When does your biological fertility clock start ticking?

More and more of us are putting off having kids to focus on our careers, so much so that we now delay having a baby for longer than women in any other country. And with celebrities like Nicole Kidman and Mariah Carey giving birth for the first time in their forties, it’s easy to imagine that we have all the time in the world. But when does the female biological clock actually start to tick? We’ve spoken to top fertility experts to give you the lowdown. British women are becoming mums for the first time later and later, and the birth of the royal baby earlier this month highlighted this trend. While Kate Middleton, at 31, was in no way old, she was still over a decade older than Princess Diana was when she gave birth to Prince William. Things have changed a lot in a generation and the number of first-time UK mothers in their 40s has risen by 15% in the last five years. But at what age do we actually need to start worrying about having kids from a biological perspective? While lots of women are able to conceive later on, could some of us be at risk of missing our chance to become a mother if we wait for too long? 35 could be key ‘There is no “magic number” at which female fertility declines but we know that eggs deteriorate with age,’ says Infertility Network UK’s deputy chief executive Susan Seenan. ‘The speed of that deterioration will vary but rises more steeply after the age of about 35. The more “fertility aware” you are the better, so you can make an informed decision and be aware that it might take you longer to conceive,’ she adds. The NHS agrees that 35 is a key age when it comes to female fertility. Women are most fertile in their early 20s and their fertility declines with age. From the age of 35, this fall becomes steeper. ‘Women in the 19-26 age group have double the chance of conceiving each menstrual cycle compared with 35-39-year olds,’ explains Fertility UK fertility nurse specialist Jane Knight. Women over 35 are also less likely to become pregnant from fertility treatments like IVF, and are more likely to suffer from miscarriages. So does this mean that we all need to get pregnant by 35 or risk never being able to have kids? Not necessarily. You may want to start worrying when you reach 37, though. ‘Egg quality diminishes significantly from about 37,’ explains Jane. Ask your mum Your personal danger age could also be down to genetics. Fertility expert Zita West suggests looking at your mum. ‘One important question to ask is at what age your mother had the menopause as this may be the same for you,’ she says. ‘The decline occurs when the quality of the eggs is diminished with age, and this is usually in the late thirties to early forties.’ But just because you’re still having periods, it doesn’t mean that you’ll get pregnant easily. ‘Nature plays a cruel trick in that women tend to go on having periods long after they have ceased to ovulate,’ says Jane. ‘The ovulation mechanism becomes faulty and the egg quality is very poor long before a woman reaches her menopause, and a woman may no longer be fertile for up to ten years before she has her last period. The average age for menopause is about 51, but many women will have a much earlier menopause.’ So does that mean that, for the average woman, 41 could be the pivotal age? Read more...

Do patients have the right to an anonymous donor?

Given that the Progress Educational Trust (PET) has just completed a project on gamete donation I was more than intrigued about this debate, which took place at the European Society for Human Reproduction and Embryology's annual meeting in London. Despite the slightly odd framing of the question I was looking forward to a really good discussion and getting a wider perspective on gamete donation. One speaker was from Denmark, where donor anonymity is still the norm, and the other from Sweden, where identity release donation was introduced in 1985. Associate Professor Lone Schmidt, arguing for the motion that parents do have the right to an anonymous donor, started by quoting a seven-year-old donor-conceived child: 'I don't care how you made me just as long as you made me'. Schmidt, from the University of Copenhagen, said that longitudinal cohort studies have shown that gamete donor families, including those who have used anonymous donation, have functioned well. It is generally accepted that non-disclosure by the parents about donor conception and the child subsequently discovering by accident that they are donor-conceived can be damaging. So, she continued, using the treatment method that suits the parents best will increase the probability that the parents tell the child how it came into the world. Open identity donation was introduced in Sweden in 1985 but research has shown that only 11 percent of children had been informed that they were donor-conceived. Schmidt postulated that mandatory open identity leads to a disclosure paradox where parents are more reluctant to be open with their children about their conception. Finally she argued that there is no reason to believe knowledge of genetic origin is a fundamental prerequisite for psychological well-being, identity and social relations. Dr Claes Gottlieb, a physician from the Sophiahemmet IVF unit in Stockholm, argued against the motion. He started by saying that although his opponent had been rather balanced in her arguments, he was not going to be so measured. He argued that the title of the debate was wrong and that it should be 'Do children conceived through gamete donation not have the right to an identifiable donor?' He argued that it was the child's interests and rights that should come first and that children have the right to know their genetic origins. He pre-empted a counter argument that children who are conceived naturally don't always know their genetic parentage by saying the 'State can't go in to the bedroom', but where outside help is needed to conceive a child the State has a role. In countries where there is still donor anonymity the demand for identity release donors is increasing, he said. As evidence he referred to one clinic in the USA where 80 percent of patients chose an open donor. Why is identifying information important? Because of the desire to know one's roots, curiosity, for medical problems such as needing a bone marrow transplant and the need to understand the donor's motives. In a Swedish study of parents of donor conceived parents of children aged one to four years, 78 percent of parents planned to tell and 16 percent had started to tell. 'If you were a donor conceived child', he asked, 'wouldn't you want identifying information?' Read more... Article: by Sarah Norcross appeared in Bionews 715 29th July 2013

http://blogs.prideangel.com/post/2013/07/55-million-reasons-to-be-thankful-for-IVF-treatment.aspx

