Low Folate Diet Linked To Sperm Abnormality
March 20, 2008
The old adage “we are what we eat” received further support this week, and may even suggest “we are what our parents ate” when a new study by researchers in the US revealed that healthy men who have a diet low in folate have a higher risk of chromosomal abnormalities in their sperm. Chromosomal abnormalities in sperm are known to cause a range of congenital conditions such as Down sydrome and learning and development disorders.
The study is the work of scientists at the University of California (UC), Berkeley, and the Lawrence Berkeley National Laboratory, and is published in the 19th March issue of the journal Human Reproduction.
Women of childbearing age are encouraged to maintain a healthy intake of folate because it is essential for healthy fetal development, and to prevent neural tube birth defects such as spina bifida or anencephaly (severe type of brain damage). That is why folic acid is now added to bread, cereal, flour and other grain products in the US.
But this is the first study to suggest that folate intake in men may affect their children.
Researcher at UC Berkeley’s School of Public Health and coordinator of the study, Suzanne Young, said:
“Recent studies have suggested that paternal diet affects sperm count and motility, which is important for conception, but this new study takes it further to say that male diet may be important for healthy offspring as well.”
Young said their study was the first to examine the effects of diet on chromosomal abnormalities in sperm.
“These abnormalities would cause either miscarriages or children with genetic syndromes if the sperm fertilized an egg,” explained Young.
The researchers said that about 1 to 4 per cent of healthy male sperm has an abnormal number of chromosomes, or aneuploidy. These abnormalities arise when cells divide (meiosis) in the testis, but their cause is not well understood.
If an aneuploidic sperm fertilizes a normal egg, the fetus would either miscarry or develop a chromosomal disorder, such as trisomy, where cells have three copies of each chromosome instead of the more usual two (one from each parent).
In this study the investigators looked at three chromosomes linked with common types of aneuploidy in live births: X, Y and chromosome 21. Down syndrome, for example, is caused by having an extra chromosome 21. Klinefelter syndrome, which can affect language and learning development, is caused by an extra X chromosome in boys, and boys carrying an extra Y chromosome have XYY syndrome, also linked to learning and behavioral difficulties.
The participants were 97 non-smoking men with no previous history of reproductive or fertility problems. The aged from 22 to 80 and were either still working at or had retired from a government research laboratory.
The men filled in questionnaires about their diet and supplements like multi-vitamins and other nutrients. Semen samples were taken up to a week later.
After taking out the effects of age, alcohol and medical history, the results showed that men who reported the highest folate intake had a 19 per cent lower rate of aneuploidic sperm that men with moderate folate intake, and 20 per cent lower than men with the lowest folate intake.
The analysis did not show any links between aneuploidy and other nutrients such as zinc, calcium, beta-carotene and other vitamins, said the researchers, who concluded that:
“Men with high folate intake had lower overall frequencies of several types of aneuploid sperm.”
Co-principal investigator of the study, professor of epidemiology and maternal and child health at UC Berkeley’s School of Public Health, Brenda Eskenazi, said:
“”The emphasis related to the birth of a healthy baby has been weighted towards the health and diet of women, not just during pregnancy, but before.”
“What we’re finding now is that a nutritious diet, specifically folate intake, may be beneficial for men as well when it comes to producing healthy offspring,” she added.
Folate, which occurs naturally in a range of foods such as liver, leafy green vegetables, peas, beans, lentils and citrus fruits, is a water soluble vitamin of the B group.
Folate is essential for DNA, RNA and protein synthesis and the development of new cells. It also helps to control homocysteine, an amino acid that has been linked to heart disease.
But before men hoping to become dads rush out to buy folic acid or start maxing out on lentils, they should take note, as the researchers themselves suggested, that this study only found a link between folate and healthy sperm, it did not establish for certain that there is a cause and effect relationship.
Study co-principal investigator and chair of the Radiation Biosciences Department at Lawrence Berkeley National Laboratory, Andrew Wyrobek, cautioned:
“We can’t yet say that increasing folate in your diet will lead to healthier sperm.”
“But we did come up with enough evidence to justify a larger, clinical and pharmacological trial in men to examine the causal relationships between dietary folate levels and chromosomal abnormalities in their sperm,” added Wyrobek.
