Tuesday, May 8, 2018

Fertility Fest 2018 in London


Fertility Fest, running at the Bush Theatre from May 8-13, is the first arts festival in the world entirely dedicated to fertility, infertility, modern families and the science of making babies.
Through performances, debate and discussion, it brings art and science together to improve people’s understanding of human fertility, as well as the emotional gamut felt by those struggling to conceive.
You can buy a day ticket to experience a range of events with a community of people, or attend one of the free events on offer. No topic will go undiscussed, from male infertility to queer families, and there will also be film screenings and artworks on display.

Tuesday, May 1, 2018

Most infants will be designer babies in 20 years


Mothers will choose embryos based on sex, intelligence, disease risk even musical ability
*African scientists call for more control of their continent’s genomic data, issue guidelines
Most infants will be ‘designer babies’ in as little as 20 years, a professor claims.Within 20-to-40 years, hopeful mothers will be able to choose the embryos implanted into their wombs based on their preferences for sex, intelligence, musical ability or disease risk, according to Professor Henry Greely from Standard University, who works in bioethics.
Professor Greely, who wrote “The End of Sex and the Future of Human Reproduction”, said: “The majority of babies of people who have good health coverage will be conceived this way.”A designer baby is an embryo that is genetically engineered for specifically selected traits before being implanted into a woman via In Vitro Fertilisation (IVF).Although initially a sci-fi concept, pre-implantation genetic diagnosis already routinely determines if embryos are at risk of diseases such as cystic fibrosis in the United Kingdom (UK) and United States (US). Designer babies are illegal in the UK.
While The Council on Ethical and Judicial Affairs supports genetic selection if it benefits a child’s wellbeing, critics argue choosing ‘preferred’ traits that do not boost health is unethical.Supporters of the practice argue parents can already influence their child’s tastes via lifestyle choices, such as taking them to concerts, and should therefore have the right to “prenatal autonomy”.
What are designer babies? And what are the pros and cons? A designer baby occurs when hopeful parents chose desirable qualities for embryos via genetic screening.The embryos are then implanted into women’s uteruses via IVF.Traits that may be selected could include choosing a daughter, a child without a risk of sickle cell disease or a son who is musically gifted.
Supporters argue genetically altering embryos could increase individuals’ life expectancies by only keeping their healthy genes.Deoxy ribonucleic Acid (DNA) that increases the risk of certain conditions, such as Alzheimer’s and Huntington’s, could be discarded.Some believe selecting for traits such as intelligence may also improve people’s quality of life.Supporters also claim parents already have an influence on their children’s personalities, such as taking them to music concerts.
They add parents should also have “prenatal autonomy”.But critics argue it is unethical for children to be genetically engineered to have certain traits, such as blue eyes, that do not benefit their health.Such genetic screening is also still in its early stages and therefore may not be completely safe.Parents may also not get the outcomes they were hoping for due to chemical modifications affecting genes after embryos are implanted in the uterus.
Critics also argue people’s upbringings and life experiences have a substantial impact on traits such as intelligence.In addition, genes that control intelligence may also influence ‘negative’ traits, like anger.Some also point out only wealthy people could likely afford such genetic screenings.Health insurers may also reject patients who did not undergo genetic selection out of concerns they have a higher disease risk.
Meanwhile, as the genomics revolution finally turns its attention to Africa and northern researchers flock there to collect data, scientists from the continent are demanding a larger role in projects.On 18 April, a group of Africa-based researchers issued guidelines for the ethical handling of samples for genomic studies. The voluntary rules are an effort to combat ‘helicopter’ research, in which foreign scientists take samples and data from communities and then return to their home institutions. The guidelines also aim to ensure that African citizens see health benefits from research.
In recent years, researchers have begun sequencing the genomes of Africans in large numbers. The data offer insights into humanity’s past as well as predisposition to disease and potential reactions to drugs in African populations — the world’s most genetically diverse.But because few institutions on the continent have the equipment to handle large genomic data sets, African scientists wanting to work on such projects have often had to accept terms offered by foreign partners, says Jantina de Vries, a bioethicist at the University of Cape Town in South Africa and co-author of the guidelines. “African research has been held over a barrel.”
The rules were issued by the ethics working group of the Human Heredity and Health in Africa (H3Africa) Initiative, a health-genomics consortium that supports research in African institutions. It is funded by the US National Institutes of Health and the biomedical research charity the Wellcome Trust.
