Pregnant IVF women more at risk of death

Researchers believe the increased threat may come from the body rejecting donated eggs or underlying health problems that may come to the fore during artificial conception.
They want increased vigilance so that the exact nature of the risk can be calculated.
"Women should be counselled and made aware of the risks they are taking and deaths should be properly reported," Professor Didi Braat at Radboud University in the Netherlands told the Sunday Times.
Prof Braat looked at the deaths between 1984 and 2008 in the Netherlands but believes they will apply to any developed country.
She found 17 women who died in pregnancy who had had IVF treatment – a death rate of 42.5 for every 100,000 pregnancies.
The death rate is 12.1 in every 100,000 for women who conceived naturally.
The rising age of mothers may be increasing the number of complications. Last year nearly 27,000 women over 40 gave birth, a rise of 50 per cent in a decade.
The research was published in the journal Human Reproduction.

Mum heads to Thailand in bid for daughter

A Melbourne woman is flying to Thailand to circumvent Australian guidelines which prevent families from determing the sex of of IVF babies.

The woman, known as Olivia, has three sons and says she has a strong desire to have a daughter.

"It's just something deep in me that I can't shake. I just feel this really strong wish to have a daughter to raise with my sons in a balanced family," she said.

"We conceived naturally for our three sons. This is not something we've taken on lightly."

Families are not allowed to choose the sex of a child through IVF in Australia under current guidelines and that is why she has to travel to Thailand for the procedure, which she estimates will cost about $15,000.

She says the treatment should be available in Australia.

"To me it's about providing choice but with parameters," she said.

"I don't think there is going to be a flood of women because this doesn't affect a lot of women."

Olivia says she is in touch with a number of other women who are also going overseas to obtain gender selection treatment.

Professor Loane Skene, from the University of Melbourne and a member of the Australian Health Ethics Committee, supports the plan.

She says Australians are allowed to travel to the United States to have a surrogate baby and does not see why Olivia and her family should be prevented from doing what they want to do.

However, Professor Skene does not think the law needs to be changed.

"I think many people are going to have sympathy for this sort of thing because it is such a strong human urge," she told ABC Radio's Jon Faine.

"It seems to me that the kerfuffle of going through IVF with all of the ups and downs and heartache of it all is not something that people are going to take on lightly quite apart from the cost."

Victorian Premier John Brumby has ruled out relaxing restrictions on access to IVF treatment in the state.

"There might be some particular cases where there is a medical case for saying that it's important to have a boy or a girl, but where it is non-medical, the Law Reform Commission and indeed the overwhelming body of advice on this suggests that it is not a requirement or a priority, in terms of changing policy," he said.

Jailed welfare cheat granted access to IVF treatment

A jailed 45-year-old welfare cheat has won the right to IVF fertility treatment while living as a serving prisoner in Australia.
Kimberley Castles, an inmate at minimum-security Tarrengower Prison, had claimed in the Supreme Court that her human rights were breached because she was refused access to fertility treatment. Debbie Mortimer, SC, had told the Supreme Court that significant psychological harm had been caused to Castles, who was having self-financed IVF treatment before she was jailed last November. Ms Mortimer told Justice Karin Emerton her client wrote to prison authorities within days of being incarcerated asking to continue IVF.

Castles sued the Justice Department, seeking an injunction and a declaration she could continue treatment.Ms Mortimer said conjugal visits were allowed at Tarrengower and that time was running out for Castles - who has age-based infertility - because she turns 46 in December and that is the cut-off date for treatment from Melbourne IVF.

Justice Emerton said: “(The relevant section of the Corrections Act) confers on Ms Castles the right to continue to undergo IVF treatment for her infertility, although not necessarily at the Melbourne IVF Clinic.“IVF treatment is both necessary for the preservation of Ms Castles’ reproductive health and reasonable given the commitment to the treatment that Ms Castles has already demonstrated, her willingness to pay for further treatment, her age and the fact that she will become ineligible for further treatment before she is released from prison.”Justice Emerton said the prisoner’s request for a permit that would enable her to leave the prison to undergo required treatment over a number of months could not be accommodated, so she would have to apply for permits on a “visit by visit basis”. Castles is serving an 18-month minimum term for fraudulently claiming almost $140,000 in single-parent welfare benefits between 1984 and 1998, and then claiming further benefits under a false name between 2000 and 2006.

