When Rotunda – The Center For Human Reproduction and its Human Sperm Banking Division opened its doors in 1996, the technology for preserving or "banking" human sperm by cryogenic methods, while nearly a quarter century old, was still in its infancy in India.
The prefix "cryo" comes from the Greek work "kryos," meaning cold or frost. The science of cryogenics deals with the effects of extremely cold temperatures on matter. Applying this technology to preservation of sperm was a natural outgrowth of the development of artificial insemination.
Although we tend to think of artificial insemination as a modern technology, it has a history dating back to 1779. That was the year an Italian priest and physiologist named Lazaro Spallanzani performed a laboratory experiment that revolutionized scientific thinking. Until that time, our understanding of reproduction was based on our understanding of how plants grow. It was believed that the embryo was the "product of male seed, nurtured in the soil of the female." Spallanzani's experiment established for the first time, that for an embryo to develop, there must be actual physical contact between the egg and the sperm. Armed with this new understanding, Spallanzani successfully inseminated frogs, fish and dogs. But while the artificial insemination of animals was quickly propelled into an industry, the application of this technology to "growing" of human babies proceeded cautiously.
The first successful artificial insemination of a woman was recorded just eleven years after Spallanzani's experiment. In 1790, the renowned Scottish anatomist and surgeon, Dr. John Hunter, reported that he had successfully inseminated the wife of a linen draper, using her husband's sperm. For over a century nothing more was heard on the subject. Then, in 1909, a letter appeared in the American journal, Medical World, spotlighting another aspect of the little known procedure. In the letter, the author, Addison Davis Hard, claimed that the first human donor insemination had been performed at the Jefferson Medical College in Philadelphia in 1884 -- twenty-five years earlier. According to Hard's letter, the mother, a patient of Dr. William Pancoast, was the Quaker wife of a local merchant, fifteen years her senior. The couple had come to the doctor seeking advise about her inability to have children. Extensive examinations of the woman revealed no abnormality. Finally, the husband was examined. It was discovered that he was azoospermic, or sterile. According to Hard's letter, when Dr. Pancoast discussed the case with his medical students, including Hard, someone in the group suggested that semen should be collected from the "best looking" member of the class, and used to inseminate the woman. Dr. Pancoast agreed to the experiment. Without informing either the woman or her husband of his intentions, he called the merchants wife back under the pretense of doing another examination. The woman was anesthetized, and the procedure was carried out. It wasn't until it became evident that the woman had actually conceived that her husband was informed. Fortunately, he was pleased. At his request, his wife was never told how she became pregnant. Hard's letter went on to say that, as a result of this medical school experiment, the merchant's wife gave birth to a son, who became the first known child by donor insemination (DI).
The idea of applying artificial insemination to human propagation was difficult enough for turn-of-the-century society to accept: to use the sperm of a man other than the woman's husband was scandalous. Hard's letter triggered heated debate among lawyers, moralists, theologians and medical practitioners. However, after a year of debates, the controversy, as the practice itself, appears to have faded into oblivion. If any doctors were treating infertility through DI, they were doing it
with the utmost discretion. DI remained virtually unknown to the public until 1954. That was the year the first comprehensive account of the process was published in The British Medical Journal. As it had before, donor insemination provoked heated public debate. The Archbishop of Canterbury established the first in a long procession of commissions that, over the years,
inquired into the development of the practice. The first commission produced a report strongly critical of DI, and recommended that the practice be made a criminal offense. A Parliamentary Commission agreed. In Italy, the Pope
declared DI a sin, and proposed that anyone using the procedure be sent to prison.
In that same year (1954), on this side of the ocean, the Supreme Court of Cook County ruled that regardless of a husband's consent, DI was "contrary to public policy and good morals, and considered adultery on the mother's part." The ruling went on to say that, "A child so conceived, was born out of wedlock and therefore illegitimate. As such, it is the child of the mother, and the father has no rights or interest in said child." This perspective was maintained as late as 1963, when a court in the United States held that a DI child was illegitimate because the sperm donor was not married to the child's mother. Regardless of her husband's consent, the court stated, the woman's insemination constituted adultery. But a year later, there were signs that attitudes were changing. In 1964 Georgia became the first state to pass a statute legitimizing children conceived by DI, on the condition that both the husband and wife consented in writing. In 1973 the Commissioners on Uniform State Laws, and a year later, the American Bar Association, approved the Uniform Parentage Act. This act provides that if a wife is artificially inseminated with donor semen under a physician's supervision, and with her husband's consent, the law treats the husband as if he were the natural father of the DI child. The laws most states have enacted pertaining to DI have been based on this act. In every case, the statute makes it clear that the donor who provides the doctor or sperm
bank with sperm is not the legal father of any child conceived by that sperm.
One court ruling in particular is relevant: the 1968 People V. Sorensen. While an earlier (1945) oral opinion in an Illinois case held that donor insemination was neither adultery nor grounds for divorce; it was not until the Sorensen case that a court ruled the DI child was legitimate. In the Sorensen case, the California Supreme Court upheld the criminal conviction of a man
for not supporting a DI child conceived with his consent during marriage. Sorensen claimed the child was not his, therefore he had no obligation to support it. The court ruled that the sperm donor had no more responsibility for the use of his sperm than a blood donor had for his blood. The court noted, "since there is no 'natural father', we can only look for a lawful father." And that was Sorensen.
The father of artificial insemination marked up another first in reproductive biology. It is believed that Spallanzani was the first to report the effects of cooling on human sperm when he noted, in 1776, that sperm cooled by snow became motionless. But efforts to actually freeze sperm did not begin until the mid 1800s. In 1866 a man by the name of Montegazza was the first to envision banks for frozen human sperm. He suggested that "a man dying on a battlefield may beget a legal heir with his semen frozen and stored at home." While it took some 150 years, during the Gulf war crises
in 1992, Montegazza's vision became a reality. Service men were able, and indeed some opted to freeze and store specimens of their sperm before leaving for battle.
Between the years 1938 and 1945, a number of scientists observed that sperm could survive freezing and storage temperatures as low as minus 321 degrees Fahrenheit. But surviving is one thing; being able to successfully function in the conception process is another. The first major breakthrough in that area came in 1949 when A.S. Parkes and two British
scientists developed a method of using a syrupy substance known as glycerol to protect semen from injury during freezing. The process was further refined in 1953 by Dr. Jerome K. Sherman, an American pioneer in sperm freezing. Sherman introduced a simple method of preserving human sperm using glycerol, but he combined this with a slow cooling of sperm, and storage with solid carbon dioxide as a refrigerant. Sherman also demonstrated for the first time that frozen sperm, when thawed, were able to fertilize an egg and induce its normal development. As a result of this research, the first successful human pregnancy with frozen spermatozoa was reported in 1953. (Shortly before the Cook County Supreme Court ruled DI was "contrary to public policy and good morals.") Considering the hostile climate for DI at the time, it is not surprising that nearly a decade passes before the first public announcement of a successful birth from frozen sperm. The announcement, made the 11th International Congress of Genetics in 1963, triggered interest in the possibility of sperm banks. Approximately a decade later, in the early 70s, the first commercial sperm bank opened.
When we (Gautam Allahbadia and Swati Allahbadia) established Rotunda – The Center For Human Reproduction in 1996, we had a specific vision for their new undertaking. I was a consultant at the Bombay Hospital, and Swati, a lecturer at Sion Hospital and we saw this new reproductive potential as a practical, viable solution to a painful dilemma we had witnessed in the practice of our professions: the often traumatic effect of sterility on men. Our observations concurred with the findings of Dr. Patricia Schreiner-Engle of the Mt. Sinai School of Medicine. According to Dr. Schreiner-Engle, the loss of a man's ability to father children often has a shattering impact on his self-esteem. It doesn't matter whether the sterilization is the result of a voluntary vasectomy, or of cancer or some other disease which requires surgery, chemotherapy or radiation. Whatever the reason, a man's loss of his ability to perpetuate his family name often triggers a crises in identity -- a sense of diminished masculinity. Infertility is still perceived by many to be a female problem. However, for nearly half of the
20 million infertile couples in the India, the problem stems from the infertility of the male. A University of Wisconsin survey, which was sent out to doctors throughout the United States who were treating problems of infertility, revealed that a surprising number of those doctors were quietly treating infertility with donor insemination. The physicians performing the procedure were using fresh semen, and usually selected the donors themselves, most often medical students, residents of other hospital personnel. Most of these doctors reported an effort to select donors who matched the husband in such things
as height, hair, skin and eye color, blood type, religious or ethnic background and educational level. Donor screening for genetic disease was usually limited to a medical history. Few of the doctors performed any biochemical tests on the donors.
The publishing of the University of Wisconsin survey generated an increased demand for anonymous donor insemination. Sperm banks across the USA responded. By the beginning of the eighties, meeting this need had become their main focus. In India, even in the early 1990s, there was only one recognised banking service in Mumbai.
At first some doctors resisted the use of frozen sperm for donor insemination. The job of a fertility specialist is to help a woman get pregnant. Research the time suggested the chances were slightly better with fresh sperm than with frozen sperm.
Over the years, expanded demand for DI, convenience, and the number and variety of donor prospects offered by sperm banks slowly eroded this resistance. Then in 1985, something happened that dramatically hastened the transition to the predominate use of frozen sperm for DI: the identification of a devastating newly recognized sexually transmitted disease --
HIV. A year later, in response to this new threat, the American Association of Tissue Banks began discouraging the use of fresh semen among its member sperm banks. In February 1988, the American Fertility Society (now, the American Society for Reproductive Medicine), the Food and Drug Administration, and the Center for Disease Control all recommended that
only frozen semen be used for DI, in conjunction with a minimum 6 month quarantine period. It became clear to the scientific community that the best way to ensure semen was not infected with HIV, hepatitis or other sexually transmitted disease is to freeze and quarantine the specimen for 6 months, at which time the donor is retested. This reduces the possibility that the donor had the virus at the time the specimen was collected and frozen. Today, the majority of sperm used for DI is frozen, clearly giving sperm banks a critical role in reproductive biology.
