The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Sunday, June 15, 2008
Saturday, June 14, 2008
Friday, June 13, 2008
Thursday, June 12, 2008
Babies with three parents
Designer babies with three parents could be born within three years. The controversial technique screens an embryo created by a man and a woman for incurable genetic diseases. Defective DNA is replaced with that from another woman, effectively giving the baby two mothers and a father.
Scientists at Newcastle University in the UK have already created embryos using the method and are perfecting it for use in IVF clinics.They say it could free children from diseases including some forms of diabetes, blindness and heart problems. Critics say it could lead to genetically-modified babies being designed to order. UK law says embryos created using the technique must be destroyed, but scientists hope this can be overturned.
The research focuses on mitochondria "batteries" inside cells, which turn food into energy. Each mitochondrion has its own DNA, which is passed from mother to child. Defects in this DNA affect more than one in 5000 babies and cause around 50 genetic diseases, some of which kill before adulthood. The researchers have managed to swap the damaged DNA with healthy genetic material.
The first step is fertilisation of an egg through IVF. The embryo is screened for defects. When it is a few hours old, the nucleus containing genetic information from the parents is removed and put into another woman's healthy egg. Mitochondria are outside the nucleus so the baby is free of defects and will look like its "real" parents.
US biologist Professor Jonathan Van Blerkom says it would be "criminal" not to allow the technique to be used. There are fears that the influence of mitochondria on areas including longevity, IQ and fertility could lead to GM babies being made to order.
Scientists at Newcastle University in the UK have already created embryos using the method and are perfecting it for use in IVF clinics.They say it could free children from diseases including some forms of diabetes, blindness and heart problems. Critics say it could lead to genetically-modified babies being designed to order. UK law says embryos created using the technique must be destroyed, but scientists hope this can be overturned.
The research focuses on mitochondria "batteries" inside cells, which turn food into energy. Each mitochondrion has its own DNA, which is passed from mother to child. Defects in this DNA affect more than one in 5000 babies and cause around 50 genetic diseases, some of which kill before adulthood. The researchers have managed to swap the damaged DNA with healthy genetic material.
The first step is fertilisation of an egg through IVF. The embryo is screened for defects. When it is a few hours old, the nucleus containing genetic information from the parents is removed and put into another woman's healthy egg. Mitochondria are outside the nucleus so the baby is free of defects and will look like its "real" parents.
US biologist Professor Jonathan Van Blerkom says it would be "criminal" not to allow the technique to be used. There are fears that the influence of mitochondria on areas including longevity, IQ and fertility could lead to GM babies being made to order.
Wednesday, June 11, 2008
New Method to Diagnose Blockage that Causes Male Infertility
Almost as common as diabetes, male infertility affects 15% of reproductive age men in India. Many cases of infertility are caused by blockages within the male sex organs that result in low sperm counts or no sperm counts. These blockages are often reversible and therefore important to diagnose as couples may be able to conceive naturally afterward. To date, one such type of blockage, termed ejaculatory duct obstruction, has been difficult to diagnose as a cause of infertility. Last month, Dr. Paul Turek, a Professor Emeritus in Urology at UCSF, published a paper in The Journal of Urology that dramatically simplifies this diagnosis. "All prior tests for this diagnosis involve simply looking at the system and trying to guess how it works, but this new test actually 'pokes' at the system and watches how it responds," says Dr. Turek, a nationally recognized microsurgeon and male infertility specialist.
"We simply applied the same principles that have been used to assess urination issues in urology for the past 30 years, termed urodynamics, to the male sex organs, and call it 'vasodynamics.'"
For the study, 2 groups of men were compared: normal fertile men and infertile men suspected of having ejaculatory duct obstruction. In addition to taking ultrasound pictures of the reproductive tract system in both groups, which is the current standard diagnostic test, he did something else. By injecting harmless, colored dye into the system through a fine needle and measuring the pressure and flow characteristics of the dye as it progressed through the ejaculatory ducts, he found large differences between the fertile and infertile groups of men.
In fertile men, it took 33 cm of water pressure to cause flow in the ejaculatory ducts, whereas in the infertile men with suspected obstruction, it took 4 times that pressure or 116 cm water pressure. "With this hydraulic technique, we can actually measure the degree of blockage in the male sex organs, which has never been done before," says Dr. Turek of the new technique. Not only that, after surgery was performed to relieve the obstruction in the blocked men, the injection procedure was repeated and the water pressures fell into the range of the normal fertile men. This response also corresponded well with improvements in semen quality after the treatment.
