The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Wednesday, February 3, 2010
Monday, February 1, 2010
Saturday, January 30, 2010
Like babies, embryos like to be rocked, too
Rocking growing embryos during IVF (in vitro fertilisation) could improve pregnancy rates among women undergoing the procedure, and decrease its risks. Scientists at the University of Michigan, US, have built a device which mimics the movement felt by embryos on their way to the uterus. When they used this during IVF with mouse embryos, they found pregnancy rates were 22 per cent higher compared to those grown statically. The research was published online in the journal Human Reproduction and was funded by the National Institutes of Health, the US Department of Agriculture, the Michigan Economic Development Corporation, the US Army Research Laboratory and the Coulter Foundation.
'By making the cells feel more at home, we get better cells, which is key to having better infertility treatment', said Shu Takayama, an associate professor in the Department of Biomedical Engineering and in macromolecular science and engineering. The rocking movement in the device is created by pulsing Braille pins, sitting underneath a thimble-sized funnel holding the embryos. The pins stimulate a flow of fluid through channels in the bottom of the funnel, copying the currents created by cilia - hair-like projections inside the body - and muscles. In the body these motions help to push fertilised eggs to the uterus and flush out waste products.
'One of our goals for years now has been to modify how we grow embryos in the lab to be more like how they grow in the human body, because we know that the human body grows them most efficiently', commented Gary Smith, co-author of the paper and associate professor in the Department of Biomedical Engineering and in macromolecular science and engineering. Presently in IVF, eggs are fertilized with sperm and left to grow for several days in a culture dish that remains still.
If similar results are found in humans, it could lead to reduced multiple pregnancies from the IVF process, its biggest risk. Professor Smith emphasised: 'We're making healthier embryos, which not only can improve pregnancy rates, but also could allow us to transfer fewer embryos per cycle and reduce the incidence of twins and triplets'. In the UK, the Human Fertilisation and Embryology Authority (HFEA) is currently campaigning to reduce multiple births, and the government wants to cut them from one in four to one in ten in IVF by 2012. Trials on humans are already underway, through the company Professor Takayama and Professor Smith founded, Incept Biosystems.
In the US, IVF currently costs around $15,000 per cycle and is often not covered by insurance. It has a success rate of about 35 per cent. 'If we could increase that, even just to 45 per cent, that's significant', said Professor Smith.
'By making the cells feel more at home, we get better cells, which is key to having better infertility treatment', said Shu Takayama, an associate professor in the Department of Biomedical Engineering and in macromolecular science and engineering. The rocking movement in the device is created by pulsing Braille pins, sitting underneath a thimble-sized funnel holding the embryos. The pins stimulate a flow of fluid through channels in the bottom of the funnel, copying the currents created by cilia - hair-like projections inside the body - and muscles. In the body these motions help to push fertilised eggs to the uterus and flush out waste products.
'One of our goals for years now has been to modify how we grow embryos in the lab to be more like how they grow in the human body, because we know that the human body grows them most efficiently', commented Gary Smith, co-author of the paper and associate professor in the Department of Biomedical Engineering and in macromolecular science and engineering. Presently in IVF, eggs are fertilized with sperm and left to grow for several days in a culture dish that remains still.
If similar results are found in humans, it could lead to reduced multiple pregnancies from the IVF process, its biggest risk. Professor Smith emphasised: 'We're making healthier embryos, which not only can improve pregnancy rates, but also could allow us to transfer fewer embryos per cycle and reduce the incidence of twins and triplets'. In the UK, the Human Fertilisation and Embryology Authority (HFEA) is currently campaigning to reduce multiple births, and the government wants to cut them from one in four to one in ten in IVF by 2012. Trials on humans are already underway, through the company Professor Takayama and Professor Smith founded, Incept Biosystems.
In the US, IVF currently costs around $15,000 per cycle and is often not covered by insurance. It has a success rate of about 35 per cent. 'If we could increase that, even just to 45 per cent, that's significant', said Professor Smith.
