Sunday, December 30, 2007

SEX BOOSTS IVF CHANCES

SEX BOOSTS IVF CHANCES

Couples who have sex at or around the time an IVF embryo is implanted have more chance of becoming pregnant, say researchers.
However, a UK expert says that the tiny risk of the womb expelling the new embryo after sex would lead him not to recommend it immediately after IVF.


The study, reported in New Scientist magazine, was carried out at Adelaide University, where scientists checked the progress of more than 1,000 embryo transfers.

Half the women involved were asked to have sex in the days around the transfer, half told to avoid it. CLICK TO READ FULL ARTICLE AT:
http://news.bbc.co.uk/2/hi/health/1058408.stm

IMMUNE SYSTEM AND IVF FAILURE

IMMUNE TREATMENT ‘CUTS IVF FAILURES’

Suppressing the immune systems of women who suffer recurrent miscarriage may be able to allow many more to give birth.


The technique may also help those who suffer repeated IVF failures, or who cannot get pregnant, without an obvious reason why.

A leading US expert is presenting the results of his first, small scale study into a therapy at a UK conference on Monday, and these suggest it could be a highly successful approach - even among older patients.

Many thousands of women have unexplained infertility, suffer recurrent miscarriages, or cannot succeed with IVF, despite their young age and apparently good health.

Professor Alan Beer from Chicago Medical School, says that, in some cases, the problem may be an immune system which turns on the newly-implanted embryo and destroys it.
Although the father's genetic material is present in the embryo and on the surface of the placenta, the mother's body does not reject it.


However, in some cases, there is strong evidence that this process goes wrong.


Test and treat
He believes he has developed both a test for those women who are at risk - and a potential treatment to counter the problem.


Professor Beer concentrated on women who have suffered recurrent IVF failures, in which implanted fertilised embryos do not produce a successful pregnancy.
He found that seven out of ten women with three IVF failures had higher than normal levels of a chemical called tumour necrosis factor alpha (TNF alpha).


This is a product of a type of immune system cell called a natural killer cell, and is responsible for damage to tissues in "autoimmune" diseases such as lupus, rheumatoid arthritis and Crohn's disease.

Professor Beer's theory is that the immune system is also attacking the embryo in women with recurrent miscarriage, saying that the body was treating the embryo "like a cancer".

Existing drugs
There are existing medications used to reduce levels of TNF alpha in the body - but these are currently only licensed to treat established auto-immune disorders.


In trials involving 100 patient who had all suffered repeated IVF failures, he found that 78% of those under 35 years old managed to become pregnant.
Even a significant proportion of those aged 40 and above managed to get pregnant this way.
The treatment has so far produced 80 live births.


Professor Beer said: "It's like when you find the correct area code and you connect the telephone call - these healthily infertile women proved to me that their bodies were made to have babies.
"The breakthrough was to find what component of the immune system was doing the killing - and then reduce that component to normal levels."


'Astonishing'
Dr Simon Thornton, from Nottingham's Care in the Park clinic, said: "A third of our patients have an unexplained infertility.


"Professor Beer suggests that an abnormally active immune system is blocking pregnancy or acting to stop it from developing.
He has shown astonishing success rates in patients who would have otherwise had very very low success rates.
"At present, we use IVF as a treatment for many patients who have unexplained infertility - but this may be a much more straightforward treatment to allow them to have a perfectly successful pregnancy."


Dr Mohammed Taranissi, from the Assisted Reproduction and Gynaecology Centre, told the BBC that the results, although small-scale, were "impressive".
He said: "It's something we have suspected for a long time.
"Now we have to see whether we can apply a drug which has been developed for another problem for infertility problems."


SOURCE: BBC NEWS

IVF FOR OLDER WOMEN SOARS

More than 20 babies a year are being born to women aged over 50 through IVF treatment, according to the latest official figures.

