The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Saturday, March 7, 2009
The Baby Skunk
A man and his wife were driving home one very cold night when the wife asks
her husband to stop the car.
There was a baby skunk lying at the side of the road, and she got out to see
if it was still alive.
It was, and she said to her husband, "It's nearly frozen to death. Can we
take it with us, get it warm, and let it go in the morning?"
He says, "OK, get in the car with it."
The wife says, "Where shall I put it to get it warm?"
He says, "Put it between your legs. It's nice and warm there."
"But what about the smell?" asked the wife.
He says, "Just hold its little nose."
The man is expected to recover, but the skunk she used to beat him with died
at the scene.
Friday, March 6, 2009
Cell Phone Guns
Most see airport security as a pain. Some feel violated. When you watch this clip, you'll understand why they want your cell phone through the x-ray machine. If you get asked to test your cell phone at the airport, this is the reason. Cell phone guns have arrived. They are real. The video clip shows how cell phone guns operate. Beneath the digital phone face is a .22 caliber handgun capable of firing four rounds in rapid succession using the standard telephone keypad.
European law enforcement officials are stunned by the discovery of these deadly decoys. They say phone guns are changing
the rules of engagement in Europe . Only when you have one in your hand do you realize that they are heavier than a regular cell phone.
Be patient if security asks to look at your cell phone or turn it on to show that it works. They have a good reason!
Wake up to our NEW WORLD!! We shouldn't complain about airport security 'invading your privacy.'
European law enforcement officials are stunned by the discovery of these deadly decoys. They say phone guns are changing
the rules of engagement in Europe . Only when you have one in your hand do you realize that they are heavier than a regular cell phone.
Be patient if security asks to look at your cell phone or turn it on to show that it works. They have a good reason!
Wake up to our NEW WORLD!! We shouldn't complain about airport security 'invading your privacy.'
Thursday, March 5, 2009
First the biopsy, then the baby
A common medical procedure may be the key to helping couples who've had no luck with artificial insemination and IVF. Could a common uterine biopsy make pregnancy "stick" for women having trouble conceiving? A small but growing number of couples are embracing an unusual use of biopsies during infertility treatments in the belief that they may help increase the chances of a successful pregnancy.
In a handful of small studies, biopsies of the endometrium, the lining of the uterus, which are usually performed as a diagnostic tool to sample tissue and test for infections, disease or other problems, have been found to boost the pregnancy rates of women who had tried in-vitro fertilization and failed to become pregnant.
One Toronto couple credits the procedure with the first successful pregnancy in 10 years of trying. After 11 artificial inseminations and two IVFs proved fruitless, Roslyn and Howard Kaman had experienced the gamut of failure, from miscarriages to ectopic pregnancies. They had opted to try adoption when they read an article about a lecture at Toronto's Weizmann Science Canada by an Israeli researcher, Nava Dekel.
In 2003, Dr. Dekel found that 45 women who had undergone a uterine biopsy during the menstrual cycle before undergoing IVF had almost twice the rate of pregnancies and births compared with a control group of 89 women. In 27.7 per cent of the women in the biopsy group, the embryo transfer was successful.
The IVF worked for just 14.2 per cent of the control group.
The Kamans wrote to Dr. Dekel, and she connected them with the fertility clinic in Israel that had performed the procedures. Doctors there sent the couple a detailed protocol, which involved three separate biopsies on particular days in the cycle just before an IVF treatment. The Kamans' Toronto fertility specialist, Fay Weisberg, agreed to try it.
Ms. Kaman became pregnant on the first IVF cycle after the procedure and baby Hannah is now three months old.
"I still can't believe it. I think I will go through my whole life and not believe we were successful," says Ms. Kaman, 41.
While broader research is being conducted to confirm the role these biopsies may be playing, anecdotal evidence is starting to mount suggesting that the disruption of the uterus somehow leads to the successful implantation of an embryo. Some practitioners say they'll wait for randomized trial results before they start offering biopsies to IVF patients.
Togas Tulandi, a McGill University medical researcher, is hoping to figure out what role the biopsies might play, if any, in the successful pregnancies of women like Ms. Kaman. He is in the midst of conducting a large randomized study (he hasn't yet reached his goal of 162 participants) and says that if the biopsies are working, the mechanism may be akin to tilling the soil before you plant a tulip bulb.
"Maybe this slight injury to the endometrium makes the environment for implantation better," he says. "If we can prove that it works, we can do it routinely."
