IVF - in pursuit of the unattainable?

The science of IVF is extraordinary. On an individual level it transforms couples’ lives, providing a solution to a devastating situation. But it’s also an expression of our collective obsession with the idea we can provide perfect lives to people in our imperfect world.

Humanity has decided its destiny is to solve all problems and provide some sort of earthly utopia. Consequently, we don’t think through the social and ethical issues of our technological progress very well.

IVF critics claim intervention is encouraged thanks to the money that can be made. This cynical view may have some truth, but no more than the deeper issue that many people not only believe they can “have it all”, but also “having it all” is a human right.

It isn’t surprising that the systems governing IVF are not sophisticated enough to deal with the wave of emotions and complex issues that arise from dabbling with the human desire to reproduce.

We are an outcome-driven society.

Governments spend millions promoting their achievements. Businesses focused on delivering profits ignore process. Our children are funnelled through 13 years of education, with only a single score received in their final high school year to show for all they’ve learned.

Being outcome-focused means the processes we undertake as human beings suffer. The ethical dilemmas presented by science and technology are not dealt with systematically. And our governments are ill-equipped to legislate when they themselves are more focused on the electorate’s interest as the end result rather than the process.

This may be because we tend towards conservatism. Our society’s initial response to change is usually negative. We oppose before engaging, whatever the issue, and prefer just to be told the end result. Our lack of participation and discussion in the decision-making process is doing us a disservice.

We continue to fail to come to terms with the issues surrounding IVF and other complex matters because we hold up choice as the dominant ethic. More choice gives us greater possibilities and opportunities to express our individuality and less chance to expose our imperfections.

The impact of that choice on the community is given insignificant attention. This is the case with scientific developments such as genetically modified crops, genetic testing and IVF technologies. All promote their ability to reduce imperfection and provide consistency in an unstable and uncertain world. But their promises of certainty are hollow without adequate longitudinal studies of their impact on society.

So I was surprised by the decision early last year not to allow a Victorian woman access to her dead husband’s sperm. The core reason was he couldn’t give his consent. His death meant his choice went to the grave with him.

To uphold the choice of the dead over that of the living is a new twist, and in some ways conflicts with another key decision in Victoria this year - to allow contact between sperm donors and their biological offspring.

How can we consider giving anonymous sperm donors access to records that will allow them to contact children they have fathered in only the most rudimentary, biological sense - even after they were under the impression that anonymity was a key clause of the initial, porn-fuelled deposit?

Yet we’re unwilling to allow a woman access to the sperm of the man she loved and shared a life with. Such decisions are made in isolation and with a lack of regard for the deeper social consciousness that tries to make sense of these outcomes.

We despise hypocrisy, but in the rapid pursuit of choice and perfection we’re unable to avoid a myriad of ethical inconsistencies.

Of course just before Christmas the Civil and Administrative Tribunal overturned this decision, and perhaps during 2006 we will have the first child fathered in Australia by a dead man. A Ripley’s Believe It or Not if ever there was one.

Still, our continued lack of adherence to rigorous and thoughtful processes exposes our human tendency to hypocrisy. We’re so very fallible. Thanks to scientific discoveries and the strangely held idea that any new science is actually “progress”, we find ourselves in an ethically confusing and contradictory world.

We need to return to the root of the dilemma and start asking questions that are progressive in action, not just in name. We need to ask how important choice is. Is it really a right for most of us to have freedom of choice above everything else?

The root of the IVF dilemma is whether IVF itself actually contributes positively to society. Is it just another example of the pursuit of unattainable perfection?

We want to believe it isn’t that complicated. But it is. The issue of fertility decision-making doesn’t have any perfect answers. The real question is not who should have access to IVF, but just how perfect do we think our lives should be?

Navigating the infertility maze

Dr John J. Stangel

For couples that have tried in vain for months -- sometimes years -- to conceive a child, the diagnosis of infertility is usually met with a barrage of emotions. The most intense of all is often confusion, as a maze of possible problems and potential solutions spurs more questions than answers. "Is it me, or is it him, or is it both of us? Will I have to take drugs, or have surgery? Do I need a specialist? Is In Vitro Fertilization (IVF) our only choice? Where do we start?"

