http://www.ivflink.com/forums/blog.php This is an ivf discussion forum including ivf, ivf and age, ivf treatment, ivf finance, ivf news, ivf center, ivf causes, improving ivf result discussions. en Tue, 07 Oct 2008 12:56:26 GMT vBulletin 60 http://www.ivflink.com/forums/images/misc/rss.jpg http://www.ivflink.com/forums/blog.php http://www.ivflink.com/forums/blogs/kaimi1993/24-day-1-my-blog.html Wed, 27 Aug 2008 15:04:53 GMT Day 1 in my blog and I will document my IVF cycle and hope you all will follow me in this journey for a BFP at the end. :) Day 1 in my blog and I will document my IVF cycle and hope you all will follow me in this journey for a BFP at the end. :) ]]> Kaimi1993 http://www.ivflink.com/forums/blogs/kaimi1993/24-day-1-my-blog.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/23-acupuncture-debate.html Thu, 20 Mar 2008 19:12:13 GMT I spotted this link in the Acupuncture and IVF forum and thought I'd add the link here too. It's a Chicago Tribune story about the debate on the value of acupuncture to assist IVF treatments. Read the story and make up your own mind.
- IVF News Reporter ]]> ivf News Reporter http://www.ivflink.com/forums/blogs/ivf-news-reporter/23-acupuncture-debate.html http://www.ivflink.com/forums/blogs/ivf-doctor/21-reproductive-outsourcing.html Tue, 11 Mar 2008 18:27:43 GMT The outsourcing of U.S. jobs has become an important topic in the current election cycle. That this "job" outsourcing now has also seriously entered fertility practice is, however, less well known.
It all started with gamete donations. Scandinavian sperm banks flouted world wide their blond, blue eyed sperm donors with college education. As the popularity of egg donations increased, the former Communist countries of Eastern Europe became sources of inexpensive egg donation. Special egg donation clinics were, amongst other places, set up in the Czech Republic, Ukraine and Russia.
Now, The New York Times reports on the latest form of reproductive outsourcing,- surrogate motherhood (Gentleman A. March 10, 2008, A9).
Overlooking the misappropriation of terminology (we are really not talking here about surrogates, but gestational carriers), this report is rather remarkable because it, once again, demonstrates how far people are willing to go in the pursuit of having children and building a family.
Gestational carriers have to be differentiated from true surrogates because the former have no genetic contribution to the pregnancy they carry. A true surrogate contributes her egg(s) to the process. Gestational carriers are, nevertheless, even in medical lingo often referred to as "surrogates" and we, therefore, will follow this terminology here, as well.
Commercial surrogacy is, of course, quite common nowadays in the U.S.. It, indeed, in some states has become subject to special legislation, which denotes children of gestational carriers rather automatically as children of their genetic parents. In states where such law does not exist, the birth mother is still considered the legitimate parent and donors of egg and sperm have no automatic parental rights.
Many European countries ban commercial surrogacy outright. In the U.S., when available, the process is extremely expensive.
Who can then be surprised that the third world has picked up on this opportunity. As Gentleman now reports in The New York Times, India is in the process of developing commercial gestational surrogacy into yet another successful outsourcing industry for their country. Legalized in India in 2002, they offer easy access to surrogates and, most importantly low cost. At approximately $25,000, IVF cycle included, costs are approximately one third of the average surrogacy attempt in the U.S. Who then can be surprised that patients from Europe, Israel and the U.S. allegedly have started flocking to Mumbai and Dehli (On a side note, The Center for Human Reproduction in Mumbai has no connections with The Center for Human Reproduction in New York City, which advertises occasionally on this website).
An Israeli couple, quoted in the New York Times article, used long-distance donated eggs (most likely from an East European donor), after reviewing egg donor profiles by e-mail, the husband's semen and an Indian gestational carrier to achieve their goal. Photos of egg donor and surrogate are plastered on the walls of their apartment in Israel.
There is, of course, in principle, nothing wrong with reproductive outsourcing but in practice things may look differently: The New York Times addressed some of the social issues that apply to the specific Indian circumstances of surrogacy. It, for example, can be easily seen how economic interests may take advantage of poor women in third world countries, whether in Asia or Europe.
Our primary concerns with reproductive outsourcing are, however, more medically motivated: How well are egg donors evaluated? How detailed are their medical, family and genetic histories taken? How accurate are their medical evaluations?
Whether it is an egg donor or the gestational carrier of my pregnancy, I would like to be certain that every i was dotted in the process of selecting my donor/surrogate. Considering recent experiences with outsourcing in much less sensitive areas, there is at least reason to be concerned. If it was me, I would be willing to shoulder higher costs to avoid those concerns. ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/21-reproductive-outsourcing.html http://www.ivflink.com/forums/blogs/ivf-doctor/20-government-regulations-art-u-k.html Tue, 11 Mar 2008 14:18:25 GMT Assisted reproductive technologies in the U.K. are heavily regulated. Now an update on the legislative framework has been proposed in Parliament under the heading Human Fertilization and Embryology Bill and, promptly, has run into stiff resistance.
