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(cz) A woman who has given birth at 66 has reignited the medical and ethical debate on fertility treatment
The maximum age at which a woman can receive IVF treatment varies from about 40 in NHS clinics to 50 in private clinics. It is normally accepted among fertility doctors that women over 50 should not be treated unless they are still having their periods. After that, they should not receive IVF unless there are very exceptional circumstances, such as a woman who had had a serious disease that had left her infertile.
The Human Fertilisation and Embryology Authority issues a code of practice, which we are expected to abide by. They look at our decisions when deciding whether to renew our licence. One of the primary things that we have to consider when deciding whether to offer IVF is the welfare of the child. The age of the mother is a very significant factor in their welfare.
When women are in their fifties and sixties, there are important medical risks to both mother and baby before the baby is born, even if the woman feels well. The most important risk is the likelihood of hypertension (high blood pressure). Normally this is not a huge problem, but in pregnancy it has a much more important place.
If the blood pressure is raised, women can develop preeclampsia, which can lead to growth retardation in the baby. Depending on how well the baby is doing, there may be other dangers. Women have an increased risk of getting late onset diabetes into their fifties and being pregnant can tip the balance. If they develop Type 2 diabetes, it can cause problems with the pregnancy. more…

From: »The Times«

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(sz) About one in 20 children in the Czech Republic is born after assisted reproduction, compared to one in six in countries such as Denmark, Finland and Belgium, Czech experts told journalists Tuesday, referring to a Czech survey the IBRS company conducted in April.
Most parents in the Czech Republic still consider it taboo to openly admit that their offspring is a “test-tube” baby, Iscare IFV centre head expert Milan Mrazek said.
Seventy-eight percent of Czechs approve of assisted reproduction as a chance for infertile couples, while one third are afraid of possible side effects and 17 percent believe that a child born after assisted fertilisation is prone to immunity defects and genetic diseases.
Tonko Mardesic, expert from Prague’s Pronatal sanatorium, said the number of babies conceived by in vitro method is lower in the Czech Republic also because the country has a less liberal legislation in this area compared to the countries on the top of the scale.
In the Czech Republic, health insurers cover three treatment procedures for a woman in her life, compared to six procedures in Belgium.
If a woman in the Czech Republic gets pregnant after the second procedure and wants to have another child by this method, the insurer covers only one further procedure for her, Mardesic said.
Belgium covers another six for her, he said.
“According to the survey, the Czechs support assisted reproduction but they lack knowledge,” said Tomas Horejsek from IBRS, that conducted the survey for the Czech Gynaecologic and Obstetric Society. more…

From: »Prague Daily Monitor«

(cz) Sperm DNA damage, which negatively affects both natural and assisted fertility, is associated with putative mechanisms such as oxidative stress and defective sperm chromatin packaging. Infertility caused due to oxidative stress-induced sperm damage is mainly through the initiation of apoptosis or the direct oxidation of the DNA by reactive oxygen species (ROS). A recent study published in Reproductive BioMedicine Online highlights the potential of oral antioxidant therapy in substantially improving the sperm DNA integrity and protamine packaging, apart from reducing apoptosis and seminal ROS production in infertile men.
Ozlem Tunc from the Discipline of Obstetrics and Gynaecology, University of Adelaide, South Australia, and coworkers, conducted the study on 50 infertile men with known oxidative stress, to determine the effect of an oral antioxidant or mineral supplement on sperm DNA integrity. The oral antioxidant therapy was administered for 3 months to all the participants, and evaluated, both before and after the treatment, for the following: sperm DNA integrity with terminal deoxynucleotidyl transferase-mediated dUDP nick-end labeling, protamination with chromomycin A3, apoptosis with annexin V, and ROS production with nitro blue tetrazolium assay. The researchers also examined serum male reproductive hormones (testosterone, luteinizing hormone, follicle stimulating hormone, and anti-Müllerian hormone), along with sperm parameters such as concentration, morphology, and motility.
The study results showed that the sperm DNA integrity (P=0.002) and protamine packaging (P<0.001) were significantly improved, in addition to a decreased production of ROS (P=0.027) and apoptosis (P=0.004) with the oral administration of antioxidants. However, the scientists did not find any alterations in the levels of the male reproductive hormones and routine sperm parameters.
Earlier, Greco et al. (Journal of Andrology, 2005) conducted a study to determine whether the oral administration of the antioxidants, vitamins C and E reduces the incidence of DNA fragmentation, pathologically enhanced in ejaculated spermatozoa. more…

