varoblog

(cz) More accurate first trimester dating of pregnancies by ultrasound is set to become available for women courtesy of new Australian research.
Currently in Australia, first trimester fetal growth charts often rely on data reported up to 30 years ago, using outdated technology and containing several important methodological limitations, according to the study authors in the Journal of Medical Imaging and Radiation Oncology (2008) 52, 471-479.
In this study [link] , researchers performed a first trimester ultrasound on almost 400 pregnant women, who were certain of their dates, including 8% who had undergone IVF . They used modern equipment, transvaginal ultrasound where appropriate, a strict protocol on how measurements were to be taken, and a current Australian urban population.
Following measurements of the crown-rump length and biparietal diameter, researchers were able to calculate equations, means and 90% reference intervals for these ultrasound growth markers.
The resulting first trimester ultrasound dating and growth charts were shown to be considerably more accurate than any previous models in predicting gestational age, which will be good news for pregnant women, up to 40% of whom have incorrect dates. more…

From: »Six Minutes«

(sz) Legislation is about to go to the South Australian Parliament which the Government says will make IVF treatment available to more couples. The proposed changes would allow use of a dead partner’s sperm.
The bill is expected to be put to a conscience vote.
SA Health Minister John Hill says currently only infertile couples, or those who are likely pass on a genetic defect, are allowed to use IVF.
“We want to expand it in two ways - the first way is to allow people who are likely to pass on a viral infection and that could be HIV-AIDS or hepatitis C or something like that to their child to have access to the legislation and to also allow women who are potentially facing procedures which could stop them from being able to ovulate,” he said.
The Minister says the legislation would allow for use of a dead partner’s sperm.
“We’ve had IVF legislation in South Australia now for 20 or so years and we’ve been looking at reviewing that legislation for some time,” he said.
Sheree Blake was given written consent from her husband to use his stored sperm before he died of leukaemia in May.
She has been unable to use IVF under current laws. more…

From: »ABC News«

(cz) Big business has swooped on Victoria’s infertility clinics, hoping to cash in as record numbers of childless couples turn to IVF.
New figures from the state’s fertility watchdog show demand for IVF cycles at Victorian clinics swelled by 17 per cent last year.
Predictions patient numbers will grow further have private equity firms jostling for a slice of the lucrative market.
Melbourne IVF, once doctor-owned, yesterday confirmed a buyout by Sydney-based IVF Australia, which is controlled by an equity fund.
And several wheelers and dealers are sniffing around industry giant Monash IVF, which has already sold off a $200 million chunk.
Clinic operators yesterday assured couples they would continue to be treated as patients, not customers, despite the buyouts.
But several industry insiders predicted the cost of treatment could increase to prop up profits for investors.
The industry shake-up comes as the Brumby Government seeks to pass controversial IVF legislation giving Victorians greater access to fertility treatment.
A Herald Sun investigation this week found: The Medicare bill for Victorians using assisted reproduction technology soared to $50 million in 2007-08, up from $10 million a decade ago. more…

From: »The Herald Sun«

(wz) An official notice was posted in Swaleside jail on the Isle of Sheppey in Kent, a Category B Prison with nearly 800 male inmates, half of whom are serving life sentences.
The form is headed “Local Notice to Prisoners, Prisoner Access to IVF Treatment”.
It is dated November 14 and signed by Governor Kieron Taylor. Prisoners are advised to”’submit an application” to Mr Taylor with the final decision to be made by Justice Secretary Jack Straw.
But Prisons Minister David Hanson said he knew nothing about the offer. He insisted the matter was still “under review” and that no decision had been taken.
The notice at Swaleside says that “relevant factors in assessing applications” include “the welfare of any child born as a result. Evidence is needed to show that the couple’s home is satisfactory”.
The IVF offer follows a landmark legal defeat for the Government last year when the European Court of Human Rights ruled that it was unlawful to stop a man jailed for murder in Britain donating sperm for his wife to use for IVF.
The Government ordered a “review” of prison rules following the decision. But it would appear that prison chiefs have jumped the gun and approved IVF procedures.
The move was condemned last night by former Shadow Home Secretary David Davis, who called it an “insult” to ordinary families.
He said: “This is madness and designed to create dysfunctional families. Nobody seems to have taken full account of the interests of a child born without a father at home or the chances of the relationship surviving. more…

