The Ramblings of a Middle Aged Fertility Physician whose life revolves around Eggs, Sperms & Embryos....
Monday, November 22, 2010
IVF mix-up: Couple decides to keep the baby
The couple in the centre of the in-vitro fertilisation (IVF) mix-up case has decided to keep the baby. Their lawyer Mr S. Palaniappan, speaking on their behalf, said that the mother has already bonded with the infant. The baby has a markedly different complexion from that of his mother, a Singaporean Chinese woman, and her husband, a Caucasian Singapore PR. The baby's blood type is B, while those of the couple is A and O. A DNA test has confirmed that the child has the mother's DNA makeup, but not the father's.
Dr Cheng Li Chang, the medical director of Thomson Fertility Centre where the couple had sought IVF treatment, said in a statement that he and his colleagues "fully empathise with the couple, and are very sorry and distressed over what has happened". It was reported that they have met the couple to explain the situation, and will keep them updated and provide them with all possible support. Dr Cheng said the centre's operating procedures "meet all regulatory requirements, and are of the highest international standards".
The Ministry of Health, however, has said that "certain practices" could be improved. While it did not specify these practices, it will be issuing additional directives to correct them in time to come. It is understood that Thomson Fertility Centre is working closely with MOH in investigating the mix-up, and will work with the ministry to implement any action it may recommend.
Meanwhile, fertility doctors have expressed shock over the case, which is the first of its kind in Singapore.
The mix-up does not seem to have shaken the confidence of other couples undergoing IVF treatment here. Patients interviewed said that they would continue with treatment, and that they would keep the child even if a mix-up happened to them as well.
Sunday, November 21, 2010
IVF cerebral palsy risks probed
Fertility problems in parents cannot explain why babies born through IVF treatment face a higher risk of cerebral palsy, say Danish scientists.
The University of Aarhus found babies of couples who struggled to conceive naturally had similar risks compared to those who conceived quickly.
But they found that the risk doubled in babies born with the help of IVF.
Other potential causes, such as the treatment itself, should be investigated, the scientists say.
UK experts said despite the low risk the issue needed to be taken seriously.
The safety of IVF and similar fertility treatments has been closely scrutinised since the first "test-tube baby" in the 1970s.
As the number of IVF babies rises, initial worries about developmental problems have faded, but there remain concerns over higher rates of cerebral palsy.
There are several possible reasons, including the increased risk of complications in multiple pregnancies, which until recently have been much more frequent in IVF pregnancies.
Doctors had also suspected that the underlying reasons for infertility might play a part, but the latest research casts doubt on that.
The team looked at a national database of medical information from thousands of pregnancies and births, the journal Human Reproduction reported.
They compared cerebral palsy rates in babies grouped depending on how long it took for their mothers to become pregnant after starting to try to conceive.
This length of time is used as a way of assessing fertility - taking more than a year to conceive might indicate some kind of problem, albeit one not severe enough to prevent pregnancy altogether.
When the "quick conceivers" were compared with those taking over a year, there was no significant difference in the rate of cerebral palsy.
However, a group of babies born after IVF or ICSI, in which sperm is directly injected into the egg, had approximately double the risk of cerebral palsy compared with those conceiving quickly.
The overall risk was not high - approximately one in 176 babies born - although this represents a significant number when set against the 12,000 babies born after IVF techniques each year in the UK.
Dr Jin Liang Zhu, who led the study, said: "Our research enabled us to examine whether untreated subfertility, measured by time to pregnancy, might be the reason for the higher risk of cerebral palsy after IVF/ICSI.
"Our results showed this was not the case because, even for couples who took a year or longer to conceive, there was no statistically significant increased risk."
He said that parents should remember that the increased risk remained very low.
The other suspect in the raised cerebral palsy risk is twin pregnancies, which carry a higher rate of problems in both mother and baby, and frequently mean that babies are delivered early.
A recent study in Sweden suggested that the trend in recent years of putting just one embryo rather than two back into a woman as part of IVF was cutting the number of children born with cerebral palsy.
Professor Karl Nygren, one of the authors of that study, said that the extra risk "may have disappeared" in countries which transferred only a single embryo.
However, Professor Richard Fleming, from the Glasgow Centre for Reproductive Medicine, said it remained a problem.
"It's pretty clear that the issue still has substance. Even though the risks are very low for individual babies, they are high enough to deserve further research.
"Single embryo transfer will improve matters, but not solve the problem entirely."
Saturday, November 20, 2010
Fastest In The World
Fastest Car in the World - Shelby Super Cars Ultimate Aero
412.28 KMPH
Fastest Animal in the World - Cheetah
113 KMPH
Fastest Bird in the World - Spine tailed swift
171 KMPH
Fastest Fish in the world - Sailfish
110 KMPH
Fastest Man in the world - Usain Bolt
40-43 KMPH
Fastest Plane in the world - X-43 Aircraft
12144 KMPH
Fastest Train in the World - Shanghai Maglev Train
581 KMPH
Fastest Bike in the world - TomaHawk (Not a Legal Bike)
675 KMPH
412.28 KMPH
Fastest Animal in the World - Cheetah
113 KMPH
Fastest Bird in the World - Spine tailed swift
171 KMPH
Fastest Fish in the world - Sailfish
110 KMPH
Fastest Man in the world - Usain Bolt
40-43 KMPH
Fastest Plane in the world - X-43 Aircraft
12144 KMPH
Fastest Train in the World - Shanghai Maglev Train
581 KMPH
Fastest Bike in the world - TomaHawk (Not a Legal Bike)
675 KMPH
Friday, November 19, 2010
Thursday, November 18, 2010
Overcoming the IVF Baby Blues: Hormones and Stress Are Major Contributors to Depression, Research Finds
Between 20 and 30 percent of women who undergo in vitro fertilization (IVF) procedures suffer from significant symptoms of depression. Many practitioners believe that the hormone therapy involved in IVF procedures is primarily responsible for this. But new research from Tel Aviv University shows that, while this is true, other factors are even more influential.
