Complication More in Women Having IVF Treatment

A report on IVF has emphasized that women having IVF treatment subject themselves to more risks and complications from the hormonal treatment to conceive a baby.

In-Vitro fertilization (IVF) has been very successful in women who are infertile due to problems with their eggs or tubes. In the procedure a donated egg and a sperm is fertilized outside the body and the product is then implanted inside the womb of a woman. The egg can sometimes be of a third party, a relative or sometime can originate from the woman herself.

‘The Sun’ newspaper has recently reported that a woman has succumbed to toxic shock after IVF treatment at St Mary's Hospital in Manchester.

A report published in ‘The Daily Telegraph’ daily in the UK features that one in seven women who receives IVF treatment maybe hospitalized with complication that can be serious and sometimes life threatening. The study done by a Finnish group emphasized that this risk was double when compared to natural pregnancies.

The complications include miscarriages, bleeding, ectopic pregnancy and ovarian hyperstimulation syndrome. The study looked at the results from the National Research and Development Centre for Welfare and Health in Helsinki. The survey had nearly 20,000 women who either underwent IVF or ovulation stimulation to donate eggs.

Infertility treatment's high price tag prompts doctors to deliver new financing options

Infertility specialists are turning to loan programs, discount packages, shared-risk plans and money-back guarantees to attract patients for whom the high cost of treatment has been out of reach.

"You begin to feel more like a car salesman," said Dr. Ronald Wilbois, medical director of the Infertility and IVF Center. "I sometimes ask myself, 'My God, what has medicine come to?' But the reality is that new business approaches are almost mandatory for survival."

The Infertility and IVF Center, a private clinic with offices at Missouri Baptist Medical Center in Town & Country, now offers a loan program through Capital One Bank. It allows patients to pay off their treatment costs over five years at an interest rate based on their credit score.

More than 6 million women and their partners in the United States struggle with infertility, defined as the inability to become pregnant after a year of trying, according to the most recent estimates available from the Centers for Disease Control and Prevention (CDC). That translates to about 10 percent of the reproductive-age female population.

Like other elective services, however, infertility treatments typically are not covered by insurance. Instead, most patients are required to pay the costs up front and out of pocket, and it's common for expenses to quickly rise into the tens of thousands of dollars.

Doctors assess health risks of multiple births from IVF

ELEANOR HALL: Australia's leading fertility specialists are meeting in Melbourne today to consider reducing the rate of high-risk multiple births arising from IVF treatment.

About 20 per cent of IVF births are multiple births. Not only can such pregnancies be more dangerous for the mother, but twins and triplets are also more likely to be born prematurely with all the associated health problems.

But many couples using IVF are prepared to accept the risks of having more than one embryo transferred in order to maximise their chances of having children.

In Melbourne, Lynn Bell reports.

LYNN BELL: Kellie Boyce and her husband Craig had nine attempts at IVF, over five years before having their first son Jesse.

Then, after two more attempts, Kellie Boyce became pregnant with twins.

KELLIE BOYCE: You're told from the outset it's a high-risk pregnancy, which is… I mean, for most people I think when they're pregnant they're very scared for their pregnancy and for their baby for, you know, a million different reasons.

With IVF I think you're 10 times more terrified something will happen because it's been so hard to get pregnant.

LYNN BELL: She says after so many years of trying she was keen to have a number of embryos transferred during her IVF treatment.

KELLIE BOYCE: I would've let them put six in me. That's how… that's how irrational you can be, and I would never want to say that to someone doing IVF, because you don't like to be told that you're being irrational, but I… you know, in my secret thoughts I would've taken any amount that they would put in. So it really is up to the doctors to be responsible.

LYNN BELL: The Director of Melbourne IVF, Professor John McBain, says multiple births can present risks for the mother and the children, and for that reason Australian IVF clinics will no longer transfer more than two embryos during a cycle.

JOHN MCBAIN: Many of our patients come along hoping for a twin pregnancy because they've had so many years of having no children, and that seems an ideal outcome.

They're given some very frank information about the potential complications of twins, and then they will still either be as emphatic that they want two embryos transferred, or they will say I really don't want in any circumstances to be put at risk of having a twin pregnancy.

LYNN BELL: Professor McBain is one of the speakers at today's conference, on preventing multiple gestation in IVF.

