Building a Brighter Kid- Consider IVF

Most parents-in-waiting like to daydream that their unborn child might develop a cure for cancer or improve upon the theory of relativity — in short, save the world. Now, new research indicates that your best shot of birthing a brainy baby might be to first conceive via in vitro fertilization (IVF).
According to a University of Iowa (UI) study published in the October issue of the journal Human Reproduction, IVF babies scored better than age- and gender-matched peers on the Iowa Test of Basic Skills – a widely used test that evaluates students' abilities — and the Iowa Test for Educational Development (ITBS/ED), which is generally considered an objective measure of educational outcomes. Researchers found that children conceived by IVF score at least as well as their peers on academic tests at all ages from grade 3 to 12.
The study should soothe parents who are concerned about adverse effects of fertility treatments on babies' cognitive skills. Although IVF is considered safe, there isn't much in the way of long-term data on health outcomes. The Iowa study tracked children to an older age than previous research.
"Our findings are reassuring for clinicians and patients as they suggest that being conceived through IVF does not have any detrimental effects on a child's intelligence or cognitive development," says lead study author Bradley Van Voorhis, a professor of obstetrics and gynecology and director of the Center for Advanced Reproductive Care at UI Hospitals and Clinics.
Van Voorhis and his fellow researchers measured the academic performance of 423 Iowa children, ages 8 to 17, who were conceived by IVF against the performance of 372 age- and gender-matched children from the same schools. The researchers also took into account whether different characteristics of the children, parents or IVF methods had an effect on children's test scores.
The study found that IVF children scored above average on standardized tests compared to their peers. The research also linked other factors to higher test scores, namely older age of the mother, higher education levels of both parents and lower levels of divorce.
“The likelihood is this has to do with nature and not nurture,” says Robert Stillman, medical director at Shady Grove Fertility Center in Rockville, Md., which has the country's largest fertility program. “Those fortunate enough to be able to afford IVF in an arena where there's little insurance coverage may very well have the means to provide a high level of education for their children.”
Would-be parents relying on assisted reproduction techniques are sometimes concerned that using frozen rather than fresh embryos is less than ideal. After all, aren't fresh veggies better than frozen ones? Yet the Iowa study debunked that, showing that children's test scores didn't fluctuate as a result of various methods of insemination or reliance on fresh vs. frozen embryos.
Deliberating between transferring one or more embryos? You might be interested to learn that the researchers found that single babies performed better than twins, who performed better than triplets — if only every so slightly. But even the triplets performed better than the average score of children conceived the old-fashioned way.
Still, that's no reason to rush into IVF if you don't have to. Says Stillman: “This is an argument not for doing IVF to have brighter kids but for having insurance coverage so everyone can have a child if they're having trouble getting pregnant.”

New Measurement of Telomere DNA Could Help Identify Most Viable Embryos for IVF

Scientists from the University of Warwick and University Hospitals Coventry and Warwickshire NHS Trust, are the first to directly measure a specific region of DNA in human embryos. The length of this region could be a quality marker for embryonic development.

Researchers at the University of Warwick's Warwick Medical School and University Hospital, Coventry, have measured telomeres, regions of repetitive DNA at the ends of a chromosome which protect it from deterioration. Telomeres shorten each time a cell divides and when telomere length becomes critically short, the cells die.

The research, published in Molecular Human Reproduction Journal, suggests that telomere length is shortest in the early stages of an embryo's development, at around two days, and then lengthens just before implantation in the womb at five days. This lengthening may be essential for normal development, because short telomeres may not be enough to survive the many rounds of cell division that take place as embryos grow.

Lead authors Professor Geraldine Hartshorne, from the University of Warwick's Warwick Medical School, and Sarah Turner, from University Hospital , Coventry, said this discovery could have implications for IVF treatment. Professor Hartshorne said: "It has already been shown that artificially shortened telomeres cause problems in animal embryos. Human embryos are highly variable, and many of them cannot develop normally. We think that telomere length might one day be used to help diagnose which are the most viable embryos. We also know that telomeres shorten with oxidative stress, so telomere length might also provide a measure of the stressfulness of the culture systems that we use in IVF and their impact on embryos."

The research project used oocytes and embryos donated by patients undergoing IVF treatment. Only material that could not be used for the patients' own treatment was accessed for research. Sarah Turner said: These results have given us plenty of new questions as well as answers. We now need to find out why telomere length is relatively short in early development. Our next steps are looking at single sperm and eggs to work out where the telomere length in early embryos is coming from. "

The Fertility Time-Bomb is Ticking!

Many women are risking their chances of being able to have children by leaving it too late, according to Bill Ledger, Professor of Obstetrics and Gynaecology at the UK's University of Sheffield. He told the Daily Telegraph newspaper that women who chose to delay motherhood until their 30s and beyond in order to establish their careers were ignoring the implications this could have for their fertility.

Professor Ledger recommends that women planing to start a family later in life have a fertility test at the age of thirty to help gauge how quickly their fertility is declining. He helped to develop a test, launched in 2006, called the 'Plan Ahead Kit' which works out the number of eggs that a woman has left in her ovaries. From this, it predicts the woman's 'ovarian reserve' for the following two years. Professor Ledger believes the test, which costs INR 16,000 could help women make more informed reproductive choices and conceive naturally.

However, Dr Gillian Lockwood, medical director of Midland Fertility Services and vice president of the Royal College of Obstetricians and Gynaecologists' ethics committee, and Tony Rutherford, chair of the British Fertility Society, have both voiced concerns that tests could also create a false sense of security, as egg reserves are not the only factor involved in getting pregnant naturally.

Professor Ledger said that too many women were relying on the availability of IVF as a fallback, not realising that the treatment was not freely available on the National Health Service (NHS) in the majority of cases. Last week a report showed that eight out of ten primary care trusts were failing to provide the recommended three cycles of IVF to women under 40 on the NHS.

Speaking to the Observer newspaper, Dr Mark Hamilton, the leading consultant obstetrician and gynaecologist at Aberdeen Maternity Hospital and former chairman of the British Fertility Society, made further calls for a campaign to raise awareness of fertility issues in primary and secondary schools: 'Sexual health messages focus entirely on avoidance of sex, but this should be coupled with promotion of fertility awareness. We should be teaching everyone, from childhood up, about all the factors linked to fertility potential, and how the huge range of things from lifestyle choices to genetic inheritance can have harmful effects on that potential.'

The average age for women to start a family is now over thirty and has been steadily increasing for decades. Research shows that fertility halves by the age of 35 and declines steadily thereafter.