Most exciting new breakthrough in IVF treatment for 30 years

Thousands of infertile couples could benefit from a new IVF procedure that can dramatically improve the success rate of having a baby through artificial reproduction. Scientists believe they can double or even triple the proportion of healthy babies born as a result fertility treatment with a relatively simple technique that takes a series of time-lapse photographs of the developing IVF embryos. On average only about 24 per cent of IVF embryos implanted into women in the UK lead to live births but the researchers believe this could be increased to 78 per cent using the new technique for selecting the best embryos. I believe it is the most exciting breakthrough we've had in probably 30 years,” said Professor Simon Fishel, managing director of the CARE Fertility Group, where the technique was developed. “Every IVF practice in the world is unintentionally and unwittingly putting back into the womb unviable embryos that don't make babies,” Professor Fishel said. “We hope to see a paradigm shift in terms of IVF. It's a game changer for everybody to have such an uplift in live birth rates. This is the beginning of something revelatory,” he said Each year, licensed clinics in Britain carry out about 60,000 IVF treatments but most of them end in failure, causing immense emotional upset to couples, many of whom have paid between £5,000 and £10,000 for each treatment cycle. The new procedure, which costs £750, identifies the best embryos to be implanted into the womb based on the time it has taken to develop between two key stages in the early life-cycle of the embryo. Thousands of time-lapse pictures are taken during the first few days of an IVF embryo's life and these are used to identify the time between the first appearance of the fluid-filled cavity, called the blastula, and the final moment before the embryo “hatches” from its protective shell. Scientists have discovered that when this period lasts longer than about six hours, the IVF embryo is likely to be carrying an abnormal number of chromosomes, called aneuploidy, which will lead to a failure of the pregnancy. A preliminary study, published in the journal Reproductive Medicine Online and based on a retrospective analysis of 88 IVF embryos of 69 couples, found that the time-lapse technique could have improved the success rate of life births in this particular group of patients from 39 per cent to 61 per cent. Even better success rates can be expected once the procedure is refined and applied to the wider population of infertile couples seeking IVF treatment, Professor Fishel said. “Our work has shown that we can easily classify embryos into low or high risk of being chromosomally abnormal. This is important because in itself this is the largest single cause of IVF failure and miscarriage,” he said. “The beauty of this technology is that the information is provided by a non-invasive process. So far we have seen a 56 per cent uplift compared to conventional technology, giving our patients the equivalent to a 78 per cent live-birth rate,” he added. Normally, IVF embryos in an incubator are checked manually each day by embryologists but the time-lapse cameras are able to do this automatically by taking pictures every 10 minutes without interfering with embryo development, said Alison Campbell, embryology director at Care Fertility in Nottingham, who developed the computer algorithm controlling the analysis. “With time-lapse we have the ability to view more than 5,000 images over the same time period to observe and measure more closely each stage of division and growth. As a result of continuous monitoring we have demonstrated that delays at defined points indicate abnormal development,” Ms Campbell said. Martin Johnson, a fertility expert and editor of the journal where the work is published, said further “prospective” studies comparing the technique to existing methods of embryo selection are still needed before the procedure is recommended as standard treatment. “There are caveats with this research….and for these reasons we have to be cautious,” he said. Sue Avery, director of Birmingham Women's Fertility Centre, said: “Unfortunately the study does not compare this exciting new approach with standard practise in embryology in which embryologists already look for the best embryos to place in the womb. Until the new technique is compared to current practise we cannot know whether different embryos are being chosen.” Egg timing: Key stages The developing embryo (image one, above) goes through two key stages when the fluid-filled cavity or “blastula” first forms (image two) and when the blastula is fully formed before the embryo “hatches” (image three). The time between the two is used to judge whether the embryo is viable, with no defects in chromosome numbers. If the period is longer than six hours, the embryo is at high risk of abnormal chromosomes, which will inevitably lead to complications. Time-lapse photographs can indicate which embryos have a shorter time-period between these two points, and so which embryos are best for implantation into the womb. Article: 17th May 2013 www.independent.co.uk Read more about IVF and alternatives to IVF at www.prideangel.com

