IntegraMed Conference Identifies 3 Trends That Will Transform Fertility Success Rates

The three trends in fertility treatment are:

1. Improved pregnancy rates with decreased multiple rates through metabolomics. With metabolomics, embryo quality can now be evaluated non-invasively to more accurately measure their quality. In doing so, only the most viable embryo needs to be transplanted rather than multiple embryos, thus improving pregnancy rates while significantly reducing the instances of multiples through in vitro fertilization (IVF).

2. Use of vitrification technology to successfully freeze eggs. One of the most exciting and long-awaited advances in fertility preservation is the ability to successfully freeze eggs via a technology called vitrification. Through vitrification, eggs are plunged in liquid nitrogen and instantly frozen, ensuring that this largely water-based cell does not form crystals that would expand and disrupt the egg’s membrane.

Dr. Schnorr predicts that within the next three to four years about 25% of all fertility preservation will utilize vitrification.

3. Improvement in the evaluation and treatment of severe male-factor infertility. Today 40 percent of infertility problems are attributed to the man. Procedures to improve the evaluation, risk assessment and treatment of severe male-factor infertility were discussed

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Global IVF Launches First Video Guest Expert Series

Global IVF strives to bring you the most current and useful information regarding all things infertility related around the world. Every month, Global IVF features ‘experts’ in their field – a reproductive endocrinologist, a reproductive clinic, an embryologist, a reproductive lawyer, a medical tourism company, a therapist, etc. Not only will you be privy to their inside information and expertise, with many of them you will have the chance to ask and get answers to your own specific questions!

This week Global IVF is featuring Guest Expert Dr. Daniel Potter of Huntington Reproductive Center and MicroSort West in Laguna Beach CA. This is the first video in a three part series featuring Dr. Potter. Doctor Potter’s active research interests include gender selection, ovarian reserve testing, endometrial preparation for IVF with donor egg, embryo cryopreservation and frozen embryo transfer. Dr. Potter is also author of the book: What to Do When You Can't Get Pregnant: The Complete Guide to All the Technologies for Couples Facing Fertility Problems (Marlow and Company, New York, New York 2005.)

About Global IVF:
To fill the niche in the ever-growing trend in cross-border travel for reproductive care, Kathryn Kaycoff-Manos and Lauri Berger de Brito founded Global IVF.com, the ultimate Global Guide devoted to Infertility and all related services available worldwide.

Free membership to GlobalIVF.com also includes bi-monthly newsletters and full access to Global IVF’s blogs and online chat forums, allowing intended parents to share experiences and collect advice about specific clinics and treatments currently offered worldwide.

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Like babies, embryos like to be rocked, too

Like babies that can be lulled to sleep with swaying, embryos also prefer to be rocked.

By gently rocking embryos while they grew during in vitro fertilization, scientists increased pregnancy rates in mice by more than 20 percent. The same rock-a-bye procedure could lead to more success for in vitro fertilization in humans, the researchers say.

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Infertile Couples Turn To Embryo Adoption

CINCINNATI -- Some couples unable to get pregnant have turned to an unusual form of adoption. The couples are getting pregnant with another couples' embryo. Jennifer Schanne and her husband endured four miscarriages before turning to in-vitro fertilization.

"We froze our embryos in case something didn't work or we only had one baby. We knew we wanted to have more then one," said Schanne.

After twins Cooper and Clair were born, the couple debated about what to do with the nine embryos that they didn't use. Read more...

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Greatest gifts

This is in response to "Embryos' fate: A fertile debate; Families struggle with science, faith when viable eggs are frozen in lab" , regarding what to do with "leftover" embryos from in-vitro fertilization treatments.

One option is to donate them to an infertile couple. Please visit www.embryoadoption.org.

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New groundbreaking technique creates embryo from 3 parents

British scientists at Newcastle University have just released information on a new technique they have created that will impact the world of infertility treatment. Their original research goal was to prevent children from getting inherited medical disorders.

