Women are risking their lives to have IVF babies

Women are risking death and bankruptcy in their desperation to become mothers, according to Professor Sammy Lee, one of the country's leading experts on infertility.

Some couples going through fertility treatment are driven by an urge "stronger than addiction and more powerful than obsession", said Lee, who pioneered egg donation in the UK when he was chief scientist of the IVF programme at Wellington Hospital, London.

"The quest to have children can become a vortex that gets faster and faster and sucks people in. Women will sell everything and anything to have the treatment if they are short of funds. They will risk their lives, there's no doubt about it," said Lee, who will discuss the issue on Friday when he chairs a major conference, Motherhood in the 21st Century, at University College, London.

"I have treated young women with cancer who have refused to have treatment for their illness until they have got pregnant and given birth, knowing they are risking their lives," added Lee, who has helped some couples through 12 cycles of IVF. The maximum number of treatments provided on the NHS is three. "Some of these women do, indeed, go on to die [from the cancer], but they die happy, feeling that they have achieved something greater than their own continued existence."

He admitted that the determination of couples to have children can lead to clinicians continuing treatment when they know there is little chance of success. "Everyone involved in these scenarios is trying to do the right thing, but the extraordinary energy of a couple's determination creates a vicious circle.

"The advances of science seem to promise women everlasting hope, which means they put ever more trust and hope in the doctors.

"Clinicians, such as myself, should refuse to treat these couples because further treatment is highly unlikely to work, but after helping that couple through three IVF attempts, you can get too pulled in to insist that enough is enough. This is how couples become implicit in their own abuse. Even if you do tell them you will no longer help them, they often just go and get treatment across the street," Lee added. "Then when they get too old to be treated in this country, they go abroad. That makes them vulnerable to yet more abuse, although again, it is abuse in which they are complicit.

"These are often professional, streetwise women who know the physical, mental and financial dangers, but who are prepared to take any risk if it offers even a sliver of hope they might end up with a baby."

Infertility affects about one in seven couples – approximately 3.5 million people. Most of the women will eventually become pregnant naturally, but a significant minority will not. At least 44,000 a year undergo IVF treatment , with about 11,000 IVF babies born every year.

Rebecca Frayn, a film-maker, screenwriter and novelist, has spoken of her fears when she chose to go through IVF. "Couples undergoing IVF are set on achieving a baby at any cost, often developing a kind of wilful moral myopia about the risks in order to avoid being deflected from their goal. I know, because it happened to me," she said. "I had questions about the cancer scares associated with all the hormones I would be required to ingest.

"Liz Tilberis and Ruth Picardie, both journalists who died respectively of ovarian and breast cancer after many rounds of IVF, believed their treatment had caused and accelerated their cancers, respectively," she added. "To attempt to achieve life at the potential expense of one's own [health] is self-evidently sobering. Yet, even then, I somehow squared what I was contemplating doing with my conscience. I was in the iron grip of procreation fever."

Dr Mark Hamilton, consultant gynaecologist at Aberdeen Maternity Hospital, has treated couples who insisted on having up to 10 attempts. "The number of cycles people are prepared to have has increased in the last few years," he said.

But Dr Tony Rutherford, chairman of the British Fertility Society, said that for some patients it was necessary to exhaust all possible options. "I have patients who undergo treatment even though I've counselled them that their chance of success is less than 5%," he said.

"I also counsel couples for whom the chance of experiencing complications through IVF is equal to their chance of success, or for whom being pregnant would be very dangerous. But for many couples having the treatment becomes key in their ability to reach closure."

Warning: Baby lust can be fatal!

This week readers of the U.K. Guardian might be forgiven for thinking that baby lust has exceeded all reasonable bounds and quite possibly become a sociopathic condition. Two articles, within two days of one another, featured women for whom motherhood is quite literally a life or death proposition: The first, titled “Women Who Kill for Babies,” reviewed the cases of women who have murdered pregnant women, then stolen their fetuses from their wombs. The second, about women who risk their own lives in pursuit of an IVF pregnancy, claims that “women are risking death and bankruptcy in their desperation to become mothers.” Taken together, the two nearly scream out that we have reached the apex of the modern motherhood fetish: Dear God, women are killing and dying for babies!

