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In Assisted-Reproduction Technology, Europe Leads The World

Europe leads the world in Assisted Reproduction Technology (ART) with most cycles initiated in the region, the 26th Annual Meeting of the European Society of Human Reproduction and Embryology heard.

According to data presented by the European IVF Monitoring Group (EIM), 479,288 treatment cycles were reported in 32 European countries in 2007 . This compares globally with 142,435 cycles from the US and 56,817 cycles from Australia and New Zealand. "The number of cycles performed in many developed countries has grown by 5-10% per annum over the last 5 years," said Dr. Jacques de Mouzon, chairman of ESHRE's EIM. "The 4.5% increase we observed in Europe from 2006 to 2007 however is partly due to more clinics reporting to our database," he added.

In 28 countries where clinics reported deliveries, more than 90,000 babies were born in 2007. There were 118,667 regular IVF treatments, 246,687 intracytoplasmic sperm injection (ICSI) cycles, 74,855 frozen embryo transfer cycles (FER), 15,028 egg donor cycles (ED), 6,822 preimplantation genetic diagnosis/screening cycles (PGD/PGS) and 660 in vitro maturation cycles (IVM). "The reverse trend from IVF to ICSI continues with now 67.5% of fresh cycles using the latter technology, although the efficacy of ICSI in terms of pregnancy rates is the same as standard IVF," he added.

He pointed out that the overall rate of multiple births was very similar to the previous year with European ART twin deliveries at 20.5% and triplet deliveries at 0.8%. Most countries in Europe are now recording fewer than 1% triplet deliveries, except for Italy (2.8%), Latvia (11.1%) and Serbia (3.3%). "The good news is that since 1997, we have observed a decline from 30% to 21% in overall multiple birth rates and a fourfold reduction in triplet deliveries from 3.7% to 0.8%," he said.

Nordic countries like Denmark still have the highest availability of ART at 13,263 cycles per million of women aged 15-45. The lowest availabilities were recorded in the largest economies in Europe such as Germany (3,931), UK (3,794) and Italy (3,829). This is also mirrored in the number of infants born after ART with only 1.5% in Germany, 1.8% in the UK and 1.2% in Italy. In comparison in Denmark 4.9% of all children were born through IVF.

"In the last 11 years since the beginnings of the EIM we have seen a gradual increase of 26% to 33% of pregnancies per transfer for IVF and ICSI, from 15% to 22% for FER and from 27% to 46% for oocyte donation, and all this despite the transfer of fewer and fewer embryos," said Dr. de Mouzon.

In order to further assess the safety of ART, the EIM has initiated a major study (MART - the Morbidity in ART study), collecting data from a large series of ART children born in Scandinavia. Funded by ESHRE and the Medical Faculty of Copenhagen University, the team will analyse data from the national ART registers in Denmark, Finland, Norway and Sweden. "We estimate that we will have about 75,000 children in our database at the end. The data from Denmark and Finland are ready, the Swedish will finalise their data soon and in Norway the application to obtain these data is currently being processed," explains Prof. Anders Nyboe Andersen, past chairman of the EIM.

Due to the possibility of cross-linking ART data with data from other health registers, the researchers will be able to assess long-term morbidity in these children and compare it with appropriate control groups. "It is the long-term commitment of the EIM to expand this database to other European countries, but it will be at least a year before we can present the results to the public," Prof. Nyboe Andersen concluded.

New Measurement of Telomere DNA Could Help Identify Most Viable Embryos for IVF

Scientists from the University of Warwick and University Hospitals Coventry and Warwickshire NHS Trust, are the first to directly measure a specific region of DNA in human embryos. The length of this region could be a quality marker for embryonic development.

Researchers at the University of Warwick's Warwick Medical School and University Hospital, Coventry, have measured telomeres, regions of repetitive DNA at the ends of a chromosome which protect it from deterioration. Telomeres shorten each time a cell divides and when telomere length becomes critically short, the cells die.

