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(wz) In vitro fertilization has given rise to a moral debate for parents
Thousands of Canadian babies have been conceived through in vitro fertilization in the years since the technique was pioneered. But experts estimate that there are tens of thousands of additional embryos holding the ingredients for human life waiting frozen in nitrogen-filled storage tanks across the country.
It provides an interesting case study in unintended consequences. Many couples who have already had success with in vitro fertilization and who do not want to have another baby face a moral debate: Do they donate their extra embryos to research, to another couple or simply discard them?
Researchers at Duke University in Raleigh, N. C., released a study recently about fertility patients’ views on frozen embryos that suggests about 500,000 frozen embryos have accumulated in U. S. fertility clinics. No official statistics are kept on the number of frozen embryos in storage in Canada, but experts estimate the number is about 10% of the U. S. total, or 50,000.
As a result, patients and doctors face difficult and even “agonizing” questions about what to do with them, and many couples are not making decisions at all. The Duke study found 70% of patients with embryos delay their decision for more than five years, while others choose to freeze them indefinitely. more…

From: »National Post« (Canada)

(wz) Fertility treatment pregnancy rates increase significantly and miscarriages are reduced if eggs that consume oxygen in a stable manner are used for in vitro fertilization, joint research by a clinic and two universities has found.
In fertility treatment, doctors decide which fertilized eggs are best for use by judging the shape and condition of the eggs using a microscope. However, this method lacks precision as it relies only on physical observations, and the rate of pregnancy using such eggs for the procedures is only 20 percent to 30 percent. Patients are often required to endure the in vitro fertilization process several times before a pregnancy occurs.
However, fertilized eggs also consume oxygen, and Takafumi Utsunomiya, director of St. Luke Clinic in Oita, measured the amount of oxygen eggs breathe by measuring subtle changes in oxygen concentration in a culture solution surrounding the egg. The technique was developed by Tohoku University and Yamagata University.
Utsunomiya and the universities compared over a two-year period the treatment results of two groups whose eggs appeared in good condition–21 women whose eggs were chosen only through visual observation and 20 women whose eggs were chosen through visual observation and measurement of oxygen consumption. The visual-observation-only group’s pregnancy rate was 38 percent, while the other group’s was 60 percent. The miscarriage rate was 25 percent for the first group and 8 percent for the latter. more…

From: »Daily Yomiuri«

(cz) Some embryos created in IVF treatment are trapped in limbo, as fertility clinics cannot trace the couples who produced them.
The clinics have had to store the embryos indefinitely after losing contact with the couples responsible for their future.
Clinicians are now wrestling with the ethical dilemma of what to do with them and have even considered seeking a legal judgment.
“At the moment it’s a bit in limbo,” said John Peek, group operations manager of the Fertility Associates clinics.
Dr Peek said a process was developed by all fertility clinics and a Government committee for discarding such embryos.
But no one had yet adopted the plan.
“I don’t think any clinics have gone ahead with it. Ethically it might have passed the test but ultimately there’s the concern there might be a couple who say, ‘That’s not what I wanted’.”
The Catholic Church told the Herald it was an ethical dilemma, and it wanted these and all other “surplus” embryos to be allowed to die.
After IVF treatment, only half of couples have any embryos left that are suitable to store. When they do, on average they have three or four frozen. It costs couples about $180 a year to store a group of embryos at Fertility Associates.
Dr Peek said several thousand frozen embryos were stored.
He said clinics wrote each year to couples who had stored embryos to ask what they wanted done with them. more…

From: »The New Zealand Harald«

(wz) Egg inducing drugs have been in use for more 30 years and have been taken by millions of women as part of IVF treatment to help them have children.
Now a study of more than 15,000 women - 30 years after they gave birth - has suggested they are at least three times more likely to develop cancer of the womb.
While the risk still remains low, the scientists who carried out the survey, believe it is worth further investigation and that those who undergo the treatment should be carefully monitored.
It is estimated that one in six couples have difficulty conceiving and around 34,000 women a year undergo fertility treatment in Britain.
Ovulation-inducing drugs are prescribed to women who have trouble conceiving, are undergoing IVF, or who want to donate or sell their eggs.
Dr Ronit Calderon-Margalit at Hadassah-Hebrew University in Jerusalem and colleagues have studied the effects of these drugs by comparing cancer incidence in a group of 15,000 Israeli women 30 years after they gave birth.
Of the 567 women who reported having been given ovulation-inducing fertility drugs, five developed uterine cancer – which is about three times the incidence in members of the group who had not been given these drugs.
For the 362 women who took clomiphene, which tricks the body into making extra eggs by blocking oestrogen receptors, the risk was over four times that of women who did not take the drugs.
Calderon-Margalit accepts that the numbers are small, but says they carry extra weight because they make “biological sense” as tamoxifen, a breast cancer treatment which, like clomiphene, reduces sensitivity to oestrogen, was known to increase the risk of womb cancer.
But Richard Kennedy, a consultant at the Centre for Reproductive Medicine at the University Hospital Coventry and a spokesman for the British Fertility Society, sought to reassure patients.
“There have been a high number of studies that have failed to find a conclusive link,” he said. more…

