Women are risking their lives to have IVF babies

Women are risking death and bankruptcy in their desperation to become mothers, according to Professor Sammy Lee, one of the country's leading experts on infertility.

Some couples going through fertility treatment are driven by an urge "stronger than addiction and more powerful than obsession", said Lee, who pioneered egg donation in the UK when he was chief scientist of the IVF programme at Wellington Hospital, London.

"The quest to have children can become a vortex that gets faster and faster and sucks people in. Women will sell everything and anything to have the treatment if they are short of funds. They will risk their lives, there's no doubt about it," said Lee, who will discuss the issue on Friday when he chairs a major conference, Motherhood in the 21st Century, at University College, London.

"I have treated young women with cancer who have refused to have treatment for their illness until they have got pregnant and given birth, knowing they are risking their lives," added Lee, who has helped some couples through 12 cycles of IVF. The maximum number of treatments provided on the NHS is three. "Some of these women do, indeed, go on to die [from the cancer], but they die happy, feeling that they have achieved something greater than their own continued existence."

He admitted that the determination of couples to have children can lead to clinicians continuing treatment when they know there is little chance of success. "Everyone involved in these scenarios is trying to do the right thing, but the extraordinary energy of a couple's determination creates a vicious circle.

"The advances of science seem to promise women everlasting hope, which means they put ever more trust and hope in the doctors.

"Clinicians, such as myself, should refuse to treat these couples because further treatment is highly unlikely to work, but after helping that couple through three IVF attempts, you can get too pulled in to insist that enough is enough. This is how couples become implicit in their own abuse. Even if you do tell them you will no longer help them, they often just go and get treatment across the street," Lee added. "Then when they get too old to be treated in this country, they go abroad. That makes them vulnerable to yet more abuse, although again, it is abuse in which they are complicit.

"These are often professional, streetwise women who know the physical, mental and financial dangers, but who are prepared to take any risk if it offers even a sliver of hope they might end up with a baby."

Infertility affects about one in seven couples – approximately 3.5 million people. Most of the women will eventually become pregnant naturally, but a significant minority will not. At least 44,000 a year undergo IVF treatment , with about 11,000 IVF babies born every year.

Rebecca Frayn, a film-maker, screenwriter and novelist, has spoken of her fears when she chose to go through IVF. "Couples undergoing IVF are set on achieving a baby at any cost, often developing a kind of wilful moral myopia about the risks in order to avoid being deflected from their goal. I know, because it happened to me," she said. "I had questions about the cancer scares associated with all the hormones I would be required to ingest.

"Liz Tilberis and Ruth Picardie, both journalists who died respectively of ovarian and breast cancer after many rounds of IVF, believed their treatment had caused and accelerated their cancers, respectively," she added. "To attempt to achieve life at the potential expense of one's own [health] is self-evidently sobering. Yet, even then, I somehow squared what I was contemplating doing with my conscience. I was in the iron grip of procreation fever."

Dr Mark Hamilton, consultant gynaecologist at Aberdeen Maternity Hospital, has treated couples who insisted on having up to 10 attempts. "The number of cycles people are prepared to have has increased in the last few years," he said.

But Dr Tony Rutherford, chairman of the British Fertility Society, said that for some patients it was necessary to exhaust all possible options. "I have patients who undergo treatment even though I've counselled them that their chance of success is less than 5%," he said.

"I also counsel couples for whom the chance of experiencing complications through IVF is equal to their chance of success, or for whom being pregnant would be very dangerous. But for many couples having the treatment becomes key in their ability to reach closure."

Warning: Baby lust can be fatal!

This week readers of the U.K. Guardian might be forgiven for thinking that baby lust has exceeded all reasonable bounds and quite possibly become a sociopathic condition. Two articles, within two days of one another, featured women for whom motherhood is quite literally a life or death proposition: The first, titled “Women Who Kill for Babies,” reviewed the cases of women who have murdered pregnant women, then stolen their fetuses from their wombs. The second, about women who risk their own lives in pursuit of an IVF pregnancy, claims that “women are risking death and bankruptcy in their desperation to become mothers.” Taken together, the two nearly scream out that we have reached the apex of the modern motherhood fetish: Dear God, women are killing and dying for babies!

But while packaged as trend stories, both pieces seem to depict situations best described as lurking on the very far margins of human behavior. The womb-robbing story, written by Diane Taylor, is in response to the recent appeal in the case of a British woman, Linda Carty, who is on death row in Texas after being convicted of abducting and murdering a young woman to steal her newborn baby. Yes, the details are grisly, as they are in most homicides. But while admitting that these cases are extremely rare, Taylor goes on to claim they seem to be a wholly modern phenomenon -- “unheard of before 1987.” How rare? Well, since 1987, Taylor can find only 13 recorded cases, 12 of which took place in the United States. Not having access to a database that compiles worldwide local crime reports over the past century -- perhaps Taylor does? -- I’m not at liberty to offer up any factual contradictions to her claim. But I would hazard to guess that, like most statistically rare, yet sensationalistic crimes -- stranger abductions, molestation, daycare Satanic panic scares -- the ones that make headlines tell us more about the current preoccupations of the day than they do about the actual crime rate (which may explain why only one country -- us -- got caught up in reporting on baby-theft homicides. Or maybe I’m totally wrong and we Americans have made yet another contribution to crimes never before seen in nature, to go along with fanny packs and wearing socks with sandals). Even so, 13 cases in 23 years -- during which time many pregnant women were killed by their partners, mothers killed their children, and strangers kidnapped already born children -- sounds pretty low to me. And I’m even more bothered by the fact that Taylor’s “expert,” Philip Resnick, a professor of psychiatry at Case Western University, seems to blur the line between demonstrably criminal behavior and just plain old baby lust. “I have been involved in three cases, and none of the women was psychotic,” he says. “They are women who want a baby very badly.”

In the next article, women who want a baby very, very badly and thus pursue IVF are described as being driven by an urge “stronger than addiction and more powerful than obsession,” according to professor Sammy Lee, one of the early pioneers of egg donation in the United Kingdom, who goes on to tell the Guardian: “The quest to have children can become a vortex that gets faster and faster and sucks people in. Women will sell everything and do anything to have the treatment if they are short on funds. They will risk their lives, there’s no doubt about it.” He then goes on to liken couples who get “addicted” to IVF cycles to the cycle of abuse, and says, “When they get too old to get treated in this country, they go abroad. That makes them vulnerable to yet more abuse, though again, it’s abuse in which they are already complicit.”

