Marsha Mezger and her husband, Doug, have been trying to have a baby since July 2006.First, Mezger took three rounds of Clomid, a fertility drug, with no success. Then they moved on to in vitro treatments at Mid-Iowa Fertility in Clive. The first two tries resulted in miscarriages; the third time, Mezger didn't get pregnant.Now the West Des Moines couple is trying another round of in vitro. But this time, Mezger - a big believer in integrating Western and Eastern medicine - also took a new class offered at The Family Tree in Des Moines called "Yoga for Fertility."
"I thought, 'Why not? It's not going to hurt,'" said Mezger, 29. "If anything, yoga is going to help me relax."Sandi Hoover, co-owner and instructor at The Family Tree, said she believes this is the first class of its kind in Iowa.The class is open to all women trying to conceive, said Hoover, a registered nurse who has been a yoga instructor since 2001. Some of her students have had medical diagnoses of polycystic ovary syndrome or endometriosis, both of which can cause infertility.
"For me, personally, yoga has been a source of stress reduction and balance," she said. "And for a lot of people struggling to conceive, there's that underlying stress. The focus (of the class) is clearly going to be inviting that reproductive energy in through a combination of breath, meditation and movement."When you're under constant stress, Hoover said, your body puts out stress hormones that deal more with survival functions such as heart rate and blood pressure. Those hormones also shut down reproduction.
Hoover said new research shows that yoga and other alternative health techniques can serve as antidotes to the harmful effects of stress on the reproductive system.Extreme stress can interfere with a woman's ovulation and reduce the number of eggs, agreed Dr. Don Young, medical director at Mid-Iowa Fertility. For men, stress can negatively affect sexual performance.Young said he has recommended yoga to his patients to relieve stress."As far as any yoga moves improving fertility, there's no evidence to support that at all," he said. "There's no yoga poses that will, say, open up fallopian tubes or improve ovulation."
Young said studies have shown that acupunture may help increase the number of eggs, embryo quality and pregnancy rate for patients undergoing in vitro treatments.Hoover's class includes specific yoga poses that help increase overall health, which will increase the overall likelihood of getting pregnant, she said. They also help improve the total alignment of the body and increase energy and stamina. The moves support the muscles in the reproductive area.
The class also serves as a support group. Topics vary weekly, ranging from letting go of obsessive thoughts to finding holistic help, through group discussion and sharing, Hoover said.Mezger said being surrounded by pregnant co-workers, pregnant women at the mall and new moms pushing strollers made her feel like she was the only one going through this."I left (the class) calm and centered," she said, "and it was certainly a way for me to be proactive in this journey and be productive. It was certainly a release - and more than once. I released buckets of tears right there in the middle of (class)."
The class helped Mezger to be more patient, she said, and to focus on the future."Our time is going to come. Having a baby has not come yet, but it doesn't mean it's never going to come," she said.
Sunday, April 5, 2009
Saturday, March 21, 2009
Single career woman has twins using stored eggs
A HIGH-flying woman in her 40s has controversially given birth to healthy twins after having her eggs frozen in case she was unable to form a relationship.
As insurance against "social infertility", the career woman, who rose to the senior ranks of a publicly listed company, paid thousands of dollars to have her eggs frozen at age 37 after being unable to develop a long-term relationship.
After turning 40, she had the eggs fertilised with donor sperm, and recently gave birth to twins.Egg freezing allowed the woman to give birth to her own genetic children rather than use donated eggs.Queensland Fertility Group clinical director David Molloy described the practice as a medical advance as profound as the contraceptive pill.
"The contraceptive pill enables women to delay their reproduction and not get pregnant on their honeymoon," he said. "It changed the way women were able to approach their careers, their lives, their sexuality, the whole thing."Social egg freezing is going to allow women who've got the resources to look at when they reproduce and how they structure their lives and their careers and still have a good chance of having children."Dr Molloy, who reported the woman's case in the latest Medical Journal of Australia, said he did not believe the practice was unethical."Here you've got someone who's financially very sound, who's now got the time to look after a child ... who's actually given up her job to say: 'I've reached the top, I've made enough money, now I can look after a child responsibly'," Dr Molloy said."Are we socially less responsible creating a pregnancy in that woman compared to the fact you've got 17-year-olds getting pregnant every day of the week because we don't have enough family planning teaching in our schools?
''This is a woman who's made it.
''She's not going to be a welfare burden on the community."However the practice is expected to be seen as controversial, given it will increase the numbers of single parent families.It does not attract Medicare funding and is expensive, costing up to $10,000 per cycle to extract eggs and another $300 a year to store them.Dr Molloy said the ideal age for women to consider egg freezing was between 31 and 35.
As insurance against "social infertility", the career woman, who rose to the senior ranks of a publicly listed company, paid thousands of dollars to have her eggs frozen at age 37 after being unable to develop a long-term relationship.
After turning 40, she had the eggs fertilised with donor sperm, and recently gave birth to twins.Egg freezing allowed the woman to give birth to her own genetic children rather than use donated eggs.Queensland Fertility Group clinical director David Molloy described the practice as a medical advance as profound as the contraceptive pill.
"The contraceptive pill enables women to delay their reproduction and not get pregnant on their honeymoon," he said. "It changed the way women were able to approach their careers, their lives, their sexuality, the whole thing."Social egg freezing is going to allow women who've got the resources to look at when they reproduce and how they structure their lives and their careers and still have a good chance of having children."Dr Molloy, who reported the woman's case in the latest Medical Journal of Australia, said he did not believe the practice was unethical."Here you've got someone who's financially very sound, who's now got the time to look after a child ... who's actually given up her job to say: 'I've reached the top, I've made enough money, now I can look after a child responsibly'," Dr Molloy said."Are we socially less responsible creating a pregnancy in that woman compared to the fact you've got 17-year-olds getting pregnant every day of the week because we don't have enough family planning teaching in our schools?
''This is a woman who's made it.
''She's not going to be a welfare burden on the community."However the practice is expected to be seen as controversial, given it will increase the numbers of single parent families.It does not attract Medicare funding and is expensive, costing up to $10,000 per cycle to extract eggs and another $300 a year to store them.Dr Molloy said the ideal age for women to consider egg freezing was between 31 and 35.
Tuesday, February 24, 2009
Too old to be a mom?
PIX RIGHT:
Donna Broderick-Reich and her husband, J.R. Reich, are excited about the baby she will deliver in a few weeks. She is 56 years old and conceived by having an egg from her daughter that was fertilized with her husband's sperm implanted. She has six other children who are mostly adults. Donna and her husband play in a rock band and are shown at local bar called Sharky's near Ocala.
Donna Broderick-Reich lay on an exam table tilted at a 50-degree angle, and looked up at her feet for 45 minutes.
As uncomfortable as it was, and as much as she needed to use the restroom, she toughed it out. And she had a good reason.
At age 56, and after having gone through menopause, Reich lay prone in a Los Angeles fertility clinic hoping to give her husband, J.R. Reich, their first child.
She remained motionless as two tiny fertilized eggs donated from her 31-year-old daughter and fertilized by J.R.'s sperm in a Petri dish found their way to a snug corner of her uterus.
One of the two did, and the couple, who live in Oxford near The Villages, are now expecting a baby boy.
Donna gets a wide range of reactions to her pregnancy, now in its 32nd week.
Her 32-year-old husband is anxious and can't believe he's going to be a father. Most of her six grown children are happy for her, although they worry about her health. Donna no longer speaks to her mother. Some strangers raise their eyebrows and shake their heads.
And in the larger scheme of things, bioethicists wonder if older women should have children, since in many cases they won't be around long enough to care for them.
Scientists say there have not been enough studies to show that older wombs are fit to carry babies, even if the donor eggs are from young women; and in the meantime, there are are no hard and fast regulations on the assisted reproductive technologies industry, which includes IVF.
The fertilization specialists who perform the procedures say they put their clients through a battery of tests and make sure they're in good health and have a solid support network. Some don't perform the procedure on older women who are single, even if they're in good health.
But to Donna the issue is deeper than the science and ethics of it all.
"For all those people who look at me strange, come up and ask me why I'm having this baby, cause I'm not out there to populate this world," she says.
When Donna met J.R., she had already divorced three husbands and had raised six children. She was 40. He was 18. The two got married two years later and got pregnant when Donna was 45. But the baby's heartbeat stopped when Donna was four and a half months pregnant. At that point the two put the idea of having children to rest.
So they focused on their new family and their music careers. They eventually formed a band called SSnakeyez and still perform on Friday and Saturday nights in local bars.
It wasn't until early last year that Donna began thinking of having a child again. Donna's daughter, Madina, and her three small children had moved in with her temporarily, and Donna found herself baby-sitting and talking about babies.
There was a part of her that worried about J.R. She knew he would outlive her, "and I was afraid that he was going to be alone," she said. "I'm his best friend and I'm still here with him and I wanted to raise his child. I wanted to leave a part of me behind"
So she did some Internet research and learned that she could get pregnant through in vitro fertilization and by using a donor egg. She found a willing doctor at Pacific Fertility Center of Los Angeles. Then there was the matter of money for the procedure, which she could raise by refinancing her home in Oxford in Sumter County.
It was at that point she approached J.R. with the idea.
There is no mandatory cutoff age for IVF, but most centers stop at 50, which is an average age for menopause. In almost 90 percent of the cases, the eggs are donated from younger women because the older the eggs, the higher the risk of complications and miscarriage.
Although the uterus of an older woman can be revived by hormones and will produce hormones on its own a few weeks after pregnancy, the body of an older woman might not be fit to go through the process. Older women who get pregnant are at a higher risk for cardiovascular problems, gestational diabetes and hypertension.
"Every program sets their own limits," said Dr. R. Stan Williams, chairman of tje Department of Obstetrics and Gynecology at the University of Florida. "The central questions are: What is the health of the woman? Is she capable of going through the pregnancy safely? And as the child is growing up, how likely is it for the mother to be around?"
Dr. Vicken Sahakian, medical director and owner of Pacific Fertility Center of Los Angeles, is well-known for performing IVF in women as old as 67.
"It's not rocket science. I don't have a magic potion. I am a women's advocate. I do think a 54-year-old woman has as much right to have a child as a 54-year-old man," he said in a recent interview. "The argument that a woman is not meant to have kids at 54 can go for cancer. If the technology is there, why not use it?"
Some bioethicists raise other issues.
"There are just differences between older and younger people when it comes to reproduction in terms of risks, safety and ability to raise children," said Arthur Caplan, director of the University of Pennsylvania Center for Bioethics. "When older dads have babies, historically, the woman is young enough to carry the baby."