HOW DOES IT WORK?

The technique as described by the British researchers was to "prevent diseases by altering human embryos, which are the product of two mothers and one father." Researchers had been working with a woman who had mitochondrial disease which she passed to her daughter. The researchers determined that they could, "prevent the passing of mitochondrial disease in a child by extracting nuclear DNA from a mother with mitochondrial disease and a father, then injecting that DNA into a donor egg from a woman without mitochondrial disease."

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Traffic fumes can increase miscarriage risk

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Toxic traffic fumes can increase the risk that women will miscarry, researchers have warned.

They said that women should avoid getting pregnant when there were high levels of pollution in the air.

Testing diesel fumes on fertilised eggs in the laboratory, the scientists found that the pollution could cause a reduction in the number of cells in one part of the embryo.

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Have you considered taking DHEA?

Barad D.H., Gleicher N. Increased oocyte production after treatment with dehydroepiandrosterone (2005) Fertility and Sterility, 84 (3), pp. 756.e1-756.e3.
Abstract Objective: To describe a case of dramatically improved ovarian reserve in a 42.7-year-old woman who was using the dietary supplement dehydroepiandrosterone (DHEA) as well as acupuncture.

Setting: Private IVF center.

Patient(s): A 42.7-year-old patient with initial severely decreased ovarian reserve. Intervention(s): Serial ovulation induction with concomitant use of DHEA dietary supplementation as well as acupuncture.

Main Outcome Measure(s): Peak E2 concentration, oocytes retrieved, and cyropreservable embryos. Result(s): In her first treatment cycle peak E 2 was 1,211 pmol/mL. After seven months of DHEA supplementation her peak E2 in cycle 8 was >18,000 pmol/mL. Because of fear of hyperstimulation we reduced her gonadotropin stimulation by 25%. In the ninth cycle peak E2 was 9,178 pmol/mL, resulting in retrieval of 17 oocytes (16 embryos). In the last 11 months the patient has undergone nine treatment cycles while continuously and dramatically improving her ovarian response and banking of 66 embryos overall.

Conclusion(s): This case illustrates the possibility that ovarian function may be salvaged, even in women of advanced reproductive age.
©2005 by American Society for Reproductive Medicine.

Barad D., Gleicher N. Effect of dehydroepiandrosterone on oocyte and embryo yields, embryo grade and cell number in IVF (2006) Human Reproduction, 21 (11), pp. 2845-2849.

Abstract Background: The aim of this study was to investigate the effect of treatment with dehydroepiandrosterone (DHEA) on fertility outcomes among women with diminished ovarian reserve.

Materials and Methods: This is a case-control study in an academically affiliated private infertility centre. Twenty-five women with significantly diminished ovarian reserve had one IVF cycle before and after DHEA treatment, with otherwise identical hormonal stimulation. Women received 75 mg of DHEA daily (25 mg three times daily) for an average of 17.6 ± 2.13 weeks. We performed a comparison of IVF outcome parameters, before and after DHEA treatment, including peak estradiol (E2) levels, oocyte and embryo numbers, oocyte and embryo quality and embryo transfer statistics.

Results: Paired analysis of IVF cycle outcomes in 25 patients, who underwent cycles both before and after DHEA supplementation, demonstrated significant increases in fertilized oocytes (P < p =" 0.001)," p =" 0.005)">

Conclusion: This study confirms the previously reported beneficial effects of DHEA supplementation on ovarian function in women with diminished ovarian reserve.
© 2006 Oxford University Press.

Barad D., Brill H., Gleicher N. Update on the use of dehydroepiandrosterone supplementation among women with diminished ovarian function (2007) Journal of Assisted Reproduction and Genetics, 24 (12), pp. 629-634.

Abstract Objective: We assessed the role of DHEA supplementation on pregnancy rates in women with diminished ovarian function.

