Is spring the secret of success for struggling IVF couples?

In the animal kingdom, spring is the mating season. Now scientists claim the same is true for humans.
They have discovered that couples trying for babies with IVF are more likely to conceive in spring than at any other time of year.
Those who had treatment in March, April or May were one-and-a-half times more likely to be successful than those trying during other months.Experts believe that the increase in light in spring could trigger women’s bodies to produce greater amounts of the sex hormone estradiol, crucial for the fertilisation of the egg and development of the embryo.
Scientists from the Assisted Fertilization Center in Sao Paulo, Brazil looked at almost 2,000 women undergoing IVF treatment during all four seasons of the year.
They found that rates of fertilisation – when the egg and sperm join together to make an embryo – and levels of estradiol in the women’s blood were significantly higher in spring.
Dr Daniela Braga, who led the study, suggested that changing light levels caused neurons in women’s brains to produce certain hormones which in turn increased the amount of estradiol produced by the ovaries.
‘This work shows that IVF cycles may have a better outcome during the spring,’ she said.
‘Our results show a significant difference in spring fertilization rate, with the fertilization
rate in the spring being almost one-and-a-half-times that of other seasons.
‘In practical terms this may mean that if you are having real difficulty in conceiving, it may be better to have an assisted reproduction cycle during this season.
‘We found higher estradiol levels in the spring. In assisted reproduction, adequate estradiol levels are important for egg maturation and other reproductive processes including fertilization and embryo development.’
The scientists now want to test if women are more likely to conceive in areas of Brazil nearer the equator, where there is more light.
Their findings back up work carried out by British scientists that showed that fertility treatment was more likely to be successful in spring or summer.
A team from Countess of Chester Hospital and Liverpool Women’s Hospital found that 20 per cent of IVF cycles from May to September resulted in a successful pregnancy, compared with 16 per cent for the remainder of the year.
These researchers suggested that this was down to humans showing the same biological processes as those that occur in birds and mammals.

Hormone melatonin improves egg quality in IVF

Women with poor egg (or oocyte) quality could double their chance of becoming pregnant through IVF if given melatonin, researchers have found.

'Despite great advances in assisted reproductive technology, poor oocyte quality remains a serious problem for female infertility', said Professor Hiroshi Tamura from the Yamaguchi University Graduate School of Medicine, Japan, who led the research. 'So far no practical and effective treatment for improving oocyte quality has been established'.

High levels of oxidising agents - a type of chemical compound - in the follicular fluids surrounding the egg indicate if a woman has low quality oocytes. These can 'stress' and damage the oocyte. The team took one of these agents known as8-OHdG and measured its levels in follicular fluid samples. Levels of melatonin, which is known to have anti-oxidising effects, were also measured.

The team found that, as melatonin concentration in the follicular fluids naturally increased, the level of 8-OHdG decreased, leading them to believe melatonin was linked to the reduction of the oxidising agents. They confirmed this finding in mice, and discovered that adding melatonin seemed to reduce the damage to the egg caused by the agents.

Next, the group set up a trial with women coming for IVF treatment at the Yamaguchi University Graduate School of Medicine to see if these findings could have real-world effects on IVF. Women who had failed to become pregnant because of poor oocyte quality after one cycle of IVF were split into two groups - 56 women were given three milligrams of melatonin before the next IVF cycle, and 59 just received a standard IVF cycle without melatonin.

The team found that melatonin treatment significantly increased melatonin concentrations in the women's follicles and significantly decreased concentrations of the damaging 8-OhdG. Their results showed 50 per cent of the eggs from women who taken melatonin could be successfully fertilised, as opposed to 22.8 per cent in the control group. When the eggs were transplanted into the womb, 19 per cent (11 out of the total 56) of the women became pregnant, as opposed to 10.2 per cent (six out of total 59) in the control group. The work was published in the Journal of Pineal Research.

