Dr Juma's Clinic - Kenya

'Miracle baby' conceived from 22-year-old sperm

A Canadian couple successfully conceived a baby boy after using sperm that had been stored 22 years, two months and two weeks - a likely record for Canadian fertility treatment. The longest-known storage period for sperm resulting in a live birth is 28 years, according to a 2005 data report in the American journal Fertility and Sterility. Jacek was born in Langley, Canada on 1 November 2007 thanks to Mike Kuzminski's discovery that a Calgary clinic, where he had stored sperm years ago prior to cancer treatment which rendered him infertile, had continued to store his sperm despite no contact or payment from Kuzminski in 22 years.Kuzminski, now a 43-year-old, was diagnosed with Hodgkin's lymphoma at 18. Because chemo and radiotherapy treatment caused 20 per cent of patients to become infertile in the 1980's - a risk that is significantly lower today - his doctor recommended that Kuzminski freeze his sperm. He did and then underwent three years of on-and-off treatment that led to his later-confirmed infertility. When he and his wife Kristin married in 2003, they had accepted that they would not be able to have children. Kuzminski had since forgotten he had frozen sperm before his treatment years ago until his sister reminded him. 'I had assumed that after 15 or 20 years the hospital had gotten rid of my sperm', he said but instead surprisingly found that the clinic had kept it and he owed Rs. 90,000 in storage fees.
Kuzminski seems to have benefited from Canada's current policy indecision regarding gamete storage time-limit guidelines for abandoned frozen sperm. He would not have been so lucky in the UK, where gametes are stored for a maximum of ten years, now with the option to request a five year extension.
Despite great anxiety regarding use of a limited supply of sperm and low success rates of fertility treatments, Jacek was born after undergoing only two intra-uterine insemination (IUI) procedures. They have enough sperm remaining for 19 more attempts but are focusing on their new parenthood and postponing consideration of whether they will try to have another child.

Insulin-secreting cells produced by stem cells

Scientists in the US have derived insulin-producing cells from human embryonic stem cells (hESCs), and have successfully implanted them into mice. The achievement, reported last week in the journal Nature Biotechnology, could help push forward research into therapies for diabetes. Type 1 diabetes, and some forms of type 2 diabetes, are caused by a deficiency of pancreatic beta cells. These are cells that produce insulin, the hormone that helps control blood glucose levels, and are part of clusters of hormone-producing cells in the pancreas called the islets of Langerhans. The disease is characterised by a lack of insulin and subsequent misregulation of blood glucose, a condition that can be fatal. Diabetes is currently the seventh leading cause of death in the US, with 200,000 deaths reported per year.
The scientists at Novocell Inc. in San Diego, led by Dr Emmanuel E. Baetge, the chief scientific officer, derived immature precursor pancreatic beta cells from hESCs. They then implanted them into mice whose own beta cells had been destroyed by chemical treatment. After 90 days, the mice had switched the precursor cells into mature beta cells that produced insulin again, which helped control blood glucose. The implanted cells were said to be 'functionally and morphologically similar' to normal beta cells.Transplanting human islet cells into diabetic patients from donated pancreases has been proven to help treat the symptoms of diabetes, but this technique relies upon donations, of which there is not a consistent supply. There is also a risk of transplanting infected or contaminated cells. The new technology could provide a readily available and renewable bank of clean cells for treatment when the patient needed it.
The scientists say that there is a long way to go before this can be taken into humans. There are safety issues still apparent as some of the mice in the study developed tumours, called 'teratomas'. Some critics are also concerned with whether the transplanted hESC derived cells would be destroyed by the recipient's body, just as their own original beta cells were.Experts, however, are in no doubt that this is an exciting advancement. 'This for the first time validates that you can use human embryonic stem cells to produce fully functional human islets', says Dr Baetge.

Husband discovered he was a father of two after estranged wife forged his signature in IVF deception

A UK man has two children he did not know existed, born after his estranged wife conceived using the IVF embryos they had created together, the Sunday Times has reported. The couple were treated for infertility at Bourn Hall clinic, near Cambridge, and the resulting embryos - created using the man's sperm - were frozen. Following the couple's separation, the woman forged her husband's signature on consent forms so that she could have the embryos thawed and returned to her womb, becoming pregnant on two separate occasions.
UK law states that consent from both parties is needed for the continued storage of frozen embryos, or for their use. However, although clinics must have written permission from the father to use an embryo created using his sperm, there is no requirement for him to attend in person. Muiris Lyons, a partner in the law firm Irwin Mitchell, commented that 'This is the first case of its kind that I have been aware of and it underlines the importance of IVF clinics ensuring they obtain proper consent'.
The husband only became aware of the children's existence when one became seriously ill, and a relative contacted him to break the news. He has since sought legal advice about suing the clinic, according to the Sunday Times. Dr Kamal Ahuja, director of the London Women's Clinic, said that they almost had a similar case two years ago - they were about to implant embryos into a woman when they discovered she had lied to them about her husband's consent. 'We were almost hoodwinked and I would imagine this is not rare', he said.
The current situation is in stark contrast to that of Natallie Evans, the UK woman who last year lost her European court appeal to use stored frozen embryos against the wishes of her former partner. Ms Evans underwent IVF with Howard Johnston in 2001, before Ms Evans had treatment for ovarian cancer that left her infertile. Mr Johnston later withdrew his consent for the six embryos to be used when the couple split up. In April 2007, the Grand Chamber of the European Court ruled unanimously that there had been no breach of the right to life (Article 2) of the European Convention on Human Rights. On the right to respect for private and family life (Article 8) and the prohibition of discrimination (Article 14), the judges ruled 13 to four against Ms Evans.

