The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Monday, December 3, 2007
Online Gene Mapping
Two rival companies have launched novel genetic services which, for a price tag of $1000 (Rs. 40,000), will allow people to have their genomes scanned, delivering them personal information about their ancestry, some personal disease risks and other inherited traits.
The first - called deCODEme - was launched by Icelandic company deCODE Genetics on 16 November. Customers send a cheek swab in the post from which DNA can be extracted and analysed for 'over one million variants in your genome', says the website. This is achieved by comparing the customer's genome with a database of thousand's of people's genomes in search for single letter changes - known as SNPs - which can act as signposts for disease risk or other inherited traits. Within 2-3 weeks customers can expect to have access to their personal genome profile via a password-protected online account.
The second - called 23andMe, a reference to the number of pairs of chromosomes in the human genome - was launched on 19 November by a start-up company based in California's Silicon Valley. Similarly, customers send a saliva sample in the post from which DNA can be extracted and analysed for 'nearly 60,000 datapoints on your genome', says the website. 23andMe
co-founder Anne Wojcicki is married to Google co-founder Sergey Brin, who is also a major funder of the venture.
Both websites emphasise that they are not medical-diagnostic services, instead marketing themselves as providers of genetic information. 23andMe even promotes the novelty of being able to 'connect with other 23andMe customers through sharing features', raising the prospect that a kind of gene-based social networking service might evolve, like MySpace or FaceBook.
Some critics have raised concerns over the potential value of a growing body of genetic information to a biotech or insurance company, particularly in light of the fact that 23andMe intends to share anonymised information with outside groups for the purpose of research. While both companies have stressed that they take confidentiality very seriously, promising to accept customers anonymously if specified, there are further concerns that insurance companies might mount legal pressure on such
companies in order to force information disclosure. 'Will they stoutly defend privacy if sued by insurers?' asks The Economist, also worried that any personal genetic information shared with doctors in the US could inadvertently make its way into the hands of insurers via medical records.
Although there are obvious benefits to be gained from the availability of personal genome services, there are also legitimate concerns that such services could cause unnecessary anxiety for some. 'I would think twice before spitting into that vial', says author Nicholas Carr, writing in the Guardian (UK).
Sunday, December 2, 2007
Bolo Ta Ra Ra Ra
A sardar went hunting one day in Ontario and bagged three ducks. He put them in the bed of his pickup truck and was about to drive home when he was confronted by an honorary game warden who didn't like sardars.
The game warden ordered the sardar to show his hunting license, and the sardar pulled out a valid Ontario hunting license. The game warden looked at the license, then reached over and picked up one of the ducks, sniffed its butt, and said, "This duck ain't from Ontario. This is a Quebec duck. You got a Quebec huntin' license, boy?" The sardar reached into his wallet and produced a Quebec hunting license.
The game warden looked at it, then reached over and grabbed the second duck, sniffed its butt, and said "This ain't no Quebec duck. This duck's from Manitoba. You got a Manitoba license?" The sardar reached into his wallet and produced a Manitoba hunting license.
The warden then reached over and picked up the third duck, sniffed its butt, and said, "This ain't no Manitoba duck. This here duck's from Nova Scotia. You got a Nova Scotia huntin' license?" Again the sardar reached into his wallet and brought out a Nova Scotia hunting license.
The game warden was extremely frustrated at this point, and he yelled at the sardar "Just where the hell are you from?" The sardar smiled turned around, bent over, dropped his pants, and said, "You tell me, you're the expert."
Saturday, December 1, 2007
Child Support Agency Forms - Dallas, USA 2007
The following are all replies that Dallas women have written on Child Support Agency forms in the section for listing fathers name details.
1.Regarding the identity of the father of my twins, child A was fathered by Jim Munson. I am unsure as to the identity of the father of child B, but I believe that he was conceived on the same night.
2.I am unsure as to the identity of the father of my child as I was being sick out of a window when taken unexpectedly from behind. I can provide you with a list of names of men that I think were at the party if this helps.
3.I do not know the name of the father of my little girl. She was conceived at a party at 3600 Grand Avenue where I had unprotected sex with a man I met that night. I do remember that the sex was so good that I fainted. If you do manage to track down the father, can you send me his phone number? Thanks.
