An artificial ovary that can mature human eggs could lend new hope to women whose fertility is at risk from cancer treatments, scientists claim.

Scientists hope it could also help answer questions about how ovaries work and enable experiments on what causes problems for egg maturation and health.

The researchers, from Brown University and Woman & Infants Hospital in America, grew the donor cells into honeycomb shapes before placing human egg cells in the holes.

Within days the cells had enveloped the immature eggs and they were able to grow to full maturity, according to the study in the Journal of Assisted Reproduction and Genetics.

Sandra Carson, professor of obstetrics and gynaecology at Brown University, wrote: “An ovary is composed of three main cell types, and this is the first time that anyone has created a 3-D tissue structure with triple cell line. This is really very, very new and is the first success in using 3-D tissue engineering principles.”

Neil McClure, professor of Obstetrics and Gynaecology at Queen’s University, Belfast, said: “This certainly has the potential to provide a very good way of maturing very immature eggs in the lab to the point where they can be used for assisted reproduction.

“There are lots of studies that need to be done but it is a huge step forward and a very novel technique that has the potential to give hope to young women who are going to be undergoing treatment which will prevent them having children naturally.”

Professor Richard Fleming, director of the GCRM fertility unit in Glasgow, said the development could have “great practical implications” on fertility treatment by maturing eggs more reliably.

He said: “It is a significant step along a long pathway but really quite an important one.

“If you try to mature eggs in a Petri dish the structure tends to collapse rather than sticking to itself. This is trying to improve the proportion of the immature eggs that get through to the mature stage.”

But other experts said the new development did not yet represent a ‘real’ artificial ovary” because it did not contain primordial follicles, which develop eggs in real ovaries.

Professor Bill Ledger, a fertility expert from Sheffield University, said: “We have no idea why a primordial follicle will rest for 30 years or more then decide to begin to develop and eventually release its egg. If we did, then we could try to lengthen a woman’s fertile lifespan or restore fertility to women after treatment with chemotherapy.

“The artificial structure does not contain primordial follicles, nor have they shown that it can regulate the ‘awakening’ of primordial follicles in an orderly manner, as in the normal ovary, so I don’t think its quite accurate to label it as an artificial ovary.”

NEW YORK (Reuters Health) – Despite studies suggesting that birth control pills might not work as well in obese women, a new study suggests that they prevent pregnancy the same no matter what a woman weighs.

As long as a woman-heavy or thin–took the pill consistently, Dr. Carolyn L. Westhoff of Columbia University Medical Center in New York City and her colleagues found, it prevented her ovaries from producing eggs. Westhoff and her team report their findings in the August issue of Obstetrics & Gynecology.

Studies have found that obese women are 30 to 40 percent more likely to get pregnant while taking the pill than were normal-weight women taking it, perhaps because excess weight might blunt its effectiveness. Overall contraception failure rates are estimated between 2 and 8 percent per year.

In their study, Westhoff and her colleagues enrolled 226 normal-weight or obese women, randomly assigning them to take a lower or higher dose version of the pill. After three or four cycles of oral contraceptives, the researchers then had the women undergo multiple ultrasounds and blood tests to determine if their ovaries were making eggs.

The researchers tested women’s blood levels several times to determine if they were using the pill consistently; about 90 percent of the normal-weight women had hormone levels indicating consistent use, compared to 72 percent of the obese women.

Ninety-seven percent of the 150 consistent pill users did not ovulate, the researchers found, meaning they would not have gotten pregnant during that cycle. Whether or not a woman was obese didn’t affect her likelihood of ovulation; among the consistent pill users, three of the 96 normal-weight women ovulated, and one of the 54 obese women did.

Two ovulations occurred in women taking the higher-dose pill, and two occurred in women on the lower dose.

But more than a third of the 13 women who were inconsistent pill users ovulated, and two-thirds of the 18 non-users produced eggs.

The new findings, along with more recent clinical trials, should put to rest concerns that obese women are more likely to get pregnant while on the pill, Westhoff says. The issue has confounded doctors, she notes, because some companies have pushed physicians to prescribe higher dose formulations to their obese patients based on the idea that lower doses aren’t effective.

The problem with this approach, she explains, is that obese women are at increased risk of developing life-threatening blood clots in their veins. Taking the pill-especially at higher doses-further increases the risk these clots will occur.

But according to her findings, Westhoff says, obese women who take lower-dose pill formulations can be reassured that they will be effective in preventing pregnancy.

Westhoff has consulted for drug firms that make oral contraceptives, including Duramed, Schering-Plough, and Bayer.

The problem with previous studies, Westhoff told Reuters Health, was that women were asked to recall unintended pregnancies that had occurred in the past; the women also reported their own weights, rather than being weighed by the research team.

Dr. Victoria Holt of the University of Washington in Seattle, who led the studies finding different failure rates among obese and normal-weight research, said she still believes obese women are more at risk of becoming pregnant while on the pill.