"The field of reproductive medicine has made rapid and incredible advances over the past decade in the area of infertility treatment options, and now the vast majority of infertile couples can achieve a successful pregnancy," says Dr. John J Stangel, Westchester County Medical Director of Reproductive Medicine Associates of Connecticut. Dr Stangel, co-author of the new book, The Unofficial Guide to Getting Pregnant, adds, "But a huge amount of new information has left many couples to navigate a maze that seems to be intimidating." This can lead to emotional frustration from not knowing which path to choose, physical discomfort from unnecessary or inappropriate treatments, and even financial troubles from the cost of treatment and the confusion over insurance coverage, notes Dr Stangel.

"Fortunately, although the sea of infertility solutions is vast and deep, there is a step-by-step system that simplifies the process of determining which path is right for each individual couple," says Dr Stangel. "The first step, of course, is to consult a reproductive specialist -- a medical doctor, often an obstetrician, trained and board certified in Reproductive Medicine and infertility," he adds.

Then, after the following five steps, an infertile couple is usually on their way to a healthy, successful pregnancy:

Step 1: The fertility workup
This exam is the crucial first step for couples requiring treatment for infertility. Both mom-to-be and dad-to-be participate, and the questions range from the mundane ("How old are you?" and "Have you ever had a child?") to the complex ("Did your mother take Diethylstilbestrol [DES] when she was pregnant with you?" and "Have you ever had chemotherapy or radiation to treat cancer, and if so, what specific drugs were used?"). Dr Stangel says, "A physical examination, along with discussion of medical histories, lifestyle histories, timing of intercourse and even choices of undergarments for dad-to-be are fair game during the workup." This is also a good time to ask specific questions, or to tell your doctor about anything you suspect might pertain to your infertility.

Step 2: The hormone check
While In Vitro Fertilization and other Assisted Reproductive Technologies (ARTs) tend to get most of the attention, the fact is that only 3% of infertile couples require IVF or other ARTs to conceive. "The great majority of female infertility can be attributed to hormone imbalances," Dr. Stangel notes. "When this is the case, there are a number of drug and hormone therapies available to normalize the hormone levels, and even some lifestyle options like weight loss or weight gain that may help regulate a woman's cycle to help conception along," he adds.

Step 3: The sperm check
Motility, viscosity, quantity, quality -- the possible problems with sperm are a contributing factor in nearly half of all infertile couples' inability to conceive. "A lab experienced at doing semen analysis should evaluate the sperm. The lab results should be interpreted by a urologist, andrologist or reproductive endocrinologist – each experienced with this type of study," Dr. Stangel urges. Again, there are a number of lifestyle- related fixes for sperm issues, as well as several drug and hormone therapies available.

Step 4: The structural inspection
Along with the above studies, specialists move to the structure of both the male and female reproductive systems. Troubles in this area include blocked fallopian tubes, uterine malformations and even problems with the penile and seminal structures. "Most of the time, if there is a structural problem surgery is needed to correct these issues in order to achieve a pregnancy," says Dr Stangel.

Step 5: Exploring the ARTs
In the event that the first four steps don't result in pregnancy, Assisted Reproductive Technology can help. From In Vitro Fertilization, ZIFT, GIFT and TET procedures to promising new techniques for maturing eggs outside the womb and cryopreservation of human eggs, the ARTs are helping tens of thousands of couples each year to achieve a healthy, successful pregnancy. Originally designed for women with damaged fallopian tubes, ART is now used to address every conceivable fertility issue, with an average success rate of about 30 percent per attempt.

"While it can be overwhelming at times, with the right guidance, the maze of infertility can be a journey of hope and, ultimately, happiness for couples wishing to have a child," concludes Dr Stangel.

Home fertility tests soar

Adriana Iliescu became the world's oldest mother when she gave birth to a baby daughter at the age of 66 last year.

The children's author had reportedly undergone fertility treatment in Romania for nine years in her attempt to become a mother.

Adriana used a donor egg to create her daughter, Eliza Maria, who was born five weeks premature - a twin had died in her womb.

Elizabeth Buttle, a farmer from Carmarthenshire, became Britain's oldest mother when she gave birth to a son at the age of 60.

It later emerged that Mrs Buttle had lied about her age to receive fertility treatment from a clinic in London. But she has remained unrepentant about her decision to have a child at that age.