We have come a long way since the days when the only viable alternative an infertile couple had to become parents was adoption. The ability to freeze and store sperm has contributed greatly to this process. It has played an integral part in the development of today's more effective reproductive technologies. Fortunately, male factor infertility no longer means a couple must forgo the experience of pregnancy and childbirth. Thanks to modern reproductive technology and sperm banks, many of these couples have the option of becoming parents by using artificial insemination. While couples and individuals requiring sperm for artificial insemination make up most of the people who use today's sperm banks, these institutions also provide help for other individuals with reproductive problems. Among them, men facing voluntary sterilization, or
sterilization resulting from medical conditions or treatments. There is a medical and legal consensus today that men facing the possibility of sterilization, reduction in fertility potential or exposure to reproductive hazards should be fully informed of the option of semen storage. This practice is frequently followed by physicians treating men who are facing vasectomy, orchiectomy, chemotherapy, radiation therapy, or high risk occupational exposure to radiation or toxic substances. Our current environmental crisis has also generated a need for sperm bank services. Men who work in industries where there is the danger of exposure to radiation, toxins or other genetically threatening environmental pollutants are using sperm banks to preserve their sperm as insurance against possible accidents that could leave them infertile, impotent, or genetically damaged. In addition to these typical uses for sperm bank services, Rotunda –The Center For Human Reproduction has responded to some unique requests; of fathers donating sperm for infertile sons and brothers donating sperm for infertile brothers.
If you are a couple with a male factor reproductive problem, or a single woman who has chosen to become a mother, you may be considering using the services of a sperm bank. Your first step should be to discuss the possibility with your doctor. His or her knowledge of your physical condition, and your doctor's experience in reproductive medicine can provide
you with insight into whether a sperm bank can help you meet your specific reproductive goals or needs. Ultimately, however, only you can make that decision. It will depend as much on who you are and your feelings and beliefs about what you are doing, as it will on what you are seeking to accomplish. But before you can make that decision, you need to understand precisely what a sperm bank can and cannot do for you.
* A sperm bank can freeze and store sperm for a man facing voluntary or medically induced sterilization. Sperm that can be thawed at a later date and used for artificial insemination.
* A sperm bank can freeze and store the sperm of a man whose vocation places him at risk for an environmental accident that could leave him infertile, impotent, or genetically damaged.
* A sperm bank can store a husband's sperm for AIH or other modern reproductive technologies that require sperm for use during ovulation.
* A sperm bank can provide safe, disease-tested sperm for artificial insemination from a wide selection of carefully screened and tested anonymous donors.
* A sperm bank can provide recipients seeking sperm from an anonymous donor with accurate and comprehensive information about their prospective donors, so that the recipients can select the donor best suited to meet their specific requirements.
In other words, a sperm bank can test, freeze, store and provide safe, disease-screened sperm for use in various reproductive technologies.
* A sperm bank cannot guarantee successful conception.
* A sperm bank cannot guarantee a healthy pregnancy or child.
* A sperm bank cannot genetically determine or in any way manipulate the intelligence, talents or physical characteristics of any child conceived from the sperm it supplies.
Legend has it that the world renowned dancer, Isadora Duncan once wrote to George Bernard Shaw, "You have the greatest brain in the world, and I have the most beautiful body, so we ought to produce the most perfect child." To which Shaw is alleged to have answered, "My dear woman, what if the child inherits my body and your brains?"
Shaw fully understood the element of chance involved in procreation; the innumerable possibilities that come into play with the union of sperm and egg. The laws of nature that dictate those possibilities remain intact whether the conception is the result of normal sexual intercourse or reproductive intervention.
1. How Safe Is The Donor Sperm Provided By Sperm Banks?
While in India, only the state of Delhi has laws at present governing the operation of sperm banks, the American Society for Reproductive Medicine and the American Association of Tissue Banks have established guidelines which most professional sperm banks the world over follow. Rotunda Sperm Bank adheres to these principles. These guidelines require the rigorous screening of donors.
So thorough is this screening process that a user of donor sperm from an accredited sperm bank probably knows more about her anonymous donor than any bride knows about the man she is about to marry. Or for that matter, more than many women know about their husbands even after ten years of marriage. Accredited sperm banks not only screen all donors for an array of genetic and sexually transmitted diseases, but freeze and quarantine all anonymous donor sperm for six months
so they can retest the donor to make sure he tests negative for HIV, hepatitis and other sexually transmitted diseases (STD). Only when this testing reveals that the donor is free of these diseases is his frozen sperm released for use. Safety is the primary advantage of using a sperm bank.
2. Are There Any Risks Involved In Being Artificially Inseminated With Frozen Sperm?
Nothing in life is without risk. In this case, however, the potential risk is not in the use of thawed frozen sperm, but in the insemination process itself. Artificial insemination is an invasive procedure, therefore there is always the possibility of infection. There is also the normal risk of defects and complications associated with any pregnancy, particularly when the woman is over forty, as is the case with many of the women who choose artificial insemination.
3. How Can I Be Sure I Am Getting The Correct Sperm?
There have been reports in the newspaper in recent years of lawsuits alleging mix-ups in sperm specimens supplied by sperm banks. Since one man's sperm cannot be distinguished from another, even under the most powerful microscope, such a mix-up is not beyond possibility, either during processing or in the doctor's office during the administration of the
insemination. Rotunda – The Center For Human Reproduction, Bandra, Mumbai In Collaboration with Andrology Laboratory Services, Incorporated, Chicago, USA has introduced the DNA-ID check which confirms your infant's identity using saliva.
What Is THE DNA-IDCHECK?
DNA-IDCHECK is an infant identification and parentage confirmation system. Using state-of-the-art DNA technology, the test is inexpensive, efficient and non-intrusive, requiring no more than a small saliva sample from the parent(s)
and infant. When a DNA mismatch occurs, the DNA-IDCHECK System can establish if you are NOT the father. Our DNA-IDCHECK System is an inexpensive screening test to decide you might require more extensive, legally certifiable
testing. The DNA-IDCHECK System, using a special analysis for matching parent-to-infant genetic code, can only identify an individual or prove if an adult is not the genetic parent of a particular infant. In other words, they convey no relevant genetic information during the testing procedure: The test reveals nothing else about the tested individual. Confidentiality and privacy issues are never violated. For more details log on to www.iwannagetpregnant.com or contact Rotunda-The Center For Human Reproduction, Bandra, Mumbai at 26553000/2000 or goralgandhi@gmail.com
However, well-run, professional cryobanks follow rigid labeling, processing and storage procedures that make such confusion unlikely. The best way to avoid this problem is to choose an experienced, efficiently operated professional sperm bank that adheres to the guidelines set up by the American Society for Reproductive Medicine. Sperm banks will, of course, never supplant the natural process for conceiving a child. But in combination with artificial insemination and other modern reproductive technologies, and by working along side reproductive care physicians, today they offer many couples and
individuals who are unable to conceive naturally the possibility of experiencing pregnancy and the birth of their desired child.
Thursday, July 12, 2007
Wednesday, July 11, 2007
Age, Infertility & Donor Eggs
While most healthy older women who become pregnant have uneventful pregnancies and healthy babies, thousands more are unable to achieve pregnancy because of declining ovarian function. A decline in ovarian function is normal with increasing age. A woman's number of eggs steadily decreases from a peak at mid-gestation of 7 million to approximately 400,000 at puberty. Certain tests can reflect gradations in ovarian reserve status and predict a woman's potential fertility. The most important lab test is the day 2/3 follicle-stimulating hormone level.
Women with declining ovarian responsiveness and clinical outcomes consistent with declining ovarian reserve have decreased day 3 serum inhibin B levels despite having non-elevated day 3 serum FSH concentrations. Declining ovarian reserve may be demonstrated by a decrease in day 3 inhibin B levels before a rise in day 3 FSH levels. A constant source of frustration in fertility centers is that patients are referred to the specialty clinic too late, when diminished ovarian reserve is so marked that treatment success is severely limited. Earlier assessment of ovarian function would alter this unfortunate trend.
Reproductive failure in women of older age appears to be directly related to ovarian age. It seems that the age-related decline in fertility may be due more to degenerative oocytes than to aneuploidy. The decline in female fertility occurs primarily as a result of a decline in oocyte quality as well as quantity A decline in the number of oocytes retrieved with age may be of less importance than the decline in oocyte quality. Embryo implanting ability and survival decline gradually after 30 years of age, but by more than two thirds after 40 years and in younger women with reduced ovarian capacity. The frequency of chromosomal anomalies in recognized abortuses increases in parallel with the age-specific rise in the incidence of spontaneous abortions. Recent techniques such as cytoplasmic or germinal vesicle transfer are designed to replace the senescent cellular machinery believed to be responsible for genetic errors that occur during early cell division. PGD can accurately identify embryos with genetic deficiencies prior to implantation.
Research indicates that much of the decline in fecundity can be attributed to an increasing risk of fetal loss with maternal age. Much of this fetal loss is due to chromosomal abnormalities--a result of ageing oocytes. Fecundability, on the other hand, does not begin to decline until the early 40s. This is also a result of ageing at the ovarian level, namely follicular atresia, in the years just prior to menopause. The irregularity of menstrual cycles--longer cycles and increasingly variable hormonal patterns--at these ages may be a direct result of the small and rapidly dwindling remaining pool of follicles. The number of small antral follicles in both ovaries as measured by vaginal ultrasonography is clearly related to reproductive age and could well reflect the size of the remaining primordial follicle pool.
There is a significant decline in human fecundity with advancing age. A significant decrement in success rates is also seen in older women undergoing assisted reproduction, including in-vitro fertilization. We have observed a drop in the ongoing pregnancy rate per patient, from about 32 % in women aged less 30 years to lesss than 28 % in women aged more than 35 years. Embryo implantation rates also decline in a linear fashion, from 5 % in women less than 30 years to approximately 2 % at age over 40 years. We observed that the impaired implantation efficiency seen in older women is apparently independent of the magnitude of their stimulation response. Although no statistically significant relationships were found between serum FSH concentrations as obtained in the early follicular phase and the number of oocytes collected, or the total dose, there was a trend to poorer response as the FSH approached closer to 10 mIU/mL. The decline in number of oocytes retrieved with increasing age can be at times overcome by augmenting the daily dose of gonadotropins to as much as 1050 mIU/mL. Oocyte factors are felt to be primarily responsible; however, some available data suggest that uterine factors, e.g. diminished endometrial receptivity, may also play a role.