4.I don't know the identity of the father of my daughter. He drives a BMW that now has a hole made by my stiletto in one of the door panels. Perhaps you can contact BMW service stations in this area and see if he's had it replaced.
5.I have never had sex with a man. I am awaiting a letter from the Pope confirming that my son's conception was immaculate and that he is Christ risen again.
6.I cannot tell you the name of child A's dad as he informs me that to do so would blow his cover and that would have cataclysmic implications for the economy. I am torn between doing right by you and right by the country. Please advise.
7.I do not know who the father of my child was as all blacks look the same to me.
8.Peter Smith is the father of child A. If you do catch up with him, can you ask him what he did with my AC/DC CDs?
9.From the dates it seems that my daughter was conceived at Disney World; maybe it really is the Magic Kingdom.
10.So much about that night is a blur. The only thing that I remember for sure is Delia Smith did a program about eggs earlier in the evening. If I'd have stayed in and watched more TV rather than going to the party at 146 Miller Drive, mine might have remained unfertilized.
11.I am unsure as to the identity of the father of my baby, after All when you eat a can of beans you can't be sure which one made you fart.
Amen!
1.Regarding the identity of the father of my twins, child A was fathered by Jim Munson. I am unsure as to the identity of the father of child B, but I believe that he was conceived on the same night.
2.I am unsure as to the identity of the father of my child as I was being sick out of a window when taken unexpectedly from behind. I can provide you with a list of names of men that I think were at the party if this helps.
3.I do not know the name of the father of my little girl. She was conceived at a party at 3600 Grand Avenue where I had unprotected sex with a man I met that night. I do remember that the sex was so good that I fainted. If you do manage to track down the father, can you send me his phone number? Thanks.
4.I don't know the identity of the father of my daughter. He drives a BMW that now has a hole made by my stiletto in one of the door panels. Perhaps you can contact BMW service stations in this area and see if he's had it replaced.
5.I have never had sex with a man. I am awaiting a letter from the Pope confirming that my son's conception was immaculate and that he is Christ risen again.
6.I cannot tell you the name of child A's dad as he informs me that to do so would blow his cover and that would have cataclysmic implications for the economy. I am torn between doing right by you and right by the country. Please advise.
7.I do not know who the father of my child was as all blacks look the same to me.
8.Peter Smith is the father of child A. If you do catch up with him, can you ask him what he did with my AC/DC CDs?
9.From the dates it seems that my daughter was conceived at Disney World; maybe it really is the Magic Kingdom.
10.So much about that night is a blur. The only thing that I remember for sure is Delia Smith did a program about eggs earlier in the evening. If I'd have stayed in and watched more TV rather than going to the party at 146 Miller Drive, mine might have remained unfertilized.
11.I am unsure as to the identity of the father of my baby, after All when you eat a can of beans you can't be sure which one made you fart.
Amen!
Friday, November 30, 2007
Anti-Epileptic Drugs
The use of antiepileptic drugs (AEDs) can lead to decreased fertility and increased incidence of reproductive endocrine disorders in both men and women. A new study published in Epilepsia investigates the effects of withdrawal from two common AEDs, carbamazepine (CBZ) and valproate (VPA), on the sex-hormones of male and female AED users. The study finds that reproductive endocrine dysfunction resulting from AED use is reversible, even after years of treatment. After withdrawal from CBZ and VPA, sexual hormone levels returned to pre-treatment levels, and treatment-associated reproductive endocrine changes reversed.
Increases in serum testosterone concentration and decreases in estradiol, another sexual hormone, lead to improved sexual function for both men and women. Women who stopped using CBZ and VPA also saw a return to normal estrogen levels and decreases in body mass index (BMI). “These findings provide further evidence of the potentially negative effects of epilepsy treatment on reproductive endocrine functions in men and women, but they also show that some of these changes may be reversible,” says Morten I. Lossius, author of the study.