Test-Tube Babies Start Inside Mom, Thanks to Anecova Silicon Womb

Human trials are about to begin on a new device that goes inside a woman's body for up to four days, holding fresh IVF embryos in place like an artificial fallopian tube. Developed by Swiss company Anecova, the 5mm-long "silicon womb" is pierced with hundreds of 40-micron holes, the better to expose the embryos to the natural environment of the uterus, rather than having to be developed artificially in an incubator. Scientists hope this will improve the chances of successful pregnancy from in-vitro fertilization.

Billiards

The Heart-Warming Story About A Little Girl & Her Goldfish

Sperm damage 'passed to children'

Sperm defects caused by exposure to environmental toxins can be passed down the generations, research suggests. Scientists say fathers who smoke and drink should be aware they are potentially not just damaging themselves, but also their heirs. Tests on rats showed sperm damage caused by exposure to garden chemicals remained up to four generations later. The US study was presented to the American Association for the Advancement of Science (AAAS). It suggests that a father's health plays a greater role in the health of future generations than has been thought. A team from the University of Idaho in Moscow tested the effects of a hormone-disrupting fungicide chemical called vinclozolin on embryonic rats. The chemical altered genes in the sperm, including a number associated with human prostate cancer. Rats exposed to it show signs of damage and overgrowth of the prostate, infertility and kidney problems.The defects were also present in animals four generations on. The scientists admitted that the rats were exposed to very high levels of vinclozolin.

But they argued that their work shows that once toxins cause defects in sperm they can be passed down the generations. Professor Cynthia Daniels, from Rutgers University in New Jersey, said men who drank a lot of alcohol had been shown to have increased rates of sperm defects; and nicotine from tobacco found its way into seminal fluid as well as blood.Professor Daniels said: "We need to open up our eyes and look at the evidence. "My advice to young couples would be moderation. Substances that have an impact on reproduction are often also carcinogenic. "If I was a young man I would not drink very heavily and not smoke two packets of cigarettes a day while I was trying to conceive a child."

Professor Neil McClure, a fertility expert at Queen's University Belfast, UK, said the DNA in sperm cells was more tightly packed than in other cells, and so, to some extent, was protected from damage. However, once sperm cell DNA was damaged, it had no mechanism by which to effect repairs. He said: "There is no doubt that if you smoke like a chimney or drink vast amounts of alcohol it will result in sperm damage, and probably damage in the DNA of the sperm. "My advice to any man trying for a baby would be to lead as healthy a lifestyle as possible."

The Great Indian "i-store" rush

There's a huge push in India right now by Reliance Digital to open 60 iStores across the nation's top twenty cities. The iStores will sell Apple products exclusively, and carry the full line, from consumer products to pro hardware.

Expect to see all sixty stores up and running within the next 18 months. We wonder how the interior design will look, and if it will resemble official Apple Stores.

If you visit one of these stores, please let us know! We'll be happy to share your photos and stories. More so, because we are an exclusive "Apple" clinic!

Aquafit Gymnasium-Spa Hybrid is Watery, Ironic

Apparently, sitting at your chair all day whilst blogging about gadgets is not supposed to be so good for your health. That's where Dimension One Spas' Aquafit 19 Dual Temp comes in. The $40,000 gymnasium/spa allows users to have a full, underwater cardiovascular workout by using the included rower, tricep pull down and simulated jogger or swimming facilities.

The exercise area maintains the water temperature at levels that are ideal for the body's thermoregulation during an intensive workout, whilst the spa area heats up to get things steamy and soothing. Additionally, the spa area is positioned so close to the gymnasium portion of the tub, you won't have to expend any more calories than is necessary to get there, which is kind of ironic for a gym. So ironic, it's giving us muscle ache just thinking about it.

A step towards three-parent babies?

Scientists at the University of Newcastle are developing a technique that they hope will enable women with a group of devastating hereditary illnesses - known as mitochondrial diseases - to have children without passing on their genetic disorders. Because the method involves sperm from one man and two eggs from different women it has been dubbed by the press as the creation of 'three-parent' embryos.
Mitochondria are tiny structures that provide cells with energy. Every cell in the body has between 1000 and 10,000 mitochondria. Whilst the vast majority of a cell's DNA is contained inside its nucleus, a handful of genes are found in the mitochondria - just 37 genes out of around 25,000 genes in total. Mutations in mitochondrial genes cause a range of disorders that affect one person in every 6,500 and include fatal liver failure, stroke-like episodes, blindness, deafness, diabetes and forms of epilepsy and muscular dystrophy. Sperm do not contribute any mitochondria to the embryo (as they are all present within the tail, which falls off after fertilisation) and, consequently, children inherit all their mitochondrial genes from their mother.
The Newcastle researchers are working on a technique that takes the DNA from the nucleus of a newly-fertilised egg, and transplants it into an egg from another woman which has had all of its nuclear DNA removed. The resulting embryo would have mitochondria from one woman, but its remaining 25,000 or so genes would come from the mother and father who provided the fertilised egg. In this way, a mother could have a child without passing on her faulty mitochondrial genes.
The work is as yet unpublished, but at a recent scientific meeting of the researchers reported successful transplants in ten embryos, which were then grown in the laboratory for five days before they were destroyed. However, all these experiments were done by exchanging DNA between two 'failed' embryos left-over from IVF, which have abnormal amounts of nuclear DNA and so are inappropriate for implantation. It is not yet known if the technique will work with healthy embryos and eggs, although experiments in mice have been successful. Team leader Professor Patrick Chinnery said: 'there are still a number of scientific issues we've got to resolve, in terms of efficiency, and in terms of whether we can do this in eggs rather than in other embryos'.