The world’s first test-tube baby has paid tribute to the fertility pioneers who gave her and millions of others life as she celebrates her 35th birthday. Louise Brown was born at Oldham General Hospital on July 25, 1978, after her parents Lesley and John became the first parents to successfully undergo in vitro fertilisation (IVF). Her birth attracted controversy, with religious leaders expressing concern over the use of artificial intervention and some raising fears that science was creating “Frankenbabies” who could experience medical difficulties later in life. There are now thought to be more than 5.5 million IVF babies worldwide and, as she prepared to celebrate her birthday with a private family meal, Mrs Brown said she hoped the public could now see the benefits of the breakthrough. “When I was born they all said it shouldn’t be done and that it was messing with God and nature but it worked and obviously it was meant to be,” she added. “It’s helped millions all around the world and if it can help improve success rates, obviously it’s a good thing. “I’ve now had my own son without IVF and lots of people I know or have heard of have gone on to have children naturally. “That shows that it is just the beginning of life that’s a little bit different, the rest is just the same.” Mrs Brown, whose younger sister Natalie was also the product of IVF, now lives near Bristol. She is married and has a six-year-old son, Cameron. She recently unveiled a plaque to honour IVF pioneers gynaecologist Patrick Steptoe and reproductive biologist Robert Edwards at Bourn Hall, the clinic they founded in Cambridge and where the techniques and drugs now used worldwide were first developed. Their research led to the successful fertilisation of a human egg outside the body and the transfer of the resulting embryo to the womb. Sir Robert, who was awarded a Nobel Prize in 2010, died aged 87 in April this year. Steptoe died in 1988 and did not receive the prize as it is not awarded posthumously. Article: 25th July 2013 www.cambridge-news.co.uk

Choosing to delay Cancer treatment to preserve Fertility

When Amy Miller was diagnosed with bowel cancer in March 2008, aged 32, her first thought was how she was going to beat the disease. "I was saying to my doctors, 'Oh my God, oh my God, start doing something now.'" But her doctors suggested delaying treatment for up to 20 days. The tumour was about 10cm in diameter at this point and lay close to her reproductive organs. Dr Miller, who has a PhD in Medieval art history, said: "It might not be right for everyone but in my case it wasn't an aggressive form of cancer and I was told that a delay of 20 days wouldn't make any difference to the effectiveness of my treatment - whereas without the delay I would never be able to have my own children. 'Difficult conversation' "Sometimes we can get so preoccupied by death that we forget to see the patient as a person who has a future ahead of them too." Dr Miller and her then-partner, now husband, Justin Ward, were referred for fertility counselling immediately after she was diagnosed. "Obviously I wasn't desperate to have children, otherwise I would have had them by then," she said. "I was 32 at the time and I was still studying for my PHD and my husband was still studying too. We hadn't really thought about having kids, but being faced with the possibility of not being able to have them, that was very different." Cancer should not define people, Dr Miller said Cancer treatment often destroys women's eggs and leaves the patient infertile, but with early intervention eggs can be harvested and fertilised and the embryos then frozen and stored until the couple wish to use them. The Teenage Cancer Trust said more care needed to be given to young women requiring cancer treatment that could damage their chances of having children. However, Dr Allan Pacey from the University of Sheffield said fertility preservation was often not a realistic option if cancer treatment needed to start immediately. Responding to a study by the cancer trust, Dr Dan Yeomanson, a consultant paediatric oncologist for Sheffield Children's NHS Foundation Trust, said there was still a need to discuss fertility issues with young patients - especially females - before treatment began, even if there were no options available for fertility preservation. Dr Miller said: "All of a sudden we had to have this really difficult conversation. We were still getting our heads around the cancer and didn't know if I was going to survive and they were asking us if we wanted to have children together. "That's a big decision for a couple to make. "They take you down the adoption route essentially and talk through what would happen to the embryos if you break up, or in the event of one or both of you dying. "But I'm so glad they did." 'Patient empowerment' Dr Miller, who is from Kenilworth in Warwickshire, said she was thrown headlong into the medical system from the instant she was diagnosed. "It's serious, it's immediate and it's complicated. They make appointments for you and you go. The staff are brilliant but it is a very dehumanising experience. "Going for fertility counselling was really comforting - just having someone listen to you that's not concerned about the cancer as such, who asks about how you are feeling, is so welcome and refreshing. "When you're dealing with cancer you don't know whether you have any future. Going through fertility treatment and creating viable embryos felt good because I knew if something happened to me, at least Justin and my family would have something of me that would survive into the future. "I think it is so important to get counselling and have the discussions early on about the impact on your reproductive system, not only if you want to have children. It's understandable that oncologists want to focus on treating the cancer, but the cancer should not become the person. "Making decisions about your own reproductive system is important to retaining a sense of wholeness and empowers you as a patient." Dr Miller has now been clear of cancer for four years, having undergone surgery and radiation therapy - but she has no immediate plans to start a family. She told the BBC she and her husband felt under no pressure. "One good thing to come out of all this is that I don't feel guilty now [about] having children later in life because my eggs have been frozen as my 32-year-old self. As we would have to go down the surrogacy route too, there is no risk to the baby from delaying this." Article: 21st July 2013 www.bbc.co.uk

