The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Tuesday, February 12, 2008
Egg Quality
A common cause of infertility in women is poor egg quality. Poor egg quality does not have to be the end of your chances for pregnancy – a variety of unique fertility treatments are available to help you achieve your pregnancy. All women have a finite number of eggs in their body which, when released during ovulation, can be fertilized to produce a child. Most people believe that all that matters when you are trying to get pregnant is the number of eggs you have – as long as you have a lot of eggs, you’ll get pregnant. Unfortunately, this is not the case. True, the number of eggs that you have does matter, but so does the quality of those eggs. Together, the number and quality of your eggs are referred to as your ovarian reserve. Egg quality refers to how prepared your eggs are to develop into embryos once they are fertilized. In order to be healthy enough to develop, an egg needs to have the proper chromosomes and the ability to combine those chromosomes with sperm. Some eggs in your body just don’t have the right number of chromosomes, making it impossible to have a successful pregnancy.
The eggs in your ovaries also need energy in order to split after fertilization. Your eggs contain mitochondria, which are tiny cell organelles that provide the energy for the egg. Without mitochondria, your egg wouldn’t have the energy to survive. As you age, these mitochondria produce less and less energy. As a result, any egg that is fertilized will eventually run out of energy and will be unable to divide.
Egg quality is greatly affected by your age. In your 20s and early 30s, you should have a large number of good quality eggs available for fertilization. Yes, you will have a few bad eggs too, but the good ones should vastly outweigh them. However, as you age your eggs will begin to decline in quality as well as in number. By the time you are in your late 30s or early 40s, you will probably have more poor quality eggs available than good quality eggs.
However, you don’t have to be over the age of 40 to have poor quality eggs. Some younger women can also have a poor ovarian reserve, either as a result of health problems or genetics. In particular, smoking, radiation therapy, and chemotherapy have been known to cause eggs to decline in health. If you suffer from endometriosis, you may also find that your egg quality is poorer than you would like it to be.
Egg quality has a huge impact on your fertility. If you have poor quality eggs, you will probably have a difficult time getting pregnant and staying pregnant. The impact of poor quality eggs is reflected in the general decline in pregnancy rates as women age. Women between the ages of 15 and 25 have a 40% chance of conceiving every cycle. Women who are over 40 however, have less than a 25% chance of becoming pregnant naturally. This is due to the fact that women who are older tend to have fewer eggs and eggs of a poorer quality. Poorer quality eggs can be one of the major causes of infertility in a number of ways. Firstly, poor quality eggs can make conceiving a child very difficult. If a baby is conceived, a poor quality egg can make the difference between carrying your baby to term or losing it in the first few weeks. Many poor quality eggs do not implant properly into the uterus once they are fertilized. Others implant properly but are simply not healthy enough to grow and divide, resulting in a miscarriage.
If you think you may be struggling with fertility issues, it is important to get checked out by a health care professional. In particular, you should probably make sure that your eggs are healthy and of a good quality. Women who are struggling with infertility and are over the age of 37 are usually tested for this.t is difficult to determine the quality of an egg simply by looking at it. Doctors usually have to implant the egg using in vitro fertilization to see whether it will grow or not. However, there is fertility testing to determine if you may be suffering from poor egg quality. Typical tests that evaluate your egg equality include:
Day 2/ 3 FSH Test: Measures your levels of FSH. Elevated levels may indicate poor egg quality.
Clomid Challenge Test (CCCT): The clomid challenge test is a blood test.
If you are suffering from poor egg quality there are a variety of fertility treatments that you can pursue to help you to conceive. Just because you have poor quality eggs does not mean that it is impossible for you to become pregnant. Using fertility drugs is one way to possibly increase the quantity and quality of your eggs. Typical female infertility drugs include clomiphene and cabergoline. In vitro fertilization is another treatment option. However, if your eggs are of too poor quality, you may be encouraged to use an egg donor.
Research into improving egg quality is ongoing. One treatment currently in the trial phase is cytoplasmic transfer. This form of treatment involves putting cytoplasm (the watery, outside layer of a cell) from a healthy donated egg into a poor quality egg in order to help it divide. Nuclear transfer is another form of treatment currently under investigation. Nuclear transfer involves taking a healthy nucleus from a donated egg and transferring it into an egg with an unhealthy nucleus. This helps to improve the quality of the egg thereby increasing the chances of conception occurring. Though neither of these procedures are currently available to the general public, there is hope that they may come to fertility clinics in the near future.
Monday, February 11, 2008
Role of the mitochondrial genome in assisted reproductive technologies
Mitochondria play a pivotal role in cellular metabolism and are important determinants of embryonic development. Mitochondrial function and biogenesis rely on an intricate coordination of regulation and expression of nuclear and mitochondrial genes. For example, several nucleus-derived transcription factors, such as mitochondrial transcription factor A, are required for mitochondrial DNA replication. Mitochondrial inheritance is strictly maternal while paternally-derived mitochondria are selectively eliminated during early embryonic cell divisions. However, there are reports from animals as well as human patients that paternal mitochondria can occasionally escape elimination, which in some cases has led to severe pathologies. The resulting existence of different mitochondrial genomes within the same cell has been termed mitochondrial heteroplasmy. The increasing use of invasive techniques in assisted reproduction in humans has raised concerns that one of the outcomes of such techniques is an increase in the incidence of mitochondrial heteroplasmy. Indeed, there is evidence that heteroplasmy is a direct consequence of ooplasm transfer, a technique that was used to 'rescue' oocytes from older women by injecting ooplasm from young oocytes. Mitochondria from donor and recipient were found in varying proportions in resulting children. Heteroplasmy is also a byproduct of nuclear transfer, as has been shown in studies on cloned sheep, cattle and monkeys. As therapeutic cloning will depend on nuclear transfer into oocytes and the subsequent generation of embryonic stem cells from resulting blastocysts, the prospect of mitochondrial heteroplasmy and its potential problems necessitate further studies in this area.