H3Africa is spending US$188 million over 10 years to fund Africa-led genomics projects, train bioinformaticians and create biobanks. South Africa has also invested in genomics facilities.The document calls for “meaningful and substantive” African intellectual contributions to research that draws on African samples. It says that researchers might be able to take specimens out of the continent in some cases, but projects should involve African scientists and build their capacity to work independently. Research should also respect African values and should benefit citizens, says de Vries’s team.
Meanwhile, most wish to leave children’s fate “in God’s hands”. Despite Professor Greely’s predictions, Dr. Louanne Hudgins, who studies prenatal genetic screening at Stanford, expects only a ‘very small minority’ of parents will want designer babies, with most preferring to leave their fate “in God’s hands”.Dr. James Grifo, from the New York University Fertility Center, who has been performing IVF since 1988, added: “No patient has ever came to me and said, ‘I want a designer baby’.”
Professor Greely doubts many parents will wish to influence their child’s intelligence or athleticism, but insists they may want to avoid childhood diseases.He adds parents will likely have less interest in conditions that typically appear in later life, such as Alzheimer’s.Designer-baby critics argue only wealthy people could likely afford such screening.
In the future, health insurers may also reject patients who have not undergone genetic selection out of concerns they have a higher disease risk.Dr. Louanne Hudgins, who studies prenatal genetic screening and diagnosis at Stanford, adds genetically screening foetuses for diseases is not supported by medical associations and therefore health insurers will unlikely pay for such treatment in the near future.
Parents may also not get the outcomes they were hoping for due to chemical modifications affecting genes after embryos are implanted in the uterus.Critics add people’s upbringings and life experiences also have a substantial impact on traits such as intelligence. Dr. Richard Scott Jr, a founding partner of Reproductive Medicine Associates of New Jersey, added: “Your child may not turn out to be the three-sport All-American at Stanford.”
Fertility technique could cause celebrities to unwittingly become parents. Designer babies aside, Professor Greely, is developing a technology that enables ordinary cells to be transformed into sperm or eggs.Although only done in mice to date, the technique may benefit infertile couples if eggs could be produced from, for example, a woman’s skin cells.
Professor Greely envisions the method could yield hundreds of eggs, which may be screened for genetic traits before couples choose one or two to implant.Dr. Amander Clark, from the University of California, LA, believes the technique may enable people who are infertile due to cancer treatments to become parents.Critics of Professor Greely’s vision argue obsessive celebrity fans may unwittingly turn stars into parents if they collect skin cells from, for instance, a discarded coffee cup.
Are designer babies legal in the UK and US? Designer babies are illegal in the UK. The US does not have specific rules preventing genetically engineering embryos, however, federal funds cannot be used for such research.In 2016, the UK Human Fertilisation and Embryology Authority (HFEA) allowed a certain team of scientists to genetically edit human embryos. The researchers, from the Francis Crick Institute in London, were able to ‘turn off’ genes that prevent IVF success and cause miscarriages.
They had to specifically apply to the HFEA for permission before going ahead with their research.They only analysed the embryos’ early development, with the cells not being allowed to grow into babies. No other researchers have been granted HFEA approval for such experiments.In 2015, the US National Institutes of Health said it “will not fund any use of gene-editing technologies in human embryos”.
At the end of that year, a United Nations Education Scientific Cultural Organisation (UNESCO) panel of scientists, philosophers and lawyers called for a halt on genetic editing until its effects are better understood.In April 2015, Chinese scientists tweaked the genes of 28 embryos to try and prevent a life-threatening blood disorder.They encountered many challenges, concluding that such technology has a long way to go before it can be safely used in humans.
Meanwhile, De Vries hopes the framework will empower local scientists in negotiations with foreign partners. African scientists could avoid being scooped by overseas teams with superior computational facilities, for instance, if project terms include extended embargo periods during which scientists not involved in collecting the data are banned from publishing.
Time frames for analysis present a real challenge for African researchers who lack the computational facilities of the global north, says Michael Pepper, a coordinator of the Southern African Human Genome Programme, based at the University of Pretoria in South Africa, who provided input into the framework. “As soon as it falls into the hands of researchers in the Northern Hemisphere, we get left behind,” he says.
The framework will also be useful for African research-ethics committees that are charged with assessing proposals for studies. Many are unsure how to treat genomic research, de Vries says. For example, some countries — including Zambia, Tanzania and Malawi — ban or discourage collection of samples under ‘broad consent’, in which study participants agree that researchers can keep their samples and use them for purposes unspecified at the time of collection.