Kate gives birth to Royal baby boy born 22nd July 2013

The Duchess of Cambridge has given birth to a baby boy, Kensington Palace has announced. The baby was delivered at 16:24 BST at St Mary's Hospital in Paddington, west London, weighing 8lb 6oz. The Duke of Cambridge said in a statement the couple "could not be happier". He and the duchess will remain in the hospital overnight. The news has been displayed on an easel in the forecourt of Buckingham Palace in line with tradition. A bulletin - signed by the Queen's gynaecologist Marcus Setchell, who led the medical team that delivered the baby - was taken by a royal aide from St Mary's to the palace under police escort. The document said: "Her Royal Highness, the Duchess of Cambridge was safely delivered of a son at 4.24pm today. "Her Royal Highness and her child are both doing well." When the news was announced, a large cheer went up from well-wishers and journalists outside the hospital while a large crowd greeted the posting of the bulletin outside Buckingham Palace. The Kensington Palace press release said the Duke of Cambridge was present for the birth of his son, who will be known as the Prince of Cambridge and who is third in line to the throne. "The Queen, The Duke of Edinburgh, The Prince of Wales, The Duchess of Cornwall, Prince Harry and members of both families have been informed and are delighted with the news," it said. A Kensington Palace spokesman said the names of the baby - who was delivered in the private Lindo Wing of St Mary's - would be announced in due course. The Prince of Wales, in a separate statement, said he and the Duchess of Cornwall were "overjoyed at the arrival of my first grandchild. "It is an incredibly special moment for William and Catherine and we are so thrilled for them on the birth of their baby boy," he added. "Grandparenthood is a unique moment in anyone's life, as countless kind people have told me in recent months, so I am enormously proud and happy to be a grandfather for the first time and we are eagerly looking forward to seeing the baby in the near future." BBC royal correspondent Peter Hunt said the duke and duchess spent time bonding with their son before they told the family their news. Royal doctor Mr Setchell described the new arrival as "wonderful baby, beautiful baby", our correspondent added. Prime Minister David Cameron, speaking outside Downing Street, hailed the "wonderful news". "It is an important moment in the life of our nation but I suppose, above all, it's a wonderful moment for a warm and loving couple who've got a brand new baby boy," he added. He said the Royal Family could "know that a proud nation is celebrating with a very proud and happy couple tonight". Scottish First Minister Alex Salmond said: "I am sure that people across Scotland will be absolutely thrilled to hear the news of the birth of a baby boy to the Royal couple and will want to join me in wishing the proud parents many congratulations." And Welsh First Minister Carwyn Jones congratulated the couple "on behalf of the people of Wales" as "they enter their journey into parenthood". The Archbishop of Canterbury, meanwhile, said he was "delighted to congratulate the Duke and Duchess of Cambridge on the arrival of their baby boy". "Along with millions here and around the world, I share in their joy at this special time," he added. "May God bless this family with love, health and happiness in their shared life ahead." Catherine and Prince William had arrived at the hospital at 06:00 BST ahead of a Kensington Palace announcement that she was in the early stages of labour. The world's media had been camped outside St Mary's for days in anticipation of the birth. Article: 22nd July 2013 www.bbc.co.uk

'Sperm donor the only option for me' says Big Brother contestant

Aisleyne said: ““Sperm donation seems the only logical option. I don’t need a man financially. I can do it myself. I’m 34, my biological clock is ticking and I haven’t got forever.” The party girl says she's had to rethink her priorities since the death of her mother and uncle from cancer last year. She was left devastated when mum Sophia, 54, passed away in February, then three months later in May her uncle Dennis lost his battle with the disease aged 52. Speaking to Now magazine, she said: “I was too busy having fun. I thought I was invincible and had forever. It made me realise how fragile life could be and that I wanted to become a mother. “I want that responsibility of looking after someone completely helpless, to bring them up to be decent and give them the best life I possibly can. I want to live for someone other than just myself.” Since making the Big Brother final in 2006, Aisleyne has kept her love life largely out of the public eye. She briefly dated Mike Tyson in 2009, but despite a rumoured proposal from the former boxer, has yet to find someone to settle down with. She said: “I do think a child needs a dad and that’s a big drawback to doing it on my own. But there are so many single parents or children with a bad father – in this day and age the nuclear family hardly exists. “If I do meet Mr Right he’s going to have to accept me with this child. And anyway, having no stability is more detrimental to a child than having no father at all.” Article: 16th July 2013 www.thesun.co.uk

