IVF News

Can We prevent Preeclampsia 

What are the novel findings of this work

Preeclampsia and pregnancy induced hypertension is one the major cause of maternal mortality and morbidity. There is continuous effort to identify the cases in early pregnancy or even identifying risk factor in early pregnancy to start anti inflammatory drug esp.Low dose aspirin. Even after this there are major chunk of pregnant patient who suffer from moderate to severe hypertension and HELLP syndrome and even eclampsia. Intra uterine growth retardation is one of major problem for fetal mortality and morbidity along with complications of prematurity.

What are the clinical implication of this work

This work is with large data with an intervention prior to pregnancy contemplation. All the pregnancies are followed till delivery. Large number are with high risk factor for development of preeclampsia. There were no pregnancy induced hypertension or preeclampsia in this large group. So intervention in early or before pregnancy may eliminate this menace and help to reduce this major problem in society and improve maternal and fetal survival to a great extent

Abstract :

Objective : To reduce the stress on cellular hyperplasia happening at the time of implantation and early part of pregnancy with spiral artery remodeling , so that there is minimal release of inflammatory factors in maternal circulation. This reduction of cellular stress is postulated by providing adequate supply of energy by way of maintaining the stored form of iron, that is serum Ferritin. This way serum iron can be maintained and  thus the level of hemoglobin. 

Method : This was a retrospective cohort study. It started mainly to prevent early pregnancy anemia. This study conducted at Ideal Fertility IVF and Genetic Centre private limited Jabalpur India. Total 335 pregnant patients are followed ( IVF 304 and spontaneous 31) from January 2020 to December 2022. It was observed that when serum ferritin was below 41 ng/ml, injection Ferric Carboxymaltose 1000 mg was infused in 300 ml of normal saline in 20 minutes ( to improve stored form of iron). It was observed retrospectively that even though majority of pregnancies are IVF pregnancies ( which is high risk factor for pregnancy induced hypertension), not a single woman developed hypertension and its complication.

Results : In total, 335 patents are followed. Blood pressure was measured at each antenatal checkup and recorded. Upper limit for defining the hypertension was 140/90 mmhg. All the patients were below this limit and had healthy delivery

Conclusion: This study and observation demonstrate that, correcting serum ferritin level before or at the beginning of pregnancy not only reduced anemia but significantly reduces incidence of pregnancy induced hypertension and preeclampsia. It also reduced the incidence of Fetal Growth Retardation. This study can be corroborated by other methods of supplying iron before or early part of pregnancy. Correcting serum ferritin before pregnancy or early part of pregnancy at larger scale may reduce the burden of pregnancy induced hypertension and pre-eclampsia and eclampsia, which is major cause of maternal mortality in India and the whole world.

Thomas Elliott is an Embryologist and inventor of CryoSentinel, the Thermographic Monitoring System for Cryogeninc Storage.

As embryologists, we are not mere laboratory professionals; rather, we serve as guardians, safeguarding the early stages of life. We care for cells that embody the dreams and aspirations of countless families. However, like any field, ours is not immune to unexpected events. Consider the recent, unimaginable instance of air traffic control malfunction in the United States, which led to the cancellation of over 1,300 flights and delays for almost 10,000 others. This event took place on January 10th, 2023, due to a failure of the Notice to Air Missions (NOTAM) system, a critical component in ensuring flight safety and smooth operations. Just a single point of failure in this system was responsible for the nation-wide disruptions. This event underscores the potential hazards associated with the absence of backup systems and provides us with an impactful lesson. As custodians of irreplaceable reproductive cells, we are duty-bound to provide our patients with the highest quality care, which includes implementing robust, redundant systems to guard against such scenarios.