He added that with donor-egg IVF, "All you're achieving is pregnancy. It's not your own child. Then why go through these risks, when all you're going to achieve is a pregnancy? So if you're going to use a donor egg, why not hire a surrogate mother?"
Donna's daughter said she didn't want to carry the pregnancy.
"I was afraid I would be too close to the baby," she said.
And Donna said she wanted the baby inside of her.
To the family, indeed, this baby - which will be a boy - is Donna's and J.R.'s and they will raise it together as mom and dad.
Donna laughs about all the jokes around the house.
"I'll be getting a senior citizen discount when he gets a happy meal," she quipped. "And I'll be on my Hoveround when he's on his bike."
Then she gets serious.
"I believe that [the doctor] instrumented the baby, but it had to be God to say that, 'I'm going to allow you to go through the pregnancy despite all adversities.' "
SOURCE: OCALA.COM
Wednesday, February 11, 2009
N.H. PETA billboard shows veggies as 'food of love'
CONCORD, N.H. (AP) — A new billboard in New Hampshire from People for the Ethical Treatment of Animals is showing some creative use of vegetables.
PETA has coupled the findings of a Harvard University study suggesting that vegetarian foods may increase fertility with the face that New Hampshire has one of the lowest birth rates in the country.
The billboard shows various vegetables arranged to mimic certain parts of the male and female anatomies next to tagline "Veggies: The Food of Love. Going vegetarian may make you more fertile."
In their book, "The Fertility Diet," Harvard researchers urge people to consume more vegetable protein and less animal protein if they hope to have children.
source: seacoastonline.com
PETA has coupled the findings of a Harvard University study suggesting that vegetarian foods may increase fertility with the face that New Hampshire has one of the lowest birth rates in the country.
The billboard shows various vegetables arranged to mimic certain parts of the male and female anatomies next to tagline "Veggies: The Food of Love. Going vegetarian may make you more fertile."
In their book, "The Fertility Diet," Harvard researchers urge people to consume more vegetable protein and less animal protein if they hope to have children.
source: seacoastonline.com
Saturday, February 7, 2009
Common Chemicals Linked to Infertility
Could your cookware and cleaning supplies make it harder for you to have a baby?
In the current issue of Human Reproduction, researchers suggest that chemicals called perfluorinated compounds, or PFCs for short, might be linked to delays in getting pregnant. But study authors and experts in the field caution that the findings are preliminary and mainly highlight an area that needs more research.
"The finding is interesting," says one of the study's authors, Joseph K. McLaughlin, professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn. "We need to know more about these chemicals because they are long lasting and have had effects in animals."
And until more is known, the researchers say, changes in health policy are unlikely.
"This is the first study in the world that has looked at this particular association," says lead study author Dr. Jorn Olsen, chair of the Department of Epidemiology at the UCLA School of Public Health. "Normally we don't base our conclusions on public health information on one study. We need to wait for other studies to make policy recommendations."
In the current issue of Human Reproduction, researchers suggest that chemicals called perfluorinated compounds, or PFCs for short, might be linked to delays in getting pregnant. But study authors and experts in the field caution that the findings are preliminary and mainly highlight an area that needs more research.
"The finding is interesting," says one of the study's authors, Joseph K. McLaughlin, professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn. "We need to know more about these chemicals because they are long lasting and have had effects in animals."
And until more is known, the researchers say, changes in health policy are unlikely.
"This is the first study in the world that has looked at this particular association," says lead study author Dr. Jorn Olsen, chair of the Department of Epidemiology at the UCLA School of Public Health. "Normally we don't base our conclusions on public health information on one study. We need to wait for other studies to make policy recommendations."
Monday, January 26, 2009
Soy protein renders womb unsuitable for pregnancy.
A soy protein, genistein, long known to affect fertility can change how pregnancies start and progress in female mice treated with it as newborns. The changes make it harder for fertilized eggs to implant and grow, possibly contributing to infertility. The effects were observed at levels comparable to those experienced by human infants feeding on soy formula.
The researchers then retrieved either unfertilized eggs or fertilized embryos from the female mice to assess egg health and reproductive organ development .They set up a series of experiments to ask several questions:
First, could unfertilized eggs grow to early development?
Second, could naturally fertilized embryos grow properly in a normal, untreated mouse?
Third, could fertilized embryos taken from untreated mice grow normally in the treated female mice?
What did they find?
Genistein impaired the implantation process in the female mice that were treated as newborns and mated after sexual maturity. After mating, the number of embryos retrieved from genistein-treated mice was about half the number of those collected from control mice.
Fewer implantation sites were present in the uterus of genistein-treated mice compared to control.
Together, these findings suggest that the reproductive tract environment in the genistein-treated mice is likely not optimal for embryonic development.
Tested in vitro, treated and control eggs were equally capable of being fertilized. However, embryos from genistein-treated females developed more slowly than controls. Over time this difference disappeared.
What does it mean?
Genistein affects the uterus and the reproductive tract -- not the egg quality -- of the adult female mice that were treated with the soy phytoestrogen while in the womb. Fertilized embryos developing in the treated females did not attach and thrive as well as embryos in the control animals, even though eggs from genistein-treated females were as healthy as those from their unexposed counterparts.
The genistein-treated mice also lost more embryos early in their development. Embryo death means fewer births and higher rates of infertility.
Together, the results suggest that the uterus may be an important factor in genistein-induced infertility.
These findings pinpoint one actual cause of the observed infertility of early life exposure to genistein. They also highlight the need for a much better understanding of how soy infant formulas and other products fed to newborns and infants may influence a developing baby's reproductive life.
Egg quality was not affected by newborn genistein treatment. The immature eggs from genistein-treated mice developed normally and produced fertile female mice just like in the controls.
These findings add to a growing body of evidence that implies that newborns that eat soy-based products may be predisposed to lower reproductive success as adults.
SOURCE: environmentalhealthnews.org
The researchers then retrieved either unfertilized eggs or fertilized embryos from the female mice to assess egg health and reproductive organ development .They set up a series of experiments to ask several questions:
First, could unfertilized eggs grow to early development?
Second, could naturally fertilized embryos grow properly in a normal, untreated mouse?
Third, could fertilized embryos taken from untreated mice grow normally in the treated female mice?
What did they find?
Genistein impaired the implantation process in the female mice that were treated as newborns and mated after sexual maturity. After mating, the number of embryos retrieved from genistein-treated mice was about half the number of those collected from control mice.
Fewer implantation sites were present in the uterus of genistein-treated mice compared to control.
Together, these findings suggest that the reproductive tract environment in the genistein-treated mice is likely not optimal for embryonic development.
Tested in vitro, treated and control eggs were equally capable of being fertilized. However, embryos from genistein-treated females developed more slowly than controls. Over time this difference disappeared.
What does it mean?
Genistein affects the uterus and the reproductive tract -- not the egg quality -- of the adult female mice that were treated with the soy phytoestrogen while in the womb. Fertilized embryos developing in the treated females did not attach and thrive as well as embryos in the control animals, even though eggs from genistein-treated females were as healthy as those from their unexposed counterparts.
The genistein-treated mice also lost more embryos early in their development. Embryo death means fewer births and higher rates of infertility.
Together, the results suggest that the uterus may be an important factor in genistein-induced infertility.
These findings pinpoint one actual cause of the observed infertility of early life exposure to genistein. They also highlight the need for a much better understanding of how soy infant formulas and other products fed to newborns and infants may influence a developing baby's reproductive life.
Egg quality was not affected by newborn genistein treatment. The immature eggs from genistein-treated mice developed normally and produced fertile female mice just like in the controls.
These findings add to a growing body of evidence that implies that newborns that eat soy-based products may be predisposed to lower reproductive success as adults.
SOURCE: environmentalhealthnews.org
Monday, January 19, 2009
Hormonal disorder leading cause of infertility
Most women have never heard of polycystic ovary syndrome (PCOS), yet it is the leading cause of infertility in women and affects about one in 10 women in the United States.
PCOS is a widespread hormonal disorder found in premenopausal women. It can be treated, so it is important for women experiencing the symptoms of PCOS to see their health care provider for diagnosis and treatment.
Obstetrician/gynecologist Dr. Tracie Traver, who is on the active medical staff of Blount Memorial Hospital, says that common symptoms of PCOS include irregular or missed menstrual periods, infertility, increased hair growth, obesity and ovarian cysts. "PCOS is caused by an excess production of a hormone class called androgens. Androgens are male hormones that all women produce, but that women with PCOS produce in excess.
There is nothing that can be done to prevent PCOS or lower the risk, although weight control may have a positive effect on it."Women with signs of androgen excess who are not ovulating are considered to have PCOS. "Sometimes lab tests are ordered to be sure there is nothing else causing these symptoms," Traver adds. "An ultrasound may be done to look for small cysts on the ovaries, however, there are some patients who have the classic presentation for PCOS, yet the ultrasound doesn't show these cysts."Traver explains that treatment of PCOS helps control symptoms and can help prevent endometrial cancer, diabetes and heart disease. "Daily exercise of at least 30 minutes can help women with PCOS by improving insulin function as well as relieving other symptoms. Also, weight loss may lower insulin levels, which will help with restoring ovulation, and may slow new hair growth."
Medications used to treat PCOS include some medicines typically used by diabetics to help with insulin function. Birth control pills also may be used to control irregular cycles and lower endometrial cancer risk. Other medications are used to cause ovulation for women with fertility issues.
There also are medications available to control the hair growth.Traver recommends that women who are experiencing PCOS symptoms such as irregular periods, difficulty getting pregnant and excess hair growth schedule an appointment with an obstetrician/gynecologist for diagnosis and treatment. "In severe cases, PCOS can lead to balding, lowering of the voice and bigger muscles," she adds. "Some women have a problem with their insulin levels or function, which leads to weight gain and difficulty losing weight. They also have an increased risk of endometrial cancer, diabetes, hypertension and heart disease."If you would like to schedule an appointment with an obstetrician/gynecologist, call the Blount Memorial HEALTHLINE at 981-3983 for a free physician referral.
SOURCE: thedailytimes.com
PCOS is a widespread hormonal disorder found in premenopausal women. It can be treated, so it is important for women experiencing the symptoms of PCOS to see their health care provider for diagnosis and treatment.
Obstetrician/gynecologist Dr. Tracie Traver, who is on the active medical staff of Blount Memorial Hospital, says that common symptoms of PCOS include irregular or missed menstrual periods, infertility, increased hair growth, obesity and ovarian cysts. "PCOS is caused by an excess production of a hormone class called androgens. Androgens are male hormones that all women produce, but that women with PCOS produce in excess.