Failed IVF attempts lead to depression and anxiety

Women who are stressed and anxious before in vitro fertilization (IVF) are no less likely to have a baby, new research suggests. But if the treatment fails, it may take a toll on their mental health. In two separate studies in the journal Fertility and Sterility, researchers found women with anxiety or depression symptoms were just as likely as others to become pregnant. One study focused on women undergoing IVF and the other followed women trying to conceive naturally. "Our findings are consistent with the most recent research," said Lauri A. Pasch, a clinical psychologist at the University of California, San Francisco Center for Reproductive Health, and the lead researcher on the IVF study. Based on that body of research, she told Reuters Health, "I think we can safely say to women, ‘Stop worrying about being worried.'" Women should not feel pressured to be a "good IVF patient" who's free of stress, Pasch said. And they should not blame themselves if they feel stressed out and their IVF attempt fails. The other study, from the UK, looked at 339 women who were trying to become pregnant naturally. Overall, 61 percent of them became pregnant over about six months. And the odds of success were not linked to women's mental well-being once the researchers accounted for factors like their age and smoking habits, a team led by Courtney Lynch of the Ohio State University College of Medicine in Columbus reported. WHEN IVF DOESN'T WORK On the other hand, women who try IVF and fail may see their mental health suffer, Pasch and her colleagues found. The researchers followed 202 women undergoing IVF at five San Francisco practices. All of the women were interviewed before their IVF attempt, which included standard questionnaires on depression and anxiety. Overall, the study found, women whose IVF treatment failed were at greater risk of anxiety or depression in the months afterward. Of 103 women with a failed attempt, 60 percent had symptoms of a clinical anxiety disorder - up slightly from 57 percent before their IVF cycles. And 44 percent had clinical depression, which was up from 26 percent before treatment. It's not surprising that many women with a failed IVF attempt would have such symptoms, according to Pasch. But there has actually been little research into how IVF outcomes may affect women's mental health, she said. And although women with a failed try at IVF were at higher risk, even women who became pregnant had substantial rates of depression and anxiety, Pasch's team found. During pregnancy, 30 percent of those women had depression in the "clinical range," while half had clinical-level anxiety. Those rates were close to what they were before IVF. According to Pasch, infertility practices should do more to help women with mental health symptoms - though not because it would be expected to improve their odds of IVF success. "Psychological interventions need to be geared toward helping women feel better, and not toward increasing their chances of pregnancy," Pasch said. Some larger, university-linked infertility centers have on-site services for women who want mental health counseling. But most practices do not, Pasch said. Women can, however, ask their center for a referral to counseling if they need it. Pasch said there are also organizations that offer help, like information on local support groups. Article: 27th June 2012 www.uk.reuters.com

IVF success up by 40% as lab mimics conditions in womb

Doctors have dramatically increased the success of IVF by creating laboratories which mimic conditions found inside the womb. The fertility experts have boosted a woman’s odds of pregnancy by up to 40 per cent simply by keeping lab conditions more similar to those inside a woman’s body.
The success of the technology, developed at Newcastle University, promises to reduce the financial cost of treatment, as well as the emotional heartache of repeatedly failing to become pregnant.

Despite some popular perceptions, IVF is far from fail-safe, with some women undergoing multiple courses costing between £3,000 and £15,000 to try to realise their dream of motherhood.

IVF is a multi-step process that culminates with the embryo being grown in an incubator for several days before being placed into the womb. However many steps, from the actual fertilisation of the egg to checks under the microscope, take place outside the incubator. This can lead to changes in temperature and air quality which can be potentially harmful to the embryo.

To get round this, experts at the Newcastle Fertility Centre created a ‘lab in box’, or a chain of interlinked incubators with in-built microscopes. This allows them to work with and examine the embryo without taking it out of the incubator.

Professor Mary Hebert, who helped draw up the system, said that while the concept is simple, it was difficult to come up with a design that allowed the delicate lab work to be done without taking the embryos out of the incubator.

She added: ‘Our aim was to keep eggs and embryos in conditions similar to those they would experience naturally inside a woman’s body. ‘This led our team to design and develop a system in which it is possible to perform all of the technical procedures while maintaining stable conditions throughout the IVF process.’

