Researchers Develop System To Predict IVF Success

Reseachers at Stanford Univesity examined 665 IVF cycles performed at Stanford in 2005. They looked at thirty different variables (including patient characteristics, clinical diagnoses, treatment protocol and embryo characteristics) to determine which variables were the most important in predicting IVF success.

The researchers found that these four factors: total number of embryos, number of eight-cell embryos, percentage of embryos that stopped dividing and would die, and the woman's follicle-stimulating hormone level, a measurement that estimates ovarian function- were most important in determining a woman's chance of becoming pregnant. When they looked at these four factors together they were seventy percent accurate in predicting whether the current IVF cycle would result in a pregnancy . They also found that all four of these measures were more important in predicting success than looking at the quality of any single embryo. A patient could have a high quality embryo but if she produced a low number of embryos for example her chance of success could actually be quite low.

Although this news is not surprising to most physicians, this is the first time it has been studied scientifically. The researchers are now conducting a follow up study with a much larger patient population (four years of data) and will use live birth rather than a positive pregnancy test, as the outcome.

Fertility Coaching Shows Promise

By: Kathleen

Going through infertility almost always increases stress levels for couples. This stress frequently feeds a negative feedback loop where the fertility problems are exacerbated by stress. So the higher the levels of stress, the worse the chances of conceiving become, which then again increases stress. It is common for high-achieving women, in particular, to feel a loss of control during IVF treatment, and for these women it can be very difficult to accept that their body is letting them down. A novel approach to improving this situation is the use of fertility coaching. Couples experiencing high levels of anxiety can hire a fertility coach trained in cognitive behavior therapy (CBT) to help them have a better outlook on their situation. This in turn lowers stress and anxiety, which improves fertility. At least that's the theory. A recent study supports this idea. Sixteen women who had functional hypothalamic amenorrhoea, a condition in which the hormone that triggers ovulation has been at a very low level, were followed. Half of the women received CBT for twenty weeks. The results were dramatic: six of the eight women receiving CBT became ovulatory, and two became pregnant within two months. Only one women in the other group started ovulating again. While the sample size was low, this certainly is promising research and suggests couples may want to seek unconventional therapies to help them through this difficult process.

Diabetes Contributes to Male Infertility

Diabetes has been added to the growing list of medical conditions that have a negative effect on male fertility. A recent study looked at the semen quality of diabetics and compared them with healthy fertile men. Although there was a small decrease in semen volume for diabetics, the most troubling findings were at the genetic level. Diabetics had sperm that were significantly less able to repair their own DNA, a vital function in cells. Poor sperm DNA quality has been linked to a variety of problems; such as embryo quality, miscarriages and even childhood cancer in offspring.

Unintended Consequences- Updated

Loss of donor anonymity leads to sperm donor shortage

A textbook story of a government mandate run amok is now playing out in the UK's sperm and egg donor business. The Human Fertilisation and Embryology Authority (HFEA) is the UK's independent regulator overseeing the use of gametes and embryos in fertility treatment and research. New HFEA regulations, which became effective in early 2005, have made it very difficult for childless couples to find an egg or sperm donor. As outlined in this article, the new regulation states that when offspring from any donor reaches the age of eighteen, they can access the identity of their donor. The regulation also stipulates that donors can no longer be compensated for their donations; they can only claim "reasonable expenses" incurred while donating.

The new regulations have had the obvious result of reducing the number of men and women who are willing to donate. The number of women treated with donor sperm fell by over 20% from 2,727 in 2005 to 2,107 in 2006. Shared eggs were used in only 680 fertility procedures in 2006, compared with 1,142 in 2004 (a 40% decline), the last year before the new regulations became effective. Donor anonymity has been typical of the egg and sperm bank business for decades in the United States, and before 2005, this was also true in the UK. While many donors have a desire to help childless couples, it's not hard to predict what would happen if they are given no choice in anonymity and are not compensated for their efforts.

The author of this article describes her quest to import donor sperm after learning of the two year wait in the UK. The author describes the struggle between different people's rights and states "Whose should be the greater? The right of the child to track down its biological parent when it's 18, the right of the donor to stay anonymous, or that of the mother simply to have the child?" At the present time, compromise would seem to be the best solution...many US sperm banks and egg donation programs now offer donors and patients a choice in anonymity. If there's anything positive that can be said about this situation, it's that it should be a clear warning to legislators in the US of the serious implications from following the UK’s regulations on donor anonymity and compensation.

Update
A year after the law changed on anonymity, two thirds of fertility clinics said their waiting times for sperm treatment had lengthened. HFEA maintains that there is no sperm donor shortage and it is a "myth" that there is a shortage as the number of sperm donors rose slightly from 2005 to 2006. But this rise is due to an increase in the number of known donors- friends and relatives that donate specifically for one couple. Secretary of the British Fertility Society, Allan Pacey, MD, a fertility expert at Sheffield University said they are treating 600 less patients. He stated "'after the change in the law, many men are exercising their right to limit the number of times their sperm can be used. They do not want 10 children turning up on their doorstep 18 years on, or they are donating only for a friend."

Infertility support groups are now calling the situation a "national crisis" as clinics close and patients travel abroad for treatment. Clare Brown, chief executive of Infertility Network UK, recently said the change in law had made a "huge difference" to the number of men volunteering. She stated: "Clinics across the country are having to close because there is a shortage of donor sperm - and that constitutes a crisis. Before the anonymity law was introduced we didn't have a shortage of sperm donors - now we have." Reports from HFEA show that as few as ten new donors are being recruited in Britain each month compared to thirty a few years ago. There is now only one active sperm donor for the whole of Scotland and Oxfordshire clinics have just one man willing to be provide sperm. Fertility experts believe there could be as few as twenty active donors being shared by the ninety-three fertility clinics in the UK. Experts also fear the shortage will lead to a rise in women seeking donors from unregulated internet sites which do not screen for diseases such as HIV.

Waiting to Conceive

By: Kathleen

A recent article's focus in the British Telegraph is on how common it has become in England to have child at an advanced maternal age. In recent years, British women in their forties have had the largest rise in conception among all demographics. According to this article, the main reason for delaying pregnancy is not the often touted "career first, family second". It is more likely to be a practical desire to find "Mr. Right" before starting a family. It also points out that waiting this long frequently results in assistance from fertility clinics. Additionally, the increased likelihood of miscarriages and other problems is well documented as women wait to have children.

Obesity Bad For Sperm

A recent study from England attempted to find the relationship between BMI and sperm quality. The research showed that as men get heavier and heavier, their percent of abnormal sperm also increases. Semen volume also decreases as the weight goes on. The lead researcher said there were a number of possible explanations, including different hormone levels in obese men, overheating of the testicles caused by excessive fat in the area, or simply the lifestyle and diet that leads to obesity also causing poorer semen quality. There are many benefits that result from an ideal body weight and these findings indicate that improved sperm quality can be added to the list.

Another recent study on the effectiveness of various popular diets showed that the low carb diets showed the best results. Subjects on the low carb / high protein (with some vegetarian sources of fat) diets showed not only weight loss but also the largest decline in cholesterol. The average weight loss for the participants was ten lbs for the low carb diet vs six lbs for the low fat diet.