Friday, January 29, 2010
Chemicals in old furniture can make it harder to get pregnant
Exposure to chemicals found in household objects such as furniture, carpets and electronic equipment increases the time taken to become pregnant, according to a study published online in the journal Environmental Health Perspectives. Professor Kim Harley and colleagues at the University of California, Berkeley (UCB) School of Public Health found that women with a higher blood concentration of polybrominated diphenyl ethers (PBDEs), which have been used as flame retardants since the 1970s, took 'significantly' longer to conceive. It is the first study in humans to examine the association between PBDEs and fertility.
The researchers interviewed 223 pregnant women living in a predominantly Mexican-immigrant, low-income community in northern California. They were asked how long it had taken for them to conceive and blood samples were collected. 'For every tenfold increase in PBDEs in the blood, we saw a 30 per cent to 50 per cent decrease in the odds of becoming pregnant in any given month,' said Professor Harley. The researchers controlled for other factors, such as pesticide exposure, which could potentially affect fertility.
PBDEs were commonly used in the US after the implementation of new fire safety standards four decades ago. Production of certain types of PBDE ceased in 2004, but the chemicals are still found in older products. Previous studies showed that 97 per cent of Americans have detectable levels of these chemicals in their blood, with Californians having higher than average levels due to strict flammability laws. Overall, the levels found in the new study were below the national average.
Household items are considered a major source of PDBE exposure. After leaching out, the chemicals can be inhaled with house dust and stored in the body's fat cells. The chemicals are also found in some foods, such as dairy products and high-fat meat. It is unclear how PDBEs may impair fertility, but one possibility is that they alter the level of the thyroid hormone, which is believed to play an important role in fertility. They have previously been associated with reproductive and hormonal defects in animals.
Industry spokesman John Kyte responded to the study by saying that the findings are limited to PBDEs no longer in use, the environmental levels of which are expected to decline over time. However, Professor Harley maintained that although several PDBEs are banned, exposure is likely to continue for many years. She also described the need for research into newer flame retardants: 'We know less about the health effects of these new chemicals than we do about PBDEs'. This is not the first time that chemicals found in household materials have been linked to reproductive problems. In January 2009 scientists found a link between perfluorinated chemicals (PFCs) and fertility, and in May last year household chemicals were reported to disrupt the sexual development of male fetuses.
The researchers interviewed 223 pregnant women living in a predominantly Mexican-immigrant, low-income community in northern California. They were asked how long it had taken for them to conceive and blood samples were collected. 'For every tenfold increase in PBDEs in the blood, we saw a 30 per cent to 50 per cent decrease in the odds of becoming pregnant in any given month,' said Professor Harley. The researchers controlled for other factors, such as pesticide exposure, which could potentially affect fertility.
PBDEs were commonly used in the US after the implementation of new fire safety standards four decades ago. Production of certain types of PBDE ceased in 2004, but the chemicals are still found in older products. Previous studies showed that 97 per cent of Americans have detectable levels of these chemicals in their blood, with Californians having higher than average levels due to strict flammability laws. Overall, the levels found in the new study were below the national average.
Household items are considered a major source of PDBE exposure. After leaching out, the chemicals can be inhaled with house dust and stored in the body's fat cells. The chemicals are also found in some foods, such as dairy products and high-fat meat. It is unclear how PDBEs may impair fertility, but one possibility is that they alter the level of the thyroid hormone, which is believed to play an important role in fertility. They have previously been associated with reproductive and hormonal defects in animals.
Industry spokesman John Kyte responded to the study by saying that the findings are limited to PBDEs no longer in use, the environmental levels of which are expected to decline over time. However, Professor Harley maintained that although several PDBEs are banned, exposure is likely to continue for many years. She also described the need for research into newer flame retardants: 'We know less about the health effects of these new chemicals than we do about PBDEs'. This is not the first time that chemicals found in household materials have been linked to reproductive problems. In January 2009 scientists found a link between perfluorinated chemicals (PFCs) and fertility, and in May last year household chemicals were reported to disrupt the sexual development of male fetuses.
Thursday, January 28, 2010
Experts warn of rising infertility in developing countries
Infertility levels are rising faster in developing countries than in developed countries, warned experts speaking at the 'Updates in Infertility Treatment (UIT) 2010' conference in Seville, Spain, last week. The infertility treatment specialists called for assisted reproductive technologies (ARTs) to be made accessible to those in the poorest parts of the world, where infertility has the greatest consequences. They proposed a low-cost IVF (in vitro fertilisation) programme that could be made available for only Rs 15,000 per couple, a fraction of the cost of treatment in the US and Western Europe.
