IVF Stimulation Drugs to Induce Ovulation: the Risks

Experience: IVF gave me a heart attack

For a long time, I felt angry with the original clinic, but then decided to channel my anger. I now work to raise awareness of the dangers of high-stimulation IVF.

I have also discovered that the UK is well behind other countries in reporting adverse reactions to IVF. This means that if I had died from my heart attack, the real cause would probably never have been found.

I feel so blessed not only to have survived, but to have had two wonderful little girls. I want to do everything I can to protect other women.

Read: IVF gave me a heart attack, the guardian, 6 May 2016.

IVF: BPA causes a linear increase in the death rate of embryos

BPA determined to have adverse effects on couples seeking in vitro fertilization

Endocrine disruptors: Manmade and natural oestrogens: opposite effects on assisted reproduction, Nature Reviews Endocrinology, 18 March 2016.

In a new study, a dramatic decrease in the frequency of implantation, pregnancy and live birth is associated with increased urine levels of Bisphenol-A (BPA) in women undergoing in vitro fertilization (IVF). However, in women who consume soy-containing foods, the interfering effect of BPA on IVF success is negated.

“The findings by Chavarro and colleagues show that the probability of having a surviving embryo goes from more than 50 percent to under 20 percent as levels of BPA increase. … … . As findings continue to mount and confirm that daily exposure to BPA is a reproductive toxicant, it becomes vital to regulate and control this chemical.”

Fred vom Saal, University of Missouri endocrinologist and researcher, BPA determined to have adverse effects on couples seeking in vitro fertilization, MedicalXpress, April 28, 2016.

IVF: the Squishy Squashy Technique to check Embryo Viability

Checking Embryo Viability? Give It a Good Squeeze

Much like a piece of ripe fruit, a human embryo has a certain squishiness that could provide fertility clinic staff with clues about its viability, a new study finds.

Abstract

Human oocyte developmental potential is predicted by mechanical properties within hours after fertilization, NATURE COMMUNICATIONS, Article number: 10809, doi:10.1038/ncomms10809, February 24, 2016.

The causes of embryonic arrest during pre-implantation development are poorly understood.

Attempts to correlate patterns of oocyte gene expression with successful embryo development have been hampered by the lack of reliable and nondestructive predictors of viability at such an early stage.

Here we report that zygote viscoelastic properties can predict blastocyst formation in humans and mice within hours after fertilization, with >90% precision, 95% specificity and 75% sensitivity. We demonstrate that there are significant differences between the transcriptomes of viable and non-viable zygotes, especially in expression of genes important for oocyte maturation. In addition, we show that low-quality oocytes may undergo insufficient cortical granule release and zona-hardening, causing altered mechanics after fertilization.

Checking Embryo Viability? Give It a Good Squeeze, livescience, February 25, 2016.

Our results suggest that embryo potential is largely determined by the quality and maturation of the oocyte before fertilization, and can be predicted through a minimally invasive mechanical measurement at the zygote stage.

Specific genetic pattern in womb might predict whether or not IVF treatment is likely to be successful

Fertility experts identify genetic pattern in womb linked to IVF failure

image of genetic-pattern
Fertility experts in Southampton and the Netherlands have identified a specific genetic pattern in the womb that could predict whether or not IVF treatment is likely to be successful.

Abstract

The discovery should help clinicians understand why IVF fails repeatedly in some women.

The primary limiting factor for effective IVF treatment is successful embryo implantation. Recurrent implantation failure (RIF) is a condition whereby couples fail to achieve pregnancy despite consecutive embryo transfers. Here we describe the collection of gene expression profiles from mid-luteal phase endometrial biopsies (n = 115) from women experiencing RIF and healthy controls. Using a signature discovery set (n = 81) we identify a signature containing 303 genes predictive of RIF. Independent validation in 34 samples shows that the gene signature predicts RIF with 100% positive predictive value (PPV). The strength of the RIF associated expression signature also stratifies RIF patients into distinct groups with different subsequent implantation success rates. Exploration of the expression changes suggests that RIF is primarily associated with reduced cellular proliferation. The gene signature will be of value in counselling and guiding further treatment of women who fail to conceive upon IVF and suggests new avenues for developing intervention.

Sources and more information
  • An endometrial gene expression signature accurately predicts recurrent implantation failure after IVF, nature, 22 January 2016.
  • Fertility experts identify genetic pattern in womb linked to IVF failure, University of Southampton, 22 January 2016.