Exercise during pregnancy reduces risk of a Caesarean birth

Women who exercise during pregnancy are less likely to require a Caesarean birth, say scientists. A brisk walk three times a week halves the risk of having a heavy infant - one of the main causes of the emergency surgery. C-sections have been linked with babies becoming obese in childhood, being more prone to infections and asthma and developing diabetes. A study of 510 sedentary expectant mothers who exercised for less than 20 minutes on only two days of the week or fewer found those given a training programme reduced their chances of giving birth to a baby weighing over 4 kilos by 58 percent. And the number of expected Caesarean deliveries fell by 34 per cent, according to the findings published in the British Journal of Sports Medicine. Both are risk factors for gestational diabetes mellitus - a condition in which previously healthy mothers develop glucose intolerance while they are pregnant. Dr Jonatan Ruiz, of Granada University in Spain, said: 'The findings reinforce the need to encourage more supervised exercise interventions during pregnancy to combat the negative effects of gestational diabetes mellitus.' The intervention group followed 55 minute sessions of aerobic, muscle strength and flexibility exercises on three days a week during the last six months of pregnancy while the others received standard care. Previous studies have shown babies delivered by Caesarean miss out on protective bugs that could help prevent a host of disorders in childhood and later life. C-sections now constitute about 25 per cent of births in England and Wales or over 190,000 a year - more than double the proportion in 1980. It's believed surgical babies may be missing out on physiological changes that happen during labour including exposure to bugs which are necessary for the immune system to mature. Women who are overweight or obese are more likely to end up having surgery when giving birth - and the rise in these deliveries coincides with the obesity epidemic. Obese women are at risk for pregnancy-related complications including hypertension, gestational diabetes and blood clots - all of which can lead to a recommendation for caesarean delivery. Article: 17th July 2013 www.dailymail.co.uk

IVF children have no significant increased risk of Autism

“Children born after certain infertility treatments at higher risk of autism,” reads the headline in The Independent. The news is based on a large long-term Swedish study. Researchers looked at how children were conceived and how this might affect their risk of developing autism, a type of autistic spectrum disorder, or “mental retardation”, a term used by researchers to describe a person with an IQ under 70 (average IQ is 100). The Independent’s headline is misleading, as the study in fact found there was no statistically significant increase in the risk of autism in children conceived through any form of in vitro fertilisation (IVF). However, there was a statistically significant increase in the risk of mental retardation, but this increase was slight. The occurrence of mental retardation was 39.8 per 100,000 births in those conceived spontaneously, compared with 46.3 per 100,000 births in those conceived through IVF. This represents a difference of just 6.5 cases per 100,000 births. This news should not cause alarm among those thinking about undergoing IVF treatment, but does highlight a potential association between IVF and mental development that warrants further study. Where did the story come from? The study was led by researchers from the Institute of Psychiatry, King’s College London and was funded by Autism Speaks, a non-profit organisation that provides funding for autism spectrum disorder research, and the Swedish Research Council. It was published in the peer-reviewed Journal of the American Medical Asssociation (JAMA). Most of the UK media’s reporting was balanced, including The Independent’s coverage, which outlined important information on how “scientists stressed that the chances of an IVF baby being affected was tiny in real terms”. But many of the headline writers failed to make a similar distinction, with the exception of The Guardian and ITV News, which wrote that “IVF findings ‘should not stop parents using fertility treatments’.” What kind of research was this? This was a prospective cohort study designed to test whether the use of any IVF procedure (as well as specific types of IVF procedures) may be associated with an increased risk of autistic spectrum disorders (ASD) and mental retardation in children conceived this way. IVF allows a woman’s egg to be fertilised by sperm outside the body under controlled laboratory conditions. Different types of IVF have been developed over the years, and the researchers pointed towards previous research that suggests intracytoplasmic sperm injection (ICSI) might damage the egg when the sperm is inserted. ICSI is usually used to treat male infertility (when the man has a low sperm count, or there are problems with the movement of sperm impeding natural conception, for instance) and involves injecting sperm directly into the egg. The research group highlight that there is little research on how IVF, and different types of IVF, influence the brain development of children conceived using these techniques. Their study aimed to fill in this gap in our knowledge. What did the research involve? The researchers reviewed the records of more than 2.5 million infants born in Sweden between 1982 and 2007. They recorded how they were conceived and whether they were diagnosed with ASD or had “mental retardation” at the age of four. Conception was categorised as being spontaneous (without IVF) or using IVF. The specific type of IVF used was also recorded, as was the source of the sperm (ejaculated or surgically removed). Out of the approximately 2.5 million infants born, 30,959 (1.2%) were conceived by IVF. These were followed-up for an average of 10 years. Overall, 103 of 6,959 children (1.5%) with ASD and 180 of 15,830 (1.1%) with mental retardation were conceived by IVF. The key results showed: There was no statistically significant difference between the risk of the child developing ASD in those conceived spontaneously and those using IVF (all types grouped together). There was a small and borderline significant increased risk of the child developing mental retardation if they were conceived using IVF (all types grouped together) compared with spontaneous conception. The occurrence of mental retardation was 39.8 per 100,000 births in those conceived spontaneously, compared with 46.3 per 100,000 births conceived through IVF. When the analysis was restricted to single births, the increased risk of mental retardation disappeared, so it only seemed relevant to multiple births from the same mother. Article: 12th July 2013 www.nursingtimes.net

