Thursday, September 4, 2008

IVF/ICSI cause of Congenital Birth Defects?



The use of in vitro fertilization (IVF) or another assisted fertility technique called intracytoplasmic sperm injection (ICSI) to conceive appears to increase the odds of Y-chromosome defects or "microdeletions" in male offspring, Chinese researchers report. Such deletions could result in defective sperm production and possibly also hypospadias -- a common birth defect of the penis that occurs when the urinary outlet develops on the underside of the penis rather than at the tip.

Although this study was small, it "at least sounds an alarm about the genetic safety of assisted reproductive technology," the investigators conclude. Prior research has tied assisted reproductive technologies with low birth weight, preterm delivery, cerebral palsy, and major birth defects, leading some researchers to hypothesize that these therapies may induce gene mutations.

In the new study, Dr. He-Feng Huang, from Zhejiang University, and colleagues sought to answer this question by testing for genetic mutations in 19 male infants conceived through IVF, 18 conceived through ICSI, and 60 conceived naturally. The fathers of the infants were also tested. In an effort to isolate the impact of the fertility treatment, the researchers only studied infants whose parents had a normal genetic background.

Huang and colleagues found Y-chromosome microdeletions in one infant conceived with IVF (5.3 percent) and in three conceived with ICSI (16.7 percent). By contrast, no Y-chromosome deletions were seen in the control group.

One of the four infants with microdeletions had hypospadias, the report indicates.

This is not the first study to link ICSI with hypospadias, the investigators note, but the mechanism has been unclear. The current findings suggest that the association may be mediated through Y-chromosome microdeletions.

ICSI is the main method used to overcome male infertility. With ICSI, a single sperm is injected directly into a single egg. If successful fertilization occurs, the embryo is then placed into the female to undergo development as usual.

Larger studies "should be conducted to confirm our preliminary results," the researchers conclude.

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.

Tuesday, September 2, 2008

Microfluidic Chip Could Someday Lead to a More Targeted Embryo Selection Process


New technology could eventually make infertility treatments more effective and less expensive. Though it has so far only been tested with mouse embryos, the hope is that it could improve the process of selecting the most viable embryos for in vitro fertilization. Research on the new technology, informally called "lab on a chip," has been published in Analytical Chemistry.

In vitro fertilization, known as IVF, involves combining eggs and sperm outside the body in a laboratory. Once an embryo or embryos form, they are then placed in the uterus. IVF is a complex and expensive procedure. The average cost of IVF is more than $12,000.

Currently, fertility doctors evaluate the quality of an embryo being considered for IVF through microscopic examination of the embryo's physical characteristics, such as cell shape. This process is time-consuming and not reliable enough, according to researchers.

Almost 130,000 women undergo IVF procedures each year in the U.S. -- yet the success rate is only about 30%. To boost a woman's chances of conceiving, doctors may put more than one embryo into the uterus. This can lead to multiple births and makes the pregnancy riskier for both mother and child.

The scientists -- from the Massachusetts Institute of Technology and Fertility Laboratories of Colorado -- worked with a device called a microfluidic chip, which they hope will someday lead to a more targeted embryo selection process. The chip, about the size of a quarter, is designed to evaluate the health of embryos being considered for transplant by measuring how the embryo alters key nutrients in the tissue culture medium surrounding embryos, according to the study.

Researchers collected fluids surrounding 10 mouse embryos and analyzed the fluids using the computer-controlled chip. Within minutes, the device could accurately measure the metabolism of the embryos from the surrounding fluids. Long-term, the chip could improve the quality of embryos selected for human IVF, and it could also reduce the cost associated with the procedure, according to the study's authors.

Monday, September 1, 2008

The World's First Test-Tube Boy Finally Speaks!




The world's first test tube baby boy has launched a campaign for a "long overdue" award for the scientist who pioneered the IVF process that gave him life.