Washington Post Commentary Explores Embryo Freezing

The Washington Post featured a commentary from Gillian St. Lawrence, a 30-year-old woman who underwent in vitro fertilization and embryo freezing as "a way to postpone parenthood without risking the higher miscarriage and genetic disorder rates that occur in babies conceived from parents older than 35." Typically, women who undergo IVF take hormones to produce several blastocyts -- five- to seven-day-old embryos -- and one or two of the embryos are implanted into the woman shortly thereafter. The remaining embryos can be frozen for future pregnancy attempts.
St. Lawrence writes that she initially did not plan on having children and that the idea of embryo freezing occurred to her while she was researching ways to donate her eggs. "My husband and I could create embryos, freeze them and, essentially, donate them to our future selves," she states.

Through her research on IVF, St. Lawrence "learned that the younger the parents are when they produce the eggs and sperm involved in any conception, whether in the womb or in vitro, the better the chance of a healthy baby." The Society for Assisted Reproductive Technology reports that 47% of IVF pregnancies derived from fresh embryos resulted in live births, compared with 35% of pregnancies from frozen embryos that resulted in live births. "Initially, those success rates did not sound high," St. Lawrence writes, adding, "But the numbers referred to a single cycle; most couples ... produce several embryos during IVF, and if the first implantation is unsuccessful, they try again, and the cumulative success rate is much higher" (St. Lawrence, Washington Post, 7/6).

Christchurch woman seeks an egg donor

Desperate to be a mum, a Christchurch woman with a genetic condition that means she cannot conceive is advertising for an egg donor after two failed in vitro fertilisation (IVF) cycles.

Can you help Lisa? Email reporters@press.co.nz.

Lisa never thought she would consider an egg donor, but said she doesn't want her inability to conceive to be her life's story.

She doesn't want to feel odd around friends and family with children, and instead wants to put her grief and anger aside and get on with her life.

But first she needs to try a donor egg to see if it will succeed where two IVF courses failed.

Now 38, there was never a time when Lisa even considered she might not be able to have children.

In a stable relationship for 10 years and married for five, she said she and her partner thought there was no hurry.

"Being able to have a family was something I took for granted."

But Lisa discovered she was the carrier of a hereditary condition that meant having children naturally wasn't an option.

The couple went through two treatment cycles. The egg harvesting went well but once the eggs became embryos only one from both cycles was worth implanting. The procedure failed.

"Trying IVF a third time would most likely end in the same heartbreaking result."

IVF was hard and the financial, emotional and physical burden too much to bear.

Lisa said the outcome has changed everything for her.

"I live daily with grief and feelings of shame surrounding my tainted femininity and inability to give life."

Her sister was also unable to have children, which means her quest for an egg needs to go beyond her immediate family.

She was widening her appeal to anyone willing to help. She needs someone between 21 and 37 who has completed her own family and who is willing to go through counselling, then IVF for no monetary reward, since egg donors are not allowed to be paid.

IVF Babies May be More Prone to Childhood Cancers

IVF babies, those children who were conceived via in vitro fertilization, seem to experience an increased risk for childhood cancer versus babies conceived naturally, wrote WebMD, citing Swedish research. The new study is believed to be the first of its kind to indicate a scientifically strong link, said the American Society for Reproductive Medicine, reported WebMD.

According to the study’s lead author, childhood cancer is considered rare and the increase seen is small to moderate, potentially linked to the infertility, said WebMD. “There is an increased risk for cancer in children born via IVF, but it’s rather small,” researcher Bengt Kallen, MD, PhD, a retired professor of embryology and head of the Tornblad Institute, University of Lund, Lund, Germany, told WebMD. “The estimate that we give is that the risk increases 40 percent, but the estimate has, of course, a degree of uncertainty,” Dr. Kallen added. The study appears in the journal Pediatrics.