Women who eat fish during pregnancy suffer less stress

Women who do not eat fish during pregnancy are more likely to experience high levels of anxiety at that time, researchers have revealed. They have found a link between the types of diet eaten, particularly whether this includes fish, and anxiety in pregnancy. The researchers suggest that eating fish during pregnancy could help reduce stress levels. Most women experience some stress during pregnancy but excessive anxiety is not good for the mother's long-term health and can result in their baby being born prematurely and/or having a low birth weight. Researchers from Children of the 90s at the University of Bristol and the Federal University of Rio de Janeiro, Brazil, looked at the fish intake of more than 9,500 pregnant women They categorised women's diets by the frequency with which different types of foods were eaten and identified five dietary patterns. They are roughly described as: health-conscious, traditional, processed, confectionery and vegetarian. The researchers found that women who never ate seafood had a 53 per cent greater likelihood of having high levels of anxiety at 32 weeks of pregnancy when compared with women who ate seafood regularly. The results suggest that two meals of white fish and one meal of oily fish each week would be an adequate amount of fish to consume. This was the case after taking into account 14 different factors that could affect anxiety, including drinking, smoking and family adversity during pregnancy. When the researchers investigated the dietary patterns, women in the top third of the vegetarian type of diet pattern were 25 per cent more likely to experience anxiety than women in the bottom third. There was also evidence that women in the top third of the health-conscious dietary pattern were 23 per cent less likely to have high levels of anxiety when compared with women in the bottom third. Women in the top third of the traditional diet pattern were 16 per cent less likely to have high levels of anxiety when compared with women in the bottom third. These findings, the researchers suggest, may be due to the lack of fish and meat in a vegetarian type of diet and because a pregnant woman's nutritional requirements increase during pregnancy, due to the demands of the growing foetus, which gets all its nutrients from the mother. Dr Juliana Vaz, the report's senior author, said: "An important message from this research is that in order to have a healthy pregnancy, women need to follow a healthy diet and not something special for pregnancy. "It means a diet containing whole cereals, vegetables, salad, fruit, dairy foods, meat, poultry, pulses and including fish - three portions per week with at least one of oily fish, such as salmon, sardine or tuna. "Sweets and fast foods should be kept to a minimum because they are low in nutrients." Article: 13th July 2013 www.news.ninemsn.com.au

Lesbian and gay parenting books should be featured in schools

Mark McGlashan, from Lancaster University, said pupils as young as five should be introduced to texts that "challenge homophobic bullying and encourage inclusivity in schools". There is evidence that giving young children access to picture books that show gay and lesbian characters in a good light can have “positive benefits” and promote equality, it is claimed. His comments come before a conference in Westminster next week aimed at understanding how homophobia and homophobic bullying can be challenged through the use of resources in primary schools. Earlier this year, the National Union of Teachers urged staff to use “anti-sexist” materials designed to challenge common gender stereotypes. The union has designed lessons using such books that are being used in schools Norfolk, Portsmouth, London and Nottingham. It recommends books such as Bill's New Frock, The Boy With Pink Hair, William's Doll, The Different Dragon, Girls Are Best and Dogs Don't Do Ballet. Last week, Michael Gove, the Education Secretary, also called for fresh action to stamp out the use of the word “gay” as an insult in schools. Mr McGlashan, who has done extensive analyses of representations of same-sex parents in picture books, said next week’s conference would “look at children's literature as a means to challenge homophobic bullying and encourage inclusivity in schools”. “Part of that aim could include increasing the availability of LGBT literature to educators,” he said. "There is evidence that promoting cultural inclusivity in early years education has positive benefits with regard to challenging homophobia and this will also be discussed at the conference. "Research has shown that resources such as picturebooks can be positively implemented in primary schools to tackle homophobia at its roots. "Ofsted now specifically looks at homophobic bullying as an issue in schools and it really is a significant problem. “The idea is that LGBT-inclusive literature could help schools address an issue that really is negatively impacting the lives of young people but the resources aren't there - there just isn't enough good literature available.” The event, which will be attended by academic experts, publishers and politicians, including Stephen Twigg, Labour's shadow education secretary, aims to generate debate on how literature featuring same-sex parents can be used to break down prejudices and challenge stereotypes prevalent in schools. The conference – funded by Lancaster’s Faculty of Arts and Social Sciences (FASS) Enterprise Centre – will be held on July 16 at Westminster Hall. The event has also been created in association with Lancaster's Centre for Corpus Approaches to Social Science (CASS), funded by the Economic and Social Research Council (ESRC). Mr McGlashan said: "The consultation should result in the production of a number of recommendations to make better quality resources available to educators. "Bringing together people to discuss the need to grow the LGBT-inclusive children's literature market, we hope will address some of the shortfalls that exist and produce a number of recommendations for the use of these books in schools as well as discuss their status in retail." He added: "Homophobic bullying in schools is a significant and prevalent issue. A Stonewall report in 2012 revealed 55 per cent of LGB children in British schools experience bullying. "Children's literature is a key educational source in creating an inclusive culture. LGBT-inclusive books are yet to become a staple of school libraries. "But, why not integrate or produce LGBT-inclusive resources that help our schools prevent homophobic bullying? There is work in the area but not enough and this is what this conference is hoping to address. "There is a growing recognition of the need, want and support for resources aimed at young people to promote inclusive, anti-homophobic practices but there is still little being done to address the lack of resources." Article: 11th July 2013 www.telegraph.co.uk

