Archive for the ‘Education’ Category

How many eggs does it take to produce an IVF success?

Monday, September 12th, 2011

The trick answer is one. But is more always better?

According to a study in the September issue of Fertility & Sterility there is an advantage to obtaining six or more mature eggs compared with five or fewer eggs. But there was no advantage to obtaining ten or more over six to nine.

We listed the misconception that "more is better" as one of the incorrect premises in our book, "Conceptions & Misconceptions."  This study supports the concept. The reason may be releated to the facts that with heavy stimulation egg quality may not be as good and the higher estrogen levels may overstimulate the endometrium, reducing the chance of implantation. These observations have led to the concept of gentler or minimal IVF cycles.

So the trends are toward less is better; less stimulation and fewer embryos transferred to reduce multiple pregnancies.

One sperm donor, 150 children

Wednesday, September 7th, 2011

According to an article in the New York Times one sperm donor fathered at least 150 children. The story profiles a woman who searched a Web-based registry for other children fathered by the same donor and helped to create an online group to track them. Over the years, she watched the number of children in her son’s group grow. Today there are 150 children, all conceived with sperm from one donor, in this group of half siblings, and more are on the way.

Now, there is growing concern among parents, donors and medical experts about potential negative consequences of having so many children fathered by the same donors, including the possibility that genes for rare diseases could be spread more widely through the population. Some experts are even calling attention to the increased odds of accidental incest between half sisters and half brothers, who often live close to one another.

Although other countries, including Britain, France and Sweden, limit how many children a sperm donor can father, there is no such limit in the United States. There are only guidelines issued by the American Society for Reproductive Medicine, that recommends restricting conceptions by individual donors to 25 births per population of 800,000.

The bottom line for women considering sperm donation is that it may be a good idea to check their potential donor on these Web-based registries to get an idea of how many children the donor may have fathered in their area.

Caloric restriction may improve egg quality

Tuesday, September 6th, 2011

Restricting calories in women nearing the end of their reproductive years may prolong fertility and reduce chromosomal defects in offspring, research published in the Proceedings of the National Academy of Sciences suggests.

A strategy that has been shown to reduce age-related health problems in several animal studies may also combat a major cause of age-associated infertility and birth defects. Investigators from Massachusetts General Hospital (MGH) have shown that restricting the caloric intake of adult female mice prevents a spectrum of abnormalities, such as extra or missing copies of chromosomes, that arise more frequently in egg cells of aging female mammals. Their report appears in the online Early Edition of the Proceedings of the National Academy of Sciences USA.

Many studies have found that animals whose food intake is restricted but still sufficient to avoid malnutrition live longer and show fewer signs of aging than do animals given access to as much food as they want. The long-term effects of a caloric restriction diet in humans are being investigated in ongoing studies, but some health improvements, including reductions in cholesterol levels and other cardiovascular risk factors, have already been reported. An earlier study  found that female mice maintained on a caloric restriction diet during most of their adulthood maintained their fertility into very advanced ages, even after being allowed to resume free feeding.

We have commented here many times about the adverse effect of on fertility; this takes it one step further. For more information check out our Lifestyle & Fertility pages.

Egg freezing is accepted as preventing disease and age-related fertility decline…in Israel

Sunday, August 28th, 2011

According to an article in the August 2011 issue of Fertility & Sterility, the Israel National Bioethics Council (INBC) issued recommendations permitting egg freezing to prevent both disease and age-related decline in fertility. The INBC considers age-related infertility a medical problem and treats the new technology favorably as preventive medicine. As a comparison, the major regulatory bodies in Europe and the U. S. consider the procedure experimental for fertility preservation unless for a medical reason such as cancer treatment. Treating this as preventive medicine allows women to avoid the need for egg donation and ineffective infertility treatments at an advanced age.

Two recent studies demonstrated that the risk of congenital anomalies is similar to natural conception as well as conception from IVF cycles. But since the technology is so new, there are no long-term data concerning the health or emotional well-being of children conceived from frozen eggs.

I believe that the Israelis are way ahead of other western countries in accepting this technology and that it will ultimately be accepted in Europe and the U. S. as more experience is gained. At Reproductive Partners we have seen that this is an effective technique to preserve fertility for both medical and social reasons.

How many eggs do you need to have a good chance of a successful IVF cycle?

Tuesday, August 23rd, 2011

Two? Five? Twenty?

I have always said that it's not about quantity; it's more about quality. Now a study in the August 2011 issue of the medical journal Fertility & Sterility shows that more eggs after you reach a certain threshold does not make success more likely. They studied 737 women having their first IVF cycle with their own eggs. They found that there was an advantage to obtaining six or more mature eggs compared with five or fewer eggs. But there was no advantage to obtaining 10 or more eggs compared to 6-9 eggs.