Since the procedure carries little risk, other than discomfort and a very small chance of infection or injury to the uterus, many fertility doctors are already incorporating it into their practices. While it is not listed on her menu of services at the First Steps Fertility clinic where she is medical partner, Dr. Weisberg says she now offers it to most of her patients who have failed to conceive with IVF and for most patients before they undergo a frozen embryo transfer.
"I suspect that it will probably soon be a routine for all patients undergoing IVF."
The only reason it's not routine is a paucity of large studies and the fact that it's painful and uncomfortable for most women, she says.
Although she can't unequivocally say whether the biopsies are effective - "the women end up being their own control" - Dr. Weisberg has a hunch that they work.
It could have something to do with increased blood flow, or the way in which the proteins in the uterus heal, she says. "I do believe something changes deep down."
And she's not worried about a stampede for the procedure on the part of desperate couples.
"Not to be cavalier, but this is a procedure already being done on younger women for bleeding of the uterus and other problems," she says. "It's easy, quick, but painful. There's no anesthetic. You can go right back to work."
Other specialists take a more cautious approach. Fertility expert Arthur Leader does not offer it to patients at the Ottawa Fertility Centre where he practises. Until a randomized study such as Dr. Tulandi's can prove that women undergoing these biopsies have a better chance of getting and staying pregnant, "the precautionary principle should apply," he says. "You shouldn't do it until a benefit has been shown."
He points out that there have been many other treatments, including low-dose Aspirin, a blood protein called albumin and a diabetes drug called metformin, that were believed to help women conceive and were routinely prescribed but which, after much study, proved either to do harm or have no effect. And, as far as Dr. Leader is concerned, "No good is harm."
For couples who end up with a healthy pregnancy after uterine biopsies, it's hard not to credit the procedure for their little bundles of joy. Still, Ms. Kaman says that even though she suspects the treatment did work, there may have been some luck involved. When she imagines trying for a second IVF baby, "part of me thinks lightning's not going to strike twice with us."
Anatomy of a biopsy
An endometrial biopsy is performed by inserting a suction catheter through the vagina and cervix, into the uterus. The end is pressed up against the uterine wall where it cuts away a small sample of the lining tissue.
Because of any number of factors, an embryo may not be able to attach itself to the cells that make up the lining of the uterus.
After the biopsy is taken, some researchers and fertility experts believe that the slight damage caused to the wall of the uterus makes it a better environment for implantation, whether because of increased blood flow, the healing process or some other factor.
Wednesday, March 4, 2009
Adult Stem Cells May Lead To New Infertility Treatment
A special class of adult stem cells, known as human induced pluripotent stem (iPS) cells, has for the first time been reprogrammed into cells that develop into human eggs and sperm. The research, carried out by members of the University of California, Los Angeles (UCLA)'s Broad Stem Cell Research Center, was published in the January 27 online edition of the journal Stem Cells.
Derived from adult body cells that have been engineered to return to an embryonic state, iPS cells have the ability to become every cell type in the human body - a characteristic they share with embryonic stem (ES) cells. In this study the iPS cells were coaxed into forming the germ line precursor cells that are capable of giving rise to sperm and eggs.
'This finding could be important for people who are rendered infertile through disease or injury'. said Amander Clark, the senior author of the study. 'We may, one day, be able to replace the germ cells that are lost, and these germ cells would be specific and genetically related to that patient'. Many infertile couples would see this process as preferable to using eggs or sperm from a donor who would then become one of the child's genetic parents.
However, Clark cautioned that scientists are still many years from offering treatments involving iPS cells to infertile patients. There are many uncertainties and dangers that need to be resolved. For example, the process of reprogramming involves using viruses to deliver genes to the cells, potentially increasing the likelihood of genetic abnormalities and cancers.
Crucially, Clark's team found that the germ line cells derived from iPS cells did not perform certain key regulatory processes as well as those generated from ES cells. The associated increased risk of chromosomal errors, or abnormal growth, could have serious health consequences for any child conceived using egg or sperm obtained in this way.
Therefore Clark believes that it is vital that research using human ES cells continues. These cells can be derived from left over embryos used during in vitro fertilisation, and would otherwise be destroyed, yet their use is controversial and the topic remains fiercely debated. Despite this President Obama is expected to reverse President Bush's restrictive policies on ES cell research in the next few weeks.
Derived from adult body cells that have been engineered to return to an embryonic state, iPS cells have the ability to become every cell type in the human body - a characteristic they share with embryonic stem (ES) cells. In this study the iPS cells were coaxed into forming the germ line precursor cells that are capable of giving rise to sperm and eggs.