From: »The Daily Telegraph«

(sz) An unborn baby that has been genetically screened to be free of an inherited form of breast cancer, is due to be born “imminently” in London. The pregnancy is the result of an embryo screening technique, that has never previously been applied in the UK, to prevent parents passing on the disease to their offspring.
If the couple had conceived naturally and the baby had inherited the altered version of the gene, called BRCA1, it would have had an 80% chance of developing breast cancer and a 60% chance of ovarian cancer. By screening embryos during IVF, doctors could be sure the child will be free of the mutation.
Dr Paul Serhal, of University College Hospital, who carried out the screening, said the technique offered hope for families who have suffered repeated cases of inherited breast cancer. “All these couples have a very strong family history of breast cancer,” he said, “You have certain couples who have been plagued by this for generations.” He refused to give any details about the mother who has requested to remain anonymous, but it is believed that she is aged 27.
The screening technique used by Serhal - called pre-implantation genetic diagnosis (PGD) - involves creating embryos using IVF, then removing a cell from each of them when they have divided to give eight cells. Genetic analysis of this cell can reveal whether each embryo contains the normal or mutated copy of BRCA1.
The embryos with the mutated copy are discarded, while one or more embryos with the normal BRCA1 are implanted back into the mother’s womb to begin the pregnancy.
PGD screening is now fairly routine for some severe inherited conditions such as cystic fibrosis and Huntington’s disease, but applying it to conditions such as inherited breast cancer has proved controversial. Because there is a chance that carriers of the mutation will not develop breast cancer, screening inevitably means some embryos that are screened out would have led healthy lives. more…

From: »The Guardian«

(sz) Overweight and obese women have as much chance of having a baby through fertility treatment as normal weight women, a Scottish study suggests.
IVF treatment is no more expensive for most obese women, the report in the journal Human Reproduction added.
But women should be advised to lose weight because of the high risk of complications, the researchers said.
Most primary care trusts limit IVF to women with a body mass index under 30, which excludes women classed as obese.
The research, on 1,700 women who underwent their first cycle of IVF between 1997 and 2006 in Aberdeen, found 28% were overweight, 8% were obese and 5% had a BMI over 35 - classed as heavily obese.
No significant difference was found between groups in the proportion of women having a positive pregnancy test, ongoing pregnancy, and live birth.
And there was no difference in the cost of a live birth between normal weight women and women with a BMI up to 35.
But a higher proportion of women in the overweight or obese groups had a miscarriage.
And they needed higher doses of drugs used to stimulate the ovaries.

Age ‘more important’
Study leader Dr Abha Maheshwari, clinical lecturer in reproductive medicine at the University of Aberdeen, said they had expected costs to be higher in overweight and obese women.
But the study showed patients should not be discriminated against because of their size, she said.
“It shows that age is a more important factor than weight. more…

From: »BBC News«

(wz) Fertility problems are now so common that IVF has become a routine practice, according to Repromed.
Infertility now affects about one in six couples, so demand for assisted reproductive technology has surged in recent years.
Repromed in Dulwich has conducted 2300 in-vitro fertilisation treatments this year, compared to 2103 in 2007 and 1644 in 2006.
Medical director Dr Richard Henshaw said many women were delaying childbirth because they were not entering stable relationships until later in life.
Age is a crucial factor in fertility, particularly for women.
Experts say fertility starts declining after the age of 30. The average age of women seeking reproductive help is 36.
“All the research suggests people delay childbirth not because of work issues but often because the girls can’t find suitable boys early enough,” he said. “Years ago the boys went out to work and the girls stayed home and made babies.
“Now women might delay because they are busy doing other things.”
Dr Henshaw said IVF had also been “normalised” as the technology improved. “It used to be a big deal but now it’s not,” he said.
“I first started doing this 12 to 13 years ago and it’s just changed out of sight over that time.
“The treatment is far, far more successful than it has ever been. The treatments are more affordable, accessible, and it doesn’t carry the stigma that it used to.”
The majority of IVF costs are covered by Medicare and private health insurance can cover other expenses.
A cycle costs between $1000 and $1800, with no guarantee of success. more…