JOHN MCBAIN: It's a timely thing to do, to look at what are the positives for patients and for the society of having single embryo transfer, and what are the positives for our patients for having double embryo transfer, because there are positives on each side and it's a matter of having an informed debate to find a balance.

LYNN BELL: Earlier this year, the Federal Government appointed an independent committee to look at the effectiveness of Assisted Reproductive Technology, and to review Medicare funding for IVF.

Professor David de Kretser, from the Monash Institute of Medical Research, will chair today's meeting, and he says it's important that the current policy continues.

DAVID DE KRETSER: It's the government policy that exists today of having no limitation on the number of cycles of stimulation and IVF that's used, and that is again a very positive thing.

And so I believe the conference will urge the Government to keep up that policy, and to remove financial pressures on the couple to transfer more embryos than are necessary.

ELEANOR HALL: And that's Professor David De Kretser from the Monash Institute of Medical Research, ending that report from Lynn Bell in Melbourne

Infertility Stress

Stress: the state when the body is not functioning as a coherent and unified whole. Given this definition, when in a state of stress, the body’s physiological functions fail to meet the individual’s needs and desires. The individual and their body go out of alignment and fail to communicate and work together.

When infertility exists it’s a clear sign that one’s body is not cooperating with that individual’s desire to conceive a child and start a family. This only enhances the overall stress level. The net result is that the stress feeds on itself causing furhter stress. I call this loop "infertility stress".

Infertility stress sends the body and its reproductive capacity further out of alignment with the individual in that body creating feelings of helplessness and despair.

As a medical researcher and stress expert for over 15 years it has been my experience that this misalignment is the result of the beliefs we carry about ourselves, others, our lives, our situation etc. Beliefs conditioned in us throughout our lives wrestle control of our bodies away from us.

When a belief serves us well that’s all well and good. However when it limits us in our life it can make one feel permanently enslaved. The discouragement that ensues only furthers one’s sense of enslavement and disempowerment. Limitations can manifest as some of the following:

Being too attached to the outcome

Feeling desperate about conceiving a child

Feeling helpless and dependent on others

The fear that the next pregnancy test will be negative

Feeling inadequate

Feeling like a failure

Feeling defective

Feeling unworthy

The need to please one’s partner

The fear that time is running out

And more…

If you feel any of the above apply to you notice what the effect on your stress level is.

I have developed a new Mind/Body modality called the Mind Resonance Process™ which helps you release all limiting and negative beliefs that separate you from your body allowing you to begin reclaiming control over your entire being.

The net result is that you can again begin to love your body, reunite with it and gently guide it to where you most desire.

Dr. Nick Arrizza is trained in Chemical Engineering, Business Management & Leadership, Medicine and Psychiatry. He is an Energy Psychiatrist, Healer, Key Note Speaker,Editor of a New Ezine Called "Spirituality And Science" (which is requesting high quality article submissions) Author of "Esteem for the Self: A Manual for Personal Transformation" (available in ebook format on his web site), Stress Management Coach, Peak Performance Coach & Energy Medicine Researcher, Specializes in Life and Executive Performance Coaching, is the Developer of a powerful new tool called the Mind Resonance Process(TM) that helps build physical, emotional, mental and spiritual well being by helping to permanently release negative beliefs, emotions, perceptions and memories. He holds live workshops, international telephone coaching sessions and international teleconference workshops on Physical. Emotional, Mental and Spiritual Well Being.

Infertility and Artificial Light

Artificial light while sleeping appears to interfere with the production of melatonin, which is a hormone associated with ovarian activity. Research shows that women’s cycles normalize when artificial light is eliminated while sleeping. Eliminating the artificial light seems to allow the hormonal system to reset itself, so to speak, and take a fresh start. Couples who were thought to be infertile have been able to conceive by eliminating artificial light while sleeping.

Many women find that menstrual cycles are easier and more harmonious if they follow the cycles of the moon: menstruation on the new moon, ovulation on the full moon. Because we are surrounded by so much artificial light, even while sleeping, it can be a challenge to get in tune with the moon’s cycles. Women report being able to gradually harmonize their cycles with the cycles of the moon by sleeping in total darkness, except for one or two nights at the time of the full moon. If you want to try sleeping in total darkness, make some dark shades for your bedroom windows and make sure there is no light of any kind from your clock radio, from under your door, etc.

