IVF: Did India miss a medicine Nobel?

Robert Edwards of Britain won the 2010 Nobel Prize in medicine for the development of in-vitro fertilization, a ground-breaking process that has helped many couples over the last two decades have children. While Edwards was working towards his dream - creating the world’s first in vitro fertilized or test tube baby - a physician in India was working on the same subject but the odds were piled heavily against him.
Bengali doctor Subhash Mukhopadhyay was two months late in announcing the birth of Durga or Kanupriya Agarwal - India’s first test tube baby created by him on October 3, 1978. While Edwards, professor emeritus at University of Cambridge, was lauded for his efforts, Mukhopadhyay was fighting a hostile state government that rubbished his findings. Ridiculed and ostracised, Mukhopadhyay was also not allowed to publicise his work in the international arena.
He was invited by the Kyoto University in 1979 to present his findings during a seminar in Japan but denied a passport by the Indian government. The depressed physician committed suicide in 1981. Here are some facts about the man considered the father of India’s IVF research, who remained unsung during his lifetime but inspired many physicians after his death to bring his life and work to the public domain.

So who was Dr. Subhash Mukhopadhyay?

Born on January 16, 1931 in Bihar, Mukhopadhyay studied medicine at the prestigious National Medical College in Kolkata. He received his doctorate from Calcutta University in reproductive physiology in 1958. He obtained a second doctorate from Edinburgh in reproductive endocrinology. He was noted for his work on ovarian stimulation - he used the protocol successfully on Durga’s mother even before any scientist in the world had resorted to the method. He was also successful in his methodology of cryopreservation of a eight cell embryo.
However, the news of the birth of Durga, the world’s second test tube baby, was met with disdain and skepticism by his peers.
The only evidence of his work was a report he had prepared for the West Bengal government facing an enquiry. He was questioned by a government committee several times and his work was discredited as “bogus”. What went against Dr. Mukhopadhyay then was the fact that no physiological or biochemical technique could distinguish between in vivo and in vitro fertilised babies. He was transferred to the ophthalmology department of Calcutta Medical College in 1981 and prevented from completing his work on IVF.
Mukhopadhyay had no documented evidence and the credit for bringing his work to the public domain is largely given to Dr. T C Anand Kumar who was recognized officially as the first to deliver a test tube baby in 1986. Kumar went through Mukhopadhyay’s notes and credited the doctor posthumously for his pioneering work.Medical scientists opine that had Mukhopadhyay been allowed to publish his work and given adequate government funds and infrastructure to complete his research, he would have been recognized as the pioneer in in vitro fertilization process, hopefully paving the way for a Nobel prize in medicine such as his precursor Edwards.
The Indian Council of Medical Research in 2005 acknowledged Mukhopadhyay as the creator of India’s first test tube baby. Filmmaker Tapan Sinha, who was deeply impressed by Mukhopadhyay’s work, based his award-winning film ‘Ek Doctor Ki Maut’ on him.

In-vitro fertilization (IVF) for the poor

British scientist Robert Edwards won a Nobel Prize for helping develop in-vitro fertilization. Now, scientists are bringing the technology to the developing world.In-vitro fertilization is a fairly common method of aiding conception. But it's expensive, and only a small percentage of people around the world can afford it. Dr. Ian Cooke, one of the founders of the Low Cost IVF Foundation, wants to change that. His organization is trying to lower the cost of IVF treatment, to make it accessible to the poorest areas in the world.

"There's a huge need in many, many parts of the world," Cooke told us, including in parts of the world concerned about overpopulation. Infertility "leads to social isolation, physical and emotional abuse and ostracism and indeed suicide," Cooke says. The problem is also more widespread in the developing world. And in many parts of the world, according to Cooke, "particularly in rural areas such as Bangladesh, this leads to increasing poverty because husbands will not let wives who are not fertile work. And so they're even further diminished."

