Why our next child must be a daughter

A couple who terminated twin boys conceived through IVF are fighting to choose the sex of their next child - because they want a girl.
In a case that raises the ethical question of sex selection, the couple have taken their fight to the Victorian Civil and Administrative Tribunal. They already have three sons and said they now want to have a girl after their baby daughter died.
An independent panel, known as the Patient Review Panel, rejected the couple's bid to choose the gender of their next child using IVF. They now want that decision overturned. The tribunal, which ruled it has the power to review the earlier decision, will hear the case in March.
The couple said they had made the decision to terminate the twin boys but could not continue to have unlimited numbers of children.
If their bid to have a daughter fails, they said they would go to US so they can conceive a girl.
The woman - in her 30s - said she loved her sons but would do anything to have a daughter. "After what we have been through we think we are due for a bit of luck," the man said.
"We know we definitely won't be replacing her in any way, but want the chance to have the baby girl we don't have."
According to Victorian law, sex selection is banned unless it is necessary to avoid the risk of transmission of a genetic abnormality or disease or the Patient Review Panel has approved such using of an embryo.
All IVF clinics in Australia also subscribe to a code of ethics, including that they stay within National Health and Medical Research Council guidelines which say sex selection should not be done except to reduce the transmission of a serious genetic condition.
The man said sex selection should be determined on a case-by-case basis. "Girls will go and get abortions and terminate when they know it's not the right sex," he said. "That's the reality.
"We think it's our right to have a chance to do it. It's ridiculous that sex selection is illegal, actually."
Australian IVF pioneer Gab Kovacs said he could not understand why the couple should be banned from having a girl.
"I can't see how it could possibly harm anyone," Professor Kovacs said.
"Laws should be made to protect people from things that are going to damage them. Why should we make this illegal? Who is this going to harm if this couple have their desire fulfilled?"

Latest iPhone application predicts IVF chances

Want to know your chance of having a baby through in-vitro fertilisation? There's an application for that.

British researchers have devised a formula which they say gives a highly accurate prediction of the potential success of IVF, to help couples decide whether to try the treatment.

They have made it available online as a simple computer calculator application, and say it will soon be available for download on Apple iPhones and other mobiles.

Scientists from the Universities of Glasgow and Bristol analysed the details of more than 144,000 IVF cycles to produce a statistical model that can give a prediction of live birth which is up to 99% accurate.

"Treatment-specific factors can be used to provide infertile couples with a very accurate assessment of their chance of a successful outcome following IVF," said Scott Nelson of the University of Glasgow, who led the research.

Nelson, whose work was published in the Public Library of Science (PLoS) Medicine journal, said that up until now estimates of success have not been very reliable.

The formula takes into account the woman's age, number of years trying to get pregnant, whether she is using her own eggs, the cause of infertility, the number of previous IVF cycles and whether she has previously been pregnant or had a baby.

"The result of this study is a tool which can be used to make incredibly accurate predictions," he said in a statement.

Nelson's team used data held by the Human Fertilisation and Embryology Authority, which regulates IVF treatment in Britain. They looked at all cycles carried out between 2003 and 2007 and assessed the chances of having a live birth.

The fertility treatment market is big and growing, with an estimated 140,000 IVF cycles in the United States in 2008. As many as 80 million couples worldwide are infertile, experts say.

In the United States and Britain, IVF is successful in about a third of women under 35 years old but in only five to 10% of women over the age of 40, Nelson said.

There are many other factors besides age which can alter the chance of success "and clinics don't usually take these into account when counselling couples or women", he added.

The calculator is already available free at www.ivfpredict.com.

Applications for iPhones and Android smart phones will be available soon, so users "can discuss the results with clinicians in the clinic", the website says.

"There is a real need in medicine to try and replace general statements such as 'high risk' and 'good chance' with well validated, quantitative estimates of probability," said Gordon Smith, head of Cambridge University's obstetrics and gynaecology department, who did not work on the study.

"This model ... provides women considering IVF with an understandable and quantitative estimate of their chances of success. It is a great resource."

IVF Breakthrough to Hit the World Market

A University of Adelaide reproductive biologist has achieved a major breakthrough in IVF technology that is expected to help millions of women around the world who have suffered previous miscarriages after IVF treatment.
Professor Sarah Robertson, an NHMRC Principal Research Fellow and member of the University's Robinson Institute, has partnered with a Danish company to develop a product which improves IVF embryo implantation rates for some women by up to 40%.
In the world's largest clinical trial on IVF media, Professor Robertson and ORIGIO a/s -- a European company specialising in assisted reproductive technologies -- have shown for the first time that growth factor molecules are critical to ensuring optimal embryo development.
The resulting product, EmbryoGen, to be released in 2011, contains a signalling molecule called GM-CSF found naturally in the mother's tissues which protects the embryo from stress, making it stronger and more robust in the early implantation period.
The clinical trial, involving 1319 IVF patients exposed to either EmbryoGen or standard IVF embryo media, resulted in an average 20% improvement in embryo implantation rates at 12 weeks for all IVF women whose embryos developed in EmbryoGen. The effect is primarily due to benefits for women who had previously miscarried, who showed an impressive 40% increase in implantation success.
"This is a wonderful advance for couples undertaking IVF, particularly those who have previously lost babies in the first trimester," Professor Robertson says.
It is also the culmination of more than two decades' work for Professor Robertson, who based her PhD on the role of growth factors in healthy pregnancies and then worked with Swedish colleagues to explore applications in IVF embryos.
"This breakthrough has been 20 years in the making," Professor Robertson says. "It's enormously rewarding to see one's basic research translate into practical outcomes that will benefit so many families."
"From day one we went right back to the fundamental biology to see what makes an embryo healthy in its normal environment in the reproductive tract. We discovered that embryo is exposed to growth factor signals from the mother's tissues, which is critical to its optimal development.
"This is a major paradigm shift for reproductive medicine. All of the other ART companies around the world, along with biologists and clinicians in this area, have thought that embryos don't need growth factors.
"We have demonstrated through extensive animal and human clinical trials that the reality is just the opposite. EmbryoGen is not only completely safe and natural -- it contains signalling molecules that the embryo expects to find in the mother's body -- but our data from animal studies shows that it may also result in IVF babies that are larger and healthier at birth."
Professor Robertson says IVF children are often smaller at birth, sometimes leading to long term effects in later life.
"By adding back this growth factor and protecting the embryo from stress, the result should be babies that are of a similar size to those naturally conceived." The data on the perinatal outcomes will be available later this year.
EmbryoGen will be launched in Europe and the Middle East by mid 2011 and in the USA in late 2012