If you want to try harmonizing your cycle with the moon’s cycles, open your shades for one night during the full moon, and sleep in the moon’s light. If this is not possible, get a nightlight and use it only during the night of the full moon. You may have to continue this practice for some months, so be patient. You may enjoy seeing your cycles gradually respond to Grandmother Moon’s light.

Marie Zenack is a teacher of fertility awareness and a facilitator of women’s rites of passage. She lives in a spiritual community in rural Southeast Iowa, where she spends her time teaching, writing, meditating, gardening, cooking and enjoying her grandchildren. http://www.menstrual-cycle-period.com/

Infertility specialists boost marketing

Infertility specialists are turning to loan programs, discount packages, shared-risk plans and money-back guarantees to attract patients for whom the high cost of treatment has been out of reach.

"You begin to feel more like a car salesman," said Dr. Ronald Wilbois, medical director of the Infertility and IVF Center. "I sometimes ask myself, 'My God, what has medicine come to?' But the reality is that new business approaches are almost mandatory for survival."

The Infertility and IVF Center, a private clinic with offices at Missouri Baptist Medical Center in Town & Country, now offers a loan program through Capital One Bank. It allows patients to pay off their treatment costs over five years at an interest rate based on their credit score.

Read more at Infertility specialists boost marketing

Doctors sidestep laws to import stem cell 'bank'

A vast "bank" of human stem cells is to be brought to Britain, bringing hope of new cures for fatal genetic diseases but fuelling ethical concerns about embryo research.

More than 140 stem cell lines - the building blocks of human life - have been created by specialists in the United States and allied clinics in Russia, Cyprus and Belize using donated IVF embryos.

The private bank, the largest of its kind in the world, will be made available without charge to British researchers hoping to find cures for inherited diseases including the degenerative disorder Huntington's, Duchenne muscular dystrophy and the blood disorder beta-thalassaemia.

A pioneering method of "tailoring" stem cells to a particular patient, which avoids the need for embryo cloning, will also be brought to Britain.

Read more at Doctors sidestep laws to import stem cell 'bank'

Age limit on IVF

Women aged 43 or older will no longer be accepted for IVF treatment at Westmead Hospital after an audit showed their chances of having a baby with the procedure was less than 1 per cent.

The policy - which is believed to be the first formal upper age limit in a Sydney clinic - was more humane than allowing women to continue with treatment that would almost inevitably fail, said Howard Smith, the director of Westmead Fertility Centre.

Dr Smith said of the 250 women aged 43 and over the clinic had treated over five years, only two had had a baby. "We said, 'Look, we need to be open and honest … that the probability of a live birth was extremely small.' There were more who got pregnant but those ended in miscarriage."

Read more at Age limit on IVF

Albany IVF joins IntegraMed network

Albany IVF, an Albany, N.Y., practice specializing in reproductive endocrinology and infertility care services, has joined the network of IntegraMed America Inc.

IntegraMed (Nasdaq: INMD), which is located in Purchase, N.Y., provides business services to a national network of 25 fertility centers. The company also distributes pharmaceutical products and treatment financing programs directly to consumers.

Peter Horvath, who founded Albany IVF in 1997, said offering IntegraMed's Shared Risk product will enable Albany IVF to serve a broader array of patients in a way that is both "more affordable and more comforting to them." Patients can qualify for up to six in vitro fertilization cycles and will get the majority of their investment refunded if they don't become pregnant.

"In addition, we receive access to the full array of IntegraMed's services and have our name associated with some of the most prestigious fertility practices in the nation," Horvath said.

Could an international stem cell consortium make San Francisco the center of an emerging market in human ova?

IT'S CLOSE TO impossible these days to avoid the debate over the ethics of stem cell research. George W. Bush raised the curtain on his presidency in 2001 by barring federal funding for research on new stem cell lines. Last month, South Korean cloning pioneer Hwang Woo-suk announced a global initiative designed, in part, to circumvent some nations' squeamishness about this promising research.

But for all the discussion, the origins of those controversial embryonic stem cells are rarely acknowledged.

"It's as if these embryos just came from nowhere," Susan Berke Fogel, head of the nascent California activist group the Pro-Choice Alliance for Responsible Research (PCARR), told the Bay Guardian.

Actually, they come from the eggs of women – living, breathing women who will have to undergo risky procedures to have their eggs removed in the name of science.

