Saturday, October 25, 2008
Friday, October 24, 2008
Catholic Mothers
Even if you didn't grow up Catholic, you'll appreciate this one....
Four Catholic ladies are having coffee together, discussing how important
their children are.
The first one tells her friends, 'My son is a priest. When he walks
into a room, everyone calls him 'Father.'
The second Catholic woman chirps, 'Well, my son is a Bishop.
Whenever he walks into a room, people say, 'Your Grace' The third Catholic woman says smugly, 'Well, not to put you
down, but my son is a Cardinal.
Whenever he walks into a room, people say 'Your Eminence'
The fourth Catholic woman sips her coffee in silence
The first three women give her this subtle 'Well...?
She replies, 'My son is a gorgeous, 6'4', hard bodied, well hung, male stripper.
Whenever he walks into a room, women say, 'Oh! ...'My God'!!!
Four Catholic ladies are having coffee together, discussing how important
their children are.
The first one tells her friends, 'My son is a priest. When he walks
into a room, everyone calls him 'Father.'
The second Catholic woman chirps, 'Well, my son is a Bishop.
Whenever he walks into a room, people say, 'Your Grace' The third Catholic woman says smugly, 'Well, not to put you
down, but my son is a Cardinal.
Whenever he walks into a room, people say 'Your Eminence'
The fourth Catholic woman sips her coffee in silence
The first three women give her this subtle 'Well...?
She replies, 'My son is a gorgeous, 6'4', hard bodied, well hung, male stripper.
Whenever he walks into a room, women say, 'Oh! ...'My God'!!!
Thursday, October 23, 2008
Understanding embryo implantation offers insight
Scientists at the University of Oxford, UK, believe they have identified the way in which embryos implant in the uterus, providing essential information which may be used in the future for infertility treatments and offering hope to thousands of infertile couples. Implantation of an embryo to the lining of the mother's uterus is an essential process that takes place at an early stage of development. The embryo initially attaches and forms a contact with the uterus lining, which triggers a cascade of signals in both the embryo and the uterus. This allows cells from the embryo to start moving across into the uterus, finding blood vessels in the mother and eventually forming the placenta. Problems in the implantation process can lead to loss of potential pregnancies, even in couples trying to conceive without infertility problems. Current estimates suggest that infertility affects one in seven couples in the UK, with around 32,000 couples seeking infertility treatment each year. It is thought that a significant number of these patients could be infertile as a result of implantation problems.
The team of scientists, led by Professor Helen Mardon from the Nuffield Department of Obstetrics and Gynaecology at Oxford, along with Professor Anne J Ridley at King's College, London, added embryos to a layer of cells from uterus lining in a culture dish to mimic events in the womb. They were then able to video embryos implanting themselves in the cell layer, allowing
the scientists to dissect the molecular processes involved. Their findings were published in the journal Proceedings of the National Academy of Sciences.Their investigation led them identify two proteins that are essential players in the implantation process. They are from the Rho GTPase family of proteins, and ensure that cells in a particular part of the uterus lining
move out of the way of the 'invading' embryonic cells. Professor Mardon said: 'We have shown that two proteins, called Rac1 and RhoA, control the invasion. The first stimulates cells in the womb lining to move and allow the embryo to invade and implant properly while the second inhibits this. We believe this controlled balance of the two proteins is critical for successful implantation of the embryo. If the balance of RhoGTPases is altered, the cells of the womb lining don't migrate and the
embryo doesn't implant'.
The findings bring new hope to people with infertility issues. The new information will help the understanding of how this process works, and therefore aid 'the development of drugs to help embryos implant properly',
said Prof Mardon.
The team of scientists, led by Professor Helen Mardon from the Nuffield Department of Obstetrics and Gynaecology at Oxford, along with Professor Anne J Ridley at King's College, London, added embryos to a layer of cells from uterus lining in a culture dish to mimic events in the womb. They were then able to video embryos implanting themselves in the cell layer, allowing
the scientists to dissect the molecular processes involved. Their findings were published in the journal Proceedings of the National Academy of Sciences.Their investigation led them identify two proteins that are essential players in the implantation process. They are from the Rho GTPase family of proteins, and ensure that cells in a particular part of the uterus lining
move out of the way of the 'invading' embryonic cells. Professor Mardon said: 'We have shown that two proteins, called Rac1 and RhoA, control the invasion. The first stimulates cells in the womb lining to move and allow the embryo to invade and implant properly while the second inhibits this. We believe this controlled balance of the two proteins is critical for successful implantation of the embryo. If the balance of RhoGTPases is altered, the cells of the womb lining don't migrate and the
embryo doesn't implant'.