Not surprisingly, the Roman Catholic Church has been at the forefront of opposition to many of the activities the new bill would allow. As The New York Sun reported on March 10, 2008, quoting a dispatch of The Daily Telegraph, the new bill would, indeed, change current ART practices in the U.K. quite fundamentally:
Maybe the most controversial new practice the bill would allow is the creation of so-called chimera embryos. Such embryos are formed by inserting human genetic material into animal cells and/or eggs. The resultant embryos then would be exclusively used for research, of course, though opponents of the bill float the rumor that scientists could use the bill to circumvent other existing laws and create chimeric human embryos and babies.
Other new provisions of the bill may seem less controversial, but have also run into considerable opposition. For example, under current law, IVF clinics have to consider the need of a father to be involved in the upbringing of a child before establishing an IVF pregnancy. This provision would now fall by the wayside, opening IVF opportunities for single women and lesbian couples. Not surprisingly, this change was declared "profoundly wrong" by the leader of the Roman catholic Church in England and Wales.
The new bill will also allow for the screening of embryos for serious genetic diseases and in order to determine whether they could serve as tissue-matched donors for siblings in need of tissue donations, but prohibits the screening of embryos with the purpose of having a child with specific abnormalities, such as inherited forms of deafness (often desired by deaf parents), and for gender selection purposes.
Finally, the bill further would impair anonymity of gamete donations, as children conceived via egg or sperm donation now will be given the right at age 16 to inquire about half-siblings from the same donor, will be able to verify lack of any relationship before marriage and be entitled to information on their donor "parents".
From the U.S. point of view the provisions of this new law look like a mixed bag: More freedom in pursuing early embryo research would seem like a positive development. Restrictions of IVF utilization to couples was in the U.S. by most IVF centers abandoned decades ago and preimplantation genetic diagnosis (PGD) for genetic diseases has become routine.
The U.K's restriction against gender selection seems silly since the literature now quite well refutes the usually heard arguments against this utilization of IVF and PGD that (1) the procedure is sexist; and (2) that allowing gender selection will lead to an imbalance of the sexes in the population (Gleicher and Barad, Hum Reprod 2007;22:3038-41).
We also don't like the piercing of confidentiality when it comes to gamete donation. This will only further limit the availability of donors and, therefore, in our opinion, overall does not serve the public well.
Let's hope that the U.S. in this case does NOT learn from the U.K., but knowing some of the so-called (professional) ethicists in this country, we better get ready for the discussion. ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/20-government-regulations-art-u-k.html http://www.ivflink.com/forums/blogs/ivf-doctor/19-does-acupuncture-help-ivf.html Fri, 08 Feb 2008 19:41:07 GMT On February 8, 2008, a scientific article in the British Medical Journal suggested that acupuncture significantly increases pregnancy rates with IVF. This paper, a so-called meta-analysis of a number of previously published articles, reminds me of the old, I believe IBM-resourced saying, "garbage in, garbage out."
Approximately a dozen studies have previously addressed this question. The authors of this recent meta-analysis chose seven amongst them, and in combining outcomes from these seven studies, concluded that IVF pregnancies improve by approximately 65% if acupuncture is used.
I am quite familiar with most of, if not all, these original studies. They are uniformly poor in study design and the results of these studies are, therefore, simply not interpretable at the current time. My read of the published literature, therefore, is that the effects of acupuncture on pregnancy outcome are unknown. Since it, however, with considerable certainty doesn't hurt, I let my patients use it, as long as they understand that they may be wasting their money.
In an unusually insightful review (for a newspaper) of this paper in the Chicago Tribune (February 8, 2008), Judith Graham writes that the academic infertility group at Northwestern is in the midst of a prospective study of acupuncture in which half of all patients receive sham acupuncture. This is, of course, the only way to determine the real effects of acupuncture on IVF outcomes. Their study should provide a final answer. In the meantime, I recommend caution. ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/19-does-acupuncture-help-ivf.html http://www.ivflink.com/forums/blogs/ivf-doctor/16-obesity-bad-female-fertility.html Wed, 30 Jan 2008 18:24:42 GMT As women gain in weight, their chances of spontaneous conception decline. A recent study out of The Netherlands, so far only electronically posted (van der Steeg JE et al. Hum Reprod. doi:10.1093/humrep/dem371), suggests that, as women's body mass index (BMI) (in studies used as standard measure of obesity) increases, they lose approximately 4% of conception rate for every unit of BMI increase.
This is, of course, not the first study, linking obesity with infertility, but it probably is the most concise one in defining potential damage to female infertility per weight unit.
Considering that the prevalence of obesity seems on the rise, this is, of course, a worrisome observation, which women should consider in their attempts at pregnancy.