A total of 24 women out of 96 aged over 50 who were treated at British fertility clinics in 2002 succesfully gave birth.
Between 1992 and 2002 the number of births to women aged 45 to 49 has increased from 15 to 106, and the number of those over 50 has increased by 24 times. Over the decade the total number of births through IVF has trebled: from 2,360 to 7,740.
The figures were released by the Human Fertilisation and Embryology Authority amid controversy over Patricia Rashbrook, 63, who announced last week that she was seven months pregnant. Dr Rashbrook conceived the baby boy using a donor egg obtained in Russia and sperm from her husband John, 61. The NHS refuses to treat women over the age of 39 but there is no legal limit for the 85 private clinics. TO READ FULL ARTICLE, CLICK BELOW:
http://www.timesonline.co.uk/article/0,,8122-2170649,00.html

Friday, December 28, 2007

DEALING WITH IVF FAILURE

DEALING WITH IVF FAILURE
Couples who undergo IVF treatment usually have very high expectations. There is a subconscious reluctance to admit that they might very well be among the unsuccessfully treated patients although it is still clear that failure is more likely than success.

IVF is an expensive and stressful experience which increases our expectations of the process. Expectations of success are considerably higher than the success rates quoted at their initial consultation.

The endpoint of IVF treatment, which is the transfer of two or sometimes three embryos into the uterus, is not the same as a pregnancy. There is a waiting period of about two weeks after the embryo transfer before it can be determined whether the woman has achieved pregnancy. This further increases the frustration of the process.

A success rate of 25-30% means that the failure rate is 75-85%. No one likes to think about failure when embarking on a new venture. There are very few medical programmes where emotions are so highly charged and where the failure rate consistently exceeds the success rate.
Treatment can fail at any stage: ovarian stimulation, egg collection, fertilization, cleavage and implantation. All that IVF demands of the person – financial, emotional, fear coupled with courage and determination potentates failure.

Any woman who decides to make the financial outlay for IVF and subject herself to the inconvenience of injecting herself everyday for up to three or four weeks expects to get pregnant from the process and the disappointment of failure becomes much more acute.

Two of the most traumatic points of failure are failure in fertilization and the return of the menses, which results from a failure in implantation. There is a feeling of isolation, confusion and helplessness and you ask, “what went wrong?”


Sometimes, one never really knows why it has failed despite the ‘good’ prognosis (relatively young age, normal uterus, high quality embryos transferred) but it is helpful to discuss with the doctor and embryologist who saw the embryos and can give an assessment. The unexplained situation is always the most difficult to bear. Failure is often easier to bear when we can pinpoint a reason for that failure.

A review of the treatment cycle by looking at the ways in which a couple responded to the drug stimulation: number of eggs collected, semen issues, fertilization and the grading of the embryos, etc., may give some clues as to how to adjust a repeat treatment.

After experiencing a failure, there is often considerable merit in delaying the decision to undergo a repeat cycle treatment.

If you have had more than one failed IVF, consider changing clinics, especially if your doctor doesn’t have a change in protocol planned.
Remember that all cycles are not alike. Using the exact same protocol on another attempt even at the same clinic can lead to different results. (Rachel Browne)
References:
‘The Bridge Clinic’s ‘Fertility Update’ September 2005 Vol No 3
‘Birthright,’ August 2005

HOW MANY TIMES CAN I DO IVF?
It is difficult to determine how many treatment cycles any particular couple will require to conceive a pregnancy. Some couples achieve a pregnancy after one cycle, some after two, some after three but most couples without major problems will conceive within four to five cycles. Three major factors are the low pregnancy rate, cost and the emotional stress associated with the treatment. It is very important for couples to receive the appropriate level of counseling and information before so as to manage their expectations before embarking on IVF treatment.

Thursday, December 27, 2007

IVF SUCCESS TIPS AND HINTS

The IVF process is expensive and stressful and tips and hints that can improve the chances of its working are shared here. Rachel Browne has a comprehensive, useful list:

The main IVF hint is to pamper yourself! An IVF cycle is a very stressful thing and anything that helps you through it without harming a potential baby is okay!Decide ahead of time where and how you want to get news each day for how much medication to take, etc. This is especially important on the big days of finding out about fertilization and pregnancy test. Those days can be tough if things don't go well! You might want your partner or a good friend around!

Rest is very important, even before transfer. All those developing eggs are taking up a lot of space and energy.

Try to get to know the people who are treating you so you aren't just another patient.
It may help to make a friend or two who is at the clinic for IVF, too.