That's because scientists have placed much of their hope in customized embryonic cells they grow themselves, using a technique called nuclear transfer. The process involves extracting genetic material from an easy-to-obtain skin cell, placing it inside an oocyte that has had its genetic material removed, and then prompting the cell to develop into a clonal embryo, from which stem cells can be extracted.

What's not evident from that description – and is so often left out of such explanations – is that an oocyte is a human egg.

That may not seem like a big deal: Women have been offering their eggs for use in fertility treatments for a quarter century. But experts say the prospect of hundreds of women undergoing egg extraction in order to supply researchers with custom-made stem cells raises novel ethical and medical questions.

Many women's health advocates believe egg extraction causes medical problems that the largely unregulated fertility industry has never been forced to address – and they worry that if this research is not handled carefully, there could be significant health risks to donors.

Bioethicists also warn that great care must be taken to ensure that donors don't have an unrealistic idea of the impact their donated ova could have on ailing friends or family.

Some even fear that without careful regulation, market forces could someday drive this whole process – and that low-income women would bear the brunt of this commercialized market in human eggs.

Until now, experts concerned about egg donation have been focused on the California Institute for Regenerative Medicine, which was set up by last year's Proposition 71 and is poised to distribute $3 billion in grants for stem cell research. Assuming the CIRM would effectively be in charge of how egg donation happens here in California, these activists have lobbied the institute to establish strict donor guidelines. Although many of the stickiest issues have yet to be worked out, both the advocates and the institute's officials have been feeling pretty good about their progress.

But nearly all were taken by surprise last month when Hwang's team announced its plan for an international network of labs that will supply new stem cell lines to researchers around the world. Dubbed the World Stem Cell Hub, the consortium will include a lab right here in the Bay Area, which could begin collecting ova from local women as early as January. And it would not automatically be subject to CIRM rules.

What will keep lab operators from offering high prices for eggs? And how can we be sure local women will get an accurate sense of the risks?

Scientists close to producing baby from two dads

IT IS a prospect worthy of a science fiction B-movie: male couples, women past the menopause, infertile couples and even celibate clergy producing their own children.

Yet this startling idea is now a serious scientific prospect, say researchers. Breakthroughs in stem-cell technology could soon lead to `non-traditional' parents having their own offspring, not always with the help of a woman's genes, some scientists saying within the next four years. The new technology currently falls outside existing controls on human fertilisation science.

"As yet the government has failed to address all the possibilities this technology opens up," said Anna Smajdor, an ethicist at Imperial College London.

Yet developments are moving so fast it is critical that a discussion of the full ethical implications of the technology be launched, she believes.

"There are no existing governmental insights or guidance as to how ethical issues related to these areas might be approached. It is something we need to address."

"You don't have to be infertile to have an interest in reproductive technology," she said last week. "This could mean anyone can become a parent; women after the menopause, gay couples, celibate men."

Pregnancy Risks: IVF or Something Else to Blame?

Women who undergo in vitro fertilization (IVF) to conceive are more likely to face various pregnancy-related risks like preeclampsia—maternal high blood pressure associated with pregnancy—and placental abnormalities. That's the conclusion of research released by a group of international medical experts.¹

Embedded Risks Possible
But some doctors not connected to the study stress that these pregnancy-related risks are typical of women who had difficulty achieving pregnancy in the first place. "It should not be surprising that women who had a medical problem that made it difficult for them to get pregnant also had problems once they became pregnant," explained William Gibbons, MD, President of the Society for Assisted Reproductive Technology (SART), in a written statement.

"The other complicating factor may be age," said Gibbons, who is a reproductive endocrinologist at the Jones Institute for Reproductive Medicine in Norfolk, Virginia. "Women who undergo infertility treatments are often older than most women who become pregnant. Age, in and of itself, is a risk factor for a more complicated pregnancy."

According to a press release about the study, it's unclear what the underlying reasons for the adverse pregnancy outcomes may be.

Link Found
The researchers found no association between the use of ART and chromosome abnormalities or birth defects in the children conceived, nor ART and low birthweight in the babies.

However, they did find a link between the use of ART and a higher risk of having an unfavorable pregnancy outcome, especially for those who underwent IVF. Those using IVF were six times as likely to develop certain placental abnormalities like placenta previa, a condition in which the placenta completely or partially covers the cervical opening. IVF patients also had two-and-a-half times the risk of developing preeclampsia, as well as a condition known as placental abruption, which involves the premature separation of the placenta from the uterine wall. Women undergoing IVF were also nearly two-and-a-half times more likely to have undergone a C-section compared to those who used other types of ART or no ART at all.