But while packaged as trend stories, both pieces seem to depict situations best described as lurking on the very far margins of human behavior. The womb-robbing story, written by Diane Taylor, is in response to the recent appeal in the case of a British woman, Linda Carty, who is on death row in Texas after being convicted of abducting and murdering a young woman to steal her newborn baby. Yes, the details are grisly, as they are in most homicides. But while admitting that these cases are extremely rare, Taylor goes on to claim they seem to be a wholly modern phenomenon -- “unheard of before 1987.” How rare? Well, since 1987, Taylor can find only 13 recorded cases, 12 of which took place in the United States. Not having access to a database that compiles worldwide local crime reports over the past century -- perhaps Taylor does? -- I’m not at liberty to offer up any factual contradictions to her claim. But I would hazard to guess that, like most statistically rare, yet sensationalistic crimes -- stranger abductions, molestation, daycare Satanic panic scares -- the ones that make headlines tell us more about the current preoccupations of the day than they do about the actual crime rate (which may explain why only one country -- us -- got caught up in reporting on baby-theft homicides. Or maybe I’m totally wrong and we Americans have made yet another contribution to crimes never before seen in nature, to go along with fanny packs and wearing socks with sandals). Even so, 13 cases in 23 years -- during which time many pregnant women were killed by their partners, mothers killed their children, and strangers kidnapped already born children -- sounds pretty low to me. And I’m even more bothered by the fact that Taylor’s “expert,” Philip Resnick, a professor of psychiatry at Case Western University, seems to blur the line between demonstrably criminal behavior and just plain old baby lust. “I have been involved in three cases, and none of the women was psychotic,” he says. “They are women who want a baby very badly.”

In the next article, women who want a baby very, very badly and thus pursue IVF are described as being driven by an urge “stronger than addiction and more powerful than obsession,” according to professor Sammy Lee, one of the early pioneers of egg donation in the United Kingdom, who goes on to tell the Guardian: “The quest to have children can become a vortex that gets faster and faster and sucks people in. Women will sell everything and do anything to have the treatment if they are short on funds. They will risk their lives, there’s no doubt about it.” He then goes on to liken couples who get “addicted” to IVF cycles to the cycle of abuse, and says, “When they get too old to get treated in this country, they go abroad. That makes them vulnerable to yet more abuse, though again, it’s abuse in which they are already complicit.”

How exactly are these women abusing themselves in pursuit of a baby? Well, in this case Lee is talking once again about a very, very tiny subset of women: those who refuse cancer drugs in order to undergo fertility treatment. "Some of these women do, indeed, go on to die [from the cancer], but they die happy, feeling that they have achieved something greater than their own continued existence." But the ethical guidelines printed in just about every IVF treatment center tell you that doctors will not start IVF treatment in former cancer patients until the woman’s condition has stabilized. But we’re not yet done. The article then goes on to suggest that women who use IVF knowingly expose themselves to cancer-causing hormones, but decide -- what the hell? -- a baby is worth dying for. Rebecca Frayn, a filmmaker and novelist who underwent IVF, claims that she was freaked out by the “cancer scares” associated with the hormones she ingested, but was so consumed with wanting a kid, she developed a “moral myopia” about the risks. She then goes even further, essentially claiming that two women she knows were killed by fertility drugs: “Liz Tilberis and Ruth Picardie, both journalists who died respectively of ovarian and breast cancer after many rounds of IVF, believed their treatment had caused and accelerated their cancers, respectively. To attempt to achieve life at the potential expense of one's own [health] is self-evidently sobering. Yet, even then, I somehow squared what I was contemplating doing with my conscience. I was in the iron grip of procreation fever."

Whether or not she’s a victim of procreation fever, Frayn is not an oncologist, and hardly qualified to diagnose what may have contributed to another woman’s cancer. While some researchers have speculated on a link between fertility drugs and cancer, the latest research seems to suggest that women who undergo IVF are no more likely to develop breast or ovarian cancer than any other woman. Anyone looking to write a story about those who defy death while pursuing cancer-causing activities could do much better with “Teens still bake in tanning beds!” Or: “Twenty-five-year-old dudes smoke Camel straights!”

