Something New in Southeast Fertility Treatment: Low-Cost IVF

For those who desire to become parents, but have trouble getting pregnant, these are optimistic times. Advances in fertility medicine, such in vitro fertilization (IVF) and PGD (pre-implantation genetic diagnosis), provide new options that weren’t available in the past.
But all that advanced medicine comes with a price. IVF treatment can easily cost $25,000 and up, with no guarantee of success. That puts fertility treatment out of reach for many.
Two Georgia infertility specialists are hoping to change all that. Drs. Edouard Servy and Joe Massey founded the Servy Massey Fertility Institute (SMFI) in August 2011 with the belief that fertility treatment should be more accessible to all.
SMFI’s goal is to provide IVF treatment at reduced prices, offering initial in vitro fertilization (IVF) cycles for only $6,575 – almost half the cost offered at many other clinics nationwide. The goal is to provide exceptional and affordable fertility care so patients can pursue their dream of having children.
Servy and Massey are both pioneers in reproductive endocrinology and the treatment of infertility, and have been helping patients build families for more than 30 years.
The Servy Massey Fertility Institute has locations in Atlanta and Augusta and works in collaboration with the Georgia Health Sciences University. The fertility docs say they are committed to eliminating hidden costs and unnecessary testing, recommending assisted reproduction only when conventional treatment fails or is not an option.
Sara and Kirby Yawn are just one family that found help at SMFI. The Yawns came face-to-face with infertility when Kirby was diagnosed with low sperm quality. Sara had already tried several treatments, including ovulation stimulation medication and a cycle of intrauterine insemination (IUI), but pregnancy seemed no closer for the Georgia couple.
Finally, Sara and Kirby met with Dr. Edouard Servy at the Augusta office to discuss in vitro fertilization (IVF).
“Dr. Servy reviewed our case and explained what he thought was the best option,” Sara says. “He was very thorough in helping us understand the entire process and was optimistic that our success rate would be high.”
In the past, the high cost of fertility treatment – especially IVF, one of the most expensive treatments – has been a barrier for many couples diagnosed with infertility. But with the creation of SMFI, Drs. Massey and Servy can work together to provide infertility solutions at affordable prices. The institute’s unique low cost program not only provides affordable treatment to hopeful couples, but continues to keep a high standard of quality and results.
“Because of the skill set required for a successful IVF procedure and the number of people involved, the cost of in vitro fertilization can be very pricey,” Dr. Massey explains. “At the Servy Massey Fertility Institute, we take pride in our expertise and never cut corners, but we also believe that everyone should have the opportunity to build a family. This is why we’ve taken great care to reduce costs wherever possible to offer affordable, low cost IVF.”
IVF is often one of the only ways for a couple diagnosed with infertility to achieve pregnancy, but has a high success rate – one of the reasons the SMFI team decided to pursue a low-cost IVF program.
For Sara and Kirby Yawn, IVF was just what they needed. After a few months of treatment, the couple found out they were pregnant. Lilian Grace Yawn was born the next year.
“We named her Lilian, which means pure, innocence and beauty, and Grace, which is a blessing from God,” Sara says. Although they know having more children may not be easy, for now Kirby and Sara are thankful to have one of their biggest dreams – parenthood – come true.

SOURCE: 2whbf.com

DuoFertility Or IVF For Infertile Couples?

duo fertility monitor

A new study published in European Obstetrics & Gynaecology (European Obstetrics & Gynaecology, 2011;6(2):92-4) shows that DuoFertility used for six months (a small body-worn monitor coupled with an expert consultancy service) gives the same chance of pregnancy as a cycle of in-vitro fertilisation (IVF) for many infertile couples. This study demonstrates that there is a viable non-invasive, drug-free alternative to IVF for thousands of couples, with the potential to save them (and the NHS) millions of pounds each year. The paper, by Chausiaux et al, is the first peer-reviewed publication of clinical pregnancy rates using the new DuoFertility product and service. The lead author, Dr. Oriane Chausiaux, has been researching infertility for over a decade in Paris and Cambridge. Summarising the results, she said "Although we have been observing higher than anticipated pregnancy rates with this programme for some time, and reporting this at academic conferences, this is the first study with sufficient statistical power to meet the stringent criteria of the peer review publication process. The results show that for couples suffering from unexplained infertility as well as a variety of other factors, six months using DuoFertility is as effective as a cycle of IVF and twelve months using DuoFertility yields a higher clinical pregnancy rate than a cycle of IVF - even at the 95% confidence level". The study followed the first 500 couples using DuoFertility from launch in 2009, including 242 who qualified for IVF/ICSI treatment, of whom 90 had previously had the procedure. The one-year clinical pregnancy rate for those who qualified for IVF was 39%, which is higher than either the UK or EU clinical pregnancy rates for a cycle of IVF (26% and 28% respectively), whilst the corresponding rate for those who had already been through a cycle of IVF/ICSI was 28%. The impact of the study by Chausiaux et al is clear. For many couples, not only is IVF invasive for the woman and demeaning for the man, it is a procedure needlessly costing the NHS, or the couple themselves, thousands of pounds. Whilst a typical cycle of IVF costs the NHS around £4,500 including drugs and consultancy, the cost in the private sector (which accounts for 80% of IVF procedures performed in the UK) is typically £7,000. By comparison the DuoFertility program offers a year of monitoring and support for £495 and has now been shown to be equally or more likely to achieve pregnancy. Not only this, but the company offers to refund those couples who have not achieved pregnancy after a year of using DuoFertility as directed - a guarantee that caught the attention of TV 'dragon' Theo Paphitis and and Boots, the UK's leading pharmacy-led health and beauty retailer, resulting in the product being stocked by Boots after appearing on the BBC documentary series "Britain's Next Big Thing" earlier this year. The publication coincides with reaching the 200th reported pregnancy by users of DuoFertility, which was celebrated with a party hosted by medical personality Dr. Miriam Stoppard. Dr. Stoppard, addressing the assembled parents and parents-to-be, said "[it is] the first product or service that I have seen in this arena which truly wraps around all of the needs of the couple, from the medical monitoring, to the review of this data by experts, and then the all-important emotional support that is provided."..."The results of the scientific studies on pregnancy rate are very encouraging, but do need to be followed up with live birth rates, and I look forward to seeing further research." IVF and assisted reproductive technologies have been in the spotlight recently with a damning report from the All Party Parliamentary Group on Infertility. The report showed that fewer than one-quarter of NHS Primary Care Trusts are providing the number of IVF cycles recommended by the NHS guidelines, and that there is widespread evidence of PCTs adding extra conditions on infertile couples that prevent them obtaining treatment. Gareth Johnson, MP leading the group, said "One in Seven couples in the UK suffer from infertility problems, indeed more women attend GP surgeries to obtain advice on infertility than any issue other than pregnancy. This shows just how big an issue infertility is for so many people". It is perhaps not surprising therefore that Cambridge Temperature Concepts, the company behind DuoFertility, was recently recognised at Downing St as one of nine innovative small businesses to help reduce costs in the public sector through the Cabinet Office Innovation Launchpad programme. The study authors caution that although non-invasive and drug-free, DuoFertility is not suitable for all couples. Dr. Husheer, inventor of DuoFertility explained "although DuoFertility is suitable for around 80% of infertile couples, there are some couples with medically identified conditions that prevent natural conception, such as a woman with two blocked fallopian tubes. In these cases IVF is absolutely the right thing to do, enabling conception where it was previously a physical impossibility."
source: medicalnewstoday

Palm Beach Fertility Center Now Offering Treatment Regimen Featuring Acupuncture Alongside IVF

The Palm Beach Fertility Center has recently announced that they are now offering a new form of treatment for couples that have been unable to conceive a child naturally. The experienced medical specialists within the facility have developed a treatment regimen that combines the benefits of acupuncture and IVF to increase the chances of a successful pregnancy.