There is nothing that can be done to prevent PCOS or lower the risk, although weight control may have a positive effect on it."Women with signs of androgen excess who are not ovulating are considered to have PCOS. "Sometimes lab tests are ordered to be sure there is nothing else causing these symptoms," Traver adds. "An ultrasound may be done to look for small cysts on the ovaries, however, there are some patients who have the classic presentation for PCOS, yet the ultrasound doesn't show these cysts."Traver explains that treatment of PCOS helps control symptoms and can help prevent endometrial cancer, diabetes and heart disease. "Daily exercise of at least 30 minutes can help women with PCOS by improving insulin function as well as relieving other symptoms. Also, weight loss may lower insulin levels, which will help with restoring ovulation, and may slow new hair growth."
Medications used to treat PCOS include some medicines typically used by diabetics to help with insulin function. Birth control pills also may be used to control irregular cycles and lower endometrial cancer risk. Other medications are used to cause ovulation for women with fertility issues.
There also are medications available to control the hair growth.Traver recommends that women who are experiencing PCOS symptoms such as irregular periods, difficulty getting pregnant and excess hair growth schedule an appointment with an obstetrician/gynecologist for diagnosis and treatment. "In severe cases, PCOS can lead to balding, lowering of the voice and bigger muscles," she adds. "Some women have a problem with their insulin levels or function, which leads to weight gain and difficulty losing weight. They also have an increased risk of endometrial cancer, diabetes, hypertension and heart disease."If you would like to schedule an appointment with an obstetrician/gynecologist, call the Blount Memorial HEALTHLINE at 981-3983 for a free physician referral.
SOURCE: thedailytimes.com
Friday, January 9, 2009
Woman has triplets against infertility odds
A woman who was told she could never have children has given birth to triplets. Sam Paciuszko, 31, gave birth 14 weeks early to two girls and a boy, each weighing just 2lb.
Mrs Paciuszko was told there was only a 30 per cent chance of all three surviving but they are now gaining weight and "doing well" as they are treated in three different hospitals for specialist treatment.
This has meant the couple making 400-mile round trips to see each one in turn.
The babies, Martha, Evie and Harry, are still in incubators in intensive care and are not expected to return home until March, the month they were originally due.
Mrs Paciuszko had been told she would never conceive because her body was not producing eggs but she began fertility treatment when she married her husband Andrew, a postman.
After three years of failure, Mrs Paciuszko had virtually abandoned hope until she fell pregnant last year. She gave birth by caesarean section on Dec 6.
Mrs Paciuszko, from Truro, Cornwall, an administration manager for Marks & Spencer, said doctors had performed "miracles".
She said: "It was a very lonely Christmas for Andrew and I because we spent it apart in different hospitals and eating microwave meals.
"We have not seen each other for three weeks. Nobody can give us a guarantee that they (the babies) will be OK but it is looking very good.
"The fact our babies are here at all is a miracle because we were told we could never have children. We just want to keep them safe."
During the pregnancy, the couple were given the option to terminate one foetus to ensure they had at least two healthy babies, but they declined.
Mrs Paciuszko gave birth at Derriford Hospital, Plymouth, Devon. A 20-strong specialist medical team delivered 1lb 13oz Harry at 10.12am, 2lb 2oz Martha at 10.14am and 1lb 12oz Evie at 10.16am.
Harry remained at Derriford while Martha was transferred to Frenchay Hospital, Bristol, Bristol, for an operation on a perforated gut. Evie was taken to the Royal Cornwall Hospital, Truro, to be near her home.
Harry and Evie are now both in incubators in Truro and Martha was expected to join them soon.
Hospital managers said the triplets had been moved to different units because they needed specialist care.
SOURCE: theafa.org
Sunday, January 4, 2009
Assisted reproduction leads to 27 live births for every 100 IVF cycles: report
TORONTO — A new report says fertility clinics in Canada achieved a success rate of 27 live births for every 100 IVF cycles in 2006, the latest year for which statistics are available.
And the Canadian Fertility and Andrology Society says the pregnancy rate for in vitro fertilization was 35 per cent in 2007, up nine percentage points since 1999, when the group first started collecting these statistics.
It was too soon to say what the rate of live births was for 2007, though it is generally expected that some of those pregnancies would have ended in miscarriage.
The report says about 15 per cent of pregnancies initiated using assisted reproduction through the society's 26 member clinics ended in miscarriage in 2006.
The live birth rates varied substantially by age, with 34 per cent of women under age 35 and 26 per cent of women aged 35 to 39 having a baby using IVF.
The rate dropped sharply, though, in women over age 40, with only 11 per cent of IVF cycles leading to a live birth.
How do the Canadian rates compare to those of fertility clinics in similar countries?
"Very well. They are very comparable," says Dr. Roger Pierson, chair of the communications committee of the society and director of the University of Saskatchewan's reproductive biology research unit.
The figures are the aggregate results of the country's 26 fertility clinics, which the clinics voluntarily provide. Pierson says that while some clinics will post their own rates on their websites, the society is not a regulatory body and does not release clinic-specific data.
He says the sector expects that when the Federal Assisted Human Reproduction Agency completes the task of drawing up its regulations, it will collect and publish clinic-specific results.
The 2006 data show that 70 per cent of babies born with the help of IVF were singletons and of the multiple births, 95 per cent were twins.
Over the years assisted reproduction has led to an explosion of multiple births. Experts have called for limits on the number of fertilized embryos implanted in each cycle with the aim of reducing the chances an IVF pregnancy will lead to multiple births.
The report says the proportion of babies born with congenital abnormalities was not elevated among IVF-assisted births.
Canadian women went through 8,278 cycles of IVF in 2006 in 25 fertility clinics across the country. In 2007 there were 9,019 treatment cycles performed through 26 clinics. The service costs between $6,000 and $15,000 a cycle, depending on the individual clinic and the type of procedure needed.
And the Canadian Fertility and Andrology Society says the pregnancy rate for in vitro fertilization was 35 per cent in 2007, up nine percentage points since 1999, when the group first started collecting these statistics.
It was too soon to say what the rate of live births was for 2007, though it is generally expected that some of those pregnancies would have ended in miscarriage.
The report says about 15 per cent of pregnancies initiated using assisted reproduction through the society's 26 member clinics ended in miscarriage in 2006.
The live birth rates varied substantially by age, with 34 per cent of women under age 35 and 26 per cent of women aged 35 to 39 having a baby using IVF.
The rate dropped sharply, though, in women over age 40, with only 11 per cent of IVF cycles leading to a live birth.
How do the Canadian rates compare to those of fertility clinics in similar countries?
"Very well. They are very comparable," says Dr. Roger Pierson, chair of the communications committee of the society and director of the University of Saskatchewan's reproductive biology research unit.
The figures are the aggregate results of the country's 26 fertility clinics, which the clinics voluntarily provide. Pierson says that while some clinics will post their own rates on their websites, the society is not a regulatory body and does not release clinic-specific data.
He says the sector expects that when the Federal Assisted Human Reproduction Agency completes the task of drawing up its regulations, it will collect and publish clinic-specific results.
The 2006 data show that 70 per cent of babies born with the help of IVF were singletons and of the multiple births, 95 per cent were twins.
Over the years assisted reproduction has led to an explosion of multiple births. Experts have called for limits on the number of fertilized embryos implanted in each cycle with the aim of reducing the chances an IVF pregnancy will lead to multiple births.
The report says the proportion of babies born with congenital abnormalities was not elevated among IVF-assisted births.
Canadian women went through 8,278 cycles of IVF in 2006 in 25 fertility clinics across the country. In 2007 there were 9,019 treatment cycles performed through 26 clinics. The service costs between $6,000 and $15,000 a cycle, depending on the individual clinic and the type of procedure needed.
Friday, December 12, 2008
Fertility and Your Sex Life
What sex life?
For couples who are trying to conceive, sex can become a mechanical process. One of the challenges couples face is the loss of spontaneity and romance when it comes to having sex while they are trying to have a baby. Fertility treatment can also change a couple's sex life.
When trying to have a baby, sex becomes a task necessary for conception. This "conception sex" can involve scheduled sex and specific sexual positions that are believed to improve the chances of getting pregnant. For many couples, these factors can make sex feel like a chore.
A couple who has been trying to conceive for some time may forget that sex can be intimate and that there is a difference between sex for pleasure and sex for conception. Couples need to recognize that the ability to conceive does not define their sexuality.
Feelings of intimacy and privacy can be lost once a couple undergoes fertility treatment. These issues often come up when discussing personal details of their sex life with their doctor, or when undergoing tests such as a semen analysis (to measure sperm counts) or the post-coital test (to assess the interaction between the sperm and the cervical mucus). Keeping a sense of humour can go a long way to help ease the frustrations and challenges you may be going through.
A couple's sex life doesn't have to suffer and become unromantic when they are trying to conceive. Communicate with your partner about your sexual desires and needs. Continue having spontaneous sex during the rest of the month, as if you weren't trying to have sex to conceive a baby. Couples who communicate and stay physically and emotionally connected can continue to have a healthy sex life.
Your doctor or fertility specialist can answer any concerns you may have about fertility and your sex life. Though it may be uncomfortable to talk to your fertility specialist about it, they are trained experts who can help with some of the challenges that couples may face while going through fertility treatment.
For couples who are trying to conceive, sex can become a mechanical process. One of the challenges couples face is the loss of spontaneity and romance when it comes to having sex while they are trying to have a baby. Fertility treatment can also change a couple's sex life.
When trying to have a baby, sex becomes a task necessary for conception. This "conception sex" can involve scheduled sex and specific sexual positions that are believed to improve the chances of getting pregnant. For many couples, these factors can make sex feel like a chore.
A couple who has been trying to conceive for some time may forget that sex can be intimate and that there is a difference between sex for pleasure and sex for conception. Couples need to recognize that the ability to conceive does not define their sexuality.
Feelings of intimacy and privacy can be lost once a couple undergoes fertility treatment. These issues often come up when discussing personal details of their sex life with their doctor, or when undergoing tests such as a semen analysis (to measure sperm counts) or the post-coital test (to assess the interaction between the sperm and the cervical mucus). Keeping a sense of humour can go a long way to help ease the frustrations and challenges you may be going through.
A couple's sex life doesn't have to suffer and become unromantic when they are trying to conceive. Communicate with your partner about your sexual desires and needs. Continue having spontaneous sex during the rest of the month, as if you weren't trying to have sex to conceive a baby. Couples who communicate and stay physically and emotionally connected can continue to have a healthy sex life.
Your doctor or fertility specialist can answer any concerns you may have about fertility and your sex life. Though it may be uncomfortable to talk to your fertility specialist about it, they are trained experts who can help with some of the challenges that couples may face while going through fertility treatment.