This information will help us set dietary folate levels that may reduce the risk of miscarriage or birth defects linked to the fathers,” he said.
If further research supports these findings, the researchers suggest it might be a good idea to increase the current recommended 400 micrograms daily allowance of folate for men hoping to become dads.
“The association of folate, zinc and antioxidant intake with sperm aneuploidy in healthy non-smoking men.”
S.S. Young, B. Eskenazi, F.M. Marchetti, G. Block, and A.J. Wyrobek.
Hum. Reprod. Advance Access published on March 19, 2008.
DOI:10.1093/humrep/den036
Click here for Abstract.
Sources: Journal abstract, press statement from University of California,Berkeley.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Fertility In Developing Countries: Words Into Action
March 15, 2008
For almost 30 years - since the world’s first “test-tube” baby was born in July 1978 - the benefits of modern infertility treatments have been largely confined to couples in developed countries. There, we have seen more than 3 million babies born as a result of IVF and, in some countries, as many as 4 per cent of all babies born conceived by modern fertility techniques.
The plight of couples in developing countries, especially women, has been acknowledged, but rarely advanced from words into action. Now, a task force of ESHRE (the European Society of Human Reproduction and Embryology), the world’s leading professional organisation in reproductive medicine, has devised a programme of fertility treatment for developing countries which aims to integrate fertility clinics within broader family health services. Two pilot IVF services have already opened in Africa.
According to Professor Oluwole Akande from University College Hospital in Ibadan, Nigeria, infertility in developing countries raises complex problems beyond those known to developed nations. “In poor resource areas,” he says, “the need for infertility treatment in general, and IVF in particular, is great. The inability to have children can create enormous problems, particularly for the woman. She might be disinherited, ostracised, accused of witchcraft, abused by local healers, separated from her spouse, or abandoned to a second-class life in a polygamous marriage.”
There are many reasons why infertility treatment has not been widely introduced in developing countries. The main explanations are poverty and limited health resources, but there is also the paradox that most of the countries where needs are greatest are also the countries where population growth is running out of control.
Says Dr Willem Ombelet, from the Genk Institute for Fertility Technology in Genk, Belgium, and co-ordinator of the ESHRE task force: “It is for these reasons that the ESHRE task force plans are to integrate infertility treatment within existing family planning and mother-care services. The most important goal is to provide treatment which is safe, affordable and culturally acceptable.
The ESHRE programme proposes three levels of treatment, but its cornerstone is the provision of affordable IVF. Currently, one cycle of IVF treatment in Europe or the USA costs between US$ 5000 and 10,000. A system of low-cost IVF now being pilot-studied in Khartoum and Cape Town aims to provide one cycle of IVF for less than $200.
One of the instigators of the low-cost IVF scheme, Dr. Luca Gianaroli from the SISMER Reproductive Medicine Unit, in Bologna, Italy, says: “It’s a different approach to IVF. We will not be able to treat every type of infertility, but many women with tubal damage as a result of infection can be helped.” While the scheme has limited laboratory facilities for incubation, embryo selection and embryo freezing, Gianaroli says triplets and high-order pregnancies will be avoided.
The cornerstones in the treatment of infertility in low-resource settings, says Ombelet, are the simplification of techniques, minimizing of complications, training for healthcare workers, and the incorporation of fertility treatments into existing healthcare programmes.
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Source: Sarah De Potter
European Society for Human Reproduction and Embryology
A Method To Select Eggs With The Best Chance Of Leading To Successful Pregnancy Developed By Researchers
March 13, 2008
A research team supervised by Universite Laval scientist Marc-Andre Sirard has identified genetic markers that allow the selection of eggs with the best chance of leading to successful pregnancy after in vitro fertilization (IVF). This finding could both increase the success rate of single embryo transfer and diminish the risk of multiple pregnancies. The details of the method developed by the researchers, for which an international patent application has been filed, are explained on the website of the scientific journal Human Reproduction.