Miscarriage risk was higher, as well, for those who underwent ovulation induction, the research team found.

The Positive Side
Despite these discoveries, the investigators stressed that the "chances of having a healthy child through ART are, overall, extremely high."

Why is understanding the reality of these risks important? The investigators stress that this knowledge will help doctors counsel patients considering ART about the possibility of adverse pregnancy outcomes.

"We are pleased to see that the study re-affirmed that the children born thanks to these technologies are no more likely to have problems than other children," Gibbons said. "It is important that patients who conceive with the help of assisted reproductive technologies discuss this with their obstetricians."

Risks: Study looks at reproductive technology

A study in the November issue of Obstetrics & Gynecology finds that assisted reproductive technology (ART) does not increase risk for certain serious adverse outcomes. The study also confirms earlier findings that in vitro fertilization (IVF), the most common form of ART, raises the risk of some less-severe complications.

Researchers followed 36,062 mothers taking part in a separate federally funded study between 1999 and 2002. There were three groups: 34,286 in the natural conception group, 554 in the IVF group and 1,222 in the ovulation-induction group (whose members were given medications to stimulate ovulation).

The study - which involved only the births of single babies, not twins, triplets or other multiples - concluded that IVF "does not seem to be linked to an increase in major morbidities of pregnancy that include having a very small baby, having a baby with a birth defect as a result of treatment or having a baby that's born with a chromosome problem as a result of treatment," said Tracy Shevell, the lead study author and a perinatologist at Stamford Hospital in Connecticut.

The IVF group had a higher risk for some less-serious problems, but it's not known if this was because of IVF or an unknown infertility-related cause, Shevell said. Compared with the control group, those who had the IVF procedure were 2.7 times more likely to develop preeclampsia (pregnancy-induced high blood pressure), 2.4 times more likely to have a placental abruption (where the placenta separates prematurely), six times more likely to have placenta previa (where the placenta implants too low in uterus), and 2.3 times more likely to have a Caesarean delivery.

Group seeks to make IVF more affordable in Nigeria

In response to problems of the high cost of In Vitro Fertilization (IVF) in the country, fertility experts under the aegis of the Nigeria Fertility Society (NFS) in collaboration with the International Federation of Fertility Societies (IFFS) are seeking ways of provide low-cost IVF to all Nigerians who require it.

Speaking during the first ever international workshop on “Assisted Conception” Chairman of the NFS Scientific Committee, Prof. Oladapo Ashiru, in his paper entitled “The State of ART of Assisted Conception and the possibility of low - cost IVF in Nigeria” said IVF has come to stay in Nigeria. He noted that Nigeria has recorded great successes from IVF and that presently there are 12 IVF centers in the country observed that ART has recorded an overall success of 30 per cent pregnancy.

His words: “About 12,000 babies have been born with the aid of this technology worldwide but the very pertinent question in all of these is how many Nigerians without privilege can really enjoy it.” He recalled that between January 1995 and March 2005 the procedures and protocols for IVF programme set up and patient cares were evaluated and the protocols and procedures that can be cost saving were examined.

In his own paper entitled, “How realistic is low-cost IVF in an Unindustrialized sub region” Vice President of the NFS, Dr. John Esangbdo said IVF treatment may become widely acceptable only if third party providers understand the inseparability of diseases peculiar to women’s well being and infertility.

NFS President, Prof. Osato Giwa Osagie in his submission, urged government to establish public sector IVF units in selected hospitals as well as set up foundations and support groups to assist clients while encouraging all practitioners to offer discounted cycles to selected bonafide clients with financial constraints.