Natural fertility rates decline in most animals with age, becoming dramatically apparent in women as they enter the fifth decade of life. By the time of the perimenopause, pregnancy rarely occurs, whether or not assisted reproductive techniques are initiated. However, if oocytes are donated by young women to older women, both embryo implantation and pregnancy rates are restored to normal levels in recipients. These results strongly suggest the pregnancy wastage experienced by older women is largely a result of degenerative changes within the aging oocyte(egg), rather than senescent changes in the uterus. The poor prognosis for fertility in older women can be reversed through oocyte donation from younger individuals.
There are presently no treatment strategies apart from oocyte donation, which have been shown to significantly improve implantation efficiency in older women. Women in the older age group have a higher chance of achieving pregnancy from ovum-donation programs than by persisting in using their own aged eggs, which have a very poor prognosis for success.
However, recent efforts have focused on the continued development of improved stimulation protocols in higher doses, facilitation of embryo implantation by zona pellucida micromanipulation, and the possibility of screening preimplantation embryos for aneuploidy. Elderly women with partners who have suboptimal sperm parameters reflected by low fertilization capacity scores may benefit from micro-manipulation procedures. Egg Donation is the only answer presently until maybe Cytoplasmic Transfer becomes routine- maybe a decade from now.
Women with declining ovarian responsiveness and clinical outcomes consistent with declining ovarian reserve have decreased day 3 serum inhibin B levels despite having non-elevated day 3 serum FSH concentrations. Declining ovarian reserve may be demonstrated by a decrease in day 3 inhibin B levels before a rise in day 3 FSH levels. A constant source of frustration in fertility centers is that patients are referred to the specialty clinic too late, when diminished ovarian reserve is so marked that treatment success is severely limited. Earlier assessment of ovarian function would alter this unfortunate trend.
Reproductive failure in women of older age appears to be directly related to ovarian age. It seems that the age-related decline in fertility may be due more to degenerative oocytes than to aneuploidy. The decline in female fertility occurs primarily as a result of a decline in oocyte quality as well as quantity A decline in the number of oocytes retrieved with age may be of less importance than the decline in oocyte quality. Embryo implanting ability and survival decline gradually after 30 years of age, but by more than two thirds after 40 years and in younger women with reduced ovarian capacity. The frequency of chromosomal anomalies in recognized abortuses increases in parallel with the age-specific rise in the incidence of spontaneous abortions. Recent techniques such as cytoplasmic or germinal vesicle transfer are designed to replace the senescent cellular machinery believed to be responsible for genetic errors that occur during early cell division. PGD can accurately identify embryos with genetic deficiencies prior to implantation.
Research indicates that much of the decline in fecundity can be attributed to an increasing risk of fetal loss with maternal age. Much of this fetal loss is due to chromosomal abnormalities--a result of ageing oocytes. Fecundability, on the other hand, does not begin to decline until the early 40s. This is also a result of ageing at the ovarian level, namely follicular atresia, in the years just prior to menopause. The irregularity of menstrual cycles--longer cycles and increasingly variable hormonal patterns--at these ages may be a direct result of the small and rapidly dwindling remaining pool of follicles. The number of small antral follicles in both ovaries as measured by vaginal ultrasonography is clearly related to reproductive age and could well reflect the size of the remaining primordial follicle pool.
There is a significant decline in human fecundity with advancing age. A significant decrement in success rates is also seen in older women undergoing assisted reproduction, including in-vitro fertilization. We have observed a drop in the ongoing pregnancy rate per patient, from about 32 % in women aged less 30 years to lesss than 28 % in women aged more than 35 years. Embryo implantation rates also decline in a linear fashion, from 5 % in women less than 30 years to approximately 2 % at age over 40 years. We observed that the impaired implantation efficiency seen in older women is apparently independent of the magnitude of their stimulation response. Although no statistically significant relationships were found between serum FSH concentrations as obtained in the early follicular phase and the number of oocytes collected, or the total dose, there was a trend to poorer response as the FSH approached closer to 10 mIU/mL. The decline in number of oocytes retrieved with increasing age can be at times overcome by augmenting the daily dose of gonadotropins to as much as 1050 mIU/mL. Oocyte factors are felt to be primarily responsible; however, some available data suggest that uterine factors, e.g. diminished endometrial receptivity, may also play a role.
Natural fertility rates decline in most animals with age, becoming dramatically apparent in women as they enter the fifth decade of life. By the time of the perimenopause, pregnancy rarely occurs, whether or not assisted reproductive techniques are initiated. However, if oocytes are donated by young women to older women, both embryo implantation and pregnancy rates are restored to normal levels in recipients. These results strongly suggest the pregnancy wastage experienced by older women is largely a result of degenerative changes within the aging oocyte(egg), rather than senescent changes in the uterus. The poor prognosis for fertility in older women can be reversed through oocyte donation from younger individuals.
There are presently no treatment strategies apart from oocyte donation, which have been shown to significantly improve implantation efficiency in older women. Women in the older age group have a higher chance of achieving pregnancy from ovum-donation programs than by persisting in using their own aged eggs, which have a very poor prognosis for success.
However, recent efforts have focused on the continued development of improved stimulation protocols in higher doses, facilitation of embryo implantation by zona pellucida micromanipulation, and the possibility of screening preimplantation embryos for aneuploidy. Elderly women with partners who have suboptimal sperm parameters reflected by low fertilization capacity scores may benefit from micro-manipulation procedures. Egg Donation is the only answer presently until maybe Cytoplasmic Transfer becomes routine- maybe a decade from now.
Tuesday, July 10, 2007
Necrozoospermia
Necrozoospermia is a condition in which all of the sperm in a man's ejaculate are dead. In point of fact, there are a number of reasons for a man to be afflicted with necrozoospermia. Indeed, necrozoospermia can be the result of everything from diet, disease, injury, medications, alcohol or illicit drug use and other factors. In many instances, if the underlying cause of necrozoospermia is resolved, the condition of necrozoospermia likewise will be rectified.
If you have been told by your doctor that you suffer from necrozoospermia, it is important that you do seek further medical attention. In some instances, necrozoospermia can be a symptom of a serious problem that can have very serious additional consequences beyond necrozoospermia. For example, in some instances, necrozoospermia is the sign of another condition or disease that could even end up resulting in erectile dysfunction. Although allopathy has no answers for this condition, some Indian Ayurvedic formulations seem to have shown improvement with this condition in isolated case reports.
For the doctor, he must distinguish between live –immotile sperms and dead-immotile sperms. Assisted Reproductive Techniques can help patients whose sperms are alive but immotile. We had a patient; the individual simply didn't follow proper collection technique and had been using a lubricant gel. As soon as he collected without the lubricant, his motility was in the normal range. One should also test the semen for autoantisperm antibodies that might have been caused by a different habit of sex, eg. Anal sex. Usually, with such severe motility problems, the patient has to undergo Intracytoplasmic Sperm Injection (ICSI). Let me start a thread here for the medical bloggers.
For a man with 100% immotile sperm in the ejaculate, of which 10% are live, are pregnancy rates better with ICSI (after selecting live sperm with a hypo-osmotic swelling test); or is it better to offer TESE-ICSI (ICSI with testicular sperm extraction)?
10% viable sperms should be good enough for ICSI. Why TESE-ICSI, if one can get 10% viable sperms in the ejaculate? Moreover, TESE is associated with complications - like fibrosis. TESE because you cannot pick out which of the 10% are viable sperm to inject with good reliability. HOS test may help but data on it's use for ICSI involves small numbers. You are much more likely to have higher viability from the testis (assuming no motile sperm are found in the vas or epididymis) than from the ejaculate. Surgical retrieval of sperm is an option that should not be ignored in such cases, as we all are driven to achieve the best possible outcomes for our patients. Do a testicular retrieval fresh at the time of IVF/ICSI. You will probably find motile (twitching) sperm. This is much more reliable than trying to identify viable sperm in a 0% immotile ejaculate.
The task of selecting a single sperm for injection, from the stated 10% viable population from the sample of zero motility, on the basis of the HOS test, is no way nearly as easy as some colleagues would like you to believe. It is technically difficult to pick up curled sperm which have been exposed to HOS solution. But you can pick the sperm up from culture media, transfer your needle into a drop of HOS solution, hold the sperm near the opening of the needle and allow the HOS solution to diffuse into the needle and you can watch the sperm start to curl inside the ICSI needle. As soon as you see the sperm tail curl, you can move to a PVP drop, break the tail and perform the ICSI.
Our experience with such situation is that (1) the outcome (in terms of fertilization and pregnancy rates) is the same between viable (non-motile) testicular sperm and viable (non-motile) ejaculated sperm; (2) motile spermatozoa can be found in some (about 40%) of the patients with 100% immotile sperm in ejaculated semen. This is the only reason that testicular biopsy is carried out in patients with 100% non-motile ejaculated sperm in our Center.
First, a viability test is essential. Alternatives to HOS are Eosin Y or Trypan blue staining, or use of a fluorescent DNA-binding probe such as Hoechst 33258. If all the sperm in semen are 'dead', we would not suggest ICSI using them. In our practice, we determine whether there is an immediate possible cause of cell death such as high reactive oxygen species generation by leukocytes, which might be addressed. If not, a vas or testicular aspiration is considered. We have seen normal (for the site)
motility from either vas or testis when semen sperm motility is poor. Second, if some of the sperm are apparently live, we would attempt to stimulate motility using pentoxifylline. Surprisingly, this has worked in some cases of 0% motility. The induced motility may or may not be of sufficient quality and quantity to consider IUI or IVF. But, even if there is only twitching motility, this may be sufficient to choose sperm for ICSI. The pentoxifylline is washed out of the sperm preparation before any of the insemination procedures. This also avoids having to use HOS to choose non-motile sperm. Third, if no sperm respond to pentoxifylline, medical, genetic, or electron microscopic evidence could be gathered to rule out an immotile cilia syndrome, followed by genetic counseling.
If you have been told by your doctor that you suffer from necrozoospermia, it is important that you do seek further medical attention. In some instances, necrozoospermia can be a symptom of a serious problem that can have very serious additional consequences beyond necrozoospermia. For example, in some instances, necrozoospermia is the sign of another condition or disease that could even end up resulting in erectile dysfunction. Although allopathy has no answers for this condition, some Indian Ayurvedic formulations seem to have shown improvement with this condition in isolated case reports.