Eggs recovered in the course of the IVF process are surrounded by follicular cells that are removed before the actual fertilization procedure begins. “While in the ovaries, these cells and the eggs are in very close interaction,” explains Sirard. “A first experiment we conducted on bovine follicular cells led us to believe that these cells might possess specific markers that would be able to give us information about the quality of an egg.”
With the help of 40 women recruited in a fertility clinic, researchers compared follicular cells surrounding eggs that ultimately led to successful pregnancies - i.e. “good” eggs - to cells surrounding ovules that did not result in pregnancy. This comparison led to the identification of five genes expressed more abundantly in follicular cells surrounding good eggs.
Currently, the way to assess which embryos are to be transferred into a woman’s uterus is based on visible criteria such as appearance and division rate. “At least 30% of embryos that look normal through visual examination nonetheless show chromosome abnormalities,” explains Professor Sirard, illustrating the limits of this type of assessment. The method developed by Sirard’s team makes it possible to objectively select ovules that have the best chance of success without altering the integrity of the embryos.
This new genomic tool could also solve an ethical problem confronting both fertility clinic doctors and the people who consult them: In order to increase the chances of pregnancy, many embryos are implanted simultaneously into the woman in the hope that at least one will survive. This procedure along with improved IVF techniques has led to an increase in multiple pregnancies. Even if doctors now tend to transfer fewer embryos, multiple pregnancies still occur in 30% of couples who resort to IVF in North America and 23% in European couples. “By selecting the embryo with the best potential, it would be possible to limit the number of embryos transferred, and thus the number of multiple pregnancies, while maintaining good success rates,” concludes Marc-André Sirard.
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This release is available in French.
In addition to Sirard, the study was co-authored by Mélanie Hamel, Isabelle Dufort, Claude Robert, and Catherine Gravel from Université Laval’s Centre de recherche en biologie de la reproduction, as well as Marie-Claude Léveillée and Arthur Leader from the Ottawa Fertility Centre.
Information:
Marc-André Sirard
Centre de recherche en biologie de la reproduction
Université Laval
Source: Jean-Fran?ois Huppé
Université Laval
New England Area Fertility Experts Issue Call For Ethnic Egg Donors
March 13, 2008
Swelling numbers of infertile couples are turning toward egg donation as a means to become pregnant and are in turn creating an acute shortage of ethnic minority donors, say physicians at the Reproductive Science Center (RSC) of New England.
As a result, RSC doctors are calling for young women of Jewish, Asian Indian and other Asian ethnic groups in New England to consider becoming egg donors as an altruistic act for couples who may have no other options for conceiving.
“Due to the shortage in New England, Asian donors are traveling to Boston from as far away as California,” said Dr. Samuel Pang, medical director of RSC. “That puts additional financial strain on a recipient, who is responsible for paying for the donor’s transportation and hotel fees.”
Cultural, religious and social traditions are often a barrier to egg donation in certain ethnic communities, Pang said. For instance, in some cultures, infertility is seen as a failure, which hinders couples from going to their friends and family about becoming possible egg donors. Traditional Asian communities might reject the idea of egg donation, because of the importance of bloodlines within their culture.
The increasing demand for egg donors is in part due to the recent success of egg donation rates. About 12 percent of IVF attempts in 2007 involved the use of donated eggs in the United States, according to the Centers for Disease Control. The number of IVF attempts that involved either donated eggs or donated embryos increased from about 5,000 attempts in 1995 to more than 16,000 attempts in 2007.
“In order to have children who resemble them, some couples have gotten creative and chosen donors outside of their ethnic group based on similar physical attributes,” said Amy Demma, Director of Donor Programs at Prospective Families, a Boston-based donor agency that works closely with RSC. “For example, Indian donors sometimes seek out Mediterranean donors, because of their dark hair and skin tone.”
“In order to keep up with demand, egg donation clinics need to develop strategies to increase the awareness of the need for egg donors among all racial groups,” Pang said.
About Reproductive Science Center of New England
With 11 locations throughout New England, Reproductive Science Center is the seventh largest medical practice of its kind nationwide, known coast to coast for its innovative patient care, advanced laboratory capabilities and for success rates that are among the highest in the United States. Founded in 1988, RSC is led today by a team of six physicians — four of whom are women, making it one of the largest groups of female reproductive endocrinologists in the Northeast. RSC is a member of IntegraMed, a national network of 29 fertility centers in 95 locations across the United States. Over 20 percent of all IVF procedures in the United States are performed in an IntegraMed fertility practice. For more information, visit http://www.rscnewengland.com.
