The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Saturday, July 19, 2008
Friday, July 18, 2008
Increased Fertility Problems For Men Over 40
Scientists have found further evidence to suggest that, like women, fertility drops in men as they age, heard delegates at the annual meeting of the European Society of Human Reproduction and Embryology. The research, led by Dr Stephanie Belloc of the Eylau Centre for Assisted Reproduction in Paris, France, said that the results - the first to show such a strong paternal effect on pregnancy and miscarriage rates - will have important implications for couples wanting to start a family.
'I think it's important to consider not only the woman, but both members of the couple in natural conception but also in assisted reproduction', Belloc told the Times, adding: 'We believe that the use of IVF should be suggested to infertile patients where either party is over 35 years of age'.
The researchers recorded rates of pregnancy, miscarriage and birth in 12,000 couples undergoing fertility treatment in the form of intrauterine inseminations (IUI), where sperm is injected into the woman's uterus while she is ovulating. They also examined the quality and quantity of the sperm, including their ability to swim, size and shape.
The results showed that, independent of the woman's age, the chances of miscarriage rose from 16.7 per cent if the man was 30-35 years old, to 32.5 per cent if he was over 40. Although the impact of the female 'biological clock' on fertility has been widely studied, this is the first time that such a strong paternal effect on reproductive outcome has been shown, said Belloc. 'Some recent studies have established a relationship between the results of IUI and DNA damage, which is also correlated with is also correlated with a man's age, suggesting that it might be an important factor, but until now there was no clinical proof', she said.
'I think it's important to consider not only the woman, but both members of the couple in natural conception but also in assisted reproduction', Belloc told the Times, adding: 'We believe that the use of IVF should be suggested to infertile patients where either party is over 35 years of age'.
The researchers recorded rates of pregnancy, miscarriage and birth in 12,000 couples undergoing fertility treatment in the form of intrauterine inseminations (IUI), where sperm is injected into the woman's uterus while she is ovulating. They also examined the quality and quantity of the sperm, including their ability to swim, size and shape.
The results showed that, independent of the woman's age, the chances of miscarriage rose from 16.7 per cent if the man was 30-35 years old, to 32.5 per cent if he was over 40. Although the impact of the female 'biological clock' on fertility has been widely studied, this is the first time that such a strong paternal effect on reproductive outcome has been shown, said Belloc. 'Some recent studies have established a relationship between the results of IUI and DNA damage, which is also correlated with is also correlated with a man's age, suggesting that it might be an important factor, but until now there was no clinical proof', she said.
Thursday, July 17, 2008
Wednesday, July 16, 2008
Rs 9000 IVF in African Countries
Plans for an affordable and universally accessible IVF programme, which will be rolled out to tackle infertility in developing countries, were announced at a press conference at the European Society for Human Reproduction and Embryology annual meeting today. Dr Willem Ombelet, who heads up the ESHRE special task force on ‘Infertility and Developing Countries’, said that the scheme, now being piloted in Khartoum and Cape Town (and shortly in Arusha, Tanzania), aims to provide one IVF cycle for less than $200.
The UN Population Division estimates that 186 million women of reproductive age in developing countries (excluding China) are infertile, with more than 30 per cent in many African countries unable to conceive a second child. Without feasible treatment options, many of these woman become subject to the social and cultural realities of these countries, facing disinheritance, ostracisation, accusations of witchcraft, abuse by local healers, separation from their spouse or abandonment to a second-class life in a polygamous marriage, highlighted Professor Oluwole Akande, from University Hospital in Ibadan, Nigeria.
While a single IVF cycle in Europe or the USA can cost anything from $5000 - $10,000, the new scheme will cut costs by simplifying procedures and customising services to ensure that patients are only given the minimum level of treatment that they need for their particular condition, said Professor Gianaroli, from the SISMER Reproductive Medicine Unit in Italy. ‘We will not be able to treat every type of infertility, but many women with tubal damage as a result of infection can be helped’, he told the press, highlighting that tubal damage resulting from disease or substandard abortions are thought to be a primary cause of infertility in developing countries.
Ombelet emphasised the need to educate the public about infertility and create an infrastructure capable of delivering the service effectively. ‘A universally accessible treatment service is impossible in most developing countries,’ he acknowledged. ‘ But a start can be made by integrating low cost treatments into existing family health services, where opportunities exist for contraception, health education, maternity and childcare, prevention and treatment of STDs and HIV. We have to make a start, and this is how we’re doing it,’ he said.
The full proceedings of an expert meeting on these issues, held in December 2007 in Arusha, Tanzania, is published this month by the journal Human Reproduction.
The UN Population Division estimates that 186 million women of reproductive age in developing countries (excluding China) are infertile, with more than 30 per cent in many African countries unable to conceive a second child. Without feasible treatment options, many of these woman become subject to the social and cultural realities of these countries, facing disinheritance, ostracisation, accusations of witchcraft, abuse by local healers, separation from their spouse or abandonment to a second-class life in a polygamous marriage, highlighted Professor Oluwole Akande, from University Hospital in Ibadan, Nigeria.