Egg-Sperm Interaction

The present era of infertility management is characterized by an increasing interest in defects of sperm-egg interactions. When the spermatozoon meets the egg, it must first react with the enveloping coat which controls sperm access to the cell surface of the oocyte. Adequate sperm motility is a major condition for penetration through the egg investments. The ability of spermatozoa to respond to physiological stimuli by a timely acrosome reaction is another necessary prerequisite for this event, as well as for sperm fusion with the oocyte.
A precise understanding in the functional competence of mammalian sperm is essential to generate clinical advances for the treatment of infertility and novel contraceptive strategies. The fundamental knowledge on the controlling parameters for spermatozoal activation process will help in the identifying the causes in fertilization failure due to male factor as well as in developing male contraceptive methodologies. The defects in the sperm-egg interaction seem to be one of the controlling mechanisms, however, none of the presently available methods for the evaluation of the fertilizing ability of sperm precisely indicates the reason for the failure or the success of sperm entry into egg. Adequate number of motile spermatozoa with normal morphology and timely occurrence of acrosome reaction are presumably the major prerequisites for the penetration through the egg investments.
Fertilization is the sum of the cellular mechanisms that pass the genome from one generation to the next and initiate development of a new organism. A typical, ovulated mammalian egg is enclosed by two layers: an outer layer of ~5000 cumulus cells and an inner, thick extracellular matrix, the zona pellucida. To reach the egg plasma membrane, sperm must penetrate both layers in steps requiring sperm motility, sperm surface enzymes, and probably sperm-secreted enzymes. Sperm also bind transiently to the egg zona pellucida and the egg plasma membrane and then fuse. Signaling in the sperm is induced by sperm adhesion to the zona pellucida, and signaling in the egg by gamete fusion. The gamete molecules and molecular interactions with essential roles in these events are gradually being discovered.

Printed Toilet Paper Flushes Humanity Down the Tubes, Again

This toilet paper printed with manga, trivia and astronomy facts has the potential to change civilization as we know it, affecting generations to come and catapulting Humanity to the Stars. Or maybe destroy the planet. It can go either way, really. It's Japan-only for now, but we demand this ingenious way to educate millions of people while disposing off their metabolism byproducts- gets marketed worldwide at once. And yes, the porn version is probably coming sooner than later.

Sweetner Shocker

Using an artificial, no-calorie sweetener rather than sugar may make it tougher, not easier, to lose weight, U.S. researchers said Sunday. Scientists at Purdue University in West Lafayette, Indiana, studied rats that were fed food with the artificial sweetener saccharin and rats fed food with glucose, a natural sugar. In comparison to rats given yogurt sweetened with glucose, those that ate yogurt sweetened with saccharin went on to consume more calories and put on more weight and body fat.
The researchers said sweet foods may prompt the body to get ready to take in a lot of calories, but when sweetness in the form of artificial sweeteners is not followed by a large amount of calories, the body gets confused, which may lead to eating more or expending less energy than normal. "The data clearly indicate that consuming a food sweetened with no-calorie saccharin can lead to greater body-weight gain and adiposity than would consuming the same food sweetened with high-calorie sugar," Purdue researchers Susan Swithers and Terry Davidson wrote in the journal Behavioral Neuroscience, published by the American Psychological Association. "Such an outcome may seem counterintuitive, if not an anathema, to human clinical researchers and health care practitioners who have long recommended the use of low- and no-calorie sweeteners as a means of weight control." Other artificial sweeteners such as aspartame that also taste sweet but do not lead to the delivery of calories may have similar effects, the researchers said.

"Animals may use sweet taste to predict the caloric contents of food. Eating sweet noncaloric substances may degrade this predictive relationship," the researchers wrote. "With the growing use of noncaloric sweeteners in the current food environment, millions of people are being exposed to sweet tastes that are not associated with caloric or nutritive consequences," the researchers added. The research was the latest to examine the question of whether artificial sweeteners -- used in many soft drinks and other foods — help or thwart those trying to lose weight. Various studies have offered mixed results.

The new research drew criticism from the food industry. "This study oversimplifies the causes of obesity," Beth Hubrich, a dietitian with the Calorie Control Council, an industry association representing companies that make low- and reduced-calorie foods and beverages, said in a statement. "The causes of obesity are multi-factorial. Although surveys have shown that there has been an increase in the use of 'sugar-free' foods over the years, portion sizes of foods have also increased, physical activity has decreased and overall calorie intake has increased," Hubrich added.

Any comments ye blogeurs?

Ten years' pain, 15 IVF attempts, £64,000... One Miracle

A British couple are celebrating the birth of a baby girl after ten years of trying to conceive using IVF, at an estimated cost of about £64,000. Their daughter, Olivia, was conceived on the couple's 15th attempt at IVF and was born last month.
Delina and Simon Tree, who are both 40 years old and from Sevenoaks in Kent, were told that they only had approximately a five per cent chance of success with IVF, due to the number of treatments they had previously had. Despite this, they kept on trying, and theirs is now thought to be one of the longest 'IVF marathons' to have ever taken place in the UK. According to fertility experts, most couple will either conceive on the fifth or sixth attempt or will give up trying, and seek alternatives, at about the same point.
The couple originally turned to IVF after Mrs Tree had had to have a Fallopian tube removed after a natural pregnancy was ectopic. She has since been examined by dozens of consultants across the country and none of them have been able to explain why her eggs, fertilised outside the body with her husband's sperm, had failed to develop once they had been re-implanted. Mrs Tree was encouraged by their family doctor to undergo a 15th IVF cycle last year. 'For the first four months I was terrified', she said. 'When friends congratulated me it didn't sink in. I would even go for extra private scans to make sure that the baby was OK', she added.
During the couple's extended period of treatment, which required them to remortgage their house - twice - and work lots of extra hours as overtime in order to be able to pay for it, they previously conceived, but suffered an early miscarriage, and also looked into adoption as an alternative. Delina Tree said all their efforts had been totally worthwhile: ' All that time, effort and money was definitely worth it in the end', she said, adding: 'We are so happy'.
The couple hope that 'going public' with their experiences will give encouragement to other couples undergoing IVF, particularly those who may be feeling disillusioned after a failed attempt. Each time they were unsuccessful - at a cost of about £4,000 - they felt that they were 'pouring money down the drain', said Mrs Tree. She explained that the couple had taken out bank loans, remortgaged, asked their parents for money and that she had stayed in a job she hated and that her husband, a carpenter, had 'worked evenings and weekends just so we had enough money for the IVF'.