A history of maternal epilepsy and its associated treatment may be linked to impaired intelligence later in life, says a new study published in Epilepsia. Dr. Nina Oyen, M.D., of the University of Bergen and Norwegian Institute of Public Health, Bergen, Norway, investigated the I.Q. levels of sons born to mothers with and without epilepsy, and found a correlation between intelligence and the illness. Drawing on extensive data on maternal epilepsy reported to the Medical Birth Registry of Norway and adult I.Q. scores and anthropometric measures taken later in life, the study monitored male children until the age of nineteen, providing a long-term look at the possible effects of maternal epilepsy on fetal brain development. The study finds that almost twenty years after birth, the sons of mothers who suffered from epilepsy before or during pregnancy exhibited reduced I.Q. scores when compared to men whose mothers did not have epilepsy. A history of maternal epilepsy was also found to be associated with shorter height. “Our results underline the need for population-based registries with complete long-term follow-up of infants with prenatal exposure to phenobarbital and phenytoin, drugs that are still widely used in many countries,” says Oyen, noting that studying the effects of exposure to newer medications is also important. Information on the specific antiepileptic drugs used by the epileptic mothers of children in the study was not available. “It remains to be seen whether the newer antiepileptic drugs are safer to offspring exposed during fetal life.”
Increases in serum testosterone concentration and decreases in estradiol, another sexual hormone, lead to improved sexual function for both men and women. Women who stopped using CBZ and VPA also saw a return to normal estrogen levels and decreases in body mass index (BMI). “These findings provide further evidence of the potentially negative effects of epilepsy treatment on reproductive endocrine functions in men and women, but they also show that some of these changes may be reversible,” says Morten I. Lossius, author of the study.
A history of maternal epilepsy and its associated treatment may be linked to impaired intelligence later in life, says a new study published in Epilepsia. Dr. Nina Oyen, M.D., of the University of Bergen and Norwegian Institute of Public Health, Bergen, Norway, investigated the I.Q. levels of sons born to mothers with and without epilepsy, and found a correlation between intelligence and the illness. Drawing on extensive data on maternal epilepsy reported to the Medical Birth Registry of Norway and adult I.Q. scores and anthropometric measures taken later in life, the study monitored male children until the age of nineteen, providing a long-term look at the possible effects of maternal epilepsy on fetal brain development. The study finds that almost twenty years after birth, the sons of mothers who suffered from epilepsy before or during pregnancy exhibited reduced I.Q. scores when compared to men whose mothers did not have epilepsy. A history of maternal epilepsy was also found to be associated with shorter height. “Our results underline the need for population-based registries with complete long-term follow-up of infants with prenatal exposure to phenobarbital and phenytoin, drugs that are still widely used in many countries,” says Oyen, noting that studying the effects of exposure to newer medications is also important. Information on the specific antiepileptic drugs used by the epileptic mothers of children in the study was not available. “It remains to be seen whether the newer antiepileptic drugs are safer to offspring exposed during fetal life.”
Thursday, November 29, 2007
Pesticides, Contaminants & Fertility
Methoxychlor (MXC), a common insect pesticide used on food crops, may interfere with proper development and function of the reproductive tract, leading to reduced fertility in women, researchers at Yale School of Medicine write in the journal Endocrinology. The researchers found that MXC, which was manufactured as a safer replacement for the now-banned DDT, alters the estrogen-regulated gene Hoxa10 in the reproductive tract and reduces the ability of the uterus to support embryo implantation. The researchers used mice and then human cell lines to confirm their findings. MXC is a man-made pesticide used to kill flies, mosquitoes, cockroaches and other insects, and is applied directly to food crops, livestock, home gardens and pets. It is one of a large number of chemicals that can mimic the action of hormones and in some instances interfere with endocrine function. Some of these endocrine disruptors bind estrogen receptors and adversely affect reproductive tract development, which is heavily influenced by estrogen. MXC and other chemicals like DDT have been shown in other studies to induce abnormalities in tissue development and function in the female reproductive tract. "MXC has an adverse effect on these mice similar to that of DES, a synthetic estrogen," said senior author Hugh S. Taylor, M.D., associate professor in the Division of Reproductive Endocrinology and Infertility in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale School of Medicine. "Female offspring of women exposed to DES were more likely to have an abnormally shaped cervix, were more prone to cancer of the vagina, miscarriages, early labor and other complications."