Women who work shifts have lower fertility and increased risk of miscarriage

Women who work shifts are more likely to have reduced fertility levels, new research has revealed. Shift work also increases the chance of menstrual disruption, while night work increases the risk of miscarriage, the study found. The annual meeting of the European Society of Human Reproduction and Embryology in London heard that previous research has linked shift work, which causes sleep deprivation and disruption to the body clock, with ill health. But little was known about the effects of shift work on reproductive health and fertility. Dr Linden Stocker headed a study by the University of Southampton which found links between shift patterns and fertility problems. The study is a meta-analysis of all studies on the subject published between 1969 and January 2013 and included data on 119,345 women. - Women who work shifts are 80% more likely to have fertility problems such as miscarriage - Women who work shifts have a 33% higher chance of disrupted periods - Women who work nights are 29 per cent more likely to have a miscarriage - Shift work can cause sleep deprivation and disruption to the body clock, both of which are associated with ill health Women who work shifts are more likely to have reduced fertility levels. Shift work also increases the chance of menstrual disruption, while night work increases the risk of miscarriage But little was known about the effects of shift work on reproductive health and fertility. Dr Linden Stocker headed a study by the University of Southampton which found links between shift patterns and fertility problems. The study is a meta-analysis of all studies on the subject published between 1969 and January 2013 and included data on 119,345 women. It found that those working shifts had a 33 per cent higher rate of menstrual disruption than those working regular hours, and an 80 per cent increased rate of reduced fertility. Women who worked only nights did not have an increased risk of menstrual disruption or difficulty conceiving, but they did have a 29 per cent increased rate of miscarriage. The investigators describe their findings as ‘novel’, but in keeping with other studies. Shift work causes sleep deprivation and disruption to the body clock both of which are associated with ill health Dr Stocker said: ‘If replicated, our findings have implications for women attempting to become pregnant, as well as for their employers.’ She added: ‘Whilst we have demonstrated an association between shift work and negative early reproductive outcomes, we have not proven causation. ‘In humans, the long-term effects of altering circadian rhythms are inherently difficult to study. As a proxy measure, the sleep disruption demonstrated by the shift workers in our study creates short- and long-term biological disturbances. ‘Shift workers adopt poor sleep hygiene, suffer sleep deprivation and develop activity levels that are out-of-sync with their body clock. ‘However, if our results are confirmed by other studies, there may be implications for shift workers and their reproductive plans. ‘More friendly shift patterns, with less impact on circadian rhythm, could be adopted where practical - although the optimal shift pattern required to maximise reproductive potential is yet to be established.’ She said that the underlying biological disturbances involved in reproductive difficulties ‘are complex and not the same across all the disease processes’. ‘Indeed,’ she said, ‘it is probable that completely different causes underlie menstrual dysfunction, miscarriage and subfertility. ‘This may explain why the effects of different types of shift work are seen in some groups of women, but not others.’ Article: 9th July 2013 www.dailymail.co.uk

