Posts Tagged ‘ IVF ’

Three-Parent Medical Technique in Development, Could Prevent Genetic Disorders

Thursday, June 5th, 2014

British researchers are close to developing a new medical technique in which genetic material from two women and one man are used to create an embryo that would not face the risk of mitochondrial diseases.  The technique, if successful, would enable women who are carriers for mitochondrial genetic mutations to bear children.  More from NPR:

“I think that [two years] is not a bad estimation,” Robin Lovell-Badge of the Medical Research Council tells . “The other sorts of experiments that we thought were necessary, again it will take about two years to complete all of those.”

The procedure targets problems in mitochondria, the energy-producing organelles that have their own DNA. Their genome is both prone to mutation and inherited maternally — characteristics that have led researchers to think up ways to help women who carry mutated genes to have healthy children.

The British panel has been reviewing two treatment methods that involve using either a donor embryo or a donor egg from a woman with normal mitochondria. The parents would contribute nuclear DNA, but the mitochondrial DNA would come from a donor.

Before that process occurs in Britain, it would have to be made legal. And as you might imagine, the review panel is also considering ethical and safety consequences.

“The direction of travel still suggests that it is all safe, but we don’t know what’s round the corner so we’re being a little cautious,” says Lovell-Badge, who is on a review board of Britain’s Human Fertilization and Embryology Authority.

The HFEA group saying evidence “does not suggest that these techniques are unsafe,” but that more experiments need to be conducted before clinical treatments begin. (You can ).

The process under review is often called oocyte modification, or more generally, three-parent IVF. In the U.S., convened meetings about a similar procedure in February, seeking expert and public comment.

Image: DNA map, via Shutterstock

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Insurance Coverage for IVF May Reduce Multiple Births

Friday, May 16th, 2014

A study of insurance coverage of in vitro fertilization (IVF) in Canada has found that the more complete the coverage of the common fertility procedure, the fewer multiple births are recorded.  Multiple births–twins, triplets, or more–often happen when multiple embryos are transferred into a woman’s uterus as part of IVF.  And multiple-embryo transfers often happen when women have limited resources to pursue a number of IVF cycles.  Reuters has more on the Canadian study:

Quebec’s universal health insurance started covering all IVF-related costs in mid-2010. The new research is based on data from the first full year of coverage.

“Multiple pregnancies have important health consequences for pregnant women and their babies,” said lead author Dr. Maria Velez, from the University of Montreal.

Multiple pregnancies have an emotional and economic impact on families and cost the health system, which is a delicate point to bring up with patients dealing with fertility issues, she told Reuters Health by email. Patients are often misinformed about the negative consequences of multiple pregnancies, she said.

“Our obligation as medical doctors is to place the health of our patients above all,” Velez said. “Our role is to prevent a patient choosing a treatment that may cause harm if there is a safer alternative.”

Five fertility centers offer IVF in Quebec. The new study compared data from the Canadian Assisted Reproductive Technologies Register from those centers in 2009, before IVF was covered, and in 2011.

There were 1,875 fresh IVF cycles performed in 2009, which rose to 5,489 cycles in 2011. The number of clinical pregnancies and projected live births increased, while the rate of multiple pregnancies decreased from 29 percent to six percent.

And although public coverage of IVF led to more government spending per treatment cycle, the cost per live birth decreased, according to results published in Human Reproduction.

Researchers said the rate of multiple pregnancies likely fell because in Quebec, as in other areas with covered IVF, public policy requires that only one embryo be transferred at a time into women under age 36, called single-embryo transfer (SET). There were no restrictions on the number of embryos transferred at one time before the public coverage policy.

Under the policy, women who undergo IVF can still have several eggs harvested and embryos produced at once, but only one fresh one is implanted. The rest are frozen, and if the first embryo does not survive, another can be thawed and implanted.

Single-embryo transfer was much more common under universal coverage: 32 percent of cycles were elective SET in 2011, compared to two percent in 2009.

“This confirms what a lot of IVF practitioners have held in the U.S., that with insurance coverage single-embryo transfers are more likely to be done which is going to lower multiple birth rates which is safer and less expensive,” said Dr. Bradley J. Van Voorhis, director of the IVF Program at the University of Iowa Carver College of Medicine in Iowa City.

Image: Test tubes, via Shutterstock

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Fertility Clinic Data May Be Difficult to Interpret

Thursday, May 1st, 2014

The multibillion dollar fertility industry tracks data on success rates and other measures of its work with women who are struggling to conceive a child, but the data–which tends not to get regulatory enforcement from the CDC and other agencies–may be difficult to decipher.  More from The New York Times:

This is a multibillion-dollar industry, and there is financial pressure for clinics to claim frequent success. “Clinics are competing with each other based on pregnancy and live birthrates,” said Dr. Vitaly Kushnir, a reproductive endocrinologist in New York who researches success rates. The clinics do not want give out negative data that might drive away patients.

