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Issue 584 (15 November 2010)

 

Welcome to BioNews by email, published by the Progress Educational Trust, providing you with news, comment and reviews on genetics, assisted conception, embryo/stem cell research and related areas.

Visit the BioNews website at www.bionews.org.uk where you can subscribe for free to receive BioNews by email in one of three formats, and search the archive of more than 6,000 articles.

 

 

CONTENTS

Comment

News Digest

Reviews


 



Unpacking Cross-Border Reproductive Care

15 November 2010

By Zeynep Gürtin-Broadbent

Centre for Family Research, University of Cambridge

Appeared in BioNews 584
The Progress Educational Trust's conference next week will tackle the subject of Cross-border Reproductive Care (CBRC), as a range of UK experts come together to present the evidence and argue over the ethical conundrums. Also referred to variously as 'reproductive tourism' or 'reproductive exile' (1), CBRC refers to the movements of people across national borders in search of fertility treatments in other jurisdictions.

Although the contested term 'reproductive tourism' has firmly entered public vernacular through the popular media, as yet little is known about this rapidly growing phenomenon. Indeed, CBRC is now recognised by many as an area in urgent need of policy engagement and rigorous enquiry. Although the empirical evidence on CBRC is patchy and fragmented for the moment, several studies have begun to provide important information. For example, a recent six-country study by European Society of Human Reproduction and Embryology (ESHRE) coordinated by Francoise Shenfield estimates that there are between 11,000 and 14,000 CBRC patients in Europe per year, with expectations of better quality and legal restrictions acting as the main reasons for travel (2). 

A study by Professor Guido Pennings corroborated the importance of legal restrictions by showing the treatments sought by patients coming to Belgium from France, the Netherlands, Italy and Germany differed in direct correlation with prohibitions in their own jurisdictions (3). However, unlike these studies, Professor Lorraine Culley and colleagues are finding that UK residents seeking Assisted Reproductive Technologies (ARTs) abroad are motivated primarily by donor gamete shortages, and not by regulatory factors (4). These studies show that it is important to note both emerging trends and the degree of diversity that exists in CBRC movements.

The many potential reasons for CBRC include the desire to access treatments that are prohibited, unavailable due to a lack of expertise or not practiced due to safety concerns in the home country. Some treatments, although generally available, may be inaccessible by certain groups (such as single women or gay couples) who travel to bypass access restrictions. Intending parents may also travel to avoid resource shortages and long waiting lists, to access treatments at cheaper prices, or to preserve their confidentiality. 

The reasons why a person or couple are travelling will depend on the regulatory and economic conditions in their home country and will influence their choice of destination. Indeed, global disparities in economic conditions, reproductive resources and regulatory structures have created a complex and heterogeneous set of CBRC trajectories. These include US citizens contracting Indian surrogates, Germans travelling to Belgium for PGD (preimplantation genetic diagnosis), and couples from the Middle East heading to Iran for sperm donation.

Closer to home, the foreign clinics exhibiting at the recent Fertility Show in London were a stark illustration of the growth and significance of CBRC in the global ARTs market. Glossy leaflets and friendly staff from clinics in Spain, India, Cyprus, the United States and the Caribbean, among others, presented an enticing alternatives to UK-based fertility treatment. While some clinics offered attractive prices and packages in sunny locations, others boasted high success rates, innovative techno-science, and readily available donors or surrogates. There were also a few clinics that provided services (such as sex selection or 'family balancing') which are illegal in the UK, although it must be said that these did not seem to be the main attractions.

Besides clinics, there were also several international brokerage agencies, promising to link intending parents with providers and clinics in streamlined international arrangements. One company offered their customers an 'East Plan' and a 'West Plan' with treatments in India and the United States respectively. A third alternative - the 'East-West Plan' - combined both by offering IVF treatment and donor eggs in the United States, followed by the importing of frozen embryos to India for surrogacy.

These arrangements represent unprecedented relationships between globalisation, consumerism and the quest for conception, posing new dilemmas and begging novel questions. While international travel remains relatively easy and major regulatory differences continue to exist between jurisdictions, there is every reason to assume markets in cross-border reproductive medicine will flourish and continue to challenge practitioners, regulators, ethicists, and potential patients.

Regulators in each jurisdiction must decide whether CBRC has legislative implications, and - if so - how best to respond to these. While potential patients may demand better information on success rates, safety standards and satisfaction levels in foreign clinics, clinicians will need to decide whether - and where - they will refer patients wishing to go overseas.

Moreover, clinics treating large numbers of 'foreign' patients will need to be aware of the specific needs of such patients - whether deriving from cultural or linguistic differences, or simply from the discomforts of 'being away from home' during their treatment - and work to adequately address these.

It is significant that the horizon scanning meeting of the UK's Human Fertilisation and Embryology Authority in 2010 defined 'reproductive tourism' as the most pressing and challenging new development in ARTs. Moreover, patient organisations, such as Infertility Network UK, Resolve in the United States, and International Consumer Support for Infertility, have developed leaflets to inform their members about the pros and cons of travelling for ARTs.

In December this year, an international academic workshop at the University of Cambridge will bring together leading researchers from a range of disciplines (including sociology, anthropology, ethics, law, psychology, counselling, economics, and clinical medicine) to discuss emerging insights and to develop and agenda for further analysis. Needless to say, the 'Passport to Parenthood' conference organised by the Progress Educational Trust will provide a timely opportunity to broaden the parameters of the UK debate on CBRC and promises to be as thought-proving as it will be informative.