Wednesday, September 7, 2016

Simple 'scratching' technique tested in first-time IVF patients

A new simple procedure which involves gently scratching the lining of the womb in the month before IVF treatment, potentially improving treatment success, is being tested on first-time IVF attempters in a ground-breaking study.

A team of scientists from the University of Sheffield and gynaecologists from Sheffield Teaching Hospitals NHS Foundation Trust are testing the technique – known as endometrial scratching – on women about to have IVF or Intra-cytoplasmic sperm injection (ICSI) for the first time.

The £1 million multi-centre study, funded by the National Institute for Health Research's Health Technology Assessment Programme, is running at Sheffield's Jessop Fertility as well as approximately 12 nationwide assisted conception units.

If shown to improve the success rate of embryo implantation, the trial could lead to endometrial scratching being offered routinely to all women having their first IVF treatment cycle.

Previous trials into the technique have focused on women who have had IVF at least once before – but initial findings from this research are highly promising, with pregnancy rates in women undergoing IVF doubling from 29 per cent to 49 per cent. The number of live births also increased from 23 per cent to 42 per cent.

The technique involves placing a small tube about the size of a drinking straw through the neck of the womb and gently scratching the womb's lining. The 'scratching' releases certain chemicals believed to help the fertilised egg implant in the womb's lining – increasing the chances of a successful pregnancy.

Mr Mostafa Metwally, a Consultant Gynaecologist and Sub-specialist in Reproductive Medicine and Surgery at Sheffield Teaching Hospitals NHS Foundation Trust, said: "The use of endometrial scratch has not yet been fully tried in women who are about to have IVF for the first time.

"If found to be beneficial then it could be used to improve the chance of achieving a pregnancy for a large group of women without the need for repeated IVF attempts, so we are delighted to be leading the way with this research. By the end of the study we hope to be able to tell whether or not endometrial scratch should be offered routinely to women having their first IVF treatment cycle."

The study will involve 1,044 participants and run over the course of two and a half years. Women taking part will be randomised to receive the Endometrial scratch or not prior to commencing their planned IVF/ICSI treatment, and need to be 37 years or younger.

SOURCE: medicalxpress.com

Monday, August 22, 2016

Mini-IVF: The next breakthrough in fertility treatments?

For three years, Saralda Ortiz-Howard and her husband tried to get pregnant until they decided to turn to fertility treatments. They spent more than $30,000 on multiple cycles of both intrauterine insemination  (IUI) and in vitro fertilization (IVF) but neither was successful, not to mention that the physical side effects of the treatments were harsh.

“The amount of medicines that I was taking, my body felt out of whack,” Ortiz-Howard, now 43, said. “I felt that was one of the reasons I wasn’t successful in achieving pregnancy.”