Design: This is a case control study of 190 women with diminished ovarian function. The study group includes 89 patients who used supplementation with 75 mg daily of oral, micronized DHEA for up to 4 months prior to entry into in vitro fertilization (IVF). The control group is composed of 101 couples who received infertility treatment, but did not use DHEA. The primary outcome was clinical pregnancy after the patient's initial visit. We developed a Cox proportional hazards model to compare the proportional hazards of pregnancy among women using DHEA with the controls group.

Results: Cumulative clinical pregnancy rates were significantly higher in the study group (25 pregnancies; 28.4% vs. 11 pregnancies; 11.9%; relative hazard of pregnancy in study group (HR 3.8; 95% CI 1.2-11.8; p<0.05).>Conclusions: DHEA treatment resulted in significantly higher cumulative pregnancy rates. These data support a beneficial effect of DHEA supplementation among women with diminished ovarian function.
© 2007 Springer Science+Business Media, LLC.

Fernandez-Shaw S., Ruesta C., Cercas R., Pons I. Use of dehydroepiandrosterone (DHEA) in low responders [Uso de dehydroepiandrosterone (DHEA) en bajas respondedoras] (2008) Revista Iberoamericana de Fertilidad y Reproduccion Humana, 25 (4), pp. 233-238.

Abstract Objective: To compare results in IVF cycles from patients with ovarian failure before and after treatment with Dehydroepiandrosterone (DHEA). Method: We included 16 patients with ovarian failure and a previous IVF cycle with a very low response. Ovarian stimulation was carried out following short protocols with recombinant FSH. We compared paired IVF results from women before and after treatment with DHEA (75 mg for 4 months).

Results: Basal FSH and estradiol were the same before and treatment with DHEA. Treatment with DHEA lowered the number of cancelled cycles and increased, although not significantly, the number of growing follicles, retrieved oocytes, mature oocytes, embryos and pregnancies obtained. Out of the 16 patients enrolled, one got pregnant spontaneously after two months of treatment with DHEA, 4 abandoned the study and 11 performed a cycle of IVF after treatment with DHEA.

Conclusion: Exogenous DHEA might be a concomitant treatment to offer to low responders to improve their ovarian stimulation, increasing the number of patients that achieve embryo transfer, and improving therefore their chances of pregnancy. However, success of this treatment is moderate, since patients, even after treatment with DHEA, continue to be low responders.

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Novel genetic test improves pregnancy rates in older women

Scientists from University of Oxford, UK claim to have developed a new less invasive genetic test that has found to greatly improve pregnancy rates in older women with failed attempts.

The new test, developed by Dr. Elpida Fragouli, examining chromosomes in human eggs a few hours after fertilisation can identify those that are capable of forming a healthy baby.

She said that her team's work had already enabled seven ongoing pregnancies in a group of older women with a history of multiple failed IVF attempts.

The findings were presented at 25th annual conference of the European Society of Human Reproduction and Embryology.

Read more: http://www.topnews.in/novel-genetic-test-improves-pregnancy-rates-older-women-2184514

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Fertility Method For Older Women Spawns Doubts

For more than a decade, thousands of older women undergoing in-vitro fertilization have relied on an expensive embryo-screening procedure to boost their chances of getting pregnant. But mounting evidence suggests that the procedure doesn’t help people become mothers.

The technique, known as pre-implantation genetic screening, or PGS, is performed in dozens of fertility clinics across the country. Most medical experts agree that embryo screening can significantly reduce the risk of serious chromosome-related illnesses, such as Down syndrome. But for older women trying to have a baby, the weight of evidence is now shifting against current PGS techniques.

Read more: http://online.wsj.com/article/SB10001424052970203366604574237912351241156.html?mod=googlenews_wsj

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Chemical in plastics may cause fertility problems

THURSDAY, Nov. 13 (HealthDay News) -- Bisphenol A, a controversial chemical used to harden plastic packaging for many foods and beverages, may affect human reproduction, researchers report.

Bisphenol A (BPA) could hurt the chances of successful in vitro fertilization, or the ability of embryos to attach to the uterus, according to presentations at the American Society for Reproductive Medicine's annual meeting, which concluded Wednesday in San Francisco.

