Monday, December 15, 2008

Freezing eggs holds promise

Human oocyte-freezing techniques are improving so rapidly that this procedure may soon be incorporated into routine in vitro fertilization cycles, experts predicted recently at the WARM meeting in Mexico last month. Currently, most oocyte freezing is done for cancer patients and other women who face potentially sterilizing chemotherapy treatments. And it is beginning to be offered for fertility preservation in young, healthy women worried about their biological clock.

But extending its application to the general in vitro fertilization (IVF) population could increase the flexibility of IVF; oocytes could be frozen rather than discarded in cycles that have to be canceled because of ovarian hyperstimulation syndrome or the absence of a sperm sample. Oocyte cryopreservation could also overcome some legal and ethical dilemmas posed by embryo freezing.

Until now, oocyte freezing has not been a satisfactory alternative to embryo freezing, because oocytes are more fragile than embryos and thus less likely to survive after being thawed. But recent technological improvements have made oocyte freezing a much more viable option, though there is still much debate over the merits of various freezing and thawing methods and of cryoprotective and culture solutions.

"Oocyte freezing will become a standard part of IVF within 5 years worldwide," predicted Giovanni Battista La Sala, M.D., whose clinic at Santa Maria Nuova Hospital in Reggio Emilia, Italy, is the first in the world to use the procedure in all standard IVF cycles. Under the protocol, patients have three of their oocytes fertilized, and the resulting embryos are transferred to the uterus. The remaining oocytes that have been retrieved are frozen and stored for future use, he told this newspaper.

Italy has always been at the forefront of oocyte-freezing research, and its efforts in this field have intensified in the last year after the introduction of new Italian legislation that bans embryo freezing and restricts standard IVF to the creation of no more than three embryos.

The Italian efforts to make oocyte freezing a viable alternative to embryo freezing may end up setting new standards even in less restricted countries, such as the United States, suggested Thomas L. Toth, M.D., director of the in vitro fertilization unit at Massachusetts General Hospital, Boston.

"This alternative approach may be more ideal for providing IVF therapies to our patients. I think the Italians have done very well, and the rest of the world should be watching carefully," he said in an interview.

Dr. La Sala's experience of incorporating oocyte freezing into his standard IVF protocol has produced only 8 ongoing pregnancies out of 324 thaw attempts in the last 14 months. However, worldwide data on oocyte freezing are more encouraging, suggested Eleonora Porcu, M.D., director of the fertility and IVF center at the University of Bologna and a pioneer in the field.

Although the world's first frozen oocyte birth was announced in 1986, followed by two more--one from her own patient and another in 1987 in the United States--there were no more such births in the ensuing decade. Since then, only about 150 babies have been produced using frozen oocytes because of specific technical difficulties, some of which can now be overcome.

"I am convinced that the previously poor results leading the majority of researchers to conclude that oocyte freezing was unreliable, inefficient, and unsafe were due to the fact that they were generally restricted to using excess oocytes," which were few, of inadequate quality, and often old, Dr. Porcu said.

In a study attempting to overcome these limitations, her team froze all oocytes of IVF patients with tubal infertility who were under age 38. They then performed oocyte thawing, fertilization, and embryo transfer in the subsequent cycle.

After more than 500 transfers, the team reported a pregnancy rate per embryo transfer of 17% and a pregnancy rate per patient of almost 24% (sometimes over more than one thaw cycle). There was a high spontaneous-abortion rate (25%), however, which has been noted by other oocyte-freezing experts.

The most extensive U.S. experience with oocyte freezing is from the IVF program at Community Hospital North in Indianapolis, where there have been 13 births reported from frozen oocytes since 1999. This brings the pregnancy rate per embryo transfer to 34% said Donald Cline, M.D., medical director of the clinic.

When comparing frozen-oocyte with frozen-embryo pregnancies, his group noted similar success rates--between 34% and 36% per transfer. "We were pleasantly surprised. It will take more numbers to determine if these data are accurate. But if they are, and we have the same pregnancy rates with frozen oocytes as we do with frozen embryos, this will be the way a number of our patients will want to go," he said.

Thursday, December 11, 2008

Meet Ricky Martin's Twins!!!!!








Take a look at the Celebrity Twins who have graced the cover of PEOPLE magazine over the past years. The latest to join them will be Ricky Martin's Twins! The biggest difference being they are born out of Donor egg IVF & Gestational Surrogacy.

Born via surrogacy in early August, Ricky Martin's 4-month-old twin boys make their debut in this week's issue of PEOPLE, on newsstands Friday.

A joyful Martin, 36, spoke candidly with PEOPLE at home in Puerto Rico about his desire to be a parent, the decision to seek the help of a surrogate, and juggling caring for twins -- he has no nanny!

Describe this time in your life?

"I'm so happy! Everything they do, from smiling to crying, feels like a blessing. Being a father feels amazing. This has been the most spiritual moment in my life."

How hands-on are you as a father?
"I don't have a nanny. I'm doing this on my own because I don't want to miss a moment. I have a personal assistant who helps me, someone who takes care of me while I'm taking care of them, but I'm the one who changes the diapers, the one that feeds them, the one that bathes them, the one that puts them to sleep. For any parent, the first couple of months tend to get a little bit intense."

Why did you choose to become a parent via surrogate?
"Adoption was one option, but it's complicated and can take a long time. Surrogacy was an intriguing and faster option. I thought, 'I'm going to jump into this with no fear.'"

Tell us about Valentino's and Matteo's personalities?