While a single IVF cycle in Europe or the USA can cost anything from $5000 - $10,000, the new scheme will cut costs by simplifying procedures and customising services to ensure that patients are only given the minimum level of treatment that they need for their particular condition, said Professor Gianaroli, from the SISMER Reproductive Medicine Unit in Italy. ‘We will not be able to treat every type of infertility, but many women with tubal damage as a result of infection can be helped’, he told the press, highlighting that tubal damage resulting from disease or substandard abortions are thought to be a primary cause of infertility in developing countries.
Ombelet emphasised the need to educate the public about infertility and create an infrastructure capable of delivering the service effectively. ‘A universally accessible treatment service is impossible in most developing countries,’ he acknowledged. ‘ But a start can be made by integrating low cost treatments into existing family health services, where opportunities exist for contraception, health education, maternity and childcare, prevention and treatment of STDs and HIV. We have to make a start, and this is how we’re doing it,’ he said.
The full proceedings of an expert meeting on these issues, held in December 2007 in Arusha, Tanzania, is published this month by the journal Human Reproduction.
Tuesday, July 15, 2008
Donor Children Doing Emotionally Well
Researchers from the Centre for Family Research at Cambridge University in the UK say that families created by the use of sperm donation, egg donation and surrogacy are doing well, particularly in terms of their psychological well-being.
The data, presented at the annual meeting of the European Society of Human Reproduction and Embryology, come from the fourth phase of a longitudinal study in which 43 donor insemination families, 46 egg donation families and 39 surrogacy families have participated, along with a control group of 70 families where the children were naturally conceived. The first data on these families was taken when the children were nine months old - they are now seven years old.
Mothers, fathers and teachers were each independently given questionnaires to assess the child’s wellbeing, as well as give individual scores on things like behavioural problems and emotional difficulties. Mothers and fathers were also separately interviewed about their relationship with their children. Children were asked to fill in a blank ‘map’ of concentric circles, assessing their relationship with family members and friends, placing the name of those with whom they believed they are closest in the innermost circle, and so on.
In terms of the psychological well-being of the parents, the quality of parent-child relationships and the psychological adjustment of the children concerned, more similarities than differences were found among the three assisted conception groups, said Polly Casey, who presented the research to the conference. Children from all family types placed their mother or father in the closest circle with the same frequency. However, there was some difference shown in the perception of emotional difficulties in the children, as reported by parents and teachers, with parents reporting no significant difficulties, but teachers (who did not know whether or not a child was born using assisted conception) indicating that children born from assisted conception having some more emotional difficulties than the control group.
Miss Casey also told the conference that only 29 per cent of donor insemination parents, 39 per cent of egg donation parents and 89 per cent of surrogacy parents had told their children how they were conceived by the time they reached the age of seven. All of these figures were markedly less than the numbers who said they would tell their child of its origins in the first phase of the study. When the results on psychological well-being and parent-child relationships were broken down by those children who had been told of their origins and those who had not, some differences emerged. ‘Those mothers who had told their children about their conception showed higher levels of sensitivity to the child and, although there was no statistical difference, we also found that fathers in disclosing families tended to show greater warmth towards their children’, she said.
In the groups who had been open with their children, mothers also reported greater ‘marital satisfaction’ and, furthermore, teachers reported lower levels of emotional and behavioural difficulties among the children who had been told of their origins. ‘We were particularly interested to find that, according to teachers, those children who had been told of their origins tended to do slightly better emotionally than those who had not’, said Miss Casey, adding that ‘of course this may simply be due to better communication within the family generally’.
The data, presented at the annual meeting of the European Society of Human Reproduction and Embryology, come from the fourth phase of a longitudinal study in which 43 donor insemination families, 46 egg donation families and 39 surrogacy families have participated, along with a control group of 70 families where the children were naturally conceived. The first data on these families was taken when the children were nine months old - they are now seven years old.
Mothers, fathers and teachers were each independently given questionnaires to assess the child’s wellbeing, as well as give individual scores on things like behavioural problems and emotional difficulties. Mothers and fathers were also separately interviewed about their relationship with their children. Children were asked to fill in a blank ‘map’ of concentric circles, assessing their relationship with family members and friends, placing the name of those with whom they believed they are closest in the innermost circle, and so on.
In terms of the psychological well-being of the parents, the quality of parent-child relationships and the psychological adjustment of the children concerned, more similarities than differences were found among the three assisted conception groups, said Polly Casey, who presented the research to the conference. Children from all family types placed their mother or father in the closest circle with the same frequency. However, there was some difference shown in the perception of emotional difficulties in the children, as reported by parents and teachers, with parents reporting no significant difficulties, but teachers (who did not know whether or not a child was born using assisted conception) indicating that children born from assisted conception having some more emotional difficulties than the control group.