Then the Hicksville, New York woman learned about mini-IVF, an alternative to traditional IVF that has been in use for years but isn’t as widely known or administered. Her physician, Dr. Zahir Merhi, director of research and development in IVF technologies at New Hope Fertility Center in New York City, explained that since mini-IVF uses a smaller amount of medication it would be less taxing on her body.

In June, Ortiz-Howard started mini-IVF treatments and said immediately she noticed her body wasn’t as swollen and she didn’t have the severe night sweats  that she had experienced with IVF.

“With the low dose, I felt regular, I felt normal,” she said. “Everything felt so much better.”

What is mini-IVF?
Mini-IVF or “minimal stimulation IVF,” is also referred to as “mild stimulation IVF” or “gentle stimulation IVF.”

“It’s very similar to IVF but you’re not stimulating the ovaries too much with high doses of medication,” Merhi said.

There isn’t data available on the number of U.S. clinics that offer mini-IVF, in 2014, there were 143 Society for Assistive Reproductive Technology (SART)-member clinics that submitted data about their use of the treatment.

Proponents of mini-IVF say it’s an option for some women who may respond better to lower doses of medication and the quality of the eggs and the embryos might even be better.

“There is this feeling that high doses of shots can be detrimental to the quality of eggs,” Merhi said.

Unlike traditional IVF which requires daily injections, mini-IVF needs fewer injections and uses tablets as well as a nasal spray in place of the “trigger shot” used for traditional IVF. However, the specific protocol varies between patients.

Since less medication is used, mini-IVF can be more affordable than IVF. A traditional IVF cycle can cost anywhere between $12,000 and $15,000 while a mini-IVF cycle might be as low as $4,500, on average.

Mini-IVF has drawbacks
Critics say that mini-IVF is not the magic bullet proponents claim it is. For starters, IVF is the most successful fertility treatment because the medications are meant to yield a large amount of eggs, said Dr. Peter Ahlering, medical director of the Missouri Center for Reproductive Medicine in St. Louis.

Studies show that after female age, the greatest predictor of pregnancy and live birth from IVF is the number of embryos produced.

“In general in IVF, quality and quantity run in parallel,” said Dr. Norbert Gleicher, founder and medical director of the Center for Human Reproduction in New York City.

Mini-IVF, on the other hand, can take more cycles on average to result in a pregnancy and a baby.

“The problem with the process is that if you get fewer eggs, then the probability of success is lower,” Ahlering said.

For women under age 35, 23.1 percent of mini-IVF cycles resulted in a single live birth, compared to 6.2 percent for women between ages 38 and 40, according to SART statistics. With traditional IVF, women under 35 had a 31.9 percent success rate, compared to 18.3 percent for women in the older demographic.

A study conducted by New Hope Fertility Center and published in the American Journal of Obstetrics and Gynecology found the live birth rate for mini-IVF was 49 percent versus 63 percent for conventional IVF.

Experts say the idea that mini-IVF results in better-quality eggs and embryos while high-dose stimulation can result in poorer quality eggs and embryos is a myth.

“If that were true, everybody would be doing [mini-IVF] all the time for all patients,” Ahlering said.

Another thing women should know is that similar to traditional IVF, there is always the chance that they will not respond to the medication, or get quality eggs or embryos, Merhi said.  

Although mini-IVF is often cited as a means to prevent ovarian hyperstimulation syndrome, a condition that can cause bloating, pain, weight gain or more serious symptoms, Ahlering said that there are traditional IVF medication protocols that can prevent this from happening.

“You can still achieve the high clinical pregnancy rates and get a good number of follicles but don’t expose the patient to extra risk of hyperstimulation,” she said.

Mini-IVF may be an option for some women, such as those who have diminished ovarian reserve, because regardless of the amount of medication they take, the same number of eggs will likely be retrieved, Ahlering said.

“I’m always going to recommend [the method] which gives the patient the optimal probability of pregnancy,” he said.

Although mini-IVF cycles are cheaper, if multiple cycles are required, it may not be cost saving in the long run.

