It's not too late to book for National Infertility Day this Saturday if you haven't done so already. It promises to be a fascinating occasion, and the presence of the IVF pioneer, Professor Robert Edwards, will be interesting as it marks thirty years since the birth of the first IVF baby.
There are a huge range of speakers covering virtually every topic you can imagine. You can learn more about the latest developments in fertility treatment, about male and female fertility problems, about donor issues and complementary therapies. There are sessions on surrogacy, adoption and involuntary childlessness as well as assisted reproduction. I am going to be speaking about treatment overseas, and sharing the results of a survey on the subject that will be released tomorrow.
The day-long event is held in Covent Garden in central London, and costs just fifteen pounds. There will also be the opportunity to visit the exhibition stands run by organisations and clinics involved in the field, and to buy books from the bookstand.
If you want to find out more, go to the National Infertility Day website at www.nationalinfertilityday.com
Monday, 14 July 2008
Wednesday, 9 July 2008
Too much ICSI?
When researchers first discovered that they could inject sperm straight into an egg in order to fertilise it (Intra-cytoplasmic sperm injection or ICSI), the prospects for men with fertility problems were transformed. Thousands of men were able to father their own genetic children thanks to ICSI when once they would have had to use donor sperm.
ICSI was soon being used in clinics across the world, and seemed to promise higher success rates than normal IVF. Some doctors no longer use it just for male fertility problems, but are also suggesting it for older couples or in cases of unexplained infertility. The European Society of Human Reproduction and Embryology meeting in Barcelona was told that ICSI is being used twice as often as IVF, despite the fact that it is far more expensive. What's more worrying, it doesn't actually improve the chances of success unless there is a male factor problem, so many people are paying more unnecessarily.
Some countries use ICSI far more than others. In the UK we have a relatively low ICSI rate, along with the Nordic countries, but in Greece, Italy and Spain it has become incredibly popular. You can read more on the subject on the ESHRE website
ICSI was soon being used in clinics across the world, and seemed to promise higher success rates than normal IVF. Some doctors no longer use it just for male fertility problems, but are also suggesting it for older couples or in cases of unexplained infertility. The European Society of Human Reproduction and Embryology meeting in Barcelona was told that ICSI is being used twice as often as IVF, despite the fact that it is far more expensive. What's more worrying, it doesn't actually improve the chances of success unless there is a male factor problem, so many people are paying more unnecessarily.
Some countries use ICSI far more than others. In the UK we have a relatively low ICSI rate, along with the Nordic countries, but in Greece, Italy and Spain it has become incredibly popular. You can read more on the subject on the ESHRE website
The male biological clock
Although we're often told about new evidence that suggests perhaps there is a male biological clock after all, the evidence doesn't seem to back this up. We've all come across men who have fathered children in their fifties and even sixties - at an age when women will have stopped producing any eggs at all
The latest research on the subject presented to the European Society of Human Reproduction and Embryology (ESHRE) in Barcelona earlier this week is interesting, as it suggests that women who have partners who are over 40 don't just take longer to get pregnant, but that they are also more likely to miscarry. The researchers studies couples who were having intra-uterine insemination, or IUI, and found clear patterns emerging where the male partner was over 40. It's thought age-related DNA damage may be the cause of the problem. You can read more about the research at the ESHRE website
The latest research on the subject presented to the European Society of Human Reproduction and Embryology (ESHRE) in Barcelona earlier this week is interesting, as it suggests that women who have partners who are over 40 don't just take longer to get pregnant, but that they are also more likely to miscarry. The researchers studies couples who were having intra-uterine insemination, or IUI, and found clear patterns emerging where the male partner was over 40. It's thought age-related DNA damage may be the cause of the problem. You can read more about the research at the ESHRE website
Tuesday, 8 July 2008
Good news for frosties
I was fascinated to read that new research from Denmark has shown that babies born after frozen embryo transfers tend to weigh more, and to be less likely to be admitted to neo-natal units than their fresh counterparts. Freezing embryos is an everyday part of IVF, and yet the idea of a life being frozen in time is still quite extraordinary when you think about it.
When I started having fertility treatment about 13 years ago, some fertility experts were still suggesting that freezing embryos was potentially risky as we didn't know whether it would have any long-term side effects. Some patients chose to discard frozen embryos rather than "risk" freezing them. When I found I was pregnant after a frozen embryo transfer, I had to keep reassuring myself that the thousands of babies who'd already been born that way hadn't shown any adverse outcomes.
Now, this Danish study suggests that in fact frozen embryos may be stronger because they have to survive the freezing and thawing process, and that only the toughest will do this. You can read more here
When I started having fertility treatment about 13 years ago, some fertility experts were still suggesting that freezing embryos was potentially risky as we didn't know whether it would have any long-term side effects. Some patients chose to discard frozen embryos rather than "risk" freezing them. When I found I was pregnant after a frozen embryo transfer, I had to keep reassuring myself that the thousands of babies who'd already been born that way hadn't shown any adverse outcomes.
Now, this Danish study suggests that in fact frozen embryos may be stronger because they have to survive the freezing and thawing process, and that only the toughest will do this. You can read more here
Acupuncture and IVF
it's the one complementary therapy that we really thought could make a difference to IVF outcomes, and it wasn't just patients who were convinced - some clinics have allowed acupuncturists in to work with patients going through fertility treatment. Now, researchers are claiming acupuncture makes absolutely no difference. A team from Guy's and St Thomas' analysed all the published research on the subject, and concluded that there was no evidence that acupuncture had any effect at all on the chances of getting pregnant after IVF.