'This finding could be important for people who are rendered infertile through disease or injury'. said Amander Clark, the senior author of the study. 'We may, one day, be able to replace the germ cells that are lost, and these germ cells would be specific and genetically related to that patient'. Many infertile couples would see this process as preferable to using eggs or sperm from a donor who would then become one of the child's genetic parents.
However, Clark cautioned that scientists are still many years from offering treatments involving iPS cells to infertile patients. There are many uncertainties and dangers that need to be resolved. For example, the process of reprogramming involves using viruses to deliver genes to the cells, potentially increasing the likelihood of genetic abnormalities and cancers.
Crucially, Clark's team found that the germ line cells derived from iPS cells did not perform certain key regulatory processes as well as those generated from ES cells. The associated increased risk of chromosomal errors, or abnormal growth, could have serious health consequences for any child conceived using egg or sperm obtained in this way.
Therefore Clark believes that it is vital that research using human ES cells continues. These cells can be derived from left over embryos used during in vitro fertilisation, and would otherwise be destroyed, yet their use is controversial and the topic remains fiercely debated. Despite this President Obama is expected to reverse President Bush's restrictive policies on ES cell research in the next few weeks.
Tuesday, March 3, 2009
Animals Who Need Help, Too
Does the famously rotund cartoon cat Garfield need a shot of insulin? We may never know, but the fact of the matter is that many household pets have diabetes, and fat cats are at higher risk for diabetes than leaner ones. “Type 2 diabetes is associated with obesity in people, and it’s the same story in cats,” says Margarethe Hoenig, DVM, PhD, professor in the College of Veterinary Medicine at the University of Georgia in Athens. She says that 45 percent of cats are overweight or obese, and as they have gotten bigger, feline diabetes has increased three- to fivefold over the past 30 years.
Canine diabetes, on the other hand, appears to be closely related to human type 1 diabetes. Pancreatic antibodies, the hallmark of human type 1 diabetes, are found in diabetic dogs, indicating that an autoimmune war is being waged on the pancreatic cells that secrete insulin. Diabetic cats, meanwhile, maintain these cells, but produce less insulin and have reduced insulin sensitivity.
Overall, 0.5–1 percent of cats and 0.2 percent of dogs are diabetic. Certain breeds—including Burmese cats and Golden Retrievers— are more prone to diabetes than others. This indicates that there may be genetic factors that predispose certain animals to the disease.
The signs that a pet may have diabetes are the same as in people: They drink more, they urinate more, they want to eat more, and they may become weak. If you suspect diabetes in your pet, make a veterinarian appointment as soon as possible. Diabetic dogs will need to be administered insulin indefinitely. For cats, insulin may be required, but a high-protein diet and exercise are also good ways to help keep blood glucose levels in check. Oral medications may also be included in care regimens.
There’s another way their human companions can help cats, by the way. It’s believed that one problem contributing to the increase in feline diabetes may be the cuteness factor: As Hoenig says, “Cat owners like their cats obese.” Of course, fans of a certain lasagna-loving feline already know that.
—Erika Gebel, PhD
Canine diabetes, on the other hand, appears to be closely related to human type 1 diabetes. Pancreatic antibodies, the hallmark of human type 1 diabetes, are found in diabetic dogs, indicating that an autoimmune war is being waged on the pancreatic cells that secrete insulin. Diabetic cats, meanwhile, maintain these cells, but produce less insulin and have reduced insulin sensitivity.
Overall, 0.5–1 percent of cats and 0.2 percent of dogs are diabetic. Certain breeds—including Burmese cats and Golden Retrievers— are more prone to diabetes than others. This indicates that there may be genetic factors that predispose certain animals to the disease.
The signs that a pet may have diabetes are the same as in people: They drink more, they urinate more, they want to eat more, and they may become weak. If you suspect diabetes in your pet, make a veterinarian appointment as soon as possible. Diabetic dogs will need to be administered insulin indefinitely. For cats, insulin may be required, but a high-protein diet and exercise are also good ways to help keep blood glucose levels in check. Oral medications may also be included in care regimens.
There’s another way their human companions can help cats, by the way. It’s believed that one problem contributing to the increase in feline diabetes may be the cuteness factor: As Hoenig says, “Cat owners like their cats obese.” Of course, fans of a certain lasagna-loving feline already know that.
—Erika Gebel, PhD
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