"I do wish I had more children while I was younger," she told sceptics a year after her son Joe's birth in 1997 - some 40 years after her first daughter Belinda was born.

"But farming is a very hard life, you're always busy and it's just one of those things you keep putting off until next year.

"A lot of mothers in their 20s, 30s and 40s die and leave children. So, just because you're older doesn't mean when you come to a certain age they are going to shoot you out of the way."

Anecdotal evidence from fertility clinics throughout England and Wales would suggest that, while Adriana Iliescu and Elizabeth Buttle may be extreme examples, large numbers of women in their 40s are seeking help to conceive - some clinics have reported that half of their clients are women aged 40 to 49.

It would appear that IVF, in spite of the age limit imposed by the NHS for its "one free go" offer, is fast becoming something of a safety net for those older women who put off parenthood earlier in life to pursue a career or financial stability.

Official figures compiled by the Office of National Statistics reveal that the proportion of women choosing to have children later in life is continuing to rise, with fathers getting older too.

The ONS said that in 2004, for the first time, the fertility rate for women aged 30 to 34 in England and Wales overtook that for the 25-to-29 age group.

The fertility rate for women aged 30 to 34 was 99.4 live births per 1,000 women - an increase of 4.9% on 2003 and the highest fertility rate in any age group since 1998.

The growing phenomenon of older parenthood - which has accompanied women becoming more visible in the workplace, and in the most senior roles - has raised a raft of concerns that women, in particular, may be being "lulled" into infertility.

A group of London-based obstetricians, writing in the British Medical Journal last year said, "The availability of in vitro fertilisation may lull women into infertility while they wait for a suitable partner and concentrated on their careers and achieving security and a comfortable living standard.

"But this expensive, invasive treatment has high failure rates - more than 70% of women undergoing a cycle of IVF do not achieve a live birth, more than 90% when older than 40."

There is also concern that male infertility is declining as a result of environmental pollution - some studies have tracked a decline in sperm numbers since the start of last century.

Nazar Amso, a senior lecturer in reproductive medicine at Cardiff University and a consultant gynaecologist, said, "There is some evidence that toxic chemicals can affect sperm quality and numbers and some of these may be increasing as pollutants in the environment.

"If this is the case then it is reasonable to assume that one has to be concerned about the future years when pollution may affect male fertility even more.

"In terms of female reproductive potential, we already know that age is an important factor and that the success of IVF treatment declines with increasing age.

"There is also evidence that pelvic inflammatory disease and repeated bouts of it can cause tube blockages and damage.

"Taking all these factors into consideration, I feel concerned that the human race's potential for reproduction is declining over time."

Peter Bowen-Simpkins, director of the Cromwell IVF and Fertility Centre, in Swansea, added, "The average age of first conception is rapidly increasing, a fact which has become very, very obvious in fertility clinics where we are seeing more and more women in their 30s coming along. And that's quite worrying.

"Lifestyle pressures are determining age of first conception - there are economic pressures as people want a job with good prospects; they want a mortgage and many want to travel more and have a few decent holidays before pregnancy. But we still have the highest teen pregnancy rate in Europe, which is very sad."

It is exactly this growing trend to delay parenthood until later in life, coupled with declining male and female fertility and long waiting lists for IVF treatment - at the moment couples are advised to wait at least a year before they even take the first steps towards seeking medical help for fertility problems - which has spawned a new market for DIY fertility tests.

But despite their high price tags - the Fertell his and hers tests developed by the University of Birmingham costs £80 and the Plan Ahead kit, which assesses the number of eggs in a woman's ovaries compared with the levels expected for others of the same age, costs £179 - experts are convinced that they are not a waste of money.

Mr Amso said, "The justification for these tests is that a couple can find out about their own fertility - it's always helpful to know whether a woman is ovulating.

"The guidelines for IVF treatment and infertility say if a couple has been trying for a year or more to get pregnant without success they should contact their GP.

"A GP will not do a sperm test on a couple who have been trying for less than a year, but if the man has tested his own sperm at home, or a woman has taken a test showing she is not ovulating, then it would be reasonable to expedite the referral to a specialist clinic."

Women with endometriosis undergoing IVF benefit from treatment with GnRH agonists

The live birth rate per woman was significantly higher in women with endometriosis who received gonadotrophin releasing hormone (GnRH) agonist for three to six months before commencing in vitro fertilisation (IVF), compared to control groups. The number of women who became pregnant was also significantly higher.