Tuesday, November 18, 2008
New test tells women how long to delay having children
Sarah North has decided to have a newly available fertility test to see if she should start having babies straight away.Miss North, a 31-year-old pharmaceutical company representative who lives with her partner at Laingholm in West Auckland, is certain she wants children - two, three, possibly even four.But she also has a mortgage. So, like many women around her age, she is weighing the benefits of delaying childbearing - such as greater financial security - against the risk that if she waits too long she might need IVF fertility treatment or not be physically able to have them at all.
"Ideally I picture myself at about 35 having children rather than right at this minute."But how long can she wait?The blood test she plans to have next week should give her an idea. A check of her level of an ovarian hormone called anti-Mullerian will show how many eggs she has left, a predictor of her chances of becoming pregnant.The new test - more sensitive than the existing method, which checks the level of follicle stimulating hormone - has been available overseas for several years. Now two chains of private fertility clinics in New Zealand have started offering it: Repromed, at a cost of $85, and Fertility Associates, at $45-$50.A woman's number of eggs is set at birth and declines naturally during her life. Egg quality also starts declining, then this accelerates in the 30s. Both factors affect fertility, which is at its peak around the age of 28.In the mid-20s, it takes on average three months to become pregnant, rising to six months in the mid-30s and a year at 40.
At least 10 per cent of women in their early 30s have an abnormally depleted reserve of eggs, but most do not know.The existing test can reveal this abnormal depletion only once the quality of the eggs has deteriorated significantly.The new test can also help to predict the risk of miscarriage and to tailor the dose of fertility drugs in IVF, but Fertility Associates director Dr Richard Fisher expects its main use will be to help women with a reduced egg count for their age decide when to try to start a family.
Repromed Auckland's medical director, Dr Guy Gudex, said he often saw couples who had been together for many years who, had they known they were going to have difficulty conceiving, would have started trying sooner."Just a couple of years can make all the difference."If a woman's anti-Mullerian hormone level was low, "we might encourage a couple to plan their family earlier."* The testA blood test to measure the level of an ovarian hormone called anti-Mullerian.It helps assess a woman's biological clock - fertility of ovaries' remaining eggs - better than existing tests.
"Ideally I picture myself at about 35 having children rather than right at this minute."But how long can she wait?The blood test she plans to have next week should give her an idea. A check of her level of an ovarian hormone called anti-Mullerian will show how many eggs she has left, a predictor of her chances of becoming pregnant.The new test - more sensitive than the existing method, which checks the level of follicle stimulating hormone - has been available overseas for several years. Now two chains of private fertility clinics in New Zealand have started offering it: Repromed, at a cost of $85, and Fertility Associates, at $45-$50.A woman's number of eggs is set at birth and declines naturally during her life. Egg quality also starts declining, then this accelerates in the 30s. Both factors affect fertility, which is at its peak around the age of 28.In the mid-20s, it takes on average three months to become pregnant, rising to six months in the mid-30s and a year at 40.
At least 10 per cent of women in their early 30s have an abnormally depleted reserve of eggs, but most do not know.The existing test can reveal this abnormal depletion only once the quality of the eggs has deteriorated significantly.The new test can also help to predict the risk of miscarriage and to tailor the dose of fertility drugs in IVF, but Fertility Associates director Dr Richard Fisher expects its main use will be to help women with a reduced egg count for their age decide when to try to start a family.
Repromed Auckland's medical director, Dr Guy Gudex, said he often saw couples who had been together for many years who, had they known they were going to have difficulty conceiving, would have started trying sooner."Just a couple of years can make all the difference."If a woman's anti-Mullerian hormone level was low, "we might encourage a couple to plan their family earlier."* The testA blood test to measure the level of an ovarian hormone called anti-Mullerian.It helps assess a woman's biological clock - fertility of ovaries' remaining eggs - better than existing tests.
Monday, November 3, 2008
101 Babies Expected After New Infertility Treatment
After suffering the heartbreak of years of infertility, scores of US couples claim their dreams came true due to a newly developed therapy. Over one hundred babies have been born or are expected by women diagnosed infertile after receiving a new physical therapy treatment, similar to a deep massage. The new treatment uses no drugs or surgery, according to its developers, physical therapist Belinda Wurn, and massage therapist Larry Wurn.
It was first used in Florida as an adjunct to medical treatments. Developed to treat infertility and pain, the patent protected Wurn Technique® is becoming available at clinics throughout the US. Cathleen, a Florida nurse, was given a five percent chance of ever becoming pregnant. She underwent four IVF attempts without success, then had a natural pregnancy and childbirth after receiving the new therapy. "It is exactly what my body needed. I was amazed to become pregnant naturally, a few months after the therapy!" Manhattan resident Julie said, "Both of my fallopian tubes were blocked with adhesions before therapy. Two months after therapy, I became pregnant at 42 years of age for the first time in my life!" Julie and Cathleen both delivered healthy baby girls.
Published medical studies "Medscape General Medicine" (6/04) examine the technique's effectiveness. 71% of infertile women in one small study conceived naturally after treatment; a larger controlled study showed that women who received the therapy before in vitro fertilization (IVF) had a 67% pregnancy rate with IVF - much higher than the control group. "Some successes in the natural therapy study were remarkable," said Richard King, MD, gynecologist and Medical Director of Florida Medical and Research Institute. "We had natural pregnancies and births in women diagnosed with adhesions, endometriosis, hormonal problems, and blocked fallopian tubes." Women in both studies averaged 5 years of infertility before the treatment. The therapy has an unusual side effect in some women: increased orgasms.
In a third study published in "Medscape General Medicine," (12/04) the therapy was shown to significantly increase desire, arousal and orgasm, and decrease sexual intercourse pain in study participants. The 20-hour therapy program can be completed in five days at Clear Passage clinics in Florida, Iowa, California or New York. See http://www.clearpassage.com. Free phone consultations are available at 1-866-BABYHERE (866-222-9437).
It was first used in Florida as an adjunct to medical treatments. Developed to treat infertility and pain, the patent protected Wurn Technique® is becoming available at clinics throughout the US. Cathleen, a Florida nurse, was given a five percent chance of ever becoming pregnant. She underwent four IVF attempts without success, then had a natural pregnancy and childbirth after receiving the new therapy. "It is exactly what my body needed. I was amazed to become pregnant naturally, a few months after the therapy!" Manhattan resident Julie said, "Both of my fallopian tubes were blocked with adhesions before therapy. Two months after therapy, I became pregnant at 42 years of age for the first time in my life!" Julie and Cathleen both delivered healthy baby girls.
Published medical studies "Medscape General Medicine" (6/04) examine the technique's effectiveness. 71% of infertile women in one small study conceived naturally after treatment; a larger controlled study showed that women who received the therapy before in vitro fertilization (IVF) had a 67% pregnancy rate with IVF - much higher than the control group. "Some successes in the natural therapy study were remarkable," said Richard King, MD, gynecologist and Medical Director of Florida Medical and Research Institute. "We had natural pregnancies and births in women diagnosed with adhesions, endometriosis, hormonal problems, and blocked fallopian tubes." Women in both studies averaged 5 years of infertility before the treatment. The therapy has an unusual side effect in some women: increased orgasms.
In a third study published in "Medscape General Medicine," (12/04) the therapy was shown to significantly increase desire, arousal and orgasm, and decrease sexual intercourse pain in study participants. The 20-hour therapy program can be completed in five days at Clear Passage clinics in Florida, Iowa, California or New York. See http://www.clearpassage.com. Free phone consultations are available at 1-866-BABYHERE (866-222-9437).
Monday, October 20, 2008
Acupuncture 'helps women have babies'
Acupuncture could help women undergoing fertility treatment become pregnant, new research has found.
One in three women given the ancient Chinese therapy - which involves the insertion of needles into specific points on the body - alongside their IVF treatment successfully conceived, scientists from the University of Southampton discovered.
The success rate among those who did not combine fertility treatment with acupuncture was one in five.
IVF treatment involves "embryo transfer" - when an egg has been fertilised in a laboratory is put into a woman's womb.
The study, which involved more than 2,000 women, discovered that the chance of the embryo implanting successfully, triggering pregnancy, increased if the patient was treated with acupuncture at about the same time as the transfer.
Its authors, however, found there was no discernible benefit if the acupuncture took place days after the fertility treatment.
They concluded: "Acupuncture around the time of embryo transfer achieves a higher live birth rate of 35 per cent compared with 22 per cent without active acupuncture."
Dr Ying Cheong, from the university's reproductive medicine unit, who led the research, said the findings would offer encouragement for the 33,000 women who embark on IVF treatment each year.
"Our research is good news, because it shows that acupuncture can help with fertility in patients undergoing IVF," Dr Cheong said.
"Whether or not acupuncture helps women achieve a live birth is a controversial issue, and opinion has been divided on it.
"We show that acupuncture, performed at the right stage, can have significant benefit. A woman who does so has a much greater chance of having a live birth than a woman who doesn't have acupuncture."
Acupuncture therapists claim that by inserting very fine needles into points on people's "energy channels", they can stimulate the body's natural healing system. However it is controversial, and many medical experts remain sceptical over its claims. Dr Cheong's research was welcomed by charities that campaign for people suffering from fertility problems.
Susan Seenan, from Infertility Network UK, said: "These results appear to show that acupuncture given with embryo transfers can help improve success rates and we look forward to further research in this area to confirm this.
"Anything that helps improve the success rates for people going through infertility treatment is good news.
"Many of our members report that alternative therapies, such as acupuncture, can help them to cope with the treatment and the general stress."
SOURCE: telegraph.co.uk
One in three women given the ancient Chinese therapy - which involves the insertion of needles into specific points on the body - alongside their IVF treatment successfully conceived, scientists from the University of Southampton discovered.
The success rate among those who did not combine fertility treatment with acupuncture was one in five.
IVF treatment involves "embryo transfer" - when an egg has been fertilised in a laboratory is put into a woman's womb.
The study, which involved more than 2,000 women, discovered that the chance of the embryo implanting successfully, triggering pregnancy, increased if the patient was treated with acupuncture at about the same time as the transfer.
Its authors, however, found there was no discernible benefit if the acupuncture took place days after the fertility treatment.
They concluded: "Acupuncture around the time of embryo transfer achieves a higher live birth rate of 35 per cent compared with 22 per cent without active acupuncture."
Dr Ying Cheong, from the university's reproductive medicine unit, who led the research, said the findings would offer encouragement for the 33,000 women who embark on IVF treatment each year.
"Our research is good news, because it shows that acupuncture can help with fertility in patients undergoing IVF," Dr Cheong said.