Infertility affects a far greater proportion of couples in developing countries than in developed nations. Estimates suggest that infertility is over three times higher in some developing regions, often as a result of inadequate healthcare, unsafe abortions or untreated infections of the reproductive organs. In many of these countries, infertility treatment is almost non-existent. Professor Basil Tarlatzis, President of the International Federation of Fertility Society (IFFS) and a human reproduction expert at Aristotle University, Greece, commented that the poorest countries fall far short of the optimum target of 1500 cycles of IVF per million population per year. Most fail to reach even one per cent of the target.
The consequences of infertility are also greatest in developing countries, and this is especially true for women. Professor Tarlatzis commented that 'womanhood is defined by motherhood in some regions so infertile women can be seen as 'cursed' and are deprived of all social status'. Infertile women can also face domestic violence, separation or a polygamous marriage. So infertility treatment could prove particularly beneficial to women in the developing world.
Professor Tarlatzis suggested a two-pronged attack to manage infertility, focusing on 'prevention of avoidable infertility and making available assisted reproduction techniques'. The prevention of avoidable infertility will require many social changes including improved sexual education, treatment of sexually transmitted diseases and the introduction of safe birthing and abortion practices. Increasing the availability of ARTs will require the provision of inexpensive fertility treatment.
A Task Force from the European Society for Human Reproduction and Embryology (ESHRE) is currently developing a framework for the provision of cheap infertility treatment in developing countries. Meanwhile the Low Cost IVF Foundation (LCIF) of Massanfo, Switzerland has funded three clinics located in the Sudan, Tanzania and South Africa to pilot their budget IVF treatment package. The LCIF has managed to cut the cost of IVF dramatically by using inexpensive equipment, simplifying procedures and customising services so that couples are given the minimum level of treatment for their specific condition.
Infertility affects a far greater proportion of couples in developing countries than in developed nations. Estimates suggest that infertility is over three times higher in some developing regions, often as a result of inadequate healthcare, unsafe abortions or untreated infections of the reproductive organs. In many of these countries, infertility treatment is almost non-existent. Professor Basil Tarlatzis, President of the International Federation of Fertility Society (IFFS) and a human reproduction expert at Aristotle University, Greece, commented that the poorest countries fall far short of the optimum target of 1500 cycles of IVF per million population per year. Most fail to reach even one per cent of the target.
The consequences of infertility are also greatest in developing countries, and this is especially true for women. Professor Tarlatzis commented that 'womanhood is defined by motherhood in some regions so infertile women can be seen as 'cursed' and are deprived of all social status'. Infertile women can also face domestic violence, separation or a polygamous marriage. So infertility treatment could prove particularly beneficial to women in the developing world.
Professor Tarlatzis suggested a two-pronged attack to manage infertility, focusing on 'prevention of avoidable infertility and making available assisted reproduction techniques'. The prevention of avoidable infertility will require many social changes including improved sexual education, treatment of sexually transmitted diseases and the introduction of safe birthing and abortion practices. Increasing the availability of ARTs will require the provision of inexpensive fertility treatment.
A Task Force from the European Society for Human Reproduction and Embryology (ESHRE) is currently developing a framework for the provision of cheap infertility treatment in developing countries. Meanwhile the Low Cost IVF Foundation (LCIF) of Massanfo, Switzerland has funded three clinics located in the Sudan, Tanzania and South Africa to pilot their budget IVF treatment package. The LCIF has managed to cut the cost of IVF dramatically by using inexpensive equipment, simplifying procedures and customising services so that couples are given the minimum level of treatment for their specific condition.
Wednesday, January 27, 2010
Merck receives EU approval for new infertility drug
The European Commission has granted approval of ELONVA, a first-in-class drug manufactured by White House Station pharmaceutical company, Merck. ELONVA is used for controlled ovarian stimulation in women embarking on IVF (in vitro fertilisation) treatment for infertility. With this approval, Merck has marketing authorisation for the drug in all EU member states.