The team researched 26,692 Swedish children born via IVF from 1982 to 2005, using the Swedish Cancer Registry, said WebMD. The group compared the IVF children who had cancer versus those conceived naturally, noted WebMD, which added that the emerging study compliments information from a prior study by the same team, which looked at some 17,000 children. The prior study showed the same results; however, the emerging study indicates a stronger link.

After accounting for a series of variables—maternal age, pregnancy instances, miscarriages, body mass index—53 cases of cancer were seen in the IVF children, an increase over the 38 that would have been statistically probable in the general population, said WebMD. Cancers included leukemia and cancers of the central nervous system and eye, as well as other solid tumors and Langerhans histiocytosis, a condition in which the body experiences an excess of a specific white blood cell, wrote WebMD. While experts disagree on this condition being a cancer, when the incidences of this condition—six cases—were removed, there still existed an increased risk of 34 percent, added WebMD.

IVF babies were 1.4 times—40 percent—likelier to experience cancer in the follow-up period, which ended in 2006, said WebMD.

Last month we wrote that the risk of birth defects seems to be twice as high in babies conceived via fertility treatment, versus babies conceived naturally, according to French scientists. Assisted reproductive technology (ART) treatment includes a variety of infertility treatment methods such as vitro fertilization (IVF) in which an egg is fertilized by sperm in a lab, and intracytoplasmic sperm injection (ICSI).

Earlier this year we wrote, citing Reuters, that women who undergo IVF or ICSI and who become pregnant, experience an increased risk of giving birth to a stillborn baby, according to Danish scientists. In 2008, we wrote that Chinese researchers reported that the use of IVF or ICSI to conceive appears to increase the odds of Y-chromosome defects or “microdeletions” in male offspring, meaning that chromosomal defects, or deletions, could result in defective sperm production and possibly hypospadias, a congenital malformation of the male sex organs in which the urinary outlet, or urethra, does not open through the glans of the penis, but develops on the penis’ underside.

Test predicts success of second IVF

A test that predicts the success of second attempts at in vitro fertilisation (IVF) treatment with 1000 times more accuracy than the existing approach has been developed.

Experts believe the patented test could help couples decide if it is worth another try at IVF after an initial failure.

About three quarters of IVF treatments fail to produce a pregnancy.

Currently, age is used as the starting point for advising patients on the likely outcome of IVF.

A woman of 38 might be told she has a 33 per cent chance of becoming pregnant with IVF but the odds are lengthened if she is low on eggs.

The new test is said to be 1000 times more accurate than age-based guidelines.

However, since it relies on data from a first IVF treatment cycle, it can only be used to predict the success or failure of a second treatment.

The procedure, developed by Dr Mylene Yao and a team of researchers at Stanford University, California, effectively turns the initial cycle into a prognostic test.

Writing in the journal Proceedings of the National Academy of Sciences, the scientists concluded: "Our findings show that the first IVF cycle can provide quantitative, customised prediction of the live birth probability in a subsequent cycle.

"This concept is radically different from the current paradigm, in which age is a major predictor."

Stanford University holds a patent on the test and a spin out company called Univfy has been formed to develop and market it.

The scientists analysed data from 1676 IVF treatments performed at Stanford between 2003 and 2006 and identified 52 factors that influenced a woman's chances of having a baby.

As well as age, they included levels of certain hormones, the number and quality of eggs, and embryo characteristics.

A computer model was developed that used the information to sort patients into different sub-groups according to their subsequent IVF success.

In 60 per cent of cases the model's predictions varied significantly from those based on age alone - and more than half of these showed an improved chance of having a baby.

The findings indicated that relying on age alone "may provide misleading live birth outcome probabilities for a large portion of patients", said the researchers.

Co-author Dr Lynn Westphal, from Stanford's Reproductive Endocrinology and Infertility Centre, said a woman's decision to repeat IVF was influenced by a number of factors including cost and the chances of becoming pregnant.

"Many patients, even if they have insurance coverage, will drop out - either because they don't understand what their odds are or they find it's a very emotionally challenging experience to go through."