The research, published in Molecular Human Reproduction Journal, suggests that telomere length is shortest in the early stages of an embryo's development, at around two days, and then lengthens just before implantation in the womb at five days. This lengthening may be essential for normal development, because short telomeres may not be enough to survive the many rounds of cell division that take place as embryos grow.

Lead authors Professor Geraldine Hartshorne, from the University of Warwick's Warwick Medical School, and Sarah Turner, from University Hospital , Coventry, said this discovery could have implications for IVF treatment. Professor Hartshorne said: "It has already been shown that artificially shortened telomeres cause problems in animal embryos. Human embryos are highly variable, and many of them cannot develop normally. We think that telomere length might one day be used to help diagnose which are the most viable embryos. We also know that telomeres shorten with oxidative stress, so telomere length might also provide a measure of the stressfulness of the culture systems that we use in IVF and their impact on embryos."

The research project used oocytes and embryos donated by patients undergoing IVF treatment. Only material that could not be used for the patients' own treatment was accessed for research. Sarah Turner said: These results have given us plenty of new questions as well as answers. We now need to find out why telomere length is relatively short in early development. Our next steps are looking at single sperm and eggs to work out where the telomere length in early embryos is coming from. "

Priceless!

Most Syrians struggle to even read Arabic, much less have a clue about English.

So,how do a group of Syrian protest leaders create the most impact with their signs by having the standard "Death To Americans"slogans printed in English?

Answer: They simply hire an English-speaking civilian to translate and write their statements into English.

Unfortunately, in this case, they were unaware that the "civilian" Insurance company employee hired for the job was a retired US Army Sergeant! Obviously, pictures of this protest rally never made their way to Arab TV networks,
but the results were PRICELESS!

Advanced 3D/4D ultrasound to guide embryo transfer during in vitro fertilization improves pregnancy rates

Using advanced 3D/4D ultrasound to guide embryo transfer during in vitro fertilization (IVF) significantly reduces a woman's risk of ectopic pregnancy and its associated complications, Robert Gergely, M.D., medical director, 3D Sonography Center of Beverly Hills, reported today.

“They are particularly traumatic for those who turn to IVF in hopes of having a baby. The good news is that 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point significantly decreases the risk of ectopic pregnancy while it increases the chance of a successful pregnancy.”

Presenting to the 2010 European Society of Human Reproduction and Embryology (ESHRE) Annual Meeting in Rome, Dr. Gergely announced results from a study of 5,073 women receiving IVF and embryo transfer at a large Southern California IVF center. Using 3D/4D ultrasound, Dr. Gergely was able to pinpoint the exact spot within the uterus where infertility specialists could place an embryo with the greatest chance of successful implantation. Dr. Gergely calls this the "Maximal Implantation Potential Point" (MIP Point).




Less sophisticated 2D ultrasound technology lacks the ability to locate the MIP Point. In 2009, Dr. Gergely reported that when the MIP Point was located with 3D/4D ultrasound and the embryo transferred to it, the pregnancy rate at the center rose 10.04%.

Additional analysis has revealed that the ectopic pregnancy rate per embryo transfer declined at the center from 1.82% using 2D ultrasound to 0.50% after adopting 3D/4D ultrasound targeting the MIP Point. This 73.1% decrease is highly statistically significant, and marks the first time such data have been reported.

In ectopic pregnancies, an embryo implants outside the uterus, typically in one of the fallopian tubes. As it grows, it can rupture, causing pain and heavy bleeding that can endanger the mother's life. Normally occurring in about 2% of natural pregnancies, ectopic pregnancy rates have historically been higher in IVF patients, ranging from 2.1% to 8.6%.

"Ectopic pregnancies can be devastating, both physically and emotionally," Dr. Gergely said. "They are particularly traumatic for those who turn to IVF in hopes of having a baby. The good news is that 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point significantly decreases the risk of ectopic pregnancy while it increases the chance of a successful pregnancy."