Building Redundancy: The Backbone of IVF Labs

Redundancy is crucial to the safety and success of IVF labs. It permeates various aspects of the lab, including:

• Power Supply: Labs should have multiple, independent power sources to guarantee continued operation even in case of a single source failure.
• Incubators: Multiple incubators are a must as they culture embryos under optimal conditions. An incubator's failure could result in a loss of developing embryos.
• Gas supply: To maintain appropriate levels of CO2 and oxygen in incubators, gases like carbon dioxide and nitrogen, among others, are needed. These gases must be supplied consistently to achieve the necessary balance, even in the face of potential resupply delays.
• Liquid Nitrogen Storage: Given its use in storing embryos, any failure in the storage system can lead to a loss of embryos. Hence, backup storage vessels (equal or greater than the capacity of your largest storage container), and additional liquid nitrogen supply are essential.
• Equipment: Backup equipment, such as microscopes integral to the IVF process, must be readily available.
• Staff: Adequate backup staff is crucial to ensure uninterrupted processes, even in the event of an unexpected absence.

Cryostorage: A Redundancy Imperative

Redundancy serves as a crucial safeguard in the preservation and monitoring of reproductive materials. Sperm, eggs, and embryos are preserved in liquid nitrogen cryostorage tanks at extremely low temperatures to prevent degradation and maintain viability. The cryogenic temperatures are upheld by a simple vacuum, a failure of which could lead to disastrous consequences. Thus, redundancy in monitoring and maintenance systems is paramount to prevent such failures and ensure the continued integrity of these precious biological assets.

Monitoring Systems: Our Technological Sentry

Even the most sophisticated monitoring systems in IVF labs can possess a single point of failure, potentially rendering them useless. Potential failure points for cryogenic storage monitoring systems include:

• Sensor malfunction: Failure or malfunctioning of sensors measuring temperature inside the cryogenic storage container can lead to inaccurate or absent readings.
• Communication failure: The monitoring system might fail to communicate with the control system, leading to a loss of data or control.
• Power outage: A disrupted power supply to the monitoring system might compromise its functionality.
• Software failure: Software used to monitor and control cryogenic storage might fail due to bugs or other issues.
• Human error: Operator or maintenance personnel mistakes, such as improper sensor calibration, sensor positioning or misconfiguration of the monitoring system, can lead to system failures.
• Equipment failure: Equipment used to store and transport cryogenic materials can fail or malfunction, leading to containment loss.
• Security breaches: Unauthorized access to the storage facility or monitoring system can lead to tampering or sabotage, causing system failures or containment loss.
• Maintenance issues: Negligent or improper maintenance of the monitoring system or cryogenic storage equipment can trigger failures or malfunctions.

Response Time: A Critical Countdown

The monitoring methods employed in our work deliver varying response times. To illustrate, in a 47L Dewar, the time span between alerts and critical glass temperature can range from a comfortable 20 hours (Thermographic monitoring) to a scant 1 hour, as with traditional monitoring systems, potentially leaving insufficient time to reach the lab and salvage samples (Pomeroy, et al. 2019. J Assist Reprod Genet. 2019 Nov;36(11):2271-2278. doi: 10.1007/s10815-019-01597-5.Epub 2019 Oct 24. | THERMOGRAPHIC IMAGING: A BREAKTHROUGH INVENTION PROVIDING AN EFFECTIVE AND RELIABLE CRYOGENIC STORAGE MONITORING. Dr. Zsolt Peter Nagy ).

Redundancy: Raising the Bar

To circumvent these risks, additional redundant systems can be implemented. These systems, utilizing alternative methods for monitoring and alerting users in the event of a potential issue, can sometimes detect failures even earlier due to their distinct monitoring approach.

Choosing Your Monitoring System: Striking a Balance

When considering additional monitoring, several factors must be weighed. Typically, hard-wired systems are less susceptible to interference or signal loss compared to their wireless counterparts, which are more cost-effective and easier to install. However, one must also factor in potential failure points that might arise during natural disasters or human-induced catastrophes, such as extreme weather conditions. Currently, liquid nitrogen dewar monitoring systems employ one or more of the following: internal temperature probes, external temperature sensors, liquid nitrogen level sensors, weight sensors, or modern technology such as thermographic monitoring. Each option has its unique set of pros and cons.