"Valentino loves to sleep. I call him 'Mr. Peace and Love' because he's so chill and serene. Matteo is more alert and active. He was up at 3 a.m. the other night and just hanging!"

What is your philosophy on raising your sons?
"I love to read books to my sons and tell them stories. I play music for them so they develop their own personalities. I want to give them information and raise them with honesty and love, and give them self-esteem and a lot of acceptance."

12 steps to shock-and-awe Pakistan's economy

12 steps to shock-and-awe Pakistan's economy
R Vaidyanathan

December 11, 2008
I did not anticipate the huge response my inbox received for the article slamming Pakistan. Many of those who wrote in have sought concrete steps to tackle the Terror Central.

The terror attack on world citizens at Mumbai has created revulsion and outrage all over the world. It is imperative that India seize the opportunity provided to destabilise Pakistan.

A stable Pakistan is not in the interest of world peace, leave alone India. Army controls the country and owns its economy.

A significant portion of its GDP is due to army-controlled entities (See: Military Inc - Inside Pakistan's Military Economy, by Ayesha Siddiqa; OUP; 2007). One can easily say that Pakistan economy and its Army/ISI are synonymous.

Unless this elementary fact is internalised, we are not going anywhere. This implies we should stop talking of a stable Pakistan since a stable Pakistan means multiple attacks on many more cities of India by that rogue organisation ISI, which is the core of the Pakistan Army and the heart of Pakistan's economy.

Let us not even assume that Zardari is in control. Poor man -- he did not trust his own investigators to probe his wife's assassination -- he wanted Scotland Yard to do the job. Now he blabbers that if his investigators are satisfied, then he will initiate action against terrorists sitting inside Pakistan.

Periodically, the Pakistan Army likes to present some useful idiots (as Lenin would have called them) as elected representatives and we swoon over such events.

India should take the following steps to destabilise the economy of Pakistan:

1. Identify the major export items of Pakistan (like Basmati rice, carpets, etc) and provide zero export tax or even subsidise them for export from India. Hurt Pakistan on the export front.

2. Identify the major countries providing arms to Pakistan and arm twist them. Tell Brazil and Germany (currently planning to supply massive defense items to Pakistan) that it will impact their ability to invest in India. Tell Germany that retail license to Metro will be off and other existing projects will be in jeopardy.

3. Incidentally, after the arrival of Coke and Pepsi in China, the human rights violations of China are not talked about much by US government organs. Think it is a coincidence? Unless we use our markets to arm-twist arms exporters to Pakistan, we will not achieve our objectives.

4. Tell American companies that for every 5% increase in FDI limit for them, their government needs to reduce equipping Pakistan by $5 billion. That is real politics, not whining. Let us remember that funds are in desperate search of emerging markets and not the other way about. Let us also remember that international economics is politics by another name.

5. Create assets to print/distribute their currency widely inside their country. To some extent, Telgi types can be used to outsource this activity. Or just drop their notes in remote areas.

6. Pressurise IMF to add additional conditionality to the loans given to them or at least do not vote for their loans.

7. Create assets within Pakistan to destabilise Karachi stock market - it is already in a shambles.

8. Cricket and Bollywood are the opium of the Indian middle classes. Both have been adequately manipulated/ controlled by the D-company since the eighties. Chase the D-company money in cricket/ Bollywood and punish by burning D-assets in India instead of trying to have them auctioned by the IT department when nobody comes to bid for it.

9. Provide for capital punishment to those who fund terror and help in that. We have the division in the finance ministry to monitor money laundering, etc. It is important that terror financing is taken seriously and fully integrated into money laundering monitoring systems and this division is provided with much larger budget and human resources. And it should coordinate with RAW.

10. Encourage and allow scientists/ academicians/ elites of Pakistan to opt for Indian passport and widely publicise that fact since it will hurt their self-respect and dignity. There will be a long queue to get Indian passports -- many will jump to get our passport -- since they will not be stopped at international airports. It is rumoured that Adnan Sami wants one. Do not give passports to all -- make it a prized possession. Let it hurt the army- and ISI-controlled country. This one step will destroy their identity and self-confidence.

11. Discourage companies from India from investing in Pakistan, particularly IT companies, till Pakistan stops exporting its own IT (international terrorism).

12. In all these, it is important that we do not bring in the domestic religious issues. The target is the terror central, namely Pakistan, and if there are elements helping them here then they also should be punished -- irrespective of religious labels. If Pakistan is dismantled and the idea of Pakistan is gone, many of our domestic issues will also be sorted out.

Will the Indian elite go for the jugular or just light more candles and scream at the formless/ nameless political class before TV cameras?

It is going to be a long haul and may be in a decade or so, we can find a solution to our existential crisis of being attacked by barbarians from the West. We need to combine strategy and patience and completely throw to the dustbin the 'Gujral Doctrine' by that mumbling prime minister about treating younger brothers with equanimity. The doctrine essentially suggests that if we are slapped on both the cheeks we should feel bad that we do not have a third cheek to show.

He, according to security experts, seems to have dismantled our human intelligent assets inside Pakistan, which has resulted in the gory death of thousands of Indian citizens in the last few years.

Such is our strategic thinking in this complex world since our political class is not adequately briefed and the elite don't think through issues. Better to be simple in our talks and vicious in our actions rather than the other way.

Hopefully, this November attack will create a new vibrant India capable of taking care of its own interests.

The author is professor of finance and control, Indian Institute of Management-Bangalore, and can be contacted at vaidya@iimb.ernet.in. The views are personal and do not reflect those of his organisation.