For the doctor, he must distinguish between live –immotile sperms and dead-immotile sperms. Assisted Reproductive Techniques can help patients whose sperms are alive but immotile. We had a patient; the individual simply didn't follow proper collection technique and had been using a lubricant gel. As soon as he collected without the lubricant, his motility was in the normal range. One should also test the semen for autoantisperm antibodies that might have been caused by a different habit of sex, eg. Anal sex. Usually, with such severe motility problems, the patient has to undergo Intracytoplasmic Sperm Injection (ICSI). Let me start a thread here for the medical bloggers.
For a man with 100% immotile sperm in the ejaculate, of which 10% are live, are pregnancy rates better with ICSI (after selecting live sperm with a hypo-osmotic swelling test); or is it better to offer TESE-ICSI (ICSI with testicular sperm extraction)?
10% viable sperms should be good enough for ICSI. Why TESE-ICSI, if one can get 10% viable sperms in the ejaculate? Moreover, TESE is associated with complications - like fibrosis. TESE because you cannot pick out which of the 10% are viable sperm to inject with good reliability. HOS test may help but data on it's use for ICSI involves small numbers. You are much more likely to have higher viability from the testis (assuming no motile sperm are found in the vas or epididymis) than from the ejaculate. Surgical retrieval of sperm is an option that should not be ignored in such cases, as we all are driven to achieve the best possible outcomes for our patients. Do a testicular retrieval fresh at the time of IVF/ICSI. You will probably find motile (twitching) sperm. This is much more reliable than trying to identify viable sperm in a 0% immotile ejaculate.
The task of selecting a single sperm for injection, from the stated 10% viable population from the sample of zero motility, on the basis of the HOS test, is no way nearly as easy as some colleagues would like you to believe. It is technically difficult to pick up curled sperm which have been exposed to HOS solution. But you can pick the sperm up from culture media, transfer your needle into a drop of HOS solution, hold the sperm near the opening of the needle and allow the HOS solution to diffuse into the needle and you can watch the sperm start to curl inside the ICSI needle. As soon as you see the sperm tail curl, you can move to a PVP drop, break the tail and perform the ICSI.
Our experience with such situation is that (1) the outcome (in terms of fertilization and pregnancy rates) is the same between viable (non-motile) testicular sperm and viable (non-motile) ejaculated sperm; (2) motile spermatozoa can be found in some (about 40%) of the patients with 100% immotile sperm in ejaculated semen. This is the only reason that testicular biopsy is carried out in patients with 100% non-motile ejaculated sperm in our Center.
First, a viability test is essential. Alternatives to HOS are Eosin Y or Trypan blue staining, or use of a fluorescent DNA-binding probe such as Hoechst 33258. If all the sperm in semen are 'dead', we would not suggest ICSI using them. In our practice, we determine whether there is an immediate possible cause of cell death such as high reactive oxygen species generation by leukocytes, which might be addressed. If not, a vas or testicular aspiration is considered. We have seen normal (for the site)
motility from either vas or testis when semen sperm motility is poor. Second, if some of the sperm are apparently live, we would attempt to stimulate motility using pentoxifylline. Surprisingly, this has worked in some cases of 0% motility. The induced motility may or may not be of sufficient quality and quantity to consider IUI or IVF. But, even if there is only twitching motility, this may be sufficient to choose sperm for ICSI. The pentoxifylline is washed out of the sperm preparation before any of the insemination procedures. This also avoids having to use HOS to choose non-motile sperm. Third, if no sperm respond to pentoxifylline, medical, genetic, or electron microscopic evidence could be gathered to rule out an immotile cilia syndrome, followed by genetic counseling.
Monday, July 9, 2007
Making Babies The Gay Way
Today being Sunday, I had a wee bit more time to blog & thought I should write on a subject close to my heart. The gay pride or simply pride campaign has three main premises: that people should be proud of their sexual orientation and gender identity, that sexual diversity is a gift, and that sexual orientation and gender identity are inherent and cannot be intentionally altered. Marches celebrating Pride (pride parades) are celebrated worldwide. Symbols of gay pride include the Rainbow colored flag, Greek lambda symbol, and also the pink and black triangles (You can see these logos on our homepage).
The average family exists only on paper.
-- Sylvia Porter, U.S. economist
Contrary to popular belief, gay men and women often want children. The only difference is, like a straight couple with fertility problems, they are somewhat limited by biology. Gay parents aren't something new – they are already out there and have been for some time. In the United States, 1 in 10 gay men identify themselves as fathers , and according to the 2000 US Census Report, one in five gay male couples have children under 18 years of age living in their households. Some gay men and women had children when they were in previous heterosexual relationships but a growing number of gay couples are now choosing to start a family together. The growing trend among gay male couples toward planning families together follows in the wake of the so-called lesbian baby boom and comes at a time when all same-sex couples are increasingly struggling for equal rights, including the right to marry and have children. Moreover, gay men are seeking to become fathers at a time of increased interest in fatherhood itself.
There are a four main ways that gay men and women can have children:
Adoption
Co-parenting arrangements (Between Lesbians & Male gay couples)
Donor insemination
Surrogacy
Why do gay men want to become fathers? They are motivated by the same needs as those of heterosexual men: the desire to nurture and raise children, wanting the constancy of children in their lives, wanting to achieve the sense of family that children provide, and wanting a sense of generativity and immortality through having children. Gay men who are planning to become fathers appear to give the idea much more thought than do heterosexual men. Yet because of entrenched stereotypes, social acceptance of gay men as fathers is far from universal. Common concerns are that children of gay men will be stigmatized, that children of homosexual fathers are more likely to become homosexual themselves, and that gay males are likely to be sexual predators who may molest their own children. Although research has largely discredited those prejudices, these preconceived notions nevertheless remain and may be one reason that some fertility programs appear reluctant to respond to appeals from gay men to achieve fatherhood through assisted reproduction. It is notable that a recent
survey of ART programs in the United States found that fertility centers routinely accept lesbians but are less likely to accept gay males as patients , despite the support for nondiscrimination in gay and lesbian parenting by such prominent
mainstream organizations as the Child Welfare League of America, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Psychiatric Association, the American Psychological Association, the
National Association of Social Workers, and the American Bar Association. Indeed, the Ethics Committee of the American Society for Reproductive Medicine recently published a statement in support of fertility treatment for gays, lesbians, and unmarried persons.
Let us go through some heart-warming stories that got a lot of media attention recently. Attractive thirty some-things, Heather and David are the happily married parents of Rissa, an engaging and precocious six-year-old . He's a high-school teacher, she's a stay-at-home mom. They have a Chevy minivan, an aged Toyota Tercel, two cats with clever names, a dog and a mortgage. A Canadian flag flutters on the front porch of their two-storey red-brick home. As contemporary family portraits go, this one is a classic.Which proves the rule about appearances and deceptiveness. Mr. and Mrs. Average Canadian -- that is, David Hoare and Heather Jopling -- boast what is an emphatically non-average familial distinction in this age of shifting social landscapes. "We're another chapter of alternative families," says Jopling, 38, a writer, actor and former Ottawan. "We're straights, we've got our one child, we've got pets, we own a house, we've got cars -- and we just also happen to have been a surrogate and a sperm donor for gay and lesbian families."
In 2003, Hoare was a sperm donor for Toronto lesbian friends Virginia West and Cheryl Reid, who are today the doting parents of Rowan, their two-year-old son. A few months after that, Jopling offered to become surrogate mother for the child their gay friends in Ottawa, Michael Mancini and Ernst Hupel, were hoping for. That couple's daughter Milena is now 19 months old, little sister to Klara, Hupel's daughter with another surrogate mother. The three families maintain contact and get together from time to time, despite the geography that separates them, openly acknowledging all their connections. Rissa knows, for instance, that she has a half-brother in Rowan (whose birthday she shares) and a half-sister in Milena, both of whom will be told the same thing when they get older. The diversity runs even deeper. Hoare's parents split up when his mother, an Anglican priest, came out as a lesbian. She and her partner, along with Hoare's father and his new partner -- who have introduced Jamaican and Filipino influences into the family portrait -- have provided Jopling with three wonderful mothers-in-law, she says, and extended Rissa's grandparental range. On Jopling's side, there are only two grandparents, though her father, a retired Air Force lieutenant-colonel, adds the variety of a military touch to the cultural mixed bag.
On a recent spring morning, Lura Stiller sat in her stocking feet in a sunny cottage in Cambridge, Massachusetts, helping Cary Friedman and his partner, Rick Wellisch, calm their daughter, a 3-month-old in a pink T-shirt. Stiller, 34, a homemaker from the Dallas, Texas, suburbs, likes to say that the number of gay people in her acquaintance before she met Friedman, a psychiatrist, and Wellisch, an internist, amounted to zero. "Everything I knew about gay people I knew from TV, which meant that everything I knew about gay people I learned from 'Will & Grace' and 'The L Word,"' she said. In December, Stiller gave birth to the baby, named Samantha, for Friedman and Wellisch, conceived with a donor egg and the sperm from one of the partners. (They chose not to know which.) In her decision to work with them, Stiller is part of a small but growing movement of surrogate mothers choosing gay couples over traditional families.
As legislatures debate giving gay couples the right to marry - hundreds of couples are finding ways to create families with or without marriage through surrogates like Stiller, who are willing to help them have children genetically linked to them and to bypass the often difficult legal challenges gay men face in adoption. John Weltman, a Boston lawyer, had a challenging time finding women to carry children for gay men when he founded Circle Surrogacy a decade ago. Today, he said, 80 percent of the surrogate mothers who come to him say they would be willing to work with gay couples, and half prefer to work with gay couples. In Los Angeles, Growing Generations, a company formed to help gay couples become parents through egg donation and surrogacy, is responsible for more than 300 births, increasing from four births in 1998 to 108 within the last 17 months Dawn Buras, a Baltimore mother of four, has been to a fertility clinic in Los Angeles three times to receive embryonic transplants for a male couple in Boston. Each time the men, one of whom works in television, accompanied her. They took adjacent hotel rooms, dined out and provided a visit to the set of "Desperate Housewives." The pregnancy attempts failed, but still the men try, refusing to work with anyone else. Some surrogates also say they find the sense of defiance in providing gay couples with children to be meaningful. "In all honesty, there's a bit of a rebellious nature in me," acknowledged Shannon Klein, a mother of three in Cypress, California, who home-schools her children. "I know that there are people who wouldn't approve of being a surrogate for gay parents, and that has made it more intriguing." Klein has borne two children for two gay couples, and she is pregnant with twins for a third.