2/3 of IVF couples conceive by 6th cycle of treatment

Scientists say patients should not view process as a ‘single shot’ as chances of success increase with number of treatments

in-vitro-fertilisation
Recent findings support the efficacy of extending the number of IVF cycles beyond 3 or 4, as 65% of women acheived a live birth by the sixth cycle. Wellcome Images.

2015 Study Abstract

It will take two-thirds of couples undergoing IVF treatment up to six attempts to have a successful pregnancy, according to new research.

Importance
The likelihood of achieving a live birth with repeat in vitro fertilization (IVF) is unclear, yet treatment is commonly limited to 3 or 4 embryo transfers.

Objective
To determine the live-birth rate per initiated ovarian stimulation IVF cycle and with repeated cycles.

Design, Setting, and Participants
Prospective study of 156 947 UK women who received 257 398 IVF ovarian stimulation cycles between 2003 and 2010 and were followed up until June 2012.

Exposures
In vitro fertilization, with a cycle defined as an episode of ovarian stimulation and all subsequent separate fresh and frozen embryo transfers.

Main Outcomes and Measures
Live-birth rate per IVF cycle and the cumulative live-birth rates across all cycles in all women and by age and treatment type. Optimal, prognosis-adjusted, and conservative cumulative live-birth rates were estimated, reflecting 0%, 30%, and 100%, respectively, of women who discontinued due to poor prognosis and having a live-birth rate of 0 had they continued.

Results
Among the 156 947 women, the median age at start of treatment was 35 years (interquartile range, 32-38; range, 18-55), and the median duration of infertility for all 257 398 cycles was 4 years (interquartile range, 2-6; range, <1-29). In all women, the live-birth rate for the first cycle was 29.5% (95% CI, 29.3%-29.7%). This remained above 20% up to and including the fourth cycle. The cumulative prognosis-adjusted live-birth rate across all cycles continued to increase up to the ninth cycle, with 65.3% (95% CI, 64.8%-65.8%) of women achieving a live birth by the sixth cycle. In women younger than 40 years using their own oocytes, the live-birth rate for the first cycle was 32.3% (95% CI, 32.0%-32.5%) and remained above 20% up to and including the fourth cycle. Six cycles achieved a cumulative prognosis-adjusted live-birth rate of 68.4% (95% CI, 67.8%-68.9%). For women aged 40 to 42 years, the live-birth rate for the first cycle was 12.3% (95% CI, 11.8%-12.8%), with 6 cycles achieving a cumulative prognosis-adjusted live-birth rate of 31.5% (95% CI, 29.7%-33.3%). For women older than 42 years, all rates within each cycle were less than 4%. No age differential was observed among women using donor oocytes. Rates were lower for women with untreated male partner–related infertility compared with those with any other cause, but treatment with either intracytoplasmic sperm injection or sperm donation removed this difference.

Conclusions and Relevance
Among women in the United Kingdom undergoing IVF, the cumulative prognosis-adjusted live-birth rate after 6 cycles was 65.3%, with variations by age and treatment type. These findings support the efficacy of extending the number of IVF cycles beyond 3 or 4.

Sources and more information
  • Live-Birth Rate Associated With Repeat In Vitro Fertilization Treatment Cycles, The Journal of American Medical Association, doi:10.1001/jama.2015.17296, December 22/29, 2015.
  • IVF: Two-thirds of couples conceive by sixth cycle of treatment, study says, independent, 22 December 2015.

Should genetically modified human embryos be allowed?

Are genetically modified embryos “essential” for science?

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It is “essential” that the genetic modification of human embryos is allowed, says a group of scientists, ethicists and policy experts. But critics say once the technology is allowed for research purposes, it is inevitable it will end up creating a market for enhanced, genetically modified babies.

Research involving genetic modification of human embryos, though controversial, is essential to gain basic understanding of the biology of early embryos and should be permitted, an international group of experts said.

The statement was issued by members of the so-called Hinxton Group, a global network of stem cell researchers, bioethicists and policy experts who met in the UK last week.

But critics say once the technology is allowed for research purposes, it is inevitable it will end up creating a market for enhanced, genetically modified babies.

Sources and more information
  • Statement on Genome Editing Technologies and Human Germline Genetic Modificationhinxtongroup, September 3-4, 2015.
  • Genetically modified human embryos should be allowed, expert group says, theguardian, 10 September 2015.
  • Genetically modified embryos “essential” for science, in-cyprus, 10/09/2015.
  • ‘Genetic modification of embryos is essential’: Report claims editing genomes holds huge potential and shouldn’t be feared, DailyMail, 10 September 2015.