 

SOURCES & REFERENCES
1) Inhorn, M. C. and P. Patrizio Rethinking reproductive 'tourism' as reproductive 'exile'.
Fertility and Sterility, 92, 904-906. | 2009
 
2) Shenfield F, De Mouzon J, Pennings G, Ferraretti A-P., Nyboe Andersen A, De Wert G and Goossens V as the ESHRE Taskforce on Cross Border Reproductive Care: Cross border reproductive care in six European countries.
Human Reproduction, 25: 1361-1368 | 2010
 
3) Pennings G, Autin C, Decleer W, Delbaere A, Delbeke L, Delvigne A, De Neubourg, D, Devroey P, Dhont M, D'hooghe T, et al. Cross-border reproductive care in Belgium.
Human Reproduction, 24, 3108-3118 | 2009
 
4) Culley L, Hudson N, Blyth E, Norton W, Pacey A and Rapport F Travelling abroad for fertility treatment: an exploratory study of UK residents seeking cross-border care.
Human Reproduction, 25, suppl. 1: i78 | 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

11 July 2011 - by Nishat Hyder 
The German parliament has passed a new law allowing PGD in limited circumstances. Under the new law, couples undergoing IVF can use PGD to screen embryos only if the parents have a predisposition to a serious genetic illness... [Read More]
14 March 2011 - by Rachel Lyons 
The feature-length documentary 'Made in India' tackles cross-border surrogacy head-on by going beyond the sensational headlines to uncover for the first time the personal lives and choices of the surrogates and infertile people involved. The film follows an American couple, Lisa and Brian Switzer, on their quest to have a baby... [Read More]
20 December 2010 - by MacKenna Roberts 
European fertility clinics are being encouraged to collaborate and ensure fertility patients receive safe and fair access to treatment abroad, according to guidelines approved this month by the European Society of Human Reproduction and Embryology (ESHRE)... [Read More]
29 November 2010 - by Dr Vivienne Raper 
Are European airlines bursting with 'fertility tourists' risking their health by travelling abroad? Do most people seeking fertility treatment overseas fit the media stereotype - white, middle-class career women over 50? Does cross-border reproductive care (CBRC) include eggs imported from abroad? Dr Françoise Shenfield and Professor Lorraine Culley tried to answer these questions during the first session of last Wednesday's Progress Educational Trust (PET) annual conference... [Read More]

08 November 2010 - by Ruth Saunders and Zeynep Gürtin-Broadbent 
Academics, clinicians and other interested people came together last week to discuss the rise of reproductive technologies. The event was the first of three 'public dialogues', organised by the Cambridge University Centre for Gender Studies in association with the Guardian newspaper. The aim of this series is to aid conversation between experts and the general public on issues of gender and 21st century biomedical advances... [Read More]
20 September 2010 - by Dr Nadeem Shaikh 
A Cypriot fertility clinic has closed down after questions about its involvement in selling human eggs. The clinic, situated in the village of Zygi, Southern Cyprus, dealt mostly with donors from Eastern Europe, AFP news agency reports... [Read More]
05 July 2010 - by Seil Collins 
Expensive UK fertility treatment and long waiting times related to a shortage of egg and sperm donors are the major reasons people seek fertility treatment abroad, according to the first academic study into cross-border reproductive care.... [Read More]



A mini break at the Fertility Show

15 November 2010

By Sarah Norcross

Appeared in BioNews 584
The Fertility Show rolled into town on 5 November. Exhibitors from acupuncturists to fertility clinics pitched their tents at Olympia to promote their goods and services. Helping people with fertility problems is big business. We at the Progress Educational Trust (PET) packed our suitcase and joined them on a mini-break. We displayed our wares between Acumedic (who specialise in Chinese medicine, acupuncture and traditional herbal treatments) and Birmingham Women's Fertility Clinic.

You could easily have thought looking through the list of exhibitors that you had wandered into the luxury foreign holiday show in the exhibition hall next door, as clinics from Barbados, South Africa and Florida rolled out their towels. There were 25 overseas clinics exhibiting and just 15 British ones.

The show was dominated by overseas clinics last year too, which influenced the theme of our annual conference 'Passport to Parenthood: The Evidence and Ethics behind Cross-Border Reproductive Care'. This year Spanish and American clinics were well represented again. Why don't more British clinics exhibit? Is it because they don't need the business? Is it because they are unconvinced the Fertility Show will provide a return on their investment? As the traditional greeting on postcards says 'I wish you were here'!

Several professional visitors to the show voiced concern about some exhibitors - asking for evidence for some of the 'alternative' therapies and services. They seemed surprised some clinics were advertising treatments which, as far as they knew, they hadn't successfully carried out. Other clinics, they told me, offered tests that wouldn't change a patient's treatment. Visitors to our stall grumbled about the cost of treatment and nutritional supplements, and expressed confusion about widgets with questionable benefits.

The PET staff and volunteers formed their own opinions of the show. One was surprised by the young age of many show visitors. Another was angry people were being sold products or services with scant scientific evidence. The slick marketing pitches reminded some of holiday time share salesmen. The fertility astrologer evoked mixed feelings. Some thought it harmless fun - like a seaside fortune teller. Others had unrepeatable views.

PET is a cash-strapped charity: exhibiting at the show was a big outlay in money, staff and volunteer time. What did we want to achieve - what were we selling? We hoped people had forgotten to pack a good read for their fertility journey and were 'selling' BioNews as a Rough Guide.

People were suspicious because BioNews is free. They wanted to know the catch, as though they were booking a budget flight. We explained there was no small print, no 'baggage in the hold' supplements, and no paywall blocking our archive. Some visitors to our stall were incredulous and demanded to know our agenda. 'We want people to make informed choices', we replied. 'In a small way, we want to help those who may feel vulnerable and desperate'.

With more than 100 exhibitors, I felt totally overwhelmed at the end of the weekend. Many people looking for answers may have felt the same way as me and  left more confused than ever.