This additional service is the result of a new study within the field that suggests that women who paired their IVF treatment with acupuncture had a 65% greater chance of becoming pregnant through the treatment. This study was released through the reputable and established British Medical Journal and included 114 women who had been approved for IVF treatment. It found that, of the women who received acupuncture, there were fewer miscarriages, more pregnancies and a 7% higher birth rate than those who did not receive the acupuncture treatment.

This study was founded upon previous research by the same medical team in which they studied 147 women who had responded poorly to IVF treatment. This previous study found that the pregnancy rate was 40%, with 11% more babies born for those who received acupuncture during their scheduled IVF treatment.

Renowned worldwide fertility treatment experts such as Raymond Chang of New York’s Meridian Medical Group have been using acupuncture within their fertility treatments for the past decade and have experienced great success.

"Acupuncture provides better circulation and better blood flow to the womb. It will give a better chance for the eggs to be nourished and therefore carried." - Dr. Raymond Chang, Director of New York's Meridian Medical Group

Now, with this additional treatment offering through the Palm Beach Fertility Center, many women from across the South Florida area will have an increased opportunity to conceive a child of their own.

SOURCE: PR.COM

Heavier women may have less IVF success

The heavier a woman is, the more trouble she may have getting pregnant and having a baby through in vitro fertilization, or IVF -- and may lose the baby more often, according to a U.S. study.

Researchers led by Barbara Luke of Michigan State University found that women who were overweight or obese were less likely to become pregnant using fertility treatments than normal-weight women.

Past studies have also hinted at worse IVF outcomes in heavier women, although they don't prove that the extra weight is directly responsible for the reproductive troubles those women experience.

"Treatment and pregnancy failures with increasing obesity significantly increased starting with overweight women," Luke and her colleagues wrote in Fertility and Sterility.

They drew data from a reporting system that includes more than 90 percent of IVF treatments done in the United States -- information on 150,000 fertility treatment cycles done in 2007 and 2008 at 361 different clinics.

For each cycle, the reporting system included whether the cycle was canceled, if it led to a pregnancy, and whether that pregnancy ended early in a miscarriage or stillbirth, or if the woman gave birth to a live baby. For most cycles, it also had data on women's height and weight before starting treatment.

From the beginning through the end of fertility treatment, heavy women saw poorer results.

"We know that being overweight and obese is not good (for IVF), it's just how bad is it and where are the bad effects?" said Brian Cooper of Mid-Iowa Fertility in Clive, who wasn't involved in the study.

About nine percent of cycles in normal-weight women were stopped early, compared to 16 percent of cycles in the heaviest women -- those with a body mass index over 50, which is equivalent to a 1.6 meter (5 foot 5 inch) woman who weighs over 136 kg (300 pounds).

Normal weight women had a 43 percent chance of getting pregnant during each cycle using their own, fresh eggs for IVF, compared to 36 percent for very heavy women. Rates for overweight and less obese women fell in between.

For women who did get pregnant, the trend continued, with the heaviest about twice as likely as normal-weight women to lose the baby in many cases.

For overweight and obese women trying to get pregnant, even a little bit of weight loss helps, said Howard McClamrock, an infertility specialist at the University of Maryland Medical Center in Baltimore.

"This is what we're constantly faced with: ideally she might like to lose weight, but she might not have that much time," added McClamrock, who was not involved in the study.

Though he noted that research has been pointing more and more toward a connection between extra weight and worse IVF outcomes, the reason is unclear.

One explanation is that extra fat tissue releases estrogen, which fools the brain into thinking the ovaries are working when they really aren't, so it doesn't do its part to kick the ovaries into gear, Cooper said.

Luke and her colleagues said that thin and heavy women may have different causes of infertility, though they added that they did not have data on lifestyle factors that may affect IVF success, or any data on the male partners.

Thin and normal-weight women generally had higher rates of endometriosis, in which cells from the lining of the womb grow on other organs. Polycystic ovary syndrome, where the ovaries become enlarged and contain several small cysts, were more common in very heavy women.

Cooper said that weight still isn't as big an issue for fertility as age, or whether a woman smokes.

"Weight isn't everything, but it's an important factor that we have control over. Fix it now, because even a little bit (of weight loss) can make a big difference," he added. SOURCE: bit.ly/pjwsra

(Reporting by Genevra Pittman at Reuters Health; editing by Elaine Lies)

Fertility Meds Work, Stress Or Not

Stressed by the fact that you are trying to get pregnant? Not to worry, the stress you are experiencing won't impact the effectiveness of the fertility drugs you may be taking, so don't sweat it. Stress and tension don't decrease the success of a woman's fertility treatment, a new study suggests.

Three and a half thousand women that took fertility treatments were surveyed in 14 studies for the presence of stress and anxiety compared to levels before they begun treatments. Many women believe that emotional distress can reduce their chances of becoming pregnant naturally or having success with fertility treatments, but the researchers say that's a mistaken idea based on anecdotal evidence and myths.

The results proved that there is no association between emotional distress and the likelihood of becoming pregnant.

Jacky Boivin, a professor in the School of Psychology at Cardiff University in Wales states:

"These findings should reassure women that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise their chance of becoming pregnant."

Health experts say that about 15 percent of couples are infertile. Infertility means not being able to get pregnant after one year of trying. Or, six months, if a woman is 35 or older. Women who can get pregnant but are unable to stay pregnant may also be infertile.

Infertility treatment can be physically uncomfortable, time-consuming, exhausting, and costly, all without a guarantee of success. The infertility experience for many can range from multiple diagnostic procedures through progressively more aggressive treatment options, all of which impose demands upon the emotional and physical self. It's no wonder that many women experience severe stress, depression, or anxiety during treatment for infertility.

Medical treatment of infertility generally involves the use of fertility medication, medical device, surgery, or a combination of these.

If the sperm are of good quality and the mechanics of the woman's reproductive structures are good (patent fallopian tubes, no adhesions or scarring), physicians may start by prescribing a course of ovarian stimulating medication. The physician may also suggest using a conception cap cervical cap, which the patient uses at home by placing the sperm inside the cap and putting the conception device on the cervix, or intrauterine insemination (IUI), in which the doctor introduces sperm into the uterus during ovulation, via a catheter. In these methods, fertilization occurs inside the body.

If conservative medical treatments fail to achieve a full term pregnancy, the physician may suggest the patient undergo in vitro fertilization (IVF). IVF and related techniques (ICSI, ZIFT, GIFT) are called assisted reproductive technology (ART) techniques.

ART techniques generally start with stimulating the ovaries to increase egg production. After stimulation, the physician surgically extracts one or more eggs from the ovary, and unites them with sperm in a laboratory setting, with the intent of producing one or more embryos. Fertilization takes place outside the body, and the fertilized egg is reinserted into the woman's reproductive tract, in a procedure called embryo transfer.

In 2007 the FDA cleared the first at home tier one medical conception device to aid in conception. The key to the kit are cervical caps for conception. This at home insemination method allows all the semen to be placed up against the cervical os for six hours allowing all available sperm to be placed directly on the cervical os. For low sperm count, low sperm motility, or a tilted cervix using a cervical cap will aid in conception.

SOURCE:MEDICAL NEWS TODAY

Assisted Reproductive Technology: Uterine Health More Important Than Egg Quality

For women seeking pregnancy by assisted reproductive technologies, such as in-vitro fertilization (IVF), a new study shows that the health of the uterus is more relevant than egg quality for a newborn to achieve normal birth weight and full gestation. This study, published in Fertility and Sterility, an international journal for obstetricians, offers new information for women with infertility diagnoses considering options for conceiving.