Using 2D ultrasound, IVF doctors must rely on guesswork to locate an implantation point. They may transfer several embryos to increase the odds of a successful pregnancy. However, this increases the likelihood of multiple births, which carries a risk of serious complications including premature birth, cerebral palsy and infant death.

Single embryo transfer, advocated by fertility organizations, requires greater precision and accuracy. By targeting the MIP Point, doctors can increase the likelihood that embryo implantation will succeed, reducing the need to transfer multiple embryos and decreasing the risk of complications, Dr. Gergely explained.

"Focusing on the MIP Point frees the physician from trying to guess the optimal point for embryo placement," Dr. Gergely said. "By overcoming the limitations of 2D ultrasound, 3D/4D ultrasound-guided embryo transfer targeting the Maximal Implantation Potential Point increases the pregnancy rate while significantly reducing the risk of ectopic pregnancy and complications associated with multiple births."

Dr. Gergely, who invented and holds the patent on 3D/4D ultrasound-guided embryo transfer, lectures at international conferences and teaches physicians so that the procedure can become available to patients worldwide.

3D/4D Ultrasound-Guided Embryo Transfer Targeting Maximal Implantation Potential (MIP) Point Increases Pregnancy Rate and Reduces Ectopic Pregnancies. Presented June 30, 2010 at the 26th Annual Meeting of the European Society of Human Reproduction and Embryology, Rome, Italy. www.eshre.com

IVF-Lite gives hope to older women who have trouble getting pregnant

It's widely known that as women age, their chances of becoming pregnant decrease. Women older than 38, in particular, often have fewer and lower quality eggs and don't respond as well as younger women to conventional efforts to produce eggs for in vitro fertilization — or IVF.

But plenty of women in this age group want to become pregnant. And they do have options.

Conventional IVF is one of these options, but it involves large doses of hormones and can cost Rs 150,000 or more per cycle for older women, with poor results. Many IVF programs turn them down anyway. Some women choose to use donor eggs, but many want to become pregnant with their own eggs. The best solution for such patients is IVF-Lite.

IVF-Lite aims to use smaller numbers of higher quality eggs. It requires fewer fertility drugs than conventional IVF, producing the best quality eggs possible and reducing the cost of drugs from an average of Rs. 100,000 to just Rs.20,000. The procedure is minimally invasive, so women experience little to no pain afterward. And it doesn't involve huge hormonal swings or ovarian hyperstimulation syndrome, a complication involving swelling of the ovaries that about one out of 10 conventional IVF patients experience because of certain fertility medications.

The success of IVF-Lite is enhanced by a new method of embryo freezing called vitrification, or essentially "flash-freezing," which avoids the damage caused by ice forming inside the cell during slow freezing. It is also enhanced by specialized air purification systems that give the eggs the best environment in which to develop.

Think of this simple parable: If you are sitting under an apple tree and wish to eat the most ripe and ready apples, you have a choice. You can chop down the tree and look at every apple on the fallen tree to see which ones were ready. Or you can simply try to shake the lower branches and eat the one or two that have fallen. That is the idea of IVF-Lite. It may not work for everyone, but for many patients, especially older women, it will remove much of the aggravation and cost associated with conventional IVF. Our team at Deccan Fertility Clinic (www.testtubebabyclinic.com) specializes in IVF-Lite & Vitrification at the most affordable rates across the Indian sub-continent. Deccan Fertility Clinic is India's first budget IVF Center, located at Shivaji Park, Dadar, Mumbai.

Data Demonstrate ViaMetrics-E Improves Implantation Rates In Single Embryo Transfer IVF Cycles, A Growing Trend In Infertility Treatment

Researchers from Molecular Biometrics, Inc. presented new data this week demonstrating that the company's ViaMetrics-E procedure more accurately predicts implantation rates in single embryo transfer (SET) cycles for patients undergoing infertility treatment. ViaMetrics-E is a rapid, non-invasive procedure used to enhance in vitro fertilization (IVF) outcomes by identifying viable embryos having the greatest reproductive potential. These research findings were presented this week at the 26th annual meeting of the European Society for Human Reproduction and Embryology (ESHRE) in Rome.