Reproductive Science Center of New England
http://www.rscnewengland.com
Fertility Centers Of Illinois Seeks In Vitro Fertilization Patients For Clinical Trial Of Investigational Drug That Promotes Pregnancy
March 10, 2008
Fertility Centers of Illinois S.C., (FCI) along with several other large infertility practices nationwide, have been selected to participate in a Phase III Clinical Trial for an investigational drug that supports pregnancy and is used with In Vitro Fertilization (IVF). FCI seeks up to 200 patients to take part in the study and is offering one cycle of In Vitro Fertilization (IVF) at no cost to all that meet the study criteria.
All patients taking part in the study will be required to take daily injections of gonadotropins to prepare the eggs, similar to a typical IVF cycle. Half of patients will be randomized into a group taking the FDA approved drug and the other half will take the investigational drug. Randomization to the progesterone treatment group will occur after a patient has reached egg retrieval.
Initially, participants of the study must be seen at the FCI River North office; however subsequent monitoring can be performed at either of the In Vitro Fertilization Centers at Highland Park or River North. Oocyte retrieval and embryo transfer will be performed at the designated IVF facility. Following embryo transfer, additional embryos can be frozen, but at the cost to the patient. As with all drug studies, strict criteria for participation apply. Please visit http://www.fcionline.com for further information about the application process and criteria for inclusion and exclusion from the program.
About Fertility Centers Of Illinois
Fertility Centers of Illinois, S.C., is one of the nation’s leading infertility treatment practices, providing advanced reproductive endocrinology services in the Chicago area for over 25 years. FCI has more babies born than the next ten centers combined with high success rates that are recognized throughout the nation. In addition to a team of nationally recognized reproductive physicians who stay current on the latest technology and procedures, FCI patients have access to many other unique support services, such as professional counseling from a licensed, Ph.D. clinical psychologist, patient advocates and innovative financial options. FCI is part of IntegraMed, the nation’s largest and most reputable network of fertility centers and has multiple offices conveniently located throughout the Chicago area.
Fertility Centers Of Illinois
ContraVac Receives FDA Approval For Post-Vasectomy Home Sperm Test
March 5, 2008
ContraVac, Inc., a biotechnology company with reproductive and fertility focus, announces the U.S. Food and Drug Administration (FDA) has recently approved SpermCheck Vasectomy®, a simple diagnostic which confirms men’s post-vasectomy sterility. The device will enable men to test their post-vasectomy fertility status at home rather than requiring the patient to return to the physician’s office or a laboratory.
SpermCheck Vasectomy is an easy-to-use diagnostic device similar to a home pregnancy test for women. It is the first test with the sensitivity and specificity required to detect low numbers of sperm and the first at-home diagnostic to receive FDA approval for sperm testing after vasectomy. Physicians will be able to provide SpermCheck Vasectomy to their patients following their vasectomy or men can purchase SpermCheck Vasectomy directly from ContraVac.
SpermCheck Vasectomy will be commercially available in the U.S. as soon as Summer 2008. ContraVac will be presenting SpermCheck Vasectomy at the American Urological Association Annual Meeting in May 2008.
Ed Leary, President of ContraVac said: “The convenience and privacy SpermCheck Vasectomy provides is anticipated to improve the compliance rate for post-vasectomy sperm testing, resulting in fewer unwanted pregnancies and providing greater peace of mind.” There are approximately 500,000 vasectomies performed each year and most physicians require two post-vasectomy sperm tests. The inconvenience and indignity associated with returning to the physician’s office or laboratory to supply semen samples has created an environment where nearly 35% of patients never return for their first sperm test and over 70% do not return for their second sperm test.
SpermCheck Vasectomy utilizes technology discovered by John C. Herr Ph.D., Director of the University of Virginia Center for Research in Contraceptive and Reproductive Health and the founder of ContraVac. According to Dr. Herr, “The SpermCheck Vasectomy Test is the result of many years of basic research, clinical chemistry know-how, customer ease-of-use trials and an appreciation for the home-use market. Our objective was to convert the genetic technology into a device which performs at sensitivities necessary to achieve our unique FDA approval status.”