The study was conducted by Dr. William Gibbons, director of The Family Fertility Program at Texas Children's Hospital and professor of obstetrics and gynecology at Baylor College of Medicine, along with colleagues at the Society for Assisted Reproductive Technologies (SART) Marcelle Cedars, MD and Roberta Ness, MD. They reviewed three years of data that compared average birth weight and gestational time for single births born as a result of standard IVF, IVF with donor eggs and IVF with a surrogate. While the ability to achieve a pregnancy is tied to egg/embryo quality, the obstetrical outcomes of birth weight and length of pregnancy are more significantly tied to the uterine environment that is affected by the reason the woman is infertile.

There were more than 300,000 IVF cycles during the time of the study producing more than 70,000 singleton pregnancies.

"This is the first time that a study demonstrated that the health of a women's uterus is a key determinant for a fetus to obtain normal birth weight and normal length of gestation," said Dr. Gibbons. "While obvious issues of uterine fibroids or conditions that alter the shape of the uterus are suspected to affect pregnancy rates, conditions that result in poorer ovarian function to the point of needing donor eggs are not known. Further research is needed to fully understand this complex issue."

As assisted reproductive technologies (ART) in the U.S. mature, increasing attention is directed not just to pregnancy rates but also to the obstetrical outcomes of those resulting pregnancies - meaning the newborn's birth weight, health and gestational age. Currently, about one percent of U.S. births are the result of ART therapies such as IVF, donor eggs, intracytoplasmic sperm injection, embryo cryopreservation, embryo donation, preimplanation genetic diagnosis, and male infertility surgery and medical therapy.

The study explored several scenarios and found that the birth weight associated with standard IVF - in which the patient carried the embryo created with her own egg - was greater than that associated with donor egg cycles, and less than that in gestational carrier cycles. This finding held true even when other factors were considered showing that the woman's own uterus may be a determining factor.

Gibbons said the study also determined that a diagnosis of male infertility did not affect birth weight or gestational age, yet every female infertility diagnosis was associated with lower birth weight and a reduced gestational age.

Patients diagnosed with a uterine health issue, such as fibroids or other factors, had babies with the lowest birth weights and gestational ages. This led the researchers to examine the uterine environment as it relates to the type of therapy being considered.

Gibbons explains that in standard IVF, an embryo is transferred to a woman who has just undergone controlled ovarian hyperstimulation, while in donor egg IVF and gestational carrier IVF, the embryo is transferred to a "natural" or unstimulated uterus. Then, the researchers looked at IVF utilizing frozen embryo transfer in which an embryo created with a patient's own egg is transferred to her own unstimulated uterus. They found that babies born of frozen embryo transfer cycles had markedly greater birth weights than those born as a result of standard IVF.

"That finding may help women seeking pregnancy and their physicians to consider frozen embryo transfer as a possible option if the uterine health is not a consideration," said Gibbons. "This study shows us how so many factors are related to a successful outcome and we continue to learn where further research may be needed."

source:medicalnews today

Delaware Fertility Centre Overcomes Miscarriages and IVF failures

Major advances utilizing embryo genetic testing with in vitro fertilization (IVF) technology have led to many new and expectant families, as reported by Reproductive Associates of Delaware (RAD) in their recent presentation at the October national meeting of the American Society for Reproductive Medicine in Denver, CO.

"This is a milestone of progress," noted Ronald F. Feinberg MD, PhD, the Center's IVF Medical Director. "We have merged our latest IVF techniques with successfully testing all 24 chromosomes within an embryo before it is placed back in the mother's uterus."

RAD's study demonstrated that almost 50% of 167 well developed and normal-appearing blastocyst embryos contained major chromosome defects, all of which were incompatible with normal pregnancy. The technology was applied to 26 patients who had previously suffered with miscarriage, unexplained infertility, and/or prior IVF failure. Preimplantation Genetic Screening (PGS) with blastocyst trophectoderm biopsy was the technique utilized.

Following PGS, 71% of patients who were found to have at least one normal embryo achieved a successful pregnancy to date, despite previously negative outcomes and poor prognosis. One RAD patient that had never been pregnant had very few normal embryos via PGS. However, she successfully delivered healthy twins earlier this year after having two normal embryos biopsied via PGS and later placed in her uterus. All of the other PGS pregnancies at RAD have been singletons, following placement of just one normal embryo.

"We likely have a new and important reason for offering IVF and PGS to patients with infertility, prior IVF failure, and miscarriage", said Marc Portmann, Director of Lab Technology and Innovation at the RAD Center, who was also the lead author of the study. "This advance in IVF is of great significance because it will improve success rates, foster increased confidence in single embryo transfer, and will lower costs and risks of IVF." Many authorities within the field believe PGS could be applied to all patients undergoing IVF, but the larger benefits need to be fully evaluated.

Though many consider IVF and PGS to be expensive treatments, RAD's physicians believe this should be weighed against other factors, such as the health, emotional, and societal costs associated with infertility and miscarriage. High risks and costs of multiple gestations caused by other suboptimal treatments, including the transfer of multiple embryos during typical IVF procecures, must also be considered.

Approximately 15-20% of reproductive age women and men attempting pregnancy have infertility, a miscarriage history, or have experienced both.

source:sfgate.com

New Method Could Make IVF More Effective

Researchers using a microscope and time-lapse photography believe they have developed a method for predicting which test-tube embryos are the most likely to develop properly, and are licensing development of a commercial test.
Their findings, published in the journal Nature Biotechnology, also provide some new insights into the development of days-old embryos, such as how babies inherit some genes from the mother and some from the father.
They said the new test could help fertility clinics pick the best embryo to implant in the womb.
This would save mothers from having several treatments and help improve on the current method of implanting multiple embryos to try to get one pregnancy and risk multiple births in the process.
"Our results shed light on human embryo development," wrote Renee Reijo Pera of Stanford University in California and colleagues. "Our methods and algorithms may provide an approach for early diagnosis of embryo potential in assisted reproduction."
So called test-tube babies are conceived by uniting egg and sperm in a lab dish and transferring the embryo into a woman's uterus to develop. Most do not develop properly and labs have been looking for ways to improve their success rate.
Although it is not recommended, some IVF clinics will implant more than one embryo into the mother's womb -- leading to the birth of triplets, quadruplets and even more. Such babies almost always are born too early and face lifelong health problems.
All pregnancies are tenuous, even those achieved the old fashioned way. The March of Dimes, a charity founded to battle birth defects, estimates that as many as 50 percent of all pregnancies end in miscarriage -- most often before a woman knows she is pregnant.
For the new test the researchers watched embryos divide and develop from the time sperm met egg in a lab dish. As the embryos split and grew, they also tested gene expression -- looking at which genes activated, and when.
To their surprise, they found that almost from the very beginning some of the handful of cells had different sets of active genes.
An embryo's fate -- whether it would develop normally or not -- seemed determined in many cases from the moment of conception and relied heavily on the mother's egg cell, they found.
Embryos most likely to form a ball of cells called a blastocyst developed at a certain, measurable rate, they found.
Auxogyn, Inc., a privately held medical technology company, said in a statement it had acquired an exclusive license from Stanford University to develop products related to the findings.
"Blastocyst formation is a critical time point in human embryo development and provides more objective criteria for selecting which embryo(s) to transfer," Lissa Goldenstein, president and CEO of Auxogyn, said in a statement.
"For years, researchers have searched for ways to predict the embryos most likely to reach the blastocyst stage in order to enable earlier transfer and ultimately improve live birth rates for in vitro fertilization procedures."
The company estimates that there are 500 clinics in the United States providing in vitro fertilization or IVF services, with combined annual revenues of nearly $2 billion.