Valentines Day

Sperm Washing

If you are having difficulties becoming pregnant, you may have decided to try certain fertility treatments in order to increase your chances of conceiving. Intrauterine insemination (IUI) is often the first type of fertility treatment attempted by couples. In order to get sperm ready for the IUI procedure, it must first be washed. Sperm washing may sound strange, but it actually works to ensure that only the healthiest sperm are used during the procedure. Sperm washing can increase your chances of conception and may help you to welcome a new addition to your family. Sperm washing is a procedure used to prepare sperm for use in IUI. It allows your partner’s sperm a better chance for survival and fertilization. Sperm washing separates sperm cells from a man’s semen, helping to get rid of dead or slow-moving sperm as well as additional chemicals that may impair fertilization. Once sperm has been washed at your fertility clinic’s laboratory, it can be used during IUI to help achieve pregnancy. There are a variety of different sperm washing procedures.

Sperm must be washed in order to be used with IUI. Raw semen cannot be inserted directly into a woman’s uterus. This is because semen contains chemicals called prostaglandins. Prostaglandins cause muscular contractions and are responsible for cramps during menstruation and pregnancy. If raw semen is inserted directly into your uterus, rather than going through the cervix first, it could cause severe pain and cramping. It could also cause your uterus to collapse, causing severe complications.
Sperm is also washed in order to increase your chances of becoming pregnant. Sperm washing can remove dead sperm and those sperm with poor motility. This leaves behind sperm that can swim faster and that are more likely to fertilize your egg. Sperm washing can also get rid of the white blood cells, mucous and seminal fluid surrounding the sperm, which can also interfere with fertility.

Anyone who pursues IUI will receive the sperm washing procedure. However, the procedure can also benefit others, especially those with:

-unexplained infertility
-male-factor infertility
-women with endometriosis
-men with antisperm antibodies


The sperm wash procedure is actually relatively easy to prepare for. Your semen will be collected after you masturbate, or from a sample taken during surgical sperm retrieval. It is important to refrain from sexual intercourse for two days before your sperm is collected. However, do not go more than five days without intercourse. Certain antibiotics may also affect the quality of your sperm, so speak with your fertility physician if you are taking any medications.

There are three commonly-used sperm washing techniques:

Simple Sperm Wash
The simple sperm wash technique is the most basic way of washing and preparing sperm for IUI. Semen is diluted in a test tube with a special solution of antibiotics and protein supplements. It is then placed in a centrifuge, a machine that spins around at extremely high speeds. As the sperm mixture is spun, sperm cells fall to the bottom of the test tube, producing a mass of dense, highly active sperm. These sperm can then be removed from the test tube and used in IUI. A simple sperm wash takes about 20 to 40 minutes.

Density Gradient Sperm Wash
The density gradient sperm wash is one of the most popular sperm washing methods. This is because it also works to separate dead sperm cells, white blood cells, and other waste products from the sperm. A test tube is filled with multiple layers of liquids of different densities. Semen is then placed on the top layer of liquid and the test tube is spun in a centrifuge. After it is spun, active, healthy sperm will make their way to the very bottom layer of liquid in the test tube, while debris and dead sperm will get caught in the top two layers. These layers can be siphoned off in order to remove the active sperm from the test tube. This sperm is then used in the IUI procedure. Density gradient sperm washes take approximately 60 minutes.

Swim Up Technique
The swim up technique is rapidly becoming more and more popular throughout Indian fertility clinics. This technique revolves around the fact that sperm need to swim forwards and up in order to reach the uterus. Only the most powerful sperm will be able to do this. In order to retrieve this powerful sperm, semen is placed in a culture dish with a layer of media culture. Sperm are attracted to this culture, and will swim up to it. As the sperm swim up to the culture, they are collected. This technique takes about an hour in order to harvest enough sperm for use in IUI.

Success Rates
Success rates do increase when sperm washing is used with IUI. Because sperm washing ensures that only the most healthy and active sperm are used for fertilization, there is an increased chance that you will become pregnant when using washed sperm. However, success rates do depend on your partner’s overall sperm count. Typically, the lowest sperm count to be used with sperm washing is one million, however, success rates are significantly lower if your sperm count falls beneath five to ten million. The best sperm counts for use with sperm washing are those between 20 and 30 million.

Cost of the Procedure
The cost of sperm washing in itself is relatively low. A basic sperm wash typically costs only Rs.3000 or so. If you opt for one of the more advanced forms of sperm washing, it could cost you up to Rs.10000. However, sperm washing is only of use when combined with other fertility treatment procedures. One session of natural IUI typically costs under Rs.3000 while IUI with the use of fertility drugs and monitoring can cost anywhere between Rs 8000 and Rs 10,000.

Egg Quality

A common cause of infertility in women is poor egg quality. Poor egg quality does not have to be the end of your chances for pregnancy – a variety of unique fertility treatments are available to help you achieve your pregnancy. All women have a finite number of eggs in their body which, when released during ovulation, can be fertilized to produce a child. Most people believe that all that matters when you are trying to get pregnant is the number of eggs you have – as long as you have a lot of eggs, you’ll get pregnant. Unfortunately, this is not the case. True, the number of eggs that you have does matter, but so does the quality of those eggs. Together, the number and quality of your eggs are referred to as your ovarian reserve. Egg quality refers to how prepared your eggs are to develop into embryos once they are fertilized. In order to be healthy enough to develop, an egg needs to have the proper chromosomes and the ability to combine those chromosomes with sperm. Some eggs in your body just don’t have the right number of chromosomes, making it impossible to have a successful pregnancy.

