Showing posts with label IUI. Show all posts
Showing posts with label IUI. Show all posts
Friday, December 31, 2010
Thursday, December 30, 2010
Tuesday, December 1, 2009
Lying down after artificial insemination improves pregnancy rates, study shows
A study in the Netherlands has shown that lying down following artificial insemination, also known as intrauterine insemination (IUI), increases the chances of pregnancy by 50 per cent.
The findings, published in the British Medical Journal (BMJ) last month, revealed that 27 per cent of women who remained in a supine position following treatment for 15 minutes achieved a live birth, compared with only 17 per cent of those who got up and moved around. In total, 391 couples aged between 18 and 43 took part in the study, which took place across several hospitals in the Netherlands. Each couple received up to three cycles of insemination and were split into two groups - one remained immobilised immediately after treatment and the other, the control group, were asked to walk around.
Lead author Dr Inge Custers, from the Academic Medical Center in Amsterdam, said that the pregnancy rate for the immobilised group was 'significantly higher'. He explained that 'immediate mobilisation might cause leakage [of the sperm]', which may take longer to reach the fallopian tubes if the woman is moving around. 'As immobilisation is easily done and carries very little cost, we suggest incorporating immobilisation as a standard procedure in intrauterine insemination treatment', said Custers, adding that clinics in the Netherlands were already adopting the method. However, there is concern that extending the period each bed is used in clinics could mean that clinics treat fewer patients. Custers said that improving the success rate of IUI will be more economical for patients. 'Although immobilisation takes more time and occupies more space in busy rooms, the intervention will be economic in the long run, as pregnant patients will not return in subsequent cycles,' he said.
In an editorial piece which accompanied Custer's publication in the BMJ, Professor William Ledger, from the Academic Unit of Reproductive and Developmental Medicine at the University of Sheffield, said that there remain many unexplained factors that need to be explored, such as the optimal length of time a woman should remain immobile following treatment to achieve pregnancy. He also noted that it was not clear what proportion of women in the study were given drugs to stimulate their ovaries to produce eggs and expressed some doubt over the benefits of remaining immobile. 'Such postcoital positioning was advocated in the United States many years ago but did not seem to improve conception rates after sex,' he said. He also warned that the overall pregnancy rate achieved in the study is somewhat lower than can be expected in Britain.
Ledger said that clinics should perform their own studies in the 'real world' to test Custers' findings. If further studies confirm the findings of the Netherlands team then he agreed that some couples will be spared the cost of IVF (in-vitro fertilisation). Artificial insemination is cheaper than IVF and requires minimal drug treatment. It is often used prior to IVF and success rates vary from 5-70 per cent, according to Ledger.
The findings, published in the British Medical Journal (BMJ) last month, revealed that 27 per cent of women who remained in a supine position following treatment for 15 minutes achieved a live birth, compared with only 17 per cent of those who got up and moved around. In total, 391 couples aged between 18 and 43 took part in the study, which took place across several hospitals in the Netherlands. Each couple received up to three cycles of insemination and were split into two groups - one remained immobilised immediately after treatment and the other, the control group, were asked to walk around.
Lead author Dr Inge Custers, from the Academic Medical Center in Amsterdam, said that the pregnancy rate for the immobilised group was 'significantly higher'. He explained that 'immediate mobilisation might cause leakage [of the sperm]', which may take longer to reach the fallopian tubes if the woman is moving around. 'As immobilisation is easily done and carries very little cost, we suggest incorporating immobilisation as a standard procedure in intrauterine insemination treatment', said Custers, adding that clinics in the Netherlands were already adopting the method. However, there is concern that extending the period each bed is used in clinics could mean that clinics treat fewer patients. Custers said that improving the success rate of IUI will be more economical for patients. 'Although immobilisation takes more time and occupies more space in busy rooms, the intervention will be economic in the long run, as pregnant patients will not return in subsequent cycles,' he said.
In an editorial piece which accompanied Custer's publication in the BMJ, Professor William Ledger, from the Academic Unit of Reproductive and Developmental Medicine at the University of Sheffield, said that there remain many unexplained factors that need to be explored, such as the optimal length of time a woman should remain immobile following treatment to achieve pregnancy. He also noted that it was not clear what proportion of women in the study were given drugs to stimulate their ovaries to produce eggs and expressed some doubt over the benefits of remaining immobile. 'Such postcoital positioning was advocated in the United States many years ago but did not seem to improve conception rates after sex,' he said. He also warned that the overall pregnancy rate achieved in the study is somewhat lower than can be expected in Britain.
Ledger said that clinics should perform their own studies in the 'real world' to test Custers' findings. If further studies confirm the findings of the Netherlands team then he agreed that some couples will be spared the cost of IVF (in-vitro fertilisation). Artificial insemination is cheaper than IVF and requires minimal drug treatment. It is often used prior to IVF and success rates vary from 5-70 per cent, according to Ledger.