SOURCE: REUTERS

IVF treatment: 66-year-old childless woman gives birth to triplets •As world’s oldest mum says she is dying from IVF complications

A 66-year-old Indian woman has become the oldest person in the world to give birth to triplets after IVF treatment at a controversial centre.
Childless Bhateri Devi gave birth to two boys and a girl –– who are now being treated in intensive care after being born dangerously underweight.

Mrs Devi received IVF treatment at the National Fertility Centre in Haryana –- where the world’s oldest mum, Rajo Devi Lohan, was also treated.
However, the doctors said the triplets, weighing 2 pounds 6 ounces, 2 lbs 4 ounces and 1pound 7 ounces, were being monitored in the intensive care unit of the centre.
Mrs Lohan, 72, who gave birth 18 months ago aged 70, has revealed she is dying –– and hit out at the centre for not explaining the risks to women about having babies later in life.
However, officials at the centre proudly boasted of their latest achievement.
Dr Anurag Bishnoi, who supervised Mrs Devi’s treatment, said: “According to the birth certificate issued by a government hospital in Rohtak district, Bhateri Devi was born on May 21, 1944 in Madina village of Rohtak.
“This birth is authentic and therefore she has become the oldest mother in the world to give birth to triplets so far.
“Bhateri Devi was coming to us for the last months for the treatment. She has become a mother for the first time and conceived only in our third attempt through IVF technique.
“For the first two attempts, only two embryos were transferred in each cycle.
“But in third attempt three embryos were transferred in her uterus, resulting in the birth of three children by caesarean.’
Mrs Devi’s husband of 44 years, Deva Singh, 64, said he was ecstatic at becoming a father for the first time.
“Bhateri has fulfilled my dream of having a child and gave my family an heir.” he said.
‘She was my first wife and after she failed to conceive a child, I married twice but again I did not have any child from my other wives also.
“I am very happy and I will provide all the best facilities to my children in the coming years.”

In November 2008, 70-year-old Mrs Lohan made headlines after she gave birth to a girl through IVF technique at the same centre.
She and her husband, Balla, 73, are uneducated farmers who said they did not understand the risk of having a baby at such an old age

Is IVF Good Value For Money?

Children conceived by Medically Assisted Reproduction (MAR) have fiscal implications for government both in terms of future government spending and tax revenue. Based on public funding to conceive a MAR child - after factoring in education, future health and pension costs, and future tax contributions of this child - the discounted net tax revenue (the difference between future government spending and tax revenue) of a child born in 2005 is roughly 127,000 euros in today's value.

Considering an average treatment cost of approximately 15,000 euros to conceive an IVF-child, this represents an 8-fold return on investment (ROI) for governments [1]. While the costs of MAR treatment represent a substantial proportion of a patient's annual disposable income, MAR typically represents less than 0.25% of total national healthcare expenditure. By comparison, obesity accounts for 10% and 2-4% of total health care spending in the US and Europe respectively.

MAR treatments elicit significant medical, reproductive and economic influence in developed countries with 3.5 million children estimated to have been born worldwide since 1978. These children make up a substantial proportion of national births with up to 4.1% in Denmark and 3.3% in Belgium. In the US, Europe, and Oceania over 600,000 treatment cycles resulted in 120,000 children being born in 2005. The European Society of Human Reproduction and Embryology (ESHRE) Task Force on 'Reproduction and Society' reviewed the economics of MAR to evaluate the benefits of funding of MAR for society and to inform policy makers on effective, safe and equitable financing of MAR. Dr. Mark Connolly and colleagues who published this review paper in the journal Human Reproduction Update based their findings on key epidemiological and economic studies. Affordability of IVF is one of the main drivers of treatment utilisation, choice of treatment, and embryo transfer practices which ultimately influence the multiple birth rate and infant outcomes.

Although the poorer clinical outcomes are well known, the indirect costs and hence the economic burden associated with MAR multiple birth children - which may extend well beyond the perinatal period - are less appreciated. Lack of affordable treatment may force patients and clinicians to opt for cheaper fertility treatments such as stimulated intrauterine insemination and ovulation stimulation which have less controllable means of minimising multiple births. If treatment is appropriately funded, there is less of a financial incentive to achieve pregnancy in a limited number of cycles. Additionally, restricted treatment and limited financial access coerces some patients to seek cross border reproductive treatment in countries where cheaper or less restrictive treatments are offered. The ESHRE Task Force on 'Cross Border Reproductive Care' showed in a recent survey that, of those patients that sought cross border reproductive care, only 13% received partial reimbursement and 4% total reimbursement in their own country. Different standards of care and less responsible embryo transfer practices are amongst the risks patients' face when going abroad

IVF HOPE AFTER BRITISH BREAKTHROUGH ON EMBRYO SCREENING TECHNIQUE

baby oliver with simon fishel

The first baby conceived with the help of a new egg screening technique which could offer hope to women for whom IVF has repeatedly failed has been born.
Oliver was born to a 41-year-old woman who had had 13 failed IVF treatments.
The new screening method, developed in Nottingham, allows a rapid analysis of the genetic material in fertilised eggs to check for chromosomal abnormalities.
The British Fertility Society said the technique was promising but that more research was needed.
Professor Simon Fishel, who led the team, said Oliver's arrival showed that the test could help couples who have repeatedly failed to become pregnant.
"All the team have been waiting for this very special baby to be born.
"Oliver's birth is an important landmark in shaping our understanding of why many women fail to become pregnant.
"Up to half of the eggs in younger women and up to 75% in women over 39 are chromosomally abnormal.
Array Comparative Genomic Hybridisation is used to screen eggs or embryos in an IVF cycle, evaluate all the chromosomes and select the most chromosomally normal embryos."
Before an egg is fertilised, it ejects half of its own set of chromosomes to leave space for the chromosomes coming from the father's sperm.
Miscarriages
These "spare" chromosomes are kept in a structure on the edge of the cell known as the "polar body".
Array CGH involves extracting the polar body and looking to see if there are too few or too many chromosomes.
It is believed that two out of three women fail at each IVF attempt because of chromosomal abnormalities in the implanted egg.
The team at Care Fertility Clinic have found a way of speeding the analysis of the genetic material they extract.
Two years ago US scientists announced that 18 women had given birth after having their eggs screened using a similar technique.
But in those cases the resulting embryos had to be frozen and re-implanted later.
The Nottingham team can get the results back in 24 hours which means that the mother can undergo IVF in the same cycle of treatment.
Oliver's parents had 13 previous failed IVF cycles and three miscarriages.
Eight eggs were tested and only two found to be chromosomally normal. One of those produced Oliver.
Great hope
British Fertility Society chairman Tony Rutherford said the technology offered much promise but the widespread use of it should await the outcome of further rigorous research.
He said there was no compelling evidence yet that pre-implantation genetic screening (PGS) tests, in which embryos are looked at for genetic abnormalities before they are implanted in the womb, improved the pregnancy rate or live birth rate.
He said: "All too often we see groundbreaking news about techniques that seem to offer great hope, but fail to live up to expectations when applied in widespread clinical practice."
Professor Peter Braude, head of the department of women's health at King's College London, said he was delighted that the mother had achieved her positive outcome after so many years of trying but he too sounded a note of caution.
"At the moment this can only be viewed as a potentially very lucky result," he said.
Stuart Lavery, a consultant gynaecologist and director of IVF at Hammersmith Hospital in London, said: "This technique is a very poweful tool that may allow us to detect which embryos of the many produced in an IVF cycle have the best chance of implantation and resulting in a birth.
"Clearly this is very early days, and our optimism needs to be tempered with caution until we have more evidence of the technique's safety and effectiveness.
"My own unit at the Hammersmith has recently been given an HFEA licence for microarray CGH and we look forward to contributing to this promising new field."
SOURCE: BBC.CO.UK

Controversial egg modification technique could increase IVF success in older women

A controversial new technique to improve the quality of eggs from older women undergoing IVF is being developed by Japanese scientists.

