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(wz) A lesbian couple have won the right to NHS treatment to help them have a baby after threatening to sue health chiefs.
NHS Greater Glasgow and Clyde (GGC) had denied Caroline Harris and Julie McMullan IVF treatment as they were not classified as an infertile couple.
The health board said it had reviewed its position in light of regulations, including the Equality Act.
The women, who were suing the health board for treatment costs, said they had not yet been offered a settlement.
The couple were claiming £20,000 after unsuccessful private fertility treatment, which followed them being refused NHS help.
They had taken their case to the Court of Session in Edinburgh and a judicial review of the decision was due to take place at a later date.
The health board at first stood by its refusal, but it has now agreed to offer the couple treatment at an assisted conception unit.
A spokesman for the board said: “As a couple, these two individuals are biologically incapable of conceiving and the board, therefore, initially took the view that the couple did not meet the necessary criteria to receive NHS-funded treatment. more…

From: »The BBC«

(sz) As freezing and thawing of human spermatozoa may affect the post-thaw qualities, including the sperm morphology, motility, DNA integrity and viability, optimization of the cryopreservation protocol is vital for the success of assisted reproductive technologies. According to a recent study published in the journal Reproductive BioMedicine Online, the supplementation of the cryopreservation medium with vitamin E may enhance the motility of human spermatozoa post-thaw, especially in patients with abnormal semen parameters.
The research headed by K Taylor, from the Concept Fertility Centre, King Edward Memorial Hospital, Western Australia, analyzed the effect of antioxidant supplementation of cryopreservation medium in augmenting the post-thaw integrity of cryopreserved human spermatozoa. During the study, both normal (n=23) and abnormal semen samples (n=20) were collected by masturbation and were assorted into three aliquots before performing the cryopreservation. The second and third aliquots were added to sperm freezing medium containing 100 µmol or 200 µmol vitamin E analogue, while the first aliquot was mixed with cryopreservation medium only.
The cryopreservation protocol included freezing the samples at –10 °C to –80 °C per minute, and plunging them into liquid nitrogen. After the thawing procedure, vitality, motility and DNA integrity of the samples were evaluated. Further evaluation were carried out using split-plot repeated-measures analysis of variance (ANOVA) to study the difference in vitality staining, post-thaw motility index, and DNA fragmentation within the subject (dose), and between normal and abnormal groups. The study results showed a significant association between vitamin E dose and post-thaw motility (P=0.041). Also, the pattern of response across doses was found comparable in both normal and abnormal groups. Although 200 µmol supplementation of vitamin E did not alter the vitality or sperm DNA fragmentation, it substantially improved the post-thaw motility of cryopreserved human spermatozoa. more…

From: »IVF News.Direct!«

(sz) Sophia Mackintosh is all too aware that she is a walking stereotype. After two miscarriages and a failed IVF attempt, she decided to give up trying for a baby and buy a dog instead. With Lulu happily installed in their newly renovated house in Islington, North London, Mackintosh and her husband, James, launched themselves wholeheartedly into the adoption process. Then, five years after that first traumatic miscarriage, she discovered that she was pregnant.
Hers is a familiar story of the type gleefully recounted by those who believe that women today try too hard to get pregnant. Mackintosh agrees - she believes that during those five years her mind was sabotaging her chances. “I became obsessed. Every month I would pee on an awful lot of sticks and be disappointed each time that I was not pregnant,” she says. “But, deep down, there was relief that at least I would not spend the next 12 weeks panicking about having another miscarriage.”
After beginning the adoption process, Mackintosh, a charity director, began seeing a fertility counsellor. “I began to see my body in a positive way again, and she taught me to be calmer about life and confident that I would have a baby one day. And because we were about to adopt, James and I weren’t trying quite so desperately to conceive.” After the fifth session, she was pregnant, and now, at the age of 40, she has two sons, aged 3 and 1 (plus Lulu the dog).
The idea that the mind has a large part to play in fertility is also advocated by the midwife Zita West, who last month launched a Manage Your Mind programme at her London clinic. Each hour-long session costs £110 and a course of one to six sessions is recommended. Techniques include guided relaxation, art therapy, hypnotherapy and cognitive behaviour therapy (turning negative thoughts into positive ones). more…