From: »The Daily Telegraph«

(wz) After his government long insisted that infertility wasn’t an illness and refused to pay for in-vitro fertilization treatment, Premier Jean Charest did an about-face yesterday [Nov, 17th – ed.].
Charest promised that if his Liberal party were returned to power in the Dec. 8 election, in-vitro fertilization would become a publicly funded medical service under Quebec’s health-insurance plan.
Quebec’s two opposition parties panned the $35 million pledge as a copycat idea, too late in coming.
But for Charest, it’s a plan that would place Quebec at the forefront in Canada of fully funded assisted reproduction, and boost the province’s mini baby boom. The Liberals believe Quebec could see an additional 1,500 babies born each year through funded in-vitro fertilizations.
Under the new regime, the first two in-vitro treatments would be covered. After that, couples still needing treatment would be able to count on a 50 per cent tax credit, already in place.
Ontario funds three courses of in-vitro fertilization treatment, but only if the woman’s fallopian tubes are blocked.
Other provinces offer “zero,” according to Dr. Seang Lin Tan, medical director of the McGill Reproductive Centre in Montreal. Tan said if Charest’s plan is implemented, Quebec will become the most generous province when it comes to such treatment.
A cycle of in-vitro treatment costs about $5,500 in Canada, plus up to $4,000 for drugs used in the process. more…

From: »The Star«

(sz) Fertilisation and pregnancy rates can be improved by delaying oocyte retrieval from 34 to 37 hours, researchers reported here at the American Society for Reproductive Medicine (ASRM) 64th Annual Meeting.
For patients undergoing fertility treatment, timing is often a key element in determining successful outcomes. Research presented examined if the difference of just a few hours may ultimately impact pregnancy rates.
“We performed oocyte retrieval at 34 hours and at 37 hours after hCG [human chorionic gonadotropin] dosing,” explained Ju Hee Lee, MS, Laboratory of In Vitro Fertilisation (IVF), Mirae & Heemang OB/GYN Clinic, Seoul, Korea, who presented the findings on November 11 on behalf of the research team.
The prospective, randomised study compared clinical outcomes for oocyte retrieval at 34 and 37 hours subsequent to hCG administration. The goal was to increase the uptake of the mature oocyte, according to co-author Jive Jung, MD, Laboratory of IVF, Mirae & Heemang OB/GYN Clinic.
They randomised 89 women into 2 treatment cohorts: 52 women underwent oocyte retrieval 34 hours after hCG administration; 37 women underwent oocyte retrieval 37 hours after hCG administration.
Patients groups were compared with respect to number of oocytes, fertilisation rate, and pregnancy rate, among other parameters. The 2 groups were similar for mean number of ampules needed for stimulation, duration of infertility, and number of previous IVF attempts.
The results demonstrated that the average number of oocytes was lower in the group that underwent oocyte retrieval at 34 hours than in the 37-hour group (10.33 vs 15.51). more…

From: »Doctor’s Guide«

(cz) Many women may not be fully aware of the potential consequences of waiting until later in life to have a baby, a UK study suggests.
The study, of 724 women who were either pregnant or having trouble getting pregnant, found that nearly all were aware that age affects the chances of conceiving. However, they often did not know that older age increases the risk of certain pregnancy complications, and many had too much faith in the success of in-vitro fertilization (IVF).
The decision to delay childbirth is a complex and personal one, the researchers note in a report in the journal Fertility & Sterility.
The point, they say, is that women should be fully aware of all the possible benefits and risks of their decision.
“The results of this and other studies suggest that women should be provided with the appropriate information on the possible outcomes of a decision to delay motherhood,” write Dr. Abha Maheshwari and colleagues at the University of Aberdeen in England.
They analyzed questionnaire responses from 362 women getting prenatal care and 362 women seeking fertility counseling at the university medical center. The researchers found that 85 percent of women with fertility problems and 76 percent of pregnant women were aware that fertility declines between the ages of 30 and 40. more…