"For several decades, the diagnosis of ejaculatory duct obstruction has involved a lot of guesswork. Vasodynamics now removes the guessing and replaces it with real information that can be used to reliably improve male fertility potential," says Dr. Turek.
"We simply applied the same principles that have been used to assess urination issues in urology for the past 30 years, termed urodynamics, to the male sex organs, and call it 'vasodynamics.'"
For the study, 2 groups of men were compared: normal fertile men and infertile men suspected of having ejaculatory duct obstruction. In addition to taking ultrasound pictures of the reproductive tract system in both groups, which is the current standard diagnostic test, he did something else. By injecting harmless, colored dye into the system through a fine needle and measuring the pressure and flow characteristics of the dye as it progressed through the ejaculatory ducts, he found large differences between the fertile and infertile groups of men.
In fertile men, it took 33 cm of water pressure to cause flow in the ejaculatory ducts, whereas in the infertile men with suspected obstruction, it took 4 times that pressure or 116 cm water pressure. "With this hydraulic technique, we can actually measure the degree of blockage in the male sex organs, which has never been done before," says Dr. Turek of the new technique. Not only that, after surgery was performed to relieve the obstruction in the blocked men, the injection procedure was repeated and the water pressures fell into the range of the normal fertile men. This response also corresponded well with improvements in semen quality after the treatment.
"For several decades, the diagnosis of ejaculatory duct obstruction has involved a lot of guesswork. Vasodynamics now removes the guessing and replaces it with real information that can be used to reliably improve male fertility potential," says Dr. Turek.
Tuesday, June 10, 2008
Children of older fathers' more likely to die early
A new study has shown that becoming a father after the age of 45 increases the likelihood that the resulting child will die before reaching adulthood. The researchers, based at the University of Aarhus in Denmark, who published their findings in the European Journal of Epidemiology, say that the reason for this is the decline in the quality of sperm as men age.
The research shows that children born from older fathers are more likely to suffer from a number of birth defects and conditions such as autism, schizophrenia or epilepsy. The majority of deaths were found to be caused by congenital defects that increased the risk of infant mortality, such as heart problems.
Children born to men aged 45 and above were found to be up to 88 per cent more likely to die before adulthood than those born to men aged between 25 and 29, the researchers found. The researchers looked at 100,000 children born between 1980 and 1996 using data taken from the Danish Fertility Database, and found that 831 of these had died before reaching the age of 13 - 601 of these died in their first year. Similar results were found for men who fathered children while still in their teens, but could perhaps be explained by their mothers also being young and often therefore disadvantaged, say the researchers.
Jin Liang Zhu, from the Danish Epidemiology Science Centre, and lead researcher in the study, said that 'the risks of older fatherhood can be very profound, and it is not something that people are always aware of'. People tend to be far more aware of the risks associated with older mothers, such as the increased prevalence of Down Syndrome, although it has also previously been shown that this may be affected by the father's age as well.
Speaking to the Melbourne Herald Sun, Professor Les Sheffield, a clinical geneticist from Melbourne's Murdoch Childrens Research Institute, explained that genetic errors in sperm increase by half a per cent when a man reaches 40, by 2 per cent when he is 50, by 5 per cent when he is 60 and by 20 per cent by the time he is 80. He added that on the basis of this, 'men around 40 ought to be thinking about the increased risk to their children, the same as women do'.
The research shows that children born from older fathers are more likely to suffer from a number of birth defects and conditions such as autism, schizophrenia or epilepsy. The majority of deaths were found to be caused by congenital defects that increased the risk of infant mortality, such as heart problems.
Children born to men aged 45 and above were found to be up to 88 per cent more likely to die before adulthood than those born to men aged between 25 and 29, the researchers found. The researchers looked at 100,000 children born between 1980 and 1996 using data taken from the Danish Fertility Database, and found that 831 of these had died before reaching the age of 13 - 601 of these died in their first year. Similar results were found for men who fathered children while still in their teens, but could perhaps be explained by their mothers also being young and often therefore disadvantaged, say the researchers.
Jin Liang Zhu, from the Danish Epidemiology Science Centre, and lead researcher in the study, said that 'the risks of older fatherhood can be very profound, and it is not something that people are always aware of'. People tend to be far more aware of the risks associated with older mothers, such as the increased prevalence of Down Syndrome, although it has also previously been shown that this may be affected by the father's age as well.
Speaking to the Melbourne Herald Sun, Professor Les Sheffield, a clinical geneticist from Melbourne's Murdoch Childrens Research Institute, explained that genetic errors in sperm increase by half a per cent when a man reaches 40, by 2 per cent when he is 50, by 5 per cent when he is 60 and by 20 per cent by the time he is 80. He added that on the basis of this, 'men around 40 ought to be thinking about the increased risk to their children, the same as women do'.