Sunday, July 26, 2009
Lesbian couple win fight for IVF on the NHS
A Lesbian couple have won the right to IVF on the NHS after a legal tussle, ahead of laws that will put same-sex patients on an equal footing with heterosexuals.
The couple, who remain anonymous, had to go through a legal fight to push the NHS to fund IVF because, at the moment, individual trusts decide whether they wish to pay for treatment for lesbians.
The couple were initially refused IVF by their primary care trust because they were of the same sex. One of the women had polycystic ovarian syndrome, which disrupts ovulation, and is one of the most common causes of infertility.
From October, clinics will no longer be able to block lesbians by referring to a child’s “need for a father”. Instead, same-sex couples will need to demonstrate only that they can offer “supportive parenting”.
If NHS trusts continue to deny lesbians fertility treatment after this date they face possible legal action.
Ruth Hunt, head of policy at Stonewall, the lesbian, gay and bisexual charity, said: “The changes in the law should mean that no infertile lesbian is refused NHS fertility treatment on the grounds of her sexual orientation.
“We have just published a guide on how to get pregnant for lesbians in response to lots of queries. This is a hot topic for us at the moment.”
While same-sex couples have won new rights, many heterosexual couples continue to be denied IVF on the NHS. Only 27% of trusts offer heterosexual couples three cycles of treatment as recommended by the National Institute for Health and Clinical Excellence, the NHS guidance body.
If lesbians are fertile they can usually conceive by intrauterine insemination (IUI), the medical name for donor insemination. This is less complicated than IVF, which involves fertilising eggs in a test tube. IUI is also cheaper,at about £700 per attempt compared with £3,000 per cycle of IVF.
The lesbian couple enlisted David Herbert, a partner at the law firm Lester Aldridge, when they were denied IVF on the grounds that they were of the same sex. The trust reversed its decision in June.
Herbert said: “Discrimination on the grounds of sexual orientation is contrary to the Human Rights Act and the Equality Act. There is an element of conflict in the Human Fertilisation and Embryology Act 1990 which requires clinics to consider a child’s ‘need for a father’.
“This was used historically to justify denying treatment to same-sex couples. The ‘need for a father’ element is just about to be removed on the grounds that it is discriminatory. The assessment will be for ‘supportive parenting’, which will come into force in October.”
The government’s equality watchdog, the Equality and Human Rights Commission, took an interest and offered its support to the couple.
This is the second known case in which lesbians have been given fertility treatment after a legal fight. In February a Scottish couple forced Greater Glasgow and Clyde NHS health board to offer them treatment.
The couple, who remain anonymous, had to go through a legal fight to push the NHS to fund IVF because, at the moment, individual trusts decide whether they wish to pay for treatment for lesbians.
The couple were initially refused IVF by their primary care trust because they were of the same sex. One of the women had polycystic ovarian syndrome, which disrupts ovulation, and is one of the most common causes of infertility.
From October, clinics will no longer be able to block lesbians by referring to a child’s “need for a father”. Instead, same-sex couples will need to demonstrate only that they can offer “supportive parenting”.
If NHS trusts continue to deny lesbians fertility treatment after this date they face possible legal action.
Ruth Hunt, head of policy at Stonewall, the lesbian, gay and bisexual charity, said: “The changes in the law should mean that no infertile lesbian is refused NHS fertility treatment on the grounds of her sexual orientation.
“We have just published a guide on how to get pregnant for lesbians in response to lots of queries. This is a hot topic for us at the moment.”
While same-sex couples have won new rights, many heterosexual couples continue to be denied IVF on the NHS. Only 27% of trusts offer heterosexual couples three cycles of treatment as recommended by the National Institute for Health and Clinical Excellence, the NHS guidance body.
If lesbians are fertile they can usually conceive by intrauterine insemination (IUI), the medical name for donor insemination. This is less complicated than IVF, which involves fertilising eggs in a test tube. IUI is also cheaper,at about £700 per attempt compared with £3,000 per cycle of IVF.
The lesbian couple enlisted David Herbert, a partner at the law firm Lester Aldridge, when they were denied IVF on the grounds that they were of the same sex. The trust reversed its decision in June.
Herbert said: “Discrimination on the grounds of sexual orientation is contrary to the Human Rights Act and the Equality Act. There is an element of conflict in the Human Fertilisation and Embryology Act 1990 which requires clinics to consider a child’s ‘need for a father’.
“This was used historically to justify denying treatment to same-sex couples. The ‘need for a father’ element is just about to be removed on the grounds that it is discriminatory. The assessment will be for ‘supportive parenting’, which will come into force in October.”
The government’s equality watchdog, the Equality and Human Rights Commission, took an interest and offered its support to the couple.
This is the second known case in which lesbians have been given fertility treatment after a legal fight. In February a Scottish couple forced Greater Glasgow and Clyde NHS health board to offer them treatment.
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