The findings bring new hope to people with infertility issues. The new information will help the understanding of how this process works, and therefore aid 'the development of drugs to help embryos implant properly',
said Prof Mardon.
Wednesday, October 22, 2008
Egg-sharing and Cryopreservation: for who's benefit?
Nataly Atalla's uncritical advertorial 'freeze and share: an evolution of egg sharing' in BioNews 476 (week 15/9/2008 - 21/9/2008) did not address a number of important points.
I would have expected some comment on the success rate of the vitrification technique in their hands. She cites 100,000 procedures in 12 countries and 95 per cent survival and 96 per cent fertilisation rates being reported, but makes no mention of live delivery rates and in particular no reference to the results at her own unit, the London Bridge Fertility Gynaecology and Genetics Centre (the Bridge Centre). Results presented at the recent European Society of Human Reproduction and Embryology (ESHRE) meeting in Barcelona were very encouraging. Chang et al in Atlanta, Georgia, US, vitrified and warmed 155 mature donated oocytes, 135 survived and 117 fertilised with ICSI. They transferred 52 blastocysts into 20 recipients and detected 29 fetal hearts in 17 recipients (1).
However, great care needs to be taken when comparing results elsewhere with those in the UK. In the US, success rates per fresh cycle of egg donation treatment are commonly quoted as being over 60 per cent, whereas the Bridge Centre's most recent published results (HFEA 2007 clinical pregnancy data) was 27 per cent (9/34). This discrepancy is probably due to
the age of the donors - 23 year-old eggs can always be expected to do better than 33 year-old eggs. The vitrification technique may prove to be better than slow freezing but cryopreservation followed by IVF and embryo transfer cannot be expected to give better results than those achieved with fresh embryos. Further, slow freezing results vary from clinic to clinic and the same is likely to be the case with vitrification. Vitrification is more demanding in the laboratory than freezing because precisely controlled exposure to the vitrification solution before cooling and the subsequent rate of warming are critical for survival (2). In the 'freeze and share' scheme, vulnerable women as they approach their mid-30s are being encouraged to put their faith in a storage technique with as yet unproven efficacy in the hands of a clinic offering to exchange storage for eggs to donate to other women. These women may then delay childbearing, become infertile, not conceive with their own stored eggs and know that a woman or women conceived with the fresh eggs they donated some years previously.
How many eggs should the donor store to give herself a 'reasonable' chance of success should she find she needs to use them? Motta et al in Sao Paulo, Brazil and Michigan, US, using excess eggs vitrified and stored and subsequently, if the woman did not conceive following fresh embryo transfer, warmed and ICSI'd, achieved a clinical pregnancy rate of 38 per cent (3).
Although the eggs they used were provided by women with a fertility problem this result is much more like what we could expect in the UK. They estimated that 17 cryopreserved oocytes were required to establish a single clinical pregnancy. At the Bridge Centre suitable donors will undergo three treatment cycles in a year. If they are to store that number of eggs they will need, in order to give half to the recipient, to produce 34 mature eggs, say a total of 40 eggs from about 50 - 60 follicles. It can be seen that this will require a degree of overstimulation with the risks that that would incur.
What proportion of women storing their eggs will need them later? Atalla's commentary makes it clear that only women who are likely to respond to relatively low doses of fertility drugs will qualify to be donors. These women are less likely than those not suitable to donate to have difficulty conceiving in their late thirties and early forties. It appears therefore that the women who are least likely to need the eggs are storing their eggs - perhaps the idea is that they will donate these eggs to the women who were not suitable to donate and store their eggs? A win / win situation for the clinic?
References
(1) C.C. Chang et al, 'Clinical evaluation of blastocyst transfer in oocyte cryopreservation cycles' (P-369 Poster. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
(2) M. Wood, 'Vitrified embryos and oocytes: the way forward' (O-092 Oral. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
(3) E. Motta et al, 'Prospective randomised study of human oocyte cryopreservation by slow-rate freezing or vitrification' (P-374 Poster. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
- John Parsons, Lead Consultant for King's Assisted Conception Unit
I would have expected some comment on the success rate of the vitrification technique in their hands. She cites 100,000 procedures in 12 countries and 95 per cent survival and 96 per cent fertilisation rates being reported, but makes no mention of live delivery rates and in particular no reference to the results at her own unit, the London Bridge Fertility Gynaecology and Genetics Centre (the Bridge Centre). Results presented at the recent European Society of Human Reproduction and Embryology (ESHRE) meeting in Barcelona were very encouraging. Chang et al in Atlanta, Georgia, US, vitrified and warmed 155 mature donated oocytes, 135 survived and 117 fertilised with ICSI. They transferred 52 blastocysts into 20 recipients and detected 29 fetal hearts in 17 recipients (1).
