A major new trial recently published in the journal Fertility and Sterility shows that for couples beginning infertility treatments, an accelerated path to in-vitro fertilization (IVF) can offer a shorter time to pregnancy, cost savings of nearly $10,000, and a lowered risk of multiple births.
For the first time, these results demonstrate that the long held treatment combining fertility injections with insemination (IUI) does not have a place in infertility treatments today. This study also demonstrates that today's infertility treatments are very successful. When fertility care is covered by insurance (or alternatively when couples can afford all needed treatment), the vast majority will have a baby, and the quickest way to get pregnant is to follow this new shortened protocol.
Elizabeth Ginsburg, President of the Society for Assisted Reproductive Technology, commented, "This is a very important study that will likely influence physicians to reduce the number of stimulated inseminations for patients with unexplained infertility. Adoption of such an accelerated course of treatment could result in many patients conceiving in less time with less expense."
Known as the FASTT (fast-track and standard treatment) Trial, this study is the largest of its kind to date to measure the effectiveness of contemporary infertility treatments. Led by Richard Reindollar, M.D., Chair of the Department of Obstetrics and Gynecology at Dartmouth-Hitchcock Medical Center and Dartmouth Medical School, the study omitted the gonadotropin-stimulated artificial insemination cycle that usually precedes assisted reproductive technology, for approximately one-half of the 503 participating couples.
"One key strength of the trial was the Massachusetts Infertility Mandate, which requires insurers to cover the cost of fertility treatments," said Dr. Reindollar. "Such a large trial would not have been possible in a self-pay or partial coverage environment in which the cost of care is a much larger factor in the couple's choice of therapy."
Reindollar says another strength of the study in relation to previous efforts on the subject was a large volume of patients available at a single IVF center which allowed for standardized protocols and procedures. In addition, since the study was done in cooperation with insurance companies, there was access to detailed charge data for the patients.
The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Tuesday, September 1, 2009
Monday, August 31, 2009
Daily Sex Increases Sperm Quality, Odds Of Pregnancy
Having sex on a daily basis improves sperm quality in men, which can enhance their chances of conceiving a child, researchers reported on Tuesday.
Dr David Greening of Sydney IVF headed the new study of 118 men to show that daily ejaculation for seven days improves their sperm quality by reducing the amount of DNA damage.
Greening presented his findings to the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam.
Prior to the study, researchers had debated whether or not it was necessary for men to abstain from ejaculation for a few days before attempting to conceive with their partner.
"All that we knew was that intercourse on the day of ovulation offered the highest chance of pregnancy, but we did not know what was the best advice for the period leading up to ovulation or egg retrieval for IVF,” said Greening.
"I thought that frequent ejaculation might be a physiological mechanism to improve sperm DNA damage, while maintaining semen levels within the normal, fertile range."
Greening studied 118 men with higher than normal sperm DNA damage. Men were instructed to ejaculate each day for seven consecutive days.
Before the study began, the men’s sperm had DNA damage ranging between 15 percent and 98 percent, based on the DNA fragmentation index.
On the seventh day of the study, Greening found that 96 men, or 81 percent, had an average 12 percent decrease in their sperm DNA damage. Meanwhile, 22 men, or 19 percent, had an average increase in damage of nearly 10 percent.
"Although the mean average was 26 percent which is in the 'fair' range for sperm quality, this included 18 percent of men whose sperm DNA damage increased as well as those whose DNA damage decreased. Amongst the men whose damage decreased, their average dropped by 12 percent to just under 23 percent DFI, which puts them in the 'good' range. Also, more men moved into the 'good' range and out of the 'poor' or 'fair' range. These changes were substantial and statistically highly significant,” said Greening.
"In addition, we found that although frequent ejaculation decreased semen volume and sperm concentrations, it did not compromise sperm motility and, in fact, this rose slightly but significantly.”
"Further research is required to see whether the improvement in these men's sperm quality translates into better pregnancy rates, but other, previous studies have shown the relationship between sperm DNA damage and pregnancy rates,” Greening concluded.
"The optimal number of days of ejaculation might be more or less than seven days, but a week appears manageable and favorable.”
Dr David Greening of Sydney IVF headed the new study of 118 men to show that daily ejaculation for seven days improves their sperm quality by reducing the amount of DNA damage.