These findings are published in the latest update of The Cochrane Library.

Endometriosis is a disease in which the lining of the womb (endometrial tissue) grows outside the womb. The condition causes menstrual pain and reduces a woman's fertility.

Women who use IVF or intra cytoplasmic sperm injection (ICSI) to circumvent sub-fertility are less likely to become pregnant if they have endometriosis, compared with women whose subfertility is due to problems with their fallopian tubes. It appears that endometriosis influences egg development and prevents the ovaries producing viable eggs. Treating women with GnRH agonists can reduce the extent of endrometriosis.

By conducting a systematic review of literature, Review Authors found that giving GnRH agonists to women with endometriosis for three to six months prior to fertility treatment produces more than a four-fold increase in the chance of becoming pregnant. "The chances of having a live birth are also increased, though currently the data is not strong enough to show how great that increase is," says lead author Professor Hassan Sallam, who works in Obstetrics and Gynaecology in Alexandria University, Egypt.

"At the moment there is no data showing whether the treatment leads to better eggs or better acceptance of embryos by the lining of the womb," says Sallam. There is also no data to show whether one particular agonist is superior to others, or whether the therapy has differential effects on women with mild or severe endometrial disease.

http://www.thecochranelibrary.com

IVF: why one egg is better than two

Women who have one embryo transferred via IVF instead of two have a higher chance of taking home a baby and face lower risks, new research has found.

A study on the outcome of IVF treatment for 406 women under the age of 38, conducted by an Australian IVF clinic, found that two-thirds of women took home babies regardless of whether they had one egg transferred or two.

But of the group who had two eggs transferred, there was a twin pregnancy rate of 34 per cent, compared with 7 per cent in the single-embryo transfer group. In the group that had two eggs transferred, five babies died from premature delivery, the study, published in the journal Fertility and Sterility, also found.

Mark Bowman, clinical director of Sydney IVF, said there had been an increasing trend towards single-egg transfer and this study confirmed it was the safest and most effective option for women under 38.

"With single-egg transfer, people still have the same chance of having a baby but without exposing themselves to the significant risk of twins," Dr Bowman said.

Melbourne IVF chairman John McBain said more couples were now opting for a single-embryo transfer. He estimated that five years ago, Melbourne IVF performed twice as many two-embryo transfers as single-embryo transfers. Now, about four single-embryo transfers were performed for every three transfers of two embryos.

Monash IVF medical director Gab Kovacs said couples should be able to choose to transfer one or two embryos. He said more were opting for single-embryo transfer, and "as a matter of principle we should certainly look more seriously at putting just one back instead of two".

Professor Kovacs said that in 2005, about half the transfers at Monash IVF were single-embryo.

Watchdog warns of risks in IVF embryo testing

The safety of genetic testing on IVF embryos will be questioned in a report by the watchdog Human Genetics Commission.

It is feared that babies born after screening to "weed out" embryos with genetic defects could suffer long-term effects. This week, the commission will call for follow-up studies of all children born after such tests in order to ensure the safety of future generations.

About 200 babies are said to have been born in Britain after embryo screening, which involves removing a single cell for examination.

The method is used to weed out embryos carrying serious gene disorders. But some IVF clinics are also using it to screen out embryos with slight defects. These are not known to lead to any disorder but may increase the risk of miscarriage or IVF failure.

The watchdog will caution against widespread use of the pre-implantation genetic diagnosis technique, saying the effects of removing a cell from an embryo are not yet fully understood.

Life to be easier for IVF mums

THE heartache aspiring parents must endure during multiple IVF cycles could soon be over.

New technology could lift conception rates.

For thousands of couples, in vitro fertilisation restores to them the chance to have children, but it can be long, expensive and traumatic.

A recent study showed it cost women under 30 an average of $25,000 to have a baby using IVF. That rose to $183,000 for women over 42.

Kailing Wang, chief scientific officer of biotechnology company Life Therapeutics, said it had developed cell separation technology.

Their "sperm sorter" is able to isolate healthy sperm, significantly increasing the chances of conception.

"The most important feature of our technology is its ability to isolate the most healthy sperm, with minimal DNA damage and cellular contamination, in a matter of minutes," Dr Wang said.