Alastair MacDonald, 29, said it is astonishing that Professor Robert Edwards has received dozens of accolades from all over the globe but he has had little recognition in his own country.

Mr Edwards, who studied at Edinburgh and Glasgow Universities, pioneered in-vitro fertilisation with Dr Patrick Steptoe, who died of cancer in 1988 aged 75, one week before he was due to receive his knighthood from the Queen at Buckingham Palace.

Mr MacDonald, from Glasgow, has written to the Prime Minister to have the man known to him as an "uncle" properly recognised.

He has the support of experts in the field from all over the world including doctors at Cambridge University, the British Fertility Society, the Society for Reproduction and Fertility, the American Society for Reproductive Medicine, Royal College of Obstetricians and Gynaecologist and the European Society for Human Reproduction and Embryology.

Although Leeds-born Mr Edwards was made a CBE 20 years ago, his peers say his achievements far outweigh that award and he "more than deserves" greater recognition, possibly a knighthood.

Professor Martin Johnson, of Cambridge University Anatomy School, described Mr Edwards as the "father of his subject".

"Prof Robert Edwards is the single most important and influential figure internationally in human reproductive biology.

"It is an indisputable fact that he has contributed more to the treatment of human infertility than any other individual and, in so doing, has made the early stages of our own development accessible to study. This achievement clearly places him in a league on his own. He is truly and uniquely the father of his subject'."

His comments were echoed in other clinics and research centres. They included Dr Key Elder, of the Bourn Clinic in Cambridgeshire, which was founded by Mr Edwards and the late Dr Steptoe, and is still going strong. It sees around 850 or 900 women a year, with an average age of 37, and around one in three cycles results in a successful birth.

Dr David Adamson, president of the ASRM, said: "I strongly support Prof Edwards and hope he will receive a knighthood, which is so justified and overdue."

Both Mr MacDonald, now a systems engineering officer with the Royal Fleet Auxiliary, and his mother, Grace, now 62, who separated from his father when he was four, believe Mr Edwards should be recognised for what they said were his "unequalled" achievements.

He wrote to Gordon Brown: "Prof Edwards has been honoured around the world . . . it is a travesty that he has not been honoured by his own country.

"I was born as the second ever IVF baby in 1979 and I have grown up very close to Prof Edwards. I simply would not be alive if it wasn't for Prof Edwards. It saddens me greatly that at his age of 83, he has never been honoured when he has given so much and has never requested anything in return.

"I hope that Prof Edwards can still be alive to see his rightful honour given to him, unlike Patrick Steptoe the co-pioneer with Robert Edwards, who died before he received his knighthood.

"I hope this government does not make that same mistake. I hope you can use your influence to give a truly great man the rightful status he deserves."

Saturday, August 30, 2008

Proud Bostonian

From the county where drunk driving is considered a sport, comes this story. Recently a routine police patrol parked outside of a bar in Boston. After last call the officer noticed a man leaving the bar so apparently intoxicated that he could barely walk.

The man stumbled around the parking lot for a few minutes, with the officer quietly observing. After what seemed an eternity in which he tried his keys on five different vehicles, the man managed to find his car and fall into it. He sat there for a few minutes as a number of other patrons left the bar and drove off.

Finally he started the car, switched the wipers on and off -- it was a fine, dry summer night -- flicked the blinkers on and off a couple of times, honked the horn and then switched on the lights. He moved the vehicle forward a few inches, reversed a little and then remained still for a few more minutes as some more of the other patrons' vehicles left. At last, when his was the only car left in the parking lot, he pulled out and drove slowly down the road.

The police officer, having waited patiently all this time, now started up his patrol car, put on the flashing lights, promptly pulled the man over and administered a breathalyzer test. To his amazement, the breathalyzer indicated no evidence that the man had consumed any alcohol at all !!!

Dumbfounded, the officer said, I'll have to ask you to accompany me to the police station. This breathalyzer equipment must be broken.'