She argues that Westhoff’s research suggests obese women are less likely to achieve adequate hormone levels while taking the pill, because just 72 percent had levels indicating consistent oral contraceptive use, compared to 90 percent of the normal-weight women.

“If indeed there is lower effectiveness among obese women, then this does not appear to be the mechanism through which it works,” Dr. James Trussell, the director of the Office of Population Research at Princeton University in New Jersey, told Reuters Health. Trussell studies contraceptive failure, but wasn’t involved in Westhoff’s research. “But nobody has any idea what the other mechanism would be.”

This November, the National Institutes of Health will convene a group of experts to investigate whether further research should be done on obesity and oral contraceptives, he noted, while the Food and Drug Administration is also planning a hearing to address evidence that a new emergency contraceptive pill is more likely to fail in obese women.

“It’s a particular concern in the United States because obesity is increasing so rapidly,” Trussell said. “I would say that the pill is still not going to be the front line, the top tier contraception for obese women.”

Methods with a lower risk of failure due to human error, like the IUD, hormonal implants, or vasectomy for the male partner, would likely be a better choice, he said.

“If a woman really doesn’t want to become pregnant I would suggest combining oral contraceptives with a barrier method,” Holt advised, such as condoms or a diaphragm.

Nature has optimized the main function of sperm cells in a similar way to race cars. These cells consist of sub-cellular organelles that contain, for example, mitochondria. Mitochondria are the power stations supplying energy for sperm motion and mobility — one of the crucial factors in fertility. The research team has shown that cellular damage on a molecular level in mitochondria can be present although changes in form and morphology are not visible. This stresses that besides morphology, which is a strict criterion by the WHO Manual for Andrology Laboratories to classify human sperm fertility, it is now possible and necessary to improve the test criteria by incorporating chemical signatures.

The RUB researchers obtained detailed 3D chemical maps which do not require the introduction of additional labels or markers. The Raman micro-spectroscopy used in this study detects sub-cellular components using the spectral fingerprints of molecules based on their characteristic vibrations. Different organelles within human sperm are visualized by their chemically unique Raman spectra. In addition to optical and morphological images, it is now possible to directly image the chemical constituents of individual human sperm cells.

This discovery may contribute to the development of new standards for the classification of healthy fertile and damaged infertile human sperm cells. Since the sperm count of human males around the world has dropped an alarming 50 per cent of what it was more than 50 years ago, there is an urgency to investigate human fertility organelles.

The development of innovative spectroscopic and microscopic methods for high resolution imaging of living cells is one of the research areas at the Chair of Physical Chemistry II (Prof. Dr. Martina Havenith-Newen). The work of Konrad Meister, Diedrich A. Schmidt and Erik Bründermann uses confocal Raman microscopy for detailed 3D imaging and identification of organelles of human sperm cells to reveal the origin of infertility on the molecular level. The funding for the Raman microscope used in this study was supported by the Federal Ministry of Education and Research (BMBF 05KS7PC2).

The findings are published in the journal The Analyst, and are also featured in Highlights in Chemical Biology and in the news section of Chemistry World of the Royal Society of Chemistry in May.

Home fertility tests aren’t just for women anymore.

A new device that looks a lot like home ovulation and home pregnancy tests but checks sperm count will soon be available in Europe, and is undergoing Food and Drug Administration review for marketing in the United States.

The test targets couples who have been trying to get pregnant for a few months, but aren’t ready to seek professional help, according to Dr. John Herr of the University of Virginia in Charlottesville, who helped develop the new test.

He said the test helps couples find out if the male is a factor in the infertility “and to do that in privacy with some cost savings.”

“The product will retail for about $25. That’s a lot cheaper than going in and having a full semen analysis,” Herr said.

He said depending on where people live in the United States, it would cost anything from $65 to $250 for a semen analysis, which may or may not be covered by insurance.

In the journal Human Reproduction, Herr and his team report on a study comparing the accuracy of their SpermCheck Fertility test with standard laboratory sperm count methods, using 225 semen samples.

The tests were accurate 96 per cent of the time, the researchers found.

Sperm counts of 20 million per millilitre of semen and above are considered normal and a test will tell if a man’s sperm count meets this level and if he has a severely low sperm count of below five million sperm per millilitre.

“It basically tells the man how deep the infertility is,” Herr said. “If both strips are negative it’s important that they then seek medical treatment for the infertility.”

The test works by detecting an antigen found on the surface of the head of a sperm cell known as SP-10, which Herr and his colleagues discovered. The work of discovering SP-10 and developing the test, much of which was funded by the National Institutes of Health, took about 10 years.

Fertility treatments, such as in vitro fertilization (IVF), have made possible the gift of children for many people not able to conceive on their own. But as with many medical advances, there comes a delicate balance of risk to reward.

With IVF, women have a much higher risk (1 in 3) of having multiple births – twins, triplets or even more babies. For an infertile couple, the choice of more babies versus no babies may seem like a slam dunk.