So why whip readers into a hysterical frenzy about those who seem to have a death wish to produce life? Most women who have undergone fertility treatments will concede that they are pretty keen on having a baby, but I would guess you’d have to search pretty hard to find anyone who was willing to kill or die for a baby. The Guardian may have had the good fortune to find a few of both within days of one another (though I’m still not convinced their IVF story succeeded in introducing us to an actual woman who actually died from IVF). But let’s at least have the good grace to label those who would as what they are: statistical outliers, not some harbinger of the next trend to come.

― Amy Benfer

CRi Oosight™ Imaging System a Key to Breakthrough Gene Replacement Method With Potential To Prevent Inherited Mitochondrial Diseases

U.S. researchers using CRi’s Oosight™ imaging system have developed a gene transfer technique that has potential to prevent inherited diseases passed on from mothers to their children through mutated DNA in cell mitochondria. The research, which demonstrated the technique in rhesus monkeys, appears in the Aug. 26 issue of the journal Nature.

The group, headed by Dr. Shoukhrat Mitalipov of the Oregon National Primate Research
Center and the Oregon Stem Cell Center, extracted the nuclear DNA from the mother’s
egg, guided by the Oosight system, and transplanted it into another egg that had the
nucleus removed. The technique allowed the mother to pass along her nuclear genetic
material to her offspring without her mitochondrial DNA. The eggs were fertilized and
transplanted into surrogate mothers, resulting in the birth of four apparently healthy
monkeys. Defects in DNA of mitochondria, the cell’s “power plants,” are associated with
a wide range of human diseases.

The Oosight system solved a key problem in avoiding damage to the nuclear DNA during
the transfer procedure by providing a non-invasive imaging technique for visualizing the genetic material. Traditional visualization methods employ a stain or involve exposure to ultraviolet light, either of which can damage DNA. The Oregon team had used the Oosight system in previous research, published in Nature in 2007, that provided a foundation for the current study. In that research, they cloned rhesus monkey embryos and used them to create embryonic stem cells.


The Oosight system uses polarized light to generate high-contrast, real-time images of
biological features such as the spindle apparatus housing the chromosomes and other
filamentous structures within the egg, such as the multi-layer zona pellucida, without the addition of toxic stains or labels, while simultaneously generating useful quantitative data of their structural composition. Two of the four offspring, Spindler and Spindy, were named after the spindle, which is what the Oosight system is used to visualize. “This study underscores the potential of the Oosight system to advance reproductive medicine and highlights the enabling capabilities or our polarized light technology,” said George Abe, president and CEO of CRi.

"With this advance, the Oosight imaging system, which is already widely used in fertility clinics, has offered new insights and possibilities into reproductive health and medicine," said Gary Borisy, director and CEO of the Marine Biological Laboratory (MBL) in Woods Hole, MA. The Oosight system is based on imaging technology originally
developed by MBL scientists Rudolf Oldenbourg and Michael Shribek, working in
collaboration with David Keefe, M.D., of the University of South Florida College of
Medicine. In In Vitro Fertilization (IVF) the Oosight system is used as an aid to intracytosplasmic sperm injection (ICSI). The system not only provides assurance that the genetic material is not damaged by the injection needle, but it can also be used as a measurement tool to assess egg viability in both fresh and frozen eggs. Data show that an egg with a weak or malformed spindle and inner layer zona as measured with the system is much less likely to result in pregnancy.


Other scientists have welcomed news of the advance. Mitochondria-expert Douglas
Wallace of the University of California, Irvine, said “results were exciting” and the
technique is “potentially very interesting.” Although he did caution that “there are safety issues that are going to need to be addressed before one could think about it in humans.” The Nature article reported that 15 embryos were transplanted into nine surrogate mothers; three became pregnant, one with twins, and four offspring were born (only three of these offspring have been reported in the Nature paper) The success rate is similar to that of conventional in vitro fertilization.


