The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Saturday, February 21, 2009
Friday, February 20, 2009
Thursday, February 19, 2009
The Ostrich Story
A man walks into a restaurant with a full-grown ostrich behind him..
The waitress asks them for their orders.
The man says, 'A hamburger, fries and a coke,' and turns to the ostrich, 'What's yours?'
'I'll have the same,' says the ostrich.
A short time later the waitress returns with the order 'That will be $9.40 please,' and the man reaches into his pocket and pulls out the exact change for payment.
The next day, the man and the ostrich come again and the man says, 'A
hamburger, fries and a coke.' The ostrich says, 'I'll have the same.'
Again the man reaches into his pocket and pays with exact change..
This becomes routine until the two enter again. 'The usual?' asks the waitress.
'No, this is Friday night, so I will have a steak, baked potato and a
salad,' says the man.
'Same,' says the ostrich.
Shortly the waitress brings the order and says, 'That will be $32.62.'
Once again the man pulls the exact change out of his pocket and places it on the table.
The waitress cannot hold back her curiosity any longer. 'Excuse me, sir. How do you manage to always come up with the exact change in your pocket every time?'
'Well,' says the man, 'several years ago I was cleaning the attic and found an old lamp. When I rubbed it, a Genie appeared and offered me two wishes.
My first wish was that if I ever had to pay for anything, I would just put my hand in my pocket and the right amount of money would always be there.'
'That's brilliant!' says the waitress. 'Most people would ask for a million dollars or something, but you'll always be as rich as you want for as long as you live!'
'That's right. Whether it's a gallon of milk or a Rolls Royce, the exact money is always there,' says the man.
The waitress asks, 'What's with the ostrich?'
The man sighs, pauses and answers, 'My second wish was for a tall chick with a big ass and long legs who agrees with everything I say.'
The waitress asks them for their orders.
The man says, 'A hamburger, fries and a coke,' and turns to the ostrich, 'What's yours?'
'I'll have the same,' says the ostrich.
A short time later the waitress returns with the order 'That will be $9.40 please,' and the man reaches into his pocket and pulls out the exact change for payment.
The next day, the man and the ostrich come again and the man says, 'A
hamburger, fries and a coke.' The ostrich says, 'I'll have the same.'
Again the man reaches into his pocket and pays with exact change..
This becomes routine until the two enter again. 'The usual?' asks the waitress.
'No, this is Friday night, so I will have a steak, baked potato and a
salad,' says the man.
'Same,' says the ostrich.
Shortly the waitress brings the order and says, 'That will be $32.62.'
Once again the man pulls the exact change out of his pocket and places it on the table.
The waitress cannot hold back her curiosity any longer. 'Excuse me, sir. How do you manage to always come up with the exact change in your pocket every time?'
'Well,' says the man, 'several years ago I was cleaning the attic and found an old lamp. When I rubbed it, a Genie appeared and offered me two wishes.
My first wish was that if I ever had to pay for anything, I would just put my hand in my pocket and the right amount of money would always be there.'
'That's brilliant!' says the waitress. 'Most people would ask for a million dollars or something, but you'll always be as rich as you want for as long as you live!'
'That's right. Whether it's a gallon of milk or a Rolls Royce, the exact money is always there,' says the man.
The waitress asks, 'What's with the ostrich?'
The man sighs, pauses and answers, 'My second wish was for a tall chick with a big ass and long legs who agrees with everything I say.'
World's first pregnancy using IVF egg-screening technique
A British woman has become the first in the world to conceive using a new IVF technique that could more than double the success rate of pregnancies. The 41-year-old woman was treated after suffering two miscarriages and having 13 courses of IVF, none of which led to a baby.
The technique allows doctors to screen fresh eggs for abnormal chromosomes, which are a major cause of miscarriage. Many embryos that have damaged or missing chromosomes miscarry, but others go on to produce conditions such as Down's syndrome.
The woman, who was treated by doctors at the Care Fertility Group in Nottingham, is expected to give birth in the next two months. Fertility clinics have long sought a way to check eggs or embryos for major chromosome abnormalities. A healthy egg carries 46 chromosomes – 23 pairs – but before it can be fertilised it needs to ditch 23 of these, which it packages into a structure called a polar body. The new technique checks the chromosomes in the polar body.
