Showing posts with label Fertility Tales. Show all posts
Showing posts with label Fertility Tales. Show all posts
Thursday, April 30, 2009
Wednesday, February 11, 2009
New Research Questions Use Of Common Fertility Treatments
A new study published on bmj.com has found that fertility is not improved in infertile couples who have been treated with long-established medical interventions. The team of researchers led by the University of Aberdeen has called for UK and national guidelines to be reviewed with this new evidence that challenges current practices.
In the UK, one in seven couples experience infertility. Of these, about 25% of the infertility is unexplained, and the standard treatment includes a body of common interventions that have been used for years and have been issued by the National Institute for Health and Clinical Excellence (NICE).
The research team set out to compare two specific interventions with expectant management (i.e., no treatment). From four teaching hospitals and a district general hospital in Scotland, they recruited a sample of 580 women who have had unexplained infertility for over two years. The women were randomly assigned such that one group had no medical intervention and tried naturally to become pregnant, a second group took oral clomifene citrate (CC) to correct subtle ovulatory dysfunction, and a third group received unstimulated intra-uterine insemination (IUI) of sperm.
During the course of the study, 101 women became pregnant and had a live birth. The birth rate for women with no intervention was 17%, and the rates for the oral CC group and the IUI group were 14% and 23%, respectively. According to the researchers, the 6% difference between the IUI and the non-intervention group is no large enough for the results to suggest a meaningful and significant improvement in the live birth rate.
Many women suffered from side effects that included: pain, bloating, hot flushes, nausea and headaches. These affected about 10 to 20% of women, most of whom were taking oral CC. Also, it is worth noting that satisfaction was higher in the groups of women being actively treated - as they were reassured by the treatment process - compared to women who received no intervention.
"These interventions, which have been in use for many years, are unlikely to be more effective than no treatment. These results challenge current practice, as endorsed by a national guideline in the UK," conclude the authors.
Tarek El-Toukhy and Yacoub Khalaf (Assisted Conception Unit at Guy's and St Thomas' NHS Foundation Trust) write in an accompanying editorial that: "As a direct result of the lack of evidence, many couples with unexplained infertility endure (and even request) expensive, potentially hazardous, and often unnecessary treatments." There is a need for high quality clinical trials as well as better information for patients to determine the best treatments in light of effectiveness and adverse effects. El-Toukhy and Khalaf also call for the current NICE guidelines to be reviewed with this research in mind.
Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial
S Bhattacharya, K Harrild, J Mollison, S Wordsworth, C Tay, A Harrold, D McQueen, H Lyall, L Johnston, J Burrage, S Grossett, H Walton, J Lynch, A Johnstone, S Kini, A Raja, A Templeton
BMJ (2008). 337: a716.
doi:10.1136/bmj.a716
In the UK, one in seven couples experience infertility. Of these, about 25% of the infertility is unexplained, and the standard treatment includes a body of common interventions that have been used for years and have been issued by the National Institute for Health and Clinical Excellence (NICE).
The research team set out to compare two specific interventions with expectant management (i.e., no treatment). From four teaching hospitals and a district general hospital in Scotland, they recruited a sample of 580 women who have had unexplained infertility for over two years. The women were randomly assigned such that one group had no medical intervention and tried naturally to become pregnant, a second group took oral clomifene citrate (CC) to correct subtle ovulatory dysfunction, and a third group received unstimulated intra-uterine insemination (IUI) of sperm.
During the course of the study, 101 women became pregnant and had a live birth. The birth rate for women with no intervention was 17%, and the rates for the oral CC group and the IUI group were 14% and 23%, respectively. According to the researchers, the 6% difference between the IUI and the non-intervention group is no large enough for the results to suggest a meaningful and significant improvement in the live birth rate.
Many women suffered from side effects that included: pain, bloating, hot flushes, nausea and headaches. These affected about 10 to 20% of women, most of whom were taking oral CC. Also, it is worth noting that satisfaction was higher in the groups of women being actively treated - as they were reassured by the treatment process - compared to women who received no intervention.