Little-discussed problem affects 15 percent of couples

Perhaps the least discussed and supported health problem affecting Georgians today is not AIDS or cancer, but infertility.
Infertility affects 6.1 million people in the U.S., which is 15 percent of reproductive age couples attempting to have a child. But unlike cancer or any other major disease, infertile people often receive little compassion or support from friends or family.
“(Infertility) is not seen as cancer or anything as horrendous as that,” said Janet Eason, former president of Resolve Georgia, a national nonprofit infertility association serving couples dealing with fertility issues. “People don’t see it as a disease, just as ‘tough luck,’ yet it can be so devastating to a marriage, family and one’s self esteem.”
It’s stressful to be infertile in a fertile world. Many men may end up struggling with masculinity issues while women may feel their bodies aren’t capable of fully functioning and are inadequate, said Sandra Fricks, a licensed marriage and family therapist who practices privately in Lawrenceville and through Covenant Counseling Center.
“When people decide to get pregnant, they’re ready and no one expects to have to consult an infertility specialist for the most part,” Fricks said.
Before couples seek fertility counseling, experts concur they should attempt a pregnancy with unprotected intercourse for anywhere between six months and a year. There are many factors that can contribute to infertility, such as smoking, drinking, acquiring sexually transmitted diseases and being overweight, said Dr. Slayden, a physician with Reproductive Biology Associates with offices also at Gwinnett Medical Center.
Although not an issue with men, a woman’s age is a factor, too. From birth, women lose eggs each year, so by the time she tops her cake with 35 candles, a woman’s egg bank is markedly less than that of a 21-year-old’s.
Once a couple decides to visit a fertility specialist there are a few options and a few hurdles.
One of the hurdles is insurance. Insurance often will refuse to cover any procedures, especially in Georgia said Slayden. Thirty percent of his patients have coverage for routine therapy, such as fertility pills while 20 percent have coverage for intrauterine insemination. And while those therapies are better than nothing, the pregnancy rates are lower and don’t help everyone.

Doctor on cutting edge of new developments in fertility

Dr. Ariel Revel is fascinated by fertility.

A member of the Department of Obstetrics and Gynecology at Hadassah Hebrew University Hospital in Jerusalem, Revel has been working on fertility in cancer patients since 2000. Recently, he spoke at the Ector County Medical Society meeting at Odessa Country Club.

"We're very much interested in preserving the ovaries of young women about to undergo cancer treatment," Revel said in an interview. He does this by freezing the woman's ovaries and later retransplanting them.

"The basic idea of this research is to find methods to preserve the fertility of young cancer patients," he said.

While it kills cancer, chemotherapy also kills a woman's eggs and the eggs don't regenerate the way hair or blood cells do after treatment, he said. This is especially frequent in patients undergoing treatment for leukemia and sarcomas.

"There are currently about one million cancer patients in the United States whose fertility issues are significant, meaning they will need (alternative) methods to have children artificially," Revel said.

At his hospital, about 100 women have preserved their ovaries to be retransplanted after cancer treatment.

"I believe this is a very significant issue, both for medical purposes É (and) in my cases it also has important psychological impact," because both the woman and her family know she may be able to have children in the future, he said. This tends to allow the woman to tolerate treatment "a lot better."

Revel was in Odessa last week as part of "Mediscope," an annual health information series focusing on the most current medical advances in Israel. His presentation last week was sponsored by Medical Center Hospital, Texas Tech University Health Sciences Center, the Ector County Medical Society and Ector County Medical Society Alliance. The title was "Medicine in the Eye of the Storm: Cutting-Edge Research and Patient Care at Hadassah Hospital."

"Fertility to me is the most fascinating field in medicine," Revel said. "I think the field requires a deep knowledge of biology. It's at the forefront of medical and scientific knowledge and there are always new techniques."

It also interests him because it helps patients create a family -- "something that gives me lots of strength and happiness in the work that I do."

"In our life, in history, we have seen a lot of death, a lot of disease. The possibility to create life is something not possible in any other field. It is truly making life. Many patients would have no children without our help today."

Research Brings New Insights for the Treatment of Male Infertility

New research is expanding what we know about the causes, diagnosis, and treatment of infertility in men.

In one recent paper, a team from New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City demonstrated the effectiveness of microsurgical sperm extraction and intracytoplasmic sperm injection (ICSI) -- techniques developed by Weill Cornell scientists -- in restoring fertility to men previously considered sterile due to Klinefelter syndrome.

And in a commentary published in the October issue of Fertility and Sterility, NewYork-Presbyterian/Weill Cornell Urologist-in-Chief and Weill Cornell Urology Chair Dr. Peter N. Schlegel compared the ease and efficacy of available sperm DNA tests.

Dr. Schlegel was also senior researcher on the study on Klinefelter syndrome, just published in the November issue of the Journal of Clinical Endocrinology & Metabolism. Both the Department of Urology and Center for Reproductive Medicine and Infertility, led by Dr. Zev Rosenwaks, collaborated on the study.