"Whether or not acupuncture helps women achieve a live birth is a controversial issue, and opinion has been divided on it.
"We show that acupuncture, performed at the right stage, can have significant benefit. A woman who does so has a much greater chance of having a live birth than a woman who doesn't have acupuncture."
Acupuncture therapists claim that by inserting very fine needles into points on people's "energy channels", they can stimulate the body's natural healing system. However it is controversial, and many medical experts remain sceptical over its claims. Dr Cheong's research was welcomed by charities that campaign for people suffering from fertility problems.
Susan Seenan, from Infertility Network UK, said: "These results appear to show that acupuncture given with embryo transfers can help improve success rates and we look forward to further research in this area to confirm this.
"Anything that helps improve the success rates for people going through infertility treatment is good news.
"Many of our members report that alternative therapies, such as acupuncture, can help them to cope with the treatment and the general stress."
SOURCE: telegraph.co.uk
Monday, October 13, 2008
BBC to pay £½m costs in IVF libel case
IVF libel case:
The BBC yesterday abandoned its claim that a Panoroma investigation into the country’s top fertility doctor constituted “responsible journalism”.
It now faces having to pay out at least £500,000 of taxpayers’ money to Mohamed Taranissi, who is suing the corporation after the flagship current affairs programme accused him of pressuring patients into paying for unnecessary treatment.
BBC lawyers in the High Court ditched a 15-month-old claim that the corporation was protected from the doctor’s libel action by qualified privilege, which shields journalists so long as they carry out “responsible journalism”.
The BBC is still defending the claim on the ground that the Panorama allegations were substantially true.
Richard Rampton, QC, Mr Taranissi’s counsel, said that the corporation had “thrown in the towel” after months of hard work and hundreds of thousands of pounds incurred by both sides. “It follows as a matter of justice, as night follows day, that they should pay,” he said.
Giving judgment, Mr Justice Eady agreed, saying that the BBC must bear the financial burden of that part of the case — estimated by Mr Taranissi’s lawyers to have cost at least half a million pounds.
Adrienne Page, QC, representing the BBC, said that the corporation continued to “stand behind its journalists and its programme and expects both to be vindicated at trial”. Mr Rampton accused the BBC of “grossly exaggerating” the number of medical sources that supported the programme’s allegations that Mr Taranissi offered “unnecessary and unproven” treatment and manipulated the success rates of his two London clinics.
“It’s Alice in Wonderland stuff,” he said. “One of the so-called medical experts was actually an administrative assistant.” He also criticised Panorama for “misleading” viewers, which the BBC denied.
The development came as Mr Taranissi was named as the UK’s most successful fertility doctor in annual figures released yesterday by the Human Fertilisation and Embryology Authority. His Assisted Reproduction and Gynaecology Centre had comfortably the highest success rate of any British clinic in 2006, with 61 per cent of patients aged under 35 having a baby after IVF treatment with their own fresh eggs. The national average for this patient group was 31 per cent.
The doctor’s other centre, the Reproductive Genetics Institute, took second place in the table, with a 50 per cent success rate for women under 35.
The results are embarrassing for the authority, which has been engaged in a long disciplinary action against the doctor over claims that he treated patients at the Reproductive Genetics Institute without the correct licence. Last year the watchdog declared Mr Taranissi unfit to be the “person responsible” for his main clinic, but it annulled the ruling last month after a legal challenge. The High Court also found that the authority used unlawful warrants to search the two clinics last January.
The General Medical Council is currently hearing complaints against Mr Taranissi from two patients, which he contests.
IVF success rates
1 Assisted Reproduction and Gynaecology Centre, London, 61% 2 Reproductive Genetics Institute, London, 50%3= Lister Fertility Clinic, London, 44%3= UCH, London, 44%5 Chelsea & Westminster Hospital, 42%6 Nurture, Nottingham, 41%7= Cromwell IVF and Fertility Centre, London, 39%7= Shropshire and Mid-Wales Fertility Centre, 39%9= Bath Fertility Centre, 38%9= CRM London, 38%9= Guy’s Hospital, London 38%
Source: Human Fertilisation and Embryology Authority (for women under 35 using own fresh embryos)
The BBC yesterday abandoned its claim that a Panoroma investigation into the country’s top fertility doctor constituted “responsible journalism”.
It now faces having to pay out at least £500,000 of taxpayers’ money to Mohamed Taranissi, who is suing the corporation after the flagship current affairs programme accused him of pressuring patients into paying for unnecessary treatment.
BBC lawyers in the High Court ditched a 15-month-old claim that the corporation was protected from the doctor’s libel action by qualified privilege, which shields journalists so long as they carry out “responsible journalism”.
The BBC is still defending the claim on the ground that the Panorama allegations were substantially true.
Richard Rampton, QC, Mr Taranissi’s counsel, said that the corporation had “thrown in the towel” after months of hard work and hundreds of thousands of pounds incurred by both sides. “It follows as a matter of justice, as night follows day, that they should pay,” he said.
Giving judgment, Mr Justice Eady agreed, saying that the BBC must bear the financial burden of that part of the case — estimated by Mr Taranissi’s lawyers to have cost at least half a million pounds.
Adrienne Page, QC, representing the BBC, said that the corporation continued to “stand behind its journalists and its programme and expects both to be vindicated at trial”. Mr Rampton accused the BBC of “grossly exaggerating” the number of medical sources that supported the programme’s allegations that Mr Taranissi offered “unnecessary and unproven” treatment and manipulated the success rates of his two London clinics.
“It’s Alice in Wonderland stuff,” he said. “One of the so-called medical experts was actually an administrative assistant.” He also criticised Panorama for “misleading” viewers, which the BBC denied.
The development came as Mr Taranissi was named as the UK’s most successful fertility doctor in annual figures released yesterday by the Human Fertilisation and Embryology Authority. His Assisted Reproduction and Gynaecology Centre had comfortably the highest success rate of any British clinic in 2006, with 61 per cent of patients aged under 35 having a baby after IVF treatment with their own fresh eggs. The national average for this patient group was 31 per cent.
The doctor’s other centre, the Reproductive Genetics Institute, took second place in the table, with a 50 per cent success rate for women under 35.
The results are embarrassing for the authority, which has been engaged in a long disciplinary action against the doctor over claims that he treated patients at the Reproductive Genetics Institute without the correct licence. Last year the watchdog declared Mr Taranissi unfit to be the “person responsible” for his main clinic, but it annulled the ruling last month after a legal challenge. The High Court also found that the authority used unlawful warrants to search the two clinics last January.
The General Medical Council is currently hearing complaints against Mr Taranissi from two patients, which he contests.
IVF success rates
1 Assisted Reproduction and Gynaecology Centre, London, 61% 2 Reproductive Genetics Institute, London, 50%3= Lister Fertility Clinic, London, 44%3= UCH, London, 44%5 Chelsea & Westminster Hospital, 42%6 Nurture, Nottingham, 41%7= Cromwell IVF and Fertility Centre, London, 39%7= Shropshire and Mid-Wales Fertility Centre, 39%9= Bath Fertility Centre, 38%9= CRM London, 38%9= Guy’s Hospital, London 38%
Source: Human Fertilisation and Embryology Authority (for women under 35 using own fresh embryos)
Friday, September 5, 2008
New master switch found in the brain that regulates appetite and reproduction
LA JOLLA, CA – Body weight and fertility have long known to be related to each other – women who are too thin, for example, can have trouble becoming pregnant. Now, a master switch has been found in the brain of mice that controls both, and researchers at the Salk Institute for Biological Studies say it may work the same way in humans.
Findings from the study, published ahead of print in the Aug. 31 online edition of Nature Medicine, suggest that variations in the gene that produces this master switch, known as TORC1, could contribute a genetic component to obesity and infertility, and might be regulated with a novel drug.
"This gene is crucial to the daisy chain of signals that run between body fat and the brain," says Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, who led the study. "It likely plays a pivotal role in how much we, as humans, eat and whether we have offspring."
It is just as important as leptin, the well-known star regulator of appetite, Montminy says, because leptin turns on TORC1, which in turn activates a number of genes known to help control feeding and fertility.
Judith Altarejos Ph.D., first author on this study, had been trying to understand human energy balance, and what can go awry to promote obesity, diabetes and other metabolic syndromes. In this study, she looked at the signals that travel from body fat to the brain, informing the brain of how well fed the body is. The primary hormone that performs that function is leptin, which travels through the bloodstream to the hypothalamus in the brain (the appetite center), keeping the brain aware of the body's nutritional status.
"Leptin tells the brain that times are good, your body is full, and that it is not necessary to eat more at the moment," Montminy says. The hormone also is known to play a role in reproduction - although, until this study, no one understood what is was. (Very thin women often do not have periods.)
"Controlling appetite and reproduction together provides a big evolutionary advantage," Montminy says. "If there is no food, the brain believes the body should not reproduce because without body fat, a baby's growth in the womb could be stunted, and without food to replenish the body's energy reserves, there will be nothing to feed the offspring."
"Leptin works remarkably well to give the brain a good indication of how much food has been eaten; 99.9 percent of the time it balances food intake with energy use," he says. "The problem is that no machine works 100 percent of the time, and that slight bit of inefficiency can lead to extra body weight."
Obesity results when the brain becomes "deaf" to the leptin signal, so one goal of Montminy's research is to "try to make a way to make sure the brain signals are being heard." But to do that, he and his research team first have to understand all of the signals involved in the satiety pathway.
Through years of research, they have uncovered a family of genes that act as energy switches, turning other genes on or off. One gene, TORC2, acts like a fasting switch that flips on the production of glucose in the liver when blood glucose levels run low, usually during sleep. During the day, the hormone insulin normally shuts down TORC2, ensuring that blood sugar levels don't rise too high. Problems along the pathway, however, can help lead to diabetes.
In this study, Altarejos looked at the function of TORC1, which she knew was produced in the brain – unlike TORC2 and TORC3 – but didn't know what its function was. To do this, she created mice that lacked one or both copies of the TORC1 gene – the first such "knock-out" mice to be developed.
Mice born without TORC1 looked fine at birth, but at about eight weeks, they began to gain weight and became persistently obese in adulthood, with two to three times as much adipose fat as normal mice, and they also became insulin resistant. "Their hormones and blood sugar resembled that seen in humans with these disorders," Montminy says.
They also discovered, to their surprise, that mice of both sexes were infertile; the uteri and ovaries in female mice were anatomically dysfunctional, for example. "We don't study infertility, but we put two and two together," he says. "We knew leptin is the critical hormone for regulating body weight, and that it is also very important for regulating reproduction."