How exactly are these women abusing themselves in pursuit of a baby? Well, in this case Lee is talking once again about a very, very tiny subset of women: those who refuse cancer drugs in order to undergo fertility treatment. "Some of these women do, indeed, go on to die [from the cancer], but they die happy, feeling that they have achieved something greater than their own continued existence." But the ethical guidelines printed in just about every IVF treatment center tell you that doctors will not start IVF treatment in former cancer patients until the woman’s condition has stabilized. But we’re not yet done. The article then goes on to suggest that women who use IVF knowingly expose themselves to cancer-causing hormones, but decide -- what the hell? -- a baby is worth dying for. Rebecca Frayn, a filmmaker and novelist who underwent IVF, claims that she was freaked out by the “cancer scares” associated with the hormones she ingested, but was so consumed with wanting a kid, she developed a “moral myopia” about the risks. She then goes even further, essentially claiming that two women she knows were killed by fertility drugs: “Liz Tilberis and Ruth Picardie, both journalists who died respectively of ovarian and breast cancer after many rounds of IVF, believed their treatment had caused and accelerated their cancers, respectively. To attempt to achieve life at the potential expense of one's own [health] is self-evidently sobering. Yet, even then, I somehow squared what I was contemplating doing with my conscience. I was in the iron grip of procreation fever."

Whether or not she’s a victim of procreation fever, Frayn is not an oncologist, and hardly qualified to diagnose what may have contributed to another woman’s cancer. While some researchers have speculated on a link between fertility drugs and cancer, the latest research seems to suggest that women who undergo IVF are no more likely to develop breast or ovarian cancer than any other woman. Anyone looking to write a story about those who defy death while pursuing cancer-causing activities could do much better with “Teens still bake in tanning beds!” Or: “Twenty-five-year-old dudes smoke Camel straights!”

So why whip readers into a hysterical frenzy about those who seem to have a death wish to produce life? Most women who have undergone fertility treatments will concede that they are pretty keen on having a baby, but I would guess you’d have to search pretty hard to find anyone who was willing to kill or die for a baby. The Guardian may have had the good fortune to find a few of both within days of one another (though I’m still not convinced their IVF story succeeded in introducing us to an actual woman who actually died from IVF). But let’s at least have the good grace to label those who would as what they are: statistical outliers, not some harbinger of the next trend to come.

― Amy Benfer

CRi Oosight™ Imaging System a Key to Breakthrough Gene Replacement Method With Potential To Prevent Inherited Mitochondrial Diseases

U.S. researchers using CRi’s Oosight™ imaging system have developed a gene transfer technique that has potential to prevent inherited diseases passed on from mothers to their children through mutated DNA in cell mitochondria. The research, which demonstrated the technique in rhesus monkeys, appears in the Aug. 26 issue of the journal Nature.

The group, headed by Dr. Shoukhrat Mitalipov of the Oregon National Primate Research
Center and the Oregon Stem Cell Center, extracted the nuclear DNA from the mother’s
egg, guided by the Oosight system, and transplanted it into another egg that had the
nucleus removed. The technique allowed the mother to pass along her nuclear genetic
material to her offspring without her mitochondrial DNA. The eggs were fertilized and
transplanted into surrogate mothers, resulting in the birth of four apparently healthy
monkeys. Defects in DNA of mitochondria, the cell’s “power plants,” are associated with
a wide range of human diseases.

The Oosight system solved a key problem in avoiding damage to the nuclear DNA during
the transfer procedure by providing a non-invasive imaging technique for visualizing the genetic material. Traditional visualization methods employ a stain or involve exposure to ultraviolet light, either of which can damage DNA. The Oregon team had used the Oosight system in previous research, published in Nature in 2007, that provided a foundation for the current study. In that research, they cloned rhesus monkey embryos and used them to create embryonic stem cells.


The Oosight system uses polarized light to generate high-contrast, real-time images of
biological features such as the spindle apparatus housing the chromosomes and other
filamentous structures within the egg, such as the multi-layer zona pellucida, without the addition of toxic stains or labels, while simultaneously generating useful quantitative data of their structural composition. Two of the four offspring, Spindler and Spindy, were named after the spindle, which is what the Oosight system is used to visualize. “This study underscores the potential of the Oosight system to advance reproductive medicine and highlights the enabling capabilities or our polarized light technology,” said George Abe, president and CEO of CRi.

"With this advance, the Oosight imaging system, which is already widely used in fertility clinics, has offered new insights and possibilities into reproductive health and medicine," said Gary Borisy, director and CEO of the Marine Biological Laboratory (MBL) in Woods Hole, MA. The Oosight system is based on imaging technology originally
developed by MBL scientists Rudolf Oldenbourg and Michael Shribek, working in
collaboration with David Keefe, M.D., of the University of South Florida College of
Medicine. In In Vitro Fertilization (IVF) the Oosight system is used as an aid to intracytosplasmic sperm injection (ICSI). The system not only provides assurance that the genetic material is not damaged by the injection needle, but it can also be used as a measurement tool to assess egg viability in both fresh and frozen eggs. Data show that an egg with a weak or malformed spindle and inner layer zona as measured with the system is much less likely to result in pregnancy.


Other scientists have welcomed news of the advance. Mitochondria-expert Douglas
Wallace of the University of California, Irvine, said “results were exciting” and the
technique is “potentially very interesting.” Although he did caution that “there are safety issues that are going to need to be addressed before one could think about it in humans.” The Nature article reported that 15 embryos were transplanted into nine surrogate mothers; three became pregnant, one with twins, and four offspring were born (only three of these offspring have been reported in the Nature paper) The success rate is similar to that of conventional in vitro fertilization.


A sample movie of the enucleation process that Dr. Mitalipov used is available at

http://www.cri-inc.com/multimedia/Oosight_SCNT_Enucleation_Rhesus_Monkey.avi,

(movie courtesy Dr. Mitalipov, OHSU).

Blood-Powered Lamp Teaches You The Hard Way

Perhaps you would be better about lowering your carbon footprint if lighting up your home required a sample of your own blood. Designer Mike Thompson thinks so.

His concept Blood Lamp calls for users to break off the top of the bulb-shaped glass, cut their finger on the jagged edge and then mix a tablet in with their own blood. Some sort of mysterious, unexplained chemistry ensues and the bulb glows. Not exactly the most practical device ever—plus the lesson about reducing your carbon footprint might backfire in the long run. Consider how many of these bulbs you would need, how many you would throw away and how many Band-Aids it would take to dress your wounds. It seems that it would end up doing more harm to harm the environment than good.