CryoSentinel: Pioneering Cryostorage Monitoring

CryoSentinel is designed with a specific purpose in mind: to provide advanced monitoring for cryogenic storage vacuum failure. By leveraging thermography (also known as thermal imaging, a technique that uses infrared radiation to visualize and measure temperature variations on the surface of an object or in an environment) CryoSentinel will detect even the earliest signs of vacuum degradation, long before catastrophic failure occurs. Its extreme sensitivity allows for early warnings of potential problems, giving users valuable time to prevent fatal loss of irreplaceable materials. When used in combination with standard internal dewar sensors like temperature, weight, or level, CryoSentinel creates a faster, more robust and comprehensive system. This integration allows for a complete understanding of the system's health and enables users to take proactive measures to protect patient cells. CryoSentinel's state-of-the-art thermographic systems offer a faster response time to dewar failure allowing for time to move samples to safety. The visual thermographic representation of the cryo storage, both locally and remotely, provides users with an easy-to-understand view of the system's health and allows for quick identification of vacuum loss.

In Summary

Our collective understanding of our responsibility is profound. Every day, we manage the earliest stages of potential lives—each one invaluable and irreplaceable. It's essential to remember that our mission transcends mere compliance with minimum standards. It's about striving for excellence. It's about fostering peace of mind—for us as professionals and for the families we serve. As we embrace technology and continually refine our practices, let redundancy be our guiding principle. With safety measures like spare storage tanks and advanced monitoring systems, we can ensure that we are doing everything within our power to protect the precious life we've been entrusted to care for.

• June 2023 Training Batch Schedule - 05^th June - 19^th June 2023.
• July 2023 Training Batch Schedule - 03^rd  June - 17^th July 2023.
• August 2023 Training Batch Schedule - 07^th Aug - 21^th Aug 2023.

                       The International School of Embryology was established to offer training for clinicians in advanced reproductive technologies. Our skill and precision to all aspirants help them to know in-depth knowledge and experience. The members of our teaching faculty aim to bring doctors and embryologists to the highest level of knowledge about reproductive techniques and practical capability in the field.

Our courses cover basics in Andrology, Embryology, ICSI, and cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218 (Whats app)

The University of Dundee have introduced a new range of part-time distance learning courses in Clinical Embryology and IVF, with the aim of making it easier for people who already work in associated fields to study for a postgraduate qualification, without having to give up on their current employment. There is an increasing worldwide demand for Assisted Reproductive Technology, including IVF, and so there are growing opportunities for enhancing your career in this field. 

Expanding on their considerable experience in delivering full-time on-campus teaching in this subject area, they have designed three part-time courses to give you the maximum flexibility. You can choose to start off with a postgraduate certificate (60 credits over 12 months), or a postgraduate diploma (120 credits over 24 months) or go for the full MSc (180 credits over 36 months). You can also start off with the certificate course, and if that works out well for you, you can continue on to complete the diploma or full MSc.

You will be provided with the wide-ranging education required to become a leader in the field of ART, including training in basic science, embryology, andrology, clinical and controversial issues, and business management. You will also explore research in reproductive medicine, designing and undertaking your own project.

There will be a joint clinical and laboratory focus, due to a dynamic collaboration with a busy clinical ART centre at Ninewells Hospital (one of Europe’s largest University Hospitals). You will have the opportunity to observe various activities within the ART centre, including embryology procedures and following patient journey from initial scans through the entire ART  process.

The people teaching on the course have a range of expertise, including scientists, clinicians, embryologists, andrologists, counsellors and business managers. A series of distinguished speakers will also give you access to seminars by world leaders in the field of embryology and ART. You will also develop a unique network of practitioners across the globe, supporting you in your future career. 

Visit their website to find out more: uod.ac.uk/ceivf-dl

The United Kingdom has welcomed its first baby conceived with DNA from three individuals, thanks to a revolutionary IVF technique called mitochondrial donation treatment (MDT). This groundbreaking method aims to prevent children from inheriting incurable diseases caused by mutated mitochondrial DNA.