From: »Adelaide Now«

(sz) A new report says fertility clinics in Canada achieved a success rate of 27 live births for every 100 IVF cycles in 2006, the latest year for which statistics are available.
And the Canadian Fertility and Andrology Society says the pregnancy rate for in vitro fertilization was 35 per cent in 2007, up nine percentage points since 1999, when the group first started collecting these statistics.
It was too soon to say what the rate of live births was for 2007, though it is generally expected that some of those pregnancies would have ended in miscarriage.
The report says about 15 per cent of pregnancies initiated using assisted reproduction through the society’s 26 member clinics ended in miscarriage in 2006.
The live birth rates varied substantially by age, with 34 per cent of women under age 35 and 26 per cent of women aged 35 to 39 having a baby using IVF.
The rate dropped sharply, though, in women over age 40, with only 11 per cent of IVF cycles leading to a live birth.
How do the Canadian rates compare to those of fertility clinics in similar countries?
“Very well. They are very comparable,” says Dr. Roger Pierson, chair of the communications committee of the society and director of the University of Saskatchewan’s reproductive biology research unit.
The figures are the aggregate results of the country’s 26 fertility clinics, which the clinics voluntarily provide. Pierson says that while some clinics will post their own rates on their websites, the society is not a regulatory body and does not release clinic-specific data. more…

From: »The Canadian Press«

(sz) In its most authoritative declaration on bio-ethics for more than 20 years, the Vatican yesterday reinforced its hostility to a wide range of techniques and treatments that have become available in recent decades. They included IVF, embryonic stem cell research, the morning-after pill and the contraceptive drug mifepristone.
A 36-page document endorsed by Pope Benedict XVI stopped short of declaring that human embryos were people. The pope’s chief adviser on bio-ethical issues, Monsignor Rino Fisichella, told a press conference that such a declaration would have embroiled the Vatican in a “very complex philosophical debate”.
But he said, the document fully backed the idea that a human embryo had the “dignity typical of a person”.
And he noted this was an “advance” on the position taken in the Vatican’s last high-level pronouncement, its 1987 instruction entitled Donum Vitae (The Gift of Life).
The formulation in its latest document, Dignitas Personae (The Dignity of the Person), comes close to equating with murder such practices as the destruction of defective embryos in IVF.
On one issue - what to do with frozen, “orphan” embryos - the Vatican admitted it was flummoxed. Dignitas Personae rules out every apparent solution: their destruction, their donation to infertile couples and their use for therapeutic or experimental purposes.
It said that proposals for the adoption of unwanted embryos were “praiseworthy in intention”, but fraught with problems.
Fisichella’s predecessor as president of the Pontifical Pro-life Academy, Monsignor Elio Sgreccia, said: “Our basic advice is that the freezing [of the embryos] ought not to be done.” It created “a blind alley”; a situation “the correction of which implies another mistake”. more…

From: »The Guardian«

(wz) Sonia Verma (name changed) became a mother way back in 2001. The single mother conceived through in-vitro fertilisation with donor sperms. But till date, she has not been able to procure a birth certificate for her seven-year-old child.
Verma’s troubles began when the hospital she delivered in wrote her father’s name where the name of the baby’s father should have been. She had to approach the court to rectify the mistake, but since it is compulsory to give the father’s name to get a birth certificate, she still hasn’t been able to get the document in the absence of an Act to deal with special cases like hers.
Verma is not alone in her predicament. Many single women have been opting to conceive through IVF, with donor sperms, where the identity of the father is not known. Confirming the new trend, IVF experts say hiccups arise as there are no laws to govern assisted reproductive technology (ART) and Indian Council of Medical Research (ICMR) only has guidelines which are yet to be transformed into an Act. In the absence of standard rules, obtaining a birth certificate for a child born to a single mother is still difficult as it is mandatory to give the father’s name.
According to ICMR guidelines for ART, a single woman can conceive through IVF and the child is considered legitimate. But the guidelines are at present open for public debate and ICMR will take some time to send them to the law ministry to be made into an Act. “There is no law regarding ART in the country and hence the inconvenience. As per guidelines, the genetic parents’ name has to be there on the birth certificate. So if the child belongs to a single mother only her name should appear, but a lot of agencies still ask for the father’s name,” said a senior ICMR official.
Meanwhile, Verma’s case has been referred to the Municipal Corporation of Delhi which is planning to seek the advice of the registrar general of India. She too has been asked to file an affidavit, which has been submitted. But it will still be a few months before the certificate is handed over to her.
“It is mandatory to write the father’s name in the birth certificate, but there are exceptions. In case a single mother has conceived through IVF from a donor sperm we can’t deny a birth certificate to the baby. So we ask the mother to submit an affidavit stating that the baby was conceived through IVF from a donor sperm. This helps avoid any confusion or dispute in future. It is up to the registrar of birth and death to decide which document is required to prove that the child was born to a single mother,” said Dr PK Sharma, medical health officer and additional chief registrar, birth and death, NDMC. more…

From: »The Times Of India«