varoblog

• ESHRE Campus
“Sperm DNA: organization, protection and vulnerability –
from basic science to clinical application”
21-22 May 2009 • Stockholm, Sweden

• ESHRE Campus
“High quality patient oriented care in assisted reproduction and
endometriosis: update for nurses, midwives and allied health professionals”
29-30 May 2009 • Leuven, Belgium

• 25th Annual Meeting
28 June to 1 July 2009• Amsterdam, The Netherlands

• ESHRE Campus workshop on
“Developing skills for infertility counseling”
29 August 2009 • Basel, Switzerland

• ESHRE Campus
“Cryobiology and cryopreservation for clinical embryologists”
26-27 September 2009 • Athens, Greece

More information…

(wz) Many couples who have trouble conceiving a child have turned to a process known as in vitro fertilization. The resulting embryos are then transferred back into the woman or placed in storage. More than 400,000 embryos are currently in storage in the United States. The quality of the egg is often the single greatest factor in the viability of the embryo, yet fertility experts lack a good method for assessing the eggs.
Barry Behr, PhD, HCLD, associate professor of obstetrics and gynecology at the Stanford University School of Medicine and director of Stanford’s IVF laboratory, recently published findings on a way to “profile” the eggs to determine which are more likely to result in pregnancies.
The question: Can a non-invasive test of a woman’s eggs be used to predict in vitro fertilization success?
Background: In vitro fertilization involves retrieving eggs from a woman’s ovaries and fertilizing the eggs in a dish by incubating them with sperm or injecting sperm directly into them. The resulting embryos are then transferred back into the woman or placed in storage. The quality of the egg is often the single biggest determinant in the viability of the embryo.
The need: There is currently no good tool to available to assess eggs. “We would stand on our head and hop on our left leg if we could find a way to give us some information about viability of embryo,” said Behr.
The technology: Metabolomic testing reveals trace molecules remaining after an array of cellular processes. Previous studies have shown that metabolomic profiling can be used to identify unique biomarkers left behind by embryos in culture, which foretell the embryos with the highest reproductive potential in IVF. more…

From: »Medical News Today«

(cz) Couples seeking IVF treatment are to be warned for the first time that their children have a higher risk of suffering birth defects, disability and life-threatening conditions.
The alert by the Human Fertilisation and Embryology Authority (HFEA), the government’s watchdog on fertility issues, follows a US study indicating test-tube babies are at a 30% greater risk of suffering from conditions such as cleft palates and defects with heart valves and the digestive system than children conceived naturally.
The research, carried out by scientists from the US Centres for Disease Control and Prevention in Atlanta, and based on 13,500 births and a further 5,000 control cases, also found IVF babies has an increased chance of rare genetic disorders such as Angelman syndrome and Beckwith-Wiedemann syndrome.
The warning comes as the Human Fertilisation and Embryology Act comes into law, and is likely to shape the decisions of the estimated one in six British couples who are infertile.
The HFEA says more than 12,000 babies were born in 2006 as a result of IVF.
An HFEA spokesman said: “As with any medical procedure, it is important that patients understand what the treatment involves and what the risks may be. more…

From: »The Guardian«

(cz) For in vitro fertilization, single embryo transfer is more effective and less expensive than double embryo transfer, researchers here said. Action Points
Explain to interested patients that in recent years, use of single embryo transfer has increased, but the live birth rate per woman has remained unchanged and the multiple birth rate has decreased substantially.
Explain that in this study, single embryo transfer appears to be less expensive than double embryo transfer, and is likely more cost-effective.
Note that the practice of implanting a single embryo has not been widely adopted because of doubts about its overall applicability, despite numerous reports about its efficacy.
Over the course of the study period, use of single embryo transfer increased while the live birth rate per woman remained unchanged and the multiple birth rate decreased substantially, Hannu Martikainen, M.D., and colleagues reported online in Human Reproduction.
“The present study provides evidence for the superiority of single embryo transfer over the traditional transfer of two embryos,” the researchers said. “These data should encourage clinics to evaluate their embryo transfer policy and adopt single embryo transfer as their everyday practice.”
The practice of implanting a single embryo has not been widely adopted because of fears that it will lower pregnancy rates per embryo transfer, increase the cost of treatments, and extend the time needed to achieve pregnancy.
However, there is “universal agreement” that multiple pregnancies, often a result of double embryo transfer, pose the biggest health risks from in vitro fertilization — mainly from complications related to prematurity.
To compare the efficacy and cost-effectiveness of single versus double embryo transfer, the researchers looked at data on 1,510 women under age 40 treated in the Infertility Unit of the Oulu University Hospital between 1995 and 2004.
Treatment was split into two periods: 1995-2000, when single embryo treatment was rarely used (4.2% of women), and 2000-2004, when it was more routinely practiced (46.2% of women). more…