“The whole thing is completely bogus [and] it’s a disservice to patients. It’s amazing that people are still using it,” Gleicher said.

For Ortiz-Howard, however, mini-IVF may turn out to be her best option for having a healthy baby. Unlike previous IVF cycles that yielded five or six viable, quality embryos, this time around doctors implanted four and froze seven. Now four weeks pregnant, she and her doctors are hopeful about the future.

“So far everything is great,” she said. 

Monday, June 13, 2016

World's First Delivery After Successful Womb Transplant: Mother tells of her 'Total Happiness' After Son's Birth


  • Malin Stenberg was only 15 when told she had been born without a womb
  • Her friend donated one as part of programme at Gothenburg University
  • She has now spoken about the magic of being a mother to her son Vincent 

Malin Stenberg was only 15 when she was told she had been born without a womb and so would never carry a child of her own.

But now she has spoken of the magic of motherhood after becoming the world’s first woman to have a baby with a womb transplant.

Miss Stenberg, 38, said she wanted to tell her story to give hope to others in the same situation.

‘If you wish for a family and you are unable to have one naturally, for whatever reason, it is so sad,’ she said

‘Total happiness comes from having a family and it doesn’t matter if it is through a womb transplant, or adoption or something else. It is magical.’

Three years ago, Miss Stenberg was given a womb by a family friend, as part of a pioneering transplant programme at Gothenburg University, in Sweden, and 20 months ago, she made history by giving birth to a son, Vincent.

Womb transplants have been attempted before but all had failed, until Vincent was born. As she watched the youngster play with a toy golf set in their home near Gothenburg, Miss Stenberg described her devastation at being told as a teenager that she suffered from MRKH Syndrome, a rare genetic condition which meant she was born without a womb.

‘I wasn’t ready to hear it, I couldn’t take it in,’ she said. ‘I thought that this means that I’ll never be able to carry a child of my own – but that is what women are made for. It felt so unfair. I loved kids and babies and I wanted to know what I had done to deserve this. I felt so alone.’

Eventually, she resigned herself to a life without children and threw herself into her career as a broker in the aviation industry.

Everything changed after she met her fiancé Claes Nilsson when she was 30. She told him about her condition early in their relationship and he vowed to find a way for them to have a family.

The couple looked into adoption and surrogacy before joining the womb transplant project at Gothenburg University.

Malin Stenberg
has spoken of the magic of motherhood after becoming the world’s first woman to have a baby with a womb transplant

Most of the nine women who took part in the scheme were given wombs donated by their own mothers. But Miss Stenberg’s donor was 61-year-old family friend Ewa Rosen.

After the womb was successfully transplanted, Miss Stenberg had IVF treatment – and became pregnant on her first attempt. She and Claes, 40, then ‘walked on eggshells’, until their son was born two months premature.

The couple chose the name Vincent, which is derived from the Latin for ‘to conquer’, to mark the extraordinary lengths they undertook to have him.

Miss Stenberg said: ‘When I held him for the first time, it was just amazing. I felt immediately that he was my baby. It just felt so natural. We truly are a family now.’

Mrs Rosen, whose womb made everything possible, is his godmother and sees him regularly.

Since Vincent was born, four more babies – three boys and a girl – have followed and several other countries have launched their own programmes.

Surgeon Richard Smith, head of charity Womb Transplant UK, is gearing up to start a series of similar operations here.

An estimated 15,000 British women were born without a womb or have had it removed because of cancer or other illness.

Vincent will not be joined by a little brother or sister because his mother has had her new womb removed over fears a second pregnancy would be more dangerous.
 