Monday, June 9, 2008
Mother freezes her own eggs to give her daughter the chance of having a baby
A mother whose young daughter will never be able to conceive naturally has frozen her own eggs to give the girl a chance of starting a family when she grows up.
The girl, aged ten, was born with a rare genetic condition which means she is infertile. Her mother had several eggs frozen in 2005 which could be used by her daughter for IVF treatment. Under the procedure, which is legal and has been approved by Government ethics committees, the girl could use her mother's eggs to give birth to her own half-sister or half-brother. But legislation limiting the amount of time eggs can be frozen means Mollie - not her real name - will have to decide before her 18th birthday whether to use the eggs.
They were harvested from her mother in 2005 when Mollie was seven. They can be stored for a maximum of ten years, so she will be only 17 when the time limit expires. If she does not use them by the end of 2015 then, by law, all the eggs would have to be destroyed. The Human Fertilisation and Embryology Authority does allow for the ten-year limit to be extended, but only if the eggs are intended for the donor's own treatment.
Now Mollie's mother is campaigning for a reform in the law which would give her daughter more time to make the life-changing decision. The mother, from Hazel Grove, Stockport, said: 'We only want to give Mollie the same chances as everyone else to have a child of her own. 'I don't want to put my daughter under pressure and I don't think she should be having to make that choice at that age.
'We feel real sadness that for no particularly justifiable reason our daughter is going to be put in an impossible situation.'
Mollie has Turner's syndrome, a chromosome abnormality which affects around one in 2,500 girls born every year. The condition causes growth problems, heart defects and physical abnormalities including infertility, a higher risk of diabetes, and ear and urinary infections. The eggs, which are stored in liquid nitrogen at minus 196 degrees Celcius, do not deteriorate and can be stored indefinitely because they are in a state of suspended animation at the temperature-at which all cellular activity ceases.
Mollie's mother said: 'She already knows that she is different. We have tried to keep her as informed as we can. 'We have talked to her about how when she has children it might be different. We just want our daughter to have the same chances as our son.
'People might think there is something strange about it but really it is no different from people who donate to their sisters.
'It is to ensure the closest possible genetic match. It has been considered by ethics committees and they have no objection to it.'
Embryology rules state that only women under the age of 36 can freeze eggs because after that the risk of birth defects increases. At least half a dozen British mothers have frozen their eggs to allow their infertile daughters to conceive at a later date.
The girl, aged ten, was born with a rare genetic condition which means she is infertile. Her mother had several eggs frozen in 2005 which could be used by her daughter for IVF treatment. Under the procedure, which is legal and has been approved by Government ethics committees, the girl could use her mother's eggs to give birth to her own half-sister or half-brother. But legislation limiting the amount of time eggs can be frozen means Mollie - not her real name - will have to decide before her 18th birthday whether to use the eggs.
They were harvested from her mother in 2005 when Mollie was seven. They can be stored for a maximum of ten years, so she will be only 17 when the time limit expires. If she does not use them by the end of 2015 then, by law, all the eggs would have to be destroyed. The Human Fertilisation and Embryology Authority does allow for the ten-year limit to be extended, but only if the eggs are intended for the donor's own treatment.
Now Mollie's mother is campaigning for a reform in the law which would give her daughter more time to make the life-changing decision. The mother, from Hazel Grove, Stockport, said: 'We only want to give Mollie the same chances as everyone else to have a child of her own. 'I don't want to put my daughter under pressure and I don't think she should be having to make that choice at that age.
'We feel real sadness that for no particularly justifiable reason our daughter is going to be put in an impossible situation.'
Mollie has Turner's syndrome, a chromosome abnormality which affects around one in 2,500 girls born every year. The condition causes growth problems, heart defects and physical abnormalities including infertility, a higher risk of diabetes, and ear and urinary infections. The eggs, which are stored in liquid nitrogen at minus 196 degrees Celcius, do not deteriorate and can be stored indefinitely because they are in a state of suspended animation at the temperature-at which all cellular activity ceases.
Mollie's mother said: 'She already knows that she is different. We have tried to keep her as informed as we can. 'We have talked to her about how when she has children it might be different. We just want our daughter to have the same chances as our son.
'People might think there is something strange about it but really it is no different from people who donate to their sisters.
'It is to ensure the closest possible genetic match. It has been considered by ethics committees and they have no objection to it.'
Embryology rules state that only women under the age of 36 can freeze eggs because after that the risk of birth defects increases. At least half a dozen British mothers have frozen their eggs to allow their infertile daughters to conceive at a later date.
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