'This work needs to be confirmed, but we believe that melatonin treatment is likely to become a significant option for improving oocyte quality in women who cannot become pregnant because of poor oocyte quality', said Professor Tamura. 'Our next step is to analyze exactly how reactive oxygen species harm the oocyte, and how melatonin reduces oxidative stress in the oocyte'.

Professor Russel Reiter from the UT Health Science Center, San Antonio, Texas, who co-authored the paper, agreed. 'it is important that this work be independently confirmed on larger numbers of subjects'. But he added that the findings 'make perfect sense', as melatonin has been shown to protect many different cells and tissues from oxidative damage - the same type of damage known to occur to oocytes.

Pair guilty over illegal internet sperm company

Two men have been found guilty of illegally making sperm available over the internet.

Ricky Gage, 49, and Nigel Woodforth, 43, from Reading, operated Fertility 1st which made sperm available from anonymous donors without a licence.

The men had denied three counts of procuring sperm illegally under the Human Fertilisation and Embryology Act.

They were granted conditional bail but the judge warned them she was considering a prison sentence and fine.

The men will be sentenced at Southwark Crown Court on 24 September.

At the start of the trial the pair had argued that their company was simply an information site which acted as an introduction database, meaning they were not procuring or making sperm available.

But jurors heard a list showed 792 deliveries had been made by the company, which helped make the men an estimated income of £250,000 between October 2007 and November 2008.

It is the first time anyone has been prosecuted under the Human Fertilisation and Embryology Act 1990.

Long waiting lists, shortages of sperm and restrictions on who can obtain treatment may be some of the reasons why women have opted to use unlicensed fertility clinics, also the impression that it might be easier to seek treatment online.

But anyone using fresh sperm from an unlicensed clinic is taking a potentially serious risk because they cannot be sure of the quality of the donation or whether it is free of sexually transmitted diseases.

At licensed clinics donors are given a blood test on the day of donation, repeated six months later because HIV can take this long to show up.

Sperm is frozen during this quarantine period and is only made available once the screening has been done and it has been checked for quality.

The men were reported to the Human Fertilisation and Embryology Authority (HFEA) after one of their clients complained about their unprofessional standards.

Melissa Bhalla-Pentley was hoping to have a baby with her partner when she ordered the sperm through the Fertility 1st website set up by Gage and Woodforth.

Ms Bhalla-Pentley paid the men £380 in total and another £150 for courier delivery and the sperm donor's expenses.

However, she contacted the company when a copy of the donor's medical tests was sent to her with his name visible.

Under the HFEA's Act, the firm should have had a licence.

The law was brought in to ensure that both donors and women wanting to conceive had access to information and counselling, and to help protect against the risks of diseases including HIV.

The website run by Gage and Woodforth, which promised women a "life-changing opportunity towards motherhood", boasted of having more than 300 donors nationwide and a 37% success rate.

Clients were allowed to choose the ethnicity, height, hair colour, education and even hobbies of the sperm donor.

Following the verdict, Professor Lisa Jardine, chair of the HFEA, said: "Getting access to fertility services can be difficult and there can be some very strong emotional pressures when trying to start a family.

"But unlicensed internet sites like these are exploiting women.

"This is a victory for those women."

‘Fast frozen’ sperm increases IVF hope

Their sperm could benefit from a rapid-freezing process which preserves up to 80 per cent of sperm activity for IVF treatment, compared with up to 40 per cent using existing slow-freezing techniques.
The new vitrification method – which sees sperm plunged into liquid nitrogen – sees seminal plasma removed, meaning HIV and other viruses can be taken out, say experts from Chile and Germany.
Vitrification is already used to quick-freeze eggs and embryos successfully for IVF treatment.
The findings were ‘very exciting’, said Ian Cooke, professor emeritus at Sheffield University.
‘In addition, the prospect of use with HIV positive patients has great potential, although we’d want to confirm the absence of residual HIV in sperm samples.’

Team Uncovers Possible Risk Gene For Schizophrenia

An international team of researchers has identified a risk gene for schizophrenia, including a potentially causative mutation, using genome-wide association data-mining techniques and independent replications.

