The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Saturday, January 17, 2009
Friday, January 16, 2009
The Frog & Golf
THIS IS HILARIOUS!
A man takes the day off work and
Decides to go out golfing.
He is on the second hole when he
Notices a frog sitting next to the green.
He thinks nothing of it and is
About to shoot when he Hears,
Ribbit 9 Iron.'
The man looks around and doesn't
See anyone.
Again, he hears, 'Ribbit 9 Iron.'
He looks at the frog and decides to
Prove the frog wrong, puts the
Club away, and grabs a 9 iron.
Boom!
He hits it 10 inches from the cup.
He is shocked.
He says to the frog,
'Wow that's amazing.
You must be a lucky frog, eh?
The frog replies,
'Ribbit Lucky frog.'
The man decides to take the frog
with him to the next hole.
'What do you think frog?'
The man asks.
'Ribbit 3 wood.'
The guy takes out a 3 wood and,
Boom! Hole in one.
The man is befuddled and doesn't know
What to say.
By the end of the day, the man golfed the
Best game of golf in his life and
asks the frog,
'OK where to next?'
The frog replies,
'Ribbit Las Vegas .
' They go to Las Vegas
and the guy says,
'OK frog, now What?'
The frog says, 'Ribbit Roulette.'
Upon approaching the roulette table,
The man asks,
'What do you think I should Bet?'
The frog replies,
'Ribbit $3000, black 6.'
Now, this is a
million-to-one shot to win, but
after the golf game the man
Figures what the heck.
Boom!
Tons of cash comes sliding back across the table.
The man takes his winnings and
buys the best room in the Hotel.
He sits the frog down and Says,
'Frog, I don't know how to repay you.
You've won me all this money and
I am forever grateful.'
The frog replies,
'Ribbit KissMe.'
He figures why not,
Since after all the frog did for Him,
He deserves it.
With a kiss, the frog turns into a
gorgeous 15-year-old girl.
'And that,
your honor, is how the girl
ended up in my room.
So help me God
Or my name is not William Jefferson Clinton.'
Thursday, January 15, 2009
Genetic screening fails women trying for IVF birth
Genetic screening, often seen as the best hope for older women undergoing IVF treatment to have a child, is ineffective and actually reduces rates of pregnancies, scientists said on Wednesday.
The surprise finding from a controlled clinical trial involving 408 women is a major setback for a technology that is used increasingly in fertility clinics worldwide.
Couples aiming for a test-tube baby can pay between $3,000 (INR 150,000) and $5,000 (INR 250,000) for a preimplantation genetic screening test. The idea is to study the genetic make-up of embryos before transfer to the womb to make sure they are healthy and likely to survive.
But while the concept is very plausible, Dutch researchers found screening in women aged 35 to 41 years actually made matters worse.
After 12 weeks, only 25 percent of women undergoing in vitro fertilisation (IVF) whose embryos had been screened were pregnant, against 37 percent in the control group. Eventual live birth rates were also lower, at 24 versus 35 percent.
Just why screening cuts the chance of a viable pregnancy is unclear but Sebastiaan Mastenbroek from the Academic Medical Centre of the University of Amsterdam said the test itself might be to blame.
"It is possible that the biopsy of a cell from an early embryo on day three after conception hampers the potential of an embryo to successfully implant, though the effect of biopsy alone on pregnancy rates has not been studied," he said in a statement.
Usually, embryos will have reached the eight-cell stage of development by day three but sometimes there may be as few as four cells, which could in theory make the procedure riskier.
Other factors may be the limited number of chromosomes that can be analysed, which may lead to the transfer of embryos that appear normal but in fact contain faults, and the fact many embryos are "mosaic", where a single cell does not properly reflect the genetic make-up of the whole.
Mastenbroek and colleagues presented their work at the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Lyon, France.
The research was also published online by the New England Journal of Medicine, alongside a recommendation from the team that preimplantation should no longer be performed routinely in older women undergoing IVF therapy.
Fertility experts said the findings were a wake-up call for clinicians and showed the need for more research into the benefits, if any, of preimplantation genetic diagnosis (PGD).
Peter Braude, professor of obstetrics and gynaecology at Kings College London, said the work showed screening did not work in older mothers-to-be and similar studies were needed on whether it helped younger women with repeated IVF failure.
"Vulnerable patients should no longer be exploited financially under the impression that it works," he said.
Joep Geraedts, ESHRE’s chairman elect and a genetics expert at the Dutch-Belgian University Limburg, told Reuters in a telephone interview the new study would come as a shock, particularly in the United States, where PGD is widely used.
"No other medical procedure with such profound medical and ethical consequences has been so poorly studied," Kathy Hudson, director of the Genetics and Public Policy Center at Johns Hopkins University, Baltimore, said.
The Aisle Seat
Two Pakistanis boarded a flight out of New Delhi.
One took a window seat and the other sat next to him in the middle
seat... Just before takeoff, a Sikh, an Indian Army NCO sat down
in the aisle seat.
After takeoff, the soldier kicked his milirary shoes off, wiggled his toes and
was settling in when the Pakistani in the window seat said, 'I need to get up
and get a coke.'
Don't get up,' said the Sardar, 'I'm in the aisle seat, 'I'll get it for you.'