MDT combines sperm and egg from the biological parents with healthy mitochondria from a female donor's egg. As a result, the baby receives DNA from both parents, as well as a small percentage of genetic material from the donor. The phrase "three-parent babies" has emerged due to the technique, even though more than 99.8% of the DNA comes from the mother and father.

The Newcastle Fertility Centre pioneered MDT research, intending to help women with mutated mitochondria have healthy children without passing on genetic disorders. In 2015, the UK Parliament approved MDT, and by 2018, the Newcastle clinic was licensed to perform the procedure. The UK's Human Fertilisation and Embryology Authority (HFEA) has since granted permission for at least 30 cases on a case-by-case basis.

The HFEA confirmed that a few babies have been born in the UK following MDT, without providing further details or an exact number. The treatment program experienced delays due to the pandemic, which discouraged some donors and affected couples seeking therapy.

These details have come to light following a Freedom of Information request submitted by The Guardian newspaper.

While MDT is a significant breakthrough, it is not without risks. In some cases, abnormal mitochondria from the mother's egg can multiply in the donor egg, potentially leading to disease in the child. However, clinical experience with MDT has been promising, but long-term follow-up is crucial to determine its safety and efficacy.

The Fertilis Academy in association with Sadbhavna IVF School is offering "The Skills of Intrauterine Insemination" for Gynecologists Embryologists, Andrologists, and IVF Professionals planning to enhance their skills.

➤ 2-Days Live Interactive Course
➤ Recording available on the app

📍Course Details -

➤ Day 1

Where does IUI work best
The stimulation, the trigger, and the luteal phase support
IUI Lab Set up
Q & A Session

➤ Day 2

IUI Step by Step
Workup of the male partner
Principles of Semen Preparation
Semen preparation step by step
Q & A Session

📍Date - 25th - 26th May 2023
📍Venue - Online
📍Timing - 5:30 PM Onwards IST

Apply through the given link below-

https://www.thefertilisacademy.com/skills-intrauterine-insemination/

📍For any queries,
Call us: +91 887 283 3919
Whatsapp us - wa.link/3ww6tg

Explore more about us at www.thefertilisacademy.com

**Certificate will be awarded at the end of the course.

June 2023 Training Batch Schedule - 05^th June - 19^th June 2023.

The International School of Embryology was established to offer training for clinicians in advanced reproductive technologies. Our skill and precision to all aspirants help them to know in-depth knowledge and experience. The members of our teaching faculty aim to bring doctors and embryologists to the highest level of knowledge about reproductive techniques and practical capability in the field.

Our courses cover basics in Andrology, embryology, ICSI, and cryosciences (Hands-on).

Limited Seats. For admission Contact  9003111598 / 8428278218 (Whats app)

Researchers at Washington State University have discovered a gene specific to male testes that could lead to the development of a highly effective, reversible, and non-hormonal male contraceptive for both humans and animals. The gene, known as Arrdc5, is expressed in the testicular tissue of mice, pigs, cattle, and humans. When the gene was knocked out in mice, male infertility resulted, impacting sperm count, movement, and shape.

The study, published in the journal Nature Communications, identified the Arrdc5 gene as being expressed only in testicular tissue, and in multiple mammalian species. When the gene was inactivated or inhibited in males, the sperm produced could not fertilize an egg, making it an ideal target for male contraceptive development. Importantly, lack of the gene also causes significant infertility, creating a condition called oligoasthenoteratospermia or OAT, which is the most common diagnosis for human male infertility. In the study, male mice lacking the gene produced 28% less sperm that moved 2.8 times slower than in normal mice, and about 98% of their sperm had abnormal heads and mid-pieces.