From: »IVF News.Direct!«

(cz) Researchers at Perth’s Telethon Institute for Child Health Research have found that twins born as a result of assisted reproductive technology (ART) such as IVF are more likely to be admitted to neonatal intensive care and to be hospitalised in their first three years of life than spontaneously conceived twins.
The research has been published online today (Thursday 21 May) in Europe’s leading reproductive medicine journal Human Reproduction.
Study author Michele Hansen said the results were based on an analysis of hospital admissions for all twin children born in Western Australia between 1994 and 2000.
The study compared outcomes for ART twins with spontaneously conceived twins of different sex so that the results were not influenced by specific complications that can affect identical twins who share a placenta.
“We found that twins conceived following ART treatment had a greater risk of preterm birth, low birthweight and death compared with spontaneously conceived twins,” Ms Hansen said.
“ART twins stayed in hospital longer after delivery and were 60 per cent more likely to be admitted to a neonatal intensive care unit. They were also more likely to be admitted to hospital in their first three years of life.”
Ms Hansen said the findings should not alarm couples undergoing ART treatment as most babies are delivered healthy or with problems that can be easily addressed.
“The aim of this type of research is to identify any potential areas where techniques or care could be improved to ensure an even better outcome for babies and their parents,” Ms Hansen said.
“We don’t know the reason for the increased risks of health problems and preliminary analysis of specific diagnoses does not provide any answers. More research is needed to establish whether it could be due to the underlying causes of parental infertility and/or components of the ART procedure. more…

From: »InSciences«

(sz) The number of babies born to mothers over the age of 40 has more than doubled since 1997, new figures showed today.
More than 26,000 older women gave birth last year, up from under 13,000 in the year Labour came to power.
Numbers of older mothers have shot up in recent years as greater numbers of well-educated women have chosen to spend their 20s and 30s pursuing careers rather than building families.
But there has also been growing pressure on younger women having to work rather than have children because of the demands of sky-high mortgages and the increasing risk of poverty faced by couples if only one of them works.
The shift towards motherhood at greater ages has been dramatised this week by the choice of divorcee businesswoman Elizabeth Adeney to become Britain’s oldest mother at the age of 66.
The figures on older childbirth released by the Office for National Statistics said that 26,419 mothers older than 40 gave birth last year.
In 1997, the year Labour came to power, the figure was 12,914.
More than 1,000 babies were born to mothers over 45.
A woman who reaches 40 now has a more than 1 in 100 chance of having another child. The latest breakdown shows that 12.6 women in every 1,000 have children after 40. The over-40 birthrate rose by five per cent in 2008 over 2007. more…

From: »The Daily Mail«

(wz) Max Healthcare recently announced the launch of ‘My Baby’ - The Centre for IVF & Reproductive Medicine at Max Medcentre, Panchsheel Park, New Delhi. A team of gynaecologists, embryologist, radiologists, endocrinologists, andrologists, physicians and psychologists will come together at Max Healthcare’s fertility centre to provide exclusive medical care to sub-fertile or infertile couples so that they may walk away with a healthy baby. Dr Puja Dewan, Consultant, Gynaecology and Infertility Specialist will be the programme leader at the centre Said Dr Pervez Ahmed, Chief Executive Officer & Managing Director, Max Healthcare, “The centre has been conceived on par with any other IVF centre with due commitment to technology, IVF techniques and quality and will deliver the full range of services to couples requiring assistance in conception.”
Said Dr Dilpreet Brar, Regional Director-South Region, Max Healthcare, “Infertility affects nearly 10-15 per cent of couples in the reproductive age group in our country. This facility will help couples who are not able to have a child on their own and need some assistance to be able to conceive”.
The statistical distribution of infertility causes suggests female factor in 40 per cent, male factor in 35 per cent, combination of both in 10-20 per cent and the rest remains unexplained. A couple’s chances of conception after one year of regular unprotected intercourse are 80 and 90per cent after 18 months. In 15 per cent females, more than one female cause is responsible for infertility. more…

From: »Express Health Care« (India)