The IVF Doctor ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/16-obesity-bad-female-fertility.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/15-rights-responsibilities-ivf.html Sat, 26 Jan 2008 21:45:03 GMT Dr Robert Norman
Sep 3, 2007

Assisted Reproductive Technology (ART) has come a long way since the early 1980s when a few Australian Universities and hospitals started their journey with IVF and associated technologies. Many couples went through numerous cycles of IVF without success while the clinical and scientific techniques were developed.

The first pregnancy was in the early days of 1980 at the Royal Women's Hospital in Melbourne and was followed by more pregnancies centred around Melbourne units which ultimately became Melbourne IVF and Monash IVF.

It was not long before groups in Adelaide started to achieve pregnancies particularly at Flinders Medical Centre and The Queen Elizabeth Hospital.

Since then Australian Scientists have been at the forefront of developing these technologies particularly through the groups at Monash (Trounsen and colleagues) and the University of Adelaide (Cox, Matthews and colleagues).

Australian units were the first to introduce donor eggs, frozen embryos and frozen eggs into the repertoire of modern IVF and were at the forefront of the development of techniques around sperm injection (ICSI) and Pre-Implantation Genetic Diagnosis (PGD). In addition they were the first to develop lifestyle programs to optimise the conditions in which women became pregnant. They have been world leaders in reducing the numbers of embryos to be transferred so that some IVF units now put back almost exclusively only one embryo and they retain world-class pregnancy rates.

All this has been done in an environment where the Federal Government, through Medicare, has made IVF treatment relatively inexpensive and as a result reduced the risk taking by both doctors and clients who participate in this process. Australian science has also been a major contributor through its fundamental discoveries in embryology, genetics and biotechnology. Close to 3 per cent of all babies in Australia are now born from IVF and we may soon approach the Danish mark of 5 per cent.

Amidst this glowing picture one must ask whether everything is as rosy as it appears.