But there’s a down side. Doctors know firsthand the toll of difficult pregnancies, problem births and babies struggling with multiple complications.

For this reason, the American Society for Reproductive Medicine (ASRM) recommends that doctors work with women to transfer the fewest number of embryos for the highest likelihood of pregnancy. For a woman under 35 who has good chances of a pregnancy developing, the guideline is to transplant only one embryo.

But the chances of the embryo transplant succeeding drop as women age. For women over 35 (and those younger women who have a higher likelihood of failure), the guidelines suggest that doctors transplant more than one and up to five embryos. This increases the chance that a pregnancy will develop. But it also ups the chance of multiple births.

How is IVF done?
IVF is the most common form of assisted reproductive technology, or ART. While there are many variations to these procedures, the basics are:

• Fertility drugs are used to cause a woman to release more eggs.
• The eggs are then removed from the woman’s body and mixed with a man’s sperm in a lab (in vitro fertilization).
• The fertilized eggs (embryos) are then transplanted back into the womb so they can grow.

All, some or perhaps none of the embryos may develop. That’s why fertility doctors often transplant more than one embryo to increase the chances that one will take hold. But, transplanting more embryos raises the risk of multiple births.

It’s important for you and your doctor to discuss how many embryos to transplant based on your age, health, the quality of your eggs and other factors. The goal is to conceive and deliver one healthy baby.

What are the risks of multiple pregnancy and multiple births?
In general, the more fetuses in the womb, the higher the risk for problems. These include miscarriage and premature birth. Multiple fetuses compete for space and nutrition in the womb.

Most multiples are born prematurely. If they survive, many have underdeveloped lungs. This can lead to serious breathing problems and often months in the neonatal intensive care unit. Some have higher risk for infections, or problems with nerve and brain development that may not be obvious for years after.

There can also be life-threatening risks to the mother who is carrying multiples. Multiple pregnancy adds significant stress to the woman’s body. This can cause dangerous nausea and vomiting, high blood pressure, gestational diabetes or anemia.

Aside from the physical risks to mother and babies, multiple babies can bring about significant financial and emotional stress to a family. Doctors and potential parents continue to grapple with these and many other ethical considerations around fertility treatment, its rewards and consequences

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If going through infertility wasn’t enough, now a clinic used wrong sperm.  My heart goes out to the individuals this happened to.

A TOP fertility clinic used the wrong sperm to fertilize eggs on at least THREE occasions earlier this year.The Sun – London,UK

Embryos belonging to the couples, who were being treated at Guy’s and St Thomas’ Hospital, had to be destroyed and their treatment cycles abandoned.

The blunder was discovered because one of the couples was also undergoing PGD – screening to ensure their child would not carry a life-limiting gene defect.

Doctors checking the embryos for gene faults realised they could not have been produced using sperm and eggs from the couple named on paperwork. The other mistakes emerged when worried staff then ran checks on all embryos created the same day.

Danger

But fertility watchdogs have known since 2006 that slack laboratory rules meant there was a danger eggs could be fertilised with the wrong sperm.

In December 2006 HFEA inspectors raised concerns about sperm samples for more than one patient being in the lab when samples were being processed.

Fertility expert Lord Winston said he was shocked that more than one sample was in the lab at any time.

“We never, never did that when I was working at Hammersmith.

The HFEA asked for a risk assessment, but did not impose any conditions on the clinic’s licence ordering doctors to tighten up their procedures.

But an inspection carried out in February 2008 revealed the clinic was still in danger of using the wrong sperm to fertilize eggs.

Inspectors noted: “The centre employs the practice of having all unprocessed sperm samples in the work area at one time.”

It added, this was “not compliant” with HFEA rules, but it went ahead and renewed the hospital’s licence without imposing any additional conditions.

Lord Winston said: “It’s a horrifying thing to happen once, you would have thought if it had happened before they would be absolutely scrupulous about making sure it didn’t happen again.”

Josephine Quintavalle of the campaign group Comment on Reproductive Ethics said: “The casualness is just dreadful.

“We don’t even know if this is just the tip of the iceberg.”

The HFEA says it hopes to issue a statement tomorrow on the blunder and its role in monitoring the clinic.

A spokeswoman for the Guy’s and St Thomas’ said the hospital was introducing electronic tagging of sperm, eggs and embryo to beef up controls.

]]> http://www.infertilitycouples.org/blog/2009/04/beware-ivf-clinic-used-wrong-sperm/feed/ 1 http://www.infertilitycouples.org/blog/2009/04/acupuncture-doesnt-boost-ivf-success-for-all/ http://www.infertilitycouples.org/blog/2009/04/acupuncture-doesnt-boost-ivf-success-for-all/#comments Fri, 17 Apr 2009 20:42:43 +0000 Leisha http://www.infertilitycouples.org/?p=184

U.S. News & World Report – ‎Apr 13, 2009‎
Most of us learned in our high school health classes that we women are born with a lifetime supply of eggs in our ovaries that drastically diminishes ..