Greening presented his findings to the 25th annual meeting of the European Society of Human Reproduction and Embryology in Amsterdam.
Prior to the study, researchers had debated whether or not it was necessary for men to abstain from ejaculation for a few days before attempting to conceive with their partner.
"All that we knew was that intercourse on the day of ovulation offered the highest chance of pregnancy, but we did not know what was the best advice for the period leading up to ovulation or egg retrieval for IVF,” said Greening.
"I thought that frequent ejaculation might be a physiological mechanism to improve sperm DNA damage, while maintaining semen levels within the normal, fertile range."
Greening studied 118 men with higher than normal sperm DNA damage. Men were instructed to ejaculate each day for seven consecutive days.
Before the study began, the men’s sperm had DNA damage ranging between 15 percent and 98 percent, based on the DNA fragmentation index.
On the seventh day of the study, Greening found that 96 men, or 81 percent, had an average 12 percent decrease in their sperm DNA damage. Meanwhile, 22 men, or 19 percent, had an average increase in damage of nearly 10 percent.
"Although the mean average was 26 percent which is in the 'fair' range for sperm quality, this included 18 percent of men whose sperm DNA damage increased as well as those whose DNA damage decreased. Amongst the men whose damage decreased, their average dropped by 12 percent to just under 23 percent DFI, which puts them in the 'good' range. Also, more men moved into the 'good' range and out of the 'poor' or 'fair' range. These changes were substantial and statistically highly significant,” said Greening.
"In addition, we found that although frequent ejaculation decreased semen volume and sperm concentrations, it did not compromise sperm motility and, in fact, this rose slightly but significantly.”
"Further research is required to see whether the improvement in these men's sperm quality translates into better pregnancy rates, but other, previous studies have shown the relationship between sperm DNA damage and pregnancy rates,” Greening concluded.
"The optimal number of days of ejaculation might be more or less than seven days, but a week appears manageable and favorable.”
Sunday, August 30, 2009
Three Month Old Cancer patient Has Reproductive Tissue Frozen
An American baby boy, undergoing treatment for cancer that is likely to leave him infertile, has had samples of his sperm-producing stem cells frozen. It is hoped that if his treatment results in infertility then he might later be able to have the tissues grown and re-implanted in an attempt to restore his fertility.
While post-pubescent children have had sperm saved - in the same fashion provided for many adult patients who are undergoing fertility-damaging treatments - this procedure can also be provided to protect the fertility of much younger children who are years away from sexual maturity. Dr Jill Ginsberg, a paediatric oncologist at the Children's Hospital of Philadelphia where the procedure was performed told the Times newspaper that 'we do not approach the families of every little boy - only if we're fairly certain the [cancer] treatment is going to leave them infertile. We're hopeful because
science advances so quickly, but we can't make any promises. It's just an
option that's never been available before'.
Rather than providing a store of frozen sperm that may be used in assisted reproductive procedures in years to come, the new procedure saves stem cells that can later be re-implanted in an attempt to restore fertility and permit non-assisted reproduction. The new technique thus has the dual developments of allowing for the treatment of even younger patients and in progressing a potential therapy for restoring fertility rather than just providing an alternative when it is lost.
The new procedure is reliant upon improved methods for encouraging the growth and multiplication of the limited number of sperm producing stem cells found in the body. It is hoped that even if re-implanting the cells does not yield success at restoring fertility then the cells will still be capable of producing sperm in the lab and these can still be used in the conventional manner via assisted reproduction.
The technology has, however, evoked concern about such procedures being performed at such an early age, inevitably relying wholly on parental consent whereas for post-pubescent patients the input and consent of the individual has been of central importance. It is however clear that the procedure provides potential further options for the child when of age and the patient could have the samples destroyed without using them if they so wished.
While post-pubescent children have had sperm saved - in the same fashion provided for many adult patients who are undergoing fertility-damaging treatments - this procedure can also be provided to protect the fertility of much younger children who are years away from sexual maturity. Dr Jill Ginsberg, a paediatric oncologist at the Children's Hospital of Philadelphia where the procedure was performed told the Times newspaper that 'we do not approach the families of every little boy - only if we're fairly certain the [cancer] treatment is going to leave them infertile. We're hopeful because
science advances so quickly, but we can't make any promises. It's just an
option that's never been available before'.