Approximately 15 per cent of couples are considered to be affected by infertility. This can be due to a number of causes such as blocked Fallopian tubes or sperm ducts. Several treatment options are now available which may enable the couple to have children, including IVF. In IVF, mature eggs are removed from 'follicles' in the female ovary and fertilised outside the body by the sperm. Viable embryos are then replaced in the uterus of the female after which pregnancy may result.
In order to increase the chances of a viable embryo being produced, multiple follicles are stimulated to mature at once in a process called superovulation. Typically the woman undergoes several injections of a hormone called 'follicle stimulating hormone' (FSH) on a daily basis. ELONVA has the same pharmacological properties to FSH, with the advantage that the stimulatory effects of ELONVA are maintained over an entire week post-injection; it is a first-in-class of sustained follicle stimulants (SFS). Consequently a single subcutaneous injection of the recommended dose of ELONVA may replace the first seven injections of any daily FSH preparation in a treatment cycle. After the first week of treatment, FSH is given on a daily basis until follicles are ready to be removed. In a trial of more than 1500 couples undergoing IVF, the pregnancy rates of those receiving ELONVA followed by FSH compared to women receiving only FSH were comparable.
'ELONVA will reduce the burden of injections for women experiencing difficulty conceiving, and the positive opinion is an important step toward a European approval,' said Mirjam Mol-Arts, senior vice president of Merck Research Laboratories, adding: 'ELONVA demonstrates Merck's commitment to providing effective patient-focused fertility treatments and extends the company's leadership in this therapy area'.
Approximately 15 per cent of couples are considered to be affected by infertility. This can be due to a number of causes such as blocked Fallopian tubes or sperm ducts. Several treatment options are now available which may enable the couple to have children, including IVF. In IVF, mature eggs are removed from 'follicles' in the female ovary and fertilised outside the body by the sperm. Viable embryos are then replaced in the uterus of the female after which pregnancy may result.
In order to increase the chances of a viable embryo being produced, multiple follicles are stimulated to mature at once in a process called superovulation. Typically the woman undergoes several injections of a hormone called 'follicle stimulating hormone' (FSH) on a daily basis. ELONVA has the same pharmacological properties to FSH, with the advantage that the stimulatory effects of ELONVA are maintained over an entire week post-injection; it is a first-in-class of sustained follicle stimulants (SFS). Consequently a single subcutaneous injection of the recommended dose of ELONVA may replace the first seven injections of any daily FSH preparation in a treatment cycle. After the first week of treatment, FSH is given on a daily basis until follicles are ready to be removed. In a trial of more than 1500 couples undergoing IVF, the pregnancy rates of those receiving ELONVA followed by FSH compared to women receiving only FSH were comparable.
'ELONVA will reduce the burden of injections for women experiencing difficulty conceiving, and the positive opinion is an important step toward a European approval,' said Mirjam Mol-Arts, senior vice president of Merck Research Laboratories, adding: 'ELONVA demonstrates Merck's commitment to providing effective patient-focused fertility treatments and extends the company's leadership in this therapy area'.
Tuesday, January 26, 2010
Britain's first iPhone baby due
The couple had tried for three years to conceive before they heard about the fertility app and downloaded it to her iPhone. The 30-year-old entered her body temperature daily and the app calculated when she would be most fertile.
A relative said: "She followed the advice and within two months she was expecting. We're all overjoyed." The mother-to-be does not want to be identified until after the baby has been born.
The relative said: "It's due any day. Every one's keeping their fingers crossed there are no complications. She's proud to say it will be an 'iPhone baby'. Without the app she might not have fallen pregnant."
Last week an iPhone application that claims to be able to tell parents what their baby's cries mean was launched.
The Cry Translator app, which costs INR 1600 is said by its designers to be 96 per cent accurate in interpreting cries of distress from babies.
The program uses the iPhone's microphone to receive the sound, analyzes it, and displays information about what it means on the screen.
Researchers led by Dr Antonio Portugal RamÃrez, a Spanish paediatrician, developed the project after finding that babies' wails could be broken down into five separate categories.
They learned that all babies, regardless of the language they are exposed to at home, have the same distinctive cries to indicate whether they are hungry, annoyed, tired, stressed or bored.
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