Altarejos discovered that TORC1, which is found within nerve cells, responds to signals from leptin, which binds to receptors on the outside of the same cells. TORC1 then turns on a spate of genes, two of which are well known. One is the CART (Cocaine and Amphetamine Regulated Transcript) gene that is known to stifle appetite. The other, KISS1 (named by its discoverers at the Penn State Hershey Medical Center) is required for reproduction; mutations in the gene produce human infertility.
So when leptin binds with its receptor on brain cells, it turns on TORC1, which, in turns activates CART to suppress appetite, because more food is not needed, and KISS1, signaling reproduction can now commence in this well-fed body. Conversely, when leptin is not activating brain receptors, TORC1 is turned off, as are CART and KISS1.
They also discovered that when mice inherit only one TORC1 gene (instead of the normal two, one from each parent), fertility is restored but the mice gain more weight than normal mice. "This suggests that half of the dose of TORC switch is enough to cause problems in leptin signaling in the brain, and it may be that subtle mutations in TORC1 in humans could be responsible for an inheritable risk factor for gaining weight," Montminy says.
Tweaking mutated and inefficient TORC genes may be possible through drug therapy, he adds. "TORC1 is regulated by phosphate handling enzymes called kinases, and kinases often make for very good drug targets," Montminy says.
SOURCE: eurekalert.org
Findings from the study, published ahead of print in the Aug. 31 online edition of Nature Medicine, suggest that variations in the gene that produces this master switch, known as TORC1, could contribute a genetic component to obesity and infertility, and might be regulated with a novel drug.
"This gene is crucial to the daisy chain of signals that run between body fat and the brain," says Marc Montminy, Ph.D., a professor in the Clayton Foundation Laboratories for Peptide Biology, who led the study. "It likely plays a pivotal role in how much we, as humans, eat and whether we have offspring."
It is just as important as leptin, the well-known star regulator of appetite, Montminy says, because leptin turns on TORC1, which in turn activates a number of genes known to help control feeding and fertility.
Judith Altarejos Ph.D., first author on this study, had been trying to understand human energy balance, and what can go awry to promote obesity, diabetes and other metabolic syndromes. In this study, she looked at the signals that travel from body fat to the brain, informing the brain of how well fed the body is. The primary hormone that performs that function is leptin, which travels through the bloodstream to the hypothalamus in the brain (the appetite center), keeping the brain aware of the body's nutritional status.
"Leptin tells the brain that times are good, your body is full, and that it is not necessary to eat more at the moment," Montminy says. The hormone also is known to play a role in reproduction - although, until this study, no one understood what is was. (Very thin women often do not have periods.)
"Controlling appetite and reproduction together provides a big evolutionary advantage," Montminy says. "If there is no food, the brain believes the body should not reproduce because without body fat, a baby's growth in the womb could be stunted, and without food to replenish the body's energy reserves, there will be nothing to feed the offspring."
"Leptin works remarkably well to give the brain a good indication of how much food has been eaten; 99.9 percent of the time it balances food intake with energy use," he says. "The problem is that no machine works 100 percent of the time, and that slight bit of inefficiency can lead to extra body weight."
Obesity results when the brain becomes "deaf" to the leptin signal, so one goal of Montminy's research is to "try to make a way to make sure the brain signals are being heard." But to do that, he and his research team first have to understand all of the signals involved in the satiety pathway.
Through years of research, they have uncovered a family of genes that act as energy switches, turning other genes on or off. One gene, TORC2, acts like a fasting switch that flips on the production of glucose in the liver when blood glucose levels run low, usually during sleep. During the day, the hormone insulin normally shuts down TORC2, ensuring that blood sugar levels don't rise too high. Problems along the pathway, however, can help lead to diabetes.
In this study, Altarejos looked at the function of TORC1, which she knew was produced in the brain – unlike TORC2 and TORC3 – but didn't know what its function was. To do this, she created mice that lacked one or both copies of the TORC1 gene – the first such "knock-out" mice to be developed.
Mice born without TORC1 looked fine at birth, but at about eight weeks, they began to gain weight and became persistently obese in adulthood, with two to three times as much adipose fat as normal mice, and they also became insulin resistant. "Their hormones and blood sugar resembled that seen in humans with these disorders," Montminy says.
They also discovered, to their surprise, that mice of both sexes were infertile; the uteri and ovaries in female mice were anatomically dysfunctional, for example. "We don't study infertility, but we put two and two together," he says. "We knew leptin is the critical hormone for regulating body weight, and that it is also very important for regulating reproduction."
Altarejos discovered that TORC1, which is found within nerve cells, responds to signals from leptin, which binds to receptors on the outside of the same cells. TORC1 then turns on a spate of genes, two of which are well known. One is the CART (Cocaine and Amphetamine Regulated Transcript) gene that is known to stifle appetite. The other, KISS1 (named by its discoverers at the Penn State Hershey Medical Center) is required for reproduction; mutations in the gene produce human infertility.
So when leptin binds with its receptor on brain cells, it turns on TORC1, which, in turns activates CART to suppress appetite, because more food is not needed, and KISS1, signaling reproduction can now commence in this well-fed body. Conversely, when leptin is not activating brain receptors, TORC1 is turned off, as are CART and KISS1.
They also discovered that when mice inherit only one TORC1 gene (instead of the normal two, one from each parent), fertility is restored but the mice gain more weight than normal mice. "This suggests that half of the dose of TORC switch is enough to cause problems in leptin signaling in the brain, and it may be that subtle mutations in TORC1 in humans could be responsible for an inheritable risk factor for gaining weight," Montminy says.
Tweaking mutated and inefficient TORC genes may be possible through drug therapy, he adds. "TORC1 is regulated by phosphate handling enzymes called kinases, and kinases often make for very good drug targets," Montminy says.
SOURCE: eurekalert.org
Sunday, August 17, 2008
FIRST IVF BABY TURNS 30 By Jennifer Rogers
Happy 30th, Louise.
As I approach my 30th birthday, having delayed marriage and children, the social and biological clock of keeping time for childbearing ticks louder. However, thanks to another 30-year-old woman, it's possible for me to feel at ease. That woman is Louise Brown, the first child born via IVF. Last week marked not only her 30th birthday but thirty years of success in giving many women and men a second chance to have a biologically-related (at least, in part) child of their own.
In fact, over 3 million babies worldwide have been born using IVF -- with over 52,000 infants born in the US, accounting for 1 percent of all births in the country.
In conversations with my close friends, it's been comforting to hear that we share the same concerns about starting a family later in life. We joke that after years of being on birth control--from condoms to pills to patches and rings and back to condoms again--diligently trying to avoid an unplanned pregnancy, we're fearful that we may, in fact, experience infertility.
Because of assisted reproduction and the tremendous successes gained in the past three decades, the clock is not ticking as loudly for me as it was for my mother. Instead, my generation has grown accustomed to this $3 billion industry--most of us know at least one friend, family member or colleague who has been through IVF. But this familiarity brings with it a whole new set of concerns. What are the ethical, moral, legal and financial impacts of this field? How do we grapple with these issues as a women's community, before others tell us what's best for our bodies and for our children? We've seen it before, and it will happen again.
It is incumbent upon the women's reproductive health community, particularly those who face these issues daily, to foster this debate. We might begin with the following concerns:
Number 1: Why is my generation of women and men more infertile than our parents? Currently, in the US, 1.2 million (or 2%) of women of reproductive age (defined by the CDC as age 10 to 49) have an infertility-related medical appointment each year; 10% receive infertility services at some point in their lives. As I've alluded, a big factor is age. To simplify things greatly, as more women gained equality in education and in the workplace, we also began to delay childbearing--for many reasons, including lack of maternity leave and inflexible work schedules.
But to highlight only age would be misleading. With so many individuals experiencing infertility (and in cases in which the underlying causes are never found), we cannot ignore the tremendous role that environmental contaminants are playing in this problem. Exposure to ubiquitous dioxins, such as cigarette smoke, lead, mercury and some agricultural pesticides are direct threats to a couple's ability to conceive or have a healthy pregnancy. And, more troubling, new research suggests that a broader range of chemicals--including many that are associated with everyday products such as household cleansers, flame retardants, personal care and beauty aids, and even plastic water bottles--could have a complex and far-reaching impact on fertility.
Number 2: Are these procedures--the hormones, the retrieval of eggs, the implantation of one or multiple embryos--safe for women and their children? The answer, for the most part, is that we don't know. While IVF has generally been accepted as safe by the American public, there are in fact very little published data, let alone quality, standardized data, on the short and long term safety of these procedures on women and children's health. As we see an increase in women going through these procedures for either their own reproduction or to donate their eggs, how can we fully inform them of the potential risks and benefits?
Number 3: The growth of this industry and the growth in the numbers of assisted fertility clinics (now at 475 in total) have increased the demand for women's eggs. While most clinics offer women an average of $3,000 to $8,000, some "baby brokers" have offered as much as $50,000-80,000 for specific egg donors. (The American Society for Reproductive Medicine's (ASRM) guidelines allow for women to be compensated for their time and risk up to $5,000 or $10,000 in some cases, but this is neither mandated nor regulated by either state or federal law.) This issue poses its own ethical and moral dilemmas: should a woman be compensated for donating her eggs? Can payment create a coercive or exploitative situation? What are the race and class implications of who demands and who gets solicited for their eggs?
As with many momentous events in my life, as I approach my 30th birthday, I'm asking myself more questions than I know answers. I have found that asking questions--and listening to a broad range of voices who have their own personal and insightful answers--is the first step in the process in advocating for change.
We must grapple with these issues and then propose solutions that follow our values and morals. So, in that vein, my parting question: what policies will empower all women to make their own decisions about having a child and yet protect her health? The answer to this will be the best 30th birthday present for me and Louise.
As I approach my 30th birthday, having delayed marriage and children, the social and biological clock of keeping time for childbearing ticks louder. However, thanks to another 30-year-old woman, it's possible for me to feel at ease. That woman is Louise Brown, the first child born via IVF. Last week marked not only her 30th birthday but thirty years of success in giving many women and men a second chance to have a biologically-related (at least, in part) child of their own.
In fact, over 3 million babies worldwide have been born using IVF -- with over 52,000 infants born in the US, accounting for 1 percent of all births in the country.
In conversations with my close friends, it's been comforting to hear that we share the same concerns about starting a family later in life. We joke that after years of being on birth control--from condoms to pills to patches and rings and back to condoms again--diligently trying to avoid an unplanned pregnancy, we're fearful that we may, in fact, experience infertility.
Because of assisted reproduction and the tremendous successes gained in the past three decades, the clock is not ticking as loudly for me as it was for my mother. Instead, my generation has grown accustomed to this $3 billion industry--most of us know at least one friend, family member or colleague who has been through IVF. But this familiarity brings with it a whole new set of concerns. What are the ethical, moral, legal and financial impacts of this field? How do we grapple with these issues as a women's community, before others tell us what's best for our bodies and for our children? We've seen it before, and it will happen again.
