varoblog

(sz) Obese women who lose even a small amount of weight may boost their chances of getting pregnant, a study suggests.
Researchers carried out a three-month study of 40 obese women who were not ovulating.
They found a 5% loss in body weight was linked with a 19% increase in blood flow to the womb.
Improved circulation can help trigger the egg release from the ovaries and may help an embryo implant in the womb.
However, the researchers from the University of Sheffield said more work was needed to determine how the finding translates to actual pregnancy rates.
IVF on the NHS is restricted to those with a body mass index (BMI) of 30 or under and the British Fertility Society recommends a cut off of 35 because of the risks to both mother and baby.
Women in the study, most of whom had polycystic ovary syndrome (PCOS), were around 29 years old on average and had a body mass index of almost 40, delegates at the European Society for Human Reproduction and Embryology (ESHRE) heard.
They were prescribed weight loss drugs orlistat or metformin and managed to lose 5% of their body weight in 12 weeks.
Previous work by the team had shown small amounts of weight loss were related to a 30-40% chance of ovulation returning in these patients.
But this is the first study looking at how blood flow is involved.
The researchers said that the increased blood flow acted as a “switch” to kick start the ovary. more…

From: »The BBC«

(cz) The in vitro fertilisation (IVF) treatment Menopur (highly-purified human menopausal gonatropin or HP-hMG, Ferring) offers considerable cost-savings over recombinant follicle stimulating hormone (rFSH), according to health economics data presented at this week’s meeting of the European Society of Human reproduction and Embryology (ESHRE), held in Amsterdam (29th June-July 1st 2009).
The results could translate into more live births for a given treatment budget and help widen access to IVF, according to speakers at a press conference held at ESHRE.
HP-hMG and rFSH are two gonadotropin drugs commonly used to enhance egg production in patients receiving IVF treatment. HP-hMG, contains both FSH and hCG-driven (human chorionic gonadotropin) LH-activity (luteinizing hormone). In contrast, rFSH is a recombinant product and contains only rFSH.
“Until recently, discussions regarding funding for infertility treatment services have been hindered by a relative paucity of economic studies of the specific treatments,” said investigator Dr Jaro Wex from PharmArchitecture, UK.
Dr Wex’s analysis determined the cost-effectiveness of different gonadotropins in IVF cycles involving frozen embryo transfers using a simulation model. The economic evaluation compared HP-hMG and rFSH using individual patient data (n=986) pooled from two recent large, randomised trials (EISG and MERiT).
The model used both live-birth data for the compared products and published UK costs of IVF related medical resources. The main objectives were to determine for each patient starting treatment consisting of one fresh and up to two cryo or fresh cycles: The number of live-births; the average cost of treatment; the average cost per live-birth; the incremental cost-effectiveness; and the impact of inclusion of maternal and neonatal costs arising from successful pregnancies. more…

From: »Pharmacy Europe«

(cz) Simple test could help women decide whether or not it is worth undertaking expensive IVF treatment, say scientists
The 30,000 women a year who undergo IVF may in the next few years be able to use a new blood test to tell them how likely they are to get pregnant, a conference heard today (July, 1st).
Scientists disclosed that they have discovered genetic markers in the blood which provide a fertility “fingerprint”. Although the research is still at an early stage, it could lead to women who are having fertility treatment being able to take a simple test that would help them decide whether or not it was worth undertaking treatment, which is expensive and both physically and emotionally demanding.
Researchers told the annual conference of the European Society of Human Reproduction and Embryology (ESHRE) that the genetic markers showed activity patterns in more than 200 genes which were different in women whose IVF treatment had succeeded or failed.
Study leader Dr Cathy Allen, from the Rotunda hospital in Dublin, said: “There does seem to be a particular signature that goes with early human pregnancy. We’re talking about a unique profile that has the potential to be used in future to predict IVF success or failure.
“The work is still in its infancy and has to be developed and validated, but we hope it will improve the blunt prognostic procedures we have now.”
Allen said the test could help women who have failed to conceive despite a history of IVF, who faced “very difficult decisions” about whether to continue with their treatment.
She and her colleagues analysed blood samples taken from the arms of women starting out on IVF. Five samples were from women who went on to become pregnant; three from those who did not conceive; and three others from sub-fertile women who achieved conception naturally. more…

