varoblog

(sz) Prof Charles Savona Ventura co-authored a report calling for State regulation of infertility treatment. But science and politics do not always make good bedfellows, in an issue fraught with moral complications.
A study published in the Malta Medical Journal shows that the unregulated and completely privatised administration of infertility treatment has led to an increase in the birth of triplets and quadruplets, a greater health risk to newborns.
The article, “Higher order multiple pregnancy outcomes in the Maltese islands 2000-2004”, published last March, is a wake-up call for action in a field which successive governments have left unregulated.
Reproductive technology, which includes the use of fertility pills and in vitro fertilisation, only accounts for 0.7% of single births. But the same methods were used in 28% of cases involving triplets and 50% of cases involving quadruplets.
The birth of triplets and quadruplets is considered by the medical profession as more prone to health risks due to the greater likelihood that these children will be born prematurely.
Charles Savona Ventura an associate Professor of Obstetrics and Gynaecology in the Faculty of Medicine and Surgery and one of the authors of the study believes that the state should start offering infertility treatments in the national health scheme.
One reason for state intervention in this sector is affordability.
“The problem I see is that hi-tech management of infertility in Malta is only available to those who can pay or are ready to make tremendous sacrifices to pay the costs of treatment.”
Savona Ventura is concerned by the psychological impact on these parents.
“Infertile couples are so desperate that they are ready to undertake extreme sacrifices to try and achieve a pregnancy. This can result in further stresses in their relationships.”
One justification for a national programme to assist infertile couples is to “enable the low-moderate income groups to avail themselves of hi-tech options when necessary.” more…

From: »Malta Today«

(cz) Children should be taught in school about infertility as well as about avoiding pregnancy, according to the new head of the Human Fertilisation and Embryology Authority, who is concerned that few young people realise the difficulties they could face in trying for a family.
Lisa Jardine’s concerns include the issues couples face over infertility brought on by factors such as obesity.
Jardine, professor of renaissance studies at Queen Mary, London University, says infertility is too little discussed. “You’ve got to start it at school,” she said. “If one in seven of us in the modern world is going to have problems with infertility then instead of all the teaching at school being about how to stop getting pregnant someone had better start teaching about how you do get pregnant, because there are going to be a lot of extremely disappointed people out there.”
She warns of a growing problem. “I think male fertility is way down. There are probably all sorts of ecological and environmental reasons why we are less fertile.” She said children at school would be told it is incredibly easy to get pregnant and that they had better be careful. “I think we could take that opportunity to talk about what happens if it isn’t easy. In other words, that would make it less of a dreadful threat if you did not get pregnant,” she said.
Recent figures from the HFEA show that more than 32,000 women a year get fertility treatment, leading to more than 11,000 births. Studies have shown that female obesity dramatically lowers the chance of conceiving and raises the risk of serious complications during pregnancy.
The British Fertility Society issued guidelines to IVF clinics last year advising starting treatment on severely overweight women only once those women had cut their body mass index to below 35. Women under 37 years should cut their weight further, to a BMI of less than 30, the guidelines stated. A woman with a BMI above 35 was half as likely to get pregnant as a woman whose BMI was less than 30.
Some experts believe obesity could be a factor that will drive one in five couples to seek fertility treatment within a decade. more…

From: »The Guardian«

(sz) The [British – ed.] Prime Minister argues that scientists must be allowed to create embryos - for all our sakes
It was in 1998 that James Thomson, a scientist at the University of Wisconsin, successfully removed stem cells from spare embryos at fertility clinics.
His discovery established the world’s first human embryonic stem cell line and launched stem cell research into the scientific mainstream.
A decade on from that moment of discovery, Parliament will make decisions this week that will affect not only the pace of scientific advance, but also the rights of different individuals to benefit from scientific advances already made in the complex field of embryology.
Should scientists be given the legal framework they say they need to pursue new cures and treatments through stem cell research or will we turn our back on these potential advances?
Should children who face death or critical illness find new hope in scientific advances that would allow their new brother or sister to be not just a blessing to their family, but also a saviour sibling to them? And should people be able to approach IVF clinics without fear of discrimination on the grounds of their sexual orientation?
My answer to all those questions is an unequivocal yes.
I have deep respect for those who do not agree with some of the provisions in the bill because of religious conviction. But I believe that we owe it to ourselves and future generations to introduce these measures and, in particular, to give our unequivocal backing, within the right framework of rules and standards, to stem cell research.
In the 10 years since James Thomson’s discovery, scientists have shown that embryonic stem cells have the potential to help create replacement cells for a broad array of tissues and organs, including the heart, liver and pancreas.
Britain is at the forefront of this research and responsible for much of the worldwide progress, so it is vital not just for us but for the world that we continue to play that role. more…