 

SOURCES & REFERENCES
The Fertility Show | 05 November 2010
 
Guardian | 06 November 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

12 November 2012 - by Kate Brian 
The annual show, now in its fourth year, is a unique event, where complementary therapists and crystal healers can be found rubbing shoulders with some of the country's leading fertility specialists... [Read More]
14 November 2011 - by Sarah Norcross 
This year the Progress Educational Trust decided to exhibit at the Fertility Show again. The Fertility Show is a popular consumer event aimed at those who want information or advice on fertility. But as such, it evokes mixed feelings... [Read More]
11 April 2011 - by Sile Lane 
At The Fertility Show in November 2010 Nicola Smuts ran a busy booth offering advice for fertility problems. She spoke to couples about finding the optimum time for trying IVF, about sperm motility and morphology, and about number and condition of eggs. She says she has helped scores of women... [Read More]

25 October 2010 - by Dr Vivienne Raper 
The first parenthood show for gay and single people was held on Saturday in London. The Alternative Families Show featured seminars about fertility treatment, adoption, surrogacy and other options for starting a family... [Read More]
13 September 2010 - by Dr Charlotte Maden 
British women are prepared to spend an average of 15,000 in order to conceive, a survey has shown, with one in ten willing to spend over 50,000 on fertility treatment... [Read More]
30 November 2009 - by Nishat Hyder 
A central London fertility clinic is offering an IVF treatment package in return for patients signing up to a health and lifestyle improvement programme, which will require patients to stop smoking, drinking, and lose weight if necessary prior to commencing IVF treatment.... [Read More]



Genetic links to morning sickness

15 November 2010

By Owen Clark

Appeared in BioNews 584

A new study suggests that severe morning sickness may have a genetic component, because it is more likely to affect women whose mothers or sisters were also affected. Focusing on hyperemesis gravidardum (HG) - a type of morning sickness that causes severe vomiting and nausea in around one percent of pregnant women - the study found that women whose sisters had HG were 17 times more likely to develop HG themselves.

The researchers looked at 207 women with one or more sisters that had HG and compared them to a control group of 110 of the patients' female friends who had nausea-free pregnancies. They found that 14 percent of women who had HG also had an affected sister versus one percent of women who did not have HG. If other severe forms of morning sickness were taken into account then 34 percent of women with HG also had an affected sister compared with eight percent of controls. The study also found similar ratios when looking at mothers who had HG instead of sisters.

Dr Marlena Fezjo, a geneticist at the University of Southern California-Los Angeles and lead author of the study said: 'The degree of  heredity is very exciting because it suggests genes are involved, and when we find those genes we may finally understand the cause of severe nausea in pregnancy and be able to make new treatments that are designed to treat the cause rather than the symptoms'. However, Dr Andrej Grjibovski from the Norwegian Institute of Public Health, points out that women with HG might have been more likely to volunteer for the study if they had relatives with HG.

These findings backup earlier evidence that HG may have a heritable component, as suggested in an analysis of birth records, which found an increased risk of severe morning sickness in women whose mothers had the condition, and that identical twins are more likely to both develop the condition compared with non-identical twins.

HG is a significant problem that leads to the hospitalisation of more than 59,000 women a year in the US. Dr Fezjo and her team are now planning to compare the genes of women with and without HG, to identify those genes that may predispose women to the condition.

 

SOURCES & REFERENCES
Familial aggregation of hyperemesis gravidarum
American Journal of Obstetrics and Gynaecology | 25 October 2010
 
Reuters | 04 November 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

12 April 2010 - by Dr Lux Fatimathas 
Scientists have uncovered a genetic link between low birth weight and developing type two diabetes in later life... [Read More]
08 March 2010 - by Dr Vivienne Raper 
Babies with few teeth on their first birthday are more likely to need corrective dental surgery by age 30, a study has found. The UK and Finnish researchers also discovered ten genetic variants influencing tooth development during a baby's first year... [Read More]
30 October 2000 - by BioNews 
Ten UK women are reported to be pregnant following treatment with the male impotence drug Viagra, prescribed by their consultant Dr Mohammed Taranissi. But fertility expert Lord Robert Winston has expressed concerns over what he called a 'reprehensible and dangerous' treatment. 'It is extraordinary that he has been allowed to... [Read More]



Gay man and lesbian couple in custody battle

15 November 2010

By Nishat Hyder

Appeared in BioNews 584

A gay man and a lesbian couple have been embroiled in a complex and unprecedented legal battle in the Court of Appeal of England and Wales over access to their two children conceived through artificial insemination.

In June this year a lower court awarded the sperm donor father joint residency, under which he has equal access to the children including 152 overnight stays. In seeking to overturn the decision, the couple, who cannot be named for legal reasons, have asked the court to acknowledge them as the children's primary carers by requiring the children to keep permanent residence at their address.

From the outset the father had 'parental responsibility' for the children, which gave him legal ground to seek further access. The outcome of this highly controversial case may clarify the rights and responsibilities of sperm donors who donate outside of licensed clinics and impact upon issues of shared residency.

The man donated sperm twice to the lesbian couple resulting in the birth of their son and daughter, aged nine and seven respectively but the relationship between the donor and the recipients broke down. Counsel for the women, June Venters, QC, told the court the children were 'aware of the difficulties between mummy and daddy'. She submitted that the women recognised a meaningful relationship existed between the children and their father and were not suggesting severing contact with him entirely, but the children needed to know which was their permanent home and 'who we all are in their lives'.

Ms Venters argued that a residency order should be made in favour of the lesbian couple who have been the children's primary carers since birth. Ms Venter told the court the current contact arrangements were 'enormously complex', and it was in the children's best interests that their day-to-day management lay with the two women. She also said the original order marginalised the mother's partner, to whom she has been married for twenty years.

Alex Verdan, QC, representing the father, submitted that the man had always made clear his wish to be involved in the children's lives and the women had made 'a very hostile application' to strip the father of his parental rights. Moreover, the father played a central role in his children's lives, including taking them to the doctor and paying their school fees. Mr Verdan impressed upon the court that 'this is not a case of two mummies'.

The case has attracted interest from both legal circles and interest groups, including fathers' groups. The latter would like shared residency (meaning both parents have joint responsibility for their children and must consult on key decisions, but not necessarily that the children reside equally with both parents) to become the norm after parents separate and are hoping that any subsequent law reform will support this stance.