IVF? It's a crazier gamble than a Las Vegas casino (and I should know - I'm a test-tube baby pioneer)

The stakes couldn't be higher... your health, your wealth, your relationships. Yet your chances of hitting the jackpot could hardly be slimmer

Above the door of every IVF clinic should hang a sign that reads: 'Welcome to Las Vegas.' When you step inside and start playing the fertility game, your chances of losing thousands of pounds far outweigh your chances of hitting the jackpot.

But like hopeless gamblers, unable to shake the idea that they might win with the next throw of the dice, an ever-increasing number of British couples are putting their emotions, their financial stability, their relationships and their own health on the line - all for the chance of a baby.

After more than 20 years in the industry (and I use that word quite deliberately), I have yet to find the words to persuade a couple to give up that dream. I can hit them hard with the bleakest facts I have to offer: that even in the most capable hands, roughly two out of three IVF cycles fails.

I often look them in the eyes and say: 'The only guarantee I can give you is that your treatment is more likely to fail than succeed.' Or: 'Keep your money. You'd be better off spending it on a holiday to help you come to terms with the inevitable.'

But after the tears (and on one memorable occasion, after a patient thumped my desk in frustration and yelled: 'We didn't come here to hear this, we came here for a baby!'), they come back more determined than ever to go ahead.

For wherever there is sliver of hope, there will be men and women queuing for IVF treatment.

It is inevitable that specialists like me come in for criticism when we are seen to treat and take money from people whose chances of conceiving are slim to none.

Making a living from desperate people who want to achieve a pregnancy at any cost can look something like exploitation, and any clinician worth his salt will worry that it is. We take their last pennies and allow them to take unquantifiable risks with their health, all for the agony of yet another failed cycle.

Forcibly removing those rose-tinted spectacles and making them question the blind faith that led them to my office is the only way I have found to ease my conscience. It releases me to do my very best for them, without the worry that i have given them false hope.

And, in my mind at least, it allows me to stay on the right side of the line that we all walk in fertility treatment between help and abuse.

Unlike other areas of medicine, it is a potent combination of money and emotion that fuels IVF and other fertility treatments. But while every treatment - successful or unsuccessful - fills our coffers, it is the emotions involved that drive us to try again and again, if at first we don't succeed.

'We take their last pennies and expose them to risk'

When patients look at me helplessly, it becomes impossible to abandon them. There are times when I think I should refuse to treat couples for whom the treatment just isn't working, but I can't ignore their desperation.

After all, doctors are human, too, and their desire to become parents grabs at our hearts and reels us in. It means that when the time comes to decide whether or not to go for it again, I don't want to say, 'Let's give up,' any more than they do.

But the fact of the matter is that if I turn a couple away, they will often go across the street for treatment. And when the clinic across the street can't help, they will go abroad, making them even more vulnerable to abuse. Abuse in which they, of course, are complicit.

When I know that a couple are prepared to invest everything - not just financially - into achieving this almost impossible dream, how could I not feel that I was failing them if I did not try everything in my power to help?

Add to this the fact that, generally speaking, IVF clinicians are a high-achieving and highly competitive breed who do not easily accept when a cause is lost, and you begin to see the complexity or the moral maze that we navigate with every patient.
Britain's oldest mother Elizabeth Adeney, 66, went to the Ukraine for IVF as the UK refuses to treat women over 50!

Some 15 years ago, as a young fertility specialist, I wrote that we were in the grip of a fertility cult, in which advances in our knowledge and capabilities had made having a baby seem not only possible, but vital. That is truer today than it ever was.

I have heard of three recent cases in which pregnant women with cancer decided to forgo all treatment until after they'd had a baby.

They knew that in delaying crucial treatment they might be condemning themselves to death, but believed so strongly that having a baby was their sole purpose, there was no stopping them. If they died, they died happy, knowing that they had achieved motherhood, despite leaving their children motherless.

Cases like that of Maria Bousada, who died from cancer this summer at the age of 69 leaving two-year-old IVF twins, are the thin end of the wedge in terms of this ever increasing worship of assisted pregnancy, no matter what the cost to the mother or the resulting children.

In effect, the development of IVF has turned people like me into high priests and priestesses, and our clinics into temples filled with the blindly and fervently faithful, unwavering in their conviction that we can make miracles happen.

For those of us who have been working in fertility since the early days, it is a very strange place to find ourselves. Although we knew that it was possible to help with conception in certain cases, there was no way of knowing that it would become so mainstream.

We could never have imagined that, one day, almost all of us would know someone who has tried it, or that we would walk into the local newsagent and see celebrities boasting about their 'miracle babies' on the front covers of magazines.

I've lost count of the number of times that someone I know, from school or university, has walked into my office. I like to let them realize for themselves that we have met before. I don't think it helps their nerves when I pipe up with: 'Hey, weren't you in my biology class?'


So how has IVF become mainstream? Well, it's certainly not because it has become affordable. It still costs up to £4,000 per cycle, at an average of £2,500 per time, and I have known two patients in my career who have invested in a dozen cycles.

Remarkably, one of those patients had a baby boy after her 12th and final try - and stories like that are the ones you remember when you are on the verge of giving up the quest.

Quite simply, the first reason for the increase is that infertility is rising. I have said in the past that it may be caused by environmental factors, such as the prevalence of chemicals in what we eat or drink, but there is still a lot of research to be done in that area.

Fertility treatments have also become part of our on-demand culture. Like it or not, making a baby the natural way takes time and effort, and won't necessarily happen within the window of time that we have set aside in our busy schedules.

I am constantly advising patients, 'Don't give up the night job', because, as obvious as it may sound, having sex is crucial.

However, because it is so hard to establish absolutely whether a couple have a fertility problem that will never result in a natural conception, many are losing patience and seeking private treatment when it's possible they don't need it at all.

Our celebrity culture is partly responsible for the boom, too. While only two or three per cent of the general population have fertility treatment, I estimate the figure is closer to 10 per cent in the celebrity population, and they are not shy of telling us all about it.

I don't know why celebrities require so much more treatment that 'ordinary people', but I do know that cocaine abuse, low body weight, drinking, smoking and being too busy to have sex, or not trying to get pregnant until you're pushing 40, will drastically reduce your chances of conceiving naturally.

And as with any celebrity trend, I believe there is now a certain cache attached to IVF. It's as if unnatural conception is cool.

But whatever the reason, we have reached a point where more patients are putting more faith than ever into what we do.

The advances of science seem to promise couples an everlasting hope. The goalposts move constantly, giving both patients and clinicians alike the belief that anything is possible, and that no problem - not even the fact that a woman is in her 60s - is insurmountable.