From: »The Guardian«

(cz) French doctors on Monday unveiled a new technique in ovarian transplant that had helped a young woman who had been menopausal for two years to give birth to a healthy baby girl.
Using a two-step process, they restored fertility to the woman after she had undergone chemotherapy treatment for sickle-cell anaemia, a disease in which red blood cells become dangerously misshaped.
The unnamed 23-year-old patient gave birth in Besancon, eastern France, on June 22.
Ovarian transplants, pioneered in 2004, entail removing an ovary from a woman before she undergoes cancer therapy. The organ is frozen and then thawed and returned to the patient after her treatment.
But one of the biggest challenges in this surgery is encouraging the transplanted tissue to grow blood vessels.
If the blood supply is insufficient, the ovary does not respond to hormonal cues that prompt it to ovulate.
The new technique, described by Pascal Piver of the Limoges University Hospital in central-western France, entails a two-phase procedure in which tiny pieces of the stored tissue are stitched in place three days before the real transplant.
“The first graft encourages the growth of blood vessels and paves the way for the ovary to become fully functioning in a shorter time scale,” the researchers said.
After the transplant, the patient started ovulating in four months and became pregnant after another two months, without the need for in-vitro fertilisation (IVF). more…

From: »France 24«

(cz) The efficacy of preimplantation genetic screening (PGS) has been one of the most hotly disputed subjects in assisted reproduction over the past few years. None of the trials carried out so far has shown conclusively whether it works or not. Now the European Society of Human Reproduction and Embryology (ESHRE) Task Force on PGS has decided to try to find out if a novel method of doing PGS using polar body biopsy and chromosome array analysis offers a possible solution.
Professor Joep Geraedts, ESHRE chairman, told the 25th annual conference of the society today (Sunday, June 28) that the Task Force would carry out a pilot study of PGS in one of each pair of 23 chromosomes in polar bodies, tiny cells that are a by-product of egg development, in collaboration with BlueGnome, a DNA technology company based in Cambridge, UK. Once a pilot study has shown that the technique is feasible, the researchers intend to carry out an international randomised trial.
The first phase will begin in September 2009 in two centres: the University of Bonn, Germany (Dr. Markus Montag and Professor Hans van der Ven), and SISMER, Bologna, Italy (Dr. Luca Gianaroli and Dr. Cristina Magli). “Because this is a new technology,” said Dr. Gianaroli, “we need to carry out a pilot study in order to be sure that the analysis can be completed within a time period that allows for fresh transfer, as well as to ensure the reliable identification of the chromosomal status of an oocyte in at least 90% of polar body biopsy attempts.”
The two centres chosen for the pilot study have considerable experience in the field of polar body biopsy because legislation in their countries restricts the possibility of undertaking embryo biopsy at a later stage of development. The data from the study will be independently analysed by Dr. Sjoerd Repping, from the Academic Medical Centre in Amsterdam, who carried out a randomised trial of PGS on three-day old embryos published in 2007. The researchers hope to present the data at ESHRE 2010 in Rome and to start the RCT with the involvement of at least six centres in different European countries later the same year. more…

From: »Eureka Alert«

(cz) An electronic ID tag that works even when cryogenically frozen could help prevent some of the mix-ups in IVF clinics that can cause heartbreak for would-be parents.
Last week, a couple from south Wales, UK, made headlines worldwide when they revealed that their last viable embryo had been taken from cryogenic storage at an IVF clinic in Cardiff and mistakenly implanted into another woman. The recipient, on learning of the bungle, terminated her pregnancy.
There were eight similar “class A” IVF mix-ups in 2008 in the UK fertility industry, according to its regulator, the Human Fertilisation and Embryology Authority. Class A means the wrong eggs, sperm or embryo were used in an IVF procedure. Such mix-ups occur when eggs, sperm or embryos are mislabelled due to slips in a lab’s verification procedures.
Part of the solution is a system called IVF Witness, which constantly monitors the identity of the gamete and embryo containers that are brought near to each other on the IVF lab bench - sounding an alarm if eggs about to be introduced to sperm, say, have come from the wrong woman.
The system, made by Research Instruments (RI) of Falmouth, UK, is installed in 16 of the nation’s 90 IVF clinics. It uses 15-millimetre- square, sticky-backed plastic radio-frequency identification (RFID) tags to label any dishes or vials that eggs, sperm or embryos are placed into. The tags house a memory chip and a coiled copper radio antenna. Each tag’s memory is programmed with a unique ID code that is transmitted by its antenna when an ultra-low-power radio pulse interrogates the chip.
As a sample moves through the IVF process, the ID code of every container it is placed in is logged, providing a secure ID audit trail. So, in theory, only sperm and eggs from the right couples can be brought together, and the resulting embryos will be implanted into the right woman. more…