Sunday, February 10, 2008
Saturday, February 9, 2008
Friday, February 8, 2008
Rotunda Management Meetings
Hi friends, we are rushing towards another weekend and also on the cusp of getting our fresh re-certification audit done for the ISO 9001-2000 standards for our clinic. Everyone is working hard towards the goal. Just found a nice cartoon in NY times about our management meetings.
Have a nice weekend, folks.
Thursday, February 7, 2008
Lab on a Chip Medical Breakthrough
It's common knowledge that to carry out genetic tests, one would need expensive, state-of-the-art laboratory. But that might soon change thanks to a group of Canadian scientists who've developed a "lab-on-a-chip" device to conduct these tests. What is interesting about the device is that it's supposed to be portable, inexpensive, and efficient.
Hailing from the University of Alberta; Professor Christopher Backhouse and Professor Linda Pilarski (Department of Oncology), along with research student, Govind Kaigala, have developed a $1,000 device the size of a shoebox that can conduct genetic tests and deliver results in less than half an hour.
Elaborating on the innovation, the researchers said that miniaturization is the key factor that has drastically brought down the cost of this gadget.
The Canadian Press quoted Professor Backhouse as saying that like computers, which in their early days, were inaccessible; somewhat like million-dollar beasts who formed a roomful, yet one needed a Ph.D. to to be able to operate one of them.
Similarly, the Professor said Life Science technologies do exist but aren't being utilized optimally because they're very expensive. Hence, the key to this mini-laboratory was to integrate, shrink, and automate. The ability of the device to implement a very wide range of tests on a standard platform quickly and inexpensively would make it indispensable for the future.
The research team believes that their miniature lab-on-a-chip will provide Cancer patients with quick genetic tests, in turn speeding up treatment processes. The team also believes the device may be useful in finding genetic signatures for particular viruses or bacteria or for testing the quality of water, and so on.
Wednesday, February 6, 2008
Sperm From Female Stem Cells
British scientists have created early-stage, human sperm from female stem cells, according to a news report in New Scientist magazine. It is claimed that the research will pave the way for same sex couples to have children that are genetically their own. However, other scientists are sceptical that this procedure would ever be possible.
Professor Karim Nayernia at the University of Newcastle initially fertilised mice with sperm derived from embryonic stem cells (ESCs) in 2006, which gave rise to seven pups, six of which survived. In more recent work, he took human male stem cells from bone marrow and formed 'spermatogonia', primitive sperm cells that can form mature sperm cells by going through a process called meiosis. Nayernia has now apparently done the same using human female stem cells, work that has yet to be published.
The next stage in the process would be to make these primitive sperm cells undergo meiosis, which Nayernia claims he has started to do. The result could be that female eggs are fertilised by 'female' sperm, thereby eradicating the need for male gametes. However, Dr Robin Lovell-Badge, a stem cell expert at the National Institute of Medical Research in London, does not think the approach will work. He told the Telegraph newspaper that the 'presence of two X chromosomes is incompatible with this. Moreover they need genes from the Y chromosome [from the male sperm] to go through meiosis. So they are at least double damned'. Safety issues have also been raised, since the mice pups in Nayernia's initial study had health problems.
A Brazilian team of scientists lead by Dr Irina Kerkis at the Butantan Institute in Sao Paolo also claim to have made sperm and eggs from male mouse ESCs, and are currently starting to take the work into human cells. The research brings hope to people dealing with infertility, a problem that affects one in six couples, although scientists say the process is still in its infancy and treatments are a long way off.
There is also potential to use 'induced pluripotent stem cells', stem cells derived from human skin cells, as a starting point for the process. This could enable gay men to donate skin cells that would be used to create stem cells from which eggs could be formed. The eggs could then be fertilised using sperm from his partner, and placed in a surrogate mother.
Greg Aharonian, a patent analyst in the US, is trying to patent the technology behind 'female' sperm and 'male' eggs. A self-proclaimed 'troublemaker', he wants to undermine the argument that marriage should remain heterosexual because its main purpose is procreation.
The controversial developments have provoked mixed responses in the UK and US. Mike Judge from the Christian Institute faith group says that 'children need male and a female role models'. Many religious groups still oppose gay marriage. Josephine Quintavalle, from the pro-life lobby group Comment on Reproductive Ethics, says: 'we are looking at absurd solutions to very obscure situations and not addressing the main issue. Nobody is interested in looking at what is causing infertility - social reasons such as obesity, smoking and age'.
Subscribe to:
Posts (Atom)