Nationally, the data suggest that a 38- to 40-year-old woman using her own unfrozen eggs has on average a 21.6 percent chance per cycle of having a baby by means of assisted reproductive technology. The average treatment cost per cycle rings in at $12,400, according to the American Society for Reproductive Medicine.

A cycle, which can take on average from 60 to 90 days from the time of the initial consultation, typically starts with hormone injections, followed by egg retrieval, fertilization and then embryo transfer. But the national success rate does not distinguish between pregnancies occurring in the first cycle or a second, fifth or later cycle. The number of cycles needed to achieve a successful pregnancy makes a big difference to would-be parents in terms of money, time and emotional strain.

The clinics also are not required to report babies born full-term or not, or those born with birth defects. “The outcome data should be included to reflect the most important goals and measures of success in I.V.F. — a healthy baby and healthy mother,” said Dr. Kushnir. Moreover, success rates at individual clinics may vary widely, depending in part on the populations they serve. Some clinics have been known to turn away women who may be difficult cases — older women or those with existing medical conditions, for example — to avoid depressing their success rates.

To potential patients browsing online, it may not be clear how these clinics define success. “Someone might think the success rate is the number of live births, when really the clinic is reporting the number of clinical pregnancies,” said Jim Hawkins, a law professor at the University of Houston who has studied the claims made on the websites of fertility clinics.

Dr. Kushnir and other researchers have pushed for more public information on the health of babies and mother after I.V.F. At the moment, potential patients can check reported success rates online, with the Society for Assisted Reproductive Technologies and the C.D.C., which separates the data by pregnancy and live births.

Image: Pregnancy test, via Shutterstock

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New 3D Film Technique Could Help IVF Success Rates

Wednesday, February 12th, 2014

A new technique that takes 3D film of moving sperm could help doctors select those sperm that have the best chance of fertilizing an egg and leading to a successful pregnancy in cases where couples are undergoing in vitro fertilization (IVF) fertility treatments.  More from The Optical Society, the professional scientific organization that published the research in its journal:

Now doctors may soon have a new technique to help them sort the good sperm cells from the less viable ones: a tracking system, developed by a team of researchers from four European institutions, that takes 3-D movies of living sperm. In addition to showing the sperm’s movement and behavior in real time, the novel method simultaneously provides detailed 3-D imaging of the sperm’s form and structure to detect potential infertility-causing anomalies, such as the “bent tail” that prevents the cells from swimming straight.

The researchers say this is the first technique for collecting data on sperm cell motility—a key predictor of IVF success—in three dimensions and over time. They describe their method in a paper published today in The Optical Society’s (OSA) open-access journal Biomedical Optics Express.

Currently, sperm concentration and mobility in semen are assessed either by subjective visual evaluation or a process known as computer-assisted sperm analysis (CASA). While the latter provides more detail and fewer errors than the former, CASA still only allows tracking and imaging in two dimensions. In their new technique, the team of researchers from Italy and Belgium combined microscopy and holography—the creation of 3-D images—to visualize live sperm in not only two dimensions (the x and y positions) but according to their depth (z position) as well.

And, “by acquiring a video of the moving sperm in 3-D, we add a fourth dimension – time,” said lead author Giuseppe Di Caprio of the Institute for Microelectronics and Microsystems of the National Research Council (NRC) in Naples, Italy, and Harvard University in Cambridge, Mass.

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Chemical that Readies Womb for Embryo Implantation Identified

Friday, February 7th, 2014

A new study from British researchers have identified a chemical, secreted by healthy embryos, that signals the womb to make itself receptive to implantation and pregnancy.  The findings have far-reaching implications for women who are struggling to achieve and sustain a pregnancy.  More from the researchers at Warwick Medical School:

Before implantation, human embryos are genetically very diverse. Some embryos will contain no normal cells at all while others contain a mixture of normal and abnormal cells. Hence, no two human embryos are the same at this early stage of development.

The article, published today in Scientific Reports, shows that high quality human embryos secrete a chemical, trypsin, which renders the lining of the womb supportive of implantation. This chemical signal is deregulated in low quality embryos and causes an alarm response in the womb, which leads to either rescue or elimination of the embryo.

Professor Jan Brosens explained, “This is important, because if the lining of the womb is not well prepared for pregnancy you may find that abnormal embryos will implant or high quality embryos will not be supported. Both scenarios can lead to pregnancy loss or even late pregnancy complications, such as foetal growth restriction or preterm birth.”

“Speaking in terms of an entrance exam; a poorly prepared womb will either make the test too rigorous or too lax – decreasing the chances of a successful pregnancy.”

Approximately 15% of clinically recognised pregnancies miscarry, attributed to the invasive nature of the human embryo and prevalence of chromosomal errors.

Professor Siobhan Quenby said, “This work adds to a growing body of evidence that assessment and optimisation of the lining of the womb may be the only effective way in preventing infertility and pregnancy complications.”

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