IVF using frozen eggs associated with lower live birth rates

Outcomes of Fresh and Cryopreserved Oocyte Donation

ivf image
Compared to using fresh eggs for in vitro fertilization, use of frozen donor eggs in 2013 was associated with lower live birth rates, according to a new study in JAMA. Intothelight by Jon © all rights reserved.

Abstract

This study used data from the 2013 annual report of US in vitro fertilization center outcomes published by the Society for Assisted Reproductive Technology to compare live birth and cycle cancellation rates using either fresh or cryopreserved donor oocytes.

Use of oocytes donated for in vitro fertilization (IVF) has increased in recent years. Donated fresh oocytes traditionally have been used immediately, creating embryos for transfer into the uterus, with extra embryos being cryopreserved for later use.

In January 2013, the American Society for Reproductive Medicine declared the technique of oocyte cryopreservation (egg freezing) no longer experimental, although it called for “more widespread clinic-specific data on the safety and efficacy of oocyte cryopreservation … before universal donor oocyte banking can be recommended.” Based on data that IVF outcomes with cryopreserved and fresh donor oocytes are comparable, some IVF centers established frozen donor egg banks. However, data reflecting IVF outcomes in routine clinical practice with cryopreserved donor oocytes had not previously been published, according to background information in the article.

Sources and more information
  • Outcomes of Fresh and Cryopreserved Oocyte Donation, JAMA. 2015;314(6):623-624. doi:10.1001/jama.2015.7556, articleid=2425734, August 11, 2015.
  • In vitro fertilization using frozen eggs associated with lower live birth rates, MedicalXpress, August 11, 2015.
  • Frozen Donor Eggs May Lead to Fewer Births Than Fresh Ones, HealthDay, Aug. 11, 2015.

Preimplantation genetic screening can increase #IVF success rates

PGS helps find embryos with the right number of chromosomes. Transferring a single embryo reduces risks

Trying to determine the health of an embryo by conventional microscopic methods has its limitations. With next-generation sequencing technologies and Preimplantation Genetic Screening (PGS) from Illumina, we can select healthier embryos that are more likely to result in successful pregnancies.

More information

Possible cause of IVF failure in some women identified: microRNA altered levels

miR-145 suppresses embryo-epithelial juxtacrine communication at implantation by modulating maternal IGF1R

Journal-of-Cell-Science banner image
Greater understanding of the mechanisms which control success or failure can lead directly to treatments to make IVF cycles more efficient so that infertile couples can start their families.

IVF only has around a 25% success rate, largely due to the high rates of failure when embryos try to implant. Some women suffer from recurrent implantation failure, where the embryo is transferred but fails to attach to the endometrium – the mucus membrane of the uterine wall where the embryo implants. This is a significant cause of the failure of IVF as most embryo losses occur at this early stage.

University of Manchester scientists noticed that women who try and fail multiple times to implant an IVF embryo have molecular traits in common. These women tend to have altered levels of microRNA in their endometrium…

Sources and more information

  • Possible cause of IVF failure in some women identified, University of Manchester, 2015/02/02.
  • miR-145 suppresses embryo-epithelial juxtacrine communication at implantation by modulating maternal IGF1R, The Company of Biologists Ltd, doi: 10.1242/jcs.164004, January 20, 2015.
  • MAJOR NEW STUDY SHOWS WHY IVF DOESN’T ALWAYS WORK, elle, FEB 3, 2015.

Three-Person IVF : could the UK be on the brink of a “historical mistake” ask scientists?

Go ahead and give your opinion!

UK parliament- image
#ThreePersonIVF babies could be at greater risk of cancer and premature ageing, and would need to be monitored all their lives, experts have said as they warn the UK it could be on the brink of a “historical mistake”!

The United Kingdom is on course to become the first country to allow in vitro fertilisation (IVF) to create babies using biological material from three people to prevent serious inherited disease, after MPs voted overwhelmingly in favour of the procedure, reports the BMJ.

The UK House of Commons voted by 382 to 128 to approve regulations allowing mitochondrial donation, after MPs were given a free vote of conscience on the issue.

The Telegraph is asking your opinion:

 

 

 

and interestingly,  the general public results look quite different from the MP’s vote…

 

 

 

 

Go ahead and give your opinion!

Sources and more information