Pregnancy rates are still patchy across Australia and the introduction of the Medicare Safety Net, which has reduced costs to patients to very low amounts, has coincided with a rapid increase in the use of IVF and a reduction in the use of other simpler technologies such as ovulation induction, intrauterine insemination and lifestyle modification.

There is still a strong case to be made that congenital abnormality rates are higher among children who have been born from IVF and ICSI although this may be a contribution of the parent rather than the technology.

Any twin pregnancy is at much higher risk of problems at birth and in pregnancy than a singleton baby and we still are producing 20 per cent of babies by multiple pregnancies.

Even single babies from IVF have double the chance of dying or having complications.

Newer genetic technologies are suggesting that gene silencing (epigenetics) can be substantially altered by the process of embryo culture, especially when extended embryo culture occurs blastocyst. There are a number of clinical diseases that can be detected at birth which, although rare, are possibly associated with the IVF technology.

We have seen the rise of reproductive tourism whereby patients fly to the United States to have surrogacy, donor embryos or sex selection of their offspring where the local laws inhibit these procedures to be performed.

Donor eggs are rare in Australia but women can fly to Russia or Spain and be given eggs with relatively little difficulty.

We are seeing the rise of IVF mega businesses whereby some of the people running IVF units are more interested in the financial aspects than the medical components of IVF.

In some places IVF is almost becoming a production line whereby diagnosis is ignored merely to get a patient into the IVF process and thereby produce a baby. With this, couples are happy to have a healthy baby but a diagnosis is never made and no research investment occurs to improve our knowledge.

Australian scientists and clinicians have been spectacularly successful in their contribution to modern assisted reproductive technology.

Numerous commendable changes have been introduced into the process that makes Australian IVF among the best in the world.

This is supported by the Medicare system which is incredibly generous for couples and clinics offering this technology.

The increasing privatisation of many units, the lack of research and the financial incentives to perform IVF, rather than simpler procedures, cast a shadow over the future of Australia's ability to remain at the forefront of this technology.

Dr Robert Norman is director of the Research Centre for Reproductive Health and Professor of obstetrics and gynaecology at Adelaide University. ]]> ivf News Reporter http://www.ivflink.com/forums/blogs/ivf-news-reporter/15-rights-responsibilities-ivf.html http://www.ivflink.com/forums/blogs/ivf-doctor/13-pgd-pgs-improve-ivf-outcome.html Fri, 25 Jan 2008 17:06:43 GMT Is anybody still telling you to do preimplantation genetic diagnosis (PGD) to select better embryos in attempts to improve pregnancy chances with in vitro fertilization (IVF)? If they do, send them packing! Avoiding the transfer of chromosomally abnormal embryos should, at least theoretically, improve pregnancy rates with IVF. This equation works, however, only if one assumes that the required embryo biopsy does not adversely affect the embryo. To assume so makes no sense, knowing how sensitive embryos are to manipulation. Accepting, therefore, that embryo biopsy mildly affects embryos adversely, the benefits of embryo selection via PGD (for this purpose also widely called preimplantation genetic screening, PGS) must outweigh the detrimental effects of embryo biopsy. This may happen in young women, who have many embryos, and therefore can afford losing one or two. It will, however, overall adversely affect chances in older women with few embryos, who cannot afford the loss of even one embryo. Nobody should, therefore, be surprised that Dutch investigators recently reported that for older women PGS actually reduces pregnancy rates for IVF (Mastenbroek et al. N Engl J Med 2007;357:9-17). Despite vocal protest by selected members of the international PGD community, SART and ASRM finally developed enough spine to formally declare that, based on currently available data, PGD/PGS does not improve pregnancy outcomes if performed for advanced maternal age, previous implantation failure, or recurrent pregnancy loss (Practice Committees of SART and ASRM, Fertil Steril 2007;88:1497-1504). Similar conclusions were also reached by prominent European investigators (Devroey et al. Lancet 2007;370:1985-6), but some in the PGD community are still not convinced (Kuliev and Verlinsky. Reprod BioMed Online 2008;16:9-10). Most amazingly, however, the Preimplantation Genetic Diagnosis International Society (PGDIS) also still doesn’t seem to get it (PGDIS. Reprod BioMed Online 2008;1:134-7). Talk about financially self-serving and scientifically bogus! - The IVF Doctor Is anybody still telling you to do preimplantation genetic diagnosis (PGD) to select better embryos in attempts to improve pregnancy chances with in vitro fertilization (IVF)? If they do, send them packing!