A sample movie of the enucleation process that Dr. Mitalipov used is available at

http://www.cri-inc.com/multimedia/Oosight_SCNT_Enucleation_Rhesus_Monkey.avi,

(movie courtesy Dr. Mitalipov, OHSU).

Blood-Powered Lamp Teaches You The Hard Way

Perhaps you would be better about lowering your carbon footprint if lighting up your home required a sample of your own blood. Designer Mike Thompson thinks so.

His concept Blood Lamp calls for users to break off the top of the bulb-shaped glass, cut their finger on the jagged edge and then mix a tablet in with their own blood. Some sort of mysterious, unexplained chemistry ensues and the bulb glows. Not exactly the most practical device ever—plus the lesson about reducing your carbon footprint might backfire in the long run. Consider how many of these bulbs you would need, how many you would throw away and how many Band-Aids it would take to dress your wounds. It seems that it would end up doing more harm to harm the environment than good.

IVF? It's a crazier gamble than a Las Vegas casino (and I should know - I'm a test-tube baby pioneer)

The stakes couldn't be higher... your health, your wealth, your relationships. Yet your chances of hitting the jackpot could hardly be slimmer

Above the door of every IVF clinic should hang a sign that reads: 'Welcome to Las Vegas.' When you step inside and start playing the fertility game, your chances of losing thousands of pounds far outweigh your chances of hitting the jackpot.

But like hopeless gamblers, unable to shake the idea that they might win with the next throw of the dice, an ever-increasing number of British couples are putting their emotions, their financial stability, their relationships and their own health on the line - all for the chance of a baby.

After more than 20 years in the industry (and I use that word quite deliberately), I have yet to find the words to persuade a couple to give up that dream. I can hit them hard with the bleakest facts I have to offer: that even in the most capable hands, roughly two out of three IVF cycles fails.

I often look them in the eyes and say: 'The only guarantee I can give you is that your treatment is more likely to fail than succeed.' Or: 'Keep your money. You'd be better off spending it on a holiday to help you come to terms with the inevitable.'

But after the tears (and on one memorable occasion, after a patient thumped my desk in frustration and yelled: 'We didn't come here to hear this, we came here for a baby!'), they come back more determined than ever to go ahead.

For wherever there is sliver of hope, there will be men and women queuing for IVF treatment.

It is inevitable that specialists like me come in for criticism when we are seen to treat and take money from people whose chances of conceiving are slim to none.

Making a living from desperate people who want to achieve a pregnancy at any cost can look something like exploitation, and any clinician worth his salt will worry that it is. We take their last pennies and allow them to take unquantifiable risks with their health, all for the agony of yet another failed cycle.

Forcibly removing those rose-tinted spectacles and making them question the blind faith that led them to my office is the only way I have found to ease my conscience. It releases me to do my very best for them, without the worry that i have given them false hope.

And, in my mind at least, it allows me to stay on the right side of the line that we all walk in fertility treatment between help and abuse.

Unlike other areas of medicine, it is a potent combination of money and emotion that fuels IVF and other fertility treatments. But while every treatment - successful or unsuccessful - fills our coffers, it is the emotions involved that drive us to try again and again, if at first we don't succeed.

'We take their last pennies and expose them to risk'

When patients look at me helplessly, it becomes impossible to abandon them. There are times when I think I should refuse to treat couples for whom the treatment just isn't working, but I can't ignore their desperation.

After all, doctors are human, too, and their desire to become parents grabs at our hearts and reels us in. It means that when the time comes to decide whether or not to go for it again, I don't want to say, 'Let's give up,' any more than they do.

But the fact of the matter is that if I turn a couple away, they will often go across the street for treatment. And when the clinic across the street can't help, they will go abroad, making them even more vulnerable to abuse. Abuse in which they, of course, are complicit.

When I know that a couple are prepared to invest everything - not just financially - into achieving this almost impossible dream, how could I not feel that I was failing them if I did not try everything in my power to help?