Because the procedure involves using eggs from two women to create a single viable egg for fertilisation, it has sparked a media furore over the potential creation of what have been inaccurately dubbed 'three-parent embryos'.
The success rate of IVF declines dramatically as the age of the woman undergoing the procedure increases. One of the reasons for this is thought to be the accumulation of abnormalities in the cytoplasm (the jelly-like substance that surrounds a cell's nucleus) of eggs from older women. Researchers at the St Mother Hospital in Kitakyushu, Japan, took the nucleus out of an egg cell from an older woman undergoing IVF and transplanted into an egg donated by a younger woman (under the age of 35) which had first had its nucleus removed. The resulting egg had the nucleus from the older woman but the cytoplasm from the younger woman.
The research team presented their results at the American Society for Reproductiove Medicine meeting in Atlanta, Georgia in October 2009. Out of 31 eggs on which the procedure was performed, 25 appeared to have transplanted successfully and looked healthy and so were used for fertilisation. Out of these 25 eggs, seven (28 per cent) formed early-stage embryos after being injected with sperm. This was a dramatic improvement on the usual three per cent success rate for the fertilisation of eggs from older women.
In this case, the embryos were not implanted back into women, but team leader Dr Atsushi Tanaka told New Scientist magazine: 'If we could transfer these constructed new embryos, I believe the success rate would be high'.
Although the vast majority of human DNA is contained inside the nuclei of cells, a handful of genes - just 37 genes out of around 25,000 genes in total - are found in the mitochondria, tiny structures that exist in the cytoplasm and provide power to cells. The embryos created by Dr Tanaka and his team would inherit only these 37 genes from the younger donor of the empty egg and cytoplasm, and their remaining 25,000 or so genes from the woman who donated the egg's nucleus and the man who donated the sperm. For this reason, a similar technique of nuclear transfer has been proposed in order to enable women who have severe genetic disorders associated with mitochondrial genes to have children of their own without passing on their condition.
The use of this technique on eggs intended for implantation is currently banned in the UK. However, the new Human Fertilisation and Embryology Act recognises what it calls the 'devastating effects' of mitochondrial diseases and will allow for secondary legislation to sanction treatment of mitochondrial diseases should therapies be developed.
SOURCE: BIONEWS.ORG.UK

For the mother 13 times unlucky with IVF, a miracle boy at last

His mother has suffered the trauma of two miscarriages, an ectopic pregnancy and 13 failed IVF attempts.
Having been through all that this little baby boy can only be described as her miracle.

The child, identified only as Oliver, has become the first in the world to be born using an IVF technique that is said to more than double the chances of pregnancy.

Oliver, from the south of England, was born in July after doctors devised a way of counting the chromosomes in eggs, allowing them to pick only the best for fertility treatment.
After years of IVF disappointment, his mother, aged 41, had all but given up hope of ever having a baby of her own.

It's hardly surprising that her doctor says the woman and her husband - who have requested privacy - are still in shock at the birth.
Simon Fishel, of the Care group of fertility clinics, said: 'You get to a point where you don't believe it is going to happen to you.
'They are absolutely thrilled, as anybody would be, but believe it is almost more of a miracle in their case because of their history.
'Oliver's birth is an important landmark in shaping our understanding of why many women fail to become pregnant.'

So far, another six or so women have become pregnant thanks to the technique. But in time it could help many more women achieve their dream of motherhood.

Initial studies suggest it can more than double the odds of conception, cutting the cost and heartache of failed IVF attempts.
The technique, known as array comparative genomic hybridisation
Healthy eggs should have 23 chromosomes but many have more or less than this, greatly cutting the chances of pregnancy and raising the risk of miscarriage and of having a child with a condition such as Down's syndrome.

Up to three-quarters of miscarriages are thought to be due to embryos having too many or too chromosomes, with eggs from older women particularly likely to be problematic.
In trials, a more basic form of the technique doubled the pregnancy rate from 25 per cent to 50 per cent.

The latest version, pioneered at Care's Nottingham clinic, removes the potentially risky step of freezing and thawing the eggs or embryos and so could boast even better results.
Dr Fishel said: 'I really don't want to raise hopes unnecessarily but I do believe that because chromosomal abnormalities are so vast in cases of IVF failure that this technique will produce higher live birth rates.
'I am hoping it will double, or even more than double, the chances in most groups of patients.'
Optimising the chances of pregnancy would also allow doctors to reduce the number of eggs they implant in a woman at one time, cutting the odds of risky twin and triplet pregnancies.
The Care team is now trying out the method on embryos, something-that could increase the chances of success even further.
Although the method is mainly being used in women who have repeatedly failed at IVF, younger women could also benefit, as up to half of their eggs have chromosomal problems.
However, the £2,000 price tag, on top of the £3,000 or so for IVF, may put many off.
Experts urged caution about the development.
Tony Rutherford, chairman of the British Fertility Society, said that while the technology offers 'much promise' more research was needed to ascertain its value.

He said: 'The widespread use of this technology should await the outcome of such research to ensure we know which patients might benefit.'
Professor Peter Braude, head of the department of women's health at King's College London, said: 'I am delighted that this patient has achieved her positive outcome after so many years of trying.
'However we need to be cautious as to whether the new technique was responsible.

New IVF test increases pregnancy chances, say researchers

A new technique for screening embryos for genetic defects during IVF more than doubles the chances that the embryo will implant in the mother's womb, according to a pilot study by UK and US researchers.
The method, which has several advantages over an existing screening technique, led to established pregnancies - meaning that foetal heartbeat was detected using ultrasound - in 78% of the 23 women who underwent the treatment. Genetic screening involves testing embryos produced during in-vitro fertilisation for abnormal chromosomes that could prevent the embryos from being carried to term.

Fertility doctors using the current technique take one or two cells at day three of the embryo's development, when it has eight cells. Once healthy embryos have been selected, they are implanted back into the patient's uterus. The technique, fluorescent in situ hybridisation, is controversial, with some studies suggesting that it provides no benefit or is counter-productive. The long-term effects of manipulating the embryo are unknown.

The new technique, called comparative genomic hybridisation (CGH), allows doctors to remove cells from the embryo at a later stage, when it is five days old and has more than 100 cells. Removing cells at this stage should be less damaging, and by analysing five or six cells the clinician can be more confident that the genetic abnormality exists in the whole embryo, and not just a few cells.

The researcher who has developed the new technique is planning to offer it in the UK for about £2,000, on top of the fee for IVF, and around the same as standard screening techniques.
"The pregnancy rates we've got so far are absolutely phenomenal," said Dr Dagan Wells at Oxford University and Reprogenetics UK, who led the study. "We're ready to begin a trial in the UK, and we have a couple of licence applications in to the Human Fertilisation and Embryology Authority to start offering CGH to patients." The HFEA is the UK's regulator of fertility clinics.

Dr Mandy Katz-Jaffe at the Colorado Centre for Reproductive Medicine, near Denver, who is part of the team, said: "The patients who are going through this knew this was their last chance of conceiving without going for donor eggs. They have a poor prognosis, with multiple failed cycles. The effect on those patients who have conceived has been beyond anything I can describe." Wells's team tested the CGH method in 23 women aged 30-42, and transferred 50 embryos. After screening and embryo transfer, 20 of the women became pregnant (foetal heartbeat confirmed by ultrasound).

Better infertility treatments may help many to become parents

An advertisement which said "Choose from a bevy of healthy super-ovulated women to make your family complete" encouraged Audrey and Derek (names changed), residents of New Castle, UK, to go doctor shopping for a baby across four continents. Finally, they zeroed in on Dr Aniruddha Malpani, who runs the Malpani Infertility Clinic in Mumbai.