It is incumbent upon the women's reproductive health community, particularly those who face these issues daily, to foster this debate. We might begin with the following concerns:
Number 1: Why is my generation of women and men more infertile than our parents? Currently, in the US, 1.2 million (or 2%) of women of reproductive age (defined by the CDC as age 10 to 49) have an infertility-related medical appointment each year; 10% receive infertility services at some point in their lives. As I've alluded, a big factor is age. To simplify things greatly, as more women gained equality in education and in the workplace, we also began to delay childbearing--for many reasons, including lack of maternity leave and inflexible work schedules.
But to highlight only age would be misleading. With so many individuals experiencing infertility (and in cases in which the underlying causes are never found), we cannot ignore the tremendous role that environmental contaminants are playing in this problem. Exposure to ubiquitous dioxins, such as cigarette smoke, lead, mercury and some agricultural pesticides are direct threats to a couple's ability to conceive or have a healthy pregnancy. And, more troubling, new research suggests that a broader range of chemicals--including many that are associated with everyday products such as household cleansers, flame retardants, personal care and beauty aids, and even plastic water bottles--could have a complex and far-reaching impact on fertility.
Number 2: Are these procedures--the hormones, the retrieval of eggs, the implantation of one or multiple embryos--safe for women and their children? The answer, for the most part, is that we don't know. While IVF has generally been accepted as safe by the American public, there are in fact very little published data, let alone quality, standardized data, on the short and long term safety of these procedures on women and children's health. As we see an increase in women going through these procedures for either their own reproduction or to donate their eggs, how can we fully inform them of the potential risks and benefits?
Number 3: The growth of this industry and the growth in the numbers of assisted fertility clinics (now at 475 in total) have increased the demand for women's eggs. While most clinics offer women an average of $3,000 to $8,000, some "baby brokers" have offered as much as $50,000-80,000 for specific egg donors. (The American Society for Reproductive Medicine's (ASRM) guidelines allow for women to be compensated for their time and risk up to $5,000 or $10,000 in some cases, but this is neither mandated nor regulated by either state or federal law.) This issue poses its own ethical and moral dilemmas: should a woman be compensated for donating her eggs? Can payment create a coercive or exploitative situation? What are the race and class implications of who demands and who gets solicited for their eggs?
As with many momentous events in my life, as I approach my 30th birthday, I'm asking myself more questions than I know answers. I have found that asking questions--and listening to a broad range of voices who have their own personal and insightful answers--is the first step in the process in advocating for change.
We must grapple with these issues and then propose solutions that follow our values and morals. So, in that vein, my parting question: what policies will empower all women to make their own decisions about having a child and yet protect her health? The answer to this will be the best 30th birthday present for me and Louise.
Wednesday, August 13, 2008
PIONEERING TECHNIQUE ENDS BABY WAIT
A couple who tried for a baby for seven years are celebrating the birth of a daughter thanks to a pioneering new technology.
Ian and Rebecca Bloomer attended the IVF clinic at the University Hospital of Wales, Cardiff. In August last year, the hospital began using a new technology to freeze unused embryos through "vitrification".
This method, offered to the Bloomers, gave the embryos a better chance of surviving the freeze so they would be available again as soon as the couple were ready to try again.
Mrs Bloomer fell pregnant almost immediately using one of these embryos and became the proud mother of a healthy baby girl on July 23.
The childhood sweethearts, from Cwmbran, South Wales, had wanted a baby since they married in 2001. But tests revealed that Mrs Bloomer, 28, had endometriosis, a condition which was making it difficult for her to conceive.
Mrs Bloomer said: "We were willing to try anything really, we'd both always wanted children.
"It's overwhelming. I'm still staring at her now thinking 'wow, she's ours - it's actually happened for us'.
"I hope that if anybody going through treatment sees us and sees Evie it gives them one last little bit of hope to go for it.
"It's been a real emotional rollercoaster. There's been ups and downs, but you get through it and, to have Evie now, you forget what you went through. It makes it all worthwhile."
Lyndon Miles, head of embryology and andrology for IVF Wales, said: "The first published study on babies born from vitrification shows no adverse effects of the technique and there are no implications to Evie's health as a result of the vitrification process."
SOURCE: The Press Association
Ian and Rebecca Bloomer attended the IVF clinic at the University Hospital of Wales, Cardiff. In August last year, the hospital began using a new technology to freeze unused embryos through "vitrification".
This method, offered to the Bloomers, gave the embryos a better chance of surviving the freeze so they would be available again as soon as the couple were ready to try again.
Mrs Bloomer fell pregnant almost immediately using one of these embryos and became the proud mother of a healthy baby girl on July 23.
The childhood sweethearts, from Cwmbran, South Wales, had wanted a baby since they married in 2001. But tests revealed that Mrs Bloomer, 28, had endometriosis, a condition which was making it difficult for her to conceive.
Mrs Bloomer said: "We were willing to try anything really, we'd both always wanted children.
"It's overwhelming. I'm still staring at her now thinking 'wow, she's ours - it's actually happened for us'.
"I hope that if anybody going through treatment sees us and sees Evie it gives them one last little bit of hope to go for it.
"It's been a real emotional rollercoaster. There's been ups and downs, but you get through it and, to have Evie now, you forget what you went through. It makes it all worthwhile."
Lyndon Miles, head of embryology and andrology for IVF Wales, said: "The first published study on babies born from vitrification shows no adverse effects of the technique and there are no implications to Evie's health as a result of the vitrification process."
SOURCE: The Press Association
Wednesday, July 30, 2008
INTERESTING AND INFORMATIVE BLOG ON INFERTILITY
CHECK OUT LOLLIPOP GOLDSTEIN'S INTERESTING BLOG ABOUT INFERTILITY AND PREGNANCY LOSS, AN EXPLORATION OF ADOPTION AND DONOR GAMETES, A BITCH SESSION ABOUT DAILY LIFE AND BOOKS, ETC at:
http://www.stirrup-queens.blogspot.com
http://www.stirrup-queens.blogspot.com
Saturday, July 26, 2008
HOW DO COUPLES COPE WHEN IVF FAILS?
Broke, babyless and in need of help. John Naish examines the taboo question of how couples cope when it all goes wrong:
Across Britain next Friday, thousands of couples will brace themselves for a welter of “miracle-baby” stories as the world marks the 30th birthday of Louise Brown, the first test-tube child. In the shadow of assisted conception's many successes are the 75 per cent of women patients for whom the gruelling medical process never works. The vast majority are neither monitored nor offered counselling but, it seems, are expected to slink away, marked “failed.”
Caroline Gallup is among the 25,000 women each year whose fertility treatment proves fruitless, often after spending all their available funds and putting their relationships under perilous strain. Rather than quietly grieving, Gallup is campaigning for the NHS and high-earning private clinics to give support after assisted conception has failed and to fund studies into what happens to these people's lives.
Very little research has been done, but in 2000 a small study of 76 women by the Royal Maternity Hospital in Belfast found that five years after their unsuccessful treatment they suffered “significant psychological dysfunction”, particularly stress and depression. The research, published in the journal Human Fertility, concluded: “There is a strong need to prepare women better for treatment failure and to ensure that counselling is available when further treatment is no longer appropriate.” This echoes the findings of a Hull University study three years earlier. Both recommendations have fallen on deaf ears.
The government watchdog, the Human Fertilisation and Embryology Authority, says that it sees issues about follow-up monitoring and counselling as outside its remit, because it regulates only the process of infertility treatment itself.
Hence Gallup's campaigning. “I see the routine provision of post-treatment counselling as a moral duty,” says the 44-year-old Londoner. “When you are treated, you have to believe that a baby will grow. When it doesn't, the crash is awful, but you're buoyed as long as you can go through another cycle. I think it's only morally right for clinics to carry on with ‘after-sales service' when that hope has disappeared.”
COUPLES HAVE THE UTMOST OPTIMISM
“The clinics do tell you at their open days that there is a 76 per cent failure rate across the board, but couples aren't in a position to take that in,” says Gallup. “The only way you can enter into something so grim is with the utmost optimism.” Indeed, a study in The Obstetrician & Gynaecologist journal found that although clear information on success rates is given to couples, “the majority believe that they will be the minority who achieve pregnancy”.
Gallup and her husband decided to stop trying after they had paid £8,000 for private treatment. “It was partly down to money - we'd run out - and partly the fact that it was wrecking our relationship. My husband said he didn't want to go through it any more. It was turning me into a total obsessive,” she says, adding: “Blame can play a really big part in relationships after treatment failure. It's one of the big reasons why counselling is needed.”
Four years after the treatment ended, she says: “My husband and I are still dealing with it. I have had to reinvent myself. I didn't know what my identity was after we had finished. That's a huge psychological thing.” Now she has taken a less demanding job in her career in events management to spend time lobbying interest groups and politicians. She is also trying to develop a career as a writer, having published a book on her fertility treatment experiences, Making Babies the Hard Way.
Emerging from fertility treatment babyless, broke and in need of professional support to get back on the rails is a common experience, according to the British Infertility Counselling Association. “A lot of people come out of the process highly stressed and they think they can go for free counselling, but there is no such thing,” says a spokeswoman. “Funding is a big problem for most people. They may well not be able to pay for private counselling because they have spent all their money on treatment.”
One of the few organisations to provide social support is More To Life, which helps involuntarily childless people to develop networks and swap advice. Membership costs £20 annually and has grown rapidly in the two years since it was established, says Susan Seenan, one of the organisers. “Social life can be difficult for infertile couples, especially women,” she says. “Wherever you go - barbecues, parties, christenings - everyone has children.
“It's difficult to talk about infertility and childlessness. It's seen as a stigma. But with more people leaving it until later in life to try for children, there is bound to be more infertility, more treatment, and more disappointed couples.”
It is not only infertile women who face bereavement and loss of purpose. David Downage regularly attends More To Life social events. He and his wife went through treatment in the NHS and privately, but ultimately decided that their hopes were beyond slim. “It was a traumatic decision, but the danger is that you go on trying too long and damage your relationship,” he says. “So we decided to move on.”
The Downages joined More To Life to extend their social network beyond old friends with their new families. “We had to find it by searching the web,” he says. “It's strange that clinics can't point you to organisations like this after the treatment has failed,” says David, 47, a property developer. “For a man, discovering that you're going to be childless raises questions about what you are doing with your life. Once you can pay the bills, what is there after that? My wife and I came to view it as an opportunity to do other things. She is keen to get involved in charity work with children. We plan to retire early and, hopefully, be able to put some of our money into building children's schools. Certainly we will be able to do that as a legacy.”