Doctors at the clinic collected nine eggs from the woman after stimulating her ovaries with standard hormone-based drugs. Using the new screening technique, they found that only two had intact chromosomes and so were likely to implant and lead to a successful pregnancy. Both embryos were implanted into the woman and one went on to a pregnancy.
Simon Fishel, director of the Care Fertility Group, said the milestone demonstrated the "wonderful ingenuity of humankind". The screening process costs £1,950 on top of standard IVF treatment, which can £3,500.
"One of the main reasons why IVF doesn't work is chromosomal abnormality," said Fishel. "Full chromosome analysis offers huge hope to many couples who have a poor chance of conceiving, those who have had many failures, and for those who want to maximise their chance at each attempt. We now have the best tool for achieving this."
Up to half the eggs of younger women, and up to 75% in women over 39, have abnormal chromosomes.
The technique, called polar body array comparative genomic hybridisation, is the first that can check all of an egg's chromosomes to see if any are missing or duplicated.
The process uses a laser to make a small incision in the outer membrane of the egg, from which doctors can extract the polar body containing the 23 chromosomes that were expelled before fertilisation. The doctors then use a computer-driven screening process to check if all of the chromosomes are present.
"This screening method has the potential to improve birth rates, minimise the incidence of miscarriage and birth defects caused by chromosomal irregularity," Fishel said.
Fishel's clinic has agreement from the government's fertility watchdog, the Human Fertilisation and Embryology Authority, to offer the technology to any of their patients. Because the procedure is experimental, however, it will not yet be offered on the NHS.
The HFEA has ordered UK fertility clinics to take steps to reduce the number of twins and triplets born to IVF couples. In most cases, this will involve transferring only one embryo to the womb at a time. Doctors believe the new technique will allow them to select the most promising embryos, increasing the chances of a succesful pregnancy.
A previous trial conducted last year by the Care Fertility Group and an American team suggests the technology could double the number of embryos that implant in the womb, from 25% to 50%.
Fertility doctors at other clinics cautiously welcomed the development today. Stuart Lavery, a senior consultant gynaecologist at Hammersmith Hospital in London, said: "Although it is still at a very early stage, this technique may offer a new diagnostic and therapeutic hope to couples who suffer from repeated implantation failure in IVF."
"Previous methods of screening embryos to detect abnormality have not proven to be sufficiently effective in increasing live birth rates. We need further research in this area so questions of reliability, efficacy and safety can be fully answered."
Tony Rutherford, chair of the British Fertility Society, said: "It is absolutely essential that these new techniques are subject to further rigorous research, and should only be offered to patients within the context of a robustly designed clinical trial, carried out in suitably experienced centres."
Around 6,000 babies a year are born in the UK to otherwise infertile couples as a result of IVF. The technique was developed in the 1970s and the first test tube baby, Louise Brown, was born in 1978.
Wednesday, February 18, 2009
Have Another ‘Fertilitini’
Once upon a time, a woman's ovaries were her own private affair. Aspiring mothers struggling with fertility issues whispered to their doctors about their travails, took drugs to stimulate their follicles and crossed their fingers. Today, aging eggs and donor sperm are the topic of open conversation on blogs, on Oprah and in movies like "Baby Mama" (storyline: a 37-year-old businesswoman hires a surrogate after being told her chance of getting pregnant is just about nil). Even politicians are in the fertility limelight. Sarah Palin's baby, Trig, was born when she was 44. And the newly appointed New York senator, Kirsten Gillibrand, cast a vote in Congress the day before giving birth to son Henry at age 41 last May.
And yet, despite the outing of the female reproductive system, many young women still don't fully understand the facts about age as a risk factor for infertility. Their Ob-Gyns don't always tell them. And 40-plus Hollywood mothers (some of whom are presumably using donor eggs to get pregnant) and cases like Palin and Gillibrand reassure them. So this week, the American Fertility Association (AFA) is launching "Manicures & Martinis" at the Dashing Diva Nail Salon in Manhattan, the first in a series of one-hour conversations about reproductive health. The event, targeted at women in their 20s and 30s who want to have children someday but aren't ready now, features a leading fertility expert, who'll talk about the reality of the biological clock and other risk factors for infertility. Yes, there'll be martinis—an offering criticized by some health advocates as irresponsible— but there will also be an organic alcohol-free "fertilitini."