In the United Kingdom, IVF costs about $5,000, and it can be much higher in the United States. "We think that the technical side of it without the staff cost could be done for as little as $200," Cooke told The World. The organization would use cheap drugs and simpler incubation programs. "And because you have the intention of only transferring a single embryo instead of larger numbers," Cooke says, "laboratory costs are kept lower."

The organization has already started work in Tanzania and Sudan. "There end up being major staffing issues that need to be resolved so we don't have a long-term functioning clinic," Cooke says. At the same, he points out, "we've only been working on this in the last twelve months or so." So there may be opportunities in the future.

Alternative Commonwealth Games

Vatican continues to attack Nobel over IVF award

The Vatican kept up its attack on the Nobel committee yesterday for giving the medicine prize to in-vitro fertilisation pioneer Robert Edwards, saying he had led to a culture where embryos are seen as commodities.

For the second day, it kept up its public criticism of the choice of Edwards, whose success in fertilising a human egg outside of the womb led to "test tube babies" and innovations such as embryonic stem cell research and surrogate motherhood.

The Vatican ratcheted up its negative opinion as several leading Italian newspapers criticised it for its attack on Edwards.

A statement by the Vatican-based International Federation of Catholic Medical Associations (FIAMC), said it was "dismayed" at the choice.

"Although IVF has brought happiness to the many couples who have conceived through this process, it has done so at enormous cost," the federation said in a statement issued on Vatican letter head.

"Many millions of embryos have been created and discarded during the IVF process," it said, adding that embryos were being used as "animals destined for destruction".

"This use has led to a culture where they are regarded as commodities, rather than the precious human individuals which they are".

A Vatican official’s initial negative reaction on Monday to the medicine prize being given to Edwards as "completely misplaced" was splashed on front pages of yesterday’s Italian newspapers, with some editorials harshly critical of its stance.

"The devil is not behind Robert Edwards, as the Church seems to suspect, but a passion for science and an attempt to satisfy the desire that women have for maternity," La Repubblica said in an editorial.

"Edwards helped – not damaged – millions of people," said an editorial in the Corriere della Sera while the leftist L’Unita sarcastically ran a headline reading "The Heretic" under a picture of Edwards with two infants born through IVF.

Yesterday’s statement by the Catholic medical federation said that "as Catholic doctors we recognise the pain that infertility brings to a couple" but that research had to be carried "within an ethical framework".

New hope for IVF couples

A new drug is offering hope to couples undergoing IVF.

The drug means women will no longer face a daily hormone injection, instead it will be a single dose each week.

IVF specialists say the drug will make the process more comfortable for women who now have to give themselves a daily injection for between seven and 10 days in a row to create eggs for collection.

The medical director of Melbourne IVF, Lyndon Hale, said an international study recently showed the drug Elonva delivered the same number of pregnancies and outcomes as the drug currently used. But he said this option was only suitable for about 80 per cent of women and not those with particular conditions, such as polycystic ovary syndrome.

The new treatment becomes available next month.

Elonva is the first sustained follicle stimulant. Due to its ability to initiate and sustain multiple follicular growth for an entire week, a single subcutaneous injection of the recommended dose of Elonva may replace the first seven injections of any conventional daily recombinant follicle stimulating hormone (rFSH) preparation in a COS treatment cycle.

"The European approval of Elonva is a positive step towards reducing the burden of injections for women experiencing difficulty conceiving," said Mirjam Mol-Arts, senior vice president, Merck Research Laboratories. "Merck is proud of the company's women's health portfolio and is committed to providing effective patient-focused fertility treatments."

The Phase III development program for Elonva included the Engage trial, the largest double-blind fertility agent trial in IVF performed to date. In the Engage trial, the ongoing pregnancy rate, the primary endpoint, obtained in the Elonva treatment arm (38.9 percent per started cycle) was similar to that achieved in patients receiving a daily dose of rFSH (38.1 percent per started cycle).