"Klinefelter syndrome affects about one in 500 or 600 men," Dr. Schlegel explained. "It occurs when the men are born with an extra X chromosome -- for reasons that are still unclear, this can dramatically lower the number of sperm in the testes. In fact, counts are so low that sperm don't leave the body, and these men were long considered sterile and untreatable."

Using a technique first described by his team in 1998 in the New England Journal of Medicine, Dr. Schlegel used microsurgery to detect viable sperm within the testes of men affected by the syndrome. Once detected, this sperm was extracted and then introduced into a mature egg using a high-tech form of in vitro fertilization called intracytoplasmic sperm injection (ICSI), previously developed by Weill Cornell scientist Dr. Gianpiero Palermo of Rosenwaks' team.

This latest study confirms the efficacy of that breakthrough technology, Dr. Schlegel said. Working with 42 men with Klinefelter syndrome, his team first used drugs called aromatase inhibitors to help boost the men's sperm production. Twenty-nine of the patients had sufficient sperm found in their testes for extraction, which were then injected into mature eggs, resulting in 18 pregnancies and 21 live births.

"The treatment allows you to use very small numbers of sperm, and it works because of surgical techniques developed here at NewYork-Presbyterian/Weill Cornell," Dr. Schlegel said. "It's given new hope to men who otherwise would never have been able to become biological fathers."

In vitro field facing slowdown

The ''test-tube baby" industry seems to have grown up.

For more than two decades, the field expanded explosively, revolutionizing a whole generation's concept of babymaking and producing more than 1 million children worldwide who would otherwise never have been conceived.

But now, fertility doctors in Boston and across the country say they are seeing a slowdown in the growth of in vitro fertilization, or IVF. At Brigham and Women's Hospital, for instance, long renowned for its reproductive care, infertility patient volume failed to grow in the last year for the first time in recent memory.

The number of infertile people is still growing, said Joseph C. Isaacs, president of Resolve, the national infertility association. Soon-to-be-released federal figures show that there were more than 6 million infertile people in 1995, compared with 7.3 million at last count in 2002.

But the growth rates of IVF are falling in part, specialists say, because of the aging of baby boomers: The youngest members of that great demographic wave are now in their 40s and starting to think more about their 401(k) than IVF.

Also, because IVF is getting more efficient, patients more often become parents after just one or two cycles now, rather than trying again and again. The better the clinics do, the faster they lose their patients.

And the cost of IVF, which can run more than $10,000 per cycle and is not covered by insurance in most states, is driving people away during uncertain economic times, Isaacs said.

Lack of means is a constant theme among callers to Resolve's infertility help line, said its coordinator, Davina Fankhauser. She can relate: She is now 17 weeks pregnant through IVF, but she and her husband went through eight years of infertility treatments -- stopping short of IVF because they could not afford it -- before moving to Massachusetts, where they found that insurance would cover it.

''I have to say the economy made me not try, actually, until I moved to Massachusetts," she said.

In 1987, Massachusetts became the first state to mandate that insurance companies cover some infertility treatments. But Isaacs and others worry that current efforts on Beacon Hill to overhaul the health insurance system may end up stripping infertile couples of that guarantee. Infertility coverage is one of the mandates in play in the debate over how to get more people insured.

''If there's a mandated program with a bull's-eye on its forehead, it's IVF," said John McDonough, executive director of Health Care for All, an advocacy group.

Fertility clinic testing new in vitro technique

A local fertility clinic is testing a surprisingly low-tech technique in women undergoing in vitro fertilization.

The usual method is to grow embryos in a temperature-controlled incubator for a few days. In the new technique, eggs are fertilized in a 2-inch plastic capsule, which is placed in the woman's vagina.

After three days, the capsule is removed, and one or more embryos are implanted in the woman's uterus.

The capsule technique eliminates the hassle and expense of incubators. There also are important psychological benefits, said Veronica Jordan, CEO of Medelle Corp., which makes the device.

"Having fertilization occur in their body is a motivating factor for women," Jordan said. "They feel more involved and more connected with the procedure."

Medelle is funding a clinical trial of the capsule at several fertility centers, including IVF 1 in Chicago and Naperville.

The capsule in vitro technique was developed in the 1980s. Studies published in the 1990s found that pregnancy rates were comparable to traditional IVF techniques. But there were technical difficulties with the capsule, and the technique didn't catch on.