Bring a book, magazine, or hand-held game with you to appointments. You might be there for awhile.

Make sure they do a mock transfer prior to the actual embryo transfer. This is not fun, but it is necessary that they know the depth of your uterus so they know where to put the embryos.
Do whatever it is you need to do to make this manageable for you. (Naps, backrubs, favorite foods, etc. Be very good to yourself during this time.)


Small amounts of alcohol will probably not adversely affect you or your eggs, but caffeine has been shown to affect fertility, even in small amounts, so try to avoid it.

Buy a good, up-to-date fertility book and try to find out as much as you can about the IVF process beforehand. There are always new advances, so try to keep up with the changes in techniques.

Always ask your RE a lot of questions about your progress, what the numbers mean, etc. That is what they are there for! Also, you should be able to get copies of anything in your file (like your follicle growth and E2 test results and fertilization report). The more knowledgeable you are, the more likely they are to openly share information and take time to explain.

It can be very comforting to find someone, either in cyberspace or in person, that is in a similar situation (factor, cycle) that you can share stories and progress with.

Try to keep a very flexible schedule the week before the pregnancy test. Some people start their periods early and are stuck somewhere where they cannot just be alone and grieve.

Start taking a prenatal vitamin prior to your cycle. At the minimum, you should take 400mcg of folic acid daily for three months before conception to reduce neural tube defects such as spina bifida. The FDA suggests 800 mcg during pregnancy, so it is best to look for a prenatal with that amount.

Some clinics believe that a diet that is high in protein and low in salt and potassium can help you avoid hyperstimulation. Gatorade is a poor choice of fluid to drink to prevent/control hyperstimulation because it contains large quantities of salt. Water or Pedialyte is best, in quantities recommended by your RE. At a certain stage of OHSS, too much fluid can be detrimental.

Remember that some people get very uncomfortable and even have a lot of pain as the ovaries are stimulated. This may get worse as the follicles ripen. Loose clothing may help.Don’t worry about your weight unless you are tracking it for hyperstimulation purposes. Unless you hyperstimulate, most of the weight gained during an IVF cycle usually disappears once your period starts and if you are lucky enough to get pregnant your weight won’t matter anyway!

If you are not taking birth control pills the cycle previous to your IVF, be sure to use birth control (no matter how ridiculous it may seem). Usually, you will start Lupron before you would know if you conceived or not and Lupron is very dangerous to a developing baby.
The extra fluid your developing follicles are taking up and being NPO before retrieval can sometimes cause constipation. Increasing your consumption of fiber and fluids as you approach egg retrieval may help alleviate this.
Don't talk to your partner too much about his role. This may cause him extra anxiety during an already stressful time and the extra stress can aggravate the performance anxiety that men suffer on the day of retrieval.
If this is your first IVF, be conservative about the number of blastocysts or embryos you transfer, especially if they are of very good quality. You may find that fertilization was your big hurdle and now that is complete you are on your way!


If you have had more than one failed IVF, consider changing clinics, especially if your doctor doesn’t have a change in protocol planned.

Remember that all cycles are not alike. Using the exact same protocol on another attempt even at the same clinic can lead to different results.

Some clinics use medications to prevent embryo rejection (low dose corticosteroids, etc.) which may help your chances of success. Check with your clinic to see if they think it would make a difference for you.

Always repeat the directions for medication to the nurse and get your E2 level. If something seems wrong or unclear, ask for clarification.Prior to the stimulation part of your cycle, make sure you and your partner discuss how many embryos or blastocysts you plan to transfer. (While remembering that your plan may have to change because of circumstances of the IVF!) If you think you will have extra embryos beyond what you want to transfer to avoid high order multiple risk, decide whether you will freeze them or discard them. Decide whether you would consider selective reduction. These are not things to discuss under pressure right before transfer!

SUPPORT & ENCOURAGEMENT FROM OTHERS UNDERGOING IVF TREATMENT

The IVF journey can be a lonely one. Especially in a situation where you cannot really tell other people that you are even receiving treatment. Many do not even understand the process and so you cannot confide in them. However you are not alone. There are forums and support groups online where you can share your fears and worries and get advice from others who have undergone IVF treatment. No matter how experienced or knowledgeable your doctors and nurses are, nothing beats the personal experience of ladies who have undergone the same treatment!