Before the development of ICSI (Intracytoplasmic Sperm Injection), where sperm is injected into the egg outside the womb, there was nothing we could do for male infertility. But suddenly there was a solution for that, too, and it brought with it a whole new wave of people who were desperate for our help.

It remains a highly experimental area, however, and comes with risks that are impossible to quantify.

Every new patient I see asks me whether IVF drugs increase the risk of certain cancers, and all I can say is that they might do. It is an area of science in its infancy, and we simply don't have the long-term figures to know what, if any, risks our patients take when they start the journey.

But some research that I have conducted suggests that women begin to produce certain antibodies when they hit their third or fourth cycle of treatment, which indicates that the drugs we use may have some longterm effects in higher doses.

One problem is that fertility treatment remains largely privately funded and because - regardless of the risks - patients will do whatever it takes, treatments develop very quickly. When emotions are running high and we have piles of readies under our noses, who has time for lengthy clinical trials?

It's not reckless, but it is experimental - and that is something that all patients accept.

The baby that was born after his mother's 12th IVF cycle would not be here today had I not taken a spur-ofthe-moment decision to try something new. She lay sobbing on the operating table, knowing that this was her last embryo and her last chance.

But as I looked at the embryo, the outer skin appeared a little thicker and yellower than is normal. So I asked her: 'Do you mind if I try something that has never been done before?' There was no time for clinical trials: she needed my help at that moment.

'Anything, anything!' she said, which can hardly count as formal consent. So I perforated the embryo all over with my needle, until it looked like a microscopic teabag.

It was controversial - but it was, I believe, her only chance. Not only did it give her the baby boy she so desperately wanted, but the technique, now known as assisted hatching, has helped many other women since.

Moments like that highlight the extraordinary possibilities. But as the expectations of our patients rise inexorably, it becomes more and more important to acknowledge our frailties and limits.

By Prof. Sammy Lee, UK

Pregnant mother forced to give up IVF baby after doctors gave her wrong embryo

A pregnant mother will have to give birth to another couple's baby after a blunder by an IVF clinic.

Carolyn Savage had the wrong embryos implanted into her and will have to give the boy up to his biological parents as soon as he is born.

Yesterday Mrs Savage, 40, who was expecting her fourth child with husband Sean, said: 'The hardest part is going to be the delivery. I remember communicating with the [unnamed] mother of this child as to what I was envisioning and hoping for.

'I said, "We want a moment to say hello, and goodbye".

'In the beginning we were really scared of that moment and it is still scary. We are trying to mentally frame it in a positive way and look at it as a gift for this family that eight months ago we didn't know.

'I think that is the only way we'll get through it.'

Mrs Savage, from Ohio in the U.S., is 35 weeks pregnant and expecting in a fortnight. The couple already have two sons aged 15 and 12 and a daughter, born with the help of IVF, who is 18 months.

Mrs Savage learned she was pregnant with a boy in February after deciding to try again with the last of her frozen embryos.

They learned about the mix-up after Mr Savage received a phone call at work and returned home to tell his wife.

She said: 'I was upstairs in my bedroom and he came to the door and said "I have some really bad news".

'You're pregnant,' he told her. 'But they transferred the wrong embryo.'

Mrs Savage said she just kept repeating: 'You're joking.'

But when she looked at her husband 'he was as white as a sheet'.

The couple decided not to have an abortion because of their religious beliefs, and have met the other couple and arranged a handover.

Mrs Savage added: 'We will wonder about this child every day for the rest of our lives.

'We have hopes for him, but they are his parents and we'll defer to their judgment on when and if they ever tell him what happened and any contact that's afforded us.

'We just want to know he's healthy and happy.'

Lawyers for the Savages are working to ensure that the fertility clinic that made the error 'will accept full responsibility for the consequences of their misconduct'.

Sized To Fit Condoms Now!

Fact: The US FDA doesn't allow very large or very small condoms. Magnum XLs are only sightly bigger than normal. In Europe, however, they are soon going to get them in 70 different sizes. Are you a J33 or a G22?

Believe it or not, using a condom that is not suited for your penis increases the possibilities of breakage and slippage, which in turn increases the possibility of sexually transmitted infections, or unwanted pregnancies. Even while they know this—as have been discovered in various studies—the US FDA doesn't allow for condoms that are longer, shorter, thinner, or thicker than the average.

In Europe, however, men will be able to print out this measuring tool, and order exactly the size they need. Hopefully, someone will bring these TheyFit condoms to the US & the rest of the world. For now, however, all you can do is print and play.

The Satellite Link That Keeps Watch On Your Children

Its vivid colour is clearly designed to appeal to youngsters. But this watch is really aimed at their parents.

For its key selling point is a satellite positioning system that locates the wearer to within ten feet.

The makers claim the GPS tracking device will offer anxious parents peace of mind and allow children the independence to go out to play on their own.

But critics have said the 'tagging' is a step too far in the climate of paranoia over child safety.

The num8 watch, pictured above, costs £149.99 and can be securely fastened to a child's wrist, triggering an alert if forcibly removed.

Parents will be able to see their child's location on Google maps by texting 'wru' to a special number, or clicking 'where r you' on the secure website linked to the device. The street address and postcode will be displayed.

Safe zones can also be set up in which children can play. An alert will be sent to the parents if the child strays out of that area.

Steve Salmon, of makers Lok8u, said: 'Losing your child, if only for a brief moment, leads to a state of panic and makes parents feel powerless. The overriding aim of num8 is to give children their freedom and parents peace of mind.'

But Dr Michele Elliott, director of children's charity Kidscape, said: 'Is the world really that unsafe that parents need to track their children electronically? I don't think so.'

Alaska

Tom had been in the liquor business for 25 years. Finally, sick of the stress, he quits his job and buys 50 acres of land in Alaska, as far from humanity as possible.He sees the postman once a week and gets groceries once a month.  Otherwise it's total peace and quiet.After six months or so of almost total isolation, someone knocks on his door.  He opens it, and a huge, bearded man is standing there.
"Name's Lars, your neighbour from forty miles up the road. Having a Christmas party Friday night... Thought you might like to come. About  5:00." 
"Great", says Tom, "after six months out here I'm ready to meet some  local folks. Thank you."
As Lars is leaving, he stops. "Gotta warn you......be some drinking'"... 
"Not a problem" says Tom. "After 25 years in the business, I can drink with the best of 'em."
Again, the big man starts to leave and stops. "More 'n' likely gonna be some fighting' too"...
"Well, I get along with people, I'll be all right. I'll be there,  Thanks again."
"More'n likely be some wild sex, too"...
"Now that's really not a problem," says Tom, warming to the idea.  "I've been all alone for six months!  I'll definitely be there. By the  way, what should I wear?"

