Single embryo IVF with genetic screening has high success rates

The transfer of one pre-screened embryo during IVF leads to birth rates equivalent to transferring two unscreened embryos, indicates new research from the USA. Preliminary results presented at the American College of Obstetricians and Gynecologists Annual Clinical Meeting revealed that single embryo transfer combined with preimplantation genetic screening (PGS) resulted in fewer twin pregnancies and better health outcomes for both mother and child. 'Single embryo transfer with comprehensive chromosome screening has the potential to be paradigm-shifting and revolutionary in the world of IVF', explained lead researcher Dr Eric Forman, of Reproductive Medicine Associates of New Jersey (RMANJ) at the Robert Wood Johnson Medical School. 'Patients can do single embryo transfer and maintain excellent delivery rates while not taking on the treatment-related risk of multiples', he added. Infertility treatment currently accounts for 18 percent of twin deliveries in the USA. However, multiple pregnancies carry increased health risks to the mother and child. In the study 175 women aged 43 or younger received either a single pre-screened chromosomally normal embryo or two unscreened embryos. Results so far indicate equivalent pregnancy rates in the two groups. No twins resulted from single embryo transfers whereas 53 percent of double embryo transfers led to multiple pregnancies. At present only ten percent of women in the USA opt for an elective single embryo transfer. Dr Forman noted that most women choose to have multiple embryos transferred because they feel that this improves their chances of becoming pregnant. However, as more people become aware of the success rates of single embryo transfer, its popularity as a treatment option may increase. 'The technology exists today to make single embryo transfer the standard of care across age groups, eliminating the vast majority of complications stemming from IVF, while maintaining excellent delivery rates for couples who have struggled with infertility', explained Dr Forman. PGS adds an extra cost to fertility treatment in the USA and research is ongoing at RMANJ to establish whether in the USA this cost is offset by the reduced healthcare burden associated with lower risk singleton pregnancies. Article: 13th May 2013 www.bionews.org.uk

Scratching lining of womb could double IVF success rates

British researchers found that gently scratching the lining of the womb a month before IVF treatment improved the chances of pregnancy. A review of research on the technique found that twice as many women became pregnant after the procedure than without, boosting pregnancy rates to almost one in two. Doctors at Guy’s and St Thomas’ hospital, central London, are carrying out a larger trial to establish the overall efficacy of the technique with the hope of offering it routinely within three to five years. It is thought that scratching the womb lining stimulates growth factors and repair mechanisms that allow the fertilised egg to embed more easily. It takes only 15 minutes in clinic, can be carried out by trained nurses and uses simple equipment already in use. The procedure may add less than £100 to the average £4,500 cost of a cycle of IVF treatment. Dr Tarek El-Toukhy, who led the review study, said: “Endometrial scratching uses simple, inexpensive equipment that most hospitals already have and which clinicians are already trained to use, so complications are rare. “It’s exciting that the chance of pregnancy could be doubled. The next step is to see if this applies to birth rates. About a third of IVF treatments result in a baby, so improving these odds would make a big difference to people trying to have children through IVF.” The findings from the review of eight studies involving 911 patients are published in Reproductive Biomedicine online. In the review, 128 out of 499 women who did not have the womb procedure became pregnant — almost 26 per cent. Of the 412 women who had the procedure, 198 fell pregnant, or 48 per cent. There were no serious side effects reported and early signs are that the doubling in rates will be translated into birth rates. The women in the study had all suffered repeated unexplained implantation failure, meaning other aspects of their fertility seemed normal but the egg did not implant properly in the womb. Maha Ragunath, the clinical director of Care Nottingham, the biggest private provider of fertility treatment in England, said the technique should be offered widely to all IVF patients in the near future. She has begun carrying out the procedure for patients who have suffered repeated failed cycles of IVF. “This is really priming the womb to receive the embryo,” she said. “It is a bit like having a smear test for cervical cancer. It is very quick and simple. “I think any doctor reading the review would want to at least talk to their patients about this procedure. “There is obviously something to be gained from it, no long-term damage and it is so inexpensive, so why not?” Article: 1st October 2012 www.telegraph.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