Please find below links to some IVF forums

http://www.ivfconnections.com/stories.htm

http://forums.fertilitycommunity.com/vitro-fertilization-ivf/262322-first-ivf-suggestions.html

http://www.sharedjourney.com/success_stories.html

THE ABC OF IVF: A MORE DETAILED LOOK

THE ABC OF IVF
EVERYTHING YOU NEED TO KNOW ABOUT TEST TUBE TREATMENT

WHEN TRYING FOR A BABY, HOW LONG SHOULD I WAIT BEFORE I WORRY ABOUT NOT GETTING PREGNANT?

It is very difficult to be specific. One in five women falls pregnant within a month of starting to try.
After six months of having sex without contraception, seven out of ten women have conceived.
After a year, approximately 85 per cent of women will be pregnant and after two years the figure is 95 per cent.

FREE IVF TREATMENT

FREE IVF TREATMENT
The cost of a cycle of IVF treatment ranges between N500, 000 – 900,000.00, an amount out of the reach of many couples and unfortunately there is no government funding in Nigeria at the moment. However it is possible to benefit from free IVF treatment if you fall within certain criteria.

Free treatment is available to a woman who VOLUNTARILY shares some of her collected eggs with another infertile couple. The eggs will be shared only if the number of eggs you produce are sufficient so you do not lose out. However you are usually required to bear just the cost of the initial test/assessment that will indicate if you are suitable for the treatment.

GENERAL QUALIFICATIONS AND CRITERIA FOR FREE TREATMENT
:

* You should be aged between 19 and 34.
* Weigh less than 85kg.
* Have regular menstrual cycles.
* Have 2 ovaries.
* Have had a maximum of 2 previous failed IVF attempts and not less than 6 collected eggs in each of these cycles.
* Have an FSH (Follicle Stimulating Hormone) level of less than 9.0 when measured between day 2 and 6 of your natural menstrual cycle.
* Have an LH (Luteinizing Hormone) level of less than 10 when taken at the same time as above.
* Do not have significant fibroids or polycystic ovaries (PCO).

Saturday, December 22, 2007

IVF CLINICS IN NIGERIA

You do not need to travel abroad for standard IVF treatment as it is now available in Nigeria at a fraction of what it would cost you abroad. You save on air fare and hotel bills and the success rates are comparable with that of clinics abroad. Plus, you are likely to get more suitable egg donors here at home, if you happen to need them.

The clinics below are listed alphabetically. There is as yet no independent official rating to verify any claims of success rates.


*PLEASE CLICK IN THE BRACKETS TO VISIT THEM*

1. BRIDGE CLINIC
Plot 1397A Tiamiyu Savage Street,
Victoria Island, Lagos.
Tel: 01-2623268 ; 2610686
Email:
info@thebridgeclinic.com
Website:(
www.thebridgeclinic.com )
Medical Director: Dr. Richardson A. Ajayi

PortHarcourt Center
Bridge Clinic

41A Evo Road, G.R.A. Phase II, Port Harcourt
Tel: (084) 465 003 - 5

2. HOPE VALLEY FERTILITY CLINIC
261, Etim Inyang Crescent,
Victoria Island, Lagos.
Tel: 01-4618989 ; 08033069466
Email:
thehopevalleyclinic@hyperia.com
Website:( http://www.thehopevalleyclinic.com/)

Medical Director: Dr. Ogunkoya


Portharcourt Center
17B Ahaimakara Road,
Transamadi Industrial Layout Road,
Portharcourt.
Tel: 084: 578956 ; 08037048134 ; 08033069466

3. MEDICAL ART CENTER
Lofom House
21 Mobolaji Bank Anthony Way
P.O.Box 5747,
Ikeja,
Lagos
Tel: 01-4971970
Email:
mart@infoweb.abs.net
Website:( http://www.medicalartcenter.com )
Medical Director: Professor Oladapo Ashiru

4. NATIONAL HOSPITAL ABUJA
Plot 132, Central Business District,
(Phase II)
Garki, Abuja
Email:
info@nationalhospitalabuja.net
Website:( www.nationalhospitalabuja.net )
Chief Medical Director: Dr. Olusegun Ajuwon
Tel: 08033495146