From: »The Times«

(wz) Emerging into the cold, harsh light of the delivery room can hardly be a pleasant experience for newborns. And to add insult to injury, just as they are adapting to this new world a baby’s delicate, soft heel is assaulted with a needle and several drops of blood are drawn.
It’s only a brief torment, and one that has the potential to save that baby’s life. Those few drops of blood are used to diagnose a range of diseases, where early diagnosis and intervention can make a huge difference to that child’s quality of life. Newborn screening has saved countless children from the worst ravages of conditions such as phenylketonuria — a genetic disorder that can damage brain development but which can be minimised with dietary changes if caught early.
But this screening is far from comprehensive. One disorder not currently on the testing list is fragile X syndrome — something that researchers from Australia and the US are now working to change.
Fragile X syndrome is the most common cause of inherited intellectual disability, even though it affects only about one in 3600 males and between one in 4000 and one in 6000 females. It’s caused by a genetic abnormality on the X chromosome, where a single sequence of three DNA base pairs is repeated far too many times, with devastating consequences.
The mutation leads to learning and intellectual disabilities ranging from mild to severe, and other problems such as anxiety and hyperactivity as well as a characteristic elongated face and prominent ears. Girls tend to be less affected than boys because of their second, unaffected X chromosome (in contrast to boys, who have an X and Y chromosome).
But for most fragile X patients, the condition means lifelong care with little or no independence. And there’s a nasty twist to fragile X. In most inherited genetic conditions, carriers — those with either a single or partly affected chromosome who can pass the mutation on to their children — are not affected by the condition.
But fragile X carriers are different. more…

From: »The Australian«

(cz) Experts have said that basic errors made by a veteran doctor caused the mix-up of fertilized eggs and subsequent impregnation of a woman with the wrong egg at Kagawa Prefectural Central Hospital in Takamatsu.
In vitro fertilization is becoming more common as more couples receive fertility treatment, in which doctors grow fertilized eggs in petri dishes. At many medical facilities offering fertility treatment, two or more medical staffers generally handle each petri dish. Doctors at these facilities say medical staff should be vigilant to avoid incidents similar to the one that occurred at the Takamatsu hospital, which had only one doctor doing most of the fertilization procedure.
At Nishikawa Clinic in Chuo Ward, Osaka, two medical staff members recently took out a plastic petri dish with fertilized eggs. They confirmed that the patient’s name on the incubator door matched the names on the petri dish and its lid by pointing at the names and reading them aloud.
“It’s Mrs. A’s, right?” one of them asked the other.
“Yes, it’s Mrs. A’s,” the other answered.
The clinic prohibits its staff from handling petri dishes of different couples in one incubator.
They repeated the name confirmation when they moved the eggs to a new petri dish on a table. Generally, petri dishes are changed at least four times after eggs are collected and fertilized. The name check is done for every dish change. When a doctor checks the condition of fertilized eggs, another doctor and a medical staffer also are present.
The clinic conducted 3,220 in vitro fertilization procedures from 1996 to 2008. The clinic avoids starting fertilization treatment–from extracting eggs to implanting fertilized eggs–for two or more couples at the same time so each procedure can be handled independently.
“Fertilization procedures have to be conducted quickly as fertilized eggs are fragile,” clinic Director Yoshinobu Nishikawa said. “If you’re concentrating on what you’re doing, you’ve no time to handle two petri dishes [containing fertilized eggs] at the same time.”
“It’s desirable that experienced medical staff members specialized in undertaking fertilization procedures take charge and a doctor regularly checks the condition of fertilized eggs,” said Yoshitaka Nakamura, director of Oak Clinic Sumiyoshi in Nishinari Ward, Osaka, which conducts about 700 in vitro fertilization treatments a year. “It’s dangerous to let only one person take charge of the process, but at public hospitals in rural areas, a small number of doctors shoulder in vitro fertilization duties and other special treatments.” more…