"This is revolutionary for fertility treatment."

To get the healthy sperm, samples are placed in a separation chamber that has an electric field.

Healthy sperm are more negatively charged, and will be attracted to the positive electrodes. The unhealthy sperm will be isolated by their slower "electrophoretic mobility".

"Our technology is very applicable to all types of patient samples, including those who suffer from infertility problems," Dr Wang said.

"This technology produces better-quality sperm and enhances the success rate of reproductive treatment."

Clinical trials of the sperm sorter are expected to be held at the Westmead Fertility Centre in April next year.

Dr Steven Fleming, from the centre, said he was seeking approval for the year-long trial.

It would answer questions such as whether the new technology would make it cheaper for couples using IVF.

"I'm hoping that it's going to dispense with what I've often described as dinosaur technology," Dr Fleming said.

"(It could) speed up what we do, simplify what we do, reduce the risk inherent in what we do -- and all of those factors combined would be a significant step forward."

The Australian Medical Association's spokesman for obstetricians and gynaecology, Andrew Pesce, said he hoped the new technology would help women avoid some of the psychological traumas and stresses of IVF.

"IVF completely dominates your life for several months. Anything, if it works, would be good," Dr Pesce said.

CHANNEL TEN newsreader Tracey Spicer has spoken out about the heartbreak of infertility, warning women: "Don't leave it too late."

Spicer, 38, told Woman's Day she was desperate to have a child with her husband, Jason Thompson, but time and biology was working against her.

"I'm 38, and the quintessential career girl who nearly left it too late.

"It took us five years to conceive, and once I did finally get pregnant there were lots of complications," she tells Woman's Day in today's edition.

"Look, you may think at 33 that you're quite young, but I'm afraid that in some cases that's not young enough. I would urge women who do want a family not to leave it too late. We forget that having a child is a miracle."

Spicer and Thompson's son, Taj Jack Thompson, was born last January.

Five embryos optimal for IVF in older women

By Clementine Wallace

New York (Reuters Health) - For women over 40 undergoing in vitro fertilization (IVF), transferring five embryos leads to the best outcomes, investigators report.

The Society for Assisted Reproductive Technology (SART) currently recommends that no more than five embryos be transferred in women over 40. "However, this isn't based on very good data," Dr. Elizabeth Ginsburg told Reuters Health.

To test the validity of the SART guidelines, Ginsburg, from the Brigham and Women's Hospital Center For Reproductive Medicine, Boston, and colleagues evaluated and compared clinical outcomes when one to 11 embryos were transferred in women in this age group.

Specifically, of 863 transfers, 142 patients received exactly five embryos, 392 received fewer, and 329 received more than five embryos, according to the report in the medical journal Fertility and Sterility.

When fewer than five embryos were transferred, the overall pregnancy rate was 19 percent, and the live birth rate was 4percent. With five embryos, the pregnancy rate was 40 percent and the live birth rate was 23 percent.

With more than five, the overall rate was 47 percent, and the live birth rate was 22 percent -- but the risks of multiple gestations rose.

"With more than five, you increase the number of multiple pregnancies, but you don't increase the likelihood of a delivery," Ginsburg pointed out.

"Triplets have a higher risk of all kinds of bad outcomes, and twins also have higher risks of prematurity," she explained. "Women are also more likely to have diabetes and pregnancy complications with twins, especially if they're over 40."

So there is "good reason to stick with the SART recommendation, which is what is currently done in clinics," Ginsburg concluded.

SOURCE: Fertility and Sterility, December 2005.

Gene may cause infertility

Scientists say dysfunction in a key gene could explain many cases of female infertility.

In studies in mice, embryos without a gene that expresses a uterine protein called CCAAT/Enhancer Binding Protein beta (C/EBPb) could not survive in uterine tissue or attach to the mother's blood supply.

"This protein in the mouse is also in humans," lead researcher Milan K. Bagchi, a professor of molecular and integrative physiology at the University of Illinois, said in a prepared statement. "We believe it plays a critical role in human pregnancy. It is expressed in the human endometrium at a time that coincides with the time of implantation."

The report appears in this week's early online edition of the Proceedings of the National Academy of Sciences.