The eggs in your ovaries also need energy in order to split after fertilization. Your eggs contain mitochondria, which are tiny cell organelles that provide the energy for the egg. Without mitochondria, your egg wouldn’t have the energy to survive. As you age, these mitochondria produce less and less energy. As a result, any egg that is fertilized will eventually run out of energy and will be unable to divide.

Egg quality is greatly affected by your age. In your 20s and early 30s, you should have a large number of good quality eggs available for fertilization. Yes, you will have a few bad eggs too, but the good ones should vastly outweigh them. However, as you age your eggs will begin to decline in quality as well as in number. By the time you are in your late 30s or early 40s, you will probably have more poor quality eggs available than good quality eggs.

However, you don’t have to be over the age of 40 to have poor quality eggs. Some younger women can also have a poor ovarian reserve, either as a result of health problems or genetics. In particular, smoking, radiation therapy, and chemotherapy have been known to cause eggs to decline in health. If you suffer from endometriosis, you may also find that your egg quality is poorer than you would like it to be.

Egg quality has a huge impact on your fertility. If you have poor quality eggs, you will probably have a difficult time getting pregnant and staying pregnant. The impact of poor quality eggs is reflected in the general decline in pregnancy rates as women age. Women between the ages of 15 and 25 have a 40% chance of conceiving every cycle. Women who are over 40 however, have less than a 25% chance of becoming pregnant naturally. This is due to the fact that women who are older tend to have fewer eggs and eggs of a poorer quality. Poorer quality eggs can be one of the major causes of infertility in a number of ways. Firstly, poor quality eggs can make conceiving a child very difficult. If a baby is conceived, a poor quality egg can make the difference between carrying your baby to term or losing it in the first few weeks. Many poor quality eggs do not implant properly into the uterus once they are fertilized. Others implant properly but are simply not healthy enough to grow and divide, resulting in a miscarriage.

If you think you may be struggling with fertility issues, it is important to get checked out by a health care professional. In particular, you should probably make sure that your eggs are healthy and of a good quality. Women who are struggling with infertility and are over the age of 37 are usually tested for this.t is difficult to determine the quality of an egg simply by looking at it. Doctors usually have to implant the egg using in vitro fertilization to see whether it will grow or not. However, there is fertility testing to determine if you may be suffering from poor egg quality. Typical tests that evaluate your egg equality include:
Day 2/ 3 FSH Test: Measures your levels of FSH. Elevated levels may indicate poor egg quality.
Clomid Challenge Test (CCCT): The clomid challenge test is a blood test.

If you are suffering from poor egg quality there are a variety of fertility treatments that you can pursue to help you to conceive. Just because you have poor quality eggs does not mean that it is impossible for you to become pregnant. Using fertility drugs is one way to possibly increase the quantity and quality of your eggs. Typical female infertility drugs include clomiphene and cabergoline. In vitro fertilization is another treatment option. However, if your eggs are of too poor quality, you may be encouraged to use an egg donor.

Research into improving egg quality is ongoing. One treatment currently in the trial phase is cytoplasmic transfer. This form of treatment involves putting cytoplasm (the watery, outside layer of a cell) from a healthy donated egg into a poor quality egg in order to help it divide. Nuclear transfer is another form of treatment currently under investigation. Nuclear transfer involves taking a healthy nucleus from a donated egg and transferring it into an egg with an unhealthy nucleus. This helps to improve the quality of the egg thereby increasing the chances of conception occurring. Though neither of these procedures are currently available to the general public, there is hope that they may come to fertility clinics in the near future.

Role of the mitochondrial genome in assisted reproductive technologies

Mitochondria play a pivotal role in cellular metabolism and are important determinants of embryonic development. Mitochondrial function and biogenesis rely on an intricate coordination of regulation and expression of nuclear and mitochondrial genes. For example, several nucleus-derived transcription factors, such as mitochondrial transcription factor A, are required for mitochondrial DNA replication. Mitochondrial inheritance is strictly maternal while paternally-derived mitochondria are selectively eliminated during early embryonic cell divisions. However, there are reports from animals as well as human patients that paternal mitochondria can occasionally escape elimination, which in some cases has led to severe pathologies. The resulting existence of different mitochondrial genomes within the same cell has been termed mitochondrial heteroplasmy. The increasing use of invasive techniques in assisted reproduction in humans has raised concerns that one of the outcomes of such techniques is an increase in the incidence of mitochondrial heteroplasmy. Indeed, there is evidence that heteroplasmy is a direct consequence of ooplasm transfer, a technique that was used to 'rescue' oocytes from older women by injecting ooplasm from young oocytes. Mitochondria from donor and recipient were found in varying proportions in resulting children. Heteroplasmy is also a byproduct of nuclear transfer, as has been shown in studies on cloned sheep, cattle and monkeys. As therapeutic cloning will depend on nuclear transfer into oocytes and the subsequent generation of embryonic stem cells from resulting blastocysts, the prospect of mitochondrial heteroplasmy and its potential problems necessitate further studies in this area.

The Newspaper Article Is Funnier Than The Signboard

Present-day Love Story

Rotunda Management Meetings

Hi friends, we are rushing towards another weekend and also on the cusp of getting our fresh re-certification audit done for the ISO 9001-2000 standards for our clinic. Everyone is working hard towards the goal. Just found a nice cartoon in NY times about our management meetings.
Have a nice weekend, folks.

Lab on a Chip Medical Breakthrough

It's common knowledge that to carry out genetic tests, one would need expensive, state-of-the-art laboratory. But that might soon change thanks to a group of Canadian scientists who've developed a "lab-on-a-chip" device to conduct these tests. What is interesting about the device is that it's supposed to be portable, inexpensive, and efficient.

Hailing from the University of Alberta; Professor Christopher Backhouse and Professor Linda Pilarski (Department of Oncology), along with research student, Govind Kaigala, have developed a $1,000 device the size of a shoebox that can conduct genetic tests and deliver results in less than half an hour.

Elaborating on the innovation, the researchers said that miniaturization is the key factor that has drastically brought down the cost of this gadget.