From: »Daily Yomiuri Online«

(cz) Lifestyle factors will no longer be allowed to exclude couples from fertility treatment under revised guidelines.
Infertile couples who are overweight or smoke will become eligible for IVF treatment as part of an overhaul of access to services.
Lifestyle factors such as a person’s weight will no longer be a reason for health trusts to exclude them from IVF under guidance to be published this year.
The Government has commissioned two reviews of IVF treatment, to be published in June, which will inform efforts to offer wider and more consistent treatment on the NHS.
The guidelines will put pressure on the 95 per cent of primary care trusts (PCTs) that do not offer the three cycles of IVF recommended by the National Institute for Health and Clinical Excellence (NICE), the value-for-money watchdog.
Most PCTs currently exclude from IVF women who have a Body Mass Index of more than 30 - although the British Fertility Society recommends a BMI cut-off of 36. Most PCTs also refuse to treat smokers.
Many trusts also enforce an age limit of 36, while some have been found to exclude any women under the age of 30. Others have even stricter age criteria, such as a six-month window between the ages of 39 and 40.
The new guidelines, which will reinforce NICE recommendations that a woman should be aged between 23 and 39 to qualify for IVF, will also recommend that clinicians have the final say on treatment. Older people, the overweight and those who smoke should not be excluded, but be considered case by case.
Between one in six and one in seven couples is affected by infertility. Almost 45,000 cycles of IVF are performed in Britain each year, but limited NHS provision means that about 75 per cent of these are conducted privately, at an average cost of £2,000 per cycle. more…

From: »The Times«

(wz) A Japanese woman became pregnant with another person’s baby following an egg mix-up during fertility treatment.
The mistake happened when the woman, who is in her twenties, underwent IVF treatment at a government-run hospital in Kagawa Prefecture.
But medical tests during the early stages of pregnancy revealed the implanted egg was unlikely to have come from the mother.
Further investigations led to the discovery that the fertilised eggs of another patient had accidentally been implanted.
The woman decided to abort at nine weeks upon discovery of the blunder and are now seeking £149,000 (in compensation from the prefectural government.
Yuzo Matsumoto, director of Kagawa Prefectural Central, said: “She was very happy after undergoing such a difficult procedure and becoming pregnant, but unfortunately a mistake had been made.”
“The in vitro procedures are carried out in sequence one after the other. In this case the eggs from one procedure may have accidentally been left over and used in the following procedure.” more…

From: »The Daily Telegraph«

(sz) The increased prevalence of multiple births associated with assisted reproduction technology (ART) can be largely attributed to the widespread use of ovulation induction medications and multiple embryo transfer. Now, a research study published in the recent issue of the journal Fertility and Sterility has suggested less aggressive stimulation as an effective strategy to reduce high-order multiple births (HOMB) due to ovulation induction (OI).
Richard Palmer Dickey, from the Department of Obstetrics and Gynecology, Louisiana State University School of Medicine, New Orleans, Louisiana, conducted the retrospective analysis to evaluate HOMB-related factors due to ovarian induction and assess the efficacy of various strategies employed for lowering its occurrence.
The study results showed a positive association between high-order multiple pregnancy (HOMP), and administration of estradiol (E2), high doses of gonadotropin, and the number of preovulatory follicles of 7-10 mm. However, an inverse relation was noted between HOMP, and number of treatment cycles and the patient’s age. The study found that strategies such as, minimal doses of gonadotropin, clomiphene use prior to gonadotropin administration, aspiration of excess follicles, and cancellation of over three follicles of >10-15 mm in size, were successful in lowering HOMP. The researcher also suggested that pregnancy rate per patient need not be affected by the administration of low-dose gonadotropin if prolonged for 4-6 cycles. Based on the study results, the researcher concluded that less aggressive ovarian stimulation may aid in reducing HOMPs due to OI to 2% or less, without affecting the patient’s overall chances of pregnancy.
In 1998, the Society for Assisted Reproductive Technology/American Society for Reproductive Medicine (SART/ASRM) Practice Committee put forth certain guidelines to aid ART programs in determining suitable number of embryo transfers, in its efforts to minimize the chances of HOMB. Earlier, the same researcher (Fertility and Sterility, 2007) analyzed the efficacy of the recommendations in reducing HOMB due to OI and ART. more…