Jordan said Medelle has developed a capsule that does not have the technical problems of the old device. The new capsule is called INVOcell.

INVOcell contains a culture medium to grow as many as 10 embryos. (Any embryos that aren't implanted are frozen for possible future use.)

Although INVOcell is leak-proof, carbon dioxide can diffuse into it. The vagina provides nearly the perfect temperature and carbon dioxide level for embryos, said IVF 1 medical director Dr. Randy Morris.

But some fertility doctors are skeptical. Growing embryos is a delicate process, and a low-tech method might result in lower-quality embryos and reduced pregnancy rates, said Dr. Norbert Gleicher, medical director of the Center for Human Reproduction in New York.

"Logically, this cannot work as well as a well-calibrated incubator with well-qualified technicians," Gleicher said. "I would love to be proven wrong."

INVOcell is kept in place with a diaphragm. An earlier study found that some women experience slight discomfort, while others feel nothing. A woman can take showers while carrying the capsule, but she should not take baths, go swimming or engage in sexual intercourse or vigorous exercise, Jordan said.

If the new study shows INVOcell is safe and effective, Medelle will seek U.S. Food and Drug Administration approval to market the device late next year.

The study will include infertile women younger than 35 whose mates have normal sperm counts. Participants will receive free in vitro fertilization, which normally costs about $12,000.

For more information, visit www.ivf1.com or call (630) 357-6540.

Embryo Screening Test not for picking Children

EMBRYO screening tests are unlikely to be used for parents wanting to pick the physical or social traits of their offspring.

Pre-implant genetic diagnosis, or PGD, has been available for several years for couples who want to avoid passing on genetic conditions to their babies.

An Infertility Treatment Authority symposium on assisted reproductive technology this week discussed the scientific, ethical and legal implications.

Read more at Designer kids reality check

Moral majority may drown us out

As the public is to be asked whether screening of embryos should be widened, two women whose sons were born with incurable diseases share their views with BBC Breakfast.

One of them, Melanie Denning, is currently undergoing embryo screening for cystic fibrosis, after her son Owen, five, was born with the hereditary disease.

Jane Field's seven-year-old son Murray was born with Duchenne muscular dystrophy. It cannot be screened for.

Read more at Moral majority may drown us out

Adoption Should Not be Taken Lightly as Abortion Alternative

One of the arguments that the pro-abortion movement continually tries to use to convince society of the necessity of abortion is that with adoption, the birth parents "will have someone else raise their baby." This view is seen as simply unacceptable for their rigid ideology because all pregnancies, not just all children, must be planned. It hardly seems logical that a planned pregnancy would result in an adoption plan, and therefore all adoption plans must come from an unplanned pregnancy. The solution for an unplanned pregnancy for pro-choice'ers? Abortion.

Adoption is a very loving and generous choice for a mother to make. It entails a great deal of sacrifice and trust, and it is not to be taken lightly by the pro-life movement or by the families of a woman who has offered her child to an adoptive family.

Last week, I had the opportunity to speak with a woman for about an hour whose friend is struggling immensely due to the decision she made to give her child for adoption over 20 years prior. She recently reconnected with her child only to find out that the "good, Catholic" family experienced a tragic divorce and the girl was now a pro-abortion advocate and does not attend church. This mother is now racked with guilt, regret and despair over her decision to give the child for adoption.

Read more at Adoption Should Not be Taken Lightly as Abortion Alternative

IVF Treatment bid on track for widow Rachel

A Black Country widow who is attempting to conceive using her late husband's frozen sperm has undergone her first scan since beginning IVF treatment. Rachel Wyke's fertility treatment is right on track, according to specialists at Birmingham Women's Hospital.

The 23-year-old had the scan to check progress and was told everything was as it should be, despite her case being complicated by polycystic ovaries.

Her husband Gareth died in Compton Hospice in December 2003 after a four year battle with testicular cancer. He had an amount of sperm frozen after being diagnosed.

Mrs Wyke, of Paddock in Walsall, was also prescribed the second type of IVF drug she has to inject daily. She must inject two types of drug at 6am every day until the end of this week when she is due a second scan to monitor the procedure. Mrs Wyke suffered no side effects from the first medicine but the second drug has hit her system harder.

Read the news at IVF Treatment bid on track for widow Rachel