By Fiona Macrae Science Editor For The Daily Mail





Friday, February 12, 2016

New IVF Device Will Allow 'Natural Fertilization'

The AneVivo device
IVF patients in the UK are to be offered a ground breaking treatment that allows fertilization to take place inside the body, rather than in a lab.
The new device will enable fertilization in the womb.
Conventional in vitro fertilization (IVF) treatment involves removing eggs from the ovaries, fertilizing them with sperm in a laboratory, selecting embryos and returning them to the womb to continue the treatment process.
 Previous studies have suggested that babies born as a result of IVF treatment have a lower birth weight. While not a problem in itself, low birth weight has been linked to long-term health, which researchers are keen to improve.
 Prof. Nick Macklon, of the Princess Anne Hospital in Southampton, UK, believes long-term health in babies born through IVF could be improved by spending a shorter time in the laboratory. He was involved with the development of the new device, which is called AneVivo.
 The technique involves putting egg and sperm cells inside a tiny capsule, which is then placed painlessly into the womb for 24 hours. During this time, embryos begin to develop.
 Doctors then remove the device, which is around 1 cm long and 1 mm wide. After 2-4 days, they select the embryos that are healthy enough to be implanted back into the lining of the womb, in the hope of achieving a pregnancy.
 Fertilization in the natural environment
Prof. Macklon believes that the device signals "a real breakthrough in IVF treatment," as it enables women to care for an embryo in its earliest stages of development for the first time.
 Psychologically, it brings parents-to-be closer to the fertilization process and early embryo development. It could provide health benefits for the baby, as fertilization will occur in the natural environment of the womb with access to nutrients and signals from the mother. It will also reduce exposure to the synthetic culture fluids used in the laboratory.
 Prof Macklon, who is also chair in obstetrics and gynaecology at the University of Southampton, says:
 "This is a very significant moment in the advancement of fertility treatment in the UK, and we are all extremely excited to be able to offer patients the option of a more natural fertilization process."
 Martin Velasco of Anecova, the company that manufactures the device, says that it will allow free passage of fluids, nutrients, endometrial cells and other cellular and non-cellular components to enable interaction between the embryos and the maternal environment.
 
The AneVivo device was approved by the Human Fertilization and Embryology Authority (HFEA) in September 2015.
 
 

Wednesday, December 30, 2015

By 6th IVF attempt, 65% of couples achieve pregnancy

A UK study recommends that couples undertaking IVF (In Vitro Fertilization) should have up to six attempts, rather than the 3 or 4 embryo transfers that is currently standard practice. By that stage, 65% of women, with an average age of 35, have been able to have a baby.

This recent study, which was published in The Journal of the American Medical Association, could give fresh hope to couples who have tried to have a child for several years via IVF. In practice, IVF is often stopped after three or four unsuccessful embryo transfers.

An IVF cycle includes treatment with hormones to stimulate the ovaries, egg retrieval and the transfer of embryos arising from that hormonal stimulation.

Professor Debbie Lawlor of the University of Bristol and Professor Scott Nelson of the University of Glasgow suggest that the number of IVF cycles per patient should be extended beyond the usual three or four. Their research shows that 65% of women have a baby by the sixth attempt, taking an average of two years.

The researchers calculated the live birth rate for each cycle, as well as the cumulative probability of achieving a live birth across multiple IVF cycles up to 9.

The study followed 156,947 patients (with an average age of 35, and a median four year duration of infertility) and 257,398 IVF ovarian stimulation cycles.

The researchers found that in all women, the live birth rate for the first cycle was 29.5%, and 32% for those under 40. The rate remained above 20% up to and including the fourth cycle for women under 40. The cumulative live birth rate across all cycles continued to increase until the ninth cycle. By the sixth cycle, 65.3% of the women had a live birth, taking an average of 2 years.

Because of these encouraging results, the study's authors advise parents-to-be to consider IVF as a process with multiple cycles, rather than a single shot.