From: »MedPage Today«

(sz) Recurrent implantation failures occur frequently during ART cycles in spite of the transfer of good quality embryos obtained from advanced embryo culturing techniques and embryo selection processes. Now, a recent study published in The Journal of Minimally Invasive Gynecology has provided more evidence about the potential of hysteroscopy in increasing the chances of conception in women with repeated implantation failures during IVF.
Evangelos Makrakis from the Embryo ART Unit, Athens, Greece and coworkers conducted the prospective study to determine the impact of hysteroscopy on subsequent conception in women with previous implantation failures following IVF. The observational study involved 1,475 patients with 2 consecutive unsuccessful implantations and on whom hysteroscopy was conducted, and 414 matched controls who either had or hadn’t undergone hysteroscopy. The researchers measured clinical pregnancy rate (CPR), ongoing pregnancy rate (OPR), and analyzed hysteroscopic findings.
Results showed 36.6% abnormal hysteroscopic and 22.2% unsuspected findings of all the study population. In comparison with the women with normal hysteroscopy results, those with abnormal findings demonstrated raised CPR and OPR in a new IVF cycle. A substantial increase in the CPR and OPR was also found in patients who had undergone hysteroscopy when compared to the controls. Also, hysteroscopy aided in detecting unsuspected abnormalities, which occurs more in women with a history of previous implantation failures post IVF. The scientists thus concluded that hysteroscopy in conjunction with appropriate therapy improves the odds of clinical and ongoing pregnancy in such women.
Earlier, Oliveira, et al. (Fertility and Sterility, 2003) conducted a prospective study to analyze the findings of hysteroscopy in 55 women with a history of repeated failed attempts to conceive following IVF-ET (embryo transfer). The patients included in the study were those who failed to conceive even after the transfer of atleast 2 good quality embryos in each attempt and whose hysterosalpingographic findings showed a normal uterine cavity prior to the initial IVF-ET cycle. Diagnostic and therapeutic hysteroscopy, along with standard transvaginal ultrasonography were the intervention methods used. more…

From: »IVF News.Direct!«

(sz) Dangers are only small for most defects, but fertility officials order change in guidelines
Couples will be encouraged to use in vitro fertilisation (IVF) treatment sparingly after a new study revealed it could leave babies with a greater risk of genetic health problems.
Fertility experts said yesterday that the findings from scientists in the United States were “interesting” and could change the way doctors give advice to prospective parents. Patients were told that the increased dangers were only “a small risk”, although there was speculation that the advice could lead to a reduction in IVF as other methods were tried first.
Surveys showed IVF babies may have an increased risk of heart abnormalities, cleft lips, bowel problems and digestive tract disorders.
In the past, prospective parents have been advised there is only a limited risk of health problems, but for some defects the risk was said to be 30 per cent greater.
The Human Fertilisation and Embryology Authority (HFEA), the government watchdog on fertility, has ordered a change in the guidance that will be issued to patients. But the authority stressed that some of the potential risks needed further investigation and, when the new advice comes into full use from October, it will be pointed out that the majority of IVF babies are born healthy.
One theory that could explain the study’s results is that older women, whose eggs are already weaker, often turn to IVF and therefore the problems faced at birth should be less surprising to scientists. Another idea is patients involved in the study may already have taken fertilisation medication and the drugs may have had an effect on the quality of eggs.
Dr Gedis Grudzinskas, a consultant gynaecologist in Harley Street, said yesterday: “Doctors will have to give this new advice. They would be silly not to. The first question that parents ask is what are the potential problems with IVF. I feel sorry for the parents going through this now, those who have asked that question at the beginning of the process. They have been reassured and now the advice has now changed.” more…

From: »The Independent«

(sz) A recent study published in The Journal of Clinical Endocrinology and Metabolism, has demonstrated that low reproductive outcomes following ART in obese women may be associated with alterations in ovarian follicular environment, in particular the raised levels of C-reactive protein (CRP), metabolites, and androgen activity.
Previous studies have reported increased time to conception in obese women, although they are young and have normal menstrual cycles, thereby suggesting an alteration in the functions of ovary during the peri-conceptual period.
Rebecca Robker and coworkers from the University of Adelaide, Australia, conducted the study to determine whether changes in the pre-ovulatory follicular environment have an effect on the oocyte developmental competence in 96 women receiving infertility treatment. Based on the body mass index (BMI), the subjects were divided into 3 groups: moderate, with BMI=20 to 24.9 kg/m2 (n=33), overweight, with BMI=25 to 29.9 kg/m2 (n=31), and obese, with BMI ≥30 kg/m2 (n=32). The follicular fluid was aspirated in each patient from single follicles at oocyte retrieval followed by the pooling of the granulosa cells from the aspirates and the collection of cumulus cells after separation from the oocytes.
The researchers further analyzed the hormones and metabolites in the follicular fluid. Also, mRNA expression of insulin signaling components (IRS-2, Glut4), glucose regulated genes (ChREBP, ACC, FAS) and insulin regulated genes (SREBP-1, CD36, SR-BI) related to obesity/insulin resistance were measured in the granulosa and cumulus cells. Results showed that BMI was directly proportional to the follicular fluid insulin, lactate, triglycerides, and CRP levels, but was inversely related to sex hormone-binding globulin levels (P=0.001). Although IRS-2, Glut4, ChREBP and SREBP displayed a cell-type specific expression, they were unaffected by BMI. The scientists also noted that obese rather than moderate weight women had a modest variation in CD36 and SRBI mRNA of granulosa cells. Considering the findings, it was suggested that alterations in the ovarian follicular environment exhibited by obese women were probably linked to poor reproduction outcomes. more…

