Wednesday, January 15th, 2014
A group of 9 women have undergone successful womb transplant surgeries in Sweden, and their next step will be to attempt to become pregnant via in vitro fertilization (IVF)–a medical first, if successful. More from Time.com:
The women, mostly in their 30s, who were either born without a uterus or had it removed because of cancer, are part of the first major experiment to see if a woman with a transplanted uterus can become pregnant and give birth to the child. The women received wombs donated from relatives. Women from two previous womb transplant attempts–in Turkey and Saudi Arabia–both failed to carry a baby.
Scientists in several countries are working on similar operations, but the Swedish group is the most advanced, the AP reports. Dr. Mats Brannstrom, chair of the obstetrics and gynecology department at the University of Gothenburg, will hold a workshop next month on how to perform womb transplants and publish their findings.
Image: Surgeons, via Shutterstock
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Thursday, December 5th, 2013
A rise in the number of multiples–triplets or even more–born in the U.S. is being attributed in a new study to a number of fertility treatments. Though many believe multiple births to be a result of multiple embryos being transferred during in vitro fertilization (IVF) procedures, the study, published in the New England Journal of Medicine, attributes the phenomenon more to drugs given to women to encourage them to produce more eggs. The Associated Press has more:
Multiple births raise medical risks and hospital bills for moms and babies. Guidelines urging the use of fewer embryos were strengthened following the 2009 “Octomom” case, in which a California woman had octuplets after her doctor transferred 12 embryos made from an IVF treatment.
But most cases of infertility are treated not with IVF but simpler measures such as drugs to make the ovaries produce eggs. The first step often is a pill, Clomid, to spur hormones that aid conception. If that doesn’t work, more powerful drugs can be given in shots, but those bring a much higher risk of multiple eggs being released.
Doctors are supposed to use ultrasound and blood tests to monitor how many eggs are being produced and advise couples against trying to conceive that month if there are too many, to minimize the risk of multiple births. But that monitoring often isn’t done, or done well, and couples eager for a baby may disregard the advice.
“It’s very easy to demonize this dumb doctor who didn’t do the right thing. That may not always be the case,” said Dr. Nanette Santoro, obstetrics chief at the University of Colorado in Denver. “Frustrated people who don’t get pregnant after a couple cycles will think more is better. It’s the American way.”
The new study examined trends over several decades and finds that the rate of triplet and higher-order births peaked in 1998 and has been declining since then.
From 1998 to 2011, the estimated proportion of twin births due to IVF increased from 10 percent to 17 percent, while the proportion of triplets-and-more declined.
During the same period, the estimated proportion of triplet and bigger multiple births from non-IVF treatments such as fertility drugs increased from 36 percent to 45 percent.
Image: Infant sleepers on clothesline, via Shutterstock
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Friday, November 1st, 2013
A team of researchers from a number of top Boston medical institutions are working together on new research that could help the best sperm from a man’s sample travel better through fluid, increasing its chances of successfully finding and fertilizing a woman’s egg. The research, if successful, could increase the chances of success for couples who undergo in vitro fertilization (IVF). More from Boston.com:
Physicist Erkan Tuzel works in a field that seems just about as far removed as possible from delicate questions about human reproduction; his lab at Worcester Polytechnic Institute develops algorithms to describe the behavior of complex fluids. But after he heard a talk by Harvard Medical School bioengineer Utkan Demirci, who carves microscopically small channels and then allows fluids to flow through them, the two began to talk about collaborating. Their common ground? Designing technology that could cull the healthiest, fastest-moving sperm from the slowpokes.
Doctors trying to help couples reproduce through in vitro fertilization would like to have an easy way to identify and isolate the sperm most likely to result in a baby. Figuring out how to reliably do that, however, may have as much to do with physics as it does with biology.
In real-world experiments, sperm can swim through tiny channels created by Demirci at Brigham and Women’s Hospital. Computer modeling by Tuzel could be used to understand how to design those channels so that they select the right sperm.
“Sperm cells interact with each other when in confined geometries,” Tuzel said. “Just like birds when they fly in formation like a flock, similarly through the fluid, the sperm cells interact with each other and they synchronize their tails—they start beating in phase. … How can we use this information to learn from it and utilize it?”
Tuzel was recently awarded a $300,000 grant from the National Science Foundation to build computational tools that could help design systems that sort sperm in real life.
Image: Sperm collection container, via Shutterstock
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Monday, October 21st, 2013
The number of women who become pregnant using donor eggs has risen in the last decade, although the number of healthy babies born on time and at a healthy weight remains less than ideal for that group. More from The Associated Press:
That ideal result occurred in about 1 out of 4 donor egg pregnancies in 2010, up from 19 percent a decade earlier, the study found.
Almost 56 percent resulted in a live birth in 2010, and though most of these were generally healthy babies, 37 percent were twins and many were born prematurely, at low birth weights. Less than 1 percent were triplets. Low birth weights are less than about 5½ pounds and babies born that small are at risk for complications including breathing problems, jaundice, feeding difficulties and eye problems.
For women who use in vitro fertilization and their own eggs, the live-birth rate varies by age and is highest — about 40 percent — among women younger than 35.
Women who use IVF with donor eggs are usually older and don’t have viable eggs of their own. Because the donor eggs are from young, healthy women, they have a good chance of success, generally regardless of the recipient’s age.
The average age of women using donor eggs was 41 in 2010 and donors were aged 28 on average; those didn’t change over 10 years.
The study, by researchers at Emory University and the federal Centers for Disease Control and Prevention, was published online Thursday in the Journal of the American Medical Association and presented at the American Society for Reproductive Medicine’s annual meeting in Boston.
Image: Pregnant woman, via Shutterstock
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Wednesday, September 18th, 2013
The average out-of-pocket cost of fertility treatments tops $5,000, according to a new study of fertility clinics in the San Francisco area. More from Reuters.com:
As expected, researchers found costs were especially high for couples undergoing in vitro fertilization (IVF) – over $19,000, on average – and rose with each additional treatment cycle.
“One of the very early questions people ask after we figure out what we need to do to help them get pregnant is how much the treatment is going to cost,” Dr. James Smith, director of male reproductive health at the University of California, San Francisco, and the study’s senior author, said.
That expense, he told Reuters Health, “has a big impact – they’re taking out second mortgages on homes, they’re borrowing from friends and family.”
Smith and his colleagues interviewed 332 couples attending one of eight fertility clinics for their first evaluation and gave each a cost diary to record all treatment-related expenses. They then interviewed the couples three more times over the next year and a half about those expenses, including money spent on clinic visits and procedures, medications and miscellaneous items such as travel and parking.
Among all couples, the average out-of-pocket cost of fertility treatment was $5,338. However, that varied depending on what type of treatment they received – from $595 for basic, one-time procedures such as uterine fibroid removal or counseling about timing sex to $19,234 for IVF, the technique used by a majority of couples.
Expenses were higher for couples who took more time to get pregnant and underwent more treatment cycles, the researchers found.
However, there was no clear difference in out-of-pocket expenses based on whether couples reported having insurance coverage for fertility care, according to findings published in The Journal of Urology.
“Usually insurance companies will cover things like labs, the basic diagnostic testing,” Smith said. “But the expensive items, like in vitro fertilization, that’s much less well covered.”
He said that is the case in California and most other states, but that a few – including Massachusetts and Illinois – require insurance companies to have more extensive coverage of fertility treatment.
According to the Society for Assisted Reproductive Technology, women received more than 150,000 cycles of IVF in 2011.
Image: Fertility lab technician, via Shutterstock
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