Avoiding the transfer of chromosomally abnormal embryos should, at least theoretically, improve pregnancy rates with IVF. This equation works, however, only if one assumes that the required embryo biopsy does not adversely affect the embryo. To assume so makes no sense, knowing how sensitive embryos are to manipulation. Accepting, therefore, that embryo biopsy mildly affects embryos adversely, the benefits of embryo selection via PGD (for this purpose also widely called preimplantation genetic screening, PGS) must outweigh the detrimental effects of embryo biopsy. This may happen in young women, who have many embryos, and therefore can afford losing one or two. It will, however, overall adversely affect chances in older women with few embryos, who cannot afford the loss of even one embryo.

Nobody should, therefore, be surprised that Dutch investigators recently reported that for older women PGS actually reduces pregnancy rates for IVF (Mastenbroek et al. N Engl J Med 2007;357:9-17). Despite vocal protest by selected members of the international PGD community, SART and ASRM finally developed enough spine to formally declare that, based on currently available data, PGD/PGS does not improve pregnancy outcomes if performed for advanced maternal age, previous implantation failure, or recurrent pregnancy loss (Practice Committees of SART and ASRM, Fertil Steril 2007;88:1497-1504).

Similar conclusions were also reached by prominent European investigators (Devroey et al. Lancet 2007;370:1985-6), but some in the PGD community are still not convinced (Kuliev and Verlinsky. Reprod BioMed Online 2008;16:9-10). Most amazingly, however, the Preimplantation Genetic Diagnosis International Society (PGDIS) also still doesn’t seem to get it (PGDIS. Reprod BioMed Online 2008;1:134-7). Talk about financially self-serving and scientifically bogus!

- The IVF Doctor ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/13-pgd-pgs-improve-ivf-outcome.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/12-diet-lifestyle-can-prevent-fertility.html Fri, 25 Jan 2008 16:46:38 GMT November 3, 2007

Boston – A report published in the November issue of Obstetrics & Gynecology has elaborated on the benefits of changes in lifestyle and diet for women suffering ovulatory disorders, whose risk of infertility reduced by 80%, in comparison to women who did not make any of those changes to their diet and lifestyle.

The study was led by researchers at the Harvard School of Public Health (HSPH) and did not examine risk associated with other kinds of infertility, such as low sperm count in men.

“The key message of this paper is that making the right dietary choices and including the right amount of physical activity in your daily life may make a large difference in your probability of becoming fertile if you are experiencing problems with ovulation,” said Walter Willett, senior author and chair of the HSPH Department of Nutrition. The lead author is Jorge Chavarro, Research Fellow in the HSPH Department of Nutrition. Both scientists have earned MDs and have appointments at Harvard Medical School.

Infertility affects one in six couples, according to studies in the U.S. and Europe. Ovulatory problems have been identified in 18 to 30 percent of those cases.

The researchers followed a group of 17,544 married women who were participants in the Nurses’ Health Study II based at the Brigham and Women's Hospital. The team devised a scoring system on dietary and lifestyle factors that previous studies have found to predict ovulatory disorder infertility. Among those factors were: • The ratio of mono-unsaturated to trans fats in diet
• Protein consumption (derived from animals or vegetables)
• Carbohydrates consumption (including fiber intake and dietary glycemic index)
• Dairy consumption (low- and high-fat dairy)
• Iron consumption
• Multivitamin use
• Body mass index (BMI, weight in kilograms divided by the square of height in meters)
• Physical activity

The researchers assigned a “fertility diet” score of one to five points. The higher the score, the lower the risk of infertility associated with ovulatory disorders.