"Don't much matter .... Just gonna be the two of us"...

HOW DO YOU DECIDE WHO TO MARRY? (written by kids)

(1) You got to find somebody who likes the same stuff. Like, if you like sports, she should like it that you like sports, and she should keep the chips and dip coming.
- Alan, age 10

(2) No person really decides before they grow up who they're going to marry. God decides it all way before, and you get to find out later who you're stuck with.
- Kristen, age 10


WHAT IS THE RIGHT AGE TO GET MARRIED?

(1) Twenty-three is the best age because you know the person FOREVER by then.
- Camille, age 10

(2) No age is good to get married at. You got to be a fool to get married.
- Freddie, age 6
(very wise for his age)


HOW CAN A STRANGER TELL IF TWO PEOPLE ARE MARRIED?

(1) You might have to guess, based on whether they seem to be yelling at the same kids.
- Derrick, age 8


WHAT DO YOU THINK YOUR MOM AND DAD HAVE IN COMMON?

(1) Both don't want any more kids.
- Lori, age 8


WHAT DO MOST PEOPLE DO ON A DATE?

(1) Dates are for having fun, and people should use them to get to know
each other. Even boys have something to say if you listen long enough.
- Lynnette, age 8
(isn't she a treasure)

(2) On the first date, they just tell each other lies and that Usually gets them interested enough to go for a second date.
- Martin, age 10
(Who said boys do not have brains)


WHAT WOULD YOU DO ON A FIRST DATE THAT WAS TURNING SOUR?

(1) I'd run home and play dead. The next day I would call all the newspapers and make sure they wrote about me in all the dead columns.
-Craig, age 9


WHEN IS IT OKAY TO KISS SOMEONE?

(1) When they're rich.
- Pam, age 7
(I could not have said it better myself)

(2) The law says you have to be eighteen, so I wouldn't want to mess with that.
- Curt, age 7
(Good Point)

(3 )The rule goes like this: If you kiss someone, then you should marry them and have kids with them. It's the right thing to do.
- Howard, age 8
(Who made the rule)


IS IT BETTER TO BE SINGLE OR MARRIED?

It's better for girls to be single but not for boys. Boys need someone to clean up after them.
- Anita, age 9
(bless you child)


HOW WOULD THE WORLD BE DIFFERENT IF PEOPLE DIDN'T GET MARRIED?

(1 ) There sure would be a lot of kids to explain, wouldn't there?
- Kelvin, age 8

And the #1 Favourite is........


HOW WOULD YOU MAKE A MARRIAGE WORK?

(1 ) Tell your wife that she looks pretty, even if she looks like a truck.
- Ricky, age 10
( The boy already understands)

US company offers celebrity ‘look-a-like’ sperm

A California-based fertility company is offering prospective parents a range of celebrity 'look-a-like' sperm donors. Cryobank, which is also planning to offer services in New York, allows customers to search through a database according to characteristics such as ethinicity and eye colour without revealing donors' photographs. In addition, the company has now added features that resemble celebrities such as David Beckham and David Blaine.

Cryobank's introduction on its website reads: ‘Have you ever wondered if your favorite donor looks like anyone famous? You know how tall he is and his hair and eye color, but wouldn't it be great to have an idea of what he really LOOKS like? Now you can find out with a click of your mouse!'

Scott Browne, a spokesman for Cryobank said that 'the intention is not to suggest the child will look like one of the celebrities. It's just to personalise the donor. I think in their heads they know the medical history is most important, but ultimately we're all interested in what someone looks like. It's what we do when we're dating or meet someone. I didn't ask my wife her medical history before I decided to marry her.'
Potential sperm donors are put through a rigorous screening process delving into their health and medical history before finding out which celebrity they most closely resemble. Browne says the process of deciding which donor resembles which celebrity is not easy: 'There's a lot that goes into it. It's not just sitting in a room deciding who looks like Ben Affleck, what sounded really easy got complicated when we realised that people see people in completely different ways,' he said. He added: 'So we're very concerned about misleading clients. One rule we made was that a donor never gets just one celeb. And one of our representatives can always get on the phone and explain.'

The company's New York Park Avenue branch will not be open for a few months but from this week prospective parents can search the database online for celebrity look-a-like sperm.

One Last Bush Cartoon

Currahee!!!

Baby Oliver is now a Beacon of Hope for IVF patients

A British woman has become the first in the world to give birth using a new IVF test that promises to improve the chances of parenthood for infertile couples.

A boy, named Oliver, was born in July to a 41-year-old woman who had tried 13 cycles of IVF without success. She conceived after her eggs were screened to select those that were the most viable.

The screening technique has the potential to raise IVF success rates significantly, particularly for women in their late 30s and 40s and couples with a history of failed fertility treatment or miscarriage. It could also be used in younger women to promote the use of a single embryo in IVF to guard against risky multiple births. If the test can pick the best eggs, one embryo could be transferred to the womb without reducing success rates.

Simon Fishel, managing director of the CARE Fertility Group in Nottingham, who treated the new parents, said: “Oliver’s birth is an important landmark in shaping our understanding of why many women fail to become pregnant.”

He said that older versions of the screening test have been shown to double the chances of IVF success for some couples with a poor prognosis, and that early results suggest that the new technique is at least as good, if not better.

Since the pregnancy that led to Oliver’s birth was announced in January, about five more women have conceived after taking the egg test, known as Array Comparative Genomic Hybridisation (Array CGH), out of about 20 treated.

All the patients treated had a poor prognosis, with multiple failed attempts at IVF, and Dr Fishel said that the early success rate of about 25 per cent was a considerable improvement. “I’d generally give these women about a 10 per cent chance of getting pregnant,” he said.

The effectiveness of Array CGH, however, has yet to be assessed in a randomised controlled trial — the gold standard for medical therapies — and other scientists were more cautious about its prospects. Several other quality tests for eggs and embryos have looked promising at first, but have been found wanting by randomised trials.

Tony Rutherford, chairman of the British Fertility Society, welcomed the birth, but added: “It is absolutely essential that these new techniques are subject to further rigorous research; and should only be offered to patients within the context of a robustly designed clinical trial, carried out in suitably experienced centres.