Audrey was on the verge of a nervous breakdown, having gone through multiple cycles of fertility treatment without any results. The couple had spent nearly 50,000 pounds in the eight years that they had been desperately trying for a baby. From swanky doctor studios they had even done the rounds of astrologers, herbal doctors and miracle-promising mendicants, driven by a single-minded obsession to become parents the biological way.

This cycle of hope-disappointment-hope was finally broken when they had Derek Jr. through In-Vitro Fertilisation (IVF) treatment in Mumbai.

Audrey and Derek are one of the many childless couples who come to India with the hope of going back home with their very own bundle of joy. Fertility tourism is big business now - the industry reportedly brings in hundreds of millions of dollars into the county. In fact, reports also suggest that the number of such cases has more than doubled in the last three years. The reasons: pocket-friendly treatment, world-class heath care facilities, a large base of English-speaking doctors, relatively fewer legal hurdlest the list is long. Dr Vibha Bansal, a Delhi-based gynaecologist, elaborates, "Fertility tourism has received a great deal of media attention of late. The cost of IVF in the West is astronomical and countries enact laws that drastically curtail women's access to assisted reproduction. However, countries like Thailand, Russia, China and India, where such treatments are easily accessible, see people not only from the developed world seeking treatment but also from places like Nepal, Bhutan and Afghanistan, where such options either do not exist, entail long waiting periods or are not of a satisfactory quality." She adds that the government has made things easier by not cluttering the space with too much legalese. According to Dr Malpani, "IVF, embryo adoption and egg donation are very popular and a major reason for this is its cost effectiveness." Take a look at the monetary contrast: At private clinics in the US, which do 70 per cent of all IVF treatment, costs can run up to $18,000 a cycle. Indian clinics offer the same at around $7,200. And to make the deal even more irresistible, many fertility centres offer package deals, throwing in plane tickets and hotel stay as well.

Other than the cost factor, Dr Malpani believes "foreigners choose India because doctors here are known to be more caring". Also, while British clinics may allow doctors to implant only two embryos in a surrogate's uterus, in India this can go up to six embryos at a time - increasing the chances of conception. But Dr Amudha Hari, Consultant Gynaecologist and Laparoscopic Surgeon in Chennai, doesn't see this as positive development.

She believes that there will always be doctors who agree to treat women deemed too old or too overweight by western standards for IVF, never mind the resultant medical complications. Which is why a patient must do a thorough recce and demand to get all his/her questions answered before going in for treatment. "Infertility is like a chronic illness and couples invest a lot of time, energy and money to fulfill their desire of building a family," says Dr Hari.
After three failed rounds of IVF treatment, Bhaskar and Anita, Non Resident Indians (NRIs) in the US, found the answer to their problem in an advertisement. It led them to Nisha, 23, from Nagapattinam, Tamil Nadu, who was willing to be a surrogate. Everything seemed compatible, she was of the same build and skin colour, except for the fact that she was not married. The issue posed an ethical dilemma for the couple but it was resolved when they were convinced that she was not under any duress but wanted to fund her education to be a nurse. Anita sent her Rs 20,000 every month until the baby was born. She even monitored Nisha's diet and doctor's visits. Their son Rohan's birth, says Anita, was "nothing short of a miracle. We had lost all hope of becoming parents and are now considering having another child after three years, the same way."

Infertility treatments, whether through IVF or surrogacy, creates families. In the process, they also help surrogates find stability in life. In fact, surrogacy has helped poor people pay off debts and get out of the vicious cycle of poverty and, in Nisha's case, get her an education. But, unfortunately, this exercise is not all about gains. If driven solely by commercial interests, fertility treatments can have dangerous consequences. There is always the question of high-risk pregnancies. Sometimes women have to go through repeated surrogacies, getting injected with hormones and the like without proper medical surveillance. All this means compromising dangerously with their health.
Dr Hari recalls a case where a woman in a Mumbai slum had been pushed by her husband to attempt surrogacy for the 18th time. The husband had made this into a kind of domestic enterprise, albeit a failed one, since the poor woman suffered from tuberculosis and was unable to deliver a child successfully. Luckily, a local NGO got a wind of what was going on and took her into a rehab where she is now recovering.

Besides the health risks, there is the issue of adoption. "The many steps involved in adoption once the child is born can be a problem," says Dr Hari. The Indian Council of Medical Research has not issued any guidelines to help deal with foreign clients using Indian surrogates. So the child has to be adopted under Indian law and all procedures outlined in the Hague Convention on inter-country adoption have to be adhered to.

Experts are quick to point out that the global capital generated by the burgeoning fertility tourism market may thwart any concerted international response to the inequities and exploitation that arise in this context. The key to ensuring that the treatment process is relatively hassle-free is to choose the right clinic, one that lays down protocols and guidelines, advises Dr Hari.

Doctor shopping can be a very taxing experience. However, a welcome trend is the easy availability of information on the Internet, making it possible for potential clients to connect with doctors and seek referrals. Blogs and e-mail are handy tools in this regard. However, Dr Abha Majumdar, Head Ultrasound at the IVF Unit in the New Delhi-based Sir Gangaram Hospital, believes that the entire fertility tourism debate is over hyped. She says that the majority of those reaching out to her or those referred from other clinics are Indians (including NRIs) - foreigners make up just 10-15 per cent of that number.

SOURCE:NATIONITTFAQ.COM

REAL FACTS ABOUT EGG DONATION

It’s becoming more the norm than the exception: women who are giving birth in their late 40’s and early 50’s.
Actress Geena Davis gave birth to twins at 48; Jane Seymour gave birth at 45; Cheryl Tiegs at 52.

Yet statistics show that once a woman reaches the age of 40, her fertility rate is pretty low. That’s why many women seek an egg donor for help.
What is egg donation? I took a closer look at the procedure and the female donors who are changing lives.

Pick up almost any college newspaper and you’ll see the ads seeking egg donors like this 24-year-old grad student who doesn’t want us to use her name.
Earlier this year at a clinic out-of-state, she donated 28 of her eggs, and she says she’s ready to do it again.
“I’m helping someone and they appreciate it,” she said.

The fact is, in a society where more and more women are waiting longer to get pregnant, egg donors like her are desperately needed.
Dr. Michael Steinkampf is the founder of Alabama Fertility Specialists, ranked among the top 25 IVF clinics in the country for women under age 35 by fertilitysuccessrates.com.
He says that when it comes to getting women pregnant, egg donation is the most successful form of invitro fertilization.
“This has become an important part of reproductive life in the United States because more women are working, more women are deferring their first pregnancy, and so more women are finding themselves with difficulty conceiving and in their mid 30’s or early 40’s and often the best treatment for them is egg donation,” Dr. Steinkampf said. “About 10 percent of all the invitro fertilization cycles in this country are done with eggs donated by another woman not the infertile woman herself.”

The problem is—there are more women needing eggs than donors. In Alabama, the average wait period for a woman to receive donated eggs is six months. In other states, up to two years.

And being an egg donor is a commitment. You must be in your early 20’s—and be no older than 32. You have a spotless medical history and agree to a strict medical regimen, including daily injections of fertility drugs to stimulate the ovaries to produce eggs and an outpatient procedure under sedation to retrieve them.

Complications are unlikely, and Dr. Steinkampf said the procedure won’t affect a donor’s egg supply.
“Taking fertility drugs being an egg donor it doesn’t use up your eggs any faster than what would normally be diminished,” Dr. Steinkampf said.But the concern for some is the lack of follow-up once a donor walks out the door.

Debra Spar is the author of “The Baby Business.” She says a national registry is needed to track the health of egg donor and ensure that egg donation is safe.
“There’s a difference here between asking people to undergo a procedure that’s about their own health and asking people to undergo a procedure that is directed toward somebody else.” Spar said.