5. NISA PREMIER HOSPITAL
Plot 618, Alex Ekwueme Way,
Jabi, Wuse, Abuja
Telephone: 08035967303
Website:(
http://www.nordica.org/nisa-hospital )
Medical Director: Dr. Ibrahim Wada

6. NORDICA FERTILITY CENTER
Road 2, Plot A3 & 4, Victoria Garden City,
Ajah, Lekki, Lagos.
Email:
info@nordicalagos.com ; yomiajayi@nordicalagos.com
Medical Director: Dr. Abayomi Ajayi

7. OMNI ADVANCED FERTILITY CENTER
18 Boyle Street,
Onikan, Lagos.
Telephone: 01-2630304 ; 01-2646304
Email:
info@ivflagos.org
Website:( www.ivflagos.org )
Medical Director: Professor Osato Giwa-Osagie.


8. RODING MEDICAL CENTER
29B Olabode George Street,
Off Ajose Adeogun Street,
Victoria Island,
Lagos.
Telephone: 01- 2626169 ; 26226170
Medical Director: Dr. Adewunmi Adeyemi Bero


9. ST. IVES SPECIALIST HOSPITAL : IVF & FERTILITY UNIT
4, Mojidi Street,
Off Toyin Street,
Ikeja, Lagos.
Telephone: 01-8974878
Email:
info@stivesng.com
Website:( www.stivesng.com )
Medical Director: Dr. Tunde Okewale




Related links: http://www.mybabytestimony.blogspot.com

http://www.babyfertile.blogspot.com

http://www.naturalfertilityaids.blogspot.com

WHAT IS IN VITRO FERTILISATION - IVF?

IVF means in vitro fertilisation which means fertilisation 'in glass' or outside the body.

IVF is necessary where other methods of treatment of infertility have failed. Whatever the cause of the problem, it is usually because the the sperm and the eggs are not uniting to form an embryo. if there is a sperm problem and the treatment of the cause of the sperm problem has failed, then a couple may require assisted conception. If there is an egg problem and ovulation cannot be induced, the woman may require assisted conception. If she has a tube problem which cannot be treated by simple methods, she will need assisted conception.

THE PROCESS OF IVF: AN IVF CYCLE

STEP 1: OVARIAN STIMULATION AND MONITORING
In a normal cycle, a single egg is produced in the ovary every month. To maximize the chances of successful fertilisation with each IVF attempt, the woman is given drugs (menogon, puregon, pergonal, humegon, metrodin, etc) to produce a lot of eggs. The growth and development of the eggs is closely monitored by repeated ultrasound and or blood tests. Based on information obtained from these tests, it is determined when ovulation will take place. Release of eggs from the ovary is then achieved by administering an injection called HCG. The woman will then be ready for egg collection. The eggs are are collected using ultrasound to guide a needle into the ovaries.


STEP 2: EGG COLLECTION
This takes place 32 to 36 hours after the HCG injection. Egg collection is usually performed via a transvaginal route under local anaesthesia. Direct vision through ultrasound helps imaging helps to identify and retrieve eggs more accurately.

STEP 3: INCUBATION AND FERTILISATION
A few hours before egg collection, the man is asked to produce a semen sample which will be processed in the laboratory in order to enhance the chances of fertilisation. The sperm and eggs are then incubated in a specially designed laboratory incubator which functions at standard body temperature. Within 48 hours, fertilisation is expected to take place and cell division can then be seen.

When there is an associated sperm problem and there is a risk that the sperms may not be able to fertilise the eggs by themselves, the sperms are picked up and with special equipment called a micromanipulator, the sperm is injected into the egg. This is called Intracytoplasmic Sperm Injection (ICSI).

STEP FOUR: EMBRYO TRANSFER
Embryo Transfer is the procedure by which the fertilised eggs are returned to the womb. The embryos are placed in a special catheter and are transferred into the uterus. After the procedure, the woman is given a progesterone hormone - series of injections or vaginal suppositories which she inserts daily for two weeks. A pregnancy test is conducted two weeks after embryo transfer.
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