"The widespread use of this technology should await the outcome of such research to ensure we know which patients might benefit. All too often we see ground-breaking news about techniques that seem to offer great hope, but fail to live up to expectations when applied in widespread clinical practice.”

Array CGH seeks to identify eggs that have the wrong number of chromosomes, which will generally fail to develop properly if fertilised with sperm. Such chromosomal abnormalities are difficult to detect in eggs or embryos by eye, and they are among the major causes of IVF failure.

Array CGH has two main advantages over other methods of screening: the first is “gene chip” technology that tests DNA very quickly, so that eggs or embryos do not need to be frozen while they are checked. The second is that instead of removing cells from embryos, which can damage them, it relies on testing the eggs, which are the cause of 85 per cent of chromosomal defects.

Healthy human cells have 46 chromosomes, 23 inherited from each parent. Before an egg is fertilised, it ejects half of its complement to leave space for the 23 paternal chromosomes carried by the sperm. The waste chromosomes are jettisoned in a structure called the polar body and are a mirror image of those left behind in the egg.

Array CGH checks that an egg’s polar body has 23 chromosomes: if it does not, its parent egg must have too many or too few. Doctors can then ensure that only normal eggs are fertilised to produce viable embryos for transfer to the womb.

Oliver’s mother produced eight eggs, of which only two were found to be normal and transferred to the womb. In several other cases Dr Fishel’s team has found no eggs suitable for transfer.

The test costs £1,950, on top of the £3,000 or so for IVF. It is not available on the NHS or at other private clinics.

Professor Peter Braude, of King’s College London, said: “I am delighted that this patient has achieved her positive outcome after so many years of trying. However we need to be cautious as to whether the new technique was responsible.

“I hope that this is not the case here and would love to see a positive outcome to rigorous analysis of this technique, but at the moment this can only be viewed as a potentially very lucky result.”

Senior Citizens

Next time you use a pair of rubber gloves, you're going to smile when you think of this:

A dentist noticed that his next patient, a little old lady, was nervous, so he decided to tell her a little joke as he put on his gloves.

'Do you know how they make these gloves?' he asked.

'No, I don't,' she replied.

'Well,' he spoofed, 'there's a building in Canada with a big tank of latex, and workers of all hand sizes walk up to the tank, dip in their hands, let them dry,
then peel off the gloves and throw them into boxes of the right size.'

She didn't crack a smile.

'Oh, well. I tried,' he thought.

But five minutes later, during a delicate portion of the procedure, she burst out laughing.

'What's so funny?' he asked.

'I was just envisioning how condoms are made!'

(Gotta watch those little old ladies! Their minds are always working!)

Yogasanas

Do you really know your theology?

Who was the 3rd man in history to walk on water?
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The 1st one was Jesus.
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The 2nd was the apostle, Peter.
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Then there was this guy, Jose...
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Wedding Invitation of the Year

The Doctor & The Bride:)))

Peanuts, Again

Woman claiming to be pregnant with 'duodecaplets' exposed as a fraud

A Tunisian woman in her 30s who earlier this month claimed to be pregnant with 12 babies, has been exposed by the country's health ministry as a fraud. The woman, from the town of Gafsa told hospital workers that she was expecting six boys and six girls.

'Our staff interviewed her at length, but her pregnancy appears to be in her imagination', said a spokesman in Tunis. 'She's claiming to be nine months pregnant...but there's absolutely nothing about her appearance which indicates this. The woman has point blank refused to undergo a medical examination. She's gone into hiding'.

A doctor at the No'man al Adab Hospital, Gasfa, confirmed that the woman had never been in their care, speculating that she may have been trying to make money from the media. The woman, a teacher, is thought to have turned to IVF treatment after having two miscarriages since her marriage in 2007. Her husband, known only as Marwan, indicated that the couple were excited about the impending births and said that 'the medical team told us my wife would give birth naturally'.

British medics had expressed their concerns about the case. Peter Bowen-Simpkins, a fellow at the Royal College of Obstetricians and Gynaecologists told the Daily Mail that 'the chances are she will deliver at 20 weeks. I wouldn't even give her a one in 100 chance of even one surviving. It's frightening'.

It was suspected that the woman had been given fertility drugs to stimulate her ovaries into releasing several mature eggs at a time in order to maximise conception. Some women using this treatment can develop ovarian hyperstimulation syndrome, in which the ovaries produce too many eggs, but experts cast doubt on this being the case.

'How could you get 12 babies into the womb at the same time?' questioned Mr Bowen-Simpkins. 'The womb just doesn't expand that much. She would have to be about seven feet tall'.

In January of this year, Nadia Suleman, a US divorcee, attracted worldwide media attention after giving birth to the world's longest-surviving octuplets. The record for multiple pregnancies was set in 1996, when a 23-year old Greek Cypriot woman had to abort nine of her 11 fetuses in order to save two.

Two Air Diasters & One Near Diasaster On Film

The Indian Octopus Baby

Wisdom of a Retiree

'I've often been asked, 'What do you old folks do now that you're retired?'




"Well..I'm fortunate to have a chemical engineering background, and one of the things I enjoy most is turning beer, wine, Scotch, and margaritas into urine."

Amazing Ads

Lord Winston, Labels Egg Feezing As "Expensive Confidence Trick"

Lord Winston, emeritus Professor of Fertility Studies at Imperial College London and pioneer of IVF, has criticized fertility clinics for over-hyping egg freezing services. In an interview with the Daily Mail newspaper he accuses providers of creating false optimism in the effectiveness of the procedure particularly where signing up patients for purely 'social' reasons. Before use of egg freezing grows further he calls for more research into both the effects of egg freezing on the ability to later conceive and into the long-term health implications for those born
from frozen eggs.
The comments come in response to calls, made at last week's European Society for Human Reproduction and Embryology (ESHRE) annual conference, for greater availability of egg freezing as an option for women who are postponing pregnancy until later in their lives. Lord Winston's comments partially mirror a joint statement made in February by the UK's Royal College of Obstetricians and Gynaecologists and the British Fertility
Society (BFS) which also called for women not to freeze eggs for social reasons.
Lord Winston noted that the production of six to ten eggs for freezing involves both the risk of ovarian hyperstimulation syndrome for the woman and an increased likelihood of chromosome defects in the eggs produced. Producing such a quantity of eggs he sees as dangerous yet also inadequate to ensure a viable embryo is produced. The BFS has stated that the average chance of success for any individual frozen egg is six per cent and only four children have been born from frozen eggs in the UK to date.
Additionally, the lack of data on the long term health effects - the first children conceived with frozen eggs are only now five - is provided as reason enough for adopting a cautious approach towards increasing availability of egg freezing and makes encouraging those without a pressing need (such as impending cancer treatment) all the more dubious. Lord Winston states, in unequivocal terms, 'in my view it is irresponsible [for clinics] to egg freeze until long-term animal research has been done'. The most detailed research to date is due to be published next month.
Describing the procedure as a 'quick fix', Lord Winston sees the best path forward for prolonging the ability to have a child, for social reasons, is to attempt to develop better means of postponing the menopause. Though the procedure can be justified for those with serious medical conditions it is not be encouraged as a means of delaying motherhood. The provision of egg freezing for social reasons, available for between £2,500 and £5,000 at 45 clinics in the UK, is in his view simply an 'undesirable commercial activity' and should not be encouraged.

