IVF success set to drop under single-embryo policy

IVF success rates will fall by up to 20 per cent because of a UK government policy designed to cut the number of damaging twin pregnancies, research has suggested.

An initiative to limit multiple births by persuading IVF patients to use only one embryo at a time will cause a “significant reduction in treatment success”, according to an analysis of a clinic’s patients.

The Human Fertilisation and Embryology Authority strategy, which aims to cut the twin birthrate by 2012 from one in four to one in ten, would in practice reduce the IVF success rate at St Mary’s Hospital in Manchester from 21 per cent to 17 per cent, the study found.

Daniel Brison, of the University of Manchester, said that the strategy was right to encourage single-embryo transfer because a multiple birth was the greatest IVF risk to mothers and babies, but its implementation needed to be backed by better NHS access to IVF, especially for follow-up courses using frozen embryos.

About a third of NHS trusts do not offer frozen back-up treatment and 85 per cent do not provide the three full cycles that the National Institute for Health and Clinical Excellence recommends.

“Single-embryo transfer is the right way forward, but we have to fund more than one cycle,” Dr Brison said. “It is very difficult to ask patients to accept any reduction in success rates if they have only one shot. Embryo freezing is also crucial, as is careful selection of patients who are suitable for a single embryo.”

IVF produces a higher rate of twins and triplets because multiple embryos are often used to maximise the chances of pregnancy. Such babies, however, are more likely to be stillborn, die in their first year, suffer disabilities or be born prematurely. There are also risks to mothers.

In the study, published in the journal Human Reproduction, Dr Brison and his colleagues Stephen Roberts and Cheryl Fitzgerald constructed a model of what would happen to their clinic’s success rates under the single-embryo strategy.

To achieve the target of 10 per cent multiple births, about 55 per cent of patients would have to have single-embryo transfer. The current rate is about 10 per cent. This would bring the success rate down by about 20 per cent. If women were selected carefully, the decline would be slightly smaller but the live birthrate would still fall to 18.5 per cent.

The paper suggests ways that women could be selected, including analysis of their embryos as well as their age and hormone levels. Such measures would be essential to limit the policy’s impact on pregnancy success, the scientists said.

The St Mary’s success rate is below the national average of 31 per cent for women under 35 who use their own fresh eggs. It is an NHS centre with a waiting list of up to three years, so couples with a good prognosis often conceive spontaneously while waiting for treatment, leaving the clinic to treat harder cases.

Professor Peter Braude, of King’s College London, led the group that drew up the single-embryo strategy. He said that patients could be chosen who would not be disadvantaged by the policy.

“It doesn’t reduce pregnancy rates in women who are most likely to get pregnant, and who are also most likely to have twins,” he said.

“We have never said that a single embryo is right for every woman and the 10 per cent target is an aspiration. A very small proportion of patients give rise to most of the twins and by identifying them, we can reduce multiple births but not the pregnancy rate.”

Pak media taunts India, Israel & the USA

Please forward this to every Indian!

I hope the patriotism and sensitivity that may be dormant in some of us will rise after watching this.

Let us take this opportunity to believe that we as Indians can rise above this - we can show the world that we are not cowered by their actions. We will face this and face this bravely and continue to grow as a nation despite our religious diversities.

Sadly, we don't have one leader who puts the party's interests behind the country's.

Let us pray our leaders wake up from their slumber. At least now! And not politicise the terror situation further.

Jai Hind!

Some Facts about Caffeine

Up to 90% of adult Americans consume caffeine every day. Most commonly, the caffeine is in coffee, tea, soft drinks, and chocolate. A health benefit of caffeine is that it can ease a headache. The stimulant of caffeine interacts with the headaches and slowly gets rid of the symptoms. Try coffee, tea, hot or cold, the more caffeine the better, soda like Coke or Pepsi and cocoa. You will notice your headache start to disappear in no time.

Research indicates that coffee provides protective effects for the following conditions:

Asthma – Drinking coffee can help to control asthma, and in some cases can even be used to treat an asthma attack when conventional medication is not available.
Colon cancer – 2 or more cups of coffee per day can reduce the risk of colon cancer by 25%.
Gallstones – The likelihood of developing gallstones is decreased nearly 50% by drinking at least 2 cups of coffee per day.
Headache – Coffee cures or diminishes some types of headaches.
Liver cirrhosis – The risk for this condition is reduced by 80% with the ingestion of 2 or more cups of coffee each day.
Parkinson’s disease – 6 studies have found that regular (caffeinated) coffee drinkers reduce their risk of developing Parkinson’s disease by as much as 80%.
Type 2 Diabetes – A Harvard study of 126,000 people found that 1 to 3 cups of caffeinated coffee per day can reduce the risk of developing diabetes.