Corey Whelan, AFA's director of development, says this is the kind of program she wishes existed when she was trying to get pregnant in her 20s and 30s while suffering from polycystic ovary syndrome. "I wanted to create a program that was soft, that was light and that was non-threatening," says Whelan, now 53 and the mother of 13-year-old twins conceived through in-vitro fertilization (IVF). The goal is to inform women so they can explore their options at an earlier age, she says, and the message is "one of hope, not one of doom and gloom."
To get the word out, AFA is joining the world of social marketing, advertising the event on Web sites like Facebook.com and Meetup.com. Whelan's hope is that women who attend will spread the word to their friends in person and electronically—a girlfriend-to-girlfriend experience, as opposed to some dreaded medical information session that few young women would be inclined to sign up for. "We would not be able to bring this particular demographic into a lecture hall or symposium," she says. "They wouldn't be interested and it wouldn't work."
But will women show up? AFA's Manhattan event is fully booked, with 25 women signed up and more than 30 on a waiting list. The confirmed participants are all single and between the ages of 21 and 34. One woman registered her daughter, her niece and her daughter's best friend, says Whelan, who plans to offer similar events in other venues (cheese shops, billiard halls) across the country in 2009.
Talking to women about age and motherhood is always controversial. No matter how public the topic of reproduction has become, an individual woman's fertility and the choices she makes about when and how to have children remain highly personal. While many women and health-care providers believe that informing women about age as a risk factor is empowering, others say that harping on the topic smacks of paternalism and is unfair to women who are still in search of a partner.
Tuesday, February 17, 2009
Mother's fury at dead daughter's fiance's plan to have baby with his sister using frozen IVF embryos
When Kay Stanley died in a car crash in Australia, her fiance and family were united in grief.
But a year on, they are at war over alleged plans to create a baby from three embryos she had frozen after becoming pregnant with IVF treatment.
Her mother Gwen Bates is horrified at the idea of having a grandchild in such a way and believes her daughter would never have approved.
She claims Miss Stanley's fiance Brett Vogel has proposed that his sister would act as a surrogate mother for the embryos in an attempt to have a 'miracle' baby.
Her daughter, a former entertainer who had toured Australia with children's show The Tweenies, was ten weeks' pregnant when she died.
Her VW Beetle was hit by a passenger train at a level crossing near Melbourne and shunted more than 200 metres as she drove to her job as a pre-school teacher. Mrs Bates, a nurse from Rotherham, said: 'I was told by Brett's family not to be sad because a miracle was about to take place.
'They told me his sister Sally was going to have one or two of the embryos implanted so that Brett could have my girl's baby.
'This was devastating news and would have an enormous impact on my life. It is also something I believe Kay would be against.'
Mrs Bates has stayed in Australia fighting to bring her daughter's body home after, she said, Miss Stanley was buried there against her wishes.
However, Mr Vogel's family will have no contact with her, so she does not know if the bizarre baby plan has gone ahead.
'It was Sally's partner who told me that it had been discussed by the family,' added Mrs Bates. 'I couldn't believe what I was hearing. It was a bombshell and I found it weird.
'Brett admitted there were three embryos still frozen from the IVF treatment Kay had been having.
'But when I tried to bring up the claims that his sister would act as a surrogate, he blanked me.
'Since the funeral Brett has been all over the world but has returned to Australia. I almost bumped into him in a cafe but he got up and walked straight out. He crossed the street when I saw him on another occasion.'
Kay Stanley died in an accident in Australia. Her mother is now fighting to bring her body back and prevent her fiance from using her frozen embryos
Mrs Bates has sought legal advice after receiving a letter from Mr Vogel's solicitors demanding she has no contact with him.
'I am trying to find out how I stand legally,' she said. 'I will take action if need be. I have a right to know.
'This will be my daughter's child and I will become a grandmother. All I have left are a few pieces of her jewellery and some candles.
'I want to bring my daughter home and have her buried in Rotherham and I will not leave without her. We come home together or we stay together here. I want to be with her.'
She is considering legal proceedings to gain ownership of her daughter's body to establish the status of the embryos.
An inquest has yet to be held. But it has been suggested Miss Stanley may not have seen the crossing warning lights because of bright sunshine.
Her mother said: 'They are using Kay as a scapegoat. They started to put the barriers up after her death but if they knew it was dangerous, something should have been done.
'The police asked if she was happy, suggesting that she may have done it deliberately. I told them she had just had IVF treatment and was about to get married. There was no one more careful than Kay.'
Mr Vogel, who was Miss Stanley's partner for four years, has declined to comment.
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