The women with the highest fertility diet scores ate less trans fat and sugar from carbohydrates, consumed more protein from vegetables than from animals, ate more fiber and iron, took more multivitamins, had a lower BMI, exercised for longer periods of time each day, and, surprisingly, consumed more high-fat dairy products and less low-fat dairy products. The relationship between a higher “fertility diet” score and lesser risk for infertility was similar for different subgroups of women regardless of age and whether or not they had been pregnant in the past.

Said Chavarro, “We analyzed what happens if you follow one, two, three, four, or more different factors. What we found was that, as women started following more of these recommendations, their risk of infertility dropped substantially for every one of the dietary and lifestyle strategies undertaken. In fact, we found a sixfold difference in ovulatory infertility risk between women following five or more low-risk dietary and lifestyle habits and those following none.”

The lead author of the study is Jorge Chavarro, Research Fellow in the HSPH Department of Nutrition. Both scientists have earned MDs and have appointments at Harvard Medical School. Chavarro and Willett have also co-authored a book with Patrick Skerrett called The Fertility Diet: Groundbreaking Research Reveals Natural Ways to Boost Ovulation & Improve Your Chances of Getting Pregnant. The book will publish in December 2007.

Journal reference: “Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility.” Jorge E. Chavarro, Janet W. Rich-Edwards, Bernard A. Rosner, and Walter C. Willett. Obstetrics & Gynecology. Vol. 110, No. 5, November 2007.

Adapted from materials provided by Harvard School of Public Health. ]]> ivf News Reporter http://www.ivflink.com/forums/blogs/ivf-news-reporter/12-diet-lifestyle-can-prevent-fertility.html http://www.ivflink.com/forums/blogs/ivf-doctor/8-infertility-surgery-dead-viva-ivf.html Tue, 22 Jan 2008 16:35:13 GMT An interesting little article appeared in the January issue of Fertility & Sterility, the official organ of the American Society for Reproductive Medicine (ASRM) and Society for Assisted Reproductive Technology (SART). With Alan DeCherney, MD, (Editor-in Chief of Fertility and Sterility and Chief of the Reproductive Biology and Medicine Branch of the National Institute of Child Health and Human Development of the National Institutes of Health, Bethesda, MD) as the senior author (though not in his formal professional capacities) this piece concluded that infertility surgery was practically passé and, in its place, in vitro fertilization (IVF) should be considered treatment of choice (Fertil Steril 2008; 89:232-6).

The article, of course, refers mostly to tubal surgery, which easily can be replaced by IVF. This is most interesting, since DeCherney built much of his early career in the field of reproductive endocrinology and infertility on his special surgical expertise. An authoritative voice, making this point, was long overdue. The thousands of unnecessary diagnostic and/or therapeutic laparoscopies and/or hysteroscopies, still performed as part of so-called routine diagnostic infertility work ups, and prior to much more efficient and cost-effective IVF, bear witness to the need of such an opinion statement. Only too bad that such a position statement has not yet come from ASRM!

To patients undergoing such work ups and receiving a recommendation for surgery, we suggest that they offer their physician a referral to this publication. In addition, however, also ask a very simple question: How, doctor, will my surgery change your treatment plans? Since there are really almost no indications left for surgery in modern infertility care (for exceptions see below), you will probably get no good answer. But, even if you do get a seemingly logical answer, we suggest a second opinion before agreeing to go under the knife. Remember, there is no “little” surgery! Surgery is only “unremarkable” if you are not the one under anesthesia.