To learn more about BPA, visit the U.S. National Institute of Environmental Health Sciences.

Read more:
http://www.wmbfnews.com/Global/story.asp?S=9346351

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Couple starts family through embryo adoption

Matthew and Jenna are 2 1/2-year-old fraternal twins. They share cute round faces, wide, inquisitive eyes that don't miss a thing and cheekbones a model would die for.

They also share a history that would make them the talk of the playground if anybody their age remotely cared: They were adopted nine months before they were born, in the form of embryos created and frozen six years before that.

But, for Jim and Barbara Seebock, Matthew and Jenna are simply the answer to a prayer, even if the method of conception they chose -- "embryo adoption" -- represents yet another twist on what used to be the straightforward business of conception.

Read more: http://www.lvrj.com/living/46567282.html

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The importance of folate, zinc and antioxidants

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The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility

UV radiation destroys folic acid, a precursor for folate, the lack of which may result in birth defects.

Current treatments of subfertile couples are usually empiric, as the true cause of subfertility often remains unknown. Therefore, we outline the role of nutritional and biochemical factors in reproduction and subfertility. A literature search was performed using MEDLINE, Science Direct and bibliographies of published work with both positive and negative results.

The studies showed that folate has a role in spermatogenesis. In female reproduction, folate is also important for oocyte quality and maturation, implantation, placentation, fetal growth and organ development. Zinc has also been implicated in testicular development, sperm maturation and testosterone synthesis.

In females, zinc plays a role in sexual development, ovulation and the menstrual cycle. Both folate and zinc have antioxidant properties that counteract reactive oxygen species (ROS). Thiols, such as glutathione, balance the levels of ROS produced by spermatozoa and influence DNA compaction and the stability and motility of spermatozoa. Oocyte maturation, ovulation, luteolysis and follicle atresia are also affected by ROS.

After fertilization, glutathione is important for sperm nucleus decondensation and pronucleus formation. Folate, zinc, ROS and thiols affect apoptosis, which is important for sperm release, regulation of follicle atresia, degeneration of the corpus luteum and endometrial shedding.

Therefore, the concentrations of these nutrients may have substantial effects on reproduction. In conclusion, nutritional and biochemical factors affect biological processes in male and female reproduction. Further research should identify pathways that may lead to improvements in care and treatment of subfertility.

Read more: http://scienceblogs.com/gnxp/2009/04/folate_fertility_skin_color.php?utm_source=sbhomepage&utm_medium=link&utm_content=channellink

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Tampa Bay couples share experiences with infertility

TAMPA — Faith and Ryan Shears for a long time shared nothing of their struggles, coping quietly as their family and closest friends invited them to celebrate baby showers, baptisms and 1-year-old birthday parties.

They want to be parents, too. So far, however, the New Port Richey couple's journey has led only to doctor's appointments and events like Saturday's New Beginnings Fertility Conference.

FAST FACTS
Success of assisted reproduction
ART and IVF: Assisted reproductive technology, which generally involves in vitro fertilization, when a woman's eggs are extracted and fertilized in a laboratory. The resulting embryos are transferred to a woman's uterus.
Success rate: 29 percent of cycles using fresh, nondonor eggs or embryos resulted in live births, 2006.
Multiple births: 29 percent of live births were twins, and 2 percent triplets or more.
Cost: In vitro fertilization can cost $10,000 to $12,000 per cycle, plus medication costs, which can run $2,000 to $5,000.
Sources: Centers for Disease Control and Prevention, Lotus Blossom Consulting

Read more:

http://www.tampabay.com/news/health/article995447.ece

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IVF Success Enhanced By New Method Of Assessing Women's Eggs

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Many couples who have trouble conceiving a child have turned to a process known as in vitro fertilization. The resulting embryos are then transferred back into the woman or placed in storage. More than 400,000 embryos are currently in storage in the United States.