The appeal was heard by the Master of the Rolls, Lord Neuberger of Abbotsbury, Lord Justice Patten and Lady Justice Black, who have reserved judgment for a later date.

 

SOURCES & REFERENCES
Independent | 08 November 2010
 
Gay father and lesbian mother in court battle over access to children
The Times | 09 November 2010
 
The Telegraph | 12 November 2010
 
Pink Paper | 09 November 2010
 
Daily Mail | 09 November 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

13 February 2012 - by Dr Linda Wijlaars 
The Court of Appeal in the UK is hearing a case in which a gay man is fighting for greater parental access to his two-year old son he fathered with his lesbian ex-wife... [Read More]
19 December 2011 - by Ayesha Ahmad 
Lesbian parents in South Australia who conceive through IVF can now both be registered on their child's birth certificate, after a new law passed to recognise female, same-sex couples as the co-parents of babies came into effect.... [Read More]

21 June 2010 - by Dr Vivienne Raper 
The ex-partner of a lesbian cannot be forced to pay child maintenance for the couple's donor-conceived child because they never entered a civil partnership, a High Court judge has ruled... [Read More]
12 December 2009 - by Ben Jones 
The Irish Supreme Court has ruled that a 42-year old man should have access to a lesbian couple's son who was conceived using his donated sperm. The highest court in Ireland ruled that the man has 'natural rights' over the son and that while he should not be entitled to guardianship over the boy it is in the child's best interests for the father to be granted contact.... [Read More]
21 April 2008 - by MacKenna Roberts 
Last Wednesday the Dublin High Court, Ireland denied a sperm donor guardianship and court-ordered access rights to his biological child, born to a lesbian couple. The homosexual 41-year-old friend of the lesbian couple, referred to as 'A', signed a written agreement to donate sperm and not... [Read More]



Skin cells turned into blood

15 November 2010

By Dr Lux Fatimathas

Appeared in BioNews 584

Canadian researchers have been the first to successfully convert human skin cells directly into blood cells. The technique may help in the production of patient-specific bloods cells for the treatment of blood cancers, anaemia and individuals with a depleted or compromised blood system such as cancer patients undergoing chemotherapy.

'The pioneering findings published today are the first to demonstrate that human skin cells can be directly converted into blood cells… Producing blood from a patient's own skin cells, has the potential of making bone marrow transplant Human Leukocyte Antigen matching and paucity of donors a thing of the past', said Dr John Kelton, a haematologist and vice-president of Health Sciences at McMaster University, Canada, who was not involved in the study.

The harvested human skin cells were infected with a virus containing the gene OCT4. OCT4 protein is able to initiate the expression of genes required for the production of blood cells. The cells were then treated with cytokines, chemical messengers that stimulate the immune system. As a result, the skin cells were reprogrammed into three functional blood cell types: red blood cells, white blood cells and platelets, all of which maintained their new identities.

'This is the most encouraging result we've seen for using blood cells for cell-replacement therapy', said Dr Mick Bhatia, director of McMaster University's Stem Cell and Cancer Research Institute, Canada, and co-author of the study. I can see this blood being used for anyone undergoing cancer therapy. Chemotherapy and radiation affect the blood system, so even though the therapy is targeting a tumour, the patient usually has to withdraw because the blood system dies as an innocent bystander. We hope our technique will provide an alternative blood source that is healthy and allows them to continue therapy and eradicate the tumour', he said.

The procedure used by researchers at McMaster University negated the need for an intermediate step whereby the skin cells are first converted into a pluripotent, stem cell-like state. These cells have the potential to transform into any cell type but are also associated with the development of tumours. The current procedure is therefore believed to be simpler and safer than existing induced pluripotent stem cell-iPS (IPSCs) or embryonic stem cell (ESC) therapies.

'Bhatia's approach detours around the pluripotent stem cell stage and thus avoids many safety issues, increases efficiency, and also has the major benefit of producing adult-type l blood cells instead of fetal blood cells, a major advantage compared to the thus far disappointing attempts to produce blood cells from human ESCs or IPSCs', explained Dr Cynthia Dunbar, head of Molecular Haematopoesis at the National Heart, Lung and Blood Institute, Maryland.

'We'll now go on to work on developing other types of human cell types from skin, as we already have encouraging evidence', said Dr Bhatia. Clinical trials, which will begin in a few years, will be required before this therapy can be tested in patients. The study was published in Nature.

 

SOURCES & REFERENCES
Guardian | 08 November 2010
 
Discovery Channel | 11 November 2010
 
Nature | 07 November 2010
 
ScienceDaily | 08 November 2010
 
Nature News | 10 November 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

24 September 2012 - by James Brooks 
The biological basis of a rare congenital disorder has been clarified, thanks to stem cell technology. The researchers say their work shows how advances in stem cell science can provide insights into genetic conditions... [Read More]
14 November 2011 - by Rosemary Paxman 
A new technique to transform skin cells into immune cells has been used in the laboratory to hunt for and attack cancer, report scientists after a proof-of-principle study... [Read More]
28 March 2011 - by Chris Chatterton 
Scientists from Scotland have been awarded an extra £2.5 million from the Scottish Funding Council to continue their work into the development of methods to create red blood cells (RBCs) from stem cells.... [Read More]
14 March 2011 - by Dr Sarah Spain 
An international collaborative team, including Cancer Research UK scientists from the University of Dundee, has uncovered the genetic cause of a rare type of skin cancer. The condition called Ferguson-Smith disease, is also known as multiple self-healing squamous epithelioma (MSSE)... [Read More]

23 August 2010 - by Chris Chatterton 
Scottish researchers have taken a major step towards the 'holy grail' of haematology - the ability to produce a limitless supply of artificial blood cells. The team successfully produced significant amounts of red blood cells from stem cells harvested from spare IVF embryos... [Read More]
19 July 2010 - by Dr Lux Fatimathas 
US and Japanese researchers have converted white blood cells (WBC) into stem cells... [Read More]
21 December 2009 - by Dr Will Fletcher 
A commercial product claiming to be the first to make use of induced pluripotent stem cells (iPS cells) has been launched, albeit not a product that can be directly used on humans. Cellular Dynamics International (CDI), a biotech company based in Madison, Wisconsin, US, has recently announced that it has released human heart cells derived from iPS cells for commercial use. CDI intends its trademarked iCell Cardiomyocytes to be used by pharmaceutical companies to aid in the drug... [Read More]



New screening technique may boost IVF success rates

15 November 2010

By Kyrillos Georgiadis

Appeared in BioNews 584

UK-based researchers have developed a new screening technique which could double or triple IVF success rates. The new test allows for any chromosomal abnormalities to be detected in embryos before they are implanted into the mother.