However, great care needs to be taken when comparing results elsewhere with those in the UK. In the US, success rates per fresh cycle of egg donation treatment are commonly quoted as being over 60 per cent, whereas the Bridge Centre's most recent published results (HFEA 2007 clinical pregnancy data) was 27 per cent (9/34). This discrepancy is probably due to
the age of the donors - 23 year-old eggs can always be expected to do better than 33 year-old eggs. The vitrification technique may prove to be better than slow freezing but cryopreservation followed by IVF and embryo transfer cannot be expected to give better results than those achieved with fresh embryos. Further, slow freezing results vary from clinic to clinic and the same is likely to be the case with vitrification. Vitrification is more demanding in the laboratory than freezing because precisely controlled exposure to the vitrification solution before cooling and the subsequent rate of warming are critical for survival (2). In the 'freeze and share' scheme, vulnerable women as they approach their mid-30s are being encouraged to put their faith in a storage technique with as yet unproven efficacy in the hands of a clinic offering to exchange storage for eggs to donate to other women. These women may then delay childbearing, become infertile, not conceive with their own stored eggs and know that a woman or women conceived with the fresh eggs they donated some years previously.
How many eggs should the donor store to give herself a 'reasonable' chance of success should she find she needs to use them? Motta et al in Sao Paulo, Brazil and Michigan, US, using excess eggs vitrified and stored and subsequently, if the woman did not conceive following fresh embryo transfer, warmed and ICSI'd, achieved a clinical pregnancy rate of 38 per cent (3).
Although the eggs they used were provided by women with a fertility problem this result is much more like what we could expect in the UK. They estimated that 17 cryopreserved oocytes were required to establish a single clinical pregnancy. At the Bridge Centre suitable donors will undergo three treatment cycles in a year. If they are to store that number of eggs they will need, in order to give half to the recipient, to produce 34 mature eggs, say a total of 40 eggs from about 50 - 60 follicles. It can be seen that this will require a degree of overstimulation with the risks that that would incur.
What proportion of women storing their eggs will need them later? Atalla's commentary makes it clear that only women who are likely to respond to relatively low doses of fertility drugs will qualify to be donors. These women are less likely than those not suitable to donate to have difficulty conceiving in their late thirties and early forties. It appears therefore that the women who are least likely to need the eggs are storing their eggs - perhaps the idea is that they will donate these eggs to the women who were not suitable to donate and store their eggs? A win / win situation for the clinic?
References
(1) C.C. Chang et al, 'Clinical evaluation of blastocyst transfer in oocyte cryopreservation cycles' (P-369 Poster. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
(2) M. Wood, 'Vitrified embryos and oocytes: the way forward' (O-092 Oral. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
(3) E. Motta et al, 'Prospective randomised study of human oocyte cryopreservation by slow-rate freezing or vitrification' (P-374 Poster. Abstracts of the 24th Annual Meeting of the ESHRE. Barcelona, Spain, 7-9 July, 2008).
- John Parsons, Lead Consultant for King's Assisted Conception Unit
Tuesday, October 21, 2008
Monday, October 20, 2008
Sunday, October 19, 2008
A Catholic Heart-attack
A man suffered a serious heart attack and had open heart bypass
surgery. He awakened from the surgery to find himself in the care of
nuns at a Catholic Hospital .
As he was recovering, a nun asked him questions regarding how he was
going to pay for his treatment. She asked if he had health insurance.
He replied, in a raspy voice, 'No health insurance.'
The nun asked if he had money in the bank.
He replied. 'No money in the bank.'
The nun asked, 'Do you have a relative who could help you?'
He said, 'I only have a spinster sister, who is a nun.'
The nun became agitated and announced loudly, 'Nuns are not spinsters!
Nuns are married to God.'
The patient replied, 'Send the bill to my brother-in -law.
surgery. He awakened from the surgery to find himself in the care of
nuns at a Catholic Hospital .
As he was recovering, a nun asked him questions regarding how he was
going to pay for his treatment. She asked if he had health insurance.
He replied, in a raspy voice, 'No health insurance.'
The nun asked if he had money in the bank.
He replied. 'No money in the bank.'
The nun asked, 'Do you have a relative who could help you?'
He said, 'I only have a spinster sister, who is a nun.'
The nun became agitated and announced loudly, 'Nuns are not spinsters!
Nuns are married to God.'
The patient replied, 'Send the bill to my brother-in -law.
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