The quality of the egg is often the single greatest factor in the viability of the embryo, yet fertility experts lack a good method for assessing the eggs.

Read more... http://www.medicalnewstoday.com/articles/143474.php

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Obesity May Lower Pregnancy Chances

Obese women may be more likely to have fertility problems, according to new research.

Researchers from Adelaide University in Australia said that obese women have changes in their ovaries that could make it hard for eggs to become embryos.

Other work has shown that obese women take longer to get pregnant, even with regular menstrual cycles.

Source:

http://www.newsnet5.com/health/18850810/detail.html

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Pay It Forward

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Non-Profit Organization Created to Help Couples, the Military and Cancer Patients Preserve Their Fertility and Build Their Families

Triad - Cary, NC - In the spirit of giving this holiday season, the North Carolina Center for Reproductive Medicine (NCCRM) announces the creation of the Pay It Forward Fertility Foundation http://www.payitforwardfertility.org/ . This new non-profit organization will help people of various circumstances afford fertility treatments that are not covered by health insurance. The mission of the Pay It Forward Fertility Foundation focuses on assisting three groups:

* Couples who cannot afford fertility treatments such as in vitro fertilization (IVF), donor egg IVF and embryo adoption.
* Military personnel at North Carolina posts and bases who are being deployed and want to preserve their fertility by cryopreserving their semen or embryos.
* Cancer patients who want to preserve their fertility before they begin treatments such as chemotherapy, radiation and/or surgery which could leave them sterile.

“This foundation is a dream realized for us at NCCRM,” says Sameh K. Toma MD, Medical Director at the North Carolina Center for Reproductive Medicine. “The majority of couples with fertility issues can get pregnant if they seek treatment. However, finances stop many people from pursuing their options because many health insurance companies in North Carolina don’t cover fertility treatments.”

The Pay It Forward Fertility Foundation is being started with a generous donation from Lori and Rob Moscato of Raleigh. The Moscatos conceived their daughter through IVF at NCCRM. After giving birth to Sophia in 2006 they conceived their son Ryan on their own. “Rob and I feel so blessed and so fortunate to have two little miracles, each in their own way,” explains Lori Moscato. “We were fortunate to have health insurance coverage for our IVF treatments but we know most people don’t. We want to help those couples because we can’t imagine life without our beautiful children and we want to pay it forward.”

The Pay It Forward Fertility Foundation will begin taking grant applications in January of 2009. A Board of Directors will review each application thoroughly as part of the approval process. Recipients of grants through the foundation will be treated at NCCRM’s Cary or Greensboro offices.

“We also want to reach out to families who can “pay it forward” by making donations to the non-profit foundation,” says Gerald Mulvaney MD, Director of NCCRM’s Greensboro office. “The name of the non-profit says it all. We want to continue helping couples in need and not have this be a one time deal for a few people. We’re hoping more people like the Moscatos will consider funding the Pay It Forward Fertility Foundation with donations.”

Media Contact: Sharon Delaney McCloud – 919-810-5085; smccloud@nc.rr.com
The Moscatos and physicians at NCCRM are available for interviews.Visit http://www.payitforwardfertility.org/ for more information.
About the North Carolina Center for Reproductive Medicine (NCCRM):
Located in Cary and Greensboro, NC, the North Carolina Center for Reproductive Medicine (NCCRM), The Talbert Fertility Institute, was founded in 1992 to provide advanced reproductive services to couples in a state of the art facility with board certified physicians. NCCRM is one of the most established, full service clinics in the Southeast and has one of the highest pregnancy rates in the country. http://www.nccrm.com/

Source: http://healthcare.dbusinessnews.com/shownews.php?type_news=latest&newsid=173289

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Hyperbaric Oxygen Therapy

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Found this post on babiesafter50@yahoogroups.com

All I have (about HBOT) is a hint - from Australia, re: horses. Here it is:

But did you know that HBOT [Hyperbaric Oxygen Therapy] is also being used to increase horse fertility and offspring outcomes. HBOT increases sperm count, HBOT diminishes risk of spontaneous abortion. As brood mares age their ability to fall pregnant diminishes; and the risk of offspring complications are increased.