Protein key to decidualisation
According to Bagchi, C/EBPb is regulated by oestrogen and progesterone. Normally, it is driven mostly by progesterone, and is produced rapidly and in large quantities during the critical four-day implantation period in mice.

During this period, the embryo attaches to the uterine wall and eventually attaches to the mother's blood supply and forms the placenta. For a successful pregnancy, a process called decidualisation needs to occur. Decidualisation produces changes in the lining of the uterus that allow the embryo to link to the mother's blood supply. C/EBPb is necessary for decidualisation, Bagchi's team found.

"We have demonstrated very clearly in the mouse that in the absence of C/EBPb there is no decidualisation. We transferred viable mouse embryos from healthy mice into mice lacking the gene, and pregnancy failed," he said.

Study co-author Indrani C. Bagchi, a professor of veterinary biosciences in the College of Veterinary Medicine at Illinois, said in a statement, "This gene is expressed when the uterus is ready for embryo attachment. Its presence indicates a window for success."

May lead to better treatment
She also believes the finding could lead to more successful treatment for infertility.

"The success rate for the practice of in vitro fertilisation currently is, on average, about 25 percent," she explained. "The major problem is that the conditions occurring when the embryo is transferred often are not the best in the uterus. It's not known if the uterus is ready to accept an embryo, so often multiple embryos are transferred in hopes that one will attach. In future studies, confirmation of C/EBPb as a marker that correctly indicates uterine readiness for implantation in the human is likely to alleviate these shortcomings."

May not apply to humans
However, another expert said it is unclear whether C/EBPb will have the same function in humans as it does in mice.

"This is so far away from the human," said Dr Richard J. Paulson, a professor of reproductive medicine at the University of Southern California.

He added that doctors already have effective methods of helping patients overcome uterine implantation difficulties. "In women who have had their ovaries removed, giving them oestrogen and progesterone can induce pregnancy that is just as good as it is in women who have functioning ovaries," he pointed out.

"Through the advent of assisted reproduction, and particularly egg donation, it was discovered that oestrogen and progesterone could be supplemented, and that this results in perfectly good receptivity of the uterus," Paulson said.

Paulson said the study does enhance understanding of key factors involved in pregnancy. "Its implication is uncertain in humans," he said. "We don't know if this factor is important, and in addition, we have not as yet identified a population of women who do not respond to oestrogen and progesterone. - (HealthDayNews)

Insecticides May Be Linked in Some Degree to Male Infertility

Male infertility is a complex problem with numerous possible causes. Sometimes the cause is related to a single reason and other times it may be associated with a combination of factors. A new study now suggests that exposure to non-persistent, or short-lasting, insecticides may be one of those factors.

According to a statement made to Reuters Health by Dr. John D. Meeker, of the University of Michigan, Ann Arbor, and lead author of the study: "Environmental exposure to chlorpyrifos or its metabolite (TCPY) may be associated with reduced levels of circulating testosterone in adult men. A decline in testosterone throughout a population could potentially lead to adverse reproductive health outcomes.

Previously, a commonly used household insecticide, the Environmental Protection Agency (EPA) restricted the use of chlorpyrifos use in homes in 2000 after research revealed it can be harmful to the central nervous system.

Despite the EPA restrictions, however, there is evidence that individuals are still being exposed to the toxin. In fact, the Second National Report on Human Exposure to Environmental Chemicals found that over 90% of U.S. men had detectable levels TCPY in their urine.

A previous report by Dr. .Meeker and colleagues found that higher levels of 1-naphthol (1N) in men's urine are linked to decreased sperm count and increased DNA damage in sperm cells.

1N is a breakdown product of the compound naphthalene, found in cigarette smoke, diesel fuel and other combustion byproducts, and carbaryl, a lawn and garden insecticide known as Sevin.

Dr. Meeker and researchers from the Harvard School of Public Health and the Centers for Disease Control and Prevention (CDC) in Atlanta looked at the link between TCPY and 1N, and reproductive hormone levels in 268 men from an infertility clinic between 2000 and 2003.

According to the report published in the journal Epidemiology, men with higher urine levels of TCPY and 1N had lower levels of the sex hormone testosterone. Testosterone levels decreased along with increasing levels of TCPY, revealing that the association with TCPY was dose-dependent.

The report also noted that higher TCPY levels were also associated with a decreased free androgen index, an indication of lower testosterone concentrations.