From: »The Guardian«

(cz) The unregulated and completely privatised administration of infertility treatment has led to an increase in the birth of triplets and quadruplets, and in turn a greater health risk to newborns, a study published in the Malta Medical Journal shows.
The study is recommending the introduction of state-funded fertility treatment to put an end to the anarchy reigning in this sector.
It also says infertility treatment “must be tempered by good adequate advice” and that the stimulation of ova in women “must be regulated and restricted only to accredited specialists”.
Doctors found that while the use of fertility pills and in vitro fertilisation (IVF) treatment was used in just 0.7% of singleton births, reproductive technology was responsible for 28% of births involving triplets and 50% involving quadruplets.
The study population included a total of 20,215 deliveries between 2000-2004, which included a total of 242 twin births, 11 triplets, and two quadruplet births.
The report’s authors said that the number of twins and higher multiple births had increased by 19% since the 1960s, mainly due to the increasing use of fertility treatment.
But the study highlights how multiple births face a greater risk of premature delivery, low birth weight, and complications like respiratory distress.
“The occurrence of multiple pregnancies remains fraught with adverse outcomes in spite of the advances in obstetric antenatal surveillance,” the report warns.
The mortality rate in multiple births remains 7.5 times higher than that registered for singleton births.
And while 85% of multiple pregnancies are born prematurely, this only happens among 4% of single births. more…

From: »Malta Today«

- ESHRE 2008 - Barcelona
Barcelona
06.07.2008 - 09.07.2008
Link: http://www.eshre.com

- DGGG Kongress
Hamburg
16.09.2008 - 19.09.2008
Link: www.dggg.de/

- MEFS & STGO 2008
Tunisia
15.10.2008 - 18.10.2008
Link: http://www.mefs.org

- ASRM 2008 Annual Meeting
San Francisco, California
08.11.2008 - 12.08.2008
Link: http://www.asrm.org/

- Jahrestreffen der Deutschen IVF-Zentren
Frankfurt/Main
13.11.2008 - 15.11.2008
Link: not available yet

(wz) Österreich bleibt bei internationaler Befragung Schlusslicht hinsichtlich der Akzeptanz
Österreicher wissen im internationalen Vergleich wenig über die Forschung an embryonalen Stammzellen (ES) und lehnen diesen Wissenschaftszweig heftig ab - die Akzeptanz steigt aber langsam. Das geht aus einer groß angelegten, nun veröffentlichten Umfrage der BBVA Foundation - eine Stiftung der spanischen Bank BBVA mit Hauptsitz in Bilbao - hervor. Die Studie zeigt über einen Fünfjahresvergleich, dass die Zustimmung zur embryonalen Stammzellforschung in vielen Industriestaaten steigt. Dies gilt auch für Österreich, das aber dennoch unter den untersuchten europäischen Ländern Schlusslicht bei der Akzeptanz ist.
Die BBVA Foundation hat die Studie “Einstellungen zur Biotechnologie” nach 2003 heuer zum zweiten Mal durchgezogen und veröffentlicht. 1.500 persönliche Interviews in jedem der zwölf untersuchten europäischen Länder - Tschechien, Deutschland, Dänemark, Spanien, Frankreich, Irland, Italien, Niederlande, Polen, Großbritannien, Schweden und Österreich - sowie in den USA, in Japan und in Israel durchgeführt. more…

From: »Der Standard«

(sz) In vitro fertilization, once a long shot for couples unable to conceive naturally, is becoming a much better option thanks to new technology, but high costs still prevent some couples from pursuing the treatment.
During a recent interview, Gil Wilshire, endocrinologist at Mid Missouri Reproductive Medicine and Surgery Inc., practically jumped out of his seat when discussing the rate of IVF pregnancies, embryos that were successfully implanted.
“I can’t even believe I’m giving this to you,” he said, sliding a piece of paper with his office’s statistics across the desk. “Last month I did five transfers, and four got pregnant. … That’s incredible.”
Last year, Wilshire said, his office broke all internal records. It saw a 44 percent success rate for patients between the ages of 38 and 40 years old and a 67 percent success rate for patients ages 35 to 37. Patients older than 40 were successful 17 percent of the time. Those numbers are significantly higher than the most recent national rates, which are also on the rise. Mid Missouri Reproductive performed 56 total IVF cycles in 2007.
The Missouri Center for Reproductive Medicine and Fertility at Columbia Regional Hospital, the other large fertility clinic in town, had a slow year, with only two pregnancies out of nine IVF cycles. But the center has just completed a move into a $1.4 million renovated fertility clinic at Columbia Regional Hospital, and doctors say they’re expecting a big 2008 and 2009. more…