"These interventions, which have been in use for many years, are unlikely to be more effective than no treatment. These results challenge current practice, as endorsed by a national guideline in the UK," conclude the authors.
Tarek El-Toukhy and Yacoub Khalaf (Assisted Conception Unit at Guy's and St Thomas' NHS Foundation Trust) write in an accompanying editorial that: "As a direct result of the lack of evidence, many couples with unexplained infertility endure (and even request) expensive, potentially hazardous, and often unnecessary treatments." There is a need for high quality clinical trials as well as better information for patients to determine the best treatments in light of effectiveness and adverse effects. El-Toukhy and Khalaf also call for the current NICE guidelines to be reviewed with this research in mind.
Clomifene citrate or unstimulated intrauterine insemination compared with expectant management for unexplained infertility: pragmatic randomised controlled trial
S Bhattacharya, K Harrild, J Mollison, S Wordsworth, C Tay, A Harrold, D McQueen, H Lyall, L Johnston, J Burrage, S Grossett, H Walton, J Lynch, A Johnstone, S Kini, A Raja, A Templeton
BMJ (2008). 337: a716.
doi:10.1136/bmj.a716
Wednesday, January 14, 2009
Folate receptor blockade may compromise fertility
Treatment of impaired folate metabolism caused by an autoimmune response might improve the chances of conception among certain women with fertility problems, research suggests.
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
Wednesday, September 3, 2008
Fertility a matter of mind as well as body
Infertile women's brains - and not just their bodies - may be blocking them from conceiving a baby, a new book says.
Some women may be sabotaging their chances of having a baby by failing to address their emotional needs, according to Melbourne author Michaela Ryan. Her new book, Trying to Conceive, tells 15 stories of women who miraculously fell pregnant after they solved a range of personal issues.
The stories include Deb and Keith, who endured 23 cycles of IVF and several miscarriages before Deb fell pregnant after she quit her job and reconnected with her long lost dad.
And there is Naomi, who spent eight years trying to conceive, but was successful only when she started relaxing more and believing in herself.
Ryan was moved to collect the stories after her own experience.
"I tried to conceive for 12 stress-filled months, then as soon as I stopped obsessing about having a baby, I fell pregnant," she said.
"So I became very interested in looking at the possible effects of emotional issues and the impact this might be having for couples wanting to fall pregnant."
Ryan, 32, a freelance writer from Elwood and her husband Ted, 34, are now the proud parents of Declan, 3.
"For a lot of the people I spoke to there were hidden fears that hadn't really been addressed like fear of repeating the mistakes of the past, fear of subsequent miscarriage or fears of not being a good mother," Ryan said.
"It's a really individual thing, but the common feeling is at some point there's an emotional shift -- a letting go -- and many women fall pregnant soon after that."
Ryan said medical science "has really caught up, and there are improved pregnancy rates for those on stress reduction programs, for instance".
"A lot of women are only given very physical approaches and this offers another angle. "
Dr Lynn Burmeister, clinical director of Monash IVF, said there was an underlying association between emotions and the body when it came to fertility.
"There are no studies in humans to confirm this, but what we do know is that stress can reduce fertility in a number of ways," she said.
"We do our best to make sure we look after our patients' minds as well as their bodies.
"Some do acupuncture and others attend our lifestyle modification clinics or see counsellors."
Dr Burmeister said she had seen patients with similar stories to those in the book.
"I have had patients who have made an appointment with us and just doing that has taken a weight off their shoulders, and they ring back saying that they are not going to need us," she said.
Some women may be sabotaging their chances of having a baby by failing to address their emotional needs, according to Melbourne author Michaela Ryan. Her new book, Trying to Conceive, tells 15 stories of women who miraculously fell pregnant after they solved a range of personal issues.
The stories include Deb and Keith, who endured 23 cycles of IVF and several miscarriages before Deb fell pregnant after she quit her job and reconnected with her long lost dad.