(cz) The package deal, long a staple of service providers from travel agencies to cable television companies, has entered the field of in vitro fertilization in Delaware County.
The Crozer Reproductive Endocrinology and Fertility Center in Upland, part of the Crozer-Keystone Health System, has introduced “multi-cycle” package that charges $12,500 for two attempts and $15,000 for three attempts. The cost of a single attempt is $9,000 to $12,000 at most reproductive centers. Several tries are often needed to achieve pregnancy and insurance typically won’t pay for the procedure.
The strategy at the Crozer center is to “make the process of achieving a healthy pregnancy more affordable and, possibly, more successful for couples experiencing fertility problems.”
In vitro fertilization is a procedure in which egg cells are fertilized outside a woman’s body, then transferred to her uterus. The Crozer center’s package plan options start at $5,500 for a single attempt.
“This field has not done much to adapt to the new economic conditions,” said Dr. Albert El-Roeiy, medical director of the Crozer Fertility Center, which has cared for 9,000 patients during the past 16 years.
While some area health-care providers have recently created programs to help patients grappling with the economic downturn, the Crozer fertility center’s package program was more than two years in the making.
Typically, in vitro fertilization treatments are administered in “cycles,” which include a variety of related diagnostic and laboratory services. If the first cycle is not successful, couples can try again — but the expense limits how many times many couples can attempt.
Under the Crozer center’s “multi-cycle” plans, patients can pre-pay for two or three IVF cycles in a package that bundles all of the related services together.
El-Roeiy said neither he nor Crozer-Keystone wanted to get involved with money-back guarantees offered by some fertility clinics. The health system didn’t want to set a precedent that patients may come to expect in other service lines. more…

From: »Philadelphia Business Journal«

(sz) A businesswoman set to become Britain’s oldest mother at 66 has left it too late to be giving birth, according to the medical world’s leading advocate for motherhood in old age.
When she gives birth next month, Elizabeth Munro will beat the previous British record for having a baby, held by Patricia Rashbrook, who became a mother at the age of 62. It is is thought that Munro became pregnant by undergoing IVF with donor eggs, like Rashbrook before her.
The news of Munro’s pregnancy reignited medical debate on the issue of the maximum age at which it is ethical to have a child.
Yesterday the man considered one of the fiercest proponents of a woman’s right to have a baby at any age spoke out against the pregnancy. Professor Severino Antinori, who treated Rashbrook and has pioneered the IVF techniques involved in impregnating older women, said Munro, who will be 67 in July, was too old.
“I am shocked by the idea of a 66-year-old woman giving birth,” he said. “I respect the choice medically but I think anything over 63 is risky because you cannot guarantee the child will have a loving mother or family.
“It is possible to give a child to the mother up to the age of 83 but it is medically criminal to do this because the likelihood is that after a year or two the child will lose his mum and suffer from psychological problems.”
Munro, who is understood never to have given birth before, is set to have her baby by caesarean section at an NHS hospital next month. She was given her IVF treatment at a clinic in Ukraine. more…

From: »The Times«

(sz) A greater understanding of the role of growth hormone (GH) in augmenting the ovarian response to gonadotropins has encouraged researchers to explore the use of GH as an adjuvant treatment for ovarian stimulation. In a recent retrospective study published in the journal, Reproductive BioMedicine Online, researchers have provided further credence to the potential of GH co-stimulation with recombinant follicle stimulating hormone (FSH) or human menopausal gonadotropin (HMG), in enhancing the IVF treatment outcomes in patients with history of repeated ART failures.
In the study conducted by Andre Hazout from the ART Unit Eylau-La Muette, Paris and coworkers, a protocol with 8 International Units (IU) of GH was evaluated in 291 patients who had ≥3 previous failures of embryo transfer without any clearly identifiable etiology. Of these subjects, the researchers analyzed only those patients (n=245) whose protocol included FSH or HMG, apart from GH. In the observational study design, the results obtained were compared retrospectively with that of the patients (with ≥3 failures) who were stimulated only with FSH or HMG, without GH.
The study results reported that the collection of oocytes and obtainment of embryos were greater in the group co-stimulated with GH. Also, a higher pregnancy rate per retrieval was noted in the study subjects when compared to the controls (25.7% versus 18.2%). Based on the findings, the scientists suggested the use of GH as an adjuvant for ovarian stimulation in patients with previous assisted reproduction failures. more…

From: »IVF News.Direct!«