Finding renewed purpose is one of the best survival strategies, says Jacky Boivin, a researcher at Cardiff University's School of Psychology. She has followed more than 100 women undertaking IVF over seven years, and is running a five-year study of 818 couples in Denmark.
“There is not much research into what happens to people in the long term after unsuccessful treatment, but our data indicates that about 40 per cent of couples are highly distressed at having to stop. After they have made the decision, around 5 to 10 per cent remain stuck in that state. People who come to the end of the IVF treatment and feel they could have had more are often seized with resentment.
“You have to reinvent a life that is not about having a family,” she stresses. “You have to look for the positive while acknowledging the negative. People have to regain a sense of control over their lives, after having it taken over by regimens that tell them exactly when they should be having sex. And they need to look at the experience as an opportunity to renew life interests. Sadly, the lack of post-treatment counselling means people don't have support in this.”
AND NOW THE GOOD NEWS
There is one surprise. Boivin says: “Oddly, the divorce rate is much lower among couples whose fertility treatment failed than for the general population: 10 per cent versus 50 per cent. We don't know why. There is life after infertility treatment. Not always an easy one, but most people will go on to find contentment, though the experience will always carry a sting.”
SOURCE: THE TIMES ONLINE
Across Britain next Friday, thousands of couples will brace themselves for a welter of “miracle-baby” stories as the world marks the 30th birthday of Louise Brown, the first test-tube child. In the shadow of assisted conception's many successes are the 75 per cent of women patients for whom the gruelling medical process never works. The vast majority are neither monitored nor offered counselling but, it seems, are expected to slink away, marked “failed.”
Caroline Gallup is among the 25,000 women each year whose fertility treatment proves fruitless, often after spending all their available funds and putting their relationships under perilous strain. Rather than quietly grieving, Gallup is campaigning for the NHS and high-earning private clinics to give support after assisted conception has failed and to fund studies into what happens to these people's lives.
Very little research has been done, but in 2000 a small study of 76 women by the Royal Maternity Hospital in Belfast found that five years after their unsuccessful treatment they suffered “significant psychological dysfunction”, particularly stress and depression. The research, published in the journal Human Fertility, concluded: “There is a strong need to prepare women better for treatment failure and to ensure that counselling is available when further treatment is no longer appropriate.” This echoes the findings of a Hull University study three years earlier. Both recommendations have fallen on deaf ears.
The government watchdog, the Human Fertilisation and Embryology Authority, says that it sees issues about follow-up monitoring and counselling as outside its remit, because it regulates only the process of infertility treatment itself.
Hence Gallup's campaigning. “I see the routine provision of post-treatment counselling as a moral duty,” says the 44-year-old Londoner. “When you are treated, you have to believe that a baby will grow. When it doesn't, the crash is awful, but you're buoyed as long as you can go through another cycle. I think it's only morally right for clinics to carry on with ‘after-sales service' when that hope has disappeared.”
COUPLES HAVE THE UTMOST OPTIMISM
“The clinics do tell you at their open days that there is a 76 per cent failure rate across the board, but couples aren't in a position to take that in,” says Gallup. “The only way you can enter into something so grim is with the utmost optimism.” Indeed, a study in The Obstetrician & Gynaecologist journal found that although clear information on success rates is given to couples, “the majority believe that they will be the minority who achieve pregnancy”.
Gallup and her husband decided to stop trying after they had paid £8,000 for private treatment. “It was partly down to money - we'd run out - and partly the fact that it was wrecking our relationship. My husband said he didn't want to go through it any more. It was turning me into a total obsessive,” she says, adding: “Blame can play a really big part in relationships after treatment failure. It's one of the big reasons why counselling is needed.”
Four years after the treatment ended, she says: “My husband and I are still dealing with it. I have had to reinvent myself. I didn't know what my identity was after we had finished. That's a huge psychological thing.” Now she has taken a less demanding job in her career in events management to spend time lobbying interest groups and politicians. She is also trying to develop a career as a writer, having published a book on her fertility treatment experiences, Making Babies the Hard Way.
Emerging from fertility treatment babyless, broke and in need of professional support to get back on the rails is a common experience, according to the British Infertility Counselling Association. “A lot of people come out of the process highly stressed and they think they can go for free counselling, but there is no such thing,” says a spokeswoman. “Funding is a big problem for most people. They may well not be able to pay for private counselling because they have spent all their money on treatment.”
One of the few organisations to provide social support is More To Life, which helps involuntarily childless people to develop networks and swap advice. Membership costs £20 annually and has grown rapidly in the two years since it was established, says Susan Seenan, one of the organisers. “Social life can be difficult for infertile couples, especially women,” she says. “Wherever you go - barbecues, parties, christenings - everyone has children.
“It's difficult to talk about infertility and childlessness. It's seen as a stigma. But with more people leaving it until later in life to try for children, there is bound to be more infertility, more treatment, and more disappointed couples.”
It is not only infertile women who face bereavement and loss of purpose. David Downage regularly attends More To Life social events. He and his wife went through treatment in the NHS and privately, but ultimately decided that their hopes were beyond slim. “It was a traumatic decision, but the danger is that you go on trying too long and damage your relationship,” he says. “So we decided to move on.”
The Downages joined More To Life to extend their social network beyond old friends with their new families. “We had to find it by searching the web,” he says. “It's strange that clinics can't point you to organisations like this after the treatment has failed,” says David, 47, a property developer. “For a man, discovering that you're going to be childless raises questions about what you are doing with your life. Once you can pay the bills, what is there after that? My wife and I came to view it as an opportunity to do other things. She is keen to get involved in charity work with children. We plan to retire early and, hopefully, be able to put some of our money into building children's schools. Certainly we will be able to do that as a legacy.”
Finding renewed purpose is one of the best survival strategies, says Jacky Boivin, a researcher at Cardiff University's School of Psychology. She has followed more than 100 women undertaking IVF over seven years, and is running a five-year study of 818 couples in Denmark.
“There is not much research into what happens to people in the long term after unsuccessful treatment, but our data indicates that about 40 per cent of couples are highly distressed at having to stop. After they have made the decision, around 5 to 10 per cent remain stuck in that state. People who come to the end of the IVF treatment and feel they could have had more are often seized with resentment.
“You have to reinvent a life that is not about having a family,” she stresses. “You have to look for the positive while acknowledging the negative. People have to regain a sense of control over their lives, after having it taken over by regimens that tell them exactly when they should be having sex. And they need to look at the experience as an opportunity to renew life interests. Sadly, the lack of post-treatment counselling means people don't have support in this.”
AND NOW THE GOOD NEWS
There is one surprise. Boivin says: “Oddly, the divorce rate is much lower among couples whose fertility treatment failed than for the general population: 10 per cent versus 50 per cent. We don't know why. There is life after infertility treatment. Not always an easy one, but most people will go on to find contentment, though the experience will always carry a sting.”
SOURCE: THE TIMES ONLINE
Wednesday, July 9, 2008
Science thinks big for better IVF
A new IVF technique involves selecting sperm with a shape and size that indicate good genetic quality. The best are injected into eggs to fertilise them. Results show improved pregnancy rates.
Infertile men can more than double their chances of fatherhood with a new IVF technique, according to the most comprehensive study of the procedure yet conducted.
The results of a major trial of the approach, which builds upon the technique of injecting sperm directly into an egg, suggest dramatic benefits for the one in 12 couples affected by male factor infertility. A far more powerful microscope is used to identify the sperm most likely to succeed.
The results, from a team in Italy, are encouraging for men with an especially poor fertility prognosis and who have tried and failed to have children by IVF at least twice in the past. Their prospect of becoming fathers using the therapy was double that with standard methods, the study found.
The method, which was first developed in 2004 by a team led by Benjamin Bartoov, of BarIlan University in Israel, is called intra-cytoplasmic morphologically-selected sperm injection (IMSI). It involves examining sperm under a high-magnification microscope, about five times more powerful than standard laboratory equipment, to select those with a shape and size that indicates good genetic quality. The best-looking sperm are then injected into eggs.
British scientists hailed the results as the strongest demonstration yet of the new therapy’s benefits. “I don’t think a lot of people in the UK have woken up to this yet, but they are going to have to,” said Allan Pacey, Lecturer in Andrology at the University of Sheffield. “This is strong evidence from a well-designed study. If it can be repeated in two or three studies, people would seriously have to think about changing their approach.”
The treatment builds on the success of intra-cytoplasmic sperm injection (ICSI), a therapy for male infertility that has enabled thousands to become fathers since it was developed in the early Nineties. ICSI involves fertilising an egg in a laboratory by injecting it with a single sperm. As the sperm does not have to swim up to the egg and penetrate it, the method can help men whose sperm would otherwise be too weak. Even when men produce no sperm, doctors can sometimes recover them surgically from the testes.
ICSI is now used in about 40 per cent of the 41,000 IVF cycles performed annually in the UK, and accounts for about 4,500 children born each year. This suggests that upwards of 10,000 men a year could be appropriate patients for the new technique.
The Italian team, led by Monica Antinori, of the Raprui clinic in Rome, has conducted the largest randomised controlled trial to compare outcomes for IMSI and ICSI. It involved 446 couples in which the man was infertile and the woman was not known to have any problems.
The results, which are published in the journal Reproductive Biomedicine Online, show that the IMSI method can deliver considerable improvements in pregnancy rate. The overall pregnancy rate for the IMSI group was 39.2 per cent, compared with 26.5 per cent for the ICSI patients.
Among men with the worst prognosis, who had had at least two failed attempts at ICSI before, the improvement was better still. The pregnancy rate for IMSI was 29.8 per cent, compared with 12.9 per cent for standard ICSI. The miscarriage rate also fell considerably.
Dr Antinori said the findings demonstrate that the technique has potential, particularly for men with a history of IVF failure. “By treating this kind of patient with this technique, we offer them an opportunity to solve their fertility problems. As you can see from the results, the group that has had two or more IVF failures can get more than twice the opportunity to have a pregnancy with this new technique.”
She cautioned, however, that IMSI is about twice as expensive as ICSI, which typically costs between £3,000 and £5,000 per cycle in Britain. It also requires special training for embryologists, and the purchase of expensive high-magnification microscopes.
IMSI is not yet offered in the UK, though it is performed by clinics in Italy, Israel, Switzerland and Spain.
Dr Pacey said: “People have been seduced into thinking that, as long as you’ve got a sperm that’s half decent, it’s got as good a chance as any. But it looks like we can do better than that.”
Source: The Times July 7 2008
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