The Canadian Press quoted Professor Backhouse as saying that like computers, which in their early days, were inaccessible; somewhat like million-dollar beasts who formed a roomful, yet one needed a Ph.D. to to be able to operate one of them.

Similarly, the Professor said Life Science technologies do exist but aren't being utilized optimally because they're very expensive. Hence, the key to this mini-laboratory was to integrate, shrink, and automate. The ability of the device to implement a very wide range of tests on a standard platform quickly and inexpensively would make it indispensable for the future.

The research team believes that their miniature lab-on-a-chip will provide Cancer patients with quick genetic tests, in turn speeding up treatment processes. The team also believes the device may be useful in finding genetic signatures for particular viruses or bacteria or for testing the quality of water, and so on.

Sperm From Female Stem Cells

British scientists have created early-stage, human sperm from female stem cells, according to a news report in New Scientist magazine. It is claimed that the research will pave the way for same sex couples to have children that are genetically their own. However, other scientists are sceptical that this procedure would ever be possible.
Professor Karim Nayernia at the University of Newcastle initially fertilised mice with sperm derived from embryonic stem cells (ESCs) in 2006, which gave rise to seven pups, six of which survived. In more recent work, he took human male stem cells from bone marrow and formed 'spermatogonia', primitive sperm cells that can form mature sperm cells by going through a process called meiosis. Nayernia has now apparently done the same using human female stem cells, work that has yet to be published.
The next stage in the process would be to make these primitive sperm cells undergo meiosis, which Nayernia claims he has started to do. The result could be that female eggs are fertilised by 'female' sperm, thereby eradicating the need for male gametes. However, Dr Robin Lovell-Badge, a stem cell expert at the National Institute of Medical Research in London, does not think the approach will work. He told the Telegraph newspaper that the 'presence of two X chromosomes is incompatible with this. Moreover they need genes from the Y chromosome [from the male sperm] to go through meiosis. So they are at least double damned'. Safety issues have also been raised, since the mice pups in Nayernia's initial study had health problems.
A Brazilian team of scientists lead by Dr Irina Kerkis at the Butantan Institute in Sao Paolo also claim to have made sperm and eggs from male mouse ESCs, and are currently starting to take the work into human cells. The research brings hope to people dealing with infertility, a problem that affects one in six couples, although scientists say the process is still in its infancy and treatments are a long way off.
There is also potential to use 'induced pluripotent stem cells', stem cells derived from human skin cells, as a starting point for the process. This could enable gay men to donate skin cells that would be used to create stem cells from which eggs could be formed. The eggs could then be fertilised using sperm from his partner, and placed in a surrogate mother.
Greg Aharonian, a patent analyst in the US, is trying to patent the technology behind 'female' sperm and 'male' eggs. A self-proclaimed 'troublemaker', he wants to undermine the argument that marriage should remain heterosexual because its main purpose is procreation.
The controversial developments have provoked mixed responses in the UK and US. Mike Judge from the Christian Institute faith group says that 'children need male and a female role models'. Many religious groups still oppose gay marriage. Josephine Quintavalle, from the pro-life lobby group Comment on Reproductive Ethics, says: 'we are looking at absurd solutions to very obscure situations and not addressing the main issue. Nobody is interested in looking at what is causing infertility - social reasons such as obesity, smoking and age'.

Less Dud, More Stud Sperms

The University of Michigan's sperm sorter consists of a penny-size silicon chip divided into two channels. Semen is dripped onto one side, a saline solution on the other. Where the channels meet, the healthy, or motile, sperm swim over to the saline channel, leaving the dead or slow sperm behind. The healthy sperm are then collected for in vitro fertilization. University of Michigan scientists have developed a new technique to sort out the swimmers from the duds in semen, which could lead to a more efficient way for men who suffer from low sperm counts to make babies.

Current methods use centrifugation, which spins the sperm at very high speed. But the technique isn't efficient because live sperm are pelted with dead ones, causing a significant number of viable sperm to die in the separation. "We can harvest motile sperm from samples where there is a low number without causing any damage to the sperm," said team member Dr. Gary Smith, associate professor of obstetrics and gynecology at the University of Michigan Health System.

In men with healthy sperm counts, each ejaculation contains about 200 million to 400 million sperm. For these men, in vitro fertilization using centrifugal separation is relatively easy because it only takes 10 million to 20 million motile sperm to fertilize an egg in a petri dish. But men with low sperm counts have had less success. "For men with very low sperm count, these other techniques are often unable to recover any motile sperm," said Shuichi Takayama, assistant professor in the Biomedical Engineering program at the University of Michigan, where the new sorter is being developed. Other methods to pinpoint live sperm in a low sperm sample require a microscope and a lot of patience. The new sperm sorter may put an end to this laborious hand sorting. "It may mean that instead of having a well-trained technician, you could have one that is not so well-trained," said Dr. Mark Surrey, of the Southern California Reproductive Center in Beverly Hills.

So far the sorter has fared well in trials. In one test the team used a sample in which only 44 percent of the sperm was motile. After going through the sorter, the count of motile sperm went up to 98 percent. The sorter employs microfluidics, a branch of physics and biotechnology that examines the microscopic flow of fluids. Within the device everything is pushed downstream by gravity and surface tension. The Michigan team notes, however, that more tests are needed before the sorter becomes a mainstay in doctors' offices. Smith said he expects it will be ready for clinical use in one to two years.

Swiss experts say individuals with undetectable viral load and no STI cannot transmit HIV during sex

Swiss HIV experts have produced the first-ever consensus statement to say that HIV-positive individuals on effective antiretroviral therapy and without sexually transmitted infections (STIs) are sexually non-infectious. The statement is published in this week’s Bulletin of Swiss Medicine (Bulletin des médecins suisses). The statement also discusses the implications for doctors; for HIV-positive people; for HIV prevention; and the legal system.

