Friday, July 18, 2008

Increased Fertility Problems For Men Over 40

Scientists have found further evidence to suggest that, like women, fertility drops in men as they age, heard delegates at the annual meeting of the European Society of Human Reproduction and Embryology. The research, led by Dr Stephanie Belloc of the Eylau Centre for Assisted Reproduction in Paris, France, said that the results - the first to show such a strong paternal effect on pregnancy and miscarriage rates - will have important implications for couples wanting to start a family.
'I think it's important to consider not only the woman, but both members of the couple in natural conception but also in assisted reproduction', Belloc told the Times, adding: 'We believe that the use of IVF should be suggested to infertile patients where either party is over 35 years of age'.
The researchers recorded rates of pregnancy, miscarriage and birth in 12,000 couples undergoing fertility treatment in the form of intrauterine inseminations (IUI), where sperm is injected into the woman's uterus while she is ovulating. They also examined the quality and quantity of the sperm, including their ability to swim, size and shape.
The results showed that, independent of the woman's age, the chances of miscarriage rose from 16.7 per cent if the man was 30-35 years old, to 32.5 per cent if he was over 40. Although the impact of the female 'biological clock' on fertility has been widely studied, this is the first time that such a strong paternal effect on reproductive outcome has been shown, said Belloc. 'Some recent studies have established a relationship between the results of IUI and DNA damage, which is also correlated with is also correlated with a man's age, suggesting that it might be an important factor, but until now there was no clinical proof', she said.

Wednesday, July 16, 2008

Rs 9000 IVF in African Countries

Plans for an affordable and universally accessible IVF programme, which will be rolled out to tackle infertility in developing countries, were announced at a press conference at the European Society for Human Reproduction and Embryology annual meeting today. Dr Willem Ombelet, who heads up the ESHRE special task force on ‘Infertility and Developing Countries’, said that the scheme, now being piloted in Khartoum and Cape Town (and shortly in Arusha, Tanzania), aims to provide one IVF cycle for less than $200.
The UN Population Division estimates that 186 million women of reproductive age in developing countries (excluding China) are infertile, with more than 30 per cent in many African countries unable to conceive a second child. Without feasible treatment options, many of these woman become subject to the social and cultural realities of these countries, facing disinheritance, ostracisation, accusations of witchcraft, abuse by local healers, separation from their spouse or abandonment to a second-class life in a polygamous marriage, highlighted Professor Oluwole Akande, from University Hospital in Ibadan, Nigeria.
While a single IVF cycle in Europe or the USA can cost anything from $5000 - $10,000, the new scheme will cut costs by simplifying procedures and customising services to ensure that patients are only given the minimum level of treatment that they need for their particular condition, said Professor Gianaroli, from the SISMER Reproductive Medicine Unit in Italy. ‘We will not be able to treat every type of infertility, but many women with tubal damage as a result of infection can be helped’, he told the press, highlighting that tubal damage resulting from disease or substandard abortions are thought to be a primary cause of infertility in developing countries.
Ombelet emphasised the need to educate the public about infertility and create an infrastructure capable of delivering the service effectively. ‘A universally accessible treatment service is impossible in most developing countries,’ he acknowledged. ‘ But a start can be made by integrating low cost treatments into existing family health services, where opportunities exist for contraception, health education, maternity and childcare, prevention and treatment of STDs and HIV. We have to make a start, and this is how we’re doing it,’ he said.
The full proceedings of an expert meeting on these issues, held in December 2007 in Arusha, Tanzania, is published this month by the journal Human Reproduction.

Tuesday, July 15, 2008

Donor Children Doing Emotionally Well

Researchers from the Centre for Family Research at Cambridge University in the UK say that families created by the use of sperm donation, egg donation and surrogacy are doing well, particularly in terms of their psychological well-being.
The data, presented at the annual meeting of the European Society of Human Reproduction and Embryology, come from the fourth phase of a longitudinal study in which 43 donor insemination families, 46 egg donation families and 39 surrogacy families have participated, along with a control group of 70 families where the children were naturally conceived. The first data on these families was taken when the children were nine months old - they are now seven years old.
Mothers, fathers and teachers were each independently given questionnaires to assess the child’s wellbeing, as well as give individual scores on things like behavioural problems and emotional difficulties. Mothers and fathers were also separately interviewed about their relationship with their children. Children were asked to fill in a blank ‘map’ of concentric circles, assessing their relationship with family members and friends, placing the name of those with whom they believed they are closest in the innermost circle, and so on.
In terms of the psychological well-being of the parents, the quality of parent-child relationships and the psychological adjustment of the children concerned, more similarities than differences were found among the three assisted conception groups, said Polly Casey, who presented the research to the conference. Children from all family types placed their mother or father in the closest circle with the same frequency. However, there was some difference shown in the perception of emotional difficulties in the children, as reported by parents and teachers, with parents reporting no significant difficulties, but teachers (who did not know whether or not a child was born using assisted conception) indicating that children born from assisted conception having some more emotional difficulties than the control group.
Miss Casey also told the conference that only 29 per cent of donor insemination parents, 39 per cent of egg donation parents and 89 per cent of surrogacy parents had told their children how they were conceived by the time they reached the age of seven. All of these figures were markedly less than the numbers who said they would tell their child of its origins in the first phase of the study. When the results on psychological well-being and parent-child relationships were broken down by those children who had been told of their origins and those who had not, some differences emerged. ‘Those mothers who had told their children about their conception showed higher levels of sensitivity to the child and, although there was no statistical difference, we also found that fathers in disclosing families tended to show greater warmth towards their children’, she said.
In the groups who had been open with their children, mothers also reported greater ‘marital satisfaction’ and, furthermore, teachers reported lower levels of emotional and behavioural difficulties among the children who had been told of their origins. ‘We were particularly interested to find that, according to teachers, those children who had been told of their origins tended to do slightly better emotionally than those who had not’, said Miss Casey, adding that ‘of course this may simply be due to better communication within the family generally’.