Rather than providing a store of frozen sperm that may be used in assisted reproductive procedures in years to come, the new procedure saves stem cells that can later be re-implanted in an attempt to restore fertility and permit non-assisted reproduction. The new technique thus has the dual developments of allowing for the treatment of even younger patients and in progressing a potential therapy for restoring fertility rather than just providing an alternative when it is lost.
The new procedure is reliant upon improved methods for encouraging the growth and multiplication of the limited number of sperm producing stem cells found in the body. It is hoped that even if re-implanting the cells does not yield success at restoring fertility then the cells will still be capable of producing sperm in the lab and these can still be used in the conventional manner via assisted reproduction.
The technology has, however, evoked concern about such procedures being performed at such an early age, inevitably relying wholly on parental consent whereas for post-pubescent patients the input and consent of the individual has been of central importance. It is however clear that the procedure provides potential further options for the child when of age and the patient could have the samples destroyed without using them if they so wished.
Saturday, August 29, 2009
Peter Peppers
Friday, August 28, 2009
Planned $95M superyacht looks like a killer whale
A spectacular superyacht has been designed by an internationally renowned urban planning architect in a very unusual shape.The design of "Oculus" was inspired by the jaw and eye socket bone structure of large oceanic fish and mammals.
The design of "Oculus" was inspired by the jaw and eye-socket bone structure of large oceanic creatures.
The planned seventy-six meter long "Oculus," which is designed for 12 guests, looks like a large sea creature, with one end looking uncannily like the jaw and eye socket of a shark or a killer whale.
A second design, the futuristic, 91-meter "Infinitas," is based on the figure-of-eight shape of an infinity loop.
The pair are the brainchild of Kevin Schopfer, a Boston, Massachusetts-based architect who felt the design of luxury yachts should move away from generic boat shapes to something more playful.
The two eye-catching designs, which include inside swimming pools and helipads, are still looking for someone to stump up the cash to pay for them. With a starting price of $95 million for Oculus and $140 million for Infinitas, they won't come cheap.
But Schopfer has teamed with naval architecture firm Sparkman & Stevens to build more of the vessels.
"There are several potential clients interested in both Oculus and Infinitas and discussions are ongoing," he told reporters. "And we are also working on several more yachts."
Thursday, August 27, 2009
The Future of Tourism is…Robot Sex?
Forget robot marriages, the future could be filled with robot hookers! At Australia's Tourism Futures conference, futurologist Ian Yeoman (of New Zealand's Victoria University) forecast that artificial resorts with robot staff, and, yep, even robot prostitutes could become a reality.
"Robotics will become important, because you're going to have labor shortages in the future,'' he said…Even robot "prostitutes'' that would not pass on diseases such as HIV could make an appearance."
"But you're talking about extreme futures," he admitted.
Dr Yeoman's talk centered on what the world might be like in 2050. He explained that indoor tourism could be the next big thing due to global warming, an older population, plus food, water and jet fuel problems.
He imagines indoor resorts with artificial ski centers and recreated landscapes; even giant sea-faring cruise ships. He also predicts rooms with chemical wallpapers that can change color to suit a guest's mood.
MSNBC, USA is running a report on the impending likelihood of legalized marital relations with robots. They have word from a leading researcher at the University of Maastricht in the Netherlands, Dr. Levy, who seems to think peeps will be getting freaky with their robots by 2012, with marriage following by 2050.
"Once you have a story like 'I had sex with a robot, and it was great!' appear someplace like Cosmo magazine, I'd expect many people to jump on the bandwagon."
We are thinking you could probably drop the phrase "with a robot," as well as the blurb after the exclamation mark, and still have us convinced. Dr. Levy goes on to suggest that Massachusetts will be the first state to contain a robot-human sexing population. He justifies his theory by stating:
"Massachusetts is more liberal than most other jurisdictions in the United States and has been at the forefront of same-sex marriage."
Though we aren't too sure the reasoning is sound, we have already seen Roomba owners gaining an emotional attachment to their machines. Whether they will be putting their winkles in the Roomba's dinkle and allowing it to have a tinkle, we very much doubt. However, if sexbots get this real, well, perhaps the ethics of robosexuals is a serious debate, after all.
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