Engage was a non-inferiority trial designed to compare Elonva 150 mcg to 200 IU rFSH. A total of 1,506 patients (with a body weight greater than 60 kg) at 34 in-vitro fertilization (IVF) clinics in North America and Europe were randomized to start stimulation with either Elonva 150 mcg or a daily dose of 200 IU rFSH for seven days. Patients also received rFSH (maximum 200 IU/day) from stimulation day eight onward, when required. Starting on stimulation day five, all patients received 0.25mg gonadotropin-releasing hormone (GnRH) antagonist until triggering of final oocyte maturation by human chorionic gonadotropin (hCG). The primary endpoint was the ongoing pregnancy rate assessed at ten weeks or more after embryo transfer. In the Elonva treatment arm the ongoing pregnancy rate (38.9 percent per started cycle) was similar to that achieved in patients receiving a daily dose of rFSH (38.1 percent per started cycle). The number of oocytes retrieved per attempt, the co-primary endpoint, was 13.7 (± 8.2) for the Elonva group and 12.5 (± 6.7) for the rFSH group.

Elonva is approved for COS in combination with a GnRH antagonist for the development of multiple follicles in women participating in an ART program. Elonva is designed as a sustained follicle stimulant with the same pharmacodynamic profile as rFSH, but with a markedly prolonged duration of FSH activity. Due to its ability to initiate and sustain multiple follicular growth for an entire week, a single subcutaneous injection of the recommended dose of ELONVA may replace the first seven injections of any daily rFSH preparation in a COS treatment cycle. is approved for COS in combination with a GnRH antagonist for the development of multiple follicles in women participating in an ART program.

New Genetic Model Accurately Predicts Who's Likely to Live to 100

In 1997, Jeanne Louise Calment of France died at the age of 122, making her the oldest documented human to have ever lived. But is there something genetically unique about centenarians that enables them to age gracefully and relatively disease-free?

According to the results of a long-term study at Boston University School of Medicine, the answer is yes. People who live to be 100 years or older are rare, and only about 1 in 600,000 people in industrialized nations live that long.

As part of the New England Centenarian Study, a team of aging research specialists led by Paola Sebastiani and Tom Perls looked at 300,000 genetic markers in 800 centenarians and compared their profiles with those of random individuals. They then developed a genetic model that can compute an individual's predisposition to living a long life and found that centenarians shared a common genetic signature that could predict extreme longevity — with 77 percent accuracy. The findings represent a breakthrough in understanding how genes influence human life spans.

"Out of 100 centenarians we could correctly predict the outcome of 77 percent, while we incorrectly predicted the outcome of 23 percent," said Sebastiani. The researchers believe the 23 percent error rate can be attributed to genetic variance not yet known and included in the analysis, as well as other factors that influence longevity. "Making healthy lifestyle choices such as eating a well balanced diet or exercising regularly and avoiding exposure to tobacco plays an undisputed role in determining how each of us will age," said Andrew Sugden, international managing editor of Science.

Centenarians are a model of aging well, and 90 percent of people who reach this milestone are disability free at the average age of 93, Perls said. But he advised caution about the possibility of "testing" people to determine longevity, saying that much more study needs to be done regarding how health care providers and the research community guide individuals about what to do with the information they get. "I think a test for exceptional longevity is not quite ready for prime time," he said. "We're quite a ways from understanding what pathways governed by these genes are involved and how the integration of these genes, not just with themselves but with environmental factors, are all playing a role in this longevity puzzle."

According to Perls, future analysis of the results may shed light on how specific genes protect centenarians from common age-related diseases, such as dementia, heart disease, and cancer. "I look at the complexity of this puzzle and feel very strongly that this will not lead to treatments that will get a lot of people to become centenarians, but it could make a dent in the onset of age-related diseases like Alzheimer's," he said.

No Cuteness Can Make Needles Any Less Terrifying

Syrinx is a syringe substitute for kids. The designers think that, by making them look like little animals with needles coming out of their noses, they are making syringes kid-friendly. Because, you know, blood sucking animals are so cute:







When they are done, the doctor can give the detachable animal to the kid, so they can keep reliving the moment when the-bad-man-in-the-white-lab-coat took a glass of blood out of their bodies in the comfort of their own bedroom.