Friday, June 7th, 2013
As fertility treatments continue to advance and women continue to pursue high-powered careers, the delicate question “when is it too late to try to have a child?” is becoming a routine part of annual gynecological exams for a growing number of doctors. The Wall Street Journal reports:
It’s a touchy topic: broaching the issue of having children. But OB-GYNs say they are increasingly making it as routine as asking about contraception during annual visits. They are educating patients about fertility rates, which gradually begin to decline around age 32 and then rapidly decline after age 37. And they are discussing the risks of miscarriage and chromosomal abnormalities, which increase at age 35 and above.
About 20% of U.S. women—a growing share—wait until after age 35 to begin their families, according to data compiled by the American Congress of Obstetricians and Gynecologists. Even with significant advances in assisted-reproductive technology, or ART, a woman’s age can be a factor in getting pregnant. A healthy 30-year-old has about a 20% chance each month of getting pregnant, while a healthy 40-year-old has about a 5% chance each month—in many cases, even when using ART, the data show.
Doctors say advances in fertility treatments and media coverage of women conceiving in their 40s and even 50s have led some people to believe they can beat the biological clock. And though more women are pursuing fertility treatments, such as in vitro fertilization, using egg donors and freezing eggs and embryos, experts note that such procedures are expensive, rarely covered by insurance, and offer no guarantee for conception. Nationally, the mean age of first-time mothers was 25.4 years in 2010, up from 24.9 years a decade earlier, according to the latest data from the Centers for Disease Control and Prevention.
“I hear many people say 40 is the new 30. But not reproductively, it’s not the new 30,” says Cynthia Austin, medical director of in vitro fertilization at the Cleveland Clinic. “Our ovaries are aging at the same rate they did 50 years ago.”
Image: Doctor talking with female patient, via Shutterstock
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Monday, May 20th, 2013
A new method of performing in vitro fertilization (IVF), one of the most common medical interventions used to help infertile couples become pregnant, has shown promising initial success rates. Developed in London, the new technique involves taking time-lapse photos of embryos as they develop, enabling doctors to choose the most “low-risk” embryos–with the lowest probability of having chromosomal abnormalities or other defects that could stop their growth–to transfer into a hopeful mother-to-be. NBC News has more:
In their study, published in the journal Reproductive BioMedicine Online, the team’s chances of producing a successful live birth after in-vitro fertilization (IVF) were increased by 56 percent using the new technique compared to the standard method of selecting embryos that look best through a microscope.
“In the 35 years I have been in this field, this is probably the most exciting and significant development that can be of value to all patients seeking IVF,” said Simon Fishel, a leading fertility doctor and director at the IVF clinic operator CARE Fertility where the technique is being developed.
Independent scientists not involved in the work welcomed it as a significant advance but said full randomized controlled trials – the gold standard in medicine – should be conducted before it is adopted as mainstream practice.
“This paper is interesting because we really do need to make advances in selecting the best embryos created during IVF,” said Allan Pacey of Sheffield University, chair of the British Fertility Society.
“The idea of monitoring embryo development more closely is being used increasingly in clinics around the world and so it is good to see the science involved submitted to peer review and publication,” he added. “All too often, developments in IVF are trumpeted as advances when they remain unproven.”
Experts say that today, as many as 1 to 2 percent of babies in the Western world are conceived through IVF. The standard methods of selecting embryos are based largely on what they look like through a microscope, and many IVF cycles fail because the embryo chosen and transferred to the womb fails to develop.
Image: Petri dish containing embryos, via Shutterstock
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Friday, April 12th, 2013
Fertility drugs that stimulate the functioning of a woman’s ovaries do not add to her chances of developing ovarian cancer later in life, a new study has found. Though previous studies had made similar conclusions, many of those were conducted outside of the United States, whereas the new study was conducted on U.S. women. Reuters has more:
“One important message is women who need to use fertility drugs to get pregnant should not worry about using these fertility drugs,” said Dr. Albert Asante, lead author of the study and a clinical fellow in the division of reproductive endocrinology at the Mayo Clinic in Rochester, Minnesota….