ViaMetrics-E is now available commercially in select countries in Europe, Asia and the Pacific Rim. The company expects to launch the product in other countries in Europe and Asia later this year. Molecular Biometrics is currently working to complete the necessary regulatory requirements to market the product in the U.S.

"Single embryo transfer is a significant and growing trend in infertility treatment in many countries, designed to help reduce the number of multiple births, and the costs and complications associated with them. Providing infertility specialists with greater confidence in identifying the best embryo(s) for transfer clearly supports this growing worldwide clinical focus," said James T. Posillico, Ph.D., President and Chief Executive Officer, Molecular Biometrics. "ViaMetrics-E, when used in conjunction with morphology -- the standard visual assessment of embryos -- gives infertility specialists a valuable new tool to more accurately predict implantation rates while reducing the potential of multiple births. Molecular Biometrics believes this is beneficial for patients, infertility specialists and the healthcare system overall."

Data described in a podium presentation delivered by Denny Sakkas, Ph.D., Adjunct Associate Professor, Yale University School of Medicine, Director of the Embryology Laboratory at Yale Fertility Center, and Molecular Biometrics' Chief Scientific Officer, indicate that differences in ViaMetrics-E Viability Scores could have an impact on which embryo to transfer in a patient's individual IVF cycle, and increase the potential for a successful pregnancy. Each Viability Score reflects the "health" or reproductive potential of the developing embryo.

In this study, spent culture media from 439 embryos from 114 patients were analyzed. Results of this study showed that Day 5 embryos of similar morphology recorded a wide variation in Viability Scores. The data further show that Day 5 embryos with the best morphology within the cohort had the best Viability Scores in only 26% of the cases, indicating that, in 74% of cases, a different embryo may have been identified for transfer using ViaMetrics-E. The authors concluded that choosing embryos with the best metabolic profiles within a cohort, in addition to morphology, could have a significant impact on the identification of the best embryos for SET.

"Because only one embryo is transferred during a single embryo transfer, identifying the embryo with the greatest reproductive potential is critical," added Sakkas. "The non-invasive assessment of embryo culture using ViaMetrics-E technology can give clinicians greater confidence in identifying embryos with the highest potential for successful implementation, directly supporting the greater adoption of SET."

Results from two other studies presented at the ESHRE conference further demonstrated the role ViaMetrics-E might play in identifying the best embryo for single embryo transfer.

Data presented by Emre Seli, M.D., Associate Professor of Reproductive Endocrinology and Infertility at Yale University School of Medicine and Chair of Molecular Biometrics' Scientific Advisory Board, compared the assessment of morphology, Viability Scores produced by ViaMetrics-E and a combination of morphology and Viability Scores in the evaluation of an embryo's reproductive potential (determined by an embryo's positive and negative fetal cardiac activity (FCA) at 12 weeks of gestation). Analysis of 209 spent embryo culture media samples collected following Day 5 SET cycles from five IVF centers in the U.S., Europe and Australia indicated that a ViaMetrics-E Viability Score more accurately predicts embryo implantation rates than does morphology alone. The authors concluded that metabolic assessment of an embryo could yield up to 15% better predictability than morphology alone.

Data presented by Lucy Botros, M.Sc., Molecular Biometrics, assessed the accuracy of ViaMetrics-E in predicting the implantation potential of individual embryos. In an international, multi-center study, 248 spent culture media samples from eight infertility centers in the U.S., Europe and Australia were collected following single embryo transfer on Day 2 (n=176) and Day 5 (n=72). The samples were then evaluated using pre-established algorithms. For both transfer days, as the Viability Score for samples increased -- indicating greater reproductive potential of an individual embryo -- so did the associated pregnancy rate (defined as fetal cardiac activity or FCA). The authors concluded that analysis of spent culture media using ViaMetrics-E can assist in the identification of embryos with the greatest reproductive potential.