Wednesday, March 28, 2007

Recent Research Says Single-Embryo Transfer IVF as Effective as Multiple Embryo Transfers

An increasing amount of research, including a study published in the March 22 edition of the journal Lancet, suggests that implanting one embryo for in vitro fertilization treatment is as likely to result in pregnancy as implanting multiple embryos, but some physicians say that most IVF patients are not interested in single-embryo transfer, the Boston Globe reports. According to the Globe, the likelihood of multiple births, premature birth and low birthweight increase with the number of embryos implanted during an IVF procedure. The Lancet study, led by Bart Fauser of Utrecht University, compared a group of women under age 38 who underwent a single-embryo transfer and a milder ovarian stimulation with a group of women who underwent multiple embryo transfers and standard ovarian stimulation. The multiple embryo group had a higher pregnancy rate after one or two IVF cycles, but the rate of the two was the same after one year.

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Tuesday, March 27, 2007

Researchers Examine Protein Vital To Reproduction, Regulation May Increase Chances Of Pregnancy

In its early and most critical stages, human reproduction requires precise, vital functions. The role of one sperm-delivered protein, which is crucial to the process, is being closely observed by scientists from the United States and Canada. Lab tests in recent years have produced valuable information and hopes of regulating that protein to enhance fertility.

Peter Sutovsky, assistant professor of animal sciences in the University of Missouri-Columbia's College of Agriculture, Food and Natural Resources and assistant professor of clinical obstetrics and gynecology in the School of Medicine, has collaborated with Richard Oko, professor of anatomy and cell biology at Queen's University (Ontario), and other academic researchers examining the role of postacrosomal sheath WW domain binding protein (PAWP), which during fertilization must function properly to initiate the reproduction process. If not, reproduction won't occur, Sutovsky said.

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Fat content of dairy foods influences fertility

Question: Women sometimes have trouble conceiving because of problems with ovulation. Might the foods they eat - specifically, the fat content of dairy products, thought by some to affect ovulation - alter women's odds of becoming pregnant?

The study: It analyzed medical and diet data on 18,555 married women, most in their early 30s, who had no history of fertility problems and who had tried to conceive or had become pregnant. During an eight-year span, infertility caused by an ovulatory problem was diagnosed in 438 of the women. This type of infertility was 85 percent more likely among those who consumed two or more servings a week of low-fat dairy products (such as skim milk, yogurt, sherbet, cottage cheese) than among women whose low-fat dairy intake was less than a serving a week. By contrast, women who consumed at least one serving a week of a high-fat dairy product (whole milk, ice cream, cheese) were 27 percent less likely to have ovulation-related infertility. Analysis of specific foods indicated that eating ice cream at least twice a week lowered the risk of infertility by 38 percent; adding a serving a day of yogurt increased the risk by 11 percent.
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Who may be affected by these findings: Women trying to conceive. Fertility is generally questioned when couples have been trying to conceive unsuccessfully for a year. Problems with ovulation are the source of infertility among women about a third of the time.

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Monday, March 26, 2007

IVF patients ignore data, keep hoping for twins

It's long been the Catch-22 of in-vitro fertilization: The chances of a successful pregnancy increase with the number of embryos implanted, but so does the likelihood of multiple pregnancies, which are riskier for both mother and offspring.

Now a new study and a growing body of research suggest that, ultimately, implanting only one embryo is just as likely to lead to pregnancy.

More and more doctors are lauding and promoting the practice of these so-called single-embryo transfers. At Massachusetts General Hospital, Dr. Thomas Toth, director of reproductive endocrinology, said it's been his "personal passion" in recent years. In 2006, he said, fully 25 percent of the 500 IVF cycles Mass. General performed were single-embryo transfers.

But other local doctors say that most of their infertility patients simply aren't interested.

That's because with single-embryo transfers it takes more tries -- and therefore more time -- to get pregnant. And when it comes to infertile patients, time is crucial.

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IVF Mistakes: Making Sure The Baby Is Yours

The Center for Disease Control (CDC) estimates 1.2 million women had an infertility-related medical appointment in 2002. More and more couples are seeking out infertility treatments such as in vitro fertilization (IVF). As the business for assisted reproduction technology booms, especially IVF, this lawsuit highlights the chance for mix-ups.

In 2002, a white British couple gave birth to black twins after an IVF mix-up. While this is not a common occurrence, clearly, mistakes do happen. It is difficult to quantify how often these mistakes happen when babies are of the same race – because it is more difficult to detect.

Dr. Randy Morris, a board certified reproductive endocrinologist and medical director of IVF1 in Chicago notes, “Each year in the us there is something like 150,000 procedures performed. Generally a story makes the news, once a year, once every other, so the risk is an estimated 1 in 150,000. If you add to this to the fact that we don’t have statistics for how many times women have an intra-uterine performed, this is an exceedingly low number of these incidences.”

Dr. Susan Lobel, a reproductive endocrinologist at American Fertility Services adds, “All reputable programs have a very careful system so that mixing up of eggs and sperm doesn’t happen. While something like this happens and gets reported, in all the cases where this happens, there is a breach in the protocol. Labs have very careful systems set up. Most of the time when this happens its because someone has breached the system, and there isn’t a problem with the system.”

For couples concerned about genetic testing while undergoing IVF, there are options.

-- Preimplantation Genetics Diagnosis (PGD) – This technique identifies genetic defects in embryos created through IVF before they are transferred to the uterus. Collecting genetic material before implantation can ensure a couple that the embryo is, in fact, a genetic match. Ask your fertility clinic in advance if they offer this testing.

-- Amniocentesis – This is a common pre-natal test where doctors take a small sample of the amniotic fluid around the fetus for examination. It is used to diagnose chromosomal and genetic birth defects. Like PGD, this allows a couple to know if the fetus is a genetic match, however then a decision must be made about continuing the pregnancy.

The Human Fertilization and Embryology Authority, which oversees IVF treatment in the United Kingdom, is also looking into ‘tagging’ embryos. The process would involve using a RFID tag, or barcode, on the sperm, eggs and embryos. The tags can set off an alarm if two Petri dishes that do not have compatible material get too close to each other. The safety and logistics of this method is still under investigation in the United Kingdom, but could offer another level of protection for patients.

For Orthodox Jewish couples, there are embryo watchers. A Rabbi oversees the process in the lab. Dr. Lobel says that this is not an option for everyone. She says this is a religious consideration, “analogous to if a restaurant is kosher, a Rabbi comes in to inspect and make sure they’re following the rules. Likewise with IVF a Rabbi, or someone who has training, comes in and observes the process. The reason is not to double check the doctors, or to imply there isn’t a system set up, but they’re there observing the process with regard to Jewish law. It is a very involved process, that is done with insemination as well as with IVF.”

So while the risk may be relatively small for a mix-up in the lab, anyone undergoing IVF should ask their doctor about the clinic’s safety procedures. Also, the fertility doctor should be a board certified reproductive endocrinologist, and the clinic should be registered with the Society of Assisted Reproductive Technologies (SART). Any assisted reproduction procedure can be a costly and emotional journey for a couple, so they deserve every precaution to deliver the baby that represents the two parts that invested in that creation.

FoxNews.com health editor Katherine Tweed contributed to this report.

Dr. Manny Alvarez is the managing editor of health news at FOXNews.com, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.

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