From: »IVF News.Direct«

(cz) Couples with fertility problems on Teesside are set to be given an extra chance to become parents.
This time last year James Cook University Hospital was offering just one cycle of IVF (In-vitro fertilisation) treatment on the NHS but now it is set to provide couples with up to three chances of conceiving.
NICE (National Institute for Clinical Excellence) guidelines issued in 2004 state that the NHS should provide three cycles of IVF treatment for suitable patients in England and Wales.
But the guidelines are not enforced by the Government which leaves patients facing a postcode lottery as to how many cycles of IVF their hospital trust will provide, if any.
Determined to offer Teesside couples with fertility problems the best chance of conceiving, the department of reproductive medicine at the Middlesbrough hospital increased its service to offer two treatments on the NHS last April with the support of local Primary Care Trusts (PCTs) and the North East Strategic Health Authority.
Now it has got the go-ahead from the South Tees Hospitals NHS Trust board to expand its service further to offer a third cycle, again with financial support from PCTs.
Currently the department provides 300 cycles of IVF treatment a year, but the extra staff and equipment it is set to acquire will enable it to offer another 153 cycles a year.
This means couples who meet the right criteria for fertility treatment on the NHS will be able to access a third cycle of IVF by 2010/11. more…

From: »Gazette Live« (UK)

(sz) Preeclampsia, affecting around 5-8% of all pregnancies in the US, annually, is the main etiological factor for both maternal and fetal morbidity and mortality. Previous researches have demonstrated that in contrast to natural conception, women opting for IVF are at an increased risk of developing preeclampsia. A recent study has suggested that the incidence of preeclampsia is higher in IVF-conceived pregnancies; however, no significant association was noted with intrauterine insemination and ovulation induction. The findings of the current study, which corroborated with the earlier results, are published in the journal Hypertension in Pregnancy.
Xi-Kuan Chen from the University of Ottawa, Canada and coworkers conducted a population-based retrospective cohort study to determine the relationship of preeclampsia risk with intrauterine insemination, IVF, and ovulation induction. Based on the data from the 2005 Niday Perinatal Database for Ontario, the study considered all pregnancies achieved with the help of assisted reproductive technology (1,357 exposure subjects and 5,190 controls). The exposure group comprised of subjects who conceived with ART, while a random matching of 4 controls by maternal age, parity, plurality, delivery hospital level and residence area was done for each exposure participant. Conditional logistic regression models were used to analyze the association. Results showed that enhanced risk for preeclampsia was found in subjects who opted for IVF (OR=1.78; 95% CI=1.05, 3.06) after adjusting for confounding factors such as maternal age, smoking during pregnancy, and initiating time of prenatal care. However, intrauterine insemination (OR=2.44; 95% CI=0.74, 8.06) and ovulation induction (OR=1.34; 95% CI=0.31, 5.75) did not show any similar association.
Earlier, Shevell, et al. (Obstetrics and Gynecology, 2005) conducted a study to determine if the use of ART is associated with an increase in adverse pregnancy outcomes, chromosomal aberrations, or fetal malformations. The data was obtained from the First And Second Trimester Evaluation of Risk trial, a large multicenter research of singleton pregnancies. The participants were distributed into 3 subsets: (1) No ART use, (2) use of ovulation induction, with or without intrauterine insemination and (3) use of IVF. The link between adverse pregnancy outcomes and ART was investigated using the multivariate logistic regression models. more…

From: »IVF News.Direct«