From: »Reuter (UK)«

(sz) A simple blood test to predict a woman’s potential fertility has become available in New Zealand.
The “anti-mullerian hormone test” looks at a woman’s egg reserve and may predict if fertility treatment will be successful, as well as help women make decisions about when to have a baby.
Fertility specialist Guy Gudex uses ultrasound to check a woman’s ovaries but now he can find out more specific information from a blood sample that measures a hormone produced by the ovary called AMH.
He said “it’s turned out to be a very good marker of the ovarian reserve, the number of eggs remaining and their likely health and quality.”
Reading AMH levels is like reading a woman’s biological clock. Levels start to fall at the age of 30 and by 35 a woman’s pool of healthy eggs is halved.
General practitioner Dr Phyllida Cotton-Barker said “as I’ve gained experience as a GP, I’ve become aware of the stress associated with infertility and will bring it up with young women even way before they are thinking about it.”
One in six couples suffer infertility. For them, AMH can predict the risk of miscarriage and even whether in-vitro fertilisation is likely to be successful.
Dr Gudex explained “if someone having an IVF cycle has a lower than normal AMH it’s quite well correlated with poorer fertilisation rates, poorer embryo quality and lower chances of getting pregnant.”
It is thought that AMH will be available in general practice within two years. more…

From: »3News«

(sz) Ferring Pharmaceuticals presented the results of a number of studies in assisted reproductive technology (ART) treatments at the 64th Annual Meeting of the American Society for Reproductive Medicine (ASRM) in San Francisco, November 8-12, 2008. Four studies compared ENDOMETRIN(R) (progesterone) Vaginal Insert, 100 mg, to intramuscular (IM) progesterone-in-oil (PIO) for luteal support. Additional studies assessed the benefits of once-daily combined gonadotropin dosing compared with twice-daily dosing, and the safety and efficacy of MENOPUR(R) (menotropins for injection, USP) in polycystic ovarian syndrome (PCOS) patients.
“Four studies presented this year demonstrate that ENDOMETRIN has comparable efficacy and pregnancy rates to IM progesterone, and is a more patient-friendly, convenient form of administration,” said Paul Korner, MD, vice president, medical affairs, Ferring Pharmaceuticals, Inc. “Other studies presented provide the infertility community with clinically relevant information about physiological differences in treatment with human menopausal gonadotropin (hMG), which contains both follicle-stimulating hormone (FSH) and luteinizing hormone (LH) activity, compared with recombinant FSH only.” more…

From: »Medical News Today«

(cz) When IVF treatment fails or ends in miscarriage, it is heartbreaking for infertile couples. It is also disappointing for their doctors, not least because the reason for many such failures is well understood.
In between half and three quarters of cases, the cause is an embryo with abnormal chromosomes. A test for identifying these problems, known as pre-implantation genetic screening (PGS), has existed for several years. But while some scientists claim it can lead to dramatic improvements in IVF success, professional bodies have been unconvinced. Both the British Fertility Society and the American Society for Reproductive Medicine (ASRM) currently advise against using PGS outside clinical trials. However, they may soon have to change their tune.
The main justification for this scepticism was a study from the Netherlands published 18 months ago, which found that PGS actually reduces success rates. The procedure involves removing a cell from an early embryo for genetic analysis, and this, it seemed, was causing excessive damage. The paper’s impact was such that some doctors even declared PGS a dead end.
That was never a particularly sound conclusion - the Dutch team’s methods have been criticised, and its lack of experience handling embryos could have accounted for the poor outcomes. And it is becoming less tenable all the time. At ASRM’s conference in San Francisco this week, it was hard to escape the feeling that the mood is changing decisively. Advocates of PGS have always claimed that in their own experience, it works. They are now starting to produce data to match and exciting new technologies that promise still greater improvements to IVF. more…

From: »The Times«