The contaminant bisphenol-A (BPA)--widely used to make many plastics found in food storage containers and dental products--can have long-term effects in female development, according to a recent study by Yale School of Medicine researchers. Lead investigator Hugh S. Taylor, said the study shows that BPA changes the expression of key developmental genes that form the uterus. Taylor explained that if pregnant women are exposed to the estrogen-like properties found in BPA, it may impact female reproductive tract development and the future fertility of female fetuses the mother is carrying. The study was conducted on pregnant female mice by administering a range of doses of BPA on days 9-16 of their pregnancies. The aim was to see what interaction BPA would have with the HOXA10 gene, which is necessary for uterine development.
Taylor and co-author Caroline C. Smith of the Department of Epidemiology and Public Health at Yale School of Medicine, found that BPA does, in fact, alter the expression of the HOXA 10 gene, implying that exposure to the popular plastics component may lead to infertility in humans. "The net effect is concerning," said Taylor. "We are all exposed to multiple estrogen-like chemicals in industrial products, food and pollutants." BPA is found in plastics, including baby bottles, epoxy resins used in canned goods and dental sealants. In addition to this new link to fertility and reproductive health, previous findings by Csaba Leranth, M.D., also in Yale Ob/Gyn, found that low doses of BPA in female rats inhibited estrogen induction in the brain. This can lead to learning impairment and, in old age, the onset of neurodegenerative disorders such as Alzheimer's disease.
The contaminant bisphenol-A (BPA)--widely used to make many plastics found in food storage containers and dental products--can have long-term effects in female development, according to a recent study by Yale School of Medicine researchers. Lead investigator Hugh S. Taylor, said the study shows that BPA changes the expression of key developmental genes that form the uterus. Taylor explained that if pregnant women are exposed to the estrogen-like properties found in BPA, it may impact female reproductive tract development and the future fertility of female fetuses the mother is carrying. The study was conducted on pregnant female mice by administering a range of doses of BPA on days 9-16 of their pregnancies. The aim was to see what interaction BPA would have with the HOXA10 gene, which is necessary for uterine development.
Taylor and co-author Caroline C. Smith of the Department of Epidemiology and Public Health at Yale School of Medicine, found that BPA does, in fact, alter the expression of the HOXA 10 gene, implying that exposure to the popular plastics component may lead to infertility in humans. "The net effect is concerning," said Taylor. "We are all exposed to multiple estrogen-like chemicals in industrial products, food and pollutants." BPA is found in plastics, including baby bottles, epoxy resins used in canned goods and dental sealants. In addition to this new link to fertility and reproductive health, previous findings by Csaba Leranth, M.D., also in Yale Ob/Gyn, found that low doses of BPA in female rats inhibited estrogen induction in the brain. This can lead to learning impairment and, in old age, the onset of neurodegenerative disorders such as Alzheimer's disease.
Wednesday, November 28, 2007
New Insight into Female Sexual Dysfunction (FSD)
The kids. The job. The house. The cell phone, blackberry and email. With all the responsibilities many women juggle, there is often no time for romance, and in many cases, even less desire. Well over a third (40 – 45%) of adult women experience at least one symptom of sexual dysfunction, and few feel they can talk about it. Researchers are working to change the condition and this way of thinking. “Women who have sexual dysfunction should realize this may be a treatable condition, not just a personal problem,” says Thuy-Tien L. Dam, M.D. “Many women don’t know that other women experience this too, and that it might be a diagnosable disorder called Hypoactive Sexual Desire Disorder or HSDD.” Dam, is conducting a clinical trial to see whether an investigational drug is safe and effective for women with low sexual desire. HSDD is the most common form of female sexual dysfunction, characterized by decreased sexual thoughts and feelings as well as a loss of desire for sex. About 17% to 55% of women have low levels of sexual interest, depending on age. “Candidates for the study are women who have desire problems; women who once had a healthy sex-drive who now notice a big difference in desire level, for some unknown reason,” says Dam. “If we can understand the physiologic process of what’s happening, we can tailor the treatment specifically for that.” Studies have shown that erectile dysfunction in men is sometimes caused by a physiologic problem, such as reduced blood flow. There is a school of thought that perhaps physiologic changes in the female brain may be associated with female sexual dysfunction. While male erectile dysfunction is widely known, publicly discussed and treated, the U.S. Food and Drug Administration has not approved any investigational drugs for treating similar disorders in women. This study is an important step in the therapeutic options to help women regain a satisfactory sex life, and to be able to talk about it, said Dam. Novel research published in a recent issue of The Journal of Sexual Medicine supports the claim that women with hypoactive sexual desire disorder or HSDD (persistent or recurrent deficiency and/or absence of sexual fanatasies/thoughts, and/or desire for, or receptivity to, sexual activity, which causes personal distress) show noted improvement in sexual desire and sexual function following low dose testosterone treatment.