The statement’s headline statement says that “after review of the medical literature and extensive discussion,” the Swiss Federal Commission for HIV / AIDS resolves that, “An HIV-infected person on antiretroviral therapy with completely suppressed viraemia (“effective ART”) is not sexually infectious, i.e. cannot transmit HIV through sexual contact.”

It goes on to say that this statement is valid as long as: the person adheres to antiretroviral therapy, the effects of which must be evaluated regularly by the treating physician, and the viral load has been suppressed (< 40 copies/ml) for at least six months, and there are no other sexually transmitted infections.

The article begins by stating that the Commission “realises that medical and biologic data available today do not permit proof that HIV-infection during effective antiretroviral therapy is impossible, because the non-occurrence of an improbable event cannot be proven. If no transmission events were observed among 100 couples followed for two years, for instance, there might still be some such events if 10,000 couples are followed for ten years. The situation is analogous to 1986, when the statement ‘HIV cannot be transmitted by kissing’ was publicised. This statement has not been proven, but after 20 years’ experience its accuracy appears highly plausible.”

For example, they note, Quinn and colleagues found that in sero-discordant couples the risk of transmission depended on the viral load of the HIV-positive partner, and refer also to a prospective study of 393 heterosexual sero-discordant couples from Castilla and colleagues found that there were no infections among partners of persons on antiretroviral therapy, compared to a rate of transmission of 8.6% among partners of untreated patients. They also note that transmission from mother to newborn also depends on the maternal viral load, and can be avoided by taking antiretroviral therapy.

They go on to assert that effective antiretroviral therapy eliminates HIV from genital secretions. They say that HIV RNA, measured in sperm, declines below the limits of detection on antiretroviral therapy, and that HIV RNA is also below the limits of female genital secretions is, as a rule, during effective antiretroviral therapy. “As a rule,” they write, “it rises after, not before, an increase in plasma viral load.” They also assert that although cell-associated viral genomes are present in genital secretions, even on antiretroviral therapy, these are not infectious virions since “HIV-containing cells in sperm lack markers of viral proliferations such as circular LTR-DNA.”

They note that the concentration of HIV RNA in sperm correlates with the risk of transmission and that “transmission risk declines towards zero with falling sperm viral load. These data indicate that the risk of transmission is greatly decreased by antiretroviral therapy.”

They add, however, several exceptions and caveats to the above statements:
After a few days or weeks of discontinuation of antiretroviral therapy, plasma viral load rises rapidly. There is at least one case report of transmission during this rebound.

In patients not on treatment, STIs such as urethritis or genital ulcer disease increase the genital viral load; it falls again after the STI is treated.

In a patient with urethritis, sperm viral load can rise slightly even while the patient is receiving effective treatment. This rise is small, however, much smaller that the rise observed in patients not on treatment.

They conclude the scientific part of the article by saying that: “During effective antiretroviral therapy, free virus is absent from blood and genital secretions. Epidemiologic and biologic data indicate that during such treatment, there is no relevant risk of transmission. Residual risk can not be scientifically excluded, but is, in the judgment of the Commission, negligibly small.”

Implications for doctors
The Commission then discusses the implications for doctor-patient discussions. It says, "the following information aims to communicate to doctors criteria allowing them to establish whether or not a patient can sexually transmit HIV.

HIV cannot be transmitted sexually if:
The HIV-positive individual takes antiretroviral therapy consistently and as prescribed and is regularly followed by his/her doctor.

Viral load is ‘undetectable’ and has been so for at least six months

The HIV-positive individual does not have any STIs."


Implications for HIV-positive people
The Commission states that an HIV-positive person in a stable relationship with an HIV-negative partner, who follows their antiretroviral treatment consistently and as prescribed and who does not have an STI, is "not putting their partner at risk of transmission by sexual contact."

"Couples must understand," they write, "that adherence will become omnipresent in their relationship when they decide not to use protection, and due to the importance of STIs, rules must be defined for sexual contacts outside of relationship."

"The same goes for people who are not in a stable relationship," they add. However due to the importance of STIs, use of condoms is still recommended.

They add that heterosexual women will have to consider eventual interactions between contraceptives and antiretrovirals before considering stopping using condoms.

They also say that insemination via sperm washing is no longer indicated when "antiretroviral treatment is efficient."

Implications for HIV prevention
The Commission says that it "is not for the time being, considering recommendations that HIV-positive individuals start treatment purely for preventative measures." Aside from the cost involved, they argue, it cannot be certain that HIV-positive people would be sufficiently motivated to follow, and apply to the letter, antiretroviral treatment on a long-term basis without medical indications. They note that poor adherence is likely to facilitate the development of resistance, and that, therefore, antiretroviral therapy as prevention is indicated only in "exceptional circumstances for extremely motivated patients."

The Commission also says that their statement should not change prevention strategies currently taking place in Switzerland. With the exception of stable HIV-positive couples where HIV-positivity and the efficacy of antiretroviral therapy can be established, measures to protect oneself must be followed at all times. "People who are not in a stable relationship must protect themselves," they note, "as they would not be able to verify whether their partner is positive or on efficient antiretroviral therapy."

Honour for creator of Dolly the sheep ‘is insult to science’

Former colleagues of Sir Ian Wilmut, the scientist widely credited as the creator of Dolly the cloned sheep, have called for the Queen to revoke his knighthood, describing the honour as an insult.

In a petition to Buckingham Palace, four former employees of the Roslin Institute, near Edinburgh, allege that Sir Ian is a “self-confessed charlatan” who “apparently lacks adequate scientific understanding”. The petition urges the Queen to “withhold, recall or reduce the Royal Assent from the knighthood of Professor Ian Wilmut”.

A letter adds: “We do feel very bitter that not only has our own work not been fully recognised but we appear to have been used . . . Wilmut’s knighthood is seen as the crowning insult to honest endeavour.”

