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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Tuesday, October 15th, 2013
An estimated 5 million babies have been born using the fertility treatment known as in vitro fertilization (IVF) since Louise Brown became the first baby born using the technique, 35 years ago. Most of those births took place in the last 6 years, a period when researchers say the stigma surrounding infertility lessened and technology improved. More from NBC News on the first-ever research presented Monday in Boston at the meeting of the International Federation of Fertility Societies and the American Society for Reproductive Medicine:
“IVF has become sort of mainstream,” says Dr. David Adamson, a reproductive endocrinologist in San Jose and Palo Alto, Calif., who led the efforts to analyze 10 reports from two international organizations that monitor births resulting from fertility treatment.
Until now, it’s been hard to get a handle on the number of IVF births worldwide, said Adamson, who is part of a nongovernmental organization called ICMART, or the International Committee for Monitoring Assisted Reproductive Technology.
The reports spanned the years from 1989 to 2007, with a few years missing in between. They relied on available data, which is far from complete, meaning that 5 million births is really a “best guess,” says Adamson.
Researchers are relying on data that assumes they have information on two-thirds of reported IVF cycles worldwide. The figures in the 10 reports come in part from the International Working Group for Registers on Assisted Reproduction, a volunteer group of physicians that banded together in the late 1980s to begin collecting IVF data. About 10 years ago, that organization evolved into ICMART, which has continued to collect information about IVF births.
“There is so much missing data, which is the reason this hasn’t been done until now,” says Adamson. “The reality is no one will ever know exactly how many babies have been born because no one ever counted.”
There are nearly 200 countries in the world, and Adamson estimates that about half have at least one IVF clinic. But just 74 countries have ever tracked and shared their data, and they don’t all do so consistently. China, which is thought to account for close to 20% of IVF births, doesn’t report its data, although Adamson said the Ministry of Health has indicated it’s working toward that goal.
Births have increased exponentially over the years, according to the research. In 1990, a little more than a decade after the first IVF birth, about 95,000 babies were born. By 2000, that figure had grown to nearly 1 million, and by 2007, it had climbed to more than 2 million.
“A lot of this has to do with increased success rates,” says Dr. Robert Stillman, medical director emeritus at Shady Grove Fertility Center in Rockville, Md., which says it performs more IVF cycles than any other U.S. clinic. “There has been a steady improvement in the ability to culture embryos and improve pregnancy rates. A 38-year-old coming to us in 1997 versus 2007 versus 2013 has a very different prognosis.”
Image: Fertility lab, 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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Monday, September 16th, 2013
Aisha Taylor, a co-host of “The Talk,” has shared for the first time that she and her husband of 11 years have struggled to conceive a child and have undergone in vitro fertilization treatments in hopes of becoming pregnant. PEOPLE.com has more:
“We went through the process. There are all these shots, they make your body crazy, they make you emotional, they hurt. I was getting shots every day. I wasn’t telling you guys — my husband and I were going through this at home together. He hated giving me the shots, he probably cried more than I did,” Tyler, 42, told her co-hosts.
“After going through a lot of procedures and spending a lot of money … the doctor said, ‘Look, based on what we’re seeing here, I just don’t think this is going to happen for you.’”
Tearing up she continued, “The hardest part is I really love my husband — he’s such a good person and he would be such a great father. But we just decided it wasn’t worth it to go through that and so we decided to stop. It was better to not go through that torture.”
Tyler’s co-hosts, who hadn’t not known about her issues, were in tears as she told them about her struggle to become a mom. But Tyler, who says she loves kids, admitted that she hasn’t given up her baby dream completely.
“I love the idea of adoption,” she admitted when Sara Gilbert asked her about exploring other avenues. “But I feel like this is such a fresh wound that I want to let it heal for a while before I think about what we could do.”
Image: Aisha Tyler, via Helga Esteb / Shutterstock.com
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