SpermCheck Vasectomy
Center For Assisted Reproduction Is First In Southwest To Offer Pioneering Test Of A Woman’s Biological Clock
February 26, 2008
The Center for Assisted Reproduction (CAR) announced it will be the first IVF center in the southwest to offer the Repromedix’s Plan Ahead™ test, an innovative blood test that provides an assessment of a woman’s egg supply by combining multiple factors including the measurement of ovary-related hormones AMH, Inhibin B, and FSH. The window of opportunity for a woman to have children by natural conception is dependent upon an adequate supply of eggs which inevitably declines as a woman ages and her “biological clock ticks.” Plan Ahead enables a woman to compare her estimated egg supply with the normal range expected for women of the same age. In addition, the Plan Ahead Report provides valuable directional information for women planning to have children after their late twenties.
“The Center for Assisted Reproduction has been a pioneer of cutting edge assisted reproductive technologies,” said Kathleen Doody, MD, co-founder of CAR with her husband Kevin Doody, MD. “CAR was the first IVF center nationwide to implement extended embryo culture (blastocyst culture) for all of its IVF patients and we had the first intra-cytoplasmic sperm injection (ICSI). So being the first in the Southwest to offer the Plan Ahead test aligns perfectly with our mission.”
As women age, their fertility naturally declines, with increasingly fewer eggs available for fertilization. “With so many women delaying pregnancy until their 30s and 40s women urgently need an accurate assessment of their egg supply,” said Dr. Kevin Doody. “And while we know that on average ovarian reserve begins a more rapid decline after age 35, it can be quite variable among women of the same age. The Plan Ahead test will provide women with the individual assessment of their own ovarian reserve to help them make more informed decisions about when to have a child. We’re pleased to be in the vanguard of this critical new test.”
“The Plan Ahead test represents an extraordinary advance in fertility diagnostics compared to what has been readily available to the general population,” said Dr. Benjamin Leader, Chief Medical Officer. “Many fertility experts view the gold standard of egg supply measurement to be the number of eggs obtained through egg retrieval, an expensive procedure reserved for specialty fertility clinics involving hormone injections and a minimally invasive procedure. The Plan Ahead test offers similar information to the general public via a simple blood test.”
Repromedix Corp., the Plan Ahead test co-developer and leading national diagnostic laboratory for fertility testing, selected the Center for Assisted Reproduction to be one of a select number of IVF centers to debut the test. Repromedix will expand the Plan Ahead test launch to major markets across the United States throughout 2008.
Plan Ahead is now available to women in the Dallas-Fort Worth area, and women interested in the Plan Ahead test can purchase a test online at http://www.planaheadtest.com/us or at the Center for Assisted Reproduction, where they can also have their blood drawn. The blood sample is sent to Repromedix, whose lab performs the advanced testing and submits the report and recommendations to the patient’s physician. The cost of the Plan Ahead test is $350.
Women interested in learning more about Plan Ahead, should visit: http://www.planaheadtest.com/us.
About Center for Assisted Reproduction
The Center for Assisted Reproduction (CAR) was established in 1989. Our Center’s goal is to provide comprehensive medical care for the treatment of infertile couples. Since being established, CAR has helped thousands of couples throughout the country achieve their dream of parenthood. Our Center has been a pioneer of cutting edge assisted reproductive technologies, not only in North Texas, but nationwide as well.
http://www.embryo.net
About Repromedix
Repromedix is the leading national diagnostic laboratory for fertility testing and offers a multifaceted approach to clinical fertility testing that encompasses many medical disciplines including endocrinology, immunology and genetics. Repromedix offers the most comprehensive suite of advanced diagnostic tests that provide valuable information regarding the complex problems of reproductive failure. Since its inception in 1993, the company has assisted more than 45,000 patients by performing over 100,000 diagnostic tests for recurrent pregnancy loss, premature ovarian failure, male infertility, and unexplained infertility. Repromedix is a portfolio company of Brook Venture Partners, Ironwood Capital Management, and Brooke Private Equity Advisors.