And there is Naomi, who spent eight years trying to conceive, but was successful only when she started relaxing more and believing in herself.
Ryan was moved to collect the stories after her own experience.
"I tried to conceive for 12 stress-filled months, then as soon as I stopped obsessing about having a baby, I fell pregnant," she said.
"So I became very interested in looking at the possible effects of emotional issues and the impact this might be having for couples wanting to fall pregnant."
Ryan, 32, a freelance writer from Elwood and her husband Ted, 34, are now the proud parents of Declan, 3.
"For a lot of the people I spoke to there were hidden fears that hadn't really been addressed like fear of repeating the mistakes of the past, fear of subsequent miscarriage or fears of not being a good mother," Ryan said.
"It's a really individual thing, but the common feeling is at some point there's an emotional shift -- a letting go -- and many women fall pregnant soon after that."
Ryan said medical science "has really caught up, and there are improved pregnancy rates for those on stress reduction programs, for instance".
"A lot of women are only given very physical approaches and this offers another angle. "
Dr Lynn Burmeister, clinical director of Monash IVF, said there was an underlying association between emotions and the body when it came to fertility.
"There are no studies in humans to confirm this, but what we do know is that stress can reduce fertility in a number of ways," she said.
"We do our best to make sure we look after our patients' minds as well as their bodies.
"Some do acupuncture and others attend our lifestyle modification clinics or see counsellors."
Dr Burmeister said she had seen patients with similar stories to those in the book.
"I have had patients who have made an appointment with us and just doing that has taken a weight off their shoulders, and they ring back saying that they are not going to need us," she said.
Monday, June 30, 2008
Misguided fertility beliefs common in young people
Young people are aware that negative lifestyle factors reduce fertility but falsely believe in fertility myths and the benefits of healthy habits, say researchers.
The UK-based team used a 21-item questionnaire to assess fertility knowledge in 110 female and 39 male under- and postgraduate university students, with an average age of just over 24 years.
Participants were far better at identifying fertility risks than myths, and better at identifying the latter than illusory benefits of healthy habits, with average correct scores of 90.70 percent, 41.53 percent, and 26.46 percent, respectively.
All risk factors, such as smoking and being overweight, were correctly identified, report Laura Bunting and Jacky Boivin from Cardiff University.
However, participants mistakenly believed that they could increase their fertility, for example by moving to the countryside, using specific coital techniques, eating fruit and vegetables, or adopting a child.
They also believed that "not doing" something unhealthy, for example never drinking alcohol, could increase fertility instead of simply reducing exposure to risk and its effects.
"Together these results would suggest that people could, if faced with a fertility problem, engage in ineffective behaviors that could delay seeking effective interventions," the researchers conclude.
The UK-based team used a 21-item questionnaire to assess fertility knowledge in 110 female and 39 male under- and postgraduate university students, with an average age of just over 24 years.
Participants were far better at identifying fertility risks than myths, and better at identifying the latter than illusory benefits of healthy habits, with average correct scores of 90.70 percent, 41.53 percent, and 26.46 percent, respectively.
All risk factors, such as smoking and being overweight, were correctly identified, report Laura Bunting and Jacky Boivin from Cardiff University.
However, participants mistakenly believed that they could increase their fertility, for example by moving to the countryside, using specific coital techniques, eating fruit and vegetables, or adopting a child.
They also believed that "not doing" something unhealthy, for example never drinking alcohol, could increase fertility instead of simply reducing exposure to risk and its effects.
"Together these results would suggest that people could, if faced with a fertility problem, engage in ineffective behaviors that could delay seeking effective interventions," the researchers conclude.
