Women who fail to conceive spontaneously within 9-12 months of surgery for endometriosis-associated infertility should be entered into an IVF program, according to specialists.
The researchers from the Department of Gynaecology, Perinatology and Human Reproduction at the University of Florence, Italy, conducted a study to determine whether IVF and embryo transfer (IVF-ET) can significantly increase the overall pregnancy rate in infertile patients with endometriosis who did not conceive spontaneously after laparoscopic surgery (the ‘gold standard’ treatment for endometriosis).
They analyzed their center’s medical records to identify 154 women with infertility associated with endometriosis of at least 1 year’s duration who underwent laparoscopic surgery. After excluding women with additional factors affecting fertility, the final study group comprised 107 women with endometriosis-associated infertility. These women had been followed up for periods ranging from 1 year to 11 years.
Writing in a paper in the current issue of the European Journal of Obstetrics & Gynecology and Reproductive Biology, the researchers report that 40 of the 107 women (37.4 percent) achieved a spontaneous pregnancy.
The fecundity rate for spontaneous conception was found to be significantly higher in the 6 months immediately after laparoscopy (23.2 percent) than in subsequent time periods.
The remaining 67 women who did not become pregnant after surgery subsequently underwent IVF-ET, and 20 became pregnant (producing an overall pregnancy rate of 56.1 percent for the study group as a whole).
As expected from previous research findings, the likelihood of pregnancy was significantly higher in women with stage I or II endometriosis (70.2 percent overall) than in women with stage III or IV disease (45 percent overall). In addition, the pregnancy rate was significantly higher in women aged 35 years or younger (54.1 percent) than in women who were older than 35 years of age (23.2 percent).
The researchers write: “IVF-ET after surgery increased the overall probability of pregnancy (56.1 percent as compared with 37.4 percent for spontaneous pregnancies alone, p = 0.009)”.
They suggest in their paper that if, following laparoscopic surgery for endometriosis, spontaneous pregnancy does not occur within 9-12 months in women seeking to become pregnant, the women should be entered in an IVF-ET program. The researchers conclude: “When patients fail to conceive spontaneously, after a maximum of 1 year from laparoscopic surgery, IVF should be suggested.”
Wednesday, June 18, 2008
Tuesday, June 17, 2008
Ovulation moment caught on camera
A doctor about to perform a partial hysterectomy on a patient has inadvertently caught the moment of ovulation on camera. The pictures have been published in the New Scientist magazine, and will also be reproduced in Fertility and Sterility.
Observing ovulation in humans is very difficult, and previous images have been very fuzzy. Jacques Donnez, of the Catholic University of Louvain in Belgium, observed the process, and commented, 'the release of the oocyte from the ovary is a crucial event in human reproduction'.
The pictures have changed the perception of human ovulation, which was thought to be an explosive affair, whereas, in reality, the process takes about 15 minutes. The follicle, a fluid-filled sac on the surface of the ovary, contains the egg. Prior to the egg's release, enzymes are released that break down the tissue in the follicle, causing a red protrusion to appear. A hole becomes visible in the protrusion out of which an egg is released. The egg then moves to the fallopian tube, which transports it to the uterus. When the egg is released it is only about the size of a full stop.
There are no immediate scientific findings resulting from the pictures, but they do give a greater insight into the ovulation process. Professor Alan McNeilly, of the Medical Research Council's Human Reproductive Unit, said 'it really is a pivotal moment in the whole process, the beginnings of life in a way'.
Monday, June 16, 2008
The USB Ovulation Detector
Finding out when you're ovulating may be a lot easier thanks to this upcoming DuoFertility device. Designed by Cambridge Temperature Concepts, a spin-off by Cambridge University PhD students, it consists of a small stick-on patch device that goes under your arm, and a handheld reader.
The patch is a small rubberized gizmo (with a new efficient battery that lasts eight months) and it sticks to your skin and measures your basal body temperature way more accurately than other systems: this temperature rises minutely during ovulation.
When the wireless reader unit gets the info on your temperature change, it then lets you know the best time to try out some baby-making with symbols on its display, or a readout on your PC— it's got a USB connection. Easy peasy, and no pee samples or early wake-ups for manual temp measurements that similar devices require. Human trials are scheduled for next month, and the device may be on sale as soon as the Fall.
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.
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