Add to this the fact that, generally speaking, IVF clinicians are a high-achieving and highly competitive breed who do not easily accept when a cause is lost, and you begin to see the complexity or the moral maze that we navigate with every patient.
Britain's oldest mother Elizabeth Adeney, 66, went to the Ukraine for IVF as the UK refuses to treat women over 50!

Some 15 years ago, as a young fertility specialist, I wrote that we were in the grip of a fertility cult, in which advances in our knowledge and capabilities had made having a baby seem not only possible, but vital. That is truer today than it ever was.

I have heard of three recent cases in which pregnant women with cancer decided to forgo all treatment until after they'd had a baby.

They knew that in delaying crucial treatment they might be condemning themselves to death, but believed so strongly that having a baby was their sole purpose, there was no stopping them. If they died, they died happy, knowing that they had achieved motherhood, despite leaving their children motherless.

Cases like that of Maria Bousada, who died from cancer this summer at the age of 69 leaving two-year-old IVF twins, are the thin end of the wedge in terms of this ever increasing worship of assisted pregnancy, no matter what the cost to the mother or the resulting children.

In effect, the development of IVF has turned people like me into high priests and priestesses, and our clinics into temples filled with the blindly and fervently faithful, unwavering in their conviction that we can make miracles happen.

For those of us who have been working in fertility since the early days, it is a very strange place to find ourselves. Although we knew that it was possible to help with conception in certain cases, there was no way of knowing that it would become so mainstream.

We could never have imagined that, one day, almost all of us would know someone who has tried it, or that we would walk into the local newsagent and see celebrities boasting about their 'miracle babies' on the front covers of magazines.

I've lost count of the number of times that someone I know, from school or university, has walked into my office. I like to let them realize for themselves that we have met before. I don't think it helps their nerves when I pipe up with: 'Hey, weren't you in my biology class?'


So how has IVF become mainstream? Well, it's certainly not because it has become affordable. It still costs up to £4,000 per cycle, at an average of £2,500 per time, and I have known two patients in my career who have invested in a dozen cycles.

Remarkably, one of those patients had a baby boy after her 12th and final try - and stories like that are the ones you remember when you are on the verge of giving up the quest.

Quite simply, the first reason for the increase is that infertility is rising. I have said in the past that it may be caused by environmental factors, such as the prevalence of chemicals in what we eat or drink, but there is still a lot of research to be done in that area.

Fertility treatments have also become part of our on-demand culture. Like it or not, making a baby the natural way takes time and effort, and won't necessarily happen within the window of time that we have set aside in our busy schedules.

I am constantly advising patients, 'Don't give up the night job', because, as obvious as it may sound, having sex is crucial.

However, because it is so hard to establish absolutely whether a couple have a fertility problem that will never result in a natural conception, many are losing patience and seeking private treatment when it's possible they don't need it at all.

Our celebrity culture is partly responsible for the boom, too. While only two or three per cent of the general population have fertility treatment, I estimate the figure is closer to 10 per cent in the celebrity population, and they are not shy of telling us all about it.

I don't know why celebrities require so much more treatment that 'ordinary people', but I do know that cocaine abuse, low body weight, drinking, smoking and being too busy to have sex, or not trying to get pregnant until you're pushing 40, will drastically reduce your chances of conceiving naturally.

And as with any celebrity trend, I believe there is now a certain cache attached to IVF. It's as if unnatural conception is cool.

But whatever the reason, we have reached a point where more patients are putting more faith than ever into what we do.

The advances of science seem to promise couples an everlasting hope. The goalposts move constantly, giving both patients and clinicians alike the belief that anything is possible, and that no problem - not even the fact that a woman is in her 60s - is insurmountable.

Before the development of ICSI (Intracytoplasmic Sperm Injection), where sperm is injected into the egg outside the womb, there was nothing we could do for male infertility. But suddenly there was a solution for that, too, and it brought with it a whole new wave of people who were desperate for our help.

It remains a highly experimental area, however, and comes with risks that are impossible to quantify.

Every new patient I see asks me whether IVF drugs increase the risk of certain cancers, and all I can say is that they might do. It is an area of science in its infancy, and we simply don't have the long-term figures to know what, if any, risks our patients take when they start the journey.