….Infertility, defined as not getting pregnant after a year of trying, is experienced by about 15 percent of couples.
Asante’s team looked specifically at whether women in the study who reported being infertile- whether or not they had taken fertility drugs – had a greater chance of developing ovarian cancer, and found no added risk.
Asante said one explanation for the result is that most of the women in his study had infertility issues, but eventually became pregnant. He would still expect to see a higher risk of ovarian cancer if he had included more women who never ended up having a baby.
Asante left open the possibility that long term use of fertility drugs – more than one year – could impact the chance of developing ovarian cancer, and to be safe these women might benefit from additional monitoring for tumors.
He said that because ovarian cancer is rare and develops later in life, there is a need for longer studies to thoroughly assess the effect of fertility drugs.
According to the National Cancer Institute, close to 13 out of every 100,000 women develop ovarian cancer, most commonly in their 60s. Family history of the disease or certain gene mutations raise a woman’s risk considerably.
Image: Fertility injection, via Shutterstock
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Thursday, April 11th, 2013
Tom Arnold, the 53-year-old actor and comedian who was public about the infertility struggles he and his wife Ashley faced, is now the proud father of a son named Jax Copeland, PEOPLE.com reports:
Following the couple’s long battle with infertility, the actor and comedian’s son was born Saturday, weighing 8 lbs., 12 oz. His safe arrival prompted Arnold, 54, to tell PEOPLE that welcoming Jax was nothing short of miraculous.
“We are still in a bit of shock,” he said shortly after the delivery. “It has been a long journey and the healthy birth of our son is a miracle.”
Image: Tom and Ashley Arnold, via Jaguar PS / Shutterstock.com
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Wednesday, April 10th, 2013
Dr. Robert Edwards, a member of the team that pioneered the reproductive assistance technique called in vitro fertililzation (IVF), has died at age 87, according to news reports. IVF is a standard treatment for infertility, and millions of babies have been born since the technique was first developed in 1978. More from The Associated Press:
Together with Dr. Patrick Steptoe, Edwards developed in vitro fertilization, or IVF, which resulted in the birth in 1978 of the world’s first test tube baby, Louise Brown. At the time, the two were accused of playing God and interfering with nature.
Since then, the European Society for Human Reproduction and Embryology estimates that about 5 million babies have been born using the technique, which creates embryos in the laboratory before transferring them into a woman.
Edwards’ ‘‘success in IVF was one of the 20th century’s great medical feats, pursued at long odds and despite great opprobrium,’’ International Federation of Fertility Societies President Joe Leigh Simpson said.
‘‘He laid the groundwork for infertile couples worldwide to have children, with 1-4 per cent of all babies in Europe, North America and Australia now born by assisted reproductive technologies started by Professor Edwards. He will be greatly missed.’’
Experts say about 350,000 babies are born by IVF every year, mostly to people with infertility problems, single people and gay and lesbian couples.
‘‘(Edwards) was an extraordinary scientist,’’ said Dr. Peter Braude, emeritus professor of obstetrics and gynecology at King’s College London, who was at Cambridge when Edwards and Steptoe were developing IVF.
‘‘There was such hysteria around the kind of work he was doing,’’ Braude said, noting that Edwards stopped his research for two years after he published details on how he had created embryos in the laboratory. ‘‘He wanted to work out what the right thing to do was, whether he should continue or whether he was out on a limb.’’
Braude said Edwards collected donor eggs from women in Oldham, where Steptoe worked. Edwards then put the eggs into test tubes which he strapped to his legs to keep them warm before catching the train to Cambridge, where he would attempt to fertilize them in the laboratory.
After Brown was born, Braude recalled a celebration at Cambridge, where scientists toasted Edwards and Steptoe’s achievement by drinking champagne out of plastic cups.
Braude said public opinion has evolved considerably since then.
‘‘I think people now understand that (Edwards) only had the best motivation,’’ he said. ‘‘There are few biologists that have done something so practical and made a huge difference for the entire world.’’
In 2010, Edwards was awarded the Nobel prize in medicine or physiology for the development of IVF.
Image: IVF laboratory, via Shutterstock
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