From the current literature, we know a great deal about the psychological well-being of lesbian mothers and their children— offspring planned and conceived through assisted reproduction (20–24)—but there are as yet no studies of gay fathers utilizing ART to create a family. We, at Rotunda should have the lead to publish in scientific journals by the year 2008. The existing literature on gay fatherhood is derived from studies of children who were born within a heterosexual marriage and whose fathers later identified themselves as gay. Although the investigators found no differences between groups in terms of intimacy and involvement with their children, there were significant differences between gay and non-gay fathers in terms of limit setting, responsiveness, and reasoning guidance. Gay fathers were more consistent about setting and enforcing limits on their children’s behavior, and gay fathers tended to be more responsive to their children’s needs.
Researchers have looked at whether children had social stigma as a result of having a gay father. Most studies noted that gay fathers reported that their children appeared to have normal social relationships with their peers and found little cause for concern about stigmatization resulting from fathers’ homosexuality. Several studies examined the sexual orientation of young adult offspring of gay fathers. In terms of gender identity and sexual preference, children of gay fathers appear to fall within normal limits and are not more likely to be homosexual then children reared by heterosexual fathers.
Future research I’m sure, will address the experience of gay male couples, and of their children who are planned and conceived through assisted reproduction. For the present, although anecdotal and media reports reveal that some programs including ours, have welcomed gay men into their fertility practices. Gay male couples increasingly are coming to the conclusion that their homosexuality need not prevent them from becoming fathers and planning a family together. Many are turning to reproductive medical centers for help in their quest for fatherhood. These gay-father families deserve the same attention (and lack of discrimination) in their care that other couples, lesbian and heterosexual, receive in fertility centers around the globe.
The average family exists only on paper.
-- Sylvia Porter, U.S. economist
Contrary to popular belief, gay men and women often want children. The only difference is, like a straight couple with fertility problems, they are somewhat limited by biology. Gay parents aren't something new – they are already out there and have been for some time. In the United States, 1 in 10 gay men identify themselves as fathers , and according to the 2000 US Census Report, one in five gay male couples have children under 18 years of age living in their households. Some gay men and women had children when they were in previous heterosexual relationships but a growing number of gay couples are now choosing to start a family together. The growing trend among gay male couples toward planning families together follows in the wake of the so-called lesbian baby boom and comes at a time when all same-sex couples are increasingly struggling for equal rights, including the right to marry and have children. Moreover, gay men are seeking to become fathers at a time of increased interest in fatherhood itself.
There are a four main ways that gay men and women can have children:
Adoption
Co-parenting arrangements (Between Lesbians & Male gay couples)
Donor insemination
Surrogacy
Why do gay men want to become fathers? They are motivated by the same needs as those of heterosexual men: the desire to nurture and raise children, wanting the constancy of children in their lives, wanting to achieve the sense of family that children provide, and wanting a sense of generativity and immortality through having children. Gay men who are planning to become fathers appear to give the idea much more thought than do heterosexual men. Yet because of entrenched stereotypes, social acceptance of gay men as fathers is far from universal. Common concerns are that children of gay men will be stigmatized, that children of homosexual fathers are more likely to become homosexual themselves, and that gay males are likely to be sexual predators who may molest their own children. Although research has largely discredited those prejudices, these preconceived notions nevertheless remain and may be one reason that some fertility programs appear reluctant to respond to appeals from gay men to achieve fatherhood through assisted reproduction. It is notable that a recent
survey of ART programs in the United States found that fertility centers routinely accept lesbians but are less likely to accept gay males as patients , despite the support for nondiscrimination in gay and lesbian parenting by such prominent
mainstream organizations as the Child Welfare League of America, the American Academy of Pediatrics, the American Academy of Family Physicians, the American Psychiatric Association, the American Psychological Association, the
National Association of Social Workers, and the American Bar Association. Indeed, the Ethics Committee of the American Society for Reproductive Medicine recently published a statement in support of fertility treatment for gays, lesbians, and unmarried persons.
Let us go through some heart-warming stories that got a lot of media attention recently. Attractive thirty some-things, Heather and David are the happily married parents of Rissa, an engaging and precocious six-year-old . He's a high-school teacher, she's a stay-at-home mom. They have a Chevy minivan, an aged Toyota Tercel, two cats with clever names, a dog and a mortgage. A Canadian flag flutters on the front porch of their two-storey red-brick home. As contemporary family portraits go, this one is a classic.Which proves the rule about appearances and deceptiveness. Mr. and Mrs. Average Canadian -- that is, David Hoare and Heather Jopling -- boast what is an emphatically non-average familial distinction in this age of shifting social landscapes. "We're another chapter of alternative families," says Jopling, 38, a writer, actor and former Ottawan. "We're straights, we've got our one child, we've got pets, we own a house, we've got cars -- and we just also happen to have been a surrogate and a sperm donor for gay and lesbian families."
In 2003, Hoare was a sperm donor for Toronto lesbian friends Virginia West and Cheryl Reid, who are today the doting parents of Rowan, their two-year-old son. A few months after that, Jopling offered to become surrogate mother for the child their gay friends in Ottawa, Michael Mancini and Ernst Hupel, were hoping for. That couple's daughter Milena is now 19 months old, little sister to Klara, Hupel's daughter with another surrogate mother. The three families maintain contact and get together from time to time, despite the geography that separates them, openly acknowledging all their connections. Rissa knows, for instance, that she has a half-brother in Rowan (whose birthday she shares) and a half-sister in Milena, both of whom will be told the same thing when they get older. The diversity runs even deeper. Hoare's parents split up when his mother, an Anglican priest, came out as a lesbian. She and her partner, along with Hoare's father and his new partner -- who have introduced Jamaican and Filipino influences into the family portrait -- have provided Jopling with three wonderful mothers-in-law, she says, and extended Rissa's grandparental range. On Jopling's side, there are only two grandparents, though her father, a retired Air Force lieutenant-colonel, adds the variety of a military touch to the cultural mixed bag.
On a recent spring morning, Lura Stiller sat in her stocking feet in a sunny cottage in Cambridge, Massachusetts, helping Cary Friedman and his partner, Rick Wellisch, calm their daughter, a 3-month-old in a pink T-shirt. Stiller, 34, a homemaker from the Dallas, Texas, suburbs, likes to say that the number of gay people in her acquaintance before she met Friedman, a psychiatrist, and Wellisch, an internist, amounted to zero. "Everything I knew about gay people I knew from TV, which meant that everything I knew about gay people I learned from 'Will & Grace' and 'The L Word,"' she said. In December, Stiller gave birth to the baby, named Samantha, for Friedman and Wellisch, conceived with a donor egg and the sperm from one of the partners. (They chose not to know which.) In her decision to work with them, Stiller is part of a small but growing movement of surrogate mothers choosing gay couples over traditional families.
As legislatures debate giving gay couples the right to marry - hundreds of couples are finding ways to create families with or without marriage through surrogates like Stiller, who are willing to help them have children genetically linked to them and to bypass the often difficult legal challenges gay men face in adoption. John Weltman, a Boston lawyer, had a challenging time finding women to carry children for gay men when he founded Circle Surrogacy a decade ago. Today, he said, 80 percent of the surrogate mothers who come to him say they would be willing to work with gay couples, and half prefer to work with gay couples. In Los Angeles, Growing Generations, a company formed to help gay couples become parents through egg donation and surrogacy, is responsible for more than 300 births, increasing from four births in 1998 to 108 within the last 17 months Dawn Buras, a Baltimore mother of four, has been to a fertility clinic in Los Angeles three times to receive embryonic transplants for a male couple in Boston. Each time the men, one of whom works in television, accompanied her. They took adjacent hotel rooms, dined out and provided a visit to the set of "Desperate Housewives." The pregnancy attempts failed, but still the men try, refusing to work with anyone else. Some surrogates also say they find the sense of defiance in providing gay couples with children to be meaningful. "In all honesty, there's a bit of a rebellious nature in me," acknowledged Shannon Klein, a mother of three in Cypress, California, who home-schools her children. "I know that there are people who wouldn't approve of being a surrogate for gay parents, and that has made it more intriguing." Klein has borne two children for two gay couples, and she is pregnant with twins for a third.
From the current literature, we know a great deal about the psychological well-being of lesbian mothers and their children— offspring planned and conceived through assisted reproduction (20–24)—but there are as yet no studies of gay fathers utilizing ART to create a family. We, at Rotunda should have the lead to publish in scientific journals by the year 2008. The existing literature on gay fatherhood is derived from studies of children who were born within a heterosexual marriage and whose fathers later identified themselves as gay. Although the investigators found no differences between groups in terms of intimacy and involvement with their children, there were significant differences between gay and non-gay fathers in terms of limit setting, responsiveness, and reasoning guidance. Gay fathers were more consistent about setting and enforcing limits on their children’s behavior, and gay fathers tended to be more responsive to their children’s needs.
Researchers have looked at whether children had social stigma as a result of having a gay father. Most studies noted that gay fathers reported that their children appeared to have normal social relationships with their peers and found little cause for concern about stigmatization resulting from fathers’ homosexuality. Several studies examined the sexual orientation of young adult offspring of gay fathers. In terms of gender identity and sexual preference, children of gay fathers appear to fall within normal limits and are not more likely to be homosexual then children reared by heterosexual fathers.
Future research I’m sure, will address the experience of gay male couples, and of their children who are planned and conceived through assisted reproduction. For the present, although anecdotal and media reports reveal that some programs including ours, have welcomed gay men into their fertility practices. Gay male couples increasingly are coming to the conclusion that their homosexuality need not prevent them from becoming fathers and planning a family together. Many are turning to reproductive medical centers for help in their quest for fatherhood. These gay-father families deserve the same attention (and lack of discrimination) in their care that other couples, lesbian and heterosexual, receive in fertility centers around the globe.