Sir Ian, 63, who won global acclaim after being credited in 1996 with creating Dolly, the first mammal to be cloned from an adult cell, was knighted in the New Year Honours for services to science. His former colleagues claim that their objections to the knighthood are shared by numerous others. They add: “Roslin, the University of Edinburgh and Scotland are all tarnished with this grant. We beg reconsideration.”

The petition is signed by Prim Singh, a molecular biologist with a history of conflict with Sir Ian; Jeremy Brown, a former research scientist at Roslin; Pauline Ward, a former bio-informatician at the institute; and Douglas Currie, managing director of Roslin Nutrition, a private research company.

At an employment tribunal in 2006, Dr Singh claimed that he had been racially discriminated against by Professor Wilmut because he was Asian. Although he lost that claim, the tribunal found that he had been unfairly dismissed as head of nuclear programming at Roslin. All his allegations against Sir Ian personally were dismissed and are the subject of an appeal. During the hearing, Professor Wilmut was asked whether the statement “I did not create Dolly” was accurate; he said it was. He said he had appeared as lead author on the paper because of an arrangment with his colleague Keith Campbell, whom he said deserved “66 per cent” of the credit.

Dr Singh told Times Higher Education yesterday: “He has admitted he isn’t the brains behind Dolly, and to then go on and award him a knighthood reflects very badly on Scottish science.”

Sir Ian, who is now director of the Scottish Centre for Regenerative Medicine at Edinburgh University, said yesterday: “I am aware of the terms of the correspondence . . . I am aware also that the Queen’s Private Secretary has indicated that this is a matter in which her Majesty would not intervene.” In a letter to Dr Singh, the Queen’s Private Secretary said that recommendations for honours were the Prime Minister’s responsibility and the petition had been referred to the Cabinet Office.

Chimera embryos have right to life, say bishops

Human-animal hybrid embryos conceived in the laboratory - so-called “chimeras” - should be regarded as human and their mothers should be allowed to give birth to them, the Roman Catholic Church said yesterday. Under draft UK Government legislation to be debated by Parliament later this year, scientists will be given permission for the first time to create such embryos for research as long as they destroy them within two weeks. But the Catholic bishops of England and Wales, in a submission to the Parliamentary joint committee scrutinising the draft legislation, said that the genetic mothers of “chimeras” should be able to raise them as their own children if they wished.The bishops said that they did not see why these “interspecies” embryos should be treated any differently than others.

The wide-ranging draft Human Tissue and Embryo Bill, which aims to overhaul the laws on fertility treatment, will include sections on test tube babies, embryo research and abortion. Ministers say that the creation of animal-human embryos - created by injecting animal cells or DNA into human embryos or human cells into animal eggs - will be heavily regulated.They insist that it will be against the law to implant “chimeras” - named after the mythical creature that was half man and half animal - into a woman’s womb. The bishops, who believe that life begins at conception, said that they opposed the creation of any embryo solely for research, but they were also anxious to limit the destruction of such life once it had been brought into existence.

In their submission to the committee, they said: “At the very least, embryos with a preponderance of human genes should be assumed to be embryonic human beings, and should be treated accordingly.

“In particular, it should not be a crime to transfer them, or other human embryos, to the body of the woman providing the ovum, in cases where a human ovum has been used to create them.

“Such a woman is the genetic mother, or partial mother, of the embryo; should she have a change of heart and wish to carry her child to term, she should not be prevented from doing so.”

The draft Bill will also allow the screening of embryos for genetic or chromosomal abnormalities that might lead to serious medical conditions, disabilities, or miscarriage. It will permit doctors to check whether an embryo could provide a suitable tissue match for a sibling suffering from a life-threatening illness.

The Bill would abolish the requirement for fertility clinics to consider the need for a father when deciding on treatment. This means clinics will no longer be able to deny treatment to lesbians and single mothers.

The Catholic bishops said that most of the procedures covered by the Bill “should not be licensed under any circumstances”, principally on the grounds that they violate human rights.

Ooplasmic Transfer

Ooplasmic transfer is an experimental fertility technique that involves injecting a small amount of ooplasm from eggs of fertile women into eggs of women whose fertility is compromised. The modified egg is then fertilized with sperm and implanted in the uterus of the woman attempting to achieve pregnancy.

Children born from this procedure have been reported to possess cytoplasmic organelles called mitochondria from both their biological mother and the ooplasmic donor, a condition referred to as mitochondrial heteroplasmy. Because mitochondria carry their own sets of genes that are passed on to succeeding generations, the mixing of parent and cytoplasmic donor mitochondria might be considered to be a form of germline modification. However, the technique does not involve modification of particular genes and could not be used as part of any procedure to create "designer babies."

In 2001, researchers at St. Barnabas Hospital in New Jersey announced that they had used ooplasmic transfer to enable several women with impaired fertility to bear children. They described their work to the press as "the first case of human germline modification."

However, ooplasmic transfer is not germline genetic modification, or inheritable genetic modification (IGM), in the usual sense. It cannot be used to modify genes housed in the cell nucleus, which influence all traits except for those regulated by mitochondrial genes. But the procedure might be considered a form of IGM in that the mixed mitochondrial DNA would be passed on to all future generations.

On the other hand, some advocates of IGM have identified ooplasmic transfer as a technology whose development and use could be used to help erode popular resistance to IGM. Following the St. Barnabas announcement, the FDA notified all US fertility clinics known to be offering the procedure that further ooplasm transfer protocols could not proceed without FDA approval.

The FDA expressed concerns about this "de facto germ line gene transfer" technique, citing its potential to alter the germline, the medical risks associated with mitochondrial heteroplasmy, the high incidence of Turner's syndrome in fetuses reported in one study (2 of 13 reported pregnancies), and the paucity of animal studies and other pre-clinical data. A general consensus was reached at the meeting that more preclinical data would be necessary before FDA would allow further clinical trials involving ooplasm transfer to proceed.