But in countries like Canada where regulations have been in place since 2004, egg donation has dropped dramatically by 50 percent.
And while some doctors admit a registry makes sense, they point to legal and privacy issues as roadblocks.

Dr. David Adamson of the American Society for Reproductive Medicine said “We have to be very careful in our country that we don’t discriminate against the infertile and don’t restrict the reproductive choice simply because it’s about reproduction and the reality is that there have been tens of thousands of babies born tens of thousands of donors.”
And for many donors that’s what it’s all about: helping others experience the miracle of life. In some states, egg donors can earn up to $20,000 dollars per egg donation.

Alabama Fertility Specialists pays its donors $3,000.
Medical guidelines suggest a woman can make six donations in her lifetime.

SOURCE: NBC13.COM

Tips for In Vitro Fertilization - IVF

Arm yourself with info, but don’t get alarmed. Our IVF doctor gave us a sheath of info and consent forms, and some of it revolves around the possible hazards of the egg retrieval and implantation surgeries. They list the possible problems (infection, intestinal punctures) and say “this is not to alarm or scare you!” One tip for IVF is to get all the info you can…but don’t let it freak you out.

Talk to couples who’ve tried IVF. When you get first-hand experiences, you’ll have more info than you ever wanted! To connect with other couples coping with infertility, ask your fertility specialist if they know of any support groups in nearby hospitals or communities. If you’re brave enough, you can ask your friends and family…and find blogs or websites like these!

Read fertility books. Current books about IVF, donor sperm, IUI, and natural treatments for infertility are great ways to learn about the procedure. The more you know about IVF, the more comfortable you’ll feel, which is why these tips for in vitro fertilization are so important.
Read Fertility Plus’ article called IVF Hints. I didn’t agree about the “don’t talk to your partner about his role, as this causes stress” part, but I think it depends on each couple. Everyone copes with infertility differently! If stress leads to performance anxiety, then by all means keep him calm…but if he’s not involved in the sperm donor process, then talk as much as you need!

Do a mock IVF transfer? This is one of the tips for in vitro fertilization suggested by Fertility Plus, but I don’t think we’ll do it. It may be good in theory, but I suspect it’ll cost more time, money, and energy than I can spare. A mock IVF transfer can give the fertility specialist an idea of the depth of your uterus, so when the real time comes, they’re ready.
Be prepared for anything. I’m prepared for pain, discomfort, mood swings, and the fact that this IVF could lead to pregnancy…or another disappointment. I’m prepared for things I can’t even fathom right now! I’m ready for anything.

Plan something fun for after the transfer! Some fertility specialists say to relax right after the egg and sperm are placed, while other say it’s not scientifically proven that increases the success of in vitro fertilization. My tip for a successful IVF is to rent a few of your favorite or new DVDs, make popcorn, snuggle up with your sweetie, and take a day or two off! Give yourself something enjoyable to look forward to.

Plan something fun for after the pregnancy test. If my in vitro fertilization isn’t successful, I’m getting laser eye surgery. Having 20/20 or better vision isn’t as good as a baby, but at least it’s something to look forward to!

As the technology of freezing eggs improves, more options open up for women

If you're not a woman of child-bearing age, you may never have heard of egg freezing.
But this form of in vitro fertilization has gained traction as its success rate has improved.

Pix left:A cryoloop, a critical tool in advancing pregnancy results from frozen eggs, is smaller than the point of a pen, right. Film is placed on the loop, which holds eggs for freezing

It was in 1978 when the first "test tube" baby was born in England. There, doctors fertilized an egg with sperm in a petri dish, then implanted the resulting embryo into the womb. Since then, hundreds of thousands of women have conceived using this method. In 2006, more than 54,000 IVF babies were born in the United States.

IVF using frozen eggs is newer. In the past decade, as many as 500 babies worldwide have been born from embroys that originated from a thawed-out egg. The first report of such a baby was in 1986. In 2007, the United States recorded its first baby born using both frozen egg and frozen sperm.
Egg freezing appeals to several groups of people, including young cancer patients facing life-saving but fertility-damaging treatments and women who want to extend the window of opportunity to have children because they don't yet have a life partner in the picture.

Couples undergoing fertility treatments also may be drawn to egg freezing. Perhaps they don't like the idea of having to destroy unused embryos or keeping them in limbo. Or -- erring on the side of caution -- they opt for the procedure to avoid the potential issue of custody: Unlike embryos created with a partner's sperm, frozen eggs, which belong to the woman, don't pose problems. (Who "owns" the embryos has landed more than a few soon-to-be-ex couples in court.)

Because oocyte cryopreservation (the medical term for egg freezing) is still considered experimental by the American Society of Reproductive Medicine, many U.S. fertility clinics only offer the service to cancer patients.
But that may soon change.

In 2006, an experimental program at Toledo Hospital's Fertility Center of Northwest Ohio welcomed the arrival of its first baby born from a once-frozen egg.
"It was our fertility doctor's idea [to join the study]," said Stacey LaPointe of suburban Toledo, who was 31 when her eggs were retrieved and frozen. "I think we were a little leery, a little hesitant at first."
But after doctors explained the process to LaPointe and her husband, Ryan, the couple decided to go forward.
"We had tried other things unsuccessfully," she said. "It was one of those crapshoots. The odds were so low, we thought, 'Well, it's worth a try.' "
Doctors froze seven of LaPointe's eggs. The five that survived the thawing process were fertilized. Two embryos were implanted, and the other three were frozen.
On Aug. 21, 2006, Claire LaPointe was born.
"We were thrilled," LaPointe said.
On April 1, 2008, she gave birth to her second child, Katie -- conceived the old-fashioned way.

Cleveland Clinic's Beachwood Fertility Center has frozen the eggs of a dozen cancer patients over the past two years. Roughly half of the Clinic's cancer patients do some type of "fertility sparing" procedure, such as embryo or sperm freezing.

As part of a trial to demonstrate that the procedure can work, the Clinic's Partnership For Families program recently picked up most of the expenses -- egg donation, freezing, thawing and fertilization -- for two healthy women in their early 40s who used frozen eggs from a woman in her early 20s. The two women have progressed beyond their first trimesters.

Prior to these two pregnancies, talking to cancer patients about freezing their eggs wasn't a comfortable conversation. No one knew if the success at other clinics could be replicated at the Clinic, said Dr. James Goldfarb, director of the in vitro program at the Clinic's fertility center.
Now, he said, "It's so much nicer to say, 'We can freeze your eggs and have a reasonable chance of this working.' "

The Clinic will consider on a case-by-case basis whether it will offer egg freezing as an elective procedure to healthy women.
University Hospitals Case Medical Center hopes to develop an egg-freezing program in the next six months, said Dr. William Hurd, director of the division of reproductive endocrinology at UH's MacDonald Women's Hospital. And like the Clinic's program, the hope is to expand it to healthy women.

Increasing chances of success
The closer you are to 40, the less likely you are to be a good candidate to freeze your eggs. The cutoff age at Extend Fertility Inc. in Massachusetts is 40, while the Florida Institute for Reproductive Medicine in Jacksonville won't accept women over age 38. CHA Fertility Clinic in Los Angeles has a cutoff of 35, with few exceptions.

Beyond age, women need to be as healthy as possible.
So what's the optimal age to freeze one's eggs? About the same that a woman should thinking about having kids.
"Before 30 is ideal," said Hurd. "In her 20s is a good time to have the first child."

At the Florida Institute for Reproductive Medicine, 53 babies have resulted from frozen eggs in the past nine years. One of those babies is now 3, the child of a cancer patient whose frozen eggs were thawed, fertilized and then carried by a surrogate.

At last count, the University of Bologna in Italy has reported a 25 percent success rate using frozen eggs -- roughly one baby for every four pregnancy attempts -- resulting in around 150 babies.