Pride Angel Journey | Russian Dolls

It was a Thursday in October, almost thirteen weeks into my pregnancy when I had the first scan. At last proper confirmation that this nausea wasn’t for nothing – there really was something inside me, something human. I was still being sick every evening but the misery was now tinged with hope and excitement: hope that the nausea might end fairly soon, and excitement at the knowledge of the life inside me. Meanwhile, a tiny being reclined comfortably in my womb as if relaxing on a sun lounger. It looked so laidback, so collected – so different from how I felt. And tiny, yes, but not a bit vulnerable or needy. Not like it might scream for hours, appalled at the shock of life itself. It was time to go public, although by this time it was only really a secret to people who lived far away and hadn’t witnessed the pathetic sight of me gnawing miserably at half a breadstick in between gulps of Gaviscon. We’d been nervous about telling our parents – I wasn’t sure how mine would take to our method of conception, involving a man from the Internet masturbating in our bathroom, but their desperation for a grandchild, the extent of which I hadn’t truly realised, apparently overrode any concerns they may have had. When I was little over seven weeks gone, my mum took the opportunity while the neighbours were on holiday (since it was still early days) to get my old baby clothes and Terry nappies out of the loft, through the wash and hanging on the line in the garden. This child was either going to look ridiculous, dressed in clothes over thirty years old, or like a supercool 70’s retro baby. Close friends either already knew our method of conception or, if they didn’t, were quick to ask. More distant friends and work colleagues tended not to ask and, while part of me wanted to correct their probable assumption that we’d been to a clinic and used anonymous donor sperm, I also felt that the quite intimate details of our child’s beginning were best kept as distant as possible from staffroom gossip. We left our parents to spread the news to the older family members still surviving, and I still experience a slight discomfort when I wonder exactly how much they were told and what their understanding is of how lesbians go about these things; it horrifies me to think that they may be under the impression that I had sex with a man – but perhaps I’m insulting the intelligence of a generation that we have actually found far more accepting of our relationship than the post-war baby boom generation that followed them. Meanwhile, my body was changing. It was around the fourteen-week mark that a sliver of tummy was starting to emerge between tops and trousers. Keen to avoid both a November crop-top look and the risk of catching a chill, I had to reassess my wardrobe. A similarly proportioned friend had very kindly leant me a mound of maternity clothes, and my forage into the bag heralded a revelation: the comfort of maternity jeans with a shrewdly practical elastic-and-button adjustable system on the waistband. There was really no hiding the emerging bump now and one break-time, a group of Year 11 girls cornered me; clearly aware of the delicacy of the issue, yet determined for answers, after a little skirting around the topic they ventured to ask whether the rumours were true. I hadn’t anticipated the screaming that my response inspired, and the anxious educator in me was a little perturbed at their complete lack of concern that their English teacher would be leaving a month before the GCSE exams. A couple of weeks later, one of the girls – interestingly a student who was rather too relaxed where her work was concerned – presented me with a hat she’d knitted for the baby. I was very touched by the effort she’d gone to, and felt a surge of guilt: my knitting needles hadn’t surfaced since the last charity blanket square I’d produced twenty years ago as a Girl Guide and now my baby was reliant on sixteen-year-olds for its wardrobe. I hastily consulted Amazon and ordered a copy of Vintage Knits for Modern Babies, some wool and needles, and hoped I’d be able to find a YouTube video on how to cast-on. Meanwhile, I was unaware that around the country a hum of clicking needles was already picking up tempo; the post-war generation may struggle a little at first with homosexuality, but news of a baby is well within their comfort zone and the automatic reaction of many of our mums’ friends and friends’ mums, it seemed, was to reach for a couple of balls of Baby DK and a pattern. By mid-November, I’d reached seventeen weeks and the misery of the nausea had been replaced by a renewed appetite for evening meals which I could now keep down. My weight started to increase – until now, despite the emerging bump, with two and a half months of minimal food and no exercise, both fat and muscle had been dropping off from the rest of my body. We started to socialise again; I was still rather prone to more severe travel-sickness than I was used to, but we managed to visit relatives in Wales and on the South Coast and for the first time in over twenty years in my family, talk was of babies. We went for an Indian meal with friends, one of whom was two months ahead of me, and we were able to share both the exasperation of being told for the fiftieth time that ginger could solve the sickness problem (it wasn’t even slightly effective for either of us) and the excitement of what we both had ahead. The fact was, that pregnancy was starting to become quite good fun. And all this time I was still only just beginning to get my head round the miracle inside me. I was reminded of the> colourful Russian Dolls I had as a child, especially when I learnt that if our child was a girl, she would already have a full complement of eggs ready to produce her own children: another two generations there, inside me. I was almost ready to don a bright yellow headscarf and paint my lips bright red. But if only birth was as easy as a brief twist and pull of two bits of painted wood… Article: by Lindsey, West Yorkshire 6th July 2013