Sunday, July 8, 2007
Sleep
A friend forwarded this Email to me- "I just finished reading the most fascinating book called Lights Out: Sleep, Sugar, and Survival by Wiley and Formby, which discusses how light pollution is damaging the health of animals and humans alike. You may have heard how the frogs and toads have been disappearing from swamps near lit soccer fields. It has also been documented that during solar eclipses, animals go to sleep, thinking it is night time. When you return to nature by going camping, have you noticed how you tend to crawl into the sleeping bag soon after it is dark, as there isn't much else to do when you can't see anything. We too, are beings that evolved living by the rules of nature, and to be healthy, we still need to live that way. It is not that long ago that the lights were turned on in our cities, and our physiology has not yet adapted to this new reality. Our bodies work in complex system of feedback loops that act like checks and balances. When systems get out of balance, our bodies don't function optimally physically or psychologically. Today's modern lifestyle means we can keep the lights on all night, sugar is always available to us to eat, and things like sitting in traffic jams can cause our stress hormones to go through the roof, so hormonally most of us are WAY out of balance.
Just like the frogs, every cell in our body is light sensitive, and hormones are activated or deactivated and neurotransmitters such as serotonin and dopamine are released daily according to the light or lack of light sensed by our cells. The hormones that depend on a lack of light to function tend to be our "rest and repair" hormones, and the hormones that are activated by light tend to be the "coping with stress" hormones. When we stay up too late at night with the lights on, long after the sun has gone down, we don't get enough hours of tissue repair and immunity building. And on the flip side, with the extended hours we spend in the light, the stress hormones that are supposed to be active during the day only, wind up working overtime. There is no balance in the daily cycle between the day hormones like cortisol, insulin, and the night hormones like the antioxidant melatonin and the immune builder, prolactin. So we are stressed and tired, in a weakened state with poor immunity, and therefore we are sitting ducks for sickness and disease.
Resist the temptation of regularly taking melatonin supplements (your night time repair hormone) as doing so would unfortunately eventually result in your pineal gland shrinking and your body being unable to produce its own melatonin. Dimming the lights and wearing rose-coloured glasses in the evening can increase melatonin production, but the bottom line is to get the critically important hormone balancing as well as the tissue repair and immune improvement, we need to get to bed in complete darkness at a reasonable hour, such as 10pm. Any light leaks will shut down melatonin, which in turn, will shut down prolactin. In the summer when the light is long, we can stay up a little longer, but once the sun goes down, bed should soon follow."
So, my blogger friends, in order to get a good night's sleep, you need to sleep in complete darkness. If there is a street light outside your window shining into your bedroom, you will sleep much better if you get light-blocking drapes. Use night lights with red bulbs so if you need to get up to go to the bathroom, you can do so without turning on the lights, which would result in the shutting down of your sleep hormone melatonin, making it harder to get the rest you need. Our bodies are very sensitive to light, and any light shining on any part of our skin makes our body think it is morning, resulting in the hormone cortisol being released to help give us the energy we need to begin our day. This is not the best situation if it is 2 AM. So go to bed turning out the lights by 10h30pm at the latest, sleep dark and sleep well. For more information on the effect of light and our sleep patterns, please enjoy the book Lights Out! by Formby & Wiley. Good Night & Sweet Dreams.
Just like the frogs, every cell in our body is light sensitive, and hormones are activated or deactivated and neurotransmitters such as serotonin and dopamine are released daily according to the light or lack of light sensed by our cells. The hormones that depend on a lack of light to function tend to be our "rest and repair" hormones, and the hormones that are activated by light tend to be the "coping with stress" hormones. When we stay up too late at night with the lights on, long after the sun has gone down, we don't get enough hours of tissue repair and immunity building. And on the flip side, with the extended hours we spend in the light, the stress hormones that are supposed to be active during the day only, wind up working overtime. There is no balance in the daily cycle between the day hormones like cortisol, insulin, and the night hormones like the antioxidant melatonin and the immune builder, prolactin. So we are stressed and tired, in a weakened state with poor immunity, and therefore we are sitting ducks for sickness and disease.
Resist the temptation of regularly taking melatonin supplements (your night time repair hormone) as doing so would unfortunately eventually result in your pineal gland shrinking and your body being unable to produce its own melatonin. Dimming the lights and wearing rose-coloured glasses in the evening can increase melatonin production, but the bottom line is to get the critically important hormone balancing as well as the tissue repair and immune improvement, we need to get to bed in complete darkness at a reasonable hour, such as 10pm. Any light leaks will shut down melatonin, which in turn, will shut down prolactin. In the summer when the light is long, we can stay up a little longer, but once the sun goes down, bed should soon follow."
So, my blogger friends, in order to get a good night's sleep, you need to sleep in complete darkness. If there is a street light outside your window shining into your bedroom, you will sleep much better if you get light-blocking drapes. Use night lights with red bulbs so if you need to get up to go to the bathroom, you can do so without turning on the lights, which would result in the shutting down of your sleep hormone melatonin, making it harder to get the rest you need. Our bodies are very sensitive to light, and any light shining on any part of our skin makes our body think it is morning, resulting in the hormone cortisol being released to help give us the energy we need to begin our day. This is not the best situation if it is 2 AM. So go to bed turning out the lights by 10h30pm at the latest, sleep dark and sleep well. For more information on the effect of light and our sleep patterns, please enjoy the book Lights Out! by Formby & Wiley. Good Night & Sweet Dreams.
Saturday, July 7, 2007
07-07-07: It was not just my birthday!
There was a lot of media hype about 07-07-07- One of my friends started addressing me as James Bond 007- just because I was going to be part of history on 07-07-07. I decided to find out what the day will have in store for me pro-actively. I surfed the web on 6th night & decided to ask a Tarot Reader about what does she see for me on 07-07-07? She promptly sent me my own Sara Freder's clairvoyance horoscope for my birthday-
"HAPPY BIRTHDAY TO YOU" It's useless to hide it to you longer Gautam, This new year which started for you will be for you an exceptionnal year of luck in everything, a year of happiness, love and money, a year where all your most crazy dreams could now really happen. I even see for you next month a very important gain of money of several thousand dollars, and I also see coming the happiness that you thought was lost. Thinking about your particular case Gautam, I'm telling in myself that the life has really been too unfair with you until now and I'm also telling in myself that it might be the time to change all of this especially because it is an important transitional period of your life.
So that's for you the beginning of a new cycle and the coming of new chances in your life
I have the intimate certainty.
It's really the first time of my life that I see that in a so clear and so precise way.
According to this clairvoyance you should have luck in everything, and more especially in the most important domain for you as: family, relations, love, money."
She wanted 15 dollars to tell me more, but I decided naa... let me first check out the first day 07-07-07 and see what changes today for me.
Long ago, before early people had a way of marking time, little attention was paid to a person's birthday. Even though everyone knew that people grew older, they had no way of correctly keeping track of time. It wasn't until the early people learned more about how time passed that they kept note about time changes and developed a calendar and began to celebrate special events such as birthdays. When birthdays were first starting to be celebrated, they were only held in honor of prominent men in a country. Unlike times of today, "common" people (like me for example) rarely celebrated their birthdays during the early days. Today, young and old alike all around the world celebrate birthdays. Many countries have different customs from ours for celebrating birthdays but at the same time there are a lot that celebrate their birthdays in quite similar ways as we do. Some of the countries that are very similar to India include Indonesia, Thailand, Cambodia, Srilanka, and Laos and here there is usually a small “puja” or visit to the temple and/or distribution of food at monasteries or orphanages.
Aside from the different customs around the world, the reasons why we celebrate birthdays and the different symbols we use are very much the same to everyone. The reason why we have birthday parties goes back to when people believed that good and evil spirits appeared when a child was born and influenced that child for life. These people also believed that it was dangerous for a person to have a change in his or her life. This led people to believe that birthdays were filled with danger since each year marked a change in a person's life. These beliefs brought about the custom of having birthday parties. They believed that surrounding the birthday person with friends, family and good wishes would scare the evil spirits away. It was an especially good influence if the well-wishers presented gifts along with their wishes. There would also be greater protection from the evil spirits if the gifts and wishes were presented early in the day. Credit is given to the Germans
for starting celebrations of children's birthdays (kinderfeste). The custom of putting candles on birthday cake started in Germany about 200 years ago. Germans were known to be excellent candle makers. One day they began to make little tiny candles and started the tradition of putting the candles on the cake. It was also decided by these candle makers that it meant good luck if you could blow out all the candles on your cake in one blow.
About 100 years ago, Mildred Hill and Patty Hill of America wrote the song, "Happy Birthday to You". This song was a huge hit all over the world. It is used in many different countries with a few modifications.
Have you every received a card for your birthday? The custom of making birthday cards started in England about 100 years ago. Now people everywhere make birthday cards and send them to friends and family to wish them a happy birthday.
For one who has admittedly never been good at math, I continue to be fascinated with the connotation of numbers and the significance they have in the world around us. Aside from numbers being the very foundation of science, all of us non-rocket scientists use numbers on a daily basis to comprehend the time, the date, the calories we consume, the paycheck we depend on, the votes we need, the spam mail we get, the number of children suffering from malnutrition or obesity, etc. Without numbers our world as we know it would be reduced to nothingness.
This constant preoccupation with numbers has led me to believe that no other number seems to have a stronger presence in our lives than the number seven and not just because I was born on the 7th of July. Those superstitious types who freaked out last year when the calendar read 06/06/06 will have something to smile about on the 7th day of the 7th month, 2007. Believing the triple appearance of the number 7 will bring luck, many people are planning important events for this first Saturday in July. Brides and grooms, especially, looking for a little extra dose of marital fortune, are flocking to the altar in droves on 07/07/07, according to wedding watchers.
The number seven is considered lucky due to its frequent and favorable appearance in the Bible, say historians.
"As the number of the days of God's first week, of the levels of heaven...of the numbers of angels and trumpets, etc., the number came in the last few centuries BC to represent divine perfection," said David Frankfurter, professor of religious studies and history at the University of New Hampshire. "Something organized seven-fold meant that it corresponded to God's own arrangement."
Lucky numbers also vary from culture to culture, proving, skeptics say, that coincidental connections between an event and the influence of a number can always be found if you're looking hard enough, no matter what the digit. Chinese culture, for example, associates "degrees" of luck according to how a number is pronounced. Eight, whose Chinese name rhymes with the words for prosperity and wealth, is considered particularly auspicious. The Beijing Olympics, as a result, will open next year at 8 p.m. on Aug. 8, 2008.
Oh, and many Chinese consider 7 a very unlucky number associated with death. Don’t tell the brides.