Tuesday, March 4, 2008
Closer Kinship Linked With Reproductive Success
In a paper published 7 Feb 2008 deCODE scientists establish a substantial and consistent positive correlation between the kinship of couples and the number of children and grandchildren they have. The study, which analyzes more than 200 years of deCODE's comprehensive genalogical data on the population of Iceland, shows that couples related at the level of third cousins have the greatest number of offspring. For example, for women born between 1800 and 1824, those with a mate related at the level of a third cousin had an average of 4.04 children and 9.17 grandchildren, while those related to their mates as eighth cousins or more distantly had 3.34 children and 7.31 grandchildren. For women born in the period 1925-1949 with mates related at the degree of third cousins, the average number of children and grandchildren were 3.27 and 6.64, compared to 2.45 and 4.86 for those with mates who were eighth cousins or more distantly related.
The findings hold for every 25-year interval studied, beginning with those born in the year 1800 up to the present day. Because of the strength and consistency of the association, even between couples with very subtle differences in kinship, the authors conclude that the effect very likely has a biological basis, one which has yet to be elucidated. The paper, 'An association between the kinship and fertility of human couples,' is published online in Science magazine at www.sciencemag.org.
This study provides the most comprehensive answer yet to the longstanding question of how kinship affects fertility in humans. Previous studies in other parts of the world have suggested that the two phenomena are positively correlated, though confounding variables, such as the impact of socioeconomic status on the size of families or age at marriage, have made the results difficult to interpret. The analysis of such a long-term series of data from Iceland effectively eliminates these variables by encompassing an entire population which has historically been highly homogeneous both culturally and economically. Moreover, the results are strikingly consistent from eras in which Iceland was a predominantly poor and rural country, to the present-day era of a highly urbanized society with one of the highest standards of living in the world.
The authors note that the findings are somewhat counterintuitive from an evolutionary perspective because closely-related parents have a higher probability of having offspring homozygous for deleterious recessive mutations, although closer parental kinship can also decrease the likelihood of immunological incompatibility between mother and offspring, for example in rhesus factor blood type. Perhaps most importantly, today's findings also suggest that the recent and dramatic demographic shift experienced in Iceland - from a rural society to a highly urbanized one - may serve to slow population growth, as individuals are exposed to a much broader range of distantly related potential mates. If so, this could be of relevance to slowing population growth in the many other - and much more populous - societies around the world undergoing transition from closely-knit rural societies to more urbanized ones. Indeed, the UN estimates that in the 2007-2008 period the majority of the world's population will, for the first time in human history, live in town and cities.
The findings hold for every 25-year interval studied, beginning with those born in the year 1800 up to the present day. Because of the strength and consistency of the association, even between couples with very subtle differences in kinship, the authors conclude that the effect very likely has a biological basis, one which has yet to be elucidated. The paper, 'An association between the kinship and fertility of human couples,' is published online in Science magazine at www.sciencemag.org.
This study provides the most comprehensive answer yet to the longstanding question of how kinship affects fertility in humans. Previous studies in other parts of the world have suggested that the two phenomena are positively correlated, though confounding variables, such as the impact of socioeconomic status on the size of families or age at marriage, have made the results difficult to interpret. The analysis of such a long-term series of data from Iceland effectively eliminates these variables by encompassing an entire population which has historically been highly homogeneous both culturally and economically. Moreover, the results are strikingly consistent from eras in which Iceland was a predominantly poor and rural country, to the present-day era of a highly urbanized society with one of the highest standards of living in the world.
The authors note that the findings are somewhat counterintuitive from an evolutionary perspective because closely-related parents have a higher probability of having offspring homozygous for deleterious recessive mutations, although closer parental kinship can also decrease the likelihood of immunological incompatibility between mother and offspring, for example in rhesus factor blood type. Perhaps most importantly, today's findings also suggest that the recent and dramatic demographic shift experienced in Iceland - from a rural society to a highly urbanized one - may serve to slow population growth, as individuals are exposed to a much broader range of distantly related potential mates. If so, this could be of relevance to slowing population growth in the many other - and much more populous - societies around the world undergoing transition from closely-knit rural societies to more urbanized ones. Indeed, the UN estimates that in the 2007-2008 period the majority of the world's population will, for the first time in human history, live in town and cities.
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