As a result, since installing the system in 2007, IVF success rates at the centre have soared. Pregnancy rates at the clinic have gone from between 32 and 35 per cent per session of IVF to 45 per cent – an increase of up to 40 per cent – and hundreds of babies have been born.

The data, published in the journal PLoS ONE applies to women aged 37 and under. A woman aged under 35 has a 32 per cent of giving birth per IVF attempt. The figure falls to 27 per cent in women aged between 35 and 37. Labs in the Netherlands, Canada and Thailand have all installed systems based on the Newcastle design.

Alison Murdoch, professor of reproductive medicine at Newcastle University, said: ‘Growing good embryos is the key to IVF success and everyone, even those with a very small prospect of success, deserves to have the best possible chance.

‘Since installing the technology over 850 babies have been born.’
The Newcastle Fertility Centre mainly does NHS work but some private patients are also treated. Dr Allan Pacey, a fertility expert at Sheffield University, said: ‘Any technical development that can improve the success rate of IVF should be given serious consideration.

‘This is a novel solution to the age-old problem of trying to control the environment in which embryos are grown during IVF. ‘Whilst different units around the world tackle this problem in different ways, we will see whether this development becomes a popular choice now that it has been the subject of scientific evaluation.

Article: 1st March 2012 www.dailymail.co.uk

Cut price IVF test improves chances of a healthy baby

A cut-price test that could dramatically increase the chances of having a healthy baby through IVF could be available within 18 months. Oxford University researchers say their test could ‘revolutionise’ the treatment as it is half the price of existing tests and may be just as effective.

It may be cheap enough for use by the Health Service. And, unlike existing tests, it does not involve the potentially risky step of taking a sample of cells from the egg or fledgling embryo, making it safer and more ethically acceptable.

Instead, it works by analysing a ‘cloud’ of cells that nurture and feed the egg. These are normally thrown away in IVF treatment but fertility doctors Dagan Wells and Elpida Fragouli believe they hold important clues to the health of the egg.

Keeping and analysing these cells could help clinics select the best eggs for fertility treatment. It should also spare would-be parents the emotional and financial heartache of going through repeated unsuccessful IVF treatments. Analysing these ‘cloud’, or cumulous, cells is also likely to be much cheaper at £1,000 or less compared with the £2,000 cost of other techniques, bringing the technology within range of many more couples.

Despite IVF’s reputation as an insurance policy, the treatment works in less than a quarter of cases, and many of the failures are because of problems with the eggs’ chromosomes. There are already several ways of checking the chromosomes, but they require a small sample from the egg or embryo and so are not completely without risk to the unborn child.

The cumulous cells, however, can be studied without harming the egg. These cells grow and mature with the egg and so any problems that damage the egg, such as a poor blood supply, should also show up in the cells. The doctors have carried out a small-scale study that has shown that certain genes being over or under-active in the cumulous cells is a sign of abnormal eggs.

Calculations suggest that using the technique to pick out the healthiest eggs would boost a woman’s odds of having a baby. Existing tests can double or triple the odds of IVF success, and it is hoped the new test will be just as good.

Dr Wells said: ‘The number of patients we looked at is very small. This is very much a work in progress, but there is good reason for optimism at this point.’

A larger-scale study is planned, and if that goes well the technique could be trialled on women for the first time in the summer of 2012. If it proves to be safe and effective, it could be in widespread use early in 2013.

Article: 28th December 2011 www.dailymail.co.uk

What if IVF treatment fails: three peoples stories

Eleni Kyriacou talks to three couples about how IVF and fertility treatment can turn lives upside down
Carole Waters, who has now adopted
Carole, 43, lives in Hampshire with her husband Andy, 43. They have had one IVF cycle and one frozen embryo transfer (FET). They have a daughter, Bea, five.

I was 29 when we first started trying to conceive and we waited five years before having IVF. I was against it for a long time – I didn't like the thought of all those drugs. I was determined to get pregnant naturally and all the tests had shown that we were both highly fertile, so there was no clinical reason why we shouldn't be able to conceive naturally.