Dr. Meeker noted that: "Although the decrements in testosterone related to TCPY were relatively small they may be of public health concern because of widespread human exposure among men.” He added that: "This is the first human evidence of an association between chlorpyrifos or its metabolite (TCPY) and testosterone levels, so other studies would be needed to substantiate our findings."

Infertility Leads To Surrogacy Minefield

WHEN an egg meets the sperm, the successful seed then releases its tightly coiled package of DNA, which fuses with the egg's own DNA and sets in motion a series of genetic events that culminate, nine months later, in the birth of a new human being.

That is how it is supposed to work.

And for hundreds of thousands of years, without anyone knowing quite how or why, it has worked — well enough to perpetuate the species, populate the planet and bring the joy and responsibility of children to countless generations of parents.

But what if it doesn't work? What if egg meets sperm and nothing happens? Human sexual reproduction can be a heartbreakingly unreliable process when the couples are infertile.

Though bio-science has made it possible to create a baby outside the human body in a lab by using a man's sperm and a woman's egg, the cold scientific experiment shut many couples out in the search for a woman willing to serve as a surrogate mother and produce for them a heir.

Read more at Infertility Leads To Surrogacy Minefield

IVF sperm 'contamination' concern

A Spanish team mixed mouse sperm with E.coli bacteria to see if accidental genetic modification could take place.

They then injected the sperm into mice eggs and found some resulting embryos did indeed contain an E.coli gene, New Scientist reports.

A UK expert said no such contamination had been known in human IVF, and was unlikely to cause ill health anyway.

The team from INIA, the Spanish agricultural research agency, used a procedure called ICSI, or intracytoplasmic sperm injection, where an individual sperm is injected directly into the egg.

ICSI is used to help men who have low sperm counts or sperm which does not move very well.

It accounts for around half of IVF procedures in many countries, including the UK and US.

But scientists have also been investigating using ICSI to make genetically modified animals, by mixing DNA with sperm before injecting it into the eggs.

Read more at IVF sperm 'contamination' concern

IVF sperm 'contamination' concern

A Spanish team mixed mouse sperm with E.coli bacteria to see if accidental genetic modification could take place.

They then injected the sperm into mice eggs and found some resulting embryos did indeed contain an E.coli gene, New Scientist reports.

A UK expert said no such contamination had been known in human IVF, and was unlikely to cause ill health anyway.

The team from INIA, the Spanish agricultural research agency, used a procedure called ICSI, or intracytoplasmic sperm injection, where an individual sperm is injected directly into the egg.

ICSI is used to help men who have low sperm counts or sperm which does not move very well.

It accounts for around half of IVF procedures in many countries, including the UK and US.

But scientists have also been investigating using ICSI to make genetically modified animals, by mixing DNA with sperm before injecting it into the eggs.

Read more at IVF sperm 'contamination' concern

Parents of IVF babies remain quiet on fertility issue

WHILE one Australian baby in 35 is now conceived through IVF, many parents still fear a stigma is attached to fertility problems.

Experts say that while about 10,000 women each year undergo the treatment nationally in an industry worth $40 million, many prefer to keep it a secret.

"There's a lot of secrecy around assisted conception and it's not entirely clear what percentage know their origins," said early childhood development expert Frances Gibson, who has conducted several studies of women on IVF programs at Macquarie University.

"Some people aren't sure how to put the words to it, how they will describe it."

As with adoption, Dr Gibson said children should know early about how they came into the world.

Telling children as soon as they started asking questions, often by the age of three, made it easier for them to discuss later on. By adolescence it was harder to alter their own sense of identity with new concepts, she said.

Read more at Parents of IVF babies remain quiet on fertility issue

Life to be easier for IVF mums

THE heartache aspiring parents must endure during multiple IVF cycles could soon be over.

New technology could lift conception rates.

For thousands of couples, in vitro fertilisation restores to them the chance to have children, but it can be long, expensive and traumatic.

A recent study showed it cost women under 30 an average of $25,000 to have a baby using IVF. That rose to $183,000 for women over 42.

Kailing Wang, chief scientific officer of biotechnology company Life Therapeutics, said it had developed cell separation technology.

Their "sperm sorter" is able to isolate healthy sperm, significantly increasing the chances of conception.

Read more at Life to be easier for IVF mums