A clinical study operated by Extend Fertility Inc. -- which works with five partner centers in Boston; Austin, Texas; New York; Beverly Hills, Calif.; and Seattle -- has resulted in 13 babies born from women who used frozen donor eggs, said spokeswoman Marla Libraty.
"The data is early, but it is encouraging," she said.
CHA Fertility Clinic in Los Angeles -- which touts itself as the country's first commercial egg bank -- has had 27 babies born. Five women are currently pregnant.

At the Florida Institute, between 40 percent and 50 percent of women who have had about 10 eggs frozen and then thawed have taken home a baby, said program director Dr. Kevin Winslow.

"In theory, eggs may be stored indefinitely. It is the freezing and thawing process that damages the eggs, not the duration that they are frozen," said Scott Brown, spokesman for California Cryobank.
Dr. Glenn Schattman, a specialist in reproductive surgery at Cornell University's Weill Medical College in New York, says many clinics don't know what their success rates will be because they haven't thawed any of the eggs that they've frozen.

"Most programs don't have their own data," he said.
Most of the women who come through the doors of CHA Fertility Clinic in Los Angeles end up not going through with the procedure, said clinic director Dr. Vicken Sepilian.
"The big misconception is that it's a sure thing and it can be done at any age, that fertility doctors can undo the clock," he said.
Prospective patients should do their research and homework before committing to freezing their eggs, Sepilian said.
Some of the most important questions to ask a clinic: How adept are you at freezing and thawing? What is your pregnancy success rate? How many babies have been born through the specific technology at your clinic?
"It's not this magical treatment that's going to work 100 percent of the time," he said. "It's a backup plan."

SOURCE: CLEVELAND.COM

A cheap, painless alternative to IVF?

Breakthrough in fertility treatment as first British babies are born using new technique

A landmark in the development of fertility treatment was announced by doctors yesterday with the birth of the first babies to be conceived using a revolutionary technique that offers a safer, cheaper alternative to IVF.

The twin boy and girl, who were born on 18 October at the Radcliffe Infirmary in Oxford, were conceived using In Vitro Maturation (IVM), a method that dispenses with the use of costly fertility drugs, saving up to £1,500 on the normal price of treatment.

The technique is also safer for the one in three women among those seeking fertility treatment who have polycystic ovaries, a condition that puts them at high risk of dangerous side effects from fertility drugs.
Specialists said the development could make in vitro techniques available to more infertile couples by cutting the cost of treatment. Infertility is estimated to affect one in six couples in the UK but IVF costs around £5,000 a cycle and treatment is restricted on the NHS.

Tim Child, a consultant gynaecologist at the Oxford Fertility Clinic and senior fellow in reproductive medicine at Oxford University, who led the work, said: "I think it is a safer, cheaper alternative to IVF for all women. However, for many women the success rates are currently much lower. Research in the future will address this."

The Oxford Fertility Clinic is the only one in the UK licensed to use the technique: 20 cycles of treatment have been carried out and four other women are currently pregnant, giving a pregnancy rate of 25 per cent. This is expected to improve with further experience. In addition, without the need for drugs, repeating the procedure would be less taxing on the woman. For standard IVF, the Oxford clinic's pregnancy rate is 45 per cent.

The parents of the babies, who have asked to remain anonymous, were delighted, Mr Child said. At birth the boy, born first, weighed 6lb 11oz and the girl weighed 5lb 14oz. "The parents are ecstatic. They have got absolutely stunning twins. They went home on Tuesday to start their new life together. It is wonderful."

In standard IVF, the woman takes fertility drugs for five weeks to stimulate production of her eggs, which are then collected direct from her ovaries under the guidance of ultrasound, before being fertilised in the laboratory. The drugs cost between £600 and £1,500, with charges often higher in London.

The procedure is time consuming and uncomfortable and for the third of women with polycystic ovaries there is a one in 10 risk of severe ovarian hyperstimulation syndrome, a dangerous side-effect that in rare cases can prove fatal.

IVM avoids the use of drugs and instead involves collecting eggs from the ovaries while they are still immature. The eggs are then grown in the laboratory for 24 to 48 hours before being fertilised and replaced in the womb.

Mr Child said: "The main advantage is improved safety for women. Women with polycystic ovaries have a one in 10 chance of severe ovarian hyperstimulation syndrome. IVM completely takes away that risk. IVF is also expensive. With IVM the cost is reduced, meaning it could become a more accessible form of fertility treatment."

The technique was pioneered by the University of McGill in Montreal, Canada, where Mr Child spent two years researching and developing it before joining the University of Oxford in 2004. It has also been used in Seoul, South Korea, and Scandinavia. To date about 400 babies have been born worldwide using IVM compared with around two million by IVF.

At present the Oxford Fertility Clinic is only offering the treatment to women with polycystic ovaries, but in the long term Mr Child said he hoped to offer the procedure to all women. "When we see patients we say these are the options and it is up to them to decide. We are not offering it to women with normal ovaries at present because we don't get enough eggs from them. It depends on the number of resting follicles and with normal ovaries you don't get so many.

"On average we get four eggs from a woman with normal ovaries compared with 16 from one with polycystic ovaries. The procedure involves a process of attrition – two-thirds mature and two-thirds of those fertilise – so you need a decent number to start with."

Research on developing the culture medium in which the eggs are matured in the laboratory could reduce the attrition rate so that fewer eggs are needed. The technique could then become suitable for women with normal ovaries, Mr Child said.

A second drawback of the procedure was that eggs grown in culture had a harder outer shell than those matured in the ovary and were more difficult for sperm to penetrate. The eggs had to be fertilised by ICSI – injecting a single sperm directly into the egg. "We hope to develop the culture medium so the egg doesn't mind being grown in the laboratory and we can use ordinary insemination [mixing eggs and sperm so fertilisation occurs naturally]. But in most IVF clinics, 50 per cent of patients are treated with ICSI anyway," he said.

A spokesman for the Human Fertilisation and Embryology Authority said IVF was expensive for most couples and a minority got treatment on the NHS. But it was too soon to tell whether IVM would replace IVF.

"Anything that reduces the cost of IVF, provided it is safe, means treatment could be available to more people. But this is an emerging technology – it is very early days. The most important thing is that patients get proper information so that they can make a decision on what is best for themselves."

Source: independent.co.uk

New tool to test sperm and improve fertility success rates

London (IANS): A novel method, developed by scientists for testing the health of a sperm before it is used in IVF, boosts chances of conception.

University of Edinburgh researchers have created a way of tagging individual sperm quality, so that only healthy ones are used in fertilising an egg as part of IVF treatment.

IVF or in-vitro fertilisation is the basic assisted reproduction technique, in which the man's sperm and the woman's egg are combined in a lab and after fertilisation, the resulting embryo is then transferred to the woman's uterus.

The sperm are captured in two highly focussed beams of laser light. Trapped in 'optical tweezers', an individual sperm's DNA properties are identified by the pattern of the vibrations they emit in a process known as Raman spectroscopy.
This process is being used for the first time to evaluate DNA damage in sperm.

Existing methods to test sperm DNA quality cut off cells in half and tag them with fluorescent dye, which ends up rendering the sperm useless. This new process leaves them unharmed. So if it is found to have good DNA quality, it can still be used in IVF treatment.

Elfick, the project head, said: "In natural conception, the fittest and healthiest sperm are positively selected by the arduous journey they make to the egg.
What our technology does is to replace natural selection with a DNA based 'quality score'. But this is not about designer babies. We can only tell if the sperm is strong and healthy not if it will produce a baby with blue eyes," he said.

The research is currently in a pre-clinical phase, and if successful could be available to patients in the next five to 10 years, said a release of Engineering and Physical Sciences Research Council, which had funded the project.

SOURCE: hindu.com