Fertility "Fingerprints"

Scientists in Ireland have discovered a group of genes that could potentially be used to predict the success of IVF treatment. The prospect of a clinical test for IVF success was raised at the annual conference of the European Society for Human Reproduction and Embryology (ESHRE), in Amsterdam.
The group, led by Dr Cathy Allen at the Rotunda Hospital, Dublin, examined the genetic profiles from blood samples taken at eight different stages during the period around conception and the early stages of the IVF cycle to analyze what differences in gene expression were seen at certain points before, during and after pregnancy. The blood samples were from five women who achieved clinical pregnancy, three women who had implantation failure and three subfertile women who conceived spontaneously.
The findings showed that activity levels of genes controlling the growth of new blood vessels, inflammation and the supply of energy to cells were different in women undergoing IVF. There was a marked difference in the expression of 200 genes at the beginning of fertility treatment between women who became pregnant and those who did not. The group concluded that this gene 'signature' was highly predictive of whether IVF worked or not, and could be used to develop a clinically useful predictive tool.
Dr Allen thinks that one of the most difficult decisions to make when undergoing IVF treatment is whether to continue with treatment after a failed attempt, as this can be emotionally and physically draining, as well as expensive. A reliable blood test could help patients and doctors with this decision.
She said: 'This work has generated a unique profile for IVF success and failure... As a practicing clinician, I think this might have a use for patients trying to decide whether they should undergo IVF or not. It's going to be a while before we have a clinical test but my gut feeling is it will be useful for identifying the unfavourable profile - those who won't get pregnant'.
Currently, advice from doctors on this decision is based upon factors such as age, lifestyle and hormone levels, but these are not often reliable. A separate team of scientists at Cardiff University has developed a questionnaire, called the FertiSTAT. Based on questions about a woman's menstrual cycle, reproductive health, lifestyle factors, age and length of time for which they have been trying for a baby, the test can be used to judge whether a woman will have fertility problems, and whether changing
their lifestyle could improve their chances of pregnancy.
Professor Luca Gianaroli, the ESHRE chairman, said of Dr Allen's findings: 'this test could save a lot of unnecessary treatment. You have to balance the cost of research and the benefits of research.'

One-stop Genetic Test For Embryos

A one-step gene mapping test for identifying genetic and chromosomal abnormalities in embryos may be available in the UK within a year. The technique, known as karyo-mapping, can screen for almost any inherited disease and is much faster than those currently available as it does not need prior knowledge of the specific gene mutation involved. The method was unveiled at the annual conference of the European Society for
Human Reproduction and Embryology (ESHRE), in Amsterdam, after researchers from the UK and US announced they had successfully screened cells taken from donated embryos that were known to have cystic fibrosis (CF).
Since 1989, couples who are known to be at risk of having a child with a genetic disorder have had the option of screening their embryos using a technique called pre-implantation genetic diagnosis (PGD). PGD involves identifying the exact mutation causing a particular disease in a particular family, then spending many months developing a custom test. The process costs several thousand pounds and can only pick up two per cent of known genetic disorders.
Now, for a similar price, karyomapping can identify any known genetic disorder and is faster because scientists do not need to know the exact DNA mutation they are looking for. Instead they compare the DNA of affected and unaffected family members to work out which DNA section is carried only by those affected by the condition. Embryos can then be screened for this section of DNA to find out if they have inherited the mutation. In practice this involves DNA comparisons at over 300,000 locations genome-wide, but can be achieved rapidly through current microchip technology known as
'microarrays'. Another advantage is that karyomapping can simultaneously check for abnormal numbers of any of the 23 pairs of chromosomes, which can lead to conditions such as Down syndrome or trigger miscarriages.
'The hope is that clinicians will be able to test embryos for specific genetic diseases and know that, with one test, they are transferring chromosomally normal embryos. This will be a step forward from current technology that is mostly limited to choosing one test or the other,' explained karryomapping's inventor, Professor Alan Handyside of the London Bridge Fertility Gynaecology and Genetics Centre in London.
Some have argued the new technique may add to the controversy over 'designer babies' because it widens the range of genetic characteristics for which embryos can be screened and could theoretically be used to screen for non-serious conditions, or non-medical traits such as blue eyes. Professor Handyside believes this is not an issue because the relevant regulations in the UK are very strict and would remain so. 'We're not mad Frankensteins working away in our laboratories to create designer babies. We are only allowed to look for major diseases which cause handicaps,' he retorted.
Elsewhere at ESHRE scientists announced that up to 90 per cent of IVF embryos contain chromosomal abnormalities, even those produced by young, fertile couples. The surprising finding implies that current PGD techniques do nothing to improve pregnancy and live birth rates, and can potentially lead to viable embryos being discarded. This news means that the timely announcement of the new karyomapping method will be warmly welcomed by many.