The Sanskrit word 'sapta' refers to number seven. The Indian Music has 'sapta swaras', means seven octats (sa re ga ma pa dha ni), which are basics of music, using which hundreds of Ragas are composed. The Month 'September' is evolved from the word 'septa' meaning seven. September was earlier seventh month before July and August were added to the calendar. Also the subsequent months names are derived from Sanskrit names 'Ashta' and 'Nava' meaning eight and nine which are now called October and November. Celestial group of seven stars are named as 'Sapta Rishi' based on the seven great saints.
Almost all occurrences of the number seven represent perfection and completeness. It is the most dominant number in religion, literature, music, nature and one of the most unusual numbers in math. The list is endless, but here are the most familiar and most important examples. In nature, the most significant presence of seven is in the colors of the rainbow or the refraction of a beam of white light through a prism which generates a spectrum of seven colors. Although it can be argued that these colors are actually thousands of different shades gradually merging into one another, our eyes naturally sort them into these seven groups:
-- Red -- Orange -- Yellow -- Green -- Blue -- Indigo -- Violet
The seven day week is used internationally, and it is said that each day is named after the seven visible planets and luminaries and moving objects in the sky:
-- Monday (Moon) -- Tuesday (Mercury) -- Wednesday (Venus) -- Thursday (Mars) -- Friday (Jupiter) -- Saturday (Saturn) -- Sunday (Sun)
In Hebrew, seven is shevah, meaning "to be full or satisfied, have enough of", and it is believed that on the seventh day God rested from the work of Creation. Hence the word (Shavath), to cease, desist, rest, and Shabbath, Sabbath, or day of rest. This root runs through various languages; e.g., Sanskrit, (saptah); Zend- Avesta., (hapta); Greek, (hepta); Persian, (haft); Latin, (septem). All these preserve the "t," which in the Semitic and Teutonic languages is dropped out; e.g. Gothic,(sibun); Germ., (sieben); Eng., (seven). In Judaism, we also have the Seven universal rules of Noah (Talmud Sanh.56a):
-- Prohibition of idolatry -- Prohibition of blasphemy -- Prohibition of murder -- Prohibition of theft -- Prohibition of illicit relations -- Prohibition of eating live meat -- Prohibition of failing to establish courts of justice
Among religions, Christianity is riddled with the number seven. The Bible is full of references to the number seven, as in the Seven Parables of Matthew 13.In the Book of Revelation, there are seven churches, seven spirits, seven stars, seven seals, seven trumpets, seven vials, seven personages, and seven dooms. There are Seven generations from David to Jesus. The beast that rises out of the sea to destroy the world mentioned in Revelations also has seven heads, and its number is 666, which is the sum of the squares of the first 7 primes: 666 = 22 + 32 + 52 + 72 + 112 + 132 + 172
But most importantly in Christianity there are the seven deadly sins:
-- Vanity -- Envy -- Gluttony -- Lust -- Wrath -- Covetousness -- Sloth
There are Seven Devas of the Hindu pantheon, and the Seven Chakras of Tantric Hinduism are:
-- Crown Chakra Sehasara, located at top of head -- Brow Chakra Anja, located in center of forehead above eyes -- Throat Chakra Visshuda , located at base of throat -- Heart Chakra Anahatha ,located at heart center of chest -- Solar Plexis Chakra Manipura ,located between the sternum bone and the belly -- Sacral Chakra, Svadistana,Located at sex organs or near belly button -- Root Chakra, Muladhara, Kundalini ,located at the tailbone base of spine
In Zoroastrianism , there are the Seven Amschaspands:
-- Ordibehesht -- Khordad -- Amordad -- Shahrivar -- Bahman -- Espandasmad -- Ahooramazda
In Islam, muslim pilgrims on "Haj" or their pilgrimage trip to Mecca, arrive by the seventh day of "Zuu- ul Hijja" (by Islamic celestial calendar), do the "Tavaf" and circle the "Kabeh" seven times , and do the "Saay" or run between the hills of "Safa" and "Marva" for seven times.
Rome, it is said, was built on seven hills, and The Seven Wonders of the Ancient World were:
--The Great Pyramid of Giza -- The Hanging Gardens of Babylon -- The Statue of Zeus at Olympia -- The Temple of Artemis at Ephesus -- The Mausoleum at Halicarnassus -- The Colossus of Rhodes -- The Lighthouse of Alexandria
The Seven Continents are:
-- Africa -- Antarctica -- Asia -- Australia -- Europe -- North America -- South America
The Seven Seas are:
-- North Atlantic -- South Atlantic -- North Pacific -- South Pacific -- Indian -- Antarctic -- Arctic
Seven is probably the most important number in Greek Literature and mythology:
-- Seven Labors of Hercules -- Seven daughters of Atlas in the Pleiades -- Seven gates of Thebes -- Seven sons and seven daughters of Niobe -- Seven strings of the lyre of Zeus -- Seven spheres
You can keep going on and on , for example an old wives' tale says that if you break a mirror you will have seven years of bad luck, or how to avoid the Seven year itch in Marriage, or why first graders are sent off to start school when they are seven years old. The examples are numerous and too many to list in one place. Hopefully these few examples won't keep you awake at night and make you lose your required seven hours of sleep.
The results of the first-ever online global vote were announced at the Official New7Wonders Declaration Ceremony tonight in Lisbon, Portugal.
Well, for me, I had a usual day at the clinic...I had a "havan" in the morning and reached the clinic 30 minutes late. My associate was not feeling up to it and decided to take the day off- I finished the patients by 1pm and came home. Had my first afternoon nap in 7 days. Wifes away for a fellowship. Provided for the kids and took my dad out for a wonderful dinner at the Masala Bay. Came back. Blogged & planning to complete my book chapter for the upcoming monograph - "Embryo Transfer". Psst... no divine intervention as yet for me on 07-07-07. Maybe I will have to pay the online Tarot lady her USD 15 to have my shower of good luck this year. Amen.
"HAPPY BIRTHDAY TO YOU" It's useless to hide it to you longer Gautam, This new year which started for you will be for you an exceptionnal year of luck in everything, a year of happiness, love and money, a year where all your most crazy dreams could now really happen. I even see for you next month a very important gain of money of several thousand dollars, and I also see coming the happiness that you thought was lost. Thinking about your particular case Gautam, I'm telling in myself that the life has really been too unfair with you until now and I'm also telling in myself that it might be the time to change all of this especially because it is an important transitional period of your life.
So that's for you the beginning of a new cycle and the coming of new chances in your life
I have the intimate certainty.
It's really the first time of my life that I see that in a so clear and so precise way.
According to this clairvoyance you should have luck in everything, and more especially in the most important domain for you as: family, relations, love, money."
She wanted 15 dollars to tell me more, but I decided naa... let me first check out the first day 07-07-07 and see what changes today for me.
Long ago, before early people had a way of marking time, little attention was paid to a person's birthday. Even though everyone knew that people grew older, they had no way of correctly keeping track of time. It wasn't until the early people learned more about how time passed that they kept note about time changes and developed a calendar and began to celebrate special events such as birthdays. When birthdays were first starting to be celebrated, they were only held in honor of prominent men in a country. Unlike times of today, "common" people (like me for example) rarely celebrated their birthdays during the early days. Today, young and old alike all around the world celebrate birthdays. Many countries have different customs from ours for celebrating birthdays but at the same time there are a lot that celebrate their birthdays in quite similar ways as we do. Some of the countries that are very similar to India include Indonesia, Thailand, Cambodia, Srilanka, and Laos and here there is usually a small “puja” or visit to the temple and/or distribution of food at monasteries or orphanages.
Aside from the different customs around the world, the reasons why we celebrate birthdays and the different symbols we use are very much the same to everyone. The reason why we have birthday parties goes back to when people believed that good and evil spirits appeared when a child was born and influenced that child for life. These people also believed that it was dangerous for a person to have a change in his or her life. This led people to believe that birthdays were filled with danger since each year marked a change in a person's life. These beliefs brought about the custom of having birthday parties. They believed that surrounding the birthday person with friends, family and good wishes would scare the evil spirits away. It was an especially good influence if the well-wishers presented gifts along with their wishes. There would also be greater protection from the evil spirits if the gifts and wishes were presented early in the day. Credit is given to the Germans
for starting celebrations of children's birthdays (kinderfeste). The custom of putting candles on birthday cake started in Germany about 200 years ago. Germans were known to be excellent candle makers. One day they began to make little tiny candles and started the tradition of putting the candles on the cake. It was also decided by these candle makers that it meant good luck if you could blow out all the candles on your cake in one blow.
About 100 years ago, Mildred Hill and Patty Hill of America wrote the song, "Happy Birthday to You". This song was a huge hit all over the world. It is used in many different countries with a few modifications.
Have you every received a card for your birthday? The custom of making birthday cards started in England about 100 years ago. Now people everywhere make birthday cards and send them to friends and family to wish them a happy birthday.
For one who has admittedly never been good at math, I continue to be fascinated with the connotation of numbers and the significance they have in the world around us. Aside from numbers being the very foundation of science, all of us non-rocket scientists use numbers on a daily basis to comprehend the time, the date, the calories we consume, the paycheck we depend on, the votes we need, the spam mail we get, the number of children suffering from malnutrition or obesity, etc. Without numbers our world as we know it would be reduced to nothingness.
This constant preoccupation with numbers has led me to believe that no other number seems to have a stronger presence in our lives than the number seven and not just because I was born on the 7th of July. Those superstitious types who freaked out last year when the calendar read 06/06/06 will have something to smile about on the 7th day of the 7th month, 2007. Believing the triple appearance of the number 7 will bring luck, many people are planning important events for this first Saturday in July. Brides and grooms, especially, looking for a little extra dose of marital fortune, are flocking to the altar in droves on 07/07/07, according to wedding watchers.
The number seven is considered lucky due to its frequent and favorable appearance in the Bible, say historians.
"As the number of the days of God's first week, of the levels of heaven...of the numbers of angels and trumpets, etc., the number came in the last few centuries BC to represent divine perfection," said David Frankfurter, professor of religious studies and history at the University of New Hampshire. "Something organized seven-fold meant that it corresponded to God's own arrangement."
