Younger women undergoing fertility treatment may stand a better chance of getting pregnant with a new procedure that does not stimulate the ovaries with powerful hormone-containing drugs, doctors said yesterday.
Findings from the first fertility centre in Britain to use in-vitro maturation (IVM) as an alternative to IVF reveal that pregnancy rates are comparable between the two techniques but only for women under 35. In IVF, women are given hormones for about two or three weeks to stimulate their ovaries to produce mature eggs before they are surgically removed for in vitro fertilisation. In IVM, however, immature eggs are removed from the ovaries without the use of drugs and matured in the laboratory before being fertilised with sperm.
The new technique, which has only recently been introduced to Britain, is considered to be safer than conventional IVF because it does not increase the risk of potentially lethal hyperstimulation syndrome, where the ovaries respond adversely to the hormones used during IVF treatment.
Tim Child, of the Oxford Fertility Centre, said that 70 women in Britain had undergone IVM in the past year and for the 40 patients who were under 35 the pregnancy rate was 48 per cent – compared to a pregnancy rate of about 55 per cent for women undergoing conventional IVF.
The percentage of under 35-year-olds achieving a clinical pregnancy – where the heartbeat of the baby has been detected – was 33 per cent. Just 10 babies of mothers undergoing IVM and attending the Oxford centre have so far been born, so it is still too early to estimate an accurate live-birth rate, which is 31 per cent for IVF.
"What we've found looking back on the first year of using IVM is that it works particularly well for a group of women at the younger end of the scale that we have treated," said Dr Child.
"It's an improvement in that we've worked out which patients do best with IVM, so it's about offering it to the right couples," he said.
About 900 babies have been born worldwide by the IVM technique. The first IVM babies in Britain were born last year after the Oxford Fertility Centre was given a licence to use the procedure by the Human Fertilisation and Embryology Authority (HFEA).
The HFEA's experts found that there was no evidence to suggest that IVM was dangerous either to women or to their babies – although further safety studies are still in progress.
Dr Child said that when IVM was first used, pregnancy rates and live-birth rates were relatively low compared to conventional IVF but better laboratory procedures, as well as patient selection, had improved the success rate significantly. "I'm not sure we will ever get better than IVF but the aim is to achieve the same success rate. The advantages of IVM are so great – it is safer and easier. Women who have had both say that they prefer IVM because they do not need several weeks of drug treatment," Dr Child said.
Svend Lindenberg, of the Copenhagen Fertility Centre, who pioneered IVM, said it was best suited to younger women who have regular periods.
SOURCE: independent.co.uk
Showing posts with label fertility treatment. Show all posts
Showing posts with label fertility treatment. Show all posts
Tuesday, November 11, 2008
Monday, October 20, 2008
IVF doctor: Patients view him with awe but rivals are less impressed
IVF doctor: Patients view him with awe but rivals are less impressed
He is Britain's most successful IVF doctor with a live birth rate twice the national average and a fortune founded on enabling women to have children, sometimes after years of fruitless treatment in other clinics.
But Mohammed Taranissi is also one of the most controversial, constantly pushing against the rules for fertility treatment and provoking the wrath of the Human Fertilisation and Embryology Authority (HFEA). His rows with the regulator may have undermined his reputation but some, such as IVF pioneer Lord Winston, believe the publicity they have attracted has raised his profile.
Creating babies is as close as most doctors come to playing God and the Egypt-born specialist is viewed by his patients, many desperate, with something close to awe. He has regularly topped the league table of IVF clinics with a live birth rate of 60.7 per cent for women under 35 in 2007, 17 per cent ahead of his nearest rival.
What is his secret? Dr Taranissi says it is about being on duty 24 hours a day so each stage of the IVF process can be carried out at the right time. Rivals claim his results are achieved by cherry-picking the healthiest patients, a charge he rejects.
A more substantive criticism is that he transfers multiple embryos to improve the chances of at least one implanting in the womb. His two London clinics had the third and fourth-highest multiple birth rates at 33 and 32 per cent.
