum, is reportedly outraged by the decision.
Italy's laws, said to be the most restrictive in Europe, have hardly been out of the news since they were passed last December. Before they were passed, the country had a reputation for being the 'Wild West' of fertility treatments due to its lack of restrictions, and many people travelled there to take advantage of controversial services they could not get in their own countries. Now, the law restricts the provision of fertility treatments to 'stable heterosexual couples' who live together and are of childbearing age, and who are shown to be clinically infertile. Research using human embryos is prohibited, as well as embryo freezing, gamete donation, surrogacy and the provision of any fertility treatments for single women or same-sex couples. The law also says that no more than three eggs can be fertilised at any one time, and that any eggs fertilised must all be transferred to the uterus simultaneously, increasing the risk of multiple births. Pre-implantation genetic diagnosis and prenatal screening for genetic disorders have also been banned. According to BBC News Online, fertility clinics across Europe have seen an increase in the numbers of Italian patients seeking treatment since the legislation came into force. Radical Party secretary Daniele Capezzone called the referendum decision 'a scandal', adding that he expected the mainstream political parties to try to pre-empt the referendum by creating new legislation to replace the old law. Supporters of the law saw the judgement as a partial victory, since it opens the law to changes but will mean it is not completely overturned. Christian Democrat Dorina Bianchi, one of the law's main proponents, called the decision 'fair and balanced'. The government must now hold the referendum between 15 April and 15 June, and at least 50 per cent of the electorate must vote if it is to have legal weight. However, several politicians from various parties said it would now be better for parliament to amend the law, rather than put complex questions to voters. [ Full Article ] News: 10th Royan International Research Award on Reproductive Biomedicine & Stem Cell Biotechnology
Kamal Alizadeh 21 December 2008
Introduction:
Royan International Research Award was founded by late director of Royan Institute; Dr. Saeid Kazemi Ashtiyani with the aim of encouraging the researchers and appreciation of their efforts. This annual award is a prize given to five prominent Research Projects in the field of Reproductive Biomedicine, Stem Cell Biology and Technology and other related subjects.
The winners will be invited to take part in the Award Ceremony on the designated day so as to be granted their awards. Each winner will be rewarded for a certificate, the symbol of Royan Award and the amount of $5000. It is necessary for winners to present their works in Royan International Twin Congress beside the Award Ceremony.
Research Projects:
Research projects can lead to several papers or maybe only one paper. Additional papers should be relevant to the main project and you have to be one of the authors of each paper. Unrelated articles will be ignored so please do not attach any unrelated papers.
The Scope of Subjects:
The research topics may fall within the following scope: 1- Reproductive Biomedicine: Male & Female infertility, Embryology, Reproductive Endocrinology, Infertility physiology and Immunology, Reproduction Biology and Reproductive Health. 2- Stem cell biology and technology: Biology, Differentiation and Preservation, Signaling, Niche, Plasticity, Transplantation and Therapy, Gene therapy and Manipulation and Cancer Stem Cells.
Online Submission:
All research projects should be submitted online via the award's homepage. First it is needed to register and get a username and password by which you can login to this site and submit your project(s) in the award or abstract(s) in the congress. (Papers and projects sent by email, post or fax or after submission deadline will be ignored.)
Deadline for submission is April 10 th, 2009.
[ Full Article ] News: Home storage for sperm samples
Dr Kirsty Horsey 04 July 2003
Men undertaking IVF treatment with their partners may be able to store their sperm at home, rather than in a laboratory, say researchers. Scientists from the Erfan and Bagedo Hospitals in Jeddah, Saudi Arabia, have created a way of 'air-drying' sperm which allows it to be stored at room temperature rather than in frozen storage.
To be 'air-dried', washed sperm is smeared onto a sterilised glass slide and left to dry in a cabinet for two to three hours. Filtered air is passed through the cabinet to ensure no contamination of the sample. When the sperm is needed for use in fertility treatment, it is re-suspended in a biological solution similar to that which surrounds human eggs in ovarian follicles. Although this process was seen to cause some damage to the tail and bodies of the sperm, the DNA contained inside appeared to be intact, therefore intracytoplasmic sperm injection (ICSI) was used in order to fertilise an egg. This means that a single sperm was extracted from the solution and being injected directly into an egg. Typically, sperm samples mixed with a protective chemical are frozen in large liquid nitrogen tanks. These have to be carefully programmed to ensure that the sperm is not damaged or destroyed by cooling too fast or too slowly. The protective chemical also has to be separated from the sperm before it can be used. 'These methods are time-consuming and cumbersome compared to our simple technique of air-drying' said Dr Daniel Imoedemhe, leader of the research team. He added 'the process can be further simplified by allowing patients to take responsibility for storing their air-dried sperm at home'. Presenting their findings at the annual conference of the European Society of Human Fertilisation and Embryology in Madrid, Spain, this week, the scientists said they had successfully created human embryos using this method. Previous experiments had been carried out successfully in mice. [ Full Article ] News: British clinics scared to use improved IVF drugs
Dr. Kirsty Horsey 21 April 2006
British women are being denied newer fertility drugs that help prepare the woman's body for egg stimulation, according to Bill Ledger, Professor of Obstetrics and Gynaecology at the University of Sheffield, The Times newspaper reports. IVF treatment requires a woman's ovaries to be stimulated in order to harvest eggs for external fertilisation. For this to happen the woman's natural menstrual cycle must be temporarily overcome. There are two classes of drugs that allow this to happen, which work to block a hormone called Gonadotrophin-releasing hormone (GnRH). [ Full Article ] |