Monday, February 27, 2017
IVF doesn’t cause low sperm counts in boy babies—they inherit it
The chicken and the egg metaphor might be too apt. A new study shows that the sons of men who conceived using an in vitro fertilization (IVF) procedure grow up to be men with low sperm counts who may eventually need to use that same procedure. The study generated a lot of buzz with several mainstream outlets publishing stories about the study, unfortunately for men, not many got it right. The coverage of the story makes it clear that many are still confused about what IVF and similar treatments do to help couples conceive.
Fertility experts at University Hospital Brussels first developed the technique called intracytoplasmic sperm injection (ICSI) in the early 90s. ICSI is ideal for men with low sperm counts or poor motility. These are men who already have issues with their sperm—but the treatment doesn’t fix their problems. Sperm motility is vital for conception because the sperm must swim through portions of the female reproductive tract to reach the egg. ICSI merely does the work for their sperm—it’s like picking up a small child to help them dunk a basketball. In this process, a woman undergoes hormone treatment and egg harvesting. Then, under a microscope, a single sperm is injected into the egg to fertilize it before the embryo is implanted in the woman’s uterus.
That same research group tracked down 54 boys conceived using the technique and compared their sperm count, motility, and shape to age-matched controls who were conceived naturally. The ICSI-conceived men had half the concentration of sperm as naturally conceived men, a little more than half the sperm count and 66 percent lower motility.
But these results shouldn’t really surprise anyone. Fertility problems that cause drastic reductions in sperm quality and quantity are thought to be genetically based. All the results show is that dad’s with fertility problems—had sons with fertility problems. Study author and ICSI pioneer Andre Van Steirteghem told the press:
These first results from the oldest group of ICSI-conceived adults worldwide indicate that a degree of ‘sub-fertility’ has, indeed, been passed on to sons of fathers who underwent ICSI because of impaired semen characteristics.
Some of the reporting about the study suggests that some view IVF and other assisted reproductive technologies as a ‘cure’ for infertility. Here’s what Hannah Devlin wrote in The Guardian (emphasis added):
ICSI is normally used to help couples conceive when the man has a low sperm count, or where there are abnormalities in the shape or movement of the sperm. The latest findings suggest that these problems tend to be passed on to the next generation – there is no suggestion that they are caused by the technique itself.
But these techniques are not promised as a cure for infertility. It’s much better to think of assisted reproduction as a costly workaround for the problems at hand much like an insulin pump assists people with diabetes in controlling the disease but does not cure or treat the underlying condition.
Other outlets focused on the painted a misleading picture: If we keep using technologies to help sub-fertile people reproduce knowing their children are likely to have the same issues will we replace natural conception all together? From Medical Daily:
These results suggest ICSI is not exactly a treatment for male infertility, but rather a way to get through a problem that the next generation will have to deal with. Previous research has estimated if even half of affected men used ICSI to have kids, the incidence of severe male factor infertility could double nationwide within seven generations… This could potentially lead to a society of men who can’t conceive children naturally.
Although IVF has become a well-established procedure since it was pioneered 40 years ago, it still draws controversy. Early this year University of California San Diego evolutionary biologist Pascal Gagneux called it a massive social experiment:
…We’re engaging in an evolutionary experiment … I would compare it to high fructose corn syrup and fast food in the US. It took 50 years; it was fantastic, you got bigger and healthier, and now the US are the first generation that are shorter and heavier and die younger. But it took 50 years…
But correlation-not-causation works in another way, too. The study showed that these ICSI-conceived men had low sperm counts. But that doesn’t guarantee they can’t conceive:
Prof Simon Fishel, Managing Director of CARE Fertility, added: “We may still find that these men are able to conceive naturally “Just having low semen parameters is not evidence for the requirement of ICSI or IVF technologies. We know many men with such are indeed able to conceive naturally.”
That’s pretty common. There are many mysteries of male reproduction, as for years the fertility industry has mainly thought of a couple’s inability to conceive was a ‘female problem.’ But that thinking we know now is incorrect as at least in 40 percent of couples who can’t conceive the sole problem is with the man’s sperm. IVF is often the only answer. Usha Lee McFraling at STAT discussed the issues which come down even to a fundamental lack of biometrics to describe it:
“How many sperm do you have and how well do they swim? That’s been the gold standard forever,” said Richard Scott a fertility expert in New Jersey. “Unfortunately, that’s a very unsophisticated view of a very complex problem.” For example, many men with a low sperm count, or sperm that are misshapen, are able to conceive. And many men with seemingly normal tests results aren’t. “We need much more powerful insights into this process.”
Currently, all we tell men who are struggling to conceive is that they should lose weight and stop smoking to benefit sperm health. But since the problem may be largely genetic–the future of male fertility treatments could be gene editing.
Meredith Knight is a contributor to the human genetics section for Genetic Literacy Project and a freelance science and health writer in Austin, Texas. Follow her @meremereknight.