The results of the research, led by Xiangning Chen, Ph.D., associate professor of psychiatry and human and molecular genetics in Virginia Commonwealth University's School of Medicine and the Virginia Institute for Psychiatric and Behavioral Genetics, and Kenneth S. Kendler, M.D., professor of psychiatry and human and molecular genetics in VCU's School of Medicine and the Virginia Institute for Psychiatric and Behavioral Genetics, are reported in the September issue of the journal Molecular Psychiatry.

In recent years, scientists have used genome-wide association studies to identify possible candidate genes responsible for diseases that include type 2 diabetes, lung cancer, Parkinson's disease, rheumatoid arthritis and systemic lupus erythematosus. However, the same approach was not as successful for the study of schizophrenia.

According to Chen, one of the many possible reasons is that many genes are involved in schizophrenia and the effect of each individual gene is relatively small. For this reason, he said, results obtained from individual samples tend to fluctuate.

Chen said that to obtain consistent results researchers need to consider the results from many independent samples. The team used that approach in this study by first screening two genome-wide association datasets with statistic, genomic, informatic and genetic data and then ranking the top candidate. Chen said that the selected candidates were verified by more than 20 independent samples.

According to Chen, the work is one of the largest genetic studies of schizophrenia and included more than 33,000 participants that identify cardiomyopathy associated 5, or CMYA5, as a risk gene for schizophrenia. Its function is unknown at this time.

"While its implication for patient care is not clear at this moment, it is fair to say that our paper provides a new target for future research and a practical method to identify other potential risk genes. The findings are one of the most consistent findings in recent literature," said Chen.

The study was supported in part by the Stanley Medical Research Institute, the National Alliance for Research on Schizophrenia and Depression and the National Institute of Mental Health. Part of the genotyping was funded by the Genetic Association Information Network organization and Eli Lilly and Company.

Fertility scientists find way of 'restarting' ovaries

Women who go through early menopause and are unable to have children have been given fresh hope after scientists found a way of "restarting" ovaries.

The study could pave the way for women to one day conceive even though they have gone through the menopause at an early age.

Premature ovarian failure affects 1% of women under 40, and one in 1,000 (0.1%) under 30. The normal age for menopause is debatable but experts consider early menopause as before 45.

Possible reasons include chromosome abnormalities, such as Down's syndrome; enzyme deficiencies, which can damage eggs and prevent the production of the hormone oestrogen; and autoimmune diseases, where the body effectively turns on itself.

Scientists at the World Congress of Fertility and Sterility in Munich said the latest work on rats could offer hope for the future.

A team from Cairo University used stem cells to restore ovarian function in a group of 60 female rats. The rats were divided into four groups, with the first not given any treatment and acting as a control.

Rats in all the other groups were treated with a chemical to stop their ovaries working, with those in the second group then given injections containing stem cells.

Group three was injected with a saline solution to act as a control, and the group four rats had ovarian failure but received no treatment, also enabling them to act as a control.

The Cairo team tested the hormone levels of all the rats to see if they returned to normal following treatment.

Within two weeks, the rats in group two, which had been treated with stem cells, had regained full ovarian function.

After eight weeks, their hormone levels were the same as rats who did not have ovarian failure.

Male stem cells were used so researchers could confirm their presence in the ovaries of the treated group by searching for the Y chromosome.

Professor Osama Azmy, who led the study, said: "The treated ovaries returned to producing eggs and hormones, and we could detect the presence of the stem cells within the newly functioning ovaries.

"What we have done is proven that we can restore apparently fully functioning ovaries in rats. The next step is to look how these rats might reproduce, and to characterise the chromosomes of offspring following treatment.

"We have not yet reached the stage of producing offspring, and so we will need to understand if the baby rats will be genetically related to the mother, or to the donor of the stem cells.

"This is proof of concept and there is still a long way to go before we can apply this to women.

"Nevertheless, this work holds out the possibility that women with premature ovarian failure might be able to bear a baby of their own."

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