The new technique allows viability of embryos to be tested without risking damage. Dr Simon Fishel, director of CARE fertility clinic in Nottingham, spoke of how the new test is a significant improvement on current methods saying it will make a 'stupendous difference'. Current PGD (preimplantation genetic diagnosis) techniques involve comparative genomic hybridization arrays, the accuracy of which has been questioned, and in utero (in the womb) prenatal screening, which can carry a risk of miscarriage.

'Before we would look down a microscope and see five, six, maybe 10 embryos knowing that half are chromosomally abnormal but there's no way of testing it. We now we have an objective test that is related to the health of the pregnancy', Dr Fishel told the BBC. At around day five of embryo development, the blastocyst has two distinct parts - a group of cells called the embryoblast which will later develop into the body of the fetus, and a group of surrounding cells, the blastocoele, which fuses with the inner membrane of the uterus to form the placenta.

'At this stage we can do a tiny biopsy of those placental cells. So we don't even touch the cells that are going to become the baby itself', Dr Fishel explained. Subsequent chromosomal analysis would show any abnormalities before the embryo is implanted.Chromosomal abnormalities are the largest cause of miscarriages, accounting for over 50 percent of embryos that abort spontaneously in the first trimester, both in IVF and natural conception.

One in 200 newborns has multiple congenital abnormalities because of a chromosomal abnormality. Trials of the new technique, held by fertility specialists at CARE Fertility in Manchester, include three women in their late 30s who having undergone the new procedure will give birth in late December.

 

SOURCES & REFERENCES
CARE Fertility, Manchester | 08 November 2010
 
BBC News | 08 November 2010
 
Times of India | 08 November 2010
 

RELATED ARTICLES FROM THE BIONEWS ARCHIVE

12 December 2011 - by James Brooks 
The third session of the Progress Educational Trust's annual conference 'The Best Possible Start in Life: The Robust and Responsive Embryo' boasted a redoubtable roll-call of eminent clinicians and researchers as speakers... [Read More]
31 May 2011 - by Dr Rosie Morley 
Multiple genetic tests have been performed on a single embryo for almost the first time, according to US researchers. The researchers from John Hopkins School of Medicine say their technique for making copies of an embryo's DNA can improve IVF success rates... [Read More]
16 May 2011 - by Dr Rosie Morley 
A study of over 400,000 IVF treatment cycles in the UK has found a 'strong association' between the number of eggs retrieved prior to a woman undergoing IVF and live birth rate. The findings suggest that chances of a live birth increased with the number of eggs collected up to the number of 15, after which it began to decline.... [Read More]
07 March 2011 - by Leo Perfect 
Researchers from the University of Western Australia have published a study suggesting IVF effectiveness could be improved by undergoing more cycles.... [Read More]
14 February 2011 - by Marianne Neary 
New research suggests that women from ethnic minority backgrounds may have lower success rates with fertility treatment.... [Read More]

08 November 2010 - by Victoria Kay 
Women who have not conceived after two cycles of IVF (in vitro fertilisation) may face reduced success rates if electing to undergo further cycles, according to a new study. The research is preliminary and many factors which may affect IVF success, such as the age and weight of the women, were not taken into account.... [Read More]
01 November 2010 - by Rosemary Paxman 
An embyro screening test could significantly increase IVF success rates, US researchers have found... [Read More]
11 October 2010 - by Dr Lux Fatimathas 
US researchers have developed a means to predict which human embryos produced through IVF are most likely to result in healthy births. Researchers filmed 242 one-cell embryos and predicted, with more than 93 percent accuracy, those that would survive up to five days. These findings may improve the success rate of IVF.... [Read More]
20 September 2010 - by Harriet Vickers 
Women with poor egg (or oocyte) quality could double their chance of becoming pregnant through IVF if given melatonin, researchers have found. The work was presented at the World Congress of Fertility and Sterility in Munich last week... [Read More]
20 September 2010 - by Gozde Zorlu 
Higher fertilisation rates have been found in women undergoing IVF in spring, according to new research presented at the World Congress of Fertility and Sterility last week... [Read More]



Australian scientists magnify sperm to identify 'healthiest'

15 November 2010

By Ken Hanscombe

Appeared in BioNews 584

A new IVF technique developed in Australia offers hope to couples who have problems conceiving due to damaged sperm. The technique called Digital High-Mag allows fertility experts to study sperm cells at much higher resolution than before, enabling them to more readily detect those cells most likely to lead to a successful conception and full-term pregnancy. The new technique enables sperm cells to be magnified to 7,300 times their actual size, which is 18 times more powerful than present technology.

Professor Peter Illingworth, Medical Director of IVF Australia, where the approach was trialled, said this 'will allow us to detect the subtle damage to sperm that can prevent successful conception or a viable pregnancy. We can then select the right sperm to inject into the egg which is most likely to produce a full term pregnancy and live birth'.

A study conducted at IVF Australia's Western Sydney laboratory found that the use of Digital High-Mag more than doubled the success rate in this patient group, with pregnancy rates increasing from 13 to 36 percent, with no reported miscarriages. This study included men who were considered to have moderate to high levels of DNA-damaged sperm, either 30 percent DNA-damaged sperm, or less than four percent of normally-shaped sperm.