Lucky numbers also vary from culture to culture, proving, skeptics say, that coincidental connections between an event and the influence of a number can always be found if you're looking hard enough, no matter what the digit. Chinese culture, for example, associates "degrees" of luck according to how a number is pronounced. Eight, whose Chinese name rhymes with the words for prosperity and wealth, is considered particularly auspicious. The Beijing Olympics, as a result, will open next year at 8 p.m. on Aug. 8, 2008.
Oh, and many Chinese consider 7 a very unlucky number associated with death. Don’t tell the brides.
The Sanskrit word 'sapta' refers to number seven. The Indian Music has 'sapta swaras', means seven octats (sa re ga ma pa dha ni), which are basics of music, using which hundreds of Ragas are composed. The Month 'September' is evolved from the word 'septa' meaning seven. September was earlier seventh month before July and August were added to the calendar. Also the subsequent months names are derived from Sanskrit names 'Ashta' and 'Nava' meaning eight and nine which are now called October and November. Celestial group of seven stars are named as 'Sapta Rishi' based on the seven great saints.
Almost all occurrences of the number seven represent perfection and completeness. It is the most dominant number in religion, literature, music, nature and one of the most unusual numbers in math. The list is endless, but here are the most familiar and most important examples. In nature, the most significant presence of seven is in the colors of the rainbow or the refraction of a beam of white light through a prism which generates a spectrum of seven colors. Although it can be argued that these colors are actually thousands of different shades gradually merging into one another, our eyes naturally sort them into these seven groups:
-- Red -- Orange -- Yellow -- Green -- Blue -- Indigo -- Violet
The seven day week is used internationally, and it is said that each day is named after the seven visible planets and luminaries and moving objects in the sky:
-- Monday (Moon) -- Tuesday (Mercury) -- Wednesday (Venus) -- Thursday (Mars) -- Friday (Jupiter) -- Saturday (Saturn) -- Sunday (Sun)
In Hebrew, seven is shevah, meaning "to be full or satisfied, have enough of", and it is believed that on the seventh day God rested from the work of Creation. Hence the word (Shavath), to cease, desist, rest, and Shabbath, Sabbath, or day of rest. This root runs through various languages; e.g., Sanskrit, (saptah); Zend- Avesta., (hapta); Greek, (hepta); Persian, (haft); Latin, (septem). All these preserve the "t," which in the Semitic and Teutonic languages is dropped out; e.g. Gothic,(sibun); Germ., (sieben); Eng., (seven). In Judaism, we also have the Seven universal rules of Noah (Talmud Sanh.56a):
-- Prohibition of idolatry -- Prohibition of blasphemy -- Prohibition of murder -- Prohibition of theft -- Prohibition of illicit relations -- Prohibition of eating live meat -- Prohibition of failing to establish courts of justice
Among religions, Christianity is riddled with the number seven. The Bible is full of references to the number seven, as in the Seven Parables of Matthew 13.In the Book of Revelation, there are seven churches, seven spirits, seven stars, seven seals, seven trumpets, seven vials, seven personages, and seven dooms. There are Seven generations from David to Jesus. The beast that rises out of the sea to destroy the world mentioned in Revelations also has seven heads, and its number is 666, which is the sum of the squares of the first 7 primes: 666 = 22 + 32 + 52 + 72 + 112 + 132 + 172
But most importantly in Christianity there are the seven deadly sins:
-- Vanity -- Envy -- Gluttony -- Lust -- Wrath -- Covetousness -- Sloth
There are Seven Devas of the Hindu pantheon, and the Seven Chakras of Tantric Hinduism are:
-- Crown Chakra Sehasara, located at top of head -- Brow Chakra Anja, located in center of forehead above eyes -- Throat Chakra Visshuda , located at base of throat -- Heart Chakra Anahatha ,located at heart center of chest -- Solar Plexis Chakra Manipura ,located between the sternum bone and the belly -- Sacral Chakra, Svadistana,Located at sex organs or near belly button -- Root Chakra, Muladhara, Kundalini ,located at the tailbone base of spine
In Zoroastrianism , there are the Seven Amschaspands:
-- Ordibehesht -- Khordad -- Amordad -- Shahrivar -- Bahman -- Espandasmad -- Ahooramazda
In Islam, muslim pilgrims on "Haj" or their pilgrimage trip to Mecca, arrive by the seventh day of "Zuu- ul Hijja" (by Islamic celestial calendar), do the "Tavaf" and circle the "Kabeh" seven times , and do the "Saay" or run between the hills of "Safa" and "Marva" for seven times.
Rome, it is said, was built on seven hills, and The Seven Wonders of the Ancient World were:
--The Great Pyramid of Giza -- The Hanging Gardens of Babylon -- The Statue of Zeus at Olympia -- The Temple of Artemis at Ephesus -- The Mausoleum at Halicarnassus -- The Colossus of Rhodes -- The Lighthouse of Alexandria
The Seven Continents are:
-- Africa -- Antarctica -- Asia -- Australia -- Europe -- North America -- South America
The Seven Seas are:
-- North Atlantic -- South Atlantic -- North Pacific -- South Pacific -- Indian -- Antarctic -- Arctic
Seven is probably the most important number in Greek Literature and mythology:
-- Seven Labors of Hercules -- Seven daughters of Atlas in the Pleiades -- Seven gates of Thebes -- Seven sons and seven daughters of Niobe -- Seven strings of the lyre of Zeus -- Seven spheres
You can keep going on and on , for example an old wives' tale says that if you break a mirror you will have seven years of bad luck, or how to avoid the Seven year itch in Marriage, or why first graders are sent off to start school when they are seven years old. The examples are numerous and too many to list in one place. Hopefully these few examples won't keep you awake at night and make you lose your required seven hours of sleep.
The results of the first-ever online global vote were announced at the Official New7Wonders Declaration Ceremony tonight in Lisbon, Portugal.
Well, for me, I had a usual day at the clinic...I had a "havan" in the morning and reached the clinic 30 minutes late. My associate was not feeling up to it and decided to take the day off- I finished the patients by 1pm and came home. Had my first afternoon nap in 7 days. Wifes away for a fellowship. Provided for the kids and took my dad out for a wonderful dinner at the Masala Bay. Came back. Blogged & planning to complete my book chapter for the upcoming monograph - "Embryo Transfer". Psst... no divine intervention as yet for me on 07-07-07. Maybe I will have to pay the online Tarot lady her USD 15 to have my shower of good luck this year. Amen.
Friday, July 6, 2007
Transethnic Surrogacy- The Saga continues at Rotunda
This is just to put on record a rare distinction that is unique to the ART community (Specialists in the field of Assisted Reproduction) in india. We successfully achieved the first documented case of gestational surrogacy in May 2006 where the genetic parents were of Chinese origin and the surrogate is a native Indian woman. I have put this on my Blog so it can be documented that the team that had the distinction of helping out this couple was led my me; albeit in a hospital that I am no longer associated with. I was a little disheartened when I recently (March 2007) got hold of a copy of the hospitals annual day magazine & did not find my own name in the title credits for this "hospital achievement". For the bloggers who visit here, the procedure can be explained thus. Mr & Mrs Xiuan Wu(name changed) came to us through the internet with a history
of five failed IVF/ICSI attempts in Singapore. Mrs. Wu had a history of tuberculous endometritis which was treated prior to all her IVF attempts and this cause was attributed to all her failed attempts. Her last treating specialist in Singapore had suggested resorting to gestational surrogacy (hiring a womb in layman's language). This couple relocated to Hyderabad as the husband took up a software contract in that city. The couple contacted almost all the major IVF services in India and selected us to be capable of taking up the challenge of surrogacy after a consultation at our Center for Human Reproduction.
This was a real challenge for our team and we planned an IVF cycle where we transferred half the cultured embryos into Mrs Wu's uterus and the other half into the Surrogates uterus which was primed with hormonal replacement therapy. Needless to say, both the patient's and surrogates menstrual cycles were synchronized using hormonal therapy. The Surrogate conceived and had an uneventful pregnancy. The intended parents were updated regards the growing pregnancy on a fortnightly basis with reports & ultrasound plates. The surrogate mother delivered a healthy baby boy weighing 3.2kg on 19.05.06 at 3:30am. The intended parents went back home with their bundle of joy.
Following this case in May 2006, we have already delivered 8 more surrogate babies & have 7 ongoing pregnancies. The intended parents are from our own country as well as across the globe including the UK, Denmark, Spain, Dubai & Israel. We have learnt a lot from our experiences with Intended Parents & the gestational surrogate mothers. We have had good, bad & ugly experiences with some of the Intended Parents. This led us to help the gestational surrogates introduce a type of partial medical coverage for emergency medical situations in the course of their pregnancy when they sign the contract with the intended parents. We are trying our best to get complete insurance for the gestational surrogates. More on this when we make more progress.
of five failed IVF/ICSI attempts in Singapore. Mrs. Wu had a history of tuberculous endometritis which was treated prior to all her IVF attempts and this cause was attributed to all her failed attempts. Her last treating specialist in Singapore had suggested resorting to gestational surrogacy (hiring a womb in layman's language). This couple relocated to Hyderabad as the husband took up a software contract in that city. The couple contacted almost all the major IVF services in India and selected us to be capable of taking up the challenge of surrogacy after a consultation at our Center for Human Reproduction.
This was a real challenge for our team and we planned an IVF cycle where we transferred half the cultured embryos into Mrs Wu's uterus and the other half into the Surrogates uterus which was primed with hormonal replacement therapy. Needless to say, both the patient's and surrogates menstrual cycles were synchronized using hormonal therapy. The Surrogate conceived and had an uneventful pregnancy. The intended parents were updated regards the growing pregnancy on a fortnightly basis with reports & ultrasound plates. The surrogate mother delivered a healthy baby boy weighing 3.2kg on 19.05.06 at 3:30am. The intended parents went back home with their bundle of joy.
Following this case in May 2006, we have already delivered 8 more surrogate babies & have 7 ongoing pregnancies. The intended parents are from our own country as well as across the globe including the UK, Denmark, Spain, Dubai & Israel. We have learnt a lot from our experiences with Intended Parents & the gestational surrogate mothers. We have had good, bad & ugly experiences with some of the Intended Parents. This led us to help the gestational surrogates introduce a type of partial medical coverage for emergency medical situations in the course of their pregnancy when they sign the contract with the intended parents. We are trying our best to get complete insurance for the gestational surrogates. More on this when we make more progress.
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