Miss Casey also told the conference that only 29 per cent of donor insemination parents, 39 per cent of egg donation parents and 89 per cent of surrogacy parents had told their children how they were conceived by the time they reached the age of seven. All of these figures were markedly less than the numbers who said they would tell their child of its origins in the first phase of the study. When the results on psychological well-being and parent-child relationships were broken down by those children who had been told of their origins and those who had not, some differences emerged. ‘Those mothers who had told their children about their conception showed higher levels of sensitivity to the child and, although there was no statistical difference, we also found that fathers in disclosing families tended to show greater warmth towards their children’, she said.
In the groups who had been open with their children, mothers also reported greater ‘marital satisfaction’ and, furthermore, teachers reported lower levels of emotional and behavioural difficulties among the children who had been told of their origins. ‘We were particularly interested to find that, according to teachers, those children who had been told of their origins tended to do slightly better emotionally than those who had not’, said Miss Casey, adding that ‘of course this may simply be due to better communication within the family generally’.
Monday, July 14, 2008
Tofu 'may raise risk of dementia'
Tofu is a widely eaten soy product. Eating high levels of some soy products - including tofu - may raise the risk of memory loss, research suggests. The study focused on 719 elderly Indonesians living in urban and rural regions of Java. The researchers found high tofu consumption - at least once a day - was associated with worse memory, particularly among the over-68s. The Loughborough University-led study features in the journal Dementias and Geriatric Cognitive Disorders.
Soy products are a major alternative protein source to meat for many people in the developing world. But soy consumption is also on the increase in the west, where it is often promoted as a "superfood". Soy products are rich in micronutrients called phytoestrogens, which mimic the impact of the female sex hormone oestrogen. There is some evidence that they may protect the brains of younger and middle-aged people from damage - but their effect on the ageing brain is less clear.
The latest study suggests phytoestrogens - in high quantity - may actually heighten the risk of dementia. Lead researcher Professor Eef Hogervorst said previous research had linked oestrogen therapy to a doubling of dementia risk in the over-65s.
She said oestrogens - and probably phytoestrogens - tended to promote growth among cells, not necessarily a good thing in the ageing brain. Alternatively, high doses of oestrogens might promote the damage caused to cells by particles known as free radicals. A third theory is that damage is caused not by the tofu, but by formaldehyde, which is sometimes used in Indonesia as a preservative. The researchers admit that more research is required to ascertain whether the same effects are found in other ethnic groups. However, previous research has also linked high tofu consumption to an increased risk of dementia in older Japanese American men.
Professor David Smith, of the University of Oxford, said tofu was a complex food with many ingredients which might have an impact. However, he said: "There seems to be something happening in the brain as we age which makes it react to oestrogens in the opposite way to what we would expect." The latest study also found that eating tempe, a fermented soy product made from the whole soy bean, was associated with better memory. Professor Hogervorst said the beneficial effect of tempe might be related to the fact that it contains high levels of the vitamin folate, which is known to reduce dementia risk. "It may be that that the interaction between high levels of both folate and phytoestrogens protects against cognitive impairment." She also stressed that there was no suggestion that eating tofu in moderation posed a problem. Rebecca Wood, of the Alzheimer's Research Trust, which funded the study, said more research was needed to pin down the potential risks and benefits of so-called superfoods. However, she said: "This kind of research into the causes of Alzheimer's could lead scientists to new ways of preventing this devastating disease. "As over half a million people have Alzheimer's in the UK today, there is a desperate need to find a new prevention or cure."
Sunday, July 13, 2008
Kolkata Beggar now Bank Account Holder
A bank in the Indian city of Calcutta has opened an account for a beggar who deposited 91kg of coins in one of the bank's branches. Laxmi Das says she has been saving the coins since she started begging more than 40 years ago as a disabled child because of an early attack of polio.
"I saved for the days when I cannot beg," she said.
"I knew one day I would grow old and have diseases, so I was prudent and saved for my pension."
Now the fruits of her labour from a busy traffic intersection in north Calcutta have been realised.
"She can be projected as a role model to encourage people to begin saving," said TK Haldar, manager of the Central Bank of India's Maniktola branch.
Ms Das says that she has been prudent and saved
"Her efforts show that you can save even if you earn a pittance."
Mr Haldar said Ms Das now has a bank account and those who want to help her can send in account payee cheques in her name to his bank branch.
Several people have written to the BBC News website offering financial help to Ms Das after her story first appeared earlier this week.
Ms Das began begging aged 16 and saved coins in iron buckets at her home in a shanty town near the crossing.
In all, she collected four buckets of coins of all denominations. Some were minted as far back as 1961 and were clearly out of date. But bank officials said they would still accept them as legal tender.
It took staff - more used to counting notes - three days to count all the coins.
"But be it a billionaire or a beggar, our doors are open for all," said bank spokesman Shantanu Neogy.
Ms Das was encouraged to deposit the money by police who feared it could have been stolen from her home.
She chose to ignore - or did not know about - a thriving racket in this part of the world in which old Indian coins are smuggled and melted down in Bangladesh to make razor blades that sell for up to seven times their value as coins.
The practice has caused an acute coin shortage in eastern India, forcing government mints to cut down on the amount of metal they use to make the coins.
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