http://www.repromedix.com
BJOG Release: Selective Single Embryo Transfer Of A Blastocyst For IVF Increases Pregnancy Rate And Lowers Twin Births
February 22, 2008
The aim of any IVF treatment is for the woman to become pregnant and to give birth to a healthy baby. In order to achieve greater success, some doctors implant more than one embryo into the womb of a woman during IVF. This practice often leads to multiple pregnancy and though commonly seen as desirable by parents, multiple pregnancy carries an increased risk of preterm birth, intrauterine growth restriction, and pre-eclampsia, thereby increasing maternal, perinatal and infant mortality. There is also a greater risk of long-term poor health for surviving babies, including the risk of cerebral palsy.
In order to lower the multiple birth rate in IVF, the Human Fertilisation and Embryology Authority (HFEA), British Fertility Society (BFS) and Royal College of Obstetricians and Gynaecologists (RCOG) have all recommended single embryo transfer (SET). The catch of choosing SET for many parents has been that in the past, pregnancy rates have been lower per cycle (although they can increase the number of pregnancy attempts using embryo freezing). This is a particular problem if the number of cycles a woman can have is limited by funding.
In a new study to be published by BJOG: An International Journal of Obstetrics and Gynaecology, scientists from the Assisted Conception Unit at Guy’s and Saint Thomas’ Hospital in London employed selective single blastocyst transfer during IVF. The technique they have developed resulted in an increase in the clinical pregnancy rate (CPR) and a significant fall in the multiple pregnancy rate (MPR).
A blastocyst is a fertilised egg which has started to develop, ready for implantation. By waiting till the fifth day of cell division, doctors can better identify the embryos that have an improved possibility of implanting in the womb, thereby achieving higher successful pregnancy rates.
The study took place between July 2004 and July 2007 and was divided into two groups. The first group (Jul 04 - Dec 05) were offered transfer of up to three embryos into the uterus, 2 - 3 days after insemination. The clinical pregnancy rate (CPR) was 27% and the multiple pregnancy rate (MPR) was 32%. In the second group (Jan 06 - Jun 07), doctors waited until day five to allow for further development of the embryos. One high quality blastocyst was transferred. The CPR per cycle for this group was 32% and the MPR was 17%.
Using this transfer technique has the added benefit of producing surplus embryos which are suitable for cryopreservation, for parents who want to try for another baby at a later stage. This reduces the need for the woman to undergo ovarian stimulation again to retrieve her eggs for future use.
Dr Yakoub Khalaf, who led the study, said “It is a myth that single embryo transfer lowers the success rate of pregnancy. If the right patients are selected for blastocyst transfer, success rates can be maintained and multiple pregnancy can be significantly reduced.
“We believe firmly that a twin pregnancy is not an ideal outcome. People think it is two for the price of one, but the risks are real and we see the heartache time after time. I would encourage every IVF clinic to look at our results when treating their patients.”
Professor Philip Steer, BJOG editor-in-chief said, “Parents who are desperate to have a baby often willingly have two embryos transferred during IVF to increase their chances of pregnancy. This has resulted in the high numbers of twin births for mothers who go through IVF, with all the major increases in pregnancy and newborn problems that multiple pregnancy brings.
“This new research has shown that the single embryo transfer of a good quality blastocyst during IVF treatment can not only increase a woman’s chances of falling pregnant, but it also has the desired effect of decreasing the risk of a multiple birth.
“The promising results of this study suggest that single embryo transfer can be the way forward for many women undergoing IVF. It is important that IVF units develop the skills to ensure that only the best blastocysts are used, and at the same time, women should be better educated about the high risks of multiple pregnancy.”
* In addition to the release of this paper, BJOG has produced a videocast of a discussion between the authors of the paper, Dr Yakoub Khalaf and Dr Tarek El-Toukhy with leading fertility experts Anthony Rutherford of the British Fertility Society and William Ledger of the Human Fertilisation and Embryology Authority. Chaired by BJOG editor-in-chief Professor Philip Steer, the panel discuss how IVF policy should change in order to allow for SET to become a reality in the UK. To view the videocast, please click here.