Eventually we got sucked into it. I was told that I had the egg reserves of a woman in her 20s, so we were very hopeful. In our area there was no NHS funding, so we paid for it. A woman in the next town had three IVF cycles, all paid for. I hated injecting myself and the mood swings that came with it. I remember the moment I saw the blood and realised it had failed. I screamed and at that point I couldn't have got any lower. It took me six months to deal with it. I became paranoid and felt depressed. For those six months, Andy and I became very insular, almost attached at the hip. We felt only we could understand each other, so we hardly socialised. And, frankly, I was getting fed up of all the platitudes, people saying: "It'll happen, just relax."

IVF made me feel such a failure. Friends were having their third baby and we were still trying for our first. A year later, we had FET – using the frozen embryos left over from the IVF cycle. But that failed too. I had a gut feeling that I would never get pregnant, so we decided to stop. The doctors kept saying there was nothing wrong with us, so we couldn't see what IVF could do for us that we couldn't do ourselves. We had already spent £4,000 and continuing would have felt like throwing money away.

So we agreed that we wouldn't have children. It was heartbreaking, though deep down I don't think I really believed that. Eventually we started socialising again and we'd walk into parties, heads held high, and pretend everything was OK and that we were quite happy the way we were.

We had briefly talked about adoption but dismissed it, as we had read that you couldn't adopt a baby if you were over 35. We wanted a baby, not a toddler; it was a basic need in me and we wanted to be as much of an influence in the child's life as possible. About a year later, by chance, I bumped into a colleague in the car park at work. She was adopting two siblings. She told me that there weren't the age limits on adopters we had assumed. I had also heard that the process was harrowing, but she said, "It's nowhere near as bad as IVF." That resonated.

Andy and I agreed that, though we were happy now, we'd be full of regret when we were older. In 10 years, we might be holidaying in the Maldives but what would it mean without a family? And what about when we were older? We regularly socialise with our parents and my Mum and I are very close. We wanted that for us in the future. We decided to explore adoption and it took two years, from that first phone call to having Bea come to live with us. She was nine months old.

I had to give up on the idea of having my own genetic child and there was a certain amount of mourning involved. The notion left my head but it was still in my heart. I can pinpoint the day when the idea finally left me for good. It was the day we were approved for adoption. Before that, I was still thinking, maybe I will still get pregnant, as everyone says it will happen when you least expect it. Since then I haven't cared about getting pregnant and now I wouldn't want a birth child, because Bea might feel left out. I don't want that complication for her. If someone said I could go back 10 years and get pregnant, I categorically wouldn't do it.

I feel so proud of our daughter and what we've done. Anyone can have a baby, but not everyone can adopt. There's no doubt in our minds that we weren't meant to have a biological child, because she was already there waiting for us. It's one of the best things we ever did. I know women on their seventh and eight IVF cycles. It's heartbreaking. I wish they would consider adoption as another way to achieve a family, rather than as a second best.

For more information on adoption, visit www.baaf.org.uk

To read more go to http://bit.ly/pZssDB

IVF success rates in US are decent, reports the Society for Assisted Reproductive Technology.

IVF treatment continues to be a popular choice for making babies. The treatment, known formally as in vitro fertilization, is successful in producing a live birth in 41.4% of treatment cycles for women under age 35, according to information released Monday by the Society for Assisted Reproductive Technology.

Data for 2009, the most recent year analyzed, showed the rate of live births per cycle with fresh embryos did not change much from 2008 when it was 41.3% for women under 35. However, that's still an improvement from 2003 when the rate of live births per cycle was 37.5% in that age group.

Success rates fall off quickly for older women, however. In 2009, the percentage of cycles with fresh embryos resulting in live births was 31.7% for women ages 35 to 37, 22.3% for women ages 38 to 40 and 12.6% for women ages 41 to 42.

The more embryos transferred, the higher the risk of multiple births. Several years ago, the Society for Assisted Reproductive Technology called on doctors and patients to limit embryo transfers to one in healthy, younger women who have a good chance of pregnancy. But if appears as if SART's goal of reducing the number of embryos transferred isn't enthusiastically embraced. Only 7.2% of women under age 35 opted for a single-embryo transfer in 2009, up from 5.2% in 2008. In 2003, the rate was 0.7%.