More Ovarian Transplants

Two studies reported at the annual conference of the European Society for Human Reproduction and Embryology (ESHRE) in Amsterdam show advances in ovarian transplant techniques. The advances could make the procedure available to women seeking to avoid fertility problems as they age.
Ovarian transplants have been primarily used as a way to preserve fertility in women undergoing treatments that damage the reproductive system, such as chemotherapy. The ovaries can be removed and frozen before such treatment begins, and then re-implanted after treatment has finished. Previously, it has only been used for women with serious disease; due to the uncertainties involved. Now, advances in the technique mean transplants are more successful, and it may be possible that the procedure can become more widely available.
In the first study Dr Sherman Silber reported that freezing ovarian tissue using vitrification gave the same success rate as using fresh tissue. Freezing ovarian tissue using the vitrification method avoids ice formation, and egg viability was almost identical to that seen in fresh tissue. Dr Silber and colleagues tested the different methods in 15 women undergoing cancer treatment. He explained that 'we found that 91.9 per cent of the fresh oocytes were viable compared with 88.9 per cent of those vitrified.
However, slow freezing resulted in a 56 per cent loss of viability. Transplantation resulted in patients regaining a normal ovarian cycle in about five months, and ovarian function lasted for four years in some of the patients. There were no differences in pregnancy rates or ovulatory menstrual cycling between the fresh and frozen grafts. In the second related study, researchers in France led by Dr Pascal
Piver reported on a technique that may improve success of ovary transplant.The technique is a two-step process, where a very small section is implanted first, and the ovary implanted three days later. This encourages blood flow and hormone supply to be quickly restored to the implanted ovary. This helps the implanted ovary to become functional - something that doctors have previously struggled to do. The procedure is also less invasive than the previous one-step method. Dr Piver reported on the first success of the technique in his clinic, saying: 'On June 22, a baby girl was born to a
mother who had been menopausal for two years as a result of treatment for sickle cell anemia. After transplanting her own ovarian tissue she started ovulating in four months and became pregnant naturally six months after transplantation. Both mother and baby are doing well.'
Experts said the possibility of healthy women being offered ovary transplants may spark controversy. 'This is not an experimental procedure for cancer patients anymore', said Dr Silber, director of the St. Louis Infertility Center in Missouri, US, adding: 'The question is whether more women should be able to have this option.'
'We are in the middle of an infertility epidemic,' he told AP news. 'With these new techniques, we could dramatically expand our reproductive lifespan', he added.

Similar Outcomes In Babies Born Following ICSI Or IVF

Analysis of the longest running ICSI programme in the United States has found reassuring evidence that babies born from frozen embryos fertilised via ICSI (intracytoplasmic sperm injection) do just as well as those born from frozen embryos fertilised via standard IVF treatment.

The researchers also compared babies born as a result of cycles in which the women had additional hormone medication with babies born as a result of unmedicated, natural cycles, and, although they found a slightly higher rate of malformations in babies born from medicated cycles, the difference was small - 2.2% versus 0.4%.

Ms Queenie Neri, a research associate at Cornell University (New York, USA) and a member of the team headed by Professor Gianpiero Palermo who pioneered ICSI in 1992, told the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam that she and her colleagues had looked at all births from frozen embryos, conceived via ICSI or IVF, between 1993 and 2007.

Ms Neri identified 720 IVF and 1231 ICSI frozen embryo transfers. The survival rate of the frozen embryos was 74% after IVF and 77.2% after ICSI. The clinical pregnancy rate was 42.8% after IVF and 39.4% after ICSI. These resulted in 84.1% IVF and 89.7% ICSI deliveries. There were 27.8% multiple IVF pregnancies and 21.1% multiple ICSI pregnancies. Outcomes at the time of birth for Apgar scores, gestational ages, birth weights and congenital malformations were similar for both IVF and ICSI singleton babies.

When she grouped the babies according to whether they came from medicated or unmedicated cycles, she found that the clinical pregnancy rate was 42.1% and 39.4% respectively; delivery rates were 86.7% (with 28.7% multiple births) and 87.5% (19.2% multiple births) respectively. Gestational ages and birth weights were similar between the two groups, but the malformation rate was 2.2% from the medicated cycles and 0.4% from the natural cycles.

Ms Neri said: "Freezing embryos as part of fertility treatment has become a fundamental part of assisted reproduction technology. We found no differences in the ability of embryo generated by IVF or ICSI to implant, even after undergoing the stress of cryopreservation. We were unable to confirm a significant benefit of the unmedicated cycle on the neonatal outcome of the cryopreserved embryos; the difference in malformation rates was small.

"The original premise of the study was to identify a difference in neonatal outcome while in the presence or absence of infertility medication, with the assumption that the unmedicated cycles would generate better offspring outcomes. Interestingly, we did not see any clear difference in neonatal outcomes between the medicated and unmedicated groups. From our study, the combination of exposure to cryopreservation and medications or both did not significantly impair offspring outcome."

The malformations ranged from heart defects to defects caused by hereditary factors and sporadic genetic mutations or interactions. However, Ms Neri said: "They were within the spectrum of malformations observed in newborns in the general population."

As there was no statistical difference between the medicated and unmedicated cycles, Ms Neri said that it was not possible to say that medicated cycles were associated with higher rates of malformations, or, if they were, what mechanism might be responsible.

"Our study reported none of the specific abnormalities linked to male factor infertility, medications or other environmental triggers such as extended in vitro culture, which have been reported by other studies," she said.

"When you think about it, the reproductive medical field has created a new sub-population. These children are now reaching puberty and their fertility status still remains to be assessed. Therefore, the continuous monitoring of children generated through artificial conception is of paramount importance," she concluded.

Weddings in Pune, Today

Accelerated fertility treatment leads to shortened time to pregnancy and cost savings

A major new trial recently published in the journal Fertility and Sterility shows that for couples beginning infertility treatments, an accelerated path to in-vitro fertilization (IVF) can offer a shorter time to pregnancy, cost savings of nearly $10,000, and a lowered risk of multiple births.

For the first time, these results demonstrate that the long held treatment combining fertility injections with insemination (IUI) does not have a place in infertility treatments today. This study also demonstrates that today's infertility treatments are very successful. When fertility care is covered by insurance (or alternatively when couples can afford all needed treatment), the vast majority will have a baby, and the quickest way to get pregnant is to follow this new shortened protocol.

Elizabeth Ginsburg, President of the Society for Assisted Reproductive Technology, commented, "This is a very important study that will likely influence physicians to reduce the number of stimulated inseminations for patients with unexplained infertility. Adoption of such an accelerated course of treatment could result in many patients conceiving in less time with less expense."

Known as the FASTT (fast-track and standard treatment) Trial, this study is the largest of its kind to date to measure the effectiveness of contemporary infertility treatments. Led by Richard Reindollar, M.D., Chair of the Department of Obstetrics and Gynecology at Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, the study omitted the gonadotropin-stimulated artificial insemination cycle that usually precedes assisted reproductive technology, for approximately one-half of the 503 participating couples.

"One key strength of the trial was the Massachusetts Infertility Mandate, which requires insurers to cover the cost of fertility treatments," said Dr. Reindollar. "Such a large trial would not have been possible in a self-pay or partial coverage environment in which the cost of care is a much larger factor in the couple's choice of therapy."

Reindollar says another strength of the study in relation to previous efforts on the subject was a large volume of patients available at a single IVF center which allowed for standardized protocols and procedures. In addition, since the study was done in cooperation with insurance companies, there was access to detailed charge data for the patients.