Disrupting the protein encoded by the Arrdc5 gene would not require hormonal interference, which is a significant hurdle in male contraception. The protein could be targeted by a drug, making the contraceptive easily reversible. As the gene is found across mammalian species, the discovery also holds promise for use in animals, potentially replacing castration as a way to control reproduction in livestock or to limit overpopulation of wildlife species. The initial focus, however, is on giving humans more control over their own reproduction. With more than half of pregnancies worldwide still unintended, according to the United Nations, the development of an effective male contraceptive could have far-reaching impacts.

The research team will work on designing a drug that would inhibit the production or function of the protein encoded by the Arrdc5 gene. They have filed a provisional patent for the development of a male contraceptive based on this gene and the protein it encodes. The study received support from the National Institutes of Health and WSU's Functional Genomics Initiative.

Sources and References

• Washington State University
  New genetic target for male contraception identified 

• Nature Communications
  ARRDC5 expression is conserved in mammalian testes and required for normal sperm morphogenesis

China's demographic decline is an increasing concern for the nation, and unmarried women seeking IVF treatment might be part of the solution. Recently, Chengdu, the capital of the southwestern Sichuan province, legalized the registration of children by unmarried women, granting them access to paid maternity leave, child subsidies, and the possibility of legal IVF treatment in private clinics. Chen Luojin, a 33-year-old divorced woman from Chengdu, is now 10 weeks pregnant through IVF, a testament to the policy's potential success.

The Chinese government has been considering implementing these changes nationwide to address the record low birth rates. Liberalizing IVF across the country could significantly increase demand for fertility treatment, straining the already limited fertility services. However, investors in the industry see a growth opportunity.

China's National Health Commission (NHC) has not commented publicly on the recommendations, but they have acknowledged that many young women are delaying plans to marry and have children due to high costs of education and child-rearing. In February, the Sichuan branch of the NHC announced changes aimed at promoting "long-term and balanced population development."

Despite challenges such as gender power imbalances, societal stigma, and uncertainty over IVF incentives, increasing access to fertility services might have a significant impact on China's demographic issues. Around 300,000 babies are currently born in China via IVF annually, making up about 3% of all newborns. As more Chinese women postpone or give up on having babies, many still desire to become mothers. For them, IVF treatments could be the solution, offering a new avenue to motherhood regardless of marital status.

Sources and References

Reuters:
China weighs giving single women IVF access to stem population decline

Last spring, engineers from Barcelona shipped their sperm-injecting robot to New York City's New Hope Fertility Center, where they reassembled the instrument, including a microscope, mechanized needle, petri dish, and laptop. An engineer with no experience in fertility medicine then used a PlayStation 5 controller to position the robotic needle, which autonomously penetrated a human egg and delivered a single sperm cell. Over a dozen eggs were fertilized using the robot, resulting in healthy embryos and eventually two baby girls.

The robot, developed by startup Overture Life, represents an initial step towards automating in vitro fertilization (IVF) and potentially making the procedure more affordable and widespread. Currently, trained embryologists earning over $125,000 per year delicately handle sperm and eggs using ultra-thin hollow needles under a microscope in IVF labs. Overture envisions an automated process, with their patent application describing a "biochip" containing hidden reservoirs of growth fluids and small channels for sperm.

Santiago Munné, chief innovation officer at Overture Life, believes that if IVF could be performed in a desktop instrument, patients might not need to visit specialized clinics, where a single attempt at pregnancy can cost $20,000 in the US. Instead, a patient's eggs could be directly input into an automated fertility system at a gynecologist's office, significantly reducing costs.

With approximately 500,000 children born through IVF globally each year, automating the process could increase access to fertility medicine for those who cannot afford or access it. However, fully automating IVF is challenging, as test-tube conception involves numerous procedures, and Overture's robot currently performs only one of them and only partially.

Some doctors are skeptical that robots can or should replace embryologists soon, while others see automation playing a more limited role, such as dispensing consistent droplets of growth medium for embryos. Despite the hurdles, automating parts of the IVF process could make it less expensive and pave the way for more radical innovations like gene editing or artificial wombs.

Sources and References

MIT Technology Review