Notes
BJOG: An International Journal of Obstetrics and Gynaecology is owned by the Royal College of Obstetricians and Gynaecologists (RCOG) but is editorially independent and published monthly by Blackwell Publishing. The journal features original, peer-reviewed, high-quality medical research in all areas of obstetrics and gynaecology worldwide. Please quote ‘BJOG’ or ‘BJOG: An International Journal of Obstetrics and Gynaecology’ when referring to the journal.
Reference
Selective single blastocyst transfer reduces the multiple pregnancy rate and increases pregnancy rates: a pre- and postintervention study.
Khalaf Y, El-Toukhy T, Coomarasamy A, Kamal A, Bolton V, Braude P.
BJOG 2008;115:385-390.
Royal College of Obstetricians and Gynaecologists
Pacific Fertility Center Announces Breakthrough In Egg Freezing Technology
February 22, 2008
A Pacific Fertility Center (PFC) patient, who underwent an embryo transfer with embryos created from vitrified and warmed donor oocytes (eggs), successfully delivered a baby in late October 2007. A healthy baby boy was born at term. Three other pregnancies are ongoing and are expected to deliver in 2008.
PFC has been developing an oocyte vitrification program for the past two years. This program is a part of their ongoing research to develop and implement new services. While it has been possible to preserve sperm for many years (the famed Dutch microscopist Antony von Leeuwenhoek allegedly cooled and then recovered sperm using snow and ice in the 17th century), reliable methods for preserving unfertilized eggs have been elusive until now.
“Vitrification” refers to a new alternative method for freezing embryos (and now eggs or oocytes). Traditionally, preservation of sperm and embryos has been achieved with the use of a technique called slow freezing. This process cools the sperm and embryos very slowly to sub zero temperatures. This technology typically only works for cells that exist individually or in small numbers, such as sperm and embryos. However, slow freezing does not work well for unfertilized human eggs. In fact, the estimates for rates of success with slow freezing is about two births for every 100 eggs thawed.
In recent months, the newer vitrification technology has been used at PFC for unfertilized egg preservation. Vitrification works by using higher concentrations of cryoprotectants and much faster cooling rates. Cells are cooled in tiny straws which achieve cooling rates of several thousand degrees per minute. When vitrification straws and cryoprotectants were first approved by the FDA for human embryos, PFC began the process of adapting the technology to unfertilized eggs (oocytes). “Even though we’ve been handling oocytes and embryos for many years, this technology provided new challenges due to the tiny size of the straws and the speed at which they had to be cooled,” says Joe Conaghan, Ph.D., HCLD, Laboratory Director and Embryologist at PFC. “Once proficient with the procedure, we began to freeze ! high quality oocytes from donors that had proven fertility. Using these quality oocytes, we could be assured that any failure would be the result of the vitrification technology and not the oocytes.”
Five oocyte donors in their twenties were recruited and all of their oocytes were vitrified immediately after their oocyte retrieval procedures. The oocytes were then offered to specific PFC patients waiting for embryo donation. The immediate availability of the vitrified oocytes and the ability to choose the sperm source made this a great alternative to accepting donated embryos.
PFC had immediate success with the first recipient. “We had vitrified 16 oocytes from the first donor. For the first recipient we warmed only 7 of these,” explains Dr. Conaghan. “Four hours later we injected a single sperm into 6 oocytes that survived the vitrification process (1 oocyte had not come through the process successfully). The next morning, 3 of the oocytes had fertilized. Two days later, 3 embryos were transferred. A positive pregnancy test and ultrasound confirmed a singleton pregnancy. This success was a great reward for our efforts.”
Overall, PFC had 7 out of 10 embryos implant after transfers to 6 recipients. What is very exciting is that this implantation rate (70%) is comparable to the implantation rates seen with donor oocytes which have not been cryopreserved. While these results are encouraging and have brought great joy to a small number of patients, there are more issues to resolve before the center declares complete success. “The 70% success rate was obtained with the use of the highest quality oocytes from young donors in their 20’s who were known to be fertile and healthy. However, we also had 2 donors that produced poor quality oocytes that did not survive the vitrification procedure,” says PFC reproductive specialist Carl Herbert, M.D. He adds, “We are uncertain how results may vary using oocytes from women in their late 30’s. As age is a prominent factor in fertility success, obviously there will be differences in the outcome. We are currently creating a protocol! that will address this issue.”