First “saviour sibling” procedure successful

In a first, a nine year old girl received tissue donated by her 18-month old brother Max who was created specifically so that he could aid her medical treatment – a procedure termed as “saviour sibling”. This is the first time that the procedure has been under the supervision of British researchers from IVF onwards.

Megan living in King’s Lynn, Norfolk suffered from a rare blood disorder which can cause bone marrow failure from birth. A search for a suitable bone marrow donor failed. With Fanconi’s Anemia needed transfusions every few weeks and was unable to fight infections. Although her parents Katie and Andy Matthews wanted another baby but were warned that the chance of the second baby born with perfect bone marrow match for Megan was still one in four. Also the second baby could be born with the deadly disease.

The research team from Cambridge, Bristol and Nottingham used donated cells from the specifically created baby and taken to treat Megan’s disorder. Two embryos were implanted into Mrs. Matthews by CARE Fertility in Nottingham after they were checked for transplant suitability. After the birth of Max, his cord blood was collected and an operation was carried out to take bone marrow for his sister. The treatment was paid for by the NHS. The tissue transplant took place in July this year at Bristol Royal Hospital for Sick Children. Megan is now recovering with only weekly check-ups at Addenbrookes hospital in Cambridge.

The procedure is fraught with ethical concerns said Simon Fishel, managing director of Care Fertility but in the end the benefits could outweigh the concerns. He said, “The ethical issues are in favour of doing this work. We are trying to save the life of a child and achieve a family without the enormous burden of a child with this disorder who would die.” Josephine Quintavalle, Director of Comment on Reproductive Ethics said, “[Max] owes his life to his capacity to be of therapeutic use to his sick sister, otherwise he would not have been chosen in the first place. This is the big ethical problem.” The practice of creating savior siblings was made legal by the Human Fertilization and Embryology (HFE) Act 2008, which passed amidst much ethical controversy.

Triplet ‘waiting in freezer’ born 11 years after sisters

One of three triplets conceived on the same day through IVF was born last month in Britain — 11 years after her twin sisters who say she was waiting "in the freezer" to be born.The girls, daughters of Lisa and Adrian Shepherd, all come from the same round of fertility treatment and it is believed there is no other known case where such an age gap exists.

The British couple began treatment in 1998 after Ms Shepherd was diagnosed with medical conditions that made her chances of her becoming pregnant naturally slim. During the treatment at the Midland Fertility Clinic near Birmingham, doctors successfully fertilised 14 eggs with Mr Shepherd’s sperm. Two embryos were implanted with the remaining 12 placed into freezer storage.

Soon afterwards scans showed Ms Shepherd was expecting twins. The girls, Megan and Bethany, arrived six weeks early and weighed less than 8lbs between them but made a great recovery.

When the girls were nine, the couple started to consider another baby. "We had been so busy raising the twins that it wasn’t until then that we stopped to think about having another one," Ms Shepherd said.

"We asked the girls what they thought about having another addition to the family and they really wanted it."

So last year, they returned to the clinic for another cycle of IVF, using the embryos stored 10 years previously. "We didn’t know if it would work… It was one last chance, and if it was meant to be, then it would happen."

And so it was meant to be with Ryleigh was born last month, weighing 7lb 10oz.

"The girls are thrilled to have a sister — and they know that she was conceived at the same time that they were, but has been in the freezer," Ms Shepherd said.

"She’s a really happy baby and has got a really good appetite — it’s as though she’s making up for lost time."

Mr Scot Wrighton, City Manager, Lavasa & the Chief Guest ET2010 delivering the Inaugural Address

One-embryo transfers have better outcome in IVF

Infertile women undergoing IVF are much more likely to end up with a healthy baby if they only have one embryo transferred during the procedure, according to new research. One of the most controversial issues surrounding IVF has been the number of embryos that are transferred into a woman’s womb. In the hopes of increasing the chances of having a baby, doctors often place more than one. But that also increases the chances that women will end up having twins, triplets or higher numbers of multiple births. And babies born in multiple births are much more likely to have complications, putting both the mother and the babies at risk.
In the new analysis, researchers at the University of Aberdeen in Britain and elsewhere analyzed data collected about 1,367 women undergoing IVF, including 683 who only had one embryo transferred and 684 who had two. In a paper published in the British medical journal BMJ, the researchers reported that 27 percent of those who had only one embryo transferred gave birth to a healthy baby, compared with 42 percent who gave birth to a healthy baby after getting two embryos transferred.
But when the women getting one embryo transferred followed that up with a second embryo that had been frozen and then thawed, that boosted the chances of successfully giving birth to a healthy baby to about the same level — 38 percent. And those women were also less likely than those who had gotten two embryos transferred to give birth prematurely or to give birth to babies who were underweight, the researchers found. In fact, women who opted for the one-embryo option were almost five times as likely to carry their babies to full term.
Based on the findings, the researchers recommended that that approach be adopted by more doctors.