From: »Columbia Daily Tribune«

(cz) Health-care systems in Canada should follow the example set by those of other developed countries and fund the cost of in-vitro fertilization for women having difficulty conceiving, a University of Western Ontario medical ethicist argues in a commentary published Thursday.
The added expense would be more than offset by a drop in the number of triplets, quadruplets and other multiple-birth infants who need intensive and expensive care in neonatal intensive care unit because they were born weeks premature, Dr. Jeff Nisker wrote in an article published in the Journal of Obstetrics and Gynecology Canada.
Canada is a world leader in high-order multiple births, said Nisker, who suggested part of the reason is that women who cannot afford the full cost of IVF are taking fertility drugs in the hopes of enhancing their chances of getting pregnant.
“Women who are denied IVF frequently will take fertility drugs without the protection of IVF and single embryo transfer and they’ll wind up with triplets or quadruplets,” he said from London, Ont., where he is a professor of obstetrics and gynecology and co-ordinator for medical ethics and humanities at the University of Western Ontario.
Many developed countries pay some or all of the cost of IVF treatment, he suggested, noting even American HMOs (Health Management Organizations) pick up these expenses. But in Canada, he said, only Ontario pays for IVF, and only then for women who have complete blockages in both Fallopian tubes. Coverage is limited to three cycles. more…

From: »Times&Transcript«

(cz) [...] At a time when most people their age would be looking forward to being grandparents, they are feeding, changing and burping their merry trio.
At 53, Joyce is part of a new, growing demographic. Births to women over age 40 are soaring and so is the birth rate.
In obstetrical terms, a woman of 35 is considered to have reached “advanced maternal age.” And a woman over 40, well, she might be scaling 13,000-foot peaks or swimming laps three times a week, but her eggs are senior citizens. Her biological clock has virtually stopped.
A woman’s fertility starts to decline around age 27. According to the American Fertility Association, the chance she will get pregnant is 20-to-30 percent per cycle until her 30s and by age 40 falls to 5 percent.
But many women are lengthening their childbearing years through assisted reproductive technologies such as fertility treatments, egg donation and in vitro fertilization, in which egg cells are fertilized by sperm outside the woman’s womb and then implanted in her uterus.
In 1995 and 2006, for example, the number of babies born to women 40 to 44 grew from 67,250 to 105,476. And the number of babies born to women older than that increased from 2,727 to 6,958, according to the federal Centers for Disease Control’s National Vital Statistics System.
The birth rate of the women 40 to 44 grew by 45 percent in that time, and the birth rate for the oldest group doubled. more…

From: »Las Cruces Sun-News«

(sz) Britain has been spared the culture wars that beset America. Most of the time there is sufficient distance between religion and politics to allow individual consciences to breathe. But next week MPs will consider a clutch of issues concerning the beginnings of human life. In scrutinising the human fertilisation and embryology bill, the Commons will debate conception, termination and medical assistance for people who need it to have a baby. The series of parliamentary votes will come in quick succession, but each will raise different moral questions that need to be disentangled.
Abortion is the most familiar of the issues, though no less controversial for that. It does not feature in the bill, but amendments will be tabled to cut the term limit from 24 weeks. Late abortions are a horrible business, and there are people on all sides of the house who want to restrict them, including David Cameron and his health spokesman Andrew Lansley. But change must be resisted. The tiny minority of abortions taking place after 20 weeks tend to arise because of medical problems or family breakdown. Women wrestling with the undoubted ethical dilemmas involved do not need to be second-guessed by the law - and especially not when new research concludes that science is not making foetuses of 20 or 22 weeks any more viable. To his credit, Mr Lansley couples his position to other reforms that could make it more straightforward to get an abortion quickly, which might reduce the need for late terminations. Others, however, see cutting the limit as the first step in a longer campaign to deny all women a choice.
When it comes to creating embryos for specific purposes, the science has moved a long way since the legal framework was established 18 years ago. more…

From: »The Guardian«