As soon as he left, he picked up the Sardar's left shoe and spat in it.
When the Sardar returned with the coke, the other Paki said, 'That looks
good, I'd really like one, too.'
Again, the Sardar obligingly went to fetch it. While he was gone, the
other Paki picked up the Sardar's right shoe and spat in it.
When the Sardar returned, they all sat back and enjoyed the flight, the
Pakis finishing their cokes. As the plane was landing, the Sardar slipped
his feet into his shoes and knew immediately what had happened.
He leaned over and asked his Pakistani neighbors ...
''Why does it have to be this way?''
''How long must this go on . . . ?"
''This fighting between our nations . . . ?''
''This hatred . . . ?''
''This animosity . . . ?''
''This spitting in shoes...
Scroll down for the punch line!
and pissing in cokes . . . ?''
One took a window seat and the other sat next to him in the middle
seat... Just before takeoff, a Sikh, an Indian Army NCO sat down
in the aisle seat.
After takeoff, the soldier kicked his milirary shoes off, wiggled his toes and
was settling in when the Pakistani in the window seat said, 'I need to get up
and get a coke.'
Don't get up,' said the Sardar, 'I'm in the aisle seat, 'I'll get it for you.'
As soon as he left, he picked up the Sardar's left shoe and spat in it.
When the Sardar returned with the coke, the other Paki said, 'That looks
good, I'd really like one, too.'
Again, the Sardar obligingly went to fetch it. While he was gone, the
other Paki picked up the Sardar's right shoe and spat in it.
When the Sardar returned, they all sat back and enjoyed the flight, the
Pakis finishing their cokes. As the plane was landing, the Sardar slipped
his feet into his shoes and knew immediately what had happened.
He leaned over and asked his Pakistani neighbors ...
''Why does it have to be this way?''
''How long must this go on . . . ?"
''This fighting between our nations . . . ?''
''This hatred . . . ?''
''This animosity . . . ?''
''This spitting in shoes...
Scroll down for the punch line!
and pissing in cokes . . . ?''
Wednesday, January 14, 2009
New IVF Progesterone Delivery System Study
A leading Southern California Fertility center esteemed for their excellent IVF success rates and national reputation was recently selected as a participant in a national, multi-center study exploring new progesterone delivery systems to replace intramuscular injections. Patients going through in vitro fertilization (IVF) often describe the progesterone injections as the most difficult and painful part of the IVF cycle. For more than 30 years doctors have been seeking effective alternatives to these painful injections.
The study compares an FDA-approved vaginal progesterone, Endometrin, with a new formulation which is administered subcutaneously, similar to the relatively painless fertility drug injections. Patients will be randomized to receive either the vaginal or subcutaneous progesterone until the pregnancy test and then until about 10 weeks of pregnancy. In case of unacceptable side effects the patient will be offered an alternative medication. Side effects are usually local reactions and mild.
Benefits to patients include free progesterone medications as well as a $1,500 (INR 72,000) honorarium for participating and completing the study questionnaires.
Participating patients will be IVF candidates, including those undergoing ICSI, Blastocyst and PGD, who are age 18-42 who have had less than three prior IVF cycles and an FSH less than 15IU/L and estradiol less than 80 pg/mL. Other exclusion criteria exist.
The study compares an FDA-approved vaginal progesterone, Endometrin, with a new formulation which is administered subcutaneously, similar to the relatively painless fertility drug injections. Patients will be randomized to receive either the vaginal or subcutaneous progesterone until the pregnancy test and then until about 10 weeks of pregnancy. In case of unacceptable side effects the patient will be offered an alternative medication. Side effects are usually local reactions and mild.
Benefits to patients include free progesterone medications as well as a $1,500 (INR 72,000) honorarium for participating and completing the study questionnaires.
Participating patients will be IVF candidates, including those undergoing ICSI, Blastocyst and PGD, who are age 18-42 who have had less than three prior IVF cycles and an FSH less than 15IU/L and estradiol less than 80 pg/mL. Other exclusion criteria exist.
Folate receptor blockade may compromise fertility
Treatment of impaired folate metabolism caused by an autoimmune response might improve the chances of conception among certain women with fertility problems, research suggests.
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
Michelle Murphy (Universitat Rovira i Virgili, Reus, Spain) and colleagues report women who tested positive for folate receptor (FR)-blocking autoantibodies were 12 times more likely to have fertility problems than those testing negative.
Observing that folate cell delivery is important in reproductive processes, the team tested for the presence of FR-blocking autoantibodies in repeated blood samples collected 10–12 weeks apart from 17 women who had failed to conceive during 12 menstrual cycles and 25 controls who had experienced a normal conception and pregnancy outcome.
Overall, five (29 percent) women with subfertility had at least one positive FR-blocking autoantibody titer, compared with just one (4 percent) women in the control group. Statistical analysis confirmed that testing positive for FR-blocking autoantibodies was a significant risk factor for subfertility (odds ratio = 12).
“Further investigation is required to understand the nature of the association between FR autoimmunity and subfertility and the potential benefits of using immune suppressants, corticosteroids, and high-dose folic acid in this disorder,” the researchers propose.
Source: Fertility and Sterility 2008; Advance online publication
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