A test to predict the success rate of IVF is currently being developed by a team at France's Montpellier University Hospital in partnership with researchers at the French institute Inserm. They are studying an IVF outcome biomarker: the cell-free DNA present in a woman's blood. With a simple blood test, it will be possible to know the best moment for fertilization, thereby increasing the chances of success. This test could be used in the hospital from January 2016.

source: yahoonews

Tuesday, February 3, 2015

UK Steps Forward on Babies Made From 3 People's DNA

scientist working during ivf process
House of Commons was in favour; Bill next moves to House of Lords

British lawmakers in the House of Commons voted today to allow scientists to create babies from the DNA of three people—a move that could prevent some children from inheriting potentially fatal diseases from their mothers. The vote in the House of Commons was 382-128 in favor. The bill must next be approved by the House of Lords before becoming law. If so, it would make Britain the first country in the world to allow embryos to be genetically modified. The controversial techniques involve altering a human egg or embryo before transferring it into the mother. British law currently forbids any such modification and critics say approving the techniques could lead to the creation of "designer babies."

Defects in the mitochondria can result in diseases including muscular dystrophy; heart, kidney, and liver failure; and severe muscle weakness. The techniques would likely only be used in about a dozen British women every year who have faulty mitochondria, the energy-producing structures outside a cell's nucleus. To fix that, scientists remove the nucleus DNA from the egg of a prospective mother and insert it into a donor egg from which the nucleus DNA has been removed. This can be done either before or after fertilization. The resulting embryo would end up with the nucleus DNA from its parents but the mitochondrial DNA from the donor. Scientists say the DNA from the donor egg amounts to less than 1% of the resulting embryo's genes. Last year, the US FDA held a meeting to discuss the techniques and scientists warned it could take decades to determine if they are safe.
source: newser.com

Tuesday, March 4, 2014

IVF After Womb Transplant

A Swedish doctor says four women who received transplanted wombs have had embryos transferred into them in an attempt to get pregnant.

He would not say on Monday whether any of the women had succeeded. In all, nine women in Sweden have received new wombs since 2012, but two had to have them removed because of complications.

The women received wombs donated by their mothers or other close relatives in an experimental procedure designed to test whether it's possible to transfer a uterus so a woman can give birth to her own biological child. The women had in vitro fertilization before the transplants, using their own eggs to make embryos.

"We have already begun transferring embryos into four of the women and plan to make attempts with the others when they are ready," said Dr. Mats Brannstrom, a professor of obstetrics and gynecology at the University of Goteburg, who is leading the research.

Brannstrom predicted that three or four of the seven women might successfully give birth.

"One or two more will perhaps get pregnant and miscarry, and one or two won't be able to get pregnant," he said.

There have been two previous attempts to transplant a womb — in Turkey and Saudi Arabia — but both failed to produce babies. Doctors in Britain and Hungary also are planning similar operations, but using wombs from women who had just died.

Brannstrom said any woman in the study who does get pregnant will be on a low dose of drugs to keep from rejecting the transplanted womb and will be monitored as a high-risk pregnancy.

The transplants are intended to benefit women unable to have children because they lost a uterus to cancer or were born without one.

Some doctors said women who got pregnant with a new uterus would have to be watched carefully for how the womb progresses throughout pregnancy.

"There are questions about how the physiological changes in the uterus will affect the mother and whether the transplanted uterus will be conducive to a growing baby," said Dr. Charles Kingsland, a spokesman for Britain's Royal College of Obstetricians and Gynaecologists and a gynecologist at Liverpool Women's Hospital.

In a study published last week, Brannstrom and colleagues described the procedures used to transplant the nine wombs and said there were "mild rejection episodes" in four patients.

He said the transplanted wombs would be removed after a maximum of two pregnancies.

Other experts called it a promising step but said it would be crucial that babies get enough nutrients from the mother's blood supply.

"We really don't know if the blood flow to the uterus will increase and adapt in the same way," as in a regular pregnancy, said Dr. Yacoub Khalaf, director of the Assisted Conception unit at Guy's and St. Thomas' hospital in London.

"It is a good sign they have done the (embryo) transfers," Khalaf said. "But a live birth will be the best validation that this works."

