I've just been reading an alarming story explaining how many clinics in the US completely ignore professional guidelines on the number of embryos that should be transferred during IVF for younger women. Here in the UK, a maximum of two embryos would be used and many women under 35 are now choosing to have one embryo put back at a time to reduce the risk of multiple pregnancy.
Apparently 80% of clinics in the US regularly transfer more that the recommended number of embryos, with some routinely transferring four embryos for women who are under the age of 35. Of course, many blame "pressure from patients", which clearly indicates that they haven't made any attempt to warn their patients of the often tragic consequences of high order multiple pregnancies. What's more likely to be the cause is their own lack of awareness of the risks they are taking with the lives of these future children and their mothers - and perhaps their own inadequacies as fertility specialists, as any consultant worth his or her salt should be aiming for success without needing to transfer four embryos.
These statistics were highlighted by the recent case of octuplets in the States. In that case, the doctor claimed to have transferred just six embryos, but even six is probably five too many in a younger women who'd already had a number of successful IVF pregnancies. You can read more about the findings here
Friday, 27 February 2009
Monday, 23 February 2009
NaPro Technology debate
Unless you happen to live in Ireland where it is quite common, you may never have heard of Natural Procreative Technology, more often known as NaPro Technology. It's a form of treatment which may be offered to couples who don't want to use any form of assisted conception, and it is often said to have high success rates. Now a debate is raging in the Journal of the American Board of Family Medicine about how effective it may be.
NaPro Technology involves close monitoring of a woman's cycle, and advocates claim it often reveals relatively simple problems that have been overlooked by conventional testing, particularly where a couple are experiencing unexplained infertility. These problems can often be treated without having to resort to assisted conception, and women who get pregnant have their hormones regularly monitored in an attempt at reducing the chances of miscarriage.
A recent study had claimed a success rate of more than 50% using NaPro Technology, with many of the patients involved having a long history of fertility problems, including unsuccessful IVF attempts. However, the response to this in the most recent edition of the Journal of the American Board of Family Medicine expresses grave concerns about using the method, particularly with older women. It is suggested that they may miss their only chance to conceive by spending time on NaPro Technology as the treatment involves monitoring for months, and may take up to two years. At a time when so many fertility problems are age-related, this does raise questions about how effective NaPro Technology may be for women who are over the age of 35. You can find more of the discussion at www.jabfm.org
NaPro Technology involves close monitoring of a woman's cycle, and advocates claim it often reveals relatively simple problems that have been overlooked by conventional testing, particularly where a couple are experiencing unexplained infertility. These problems can often be treated without having to resort to assisted conception, and women who get pregnant have their hormones regularly monitored in an attempt at reducing the chances of miscarriage.
A recent study had claimed a success rate of more than 50% using NaPro Technology, with many of the patients involved having a long history of fertility problems, including unsuccessful IVF attempts. However, the response to this in the most recent edition of the Journal of the American Board of Family Medicine expresses grave concerns about using the method, particularly with older women. It is suggested that they may miss their only chance to conceive by spending time on NaPro Technology as the treatment involves monitoring for months, and may take up to two years. At a time when so many fertility problems are age-related, this does raise questions about how effective NaPro Technology may be for women who are over the age of 35. You can find more of the discussion at www.jabfm.org
Tuesday, 17 February 2009
Marijuana link to cancer
Dope smoking is often seen as the acceptable face of illegal drug use, and it's easy to assume that smoking marijuana is really pretty harmless. However, a new study suggests that the dangers may be even greater than previously thought.
The link between regular marijuana use and impotence, low sperm quality and reduced testosterone levels in men has been established for some time, but this new research has discovered that there is also a link with testicular cancer. Regular marijuana users have double the risk of getting testicular cancer, and they seem to be particularly susceptible to the most aggressive form of the disease. You can see an abstract of the research paper here
The link between regular marijuana use and impotence, low sperm quality and reduced testosterone levels in men has been established for some time, but this new research has discovered that there is also a link with testicular cancer. Regular marijuana users have double the risk of getting testicular cancer, and they seem to be particularly susceptible to the most aggressive form of the disease. You can see an abstract of the research paper here
Regulation at work
If you have an interest in the way IVF is regulated in the UK, there's an opportunity to see the regulator at work in March when the Human Fertilisation and Embryology Authority holds an open meeting. Anyone can attend the meeting on March 18 which will be held in central London. The topics up for discussion include the public consultation on the new Code of Practice. For more details, see the HFEA website at www.hfea.gov.uk
Wednesday, 4 February 2009
It couldn't happen here...
The story of the American octuplets left most of us who've had fertility treatment wondering why anyone would choose to have eight embryos transferred, and what kind of clinic would agree to such a move. Like me, you'd probably assumed the mother must be in her forties, and the eight embryos had been a last ditch attempt at fertility treatment after many unsuccessful cycles in the past. The fact that she was only 33, and had already had six children by IVF, must surely lead to questions about the lack of regulation of fertility treatment in the US.
The Human Fertilisation and Embryology Authority often faces criticism from patients in the UK that it regulates too strictly and with an excessively paternalistic attitude, but it is thanks to our regulatory framework that high order multiple pregnancies after fertility treatment are largely a thing of the past in the UK. The case of Mandy Allwood, who lost all her eight babies more than ten years ago, led to many questions about multiple pregnancies and fertility treatment although she had not actually had IVF but had been taking fertility drugs (which does not fall under the HFEA's remit).
Transferring eight embryos is always going to be deeply questionable medical practice, but the clinician who decided to transfer eight embryos for a woman under the age of 35 who'd already had six successful IVF attempts has some difficult questions to answer. An octuplet pregnancy is dangerous for mother and babies and, as Mandy Allwood's experience shows, can so often end in tragedy.
The Human Fertilisation and Embryology Authority often faces criticism from patients in the UK that it regulates too strictly and with an excessively paternalistic attitude, but it is thanks to our regulatory framework that high order multiple pregnancies after fertility treatment are largely a thing of the past in the UK. The case of Mandy Allwood, who lost all her eight babies more than ten years ago, led to many questions about multiple pregnancies and fertility treatment although she had not actually had IVF but had been taking fertility drugs (which does not fall under the HFEA's remit).
Transferring eight embryos is always going to be deeply questionable medical practice, but the clinician who decided to transfer eight embryos for a woman under the age of 35 who'd already had six successful IVF attempts has some difficult questions to answer. An octuplet pregnancy is dangerous for mother and babies and, as Mandy Allwood's experience shows, can so often end in tragedy.
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