Actually less stimulation might result in better egg and embryo quality accounting for the fact that larger numbers of eggs did not provide an advantage.

New evidence shows antioxidants may be helpful in infertility

Wednesday, August 17th, 2011

A growing body of evidence suggests that antioxidants may have significant value in addressing infertility issues in both women and men, including erectile dysfunction and researchers say that large, specific clinical studies are merited to determine how much they could help.

A new analysis, published online in the journal Pharmacological Research, noted that previous studies on the potential for antioxidants to help address this serious and growing problem have been inconclusive, but that other data indicates nutritional therapies may have significant potential.

The findings were made by Tory Hagen, in the Linus Pauling Institute at Oregon State University, and Francesco Visioli, lead author of the study at the Madrid Institute for Advanced Studies in Spain. The results from early research have been equivocal, Hagen said, but that may be because they were too small or did not focus on antioxidants. Laboratory and in-vitro studies have been very promising, especially with some newer antioxidants such as lipoic acid that have received much less attention.

RPMG's Dr. David Meldrum has written extensively on the effect of diet and supplements including his book, "The Survival of the Firmest." For more information see the Lifestyle and Fertility pages of our website.

A blood test to determine fetal sex at 7 weeks

Wednesday, August 10th, 2011

A study published in the Journal of the America Medical Association released today claims that a blood test at 7 weeks can reliably predict the sex of the fetus.

While the technology could help families at high risk of having a baby with rare genetic diseases, some experts also worry that couples could misuse the blood tests in order to abort a fetus based on gender.

The technology works by detecting "cell-free fetal DNA," or DNA from the fetus, which floats freely in a pregnant woman's blood, says author Diana Bianchi of the Tufts University School of Medicine in Boston. Her analysis of 57 studies from peer-reviewed medical journals showed that these blood tests, common in Europe but not in the USA, can reveal a fetus' sex only a week or two after a pregnant woman misses her period. Women usually learn the sex through an ultrasound, at 18 to 20 weeks.

Of course the test is not yet available in the U.S. and couples are warned about trying to obtain it through the Internet. Bianchi didn't evaluate claims from mail-order and Internet companies, and says there's no way for consumers to know if their results are reliable. She notes that one company offering the kits went out of business after being hit with lawsuits from disappointed customers, who said they got inaccurate results.

So, for now, I will rely on my ouija board. :)

Predicting how long a woman may remain fertile

Monday, August 8th, 2011

I don't believe it, but according to a study performed by scientists from the Universities of St. Andrews, Edinburgh and Glasgow has determined what the normal range of AMH (anti-Mullerian Hormone) levels are – this hormone reflects how active the ovaries are across a woman's lifespan.

The investigators say their findings should help younger females find out whether their menopause will arrive early or late, and thus how long they are likely to be able to get pregnant. There are no reliable or accepted tests today that can predict how many immature eggs a woman still has. AMH measurement is commonly used by doctors today as a surrogate measure of what reserves of eggs there are in the ovaries prior to IVF.

However, the AMH levels correlate well with the ability of the ovaries to respond to fertility drugs, but the levels do not even correlate directly to IVF success. In addition, up to now they have not been able to predict predict how soon a woman would lose her ability to respond or how quickly her fertility may decline.

So I don't believe it. I think they are reading too much into their results and have not shown that one test can do more than predict response at that time, certainly not predict into the future.

 

Results of a survey on couples’ beliefs about fertility

Tuesday, August 2nd, 2011

A website has been established with the results of a survey of U.S. couples' understanding of fertility issues and their attitudes toward treatment. The survey was conducted by Merck and the complete results can be found at planforsomeday.com.

Some of the interesting findings:

  • 54% of women incorrectly assume that fertility starts to decline at age 36 or older
  • 62% of women surveyed believe new stories about celebrities having babies over the age of 40 are good because they give hope (of course without disclosing that many are from egg donation)
  • 91% of couples would have seen a specialist sooner if they could do it all over again.

The take home message: get off the Internet and see a specialist now and don't be one of those regretting not doing it.

Fertility preservation for cancer patients by egg freezing

Monday, July 25th, 2011

Until recently there were no good options for preserving a woman's fertility when she had to go through cancer treatments which could potentially destroy her ferrtility. In the past several years egg freezing has become a viable option. The question that had not been answered was if the cancer itself was likely to have altered their fertility even before cancer treatments such as radiation and chemotherapy.

Now a study in the July 2011 issue of the medical journal, Fertility & Sterility, provides reassurance that on an age-related basis, cancer sufferers' fertility potential is not different than women going through IVF for male factor infertility. The author found no difference in ovarian reserve, response to fertility drugs, numbers of eggs retrieved and egg maturity between the two groups. These parameters remain unaltered by the neoplastic process. This is in contrast to the impairment of spermatogenesis before therapy in men with cancer,