Drinking coffee provides a number of health benefits, including reduced risk for Parkinson’s disease, diabetes, colon cancer and even suicide. However, on the negative side, coffee can cause a number of problems for some people, particularly in large doses:

Acid imbalance - Caffeine can cause indigestion, skin irritations and arthritis flare-ups.
Hypoglycemia - Caffeine causes a release of glycogen by the liver, which can generate wild swings in blood sugar, causing attacks of hypoglycemia (low blood sugar). Hypoglycemia has a variety of unpleasant symptoms, including weakness, nervousness, sweating and heart palpitations.
Increased cholesterol - In some individuals, coffee can raise cholesterol, which increases the risk of developing cardiovascular disease.
Infertility, miscarriages and low birth weights among babies - Women who are pregnant or attempting to get pregnant should avoid excess caffeine consumption, which may increase the risk for a variety of fertility problems.
Kidney stones and gout - These conditions can result from the strain that caffeine puts on the kidneys.
Nervousness, anxiety, rapid heartbeat and trembling - Excess caffeine can overstimulate the central nervous system. This not only causes anxiety, but can also exhaust the adrenal glands over time, decreasing resistance to stress and increasing vulnerability to disease.
Osteoporosis: Because coffee prevents the full absorption of necessary minerals, it increases the risk of developing osteoporosis. Women who consume 300 mg (2-3 cups) or more of coffee per day suffer accelerated loss of spinal bone mass.
Possible addiction: People who quit coffee often experience withdrawal symptoms such as fatigue, headache, decreased energy and alertness, difficulty concentrating, and even irritability and depression. These symptoms usually begin within 12-24 hours of quitting caffeine and hit a peak within 20-51 hours. Overall, symptoms tend to last anywhere from 2-9 days.
Stretch marks – Caffeine consumption increases the risk of developing stretch marks.
Weight gain – Caffeine increases the risk of long-term weight gain by increasing stress hormones and creating a greater risk for hypoglycemia, which stimulates appetite. Although caffeine can assist with short-term weight loss, in the longer term, heavy consumption is more likely to lead to weight gain.

Most people who drink decaffeinated coffee do so because it doesn't make them jittery or keep them awake. But some believe it's better for them than regular coffee. A recent study of women in Iowa found that those drinking four or more cups a day of decaf had an elevated risk of rheumatoid arthritis.Decaf can, however, have some of the same effects on the body as regular coffee. It too can cause heartburn or irritate stomach ulcers in susceptible people. And oddly enough, even without the caffeine, it too can stimulate the nervous system and briefly boost blood pressure in those unaccustomed to coffee, according to Swiss researchers. But coffee, decaf or regular, does not cause hypertension. In sodas, caffeine is both a natural and an added ingredient. Only about 5 percent of the caffeine in colas and pepper-flavored soft drinks is obtained naturally from cola nuts; the remaining 95 percent is added. Caffeine-free drinks contain virtually no caffeine. Many prescription and nonprescription drugs also contain caffeine. Caffeine increases the ability of aspirin and other painkillers to do their job, and it is often used in headache and pain-relief remedies as well as in cold products and alertness or stay-awake tablets.

Because children have developing nervous systems, it is important to moderate their caffeine consumption. For children, major sources of caffeine include soft drinks and chocolate. Remember, I'm not a doctor. I just sound like one.

Take good care of yourself and live the best life possible! Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended, nor implied, to be a substitute for professional medical advice.

Glenn Ellis, author of Which Doctor?, is a health columnist and radio commentator who lectures, and is an active media contributor nationally and internationally on health related topics

This is the first time I was made to feel like Jews

As a Christian, I occasionally remind my Jewish friends that I owe my faith to them. Indian tradition maintains that a few years after Christ's death, one of his apostles, Thomas (‘the Doubter’), sailed to Kerala to share the Good News with his co-religionists. Jews have lived in India for thousands of years, perhaps arriving on a mission from the court of King Solomon to trade in ‘elephant's tooth, peacocks and apes’. The Jews of Cochin are said to have been less than receptive to Thomas’s message, though he did make many other converts.

India’s ancient Jewish history, evidence of the country’s tolerance for people of all faiths, has long been a source of pride for us. But an even greater cause for satisfaction has been the fact that Indian Jews have never faced persecution. Indian Jews have flourished, and nowhere is that more evident than in Mumbai. Some of the city’s best-known landmarks, including Flora Fountain, have been built with donations from Jewish philanthropists who grew prosperous on trade and manufacturing. Most notable among them were the Sassoons, a family from Iraq. Their name is etched in plaques in at least four schools, a magnificent library, a dockyard and at least two of the city’s nine synagogues.

A more chilling reminder of the city’s role as a sanctuary for Jews is to be found on another set of marble tablets in a cemetery in Chinchpokli in Central Mumbai. One wall bears memorials to people who died in faraway concentration camps such as Auschwitz. It was donated by friends and relatives who found refuge here. Many of these exiles had arrived in India because of the intervention of Jawaharlal Nehru. “Few people can withhold their deep sympathy from the Jews for the long centuries of most terrible oppression to which they have been subjected all over Europe,” Nehru wrote, as he lobbied the British government to allow Eastern European Jews into India. “Fewer still can repress their indignation at the barbarities and racial suppression of Jews which the Nazis have indulged in during the last few years.”