Professor Illingworth said: 'Our experience has shown this technique produces more fertilised eggs, more embryos to transfer or freeze, and a significantly higher pregnancy ratethan was possible before'. He added: 'For the first time, there is an effective, non-invasive approach to IVF that will assist men with DNA damage in their sperm to have children'.

 

SOURCES & REFERENCES
Sydney Morning Herald | 11 November 2010
 
IVF Australia | 11 November 2010
 
Daily Telegraph, Australia | 13 November 2010
 

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19 November 2012 - by Joseph Jebelli 
Small breaks in the DNA of a man's sperm may contribute to reduced pregnancy rates following IVF, according to research at Queen's University, Belfast.... [Read More]
05 September 2011 - by Dr Lux Fatimathas 
Researchers have discovered a molecule present on the outer surface of a human egg that binds sperm and eggs together before fertilisation. Understanding this mechanism may help people with previously unexplained fertility problems... [Read More]

18 October 2010 - by Antony Blackburn-Starza 
Two men convicted of providing sperm over the internet without a licence have escaped a custodial sentence... [Read More]
20 September 2010 - by Antony Blackburn-Starza 
Two men prosecuted for illegally providing fresh sperm over the internet have been convicted at Southwark Crown Court. Ricky Gage, 49, and Nigel Woodforth, 43, operated a website called Fertility 1st through which fertility patients could select from a database of sperm donors and order 'fresh' sperm to be directly delivered, for a fee, to their door.... [Read More]
20 September 2010 - by Ben Jones 
A Canadian doctor is being sued by two of his patients who discovered their children were not genetically related to the believed donors, reports the Canadian newspaper The Globe and Mail... [Read More]
09 August 2010 - by Julianna Photopoulos 
A sperm test that could help thousands of men who are infertile has been developed by UK and US scientists, according to The Times.... [Read More]



Cord blood used to treat infant with SCID

15 November 2010

By Chris Chatterton

Appeared in BioNews 584

Doctors from Great Ormond Street Hospital (GOSH) have used stem cells from donated cord blood to treat a child with a rare genetic disorder. Eleven-month old Imtiyaz Ahmed had severe combined immuno-deficiency (SCID), also called 'bubble boy syndrome', a condition where the body does not make enough white blood cells - key components of the immune system - that makes individuals very vulnerable to infections. Imtiyaz's brother Mirza also had the condition, and died of an infection because his body was unable to fight it. However, doctors from GOSH were able to successfully treat Imtiyaz by using stem cells collected from cord blood.

There are a number of different forms of this inherited genetic condition. One of the most common is an X chromosome linked version, but there are also autosomal recessive variants, and those caused by spontaneous mutations. In this family, the condition was the result of an autosomal recessive inheritance. This meant that Imtiyaz inherited a faulty gene from both parents. Families affected in this way therefore have a one in four chance of having a child with this condition.

Doctors previously used bone marrow transplants to treat children with SCID, but are now using stem cells from cord blood, because they offer a number of advantages. Cord blood is particularly useful, because it is a comparatively rich source of stem cells. The NHS set up a cord blood blank in 1996, in order to process and supply cord blood, however only a small number of hospitals - all located in the South East of England - have trained staff who are able to collect this material.

Mrs Ahmed told the Evening Standard: 'I'm very grateful to the mother who donated her baby's cord so my child has the chance to be the normal fun-loving child he deserves to be'.

 

SOURCES & REFERENCES
London Evening Standard | 11 November 2010
 
NHS Blood and Transplant |
 

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30 August 2011 - by Rosemary Paxman 
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28 March 2011 - by Chris Chatterton 
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02 February 2009 - by Dr Megan Allyse 
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27 April 2006 - by BioNews 
Replacement genes used to treat an inherited immune disorder could trigger cancer, new research carried out on rodents suggests. The study, published in the journal Nature, shows that treating mice with a normal copy of the gene defective in X-linked severe combined immune deficiency (X-SCID) results in cancer of the... [Read More]
13 March 2005 - by BioNews 
Doctors at Great Ormond Street Hospital (GOSH) for Children and the Institute of Child Health have successfully treated a second disease using pioneering gene therapy treatment. The four-year old boy who received the therapy was affected by ada-SCID, a life-threatening immune deficiency condition. He is now attending pre-school and living... [Read More]
21 July 2003 - by BioNews 
A second patient in a gene therapy trial taking place at Great Ormond Street Hospital in London has been successfully treated, his parents and doctors announced last week. Christopher Reid, now two years old, received gene therapy for the immune system disorder X-linked severe combined immune deficiency (X-SCID) in December... [Read More]



Sister set to become surrogate for gay brother

15 November 2010

By Rosie Beauchamp

Appeared in BioNews 584

The London Women's Clinic (LWC) has reportedly received an application for fertility treatment by two gay men wanting to raise a child who wish to use one of the couple's sister as a surrogate.

Up to 30 percent of LWC's clients are lesbian couples, representing an increase of about ten percent from ten years ago, but the applications to the clinic made this week are the first to be received from a male same-sex couple. In an interview with the Evening Standard, Dr Kamal Ahuja, scientific director at LWC confirmed that the clinic's ethics committee was considering the application alongside another received from a gay couple who have also applied for treatment using a surrogate.

The LWC was one of the first clinics to admit lesbian's for donor insemination and has carried out studies demonstrating that the wellbeing of children is not compromised by the absence of a 'father figure'.

Dr Ahuja said: 'The definition of a traditional family is progressively fading. Though we had concerns some years ago, the evidence now is that we need not worry in terms of same-sex parenting'. He added: 'Families of the future may combine up to five parents. Regardless of culture, the evidence is that children adapt well and it's the quality of the nurturing environment which is important'.