But some research that I have conducted suggests that women begin to produce certain antibodies when they hit their third or fourth cycle of treatment, which indicates that the drugs we use may have some longterm effects in higher doses.

One problem is that fertility treatment remains largely privately funded and because - regardless of the risks - patients will do whatever it takes, treatments develop very quickly. When emotions are running high and we have piles of readies under our noses, who has time for lengthy clinical trials?

It's not reckless, but it is experimental - and that is something that all patients accept.

The baby that was born after his mother's 12th IVF cycle would not be here today had I not taken a spur-ofthe-moment decision to try something new. She lay sobbing on the operating table, knowing that this was her last embryo and her last chance.

But as I looked at the embryo, the outer skin appeared a little thicker and yellower than is normal. So I asked her: 'Do you mind if I try something that has never been done before?' There was no time for clinical trials: she needed my help at that moment.

'Anything, anything!' she said, which can hardly count as formal consent. So I perforated the embryo all over with my needle, until it looked like a microscopic teabag.

It was controversial - but it was, I believe, her only chance. Not only did it give her the baby boy she so desperately wanted, but the technique, now known as assisted hatching, has helped many other women since.

Moments like that highlight the extraordinary possibilities. But as the expectations of our patients rise inexorably, it becomes more and more important to acknowledge our frailties and limits.

By Prof. Sammy Lee, UK

Pregnant mother forced to give up IVF baby after doctors gave her wrong embryo

A pregnant mother will have to give birth to another couple's baby after a blunder by an IVF clinic.

Carolyn Savage had the wrong embryos implanted into her and will have to give the boy up to his biological parents as soon as he is born.

Yesterday Mrs Savage, 40, who was expecting her fourth child with husband Sean, said: 'The hardest part is going to be the delivery. I remember communicating with the [unnamed] mother of this child as to what I was envisioning and hoping for.

'I said, "We want a moment to say hello, and goodbye".

'In the beginning we were really scared of that moment and it is still scary. We are trying to mentally frame it in a positive way and look at it as a gift for this family that eight months ago we didn't know.

'I think that is the only way we'll get through it.'

Mrs Savage, from Ohio in the U.S., is 35 weeks pregnant and expecting in a fortnight. The couple already have two sons aged 15 and 12 and a daughter, born with the help of IVF, who is 18 months.

Mrs Savage learned she was pregnant with a boy in February after deciding to try again with the last of her frozen embryos.

They learned about the mix-up after Mr Savage received a phone call at work and returned home to tell his wife.

She said: 'I was upstairs in my bedroom and he came to the door and said "I have some really bad news".

'You're pregnant,' he told her. 'But they transferred the wrong embryo.'

Mrs Savage said she just kept repeating: 'You're joking.'

But when she looked at her husband 'he was as white as a sheet'.

The couple decided not to have an abortion because of their religious beliefs, and have met the other couple and arranged a handover.

Mrs Savage added: 'We will wonder about this child every day for the rest of our lives.

'We have hopes for him, but they are his parents and we'll defer to their judgment on when and if they ever tell him what happened and any contact that's afforded us.

'We just want to know he's healthy and happy.'

Lawyers for the Savages are working to ensure that the fertility clinic that made the error 'will accept full responsibility for the consequences of their misconduct'.

Sized To Fit Condoms Now!

Fact: The US FDA doesn't allow very large or very small condoms. Magnum XLs are only sightly bigger than normal. In Europe, however, they are soon going to get them in 70 different sizes. Are you a J33 or a G22?

Believe it or not, using a condom that is not suited for your penis increases the possibilities of breakage and slippage, which in turn increases the possibility of sexually transmitted infections, or unwanted pregnancies. Even while they know this—as have been discovered in various studies—the US FDA doesn't allow for condoms that are longer, shorter, thinner, or thicker than the average.

In Europe, however, men will be able to print out this measuring tool, and order exactly the size they need. Hopefully, someone will bring these TheyFit condoms to the US & the rest of the world. For now, however, all you can do is print and play.