PFC offers oocyte vitrification unconditionally to unmarried young women with cancer whose treatments may render them sterile. In the future, oocyte vitrification may be a possible option for women who need or wish to delay child bearing. However, until there are more data with oocytes from a variety of women, PFC is being very careful about offering vitrification routinely to women who are worried about the biological clock. That said, PFC reproductive specialist Carolyn Givens, M.D. reveals, “We are currently planning a study in women in their mid- to late thirties to vitrify and warm their eggs in order to determine whether or not rates of egg survival will be comparable to those we are experiencing with young and healthy donor eggs. If we see rates of conception with transfer of embryos from vitrified eggs in our th! irty-something year-old patients that are comparable to the rates we would expect with embryos that had never been cryopreserved, we would expect to offer this technology as one of our services.”
About Pacific Fertility Center
Pacific Fertility Center (PFC) is a fertility medical practice and egg donor agency located in San Francisco, California. PFC physicians are board certified by the American Board of Obstetrics and Gynecology in Reproductive Endocrinology and Infertility. The physicians at PFC are members of the Society of Assisted Reproductive Technology (SART); Society of Reproductive Endocrinology and Infertility (SREI); and the American Society of Reproductive Medicine (ASRM). They each have many years of successful clinical, academic, and scientific experience. The onsite innovative laboratory at PFC is operated by one the most experienced embryology teams in the nation. PFC is highly regarded for its ability to offer technologically advanced solutions to the most resistant fertility challenges, while conveying warmth and compassion to their patients.
Pacific Fertility Center
Two Newspapers Publish Fertility Treatment-Related Articles
February 22, 2008
The New York Times and Wall Street Journal published articles about fertility treatments on Monday. Summaries appear below.
- New York Times: In response to an increase in multiple births following fertility treatments, some experts are taking steps to reduce the risk of twin and larger multiple pregnancies among women undergoing fertility treatments, the Times reports. Multiple pregnancies carry an increased risk of preterm birth and other complications. The percentage of twin births has increased by 70% to 3.2% of all live births since 1980, when in vitro fertilization first became available in the U.S., according to the Times. As IVF success rates have increased, fertility clinics are focusing on transferring fewer embryos and identifying embryos most likely to result in a live birth. The number of IVF cycles in which four or more embryos are transferred has decreased from 62% in 1996 to 21% in 2004, resulting in a decrease in triplets born through IVF. The rate of twin births has remained constant because few women are willing to undergo a single embryo transfer during IVF. The American Society of Reproductive Medicine recommends that women younger than age 35 undergoing IVF who have a good prognosis have only one embryo transferred and that women older than age 37 have three to five embryos implanted. According to the Times, the “main obstacle” to SET is the procedure’s lower success rate compared with multiple embryo transfer, but physicians are developing tests aimed at identifying embryos with genetic abnormalities in an effort to increase the success of SET (Tarkan, New York Times, 2/19).
- Wall Street Journal: An increasing number of U.S. couples are traveling abroad to undergo IVF because of the procedure’s lower cost in countries such as Canada, the Czech Republic, Israel and Thailand. According to the Journal, IVF in foreign countries often costs a “fraction” of what it does in the U.S., even after accounting for travel costs. In addition, some women are seeking IVF abroad because they have been turned away by U.S. clinics because of their age. According to U.S. fertility experts, IVF is a low-risk procedure but patients seeking IVF abroad should consider the reputation and success and complication rates of fertility clinics, as well as their liability and right to pursue legal action if necessary. The Web site http://www.ivfvacation.com/ charges couples between $1,500 and $2,500 to arrange appointments at a Czech fertility clinic and to provide translation and other services. Another Web site, http://www.ivfthailand.com/, helps couples arrange treatments at fertility clinics in Thailand, and the CHEN Patient Fertility Association in Israel helps couples arrange for fertility treatments and sightseeing tours in the country (Tesoriero, Wall Street Journal, 2/19).
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