The surrogacy application made to LWC is not unique in the UK. Last year it was reported that Lorna Bradley had acted as a surrogate for her brother and his partner but until recently gay couples have been said to be more likely to travel to the United States to enter into surrogacy arrangements where there is less regulation. If the application is accepted by LWC and the attempted surrogacy is successful, the couple will be among the first gay men in the UK who will both be entitled to be a named parent on the child's birth certificate since changes were made to the law in April 2010.

 

SOURCES & REFERENCES
London Evening Standard | 11 November 2010
 
Daily Mail | 11 November 2010
 

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19 December 2011 - by Ayesha Ahmad 
Lesbian parents in South Australia who conceive through IVF can now both be registered on their child's birth certificate, after a new law passed to recognise female, same-sex couples as the co-parents of babies came into effect.... [Read More]
11 April 2011 - by Dr Lux Fatimathas 
A British woman has given birth to her cousin, as part of a surrogacy arrangement to help her aunt. The 29-year-old mother of three became pregnant from sperm donated by her aunt's husband, to whom she was not related by blood. This resulted in the birth of a baby girl who is both her biological daughter and cousin.... [Read More]
04 April 2011 - by Kyrillos Georgiadis 
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21 February 2011 - by Leo Perfect 
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07 February 2011 - by Ben Jones 
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19 April 2010 - by Dr Vivienne Raper 
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01 March 2010 - by Dr Elly Teman 
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07 February 2010 - by Dr Sophie Pryor 
The Court of Appeals in Indiana, US, is to decide who is the legal mother of an 11-month old baby boy conceived by IVF and born to a surrogate. The boy's genetic parents, known in court records as T.G. and V.G, are a married couple from northern Indiana. The birth mother is the wife's sister, who agreed to carry the baby for the couple. The boy's father's name is listed on his birth certificate but his mother's name will not be added unti... [Read More]
29 October 2009 - by Nishat Hyder 
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27 October 2009 - by Natalie Gamble and Louisa Ghevaert 
Of all the prospective parents conceiving through assisted reproduction, those in surrogacy arrangements often face the most difficult legal issues. The surrogate and usually also her husband will be treated as the child's legal parents at birth, leaving the commissioning parents with no legal connection with their child whatsoever, even where both are the biological parents.... [Read More]



Laptops and sperm: Scientists find angle of incidence

15 November 2010

By Ben Jones

Appeared in BioNews 584

A study has suggested that to prevent potential damage to their fertility men should sit with their legs separated when using laptops placed on their legs. In an article published in the journal Fertility and Sterility, data on scrotal temperature during laptop use suggests that the use of a laptop pad, a device used to transfer heat generated by laptops away from the human body, may be insufficient to avoid temperatures at which sperm could become damaged.

Researchers at the Department of Urology and the Department of Applied Mathematics at the State University of New York identified the potential for rapid hyperthermia (over-heating) among male laptop users and explored potential means of reducing the risk posed. The conclusion drawn was that prevention of scrotal hyperthermia was not presently feasible but that it may be reduced in degree by means of adopting a 'modified sitting position'

While all of the twenty-nine young men studied experienced temperature elevation of between 1.4 and 2.3 °C (degrees celsius), those who sat with their knees at a 70 degree angle demonstrated temperatures at the lower end of the range. Though the raised temperature was not generally noticed by the participants, for those with their legs together it took only ten to 15 minutes before the temperature exceeded normal levels.

For those with their legs apart, this doubled to an average of 28 minutes. The testes are maintained at a temperature generally a couple of degrees cooler than the rest of the human body and earlier research suggests that warming the scrotum by as little as one degree may present a risk of damage to sperm

Dr Yefim Shynkin, who led the study, believes that scrotal hyperthermia induced by even modest laptop use may lead to increased risks of infertility. While he advocates not only a wide sitting stance and 'significantly shorter use' of laptop computers, he makes clear that short of using a desk - 'No matter what you do, even with the legs spread wide apart, the temperature is still going to be higher than what we call safe'.

 

SOURCES & REFERENCES
Reuters | 07 November 2010
 
Wired Science | 10 November 2010
 
The Independent | 08 November 2010
 
Fertility and Sterility |
 
Fertility and Sterility | 08 November 2010
 
PC Magazine | 08 November 2010
 

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05 December 2011 - by Luciana Strait 
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13 June 2011 - by Kyrillos Georgiadis 
A new fertility test for men which can detect DNA damage in sperm has been developed in the UK. The test, called SpermComet, could save couples undergoing fertility treatment both time and money, since it will allow clinics to fast-track patients to the most appropriate treatment, say its developers... [Read More]

08 September 2008 - by Katy Sinclair 
Scientists from the University of Giessen in Germany, reporting in the New Scientist, have warned that heated car seats could damage sperm production. The optimal temperature for healthy sperm production is between 35 and 36 degrees centigrade , which is 1 to 2 degrees centigrade lower than core... [Read More]
09 December 2004 - by BioNews 
Fertility experts from the US have warned that men who tend to use their laptop computers on their laps may find their fertility decreased. The researchers, from the State University of New York at Stony Brook, looked at what effect laptop use might have, given that a warm temperature around... [Read More]



Painkillers in pregnancy linked to sons' fertility

15 November 2010

By Seil Collins

Appeared in BioNews 584

New preliminary research suggests a possible link between the use of mild painkillers during pregnancy and the birth of male children with congenital cryptorchidism, more commonly known as undescended testes, a condition which reduces male fertility. The rates of undescended testes seen in the study remained relatively low.

The researchers found that the risk of congenital cryptorchidism was not significantly increased by overall use of mild analgesics such as paracetamol, ibuprofen or aspirin during pregnancy compared with no use. However, the researchers also studied several subgroups and found that while there was no link between use of painkillers in the first trimester and the condition, use in the second trimester more than doubled the likelihood of male babies being born with the condition. The risk of the disorder was also increased in women reporting using painkillers for more than two weeks.