According to Dr. Miki Bloch of Tel Aviv University's Sackler Faculty of Medicine and the Sourasky Medical Center in Tel Aviv, stress, pre-existing depression, and anxiety are more likely than hormone therapy to impact a woman's depression levels when undergoing IVF. Combined, these factors may also affect IVF success rates -- so diagnosis and treatment of this depression is very important.
Recently reported in the journal Fertility and Sterility, Dr. Bloch's research clarifies the involvement of different hormonal states as triggers for depression during IVF, both for long- and short-term protocols.
The long and short stories
In the long-term IVF protocol, explains Dr. Bloch, women receive injections which block ovulation, resulting in a sharp decline in estrogen and progesterone levels. This state continues for a two-week period before the patient is injected with hormones to stimulate ovulation, at which point the eggs are harvested and fertilized before being replanted into the womb. The short-term IVF protocol, on the other hand, does not include the initial two-week period of induction of a low hormonal state.
Some gynaecologists believe that depression is more likely when a woman undergoes long-term IVF therapy because of those first two weeks of hormonal repression. But Dr. Bloch's research has demonstrated that the difference between the two different procedures is negligible -- depression and anxiety rates for women who undergo the long protocol and those who undergo the short are exactly the same.
Dr. Bloch and his fellow researchers conducted a random assignment study, in which 108 women who came to the Sourasky Medical Center for IVF were randomly assigned to either the long- or short-term protocol. They were given questionnaires and interviews at the start of the therapy and at four other points during the IVF treatment.
The results, says Dr. Bloch, show consistently increasing depression rates among patients in both groups, irrespective of which protocol they underwent. The first two weeks of hormonal repression, he explains, thus have no impact on whether a woman experiences depression during IVF. "Once the patient begins ovulating, her estrogen rises to high levels. Then, after the ovum is replanted in her uterus, there is a precipitous drop in these hormonal levels," he explains. It's the severity of the estrogen drop, a feature of both protocols, that was found to affect the patient's emotional state.
Preventing stress in susceptible women
Whatever the specific effect of hormones, during their study Dr. Bloch and his fellow researchers discovered that the stress and anxiety experienced during the treatment has a significant impact on patient depression rates. When compared to a "normal" population, women undergoing IVF experience very high levels of anxiety and depression even before the treatment begins. As the protocol advances, explains Dr. Bloch, women experience increased anxiety about the success of the implantation.
Women who have a previous history of anxiety or depression disorders before the IVF treatment are even more susceptible, he says. This is likely due to the fact that these women are more emotionally vulnerable to the toll of the IVF process rather then increased reactivity to changing hormonal levels, Dr. Bloch says.
Choosing the right protocol
When it comes to depression rates, the type of protocol a patient undergoes, whether short-term or long-term, has no impact, Dr. Bloch concluded. The combination of the stress surrounding the treatment, a personal history of psychiatric disorders, and a sharp decline in estrogen levels are the main contributing factors towards depression during IVF therapy. While doctors should look at their patient's individual needs when deciding on an IVF protocol, the current report suggests the type of protocol per se is not an important factor in the induction of depression.
Wednesday, November 17, 2010
Little Sipho
Young Sipho goes into the kitchen where his mother is baking.
He puts his hands in the flour and covers his head with it.
He says: "Look mamma, I am a white boy!"
His mother slaps him hard on the face and says: "Sipho, go show your dad what you've done!!"
So he does, and his dad slaps him too.
His granny happens to be right next to his dad and she slaps him vehemently in disgust.
Then Sipho's mom says: "Did you learn something from all this?
The poor little Sipho shakes his head, crying and says:
"I did. I've only been a white boy for 5 minutes and I'm already scared of you blacks!"
Tuesday, November 16, 2010
Take Care While Driving!
The Honda rider was traveling at such a high speed, his reaction time was not sufficient enough to avoid this accident. Swedish Police estimate a speed of ~250 KM/h (155mph) before the bike hit the slow moving car side-on at an intersection. At that speed, they predicted that the rider's reaction time (once the vehicle came into view) wasn't sufficient enough for him to even apply the brakes.
The car had two passengers and the bike rider was found INSIDE the car with them. The Volkswagen actually flipped over from the force of impact and landed 10 feet from where the collision took place. All three involved (two in car and rider) were killed instantly. This graphic demonstration was placed at the Stockholm Motorcycle Fair by the Swedish Police and Road Safety Department. The sign above the display also noted that the rider had only recently obtained his license.
At 250 KM (155 mph) the rider is traveling at 227 feet per second. With normal reaction time to SEE-DECIDE-REACT of 1.6 seconds the above rider would have traveled over 363 feet while making a decision on what actions to take. In this incident the Swedish police indicate that no actions were taken.
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