'I doubt it,' said the truly proud Bostonian, 'Tonight I'm the designated decoy.'

Friday, August 29, 2008

Life, Lust & LaVaSa











The sea is only beautiful if there's a shore. Life is like the sea. There'll be a direction to follow even if you sail more than one day or one life... the promise of a new land is your guide, because you know that the sea is a huge world that's beautiful only if there's a shore.
Patricky Field, as quoted in Beautiful if there's a shore (2008) song by Patricky Field

I'm in love with Lavasa. My wife & kids say they have never seen me in love with anyone like I love Lavasa. It was love at first sight. Now, the staff there agrees too! Almost every weekend, they look at me with wide eyes, treat me with kid-gloves and wonder what does doctor see in the Construction Sites? Ekaant is my base & I love exploring the nooks & corners of the growing city.

Lavasa is India's first hill station since Independence. It is being developed by HCC India near Pune. It is spread over 12,500 acres (51 km2) of land and is scheduled to be completed by 2021. The first phase (Dasave) is scheduled to become operational by June 2009. It will be a self-equipped city developed on the principles of New Urbanism.The city is planned to strike a balance between urban living and preservation of the environment. The master plan by HOK envisages a township in harmony with nature where nature begins at the doorstep. This master plan won both the Award for Excellence 2005, given by the Congress for the New Urbanism (USA) and the American Society of Landscape Architects Award—2005. The concept of a hill town dates from British colonial times and describes locations where British administrators went during the Indian tropical summer, prominent examples being Shimla, Kulu, and Ooty. It is just 210 minutes from home in Mumbai & this drive takes you to another world. The monsoons in Western India are the best time to visit the Sahyadris & with the Lavabahn (the equivalent of the German Autobahn) rolled out three years ago by HCC from Pirangut to Lavasa, driving in the rains on the Lavabahn is pure Lust!

Lust is any intense desire or craving for gratification and excitement. Lust can mean strictly sexual lust, although it is also common to speak of a "lust for men", "lust for blood" (bloodlust), or a "lust for power" (or other goals), and to "lust for love" - Wikipedia

The Greek word which translates as lust is epithymia (επιθυμια), which is also translated into English as "to covet". The word 'lust' originally had no negative connotation, but it has developed a connotation of sexual sin. We must add "Lust For Lavasa" to the Wikipedia annals. A few weekends ago, I decided to add to my solitude at Ekaant & introduce my Dad to Lavasa. My Dad convinced my daughter to accompany us. It was a beautiful weekend with Monsoon madness interrupted by the changing colors of the sky over the Mose valley. The clouds as I had promised them walked into our rooms & wafted into our nostrils. If you have never tasted a water-rich cloud, take in the fragrance at Ekaant on the upper level rooms. You open the 8 feet glass doors & the clouds come dancing in. The rains had scrubbed the place clean. This time the staff had some ugly tarpaulin & plastic curtains strapped down obliterating the view to the Warasgaon lake. Their argument was the rain lashes into the bedrooms if we leave them open. I convinced the FOM, Subashis Dutta that he was cutting off my Oxygen with the strapped down curtains. I spent most of Saturday evening walking around in the open - getting wet like I was having an anatabuse reaction! Early next morning, his staff got the curtains off & I got a new lease of life on this Wet Sunday.

I invited my Dad for a personal recce of the Valley city and told him how the lake was not yet full, but would be overflowing by our Independence day if the rains keep coming down like this. We decided not to go back on Sunday evening - Akanksha (my daughter) vetoed going back on Sunday evening. I was the happiest man at Ekaant! We decided to checkout at 5am on Monday so we could all be at our places of work by 9am Monday.

I am convinced that this will be the most beautiful amalgam of man & nature that India has ever seen in half a decade. as Indians, we should be proud of our brethren who had the vision.

Life is not measured by the number of breaths we take, but by the moments that take our breath away.
-Unknown