From: »New Scientist«

(cz) Fertility Experts call for better GP access to fertility tests to improve diagnosis and management across the UK.
A greater role for GPs would improve infertility management in the UK, according to a study in the north-east of England.
The study looked at referral patterns and outcomes in 797 infertile couples presenting at 58 practices in Northumberland and Tyne and Wear between January 2005 and June 2006.
A diagnosis was recorded in 64 per cent of couples after 12 months. Diagnosis was made in primary care in 6 per cent of cases, and the rest after referral.
Of the couples that reached diagnosis, 51 per cent were offered IVF or intracytoplasmic sperm injection as first line-therapy, but 36 per cent of these were initially referred to a non-HFEA licensed fertility unit and required onward referral before they could begin treatment.
Lead researcher and GP Dr Scott Wilkes from the University of Sunderland said that increasing the capacity of GPs to diagnose infertility would cut misdirected referrals.
He backed increasing GP access to fallopian tube assessment with open access hysterosalpingography (HSG).
‘GPs have the ability to check for sperm and ovulatory problems, but they do not usually have the ability to test the fallopian tubes. Therefore GPs currently cannot make a diagnosis for these patients.
‘The 36 per cent of patients initially misdirected to a centre where they could not be treated directly reflects the lack of access that GPs have to tubal assessment with HSG. more…

From: »healthcare republic«

(sz) Over a quarter of local health bodies are offering the recommended three free cycles of fertility treatment to couples trying to have a child.
The Department of Health said 27% of English primary care trusts offer three cycles - up from just 5% in 2007.
Health minister Gillian Merron said the health service was making “excellent progress” in improving IVF access.
Patient groups welcomed the increase, but said there was still “a long way to go”.
Infertility Network UK, which campaigns for better access to fertility care, has worked with the Department of Health to improve access to NHS treatment.
Guidance from the National Institute for health and Clinical Exellence already recommends women should have a body mass index (BMI) of no more than 30, and that they should not smoke.
The new guidance says where needed, women should be given advice on diet, and on physical activity to help them achieve a healthy BMI.
They should also be given advice and support on stopping smoking and a referral to a smoking cessation clinic.
It also says local health services should provide IVF for those who do not have children, including couples where one partner is childless. more…

From: »The BBC«

(wz) The National Infertility Awareness Campaign (NIAC) welcomed the document ‘Standardising Access Criteria to NHS Fertility Treatment’1 produced by Infertility Network UK (I N UK) and funded by the Department of Health.
The NICE Guideline issued in 2004 recommended that eligible couples should receive three full cycles of IVF or ICSI NHS treatment, and defines a cycle as one which includes frozen embryo transfers (FET), but more than five years on there remains considerable disparity not only in the number of cycles being funded by the Primary Care Trusts (PCTs) but equally importantly in the access criteria applied by the PCTs in determining who can receive treatment.
Recent measures announced by the Government to encourage implementation of the Guideline have led to an improvement in the provision in some areas but more needs to be done by Primary Care Trusts in England to ensure that patients have equal and timely access to the full range of treatment recommended by NICE, and to tackle the ongoing variations in provision that exist across the country.
Clare Lewis-Jones, Chair of NIAC and Chief Executive of Infertility Network UK said “Although there has been an improvement recently in the provision of treatment by some PCTs, there still remains considerable variation in the criteria used to determine whether or not couples can access treatment. more…

From: »Medical News Today«

(cz) MedITEX IVF erleichtert Organisation, Dokumentation und Qualitätsmanagement in der Reproduktionsmedizin
Die auf medizinische Lösungen spezialisierte IT-Beratungsgesellschaft CRITEX präsentiert ihre neue Software für In-vitro-Fertilisation MedITEX IVF vom 28. Juni bis zum 1. Juli in Amsterdam beim 25. Treffen der ESHRE (”European Society of Human Reproduction and Embryology”). Die Softwarelösung ist das einzige in Deutschland zertifizierte Programm für die Dokumentation und das Qualitätsmanagement von ART und Non-ART-Therapien im Rahmen reproduktionsmedizinischer Behandlungen sowie die Information der Patienten und die Weiterverarbeitung der Daten zu wissenschaftlichen Analysen. MedITEX IVF hat sich bereits in weit über 200.000 Therapien bewährt. Speziell für die ESHRE 2009 wird die Demoversion der Software auch auf USB-Sticks ausgegeben.
MedITEX IVF ist von IT-Spezialisten und medizinischen Experten speziell für Kliniken, Zentren und Praxen entwickelt, die sich schwerpunktmäßig mit dem unerfüllten Kinderwunsch beschäftigen. Die Software lässt sich individuell an die jeweiligen technischen und organisatorischen Anforderungen im Praxisalltag anpassen und ermöglicht über die übersichtliche Benutzeroberfläche die intelligente Organisation von Abläufen sowie die transparente Dokumentation von Informationen und sensiblen Daten. more…

From: »presseecho.de« (press release)