So when is surgery indicated, after all? Only three scenarios come to mind: (1) an abnormal uterine cavity that can be corrected before IVF in order to maximize implantation chances for embryos; (2) the removal or clipping of large hydrosalpinges before IVF (which, because of backflow of toxic tubal fluid into the cavity, have been reported to reduce pregnancy rates with IVF, if left unattended); (3) myomectomies, when fibroids greatly distort the uterine cavity.

DeCherney et al put it best in the last paragraph of their paper noting that “surgical management should only be reserved for cases in which ART (i.e., IVF) was not initially effective.” And, they concluded, “...it becomes increasingly clear that infertility surgery is dead: only the obituary remains.”

- The IVF Doctor
]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/8-infertility-surgery-dead-viva-ivf.html http://www.ivflink.com/forums/blogs/ivf-doctor/4-notes-ivf-doctor.html Thu, 17 Jan 2008 18:06:45 GMT Welcome to the blog of the IVF Doctor! My posts are devoted to building an ongoing series of commentaries to illuminate the concepts, methods, and treatments related to the fertility procedure, in vitro fertilization.

In committing to keeping this record. I hope to make this potentially life-altering procedure accessible to lay readers by providing intelligible and understandable answers to the most prevalent questions and concerns that have been voiced by my patients over now 25-plus years as a reproductive endocrinology and infertility specialist.

I will include comments on new science and treatments, and share my conclusions on trends in the field. I also plan to discuss specific procedures, recognizing ones that I have come to trust, and sharing my honest opinions on others I am less sure of. In short, my IVF Doctor's blog represents a unique and valuable resource for individuals and families who may be considering, or want to learn more about, in vitro fertilization.

I invite you to check in regularly and follow along. And I welcome your thoughts and comments.

- The IVF Doctor ]]> IVF Doctor http://www.ivflink.com/forums/blogs/ivf-doctor/4-notes-ivf-doctor.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/3-smokings-effects-uterus-harm-fertility.html Thu, 17 Jan 2008 16:29:52 GMT While surfing the Internet, I found the following article and I wanted to share it with the readers of my blog.

THURSDAY, Nov. 9 (HealthDay News)
Although it's a well known fact that heavy smoking can hurt your chances of concieving, I believe that it never hurts to reiterate good information. If you thought all the risks of cigarette smoking were already known, think again. New research finds that heavy smoking impairs women's fertility by reducing the odds that a fetus will implant in the uterus.

Previously, experts had thought that heavy smoking reduced fertility because of its effect on the ovaries. The new finding suggests tobacco deals women a double blow. "Tobacco consumption reduces your pregnancy probability, not only due to the already known ovarian effects but also due to impaired uterine receptiveness," said Dr. Sergio R. Soares, lead author of the study and director of the IVI Clinic in Lisbon, Portugal. "This is the first study that shows the clinical impact of cigarette smoking on uterine receptiveness," added Soares, whose study is published in the Nov. 9 online edition of Human Reproduction.

The take-home message remains the same: "A healthy pregnancy starts with a healthy mother," said Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City. "Quit smoking before you become pregnant." The effect of cigarette smoking on the ovaries has been known for a while, she said. "There's often ovulatory dysfunction in heavy smokers, and they tend to have menopause at an earlier stage," Wu noted.

The authors of the study looked retrospectively at 741 non-heavy smokers (under 10 cigarettes a day) and 44 heavy smokers (over 10 cigarettes a day). All of the women had received oocyte donations as part of in vitro fertilization (IVF) between January 2002 and June 2005.

None of the women's partners smoked and none of the oocyte donors were heavy smokers.
According to the study, the lighter smokers had a significantly higher pregnancy rate (52.2 percent) than the heavy smokers (34.1 percent).

The fact that the oocytes were donated means the problem lies with the uterus, not the ovaries, the researchers noted.
Previous research had also shown that light smoking had no significant effect on IVF cycles.
Oddly, heavy smokers had about double the rate of multiple pregnancies (60 percent) than non-heavy smokers (31 percent). Although this may be a glitch in the findings, it's also possible that different women respond differently to cigarette smoking, Soares said. Soares and his team are now looking at the genetics behind the phenomenon.