Many of the exiles soon became an important part of Mumbai society, serving as catalysts for the modern Indian art scene. Rudolf von Leyden, Walter Langhammer, and Emanuel Schlesinger had brought with them full-colour reproductions of European masters and a world of ideas and discussion. They proved vital in helping the Mumbai artists discover a new way of seeing. These ideas found expression on canvas when painters such as M.F. Husain, F.N. Souza, and K.H. Ara founded the Progressive Artists Movement in 1947, bound together by the desire to find a new way to depict the stories of their newly independent nation.


Despite the significance of the contributions of the Baghdadis or the European exiles, the Jewish community that has left the deepest impression on the city are the Bene Israelis, who believe their ancestors were shipwrecked just south of Mumbai in 175 B.C.E. Centuries later, many of them migrated to Mumbai, where they built a synagogue in 1796.

Perhaps the best-known member of the community was Nissim Ezekiel, one of the pioneers of Indian poetry in English. My favorite of his poems is ‘Island,’ a tribute to my home city. The first stanza says, “Unsuitable for song as well as sense/ the island flowers into slums/ and skyscrapers, reflecting/ precisely the growth of my mind./ I am here to find my way in it.”

Though thousands of Indian Jews have emigrated to Israel over the years, many of those who stayed behind have an ambiguous relationship with the country that offers them the Right of Return. Among them is my friend Robin David, the author of City of Fear, a gem of a memoir that describes the horrors he witnessed as a reporter during the anti-Muslim pogrom in Gujarat in 2002. He also explains his frustration with Israel, a country to which he has attempted to emigrate three times, only to return. “I realised that the Promised Land was not my country,” he writes. “Even the strong fragrance of spices, wafting in from the Arab market through the yellowing Jerusalem sandstone, did not help. Just like Teen Darwaza [in Ahmedabad], but not quite home."

There’s another aspect to the relationship that goes unnoticed by most Indians. Each year, an estimated 20,000 Israelis take their vacations in India after finishing their three-year compulsory military service stints. Their 15,000-shekel bonuses go much further in India and, as one Israeli told me recently, “It’s nice to be in a place where you don't always have to watch your back.” The beaches of Goa and the slopes of Kulu and Manali rank high on the visitors’ itineraries. The massive numbers of Israelis in the subcontinent prompted the Brooklyn-based Lubavitcher sect to open its first Indian mission centre — known around the world as Chabad Houses — in Pune in 2000.

Two years ago, I travelled to Pune to interview Rabbi Betzalel Kupchick, who ran the centre. By offering his hundreds of Jewish visitors a year free meals and the chance to chat in Hebrew, Rabbi Kupchick believed he was opening an opportunity for dialogue. “There are many ways that God brings people to Him,” he told me patiently. “Here, without the pressure of family and society, Israelis are more open-minded. Often, this is their first exposure to spiritual things. When they're come to India, they’re searching.”

Mumbai’s Jewish community doesn’t have much to do with the Israeli visitors. The ultra-orthodox leanings of the Lubavitchers have been regarded with some suspicion by liberal Indian Jews. That divide disappeared on Wednesday night. When I spoke to Robin David on the phone on Friday, he was still trying to make sense of it all. “The Indian Jewish identity is the only one that hasn’t been created by persecution,” he said. “We’ve never felt scared. This is the first time we’ve been made to feel like Jews.”

That, to me, has been among the most tragic casualties of this terrorist attack. In a barrage of grenades and bullets, a part of the Indian dream that’s 2,500 years old has now been buried in a pile of bloody concrete shards.

By Naresh Fernandes
Editor of Time Out Mumbai

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Fly Catcher

Shame on Us!

Vote out this incompetent weak, government and speak out against these impotent corrupt politicians!
Vote for zero tolerance against Pakistan and any other hostile neighbour.
Stop this drama of Indo-Pak friendship tours/talks.. anything...boycott everything Pakistani....hurt their economy so their bankrupt government does not sponsor ISI/terrorism.
Look at Israel... 4 million citizens with 40 million hostile neighbours but no one dares pick up a fight with them..
Don't believe anything politicians say from across the border.
Start with convincing our pseudo-wanna-be-politicos like Mahesh Bhatt & co to stop all these pseudo-friendship tours to hostile neighbouring countries... their states kill and maim us repeatedly and we go wagging our domesticated tails to get patted on our backs by these masters of ISI...
And please stop lighting candles at the Gateway of India. We have been doing this after every terrorist attack on Mumbai.
If Javed Jaffrey is not happy staying in India, he should be free to go settle in Pakistan.
Shame on us!