From: »IVF News.Direct!«

(wz) M. Kara Neumann, age 11, died of diabetes because her parents prayed rather than taking her to doctors. Caleb Moorhead, age 6 months, died after his deeply religious vegan parents refused a simple vitamin injection to cure his malnutrition. The list of children killed by their parents’ superstition or wilful ignorance is a long one.
Most people are rightly appalled by such cases. How can parents stand by and let their children die instead of doing all in their power to get the best medical care available?
Yet this is precisely what society is doing. We now have the ability to ensure that children are born free of any one of hundreds of serious genetic disorders, from cystic fibrosis to early-onset cancers. But children continue to be born with these diseases.
All would-be parents should be offered screening to alert them to any genetic disorders they risk passing on to their children. Those at risk should then be offered IVF with pre-implantation genetic diagnosis (IVF-PGD) to ensure any children are healthy.
Why isn’t it happening? Because most people still regard attempts to influence which genes our children inherit as taboo. When a fertility clinic in Los Angeles recently offered would-be parents the chance to choose their child’s eye colour, for instance, it provoked a storm of criticism that forced the clinic to reconsider
Such fears are misplaced: IVF-PGD is little use for creating designer babies. You cannot select for traits the parents don’t have, and the scope for choosing specific traits is very limited. What IVF-PGD is good for is ensuring children do not end up with disastrous genetic disorders. more…

From: »New Scientist«

(cz) German developed Intracytoplasmic Morphologically Selected Sperm Injection (IMSI) technique has been installed at Pune’s Ruby Hall Clinic (RHC).
Said Dr Sunita Tandulwadkar, Head, IVF & Endoscopy Centre of RHC, “The IMSI technology is available in few countries and Ruby hall is the first in the city and the third in the country to have installed this latest technology.”
She added, “We are becoming aware of overuse of driving, alcohol, tobacco, laptop and many new lifestyle ‘addictions’ that have contributed to falling quality of sperms. The previously done ICSI with low magnification is now yielding to newer technology of IMSI.”
Technology has moved so much that sperm is being seen more closely with 7000X magnification, wherein the morphology is clearly visualised and also a good reading of abnormality noted.
Using this IMSI technique, a better embryo is formed. The vacuolar structure of the sperm is recognised and this defines the quality, and the strictly selected morphologically best sperm is chosen for fertilsation. With this, the abortion rate is reduced, which increases the take home baby rate.
“In a country like India, where neither the Government nor the insurance companies cover the cost of infertility treatment, it becomes utmost important for all of us to see that we achieve success in the very first IVF cycle. We have to understand the emotional, economical and physical pain of the patient and try to take steps to improve our result at each level,” she added. more…

From: »Express Healthcare« (India)

(wz) Familienministerin von der Leyen wünscht sich mehr Retortenbabys. Mediziner unterstützen ihren Vorstoß.
Möglich, dass potentiellen Eltern schon bald geholfen wird. Zehn bis 15 Prozent der Paare gelten als ungewollt kinderlos. Bei der Vorstellung des Familienreports 2009 stieß Bundesfamilienministerin Urusla von der Leyen (CDU) eine Debatte über künstliche Befruchtung an. Eindringlich verlangte sie, „über die bemerkenswerte Initiative Sachsens nachzudenken.“ Seit Anfang März bezuschusst der Freistaat drei Versuche mit jeweils 900 Euro und übernimmt den vierten Versuch künstlicher Befruchtung bei verheirateten Paaren sogar komplett. Sozialministerin Christine Clauß (CDU) spendiert aus ihrem Etat 1,1 Millionen Euro im Jahr. Erst vergangene Woche hatte das Bundessozialgericht die derzeitige Praxis bestätigt, dass über 40 Jahre alte Frauen für künstliche Befruchtungen selbst zahlen müssen. Es wies die Klage einer 44-Jährigen ab.
Von der Leyens Vorschlag, das „Thema neu zu diskutieren“, wurde nun auch vom hessischen Sozialminister Jürgen Banzer (CDU) aufgegriffen. Er brachte eine Stiftung ins Spiel, weil „er Paaren helfen möchte, ihren Kinderwunsch zu erfüllen.“ Die bessere Finanzierung von Kinderwunschbehandlungen, die angeblich zu einem Plus von mindestens 6400 bis 10 000 Geburten im Jahr führen würde, wie die Selbsthilfeorganisation Wunschkind schätzt, hat für die von der Leyen eine „ausgesprochene familienpolitische Komponente“. Nachdem ihre Kabinettskollegin Ulla Schmidt (SPD) es bereits abgelehnt hat, die gesetzlichen Krankenkassen durch weitere Ausgaben zu belasten, sucht von der Leyen nun nach neuen Wegen – wohl auch um ihre eigene Bilanz zu verbessern. more…

From: »FOCUS« (Germany)