A twin or triplet birth increases risks for mother and babies as well as imposing a burden on the parents and the HFEA has set targets to reduce it. But Dr Taranissi argues this decision should be left to clinicians and their patients.
IVF treatment attracts some of the biggest personalities in medicine and brings huge rewards – Dr Taranissi's fortune was once estimated at £38m.
The HFEA has stumbled badly in its dealings with Dr Taranissi. Two years ago, it ordered a police raid on one of his clinics which he was suspected of operating without a licence – while at the same time contributing to a BBC Panorama investigation of the doctor screened on the day as the raids.
The incident drew charges of "trial by television" and led Dr Taranissi to launch a libel action against the BBC and a court action against the HFEA. The latter was settled last week with the withdrawal of all charges against him. His latest clash with the authorities before the GMC is being keenly watched.
SOURCE: independent.co.uk
He is Britain's most successful IVF doctor with a live birth rate twice the national average and a fortune founded on enabling women to have children, sometimes after years of fruitless treatment in other clinics.
But Mohammed Taranissi is also one of the most controversial, constantly pushing against the rules for fertility treatment and provoking the wrath of the Human Fertilisation and Embryology Authority (HFEA). His rows with the regulator may have undermined his reputation but some, such as IVF pioneer Lord Winston, believe the publicity they have attracted has raised his profile.
Creating babies is as close as most doctors come to playing God and the Egypt-born specialist is viewed by his patients, many desperate, with something close to awe. He has regularly topped the league table of IVF clinics with a live birth rate of 60.7 per cent for women under 35 in 2007, 17 per cent ahead of his nearest rival.
What is his secret? Dr Taranissi says it is about being on duty 24 hours a day so each stage of the IVF process can be carried out at the right time. Rivals claim his results are achieved by cherry-picking the healthiest patients, a charge he rejects.
A more substantive criticism is that he transfers multiple embryos to improve the chances of at least one implanting in the womb. His two London clinics had the third and fourth-highest multiple birth rates at 33 and 32 per cent.
A twin or triplet birth increases risks for mother and babies as well as imposing a burden on the parents and the HFEA has set targets to reduce it. But Dr Taranissi argues this decision should be left to clinicians and their patients.
IVF treatment attracts some of the biggest personalities in medicine and brings huge rewards – Dr Taranissi's fortune was once estimated at £38m.
The HFEA has stumbled badly in its dealings with Dr Taranissi. Two years ago, it ordered a police raid on one of his clinics which he was suspected of operating without a licence – while at the same time contributing to a BBC Panorama investigation of the doctor screened on the day as the raids.
The incident drew charges of "trial by television" and led Dr Taranissi to launch a libel action against the BBC and a court action against the HFEA. The latter was settled last week with the withdrawal of all charges against him. His latest clash with the authorities before the GMC is being keenly watched.
SOURCE: independent.co.uk
Friday, July 25, 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
Saturday, February 16, 2008
IVF IN THE UNITED STATES (II)
According to a 2006 survey by the Genetics and Public Policy Center at John Hopkins University, there are 415 ivf clinics in the United States.
Faced with such a daunting number, anyone considering ivf treatment in the US can certainly do with careful guidance because the choice of clinic plays a large, if not most important part in determining the final outcome of fertility treatment. In fact it is the belief of Rhonda Levy, that had she been well informed (at the time of her own ivf treatment) as to the choices she had, she would have achieved conception in the very first cycle of her ivf treatment. She has this to say:
"Although I was finally the mother I so desperately longed to be, I could not erase the horror of our long struggle from my thoughts. What troubled me most was the naiveté of my early assumption that I could place my faith in my physicians to guide me through the maze. I now understood that I had been handicapped because I did not know what I did not know: that there was an enormous disparity between the best and worst of the more than 400 fertility clinics in the United States, and that the vast majority offered low or only average odds for success with assisted reproduction. Unless a couple had the good fortune to find themselves in treatment at a superior clinic, they would be more likely to spend more time, more money, and to suffer significantly greater heartache than necessary. Reproductive medicine had become one of the most lucrative industries in medical history and its landscape was littered with dangerous landmines."
PLEASE CLICK BELOW TO READ HER FULL STORY:
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