"We are beginning a study of gene expression in the endometrium of heavy smoking oocyte recipients to see which might be the key molecules involved in the implantation process that are altered in these patients," he said. ]]> ivf News Reporter http://www.ivflink.com/forums/blogs/ivf-news-reporter/3-smokings-effects-uterus-harm-fertility.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/2-woman-half-ovary-gives-birth-healthy-baby-boy.html Thu, 17 Jan 2008 16:17:56 GMT Daily Mail
David Wilkes
16th January 2008

She had given up hope of ever having a baby. Trudi Siviter had only half an ovary - and even that was not working properly. After cancer of the cervix as a teenager, two ectopic pregnancies and three failed attempts at IVF, Mrs Siviter and her husband thought it was impossible for her to have children.

Doctors agreed, and she was ready to have a hysterectomy. But three months before she was due to have the procedure, the 39-year-old was shocked and thrilled to discover she was pregnant - with a baby doctors and the ecstatic couple were calling a "miracle" on Tuesday. Mrs Siviter gave birth naturally to a son at Staffordshire General Hospital's maternity unit eight months into the pregnancy on December 7. Alfie weighed just 3lb 8oz, but despite being tiny was healthy.

Yesterday Mrs Siviter, a customer services manager for Tesco, said: "He's the miracle child from nowhere. "Last July I wasn't feeling well and, when I went for a check-up, they found I was pregnant. "And now to our amazement we have our little Alfie, who has white-blond hair, big blue eyes and is the double of his dad."

The proud mother, from Stafford, was first told she would never have children after cancerous cells were found in her cervix 20 years ago. She later had two ectopic pregnancies, where the baby develops outside the womb, which left her with only a small piece of fallopian tube. Her right ovary was removed, as well as half of her left one. Her womb was not thought to be strong enough to support a pregnancy and three attempts at IVF fertility treatment failed.

She and her husband Christopher, 40, had resigned themselves to never having children and threw themselves into organising foreign holidays - which they ended up cancelling when she finally learned she was pregnant.

"It just goes to show we can never say never."

http://www.dailymail.co.uk/pages/liv...=1774&ito=1490 ]]> ivf News Reporter http://www.ivflink.com/forums/blogs/ivf-news-reporter/2-woman-half-ovary-gives-birth-healthy-baby-boy.html http://www.ivflink.com/forums/blogs/ivf-news-reporter/1-test-tube-babies-need-fathers.html Thu, 17 Jan 2008 15:00:25 GMT From The Times
Ruth Deech

This proposal to change IVF law is misconceived. Doesn't a child need a father? Since in vitro fertilisation was first regulated in 1990 doctors have been required to consider the welfare of the baby, including “the need of that child for a father”. This is one of the few ethical principles in IVF law and has served as a reminder that the welfare of the child is more important than the wishes of the would-be parents.

But no longer, it seems. The Government is seeking, in a new Bill in the House of Lords, to delete that obligation. Instead, IVF providers will have to consider “the need for supportive parenting”, a change that is both unacceptable and inappropriate. The phrase “supportive parenting” will mean little to the public. Because it is speculative it will be difficult for practitioners to interpret, and it adds nothing of substance to the existing requirement to have regard to the welfare of the child. There is no reason to change the current approach, which works well.

A substantial amount of research has demonstrated that fathers make a distinctive contribution to child rearing, without which children are generally the poorer. If we believe that the welfare of children is important, it would be irresponsible to allow the law to move backwards and lose explicit reference to fathers.

The need to have regard to the role of fathers is not discriminatory. It has not and does not prevent same-sex couples from receiving IVF - the numbers of lesbian couples having such treatment is increasing. It simply asks those assessing IVF patients to consider the need of a child for a father, an eminently sensible provision that sends out a vital signal about the centrality of fathers.

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