It had been thought that acupuncture could increase the likelihood of an embryo implanting in the womb if it was carried out around the time of embryo transfer, and that's one reason why it has proved so popular with fertility patients. In fact it seems the only clear effect of acupuncture is to reduce the need for pain relief at the time of egg collection.
When I wrote The Complete Guide to Female Fertility , I interviewed dozens of women who'd been through IVF, and many of them had tried acupuncture. Not one of them felt it had been a waste of time or money, and in fact most claimed they were sure it had made a real difference. Perhaps this is all psychological, but when we know that stress has a role in causing infertility, anything that helps reduce that must surely be of some benefit.
You can read more on this on the BBC website
It had been thought that acupuncture could increase the likelihood of an embryo implanting in the womb if it was carried out around the time of embryo transfer, and that's one reason why it has proved so popular with fertility patients. In fact it seems the only clear effect of acupuncture is to reduce the need for pain relief at the time of egg collection.
When I wrote The Complete Guide to Female Fertility , I interviewed dozens of women who'd been through IVF, and many of them had tried acupuncture. Not one of them felt it had been a waste of time or money, and in fact most claimed they were sure it had made a real difference. Perhaps this is all psychological, but when we know that stress has a role in causing infertility, anything that helps reduce that must surely be of some benefit.
You can read more on this on the BBC website
The truth about IVF twin risks
You're probably aware of the controversy over moves to reduce the number of multiple births after IVF, but now the deep disagreements on the subject have been highlighted at a European fertility conference in Barcelona.
An American fertility specialist, Norbert Gleicher, claimed that doctors have been exaggerating the risks of twin pregnancies to try to mislead patients who will end up having more treatment if they put back one embryo at a time. His speech at the conference was immediately condemned by many leading fertility specialists, including the chair of the European conference, who are adamant that the claims are at odds with all the evidence.
Here, the Human Fertilisation and Embryology Authority has called on clinics to cut the twin rate in order to ensure babies, and mothers, do not face unnecessary risks. One of the problems with trying to do this successfully is that not all fertility doctors are behind the move and some, like Norbert Gleicher, believe the dangers are not so great.
For most patients, it is difficult to assess what any of this means in relation to your individual situation and how many embryos you should be choosing to put back in an IVF cycle. The reality is that single embryo transfer is never going to be the right thing for everyone, but for women who have a high chance of having a twin pregnancy, it can cut out the risks without having a great impact on the chances of success. How we view the risks as patients may be largely governed by how our doctors see them and if you're treated by Norbert Gleicher you're unlikely to be insisting on a single embryo transfer. If your doctor spends time explaining what the risks might mean for you, you may be happy to give it a go. If you want to find out more about single embryo transfer, there's lots of information on the oneatatime.org,uk website.
An American fertility specialist, Norbert Gleicher, claimed that doctors have been exaggerating the risks of twin pregnancies to try to mislead patients who will end up having more treatment if they put back one embryo at a time. His speech at the conference was immediately condemned by many leading fertility specialists, including the chair of the European conference, who are adamant that the claims are at odds with all the evidence.
Here, the Human Fertilisation and Embryology Authority has called on clinics to cut the twin rate in order to ensure babies, and mothers, do not face unnecessary risks. One of the problems with trying to do this successfully is that not all fertility doctors are behind the move and some, like Norbert Gleicher, believe the dangers are not so great.
For most patients, it is difficult to assess what any of this means in relation to your individual situation and how many embryos you should be choosing to put back in an IVF cycle. The reality is that single embryo transfer is never going to be the right thing for everyone, but for women who have a high chance of having a twin pregnancy, it can cut out the risks without having a great impact on the chances of success. How we view the risks as patients may be largely governed by how our doctors see them and if you're treated by Norbert Gleicher you're unlikely to be insisting on a single embryo transfer. If your doctor spends time explaining what the risks might mean for you, you may be happy to give it a go. If you want to find out more about single embryo transfer, there's lots of information on the oneatatime.org,uk website.
Wednesday, 2 July 2008
Predicting IVF success
One of the most difficult things about fertility treatment is that no one can really give you any idea of how likely it is to work. They may tell you that based on your age, or medical condition, your chances are slightly higher or lower than average, but predictions are always vague at the best of times.
Now, researchers in the United States have managed to predict with 70% accuracy whether IVF is likely to be successful or not. The team from Stanford University in California didn't use any amazing new techniques for the study, which was published this week. Instead, looking at 665 treatment cycles, they managed to work out how to predict success from existing evidence, using four basic measures.
They found the relevant factors were
1. The number of embryos
2. The number of embryos that had 8-cells
3. The percentage of embryos that had stopped dividing and would perish
4. The woman's FSH levels
By combining these factors, they found they could obtain a surprisingly accurate analysis of the chances of success. You can read more about the research at www.plosone.org
Now, researchers in the United States have managed to predict with 70% accuracy whether IVF is likely to be successful or not. The team from Stanford University in California didn't use any amazing new techniques for the study, which was published this week. Instead, looking at 665 treatment cycles, they managed to work out how to predict success from existing evidence, using four basic measures.
They found the relevant factors were
1. The number of embryos
2. The number of embryos that had 8-cells
3. The percentage of embryos that had stopped dividing and would perish
4. The woman's FSH levels
By combining these factors, they found they could obtain a surprisingly accurate analysis of the chances of success. You can read more about the research at www.plosone.org
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