 

Sunday, February 2, 2014

'Most exciting breakthrough in IVF treatment in 30 years' could triple number of births

Thousands of infertile couples could benefit from a new IVF procedure that can dramatically improve the

Scientists believe they can double or even triple the proportion of healthy babies born as a result fertility treatment with a relatively simple technique that takes a series of time-lapse photographs of the developing IVF embryos.

On average only about 24 per cent of IVF embryos implanted into women in the UK lead to live births but the researchers believe this could be increased to 78 per cent using the new technique for selecting the best embryos.

“I believe it is the most exciting breakthrough we've had in probably 30 years,” said Professor Simon Fishel, managing director of the CARE Fertility Group, where the technique was developed.

“Every IVF practice in the world is unintentionally and unwittingly putting back into the womb unviable embryos that don't make babies,” Professor Fishel said.

“We hope to see a paradigm shift in terms of IVF. It's a game changer for everybody to have such an uplift in live birth rates. This is the beginning of something revelatory,” he said

Each year, licensed clinics in Britain carry out about 60,000 IVF treatments but most of them end in failure, causing immense emotional upset to couples, many of whom have paid between £5,000 and £10,000 for each treatment cycle.

The new procedure, which costs £750, identifies the best embryos to be implanted into the womb based on the time it has taken to develop between two key stages in the early life-cycle of the embryo.

Thousands of time-lapse pictures are taken during the first few days of an IVF embryo's life and these are used to identify the time between the first appearance of the fluid-filled cavity, called the blastula, and the final moment before the embryo “hatches” from its protective shell.

Scientists have discovered that when this period lasts longer than about six hours, the IVF embryo is likely to be carrying an abnormal number of chromosomes, called aneuploidy, which will lead to a failure of the pregnancy.

A preliminary study, published in the journal Reproductive Medicine Online and based on a retrospective analysis of 88 IVF embryos of 69 couples, found that the time-lapse technique could have improved the success rate of life births in this particular group of patients from 39 per cent to 61 per cent.

Even better success rates can be expected once the procedure is refined and applied to the wider population of infertile couples seeking IVF treatment, Professor Fishel said.

“Our work has shown that we can easily classify embryos into low or high risk of being chromosomally abnormal. This is important because in itself this is the largest single cause of IVF failure and miscarriage,” he said.

“The beauty of this technology is that the information is provided by a non-invasive process. So far we have seen a 56 per cent uplift compared to conventional technology, giving our patients the equivalent to a 78 per cent live-birth rate,” he added.

Normally, IVF embryos in an incubator are checked manually each day by embryologists but the time-lapse cameras are able to do this automatically by taking pictures every 10 minutes without interfering with embryo development, said Alison Campbell, embryology director at Care Fertility in Nottingham, who developed the computer algorithm controlling the analysis.

“With time-lapse we have the ability to view more than 5,000 images over the same time period to observe and measure more closely each stage of division and growth. As a result of continuous monitoring we have demonstrated that delays at defined points indicate abnormal development,” Ms Campbell said.

Martin Johnson, a fertility expert and editor of the journal where the work is published, said further “prospective” studies comparing the technique to existing methods of embryo selection are still needed before the procedure is recommended as standard treatment. “There are caveats with this research….and for these reasons we have to be cautious,” he said.

Sue Avery, director of Birmingham Women's Fertility Centre, said: “Unfortunately the study does not compare this exciting new approach with standard practise in embryology in which embryologists already look for the best embryos to place in the womb. Until the new technique is compared to current practise we cannot know whether different embryos are being chosen.”

Egg timing: Key stages

The developing embryo (image one, above) goes through two key stages when the fluid-filled cavity or “blastula” first forms (image two) and when the blastula is fully formed before the embryo “hatches” (image three).

The time between the two is used to judge whether the embryo is viable, with no defects in chromosome numbers. If the period is longer than six hours, the embryo is at high risk of abnormal chromosomes, which will inevitably lead to complications. Time-lapse photographs can indicate which embryos have a shorter time-period between these two points, and so which embryos are best for implantation into the womb.
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