The older brood mare loses vital function in the placenta which becomes deprived of oxygenated blood; placental hypoxia causes inadequate blood flow to the developing brain of the foal. Hypoxic injury to the foal’s brain results in a condition known as ‘Dumb foal’ with all International Veterinary colleges teaching and recommending the use of – Hyperbaric Oxygen Therapy.

However if the mother is human and if the baby suffers an ‘hypoxic injury’ often referred to as ‘Cerebral Palsy’ ‘Delayed Development Syndrome’ etc then why isn’t Hyperbaric Oxygenation recommended as the first line of therapy?

http://www.hypermed.com.au/HyperMED/HyperMED%20Newsletter%20August%202006.pdf

Another link:
http://www.spinalrehab.com.au/HyperMED/HyperMED%20Fertility.htm

For all the older ladies wanting to conceive using their own eggs, my question is, Why could not HBOT improve ovarian function (similar to improved sperm count) through enhanced microcirculation? And apparently, it helps the uterus/ placenta in the same way.

BTW, I don't have any financial stake in suggesting this; I am simply wanting to present something which could offer a basis for hope in the face of longing.

Source: http://health.groups.yahoo.com/group/babiesafter50

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A Proven Solution Revolutionizing Infertility Treatment

On November 1, 2008, BioXcell officially changed its name to INVO Bioscience. INVO Bioscience better represents our dynamic approach to providing unique fertility treatment options for patients, and our commitment to the highest levels of clinical excellence, novel treatment strategies and patient-centered care. In the coming months, we will also be updating our website, so please check back for more information and news about INVO Bioscience.

“INVOcell allows conception and embryo development to take place inside the mother's body, making having a baby simpler and less expensive, while promoting more involvement by the woman"

The INVOcell, and the INVO procedure are less expensive and easier to perform than conventional in vitro fertilization.”

INVOcell has received the CE Mark “Declaration of Conformity” from the European CE Marking and is equivalent to approval by the Food and Drug Administration (FDA) in the U.S.

INVOcell offers a new fertility treatment that can be performed successfully in the office of an infertility specialist.

Source: http://bioxcell.homestead.com/index.html

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IVF culture oxygen levels 'high, limit embryo quality'

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Comparing the effects of different oxygen concentrations in embryo culture medium on the development of embryos in vitro.

MedWire News: The concentrations of oxygen commonly used to culture embryos in vitro limit blastocyst development, say scientists who recommend an alternative method for increasing yield.

In normal pregnancy, embryos are exposed to oxygen concentrations of 2-8 percent but in vitro embryo cultures are typically maintained at atmospheric oxygen levels of 20 percent.

The small amount of available research indicates that atmospheric oxygen levels inhibit normal embryo development.

To investigate further, Mustafa Bahceci (Bahceci Women's Health Care Center, Istanbul, Turkey) and co-workers randomly allocated sibling oocytes to culture conditions that mimicked the physiological norm (6 percent carbon dioxide, 5 percent oxygen, and 89 percent nitrogen) for 6 days from insemination, or to atmospheric oxygen levels (20 percent) and the same carbon dioxide and nitrogen levels for 3 days after insemination, before switching to physiologically normal conditions.

Exposing embryos to a physiological-normal gaseous environment improved blastocyst yield at day 6 after insemination from an average of 42.4 to 47.7 and significantly improved overall embryo quality.

Bahceci and colleagues say: "Increased blastocyst yield with better quality may cause improved pregnancy, implantation, and delivery rates in a physiologic oxygen environment."

They conclude that modifying the oxygen concentrations used in IVF cultures might improve pregnancy rates after IVF.

(c) 2008 Current Medicine Group Ltd, a part of Springer Science+Business Media
Source: Fertility and Sterility 2008; Advance online publication

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