Male fertility treatment increases mental impairment and autism in children

Researchers have reported that children born following an IVF treatments for male infertility are 51% more at risk of developing intellectual impairments than those born by normal conception. Around half of the 48,000 IVF treatments carried out annually in Britain use this form of fertility treatment, known as intra-cytoplasmic sperm injection (ICSI). It is used where the men are deemed to be almost completely infertile and involves injecting the sperm directly into their partner’s egg. However, the technique is already considered to be controversial as it has been linked to an increased risk of birth defects. The study also found that in the most severe cases of male infertility, where men require surgery as part of the treatment, children were more than four times more likely to develop autism. However, the number of men who undergo this are small so the numbers of actual cases are extremely low. Dr Avi Reichenberg, from the Institute of Psychiatry at King's College London, who led the study, said: "About 50 per cent of IVF treatments use ICSI in the UK. “Our study shows that these treatments developed to manage male infertility are associated with an increased risk for developmental disorders in the offspring. “Whilst intellectual disability or autism remain a rare outcome for IVF, being aware of the increased risk associated with certain types of IVF means offspring at risk can be identified and potentially monitored for developmental disorders.” The study, which is published in the Journal of the American Medical Association, analysed data from more than 2.5 million births in Sweden, of which 30,959 were conceived using IVF treatment. They found that among those children who were conceived naturally, the risk of mental disability, defined by an IQ below 70 and an inability to perform every day skills such as learning, communication or social relationships, was just 62 out of every 100,000 births. Standard IVF increased the risk by around 18 per cent, but when children who had been born as twins or triplets were taken into account this increase disappeared. This is because even naturally conceived twins and triplets have an increased risk of developing a mental disability in later life, however, mothers who undergo IVF are more likely to give birth to multiple children in one pregancy. However, among those children conceived following IVF with ICSI, the risk increased by 51 per cent compared to natural conception, with 93 out of every 100,000 developing a mental disability. This remained high even after taking twins into account. In the UK, this would be equivalent to 22 of the 24,000 births achieved using IVF with ICSI would have an intellectual disability. A subset of the patients who had received IVF with ICSI saw the men need surgery to retrieve their sperm. This increased the risk of the children developing severe autism by 4.6 times standard IVF. However, the number of patients who have to undergo surgical ICSI are extremely low and when the researchers looked at children who had been born alone the risk disappeared. It is unclear why the risk is so much greater in multiple births using this technique than in the general population. The researchers claim this presents a strong argument for an increase in the use of IVF techniques that transfer just a single fertilised egg into the mother as this would help to reduce the chance of twins or triplets being born. Dr Karl-Gösta Nygren, co-author of the paper from the department of medical epidemiology at Karolinska Institutet, said: “I find these results reassuring as the risk is very small. The risk of birth defects is much higher. “Some of these risks are even preventable, so using single egg transfer could prevent multiple births for example. “There is a strong argument for extending the use of single egg transfer to diminish these risks.” He added that it is likely the increased risk created by the use of ICSI is due to defects carried in the sperm rather from the procedure itself. The use of ICSI has attracted criticism in recent years as it can cause sperm that contain genetic defects to be selected and injected into an egg when they would not normally survive to make the arduous journey to the egg. It has also caused ethicists to question whether such techniques should be used as it circumvents one of the ways nature has evolved to prevent poor quality genes from being passed on. A recent found, for example, that in 10 per cent of births using ICSI, the baby had a birth defect, compared to less than six per cent in natural births. Dr Alan Pacey, a fertility expert at the university of Sheffield and chairman of the British Fertility Society, said: “The main message of the paper is a positive one, suggesting that any risk of these disorders is very low in comparison to children conceived naturally. “It does highlight the importance of preferentially using standard IVF rather than ICSI.” Between one and two per cent of the children born in the UK are conceived through IVF. Sally Goddard Blythe, director of the Institute for Neuro-Physiological Psychology in Chester, which helps children with learning disabilities, said that she has noticed an increase in the number of children she was working with who had been conceived through IVF. She said: “Over the past 20 years, we are seeing an increase in the percentage of children at an older age who were conceived as a result of IVF. “We have 75 to 80 new families coming in to see us a year. The incidence of IVF in their developmental history in the past two years is 10 per cent while 20 years ago “Obviously there are more children being conceived through IVF but these figures still seem higher than they would normally be without it being an additional risk factor.” “More attention needs to be paid to this.” Article: 4th July 2013 www.telegraph.co.uk

Men with a poor sense of taste may have poor sperm or be infertile

A poor sense of taste in men may link to a problem with their sperm and fertility. Proteins that allow us to taste flavours play a crucial role in making men fertile, a study shows. American researchers found that two proteins, which allow the body to taste sweet and savoury flavours on the tongue, play a vital part in sperm development. The study, from the Monell Centre in Philadelphia, could suggest new ways to help male infertility or even spark the production of new male contraceptives. The surprising findings were made when mice were bred for taste related studies, without the two proteins known as taste receptors. They were found to be sterile, according to the study published in Proceedings of the National Academies of Sciences. Molecular Biologist Dr Bedrich Mosinger, said: 'This paper highlights a connection between the taste system and male reproduction. 'It is one more demonstration that components of the taste system also play important roles in other organ systems.' The taste receptors are more popularly known to help tongues detect sugars, salts and acids, which lead us to enjoy sweet, bitter, salty and sour tastes. While previous research has shown that taste receptors are located in different parts of the body, including the stomach and intestines, their function remains unclear. To try and work out their purpose, researchers examined the taste receptors that allow taste buds found on the tongue to detect sugars and amino acids that produce savoury and sweet tastes. LITTLE SENSE OF TASTE? COULD MEAN YOU LACK: Zinc. (RDA): 5.5-9.5mg for men Poor zinc intake can affect our sense of taste. In research carried out at the University of Ulster involving 387 people, those who had lower levels of zinc in their red blood cells were less able to detect salty tastes. How low zinc levels affect taste is unclear, but might be because zinc is required for the production of salivary enzymes and development and maintenance of tastebuds in general. Other signs of zinc deficiency can include more frequent infections, such as colds and flu, and delayed healing of wounds, probably because the mineral has a vital role to play in the functioning of the immune system and in the repair and renewal of cells. ZINC is important for sperm Zinc is an antioxidant mineral that is also important in protecting sperm against free radical attack. Semen is rich in zinc, with an estimate of each ejaculate containing as much as 5 mg - one third of the recommended daily nutrient intake. Thus a zinc deficiency would affect the protection of sperm. FOOD SOLUTION: Red meat - beef and lamb are among the best sources of zinc, so aim to eat one to two portions the size of an 8oz steak or equivalent a week. Other sources include nuts, especially cashews and peanuts, oysters, crab and dark chocolate. Article extracts: 2nd July 2013 www.dailymail.co.uk