Researchers at Yale School of Medicine and the Albert Einstein College of Medicine have found that female sexual dysfunction (FSD) affects 48.2 percent of women in a new study and that these women had decreased sensation in the clitoris, which increased the risk of sexual dysfunction. "There is a paucity of data available on FSD and this study brings attention to the possibility of a neurological cause for the dysfunction," said lead author Kathleen Connell, from the Yale School of Medicine.
Connell said previous epidemiological studies have shown that about 10 million women between the ages of 50 and 74 report abnormal sexual complaints, including decreased desire, inability to reach orgasm and increased pain with intercourse. In contrast to data on men, Connell said clinical trials evaluating the physiologic mechanisms responsible for sexual function in women are few, despite reports of other investigators, which suggest that sexual dysfunctions may be more common in women than men. "The sexual response is complex and involves interaction between the nervous system, the vascular system and the musculoskeletal system," said Connell. "Alterations in any of these systems could potentially cause FSD." The team studied the pudenal nerve, which provides nerve fibers to the pelvic floor muscles and is also responsible for sensation in the genital region. They evaluated the role of genital neurological integrity and sexual function in 56 women. They used a validated screening questionnaire to identify women between ages 18 and 68 with FSD and tested vibratory and pressure sensation in the genital region. The team found that almost half of the women studied reported sexual dysfunction. Of the women with FSD, 23.2 percent had more than one form of sexual dysfunction. Those with sexual dysfunction had decreased sensation in the clitoris compared to asymptomatic women. An investigational hormone patch developed by Proctor & Gamble and now in clinical trials may offer hope to women who have experienced a decline in sexual desire. The clinical trials of a thin, nearly-transparent patch worn discreetly on the abdomen are being conducted at University Hospitals of Cleveland and more than 150 other sites in the U.S. and Canada.
Researchers at Yale School of Medicine and the Albert Einstein College of Medicine have found that female sexual dysfunction (FSD) affects 48.2 percent of women in a new study and that these women had decreased sensation in the clitoris, which increased the risk of sexual dysfunction. "There is a paucity of data available on FSD and this study brings attention to the possibility of a neurological cause for the dysfunction," said lead author Kathleen Connell, from the Yale School of Medicine.
Connell said previous epidemiological studies have shown that about 10 million women between the ages of 50 and 74 report abnormal sexual complaints, including decreased desire, inability to reach orgasm and increased pain with intercourse. In contrast to data on men, Connell said clinical trials evaluating the physiologic mechanisms responsible for sexual function in women are few, despite reports of other investigators, which suggest that sexual dysfunctions may be more common in women than men. "The sexual response is complex and involves interaction between the nervous system, the vascular system and the musculoskeletal system," said Connell. "Alterations in any of these systems could potentially cause FSD." The team studied the pudenal nerve, which provides nerve fibers to the pelvic floor muscles and is also responsible for sensation in the genital region. They evaluated the role of genital neurological integrity and sexual function in 56 women. They used a validated screening questionnaire to identify women between ages 18 and 68 with FSD and tested vibratory and pressure sensation in the genital region. The team found that almost half of the women studied reported sexual dysfunction. Of the women with FSD, 23.2 percent had more than one form of sexual dysfunction. Those with sexual dysfunction had decreased sensation in the clitoris compared to asymptomatic women. An investigational hormone patch developed by Proctor & Gamble and now in clinical trials may offer hope to women who have experienced a decline in sexual desire. The clinical trials of a thin, nearly-transparent patch worn discreetly on the abdomen are being conducted at University Hospitals of Cleveland and more than 150 other sites in the U.S. and Canada.
Tuesday, November 27, 2007
India's First Same-Sex Couple Surrogacy Success Story
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