Overall, the average number of fresh embryos transferred was 2.0 for all age groups in 2009 compared with 2.6 in 2003.

The rate of live births with twins for women under age 35 was 32.9%, a trend that hasn't changed much since 2003. The rate of triplet births in that age group, however, was 1.6% in 2009 compared with 6.4% in 2003.

The leading, single cause of infertility continues to be male factor, which accounts for 17% of cases in which people seek IVF treatment. A diminished number of eggs, which occurs most often in women age 35 and older, accounted for 15% of cases, and in 12% of cases the cause of infertility cannot be explained.

To read more go to http://bit.ly/gftipF

Online IVF calculator predicts fertility treatment success rates

Web resource based on five years of medical records aims to tell women their likelihood of giving birth with 99% accuracy
Women hoping to have a baby through fertility treatment can from today use an online calculator to show them how likely they are to succeed.

IVF (in-vitro fertilisation) is expensive, only sometimes available on the NHS and less successful than many people think.

To help couples to decide whether IVF is worth pursuing for them, academics at Glasgow and Bristol have created the calculator, which they say will predict a woman's likelihood of giving birth with up to 99% accuracy.

"In the US and the UK, IVF is successful in about a third of women under 35 years old, but in only 5%-10% of women over the age of 40," said Professor Scott Nelson, Muirhead chair of reproductive and maternal medicine at the University of Glasgow.

"However, there are many other factors in addition to age which can alter your chance of success, and clinics don't usually take these into account when counselling couples or women."

The calculator, available for free at www.ivfpredict.com, is based on data from more than 144,000 IVF cycles held by the Human Fertilisation and Embryology Authority (HFEA) – all the outcomes of treatments undergone between 2003 and 2007.

"Essentially, these findings indicate that treatment-specific factors can be used to provide infertile couples with a very accurate assessment of their chance of a successful outcome following IVF," Nelson said.

"It provides critical information on the likely outcome for couples deciding whether to undergo IVF. Up until now, estimates of success have not been reliable.

"The result of this study is a tool which can be used to make incredibly accurate predictions."

To read more go to http://bit.ly/eyUW3w

Intralipid fertility treatment may cut miscarriages and boost pregnancy rates

An experimental fertility treatment increases the odds of an IVF pregnancy up to six times while also inhibiting chemicals which cause miscarriages, a study has found. When women who had gone through IVF time and time again without success were given a soya-based substance, half became pregnant. In contrast, fewer than one in ten of those who had conventional fertility treatment alone conceived.
The doctors behind the remarkable study believe that the Intralipid liquid, a fat and calorie-rich potion normally used when tube-feeding very sick patients, could help many more women achieve their dream of motherhood.

Improving success rates would spare women the emotional and financial pain of going through repeated IVF treatments, only for them to fail. The liquid also stems the production by the body of harmful chemicals which can lead to miscarriage.

George Ndukwe, of the Care fertility clinic in Nottingham, said: ‘Every day in my clinic I see women who have had numerous IVF cycles all with the same negative outcome and no baby. ‘I also regularly see couples who have suffered the misery of repeated miscarriages. ‘People talk about the financial implications but the emotional one is as bad or, I would say, worse. ‘These women are at the bottom of a dark pit and can’t climb out and can’t see the light.

We are devoting our attention to finding answers when nature goes wrong.’ Dr Ndukwe, the clinic’s medical director, believes that up to one in four women who struggle conceiving have faulty immune systems.

It is thought that extra high levels of white blood cells called natural killer cells ‘fight’ the pregnancy by triggering the production of chemicals that attack the placenta or the embryo. The chemicals are already known to trigger rheumatoid arthritis and the arthritis drug Humira has shown promise in boosting pregnancy rates.

However, it costs up to £2,000 per patient and does not work for everyone. At around £200 per woman, Intralipid, which is given through a drip around a week before a woman has IVF, is much cheaper.

To read more go to http://bit.ly/ieus05