Professor Richard Sharpe, from the Medical Research Council, explained that the second stage of pregnancy was the final stage of testes development, where disruption was most likely. But he told the Daily Mail: 'It is important to say it was prolonged use of painkillers that had the biggest effect. Taking one or two painkillers occasionally for a headache is not going to affect the baby'.  

The study featured an analysis of pregnant women's medication use and animal research looking at the fetal development of rats under exposure to painkillers. In the first phase, the researchers surveyed the medication use of 2,297 Danish and Finnish pregnant women and assessed the prevalence of cryptorchidism in the newborn male babies. The majority of the women were questioned using a written questionnaire during their third trimester and a relatively small number undertook a telephone interview.

More women reported using mild painkillers when interviewed over the telephone and the main findings were based on these 491 women. In the second phase of the study, the researchers assessed the impact of exposure to painkillers on the development of rat fetuses. They found that exposure to painkillers reduced the anogenital distance, the size of the perineum, in the males of the litters, suggesting a reduced exposure to testosterone.

Dr Allan Pacey, Senior Lecturer in Andrology at the University of Sheffield, explained that to date there have been relatively few concrete examples of the effects chemicals a mother may be exposed to during pregnancy on the reproductive health of male babies and much of the research so far has been 'theoretical'. 'Clearly further research is needed as a matter of priority', he said.

Current guidance advises pregnant women to avoid medication and, if needed, to use paracetamol rather than ibuprofen or aspirin. The collective results, soon to be published in Human Reproduction, suggest that the use of mild painkillers in pregnancy may have an effect on fetal development but due to the small size of the study, the evidence does not yet point to a definite link.

 

SOURCES & REFERENCES
Daily Mail | 09 November 2010
 
Medical News Today | 08 November 2010
 
Channel 4 | 08 November 2010
 
NHS Choices | 09 November 2010
 

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15 August 2011 - by Victoria Kay 
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04 October 2010 - by Owen Clark 
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Book Review: Adopting after Infertility - Messages from Practice, Research and Personal Experience

15 November 2010

By Berenice Golding

PhD student in social work. Her research focuses on egg sharing from the perspective of the egg share donor

Appeared in BioNews 584

Adopting After Infertility: Messages from Practice, Research and Personal Experience

Edited by Rachel Balen and Dr Marilyn Crawshaw

Published by Jessica Kingsley Publishers

ISBN-10: 1849050287, ISBN-13: 978-1849050289

Buy this book from Amazon UK or Amazon USA

'Adopting After Infertility: Messages from Practice, Research and Personal Experience' edited by Rachel Balen and Dr Marilyn Crawshaw


This book is a must-read for those with an academic, professional and personal interest in the topic of adoption and assisted reproduction. It provides an accessible, insightful - and at times emotive account - of what it means to be infertile, how the adoption process works, and what it is like to be an adoptive parent. Some of the interdisciplinary, theoretical perspectives, and the psychological and social difficulties that must be negotiated by those seeking to adopt are covered. The chapters can be read in succession or individually, dependent upon the reader's interests.

The chapters include research from the United Kingdom (UK), Denmark and Germany. Common to the chapters are the issues those diagnosed with infertility have to navigate. The inclusion of international perspectives further highlights the issues infertile couples face here in the UK and abroad when they decide to adopt. Additionally, including personal accounts about the process of becoming an adoptive parent demonstrates what it means to parent in the absence of a genetic link to one's children.

One of the best things about this book is it covers many aspects of the journey from infertility to adoption in a single volume. Thus, I believe it can act as a useful starting point for research into infertility and the adoption process. Accounts of the impact of infertility locate the issue within the wider context of access to assisted reproduction treatments (ARTs) in the UK and Europe.

The account provided by Professor Gayle Letherby demonstrates the multi-faceted nature of the quest to achieve parenthood for some people. Drawing upon sociological literature and dominant discourses surrounding what society perceives to be 'natural', Professor Letherby suggests that - while societal perceptions are changing - there may be stigma associated with involuntary childlessness that is not necessarily alleviated through adoption.

Interestingly, the book provides an account of the experiences of German infertile couples. This comparative account provides an interesting international perspective regarding the counselling process and new family formation. A further area of interest is the chapter by Dr Marilyn Crawshaw and Rachel Balen, who explore the adoption process from the perspective of professionals working with people with existing health conditions.

Dr Crawshaw and Ms Balen question whether people with acquired or congenital health conditions make suitable adoptive parents. The authors argue that - rather than being excluded as potential adoptive parents - a full consideration of the wider implications of their health conditions should be undertaken. Thus, they contend professionals and adoption social workers need to draw upon a greater knowledge base, an analysis I would agree with.

In Chapter five, Dr Crawshaw's commentary would interest adoption social workers. Her account explores not only the feelings of potential adoptive parents; it also considers the impact of adoption on wider interpersonal relationships. She also provides useful assessment tools that can aid the work of adoption social workers in their assessment of couples suitable to become adoptive parents.

The following chapter provides an overview of the adoption process and the adoption panel's role. I believe this makes the chapter of interest to those considering adoption, particularly as it might help allay any fears prospective parents might have about panel meetings. The book also contains an analysis of the perceptions of adoption and the willingness to adopt among British South Asian communities. This illustrates how these communities react towards involuntary childlessness and adoption.

The final chapters explore inter-country adoption, what it means to become a parent following adoption, the research and theories that underpin current understandings of nature and nurture, and the impact upon familial relationships following an adopted child's decision to seek their birth parents. These chapters further inform and enable the reader to explore a range of issues pertinent to this field.

One of the highlights of the book for me is the integration of the cultural perspective provided by Sally Baffour in Chapter eight. Her moving account of being a black adoptive parent provides an invaluable account of the issues she had to face. She also provides an account of life as an adoptive parent. I highly recommend this book. The messages from practice, research and personal experience provide an important insight into the adoption process following an infertility diagnosis.


Buy Adopting After Infertility: Messages from Practice, Research and Personal Experience from Amazon UK or Amazon USA.

 

SOURCES & REFERENCES

 

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