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56-year-old surrogate shocks everyone by giving birth to triplet girls
Jaci is 56 years old and she was tired of seeing her daughter struggle with fertility, so she volunteered to be her surrogate. She was shocked when she did become pregnant, but even more surprising was giving birth to triplets!
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An end to ultra-expensive rounds of IVF treatment? Doctors develop new way of producing higher quality eggs that knocks a quarter off the cost
A breakthrough fertility treatment for women who need IVF could produce fewer eggs of higher quality and at a lower cost, doctors have said.
Experts praised the new technique, known as minimal stimulation transfer, which involves women taking a ‘cheap but powerful’ drug alongside the hormone used in IVF to encourage ovarian stimulation.
The new IVF treatment developed in America, has women take another drug alongside the usual hormone, and could means big cost savings. File photo
According to the Sunday Telegraph, the new treatment was 27 per cent cheaper than normal IVF and offered a 25 per cent cheaper cost per live birth.
The research has been carried out by an American team from the Reproductive Associates of Delaware.
The paper reports that 83 w
The paper reports that 83 women of 137 with good prognosis were given the new treatment, taking clomiphene alongside the FSH hormone.
It could mean the NHS could provide more than one cycle of IVF treatment.
Dr Ronald Feinberg, from the group, said: ‘Clomiphene is a very under-appreciated drug when you look at the potency and power it can have in inducing a women’s production of her own FSH.
‘That generated in and of itself significant cost-savings.’
Dr Ronald Feinberg, from the group, said: ‘Clomiphene is a very under-appreciated drug when you look at the potency and power it can have in inducing a women’s production of her own FSH.
‘That generated in and of itself significant cost-savings.’
In IVF, an egg is fertilised outside the womb and then implanted into the woman at the optimum stage in her cycle.
According to UK figures, the success rate of IVF for women under 35 is 32.3 per cent, going down to 5.1 per cent for women aged between 43 and 44.
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Woman wins right to have her dead husband’s baby
Samantha Jefferies has every reason to be overjoyed: after a lengthy court case, the 42-year-old British woman has won the right to use her deceased husband’s sperm to have a baby.
Jefferies and her husband Clive, who served in the Royal Army Medical Corps, had been undergoing IVF when Clive died of a brain haemorrhage in 2014. He was 51.
Before Clive passed away the couple had been through two failed rounds of IVF, including a miscarriage at 8 weeks, and were preparing for a third attempt.
The couple had initially been told that their embryos could be stored for 10 years. However the fertility clinic changed this to two years when public health funding ran out, meaning that Jefferies had missed the deadline to use them.
The clinic admitted that they should have alerted Jefferies to the change and offered to pay for any legal fees.
On September 28, the family court ruled that the amendment made by the clinic was “invalid”, meaning that the embryos can still be stored and used.
“After two years of hell, I have finally been granted the chance to use the embryos Clive and I so badly wanted,” Jefferies wrote in London’s Sunday Telegraph.
“I think about how this baby might look like Clive, and share his good looks, his fitness, his love of the outdoors.”
Jefferies admitted that the prospect of raising children alone was “daunting”, but that she knows she will have plenty of support.
“I know these babies are going to be so well looked after by the incredible friends Clive has left behind,” she said.
“And when they grow up, I’ll tell them about their brave, gentle father, and the extraordinary chain of events that brought them to us.”
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Gay couple’s triplets have DNA from BOTH their dads in amazing IVF pregnancy
Two fathers have each transmitted their genetic material to their children in a rare IVF pregnancy.
Justin Ruehs and his husband Adam Smeets, who live in Chicago, Illinois, became parents earlier this year.
They had spent four years trying to start a family and finally welcomed triplets. But in an odd-defying IVF process, embryos from both Ruehs and Smeets were implanted successfully.
This means their surrogate delivered not a traditional set of triplets, but twin girls and a baby boy.
In an odd-defying IVF pregnancy, embryos with DNA from each father were implanted successfully. They welcomed identical twin girls and a boy (all three babies are pictured)
Emmett, the couple’s son, has Smeets’ DNA while the girls, Harper and Collins, share Ruehs‘, CBS Chicago reported.
The babies were born in June and turned three months old this week.
Gay couples in Ruehs and Smeets’ situation typically have just one biological father.
Two fathers have each transmitted their genetic material to their children in a rare IVF pregnancy.
Justin Ruehs and his husband Adam Smeets, who live in Chicago, Illinois, became parents earlier this year.
They had spent four years trying to start a family and finally welcomed triplets. But in an odd-defying IVF process, embryos from both Ruehs and Smeets were implanted successfully.
This means their surrogate delivered not a traditional set of triplets, but twin girls and a baby boy.
Some couples choose to have a surrogate who will be artificially inseminated with the biological father’s sperm.
Others elect to do an IVF first using eggs from a donor, then to implant the resulting embryos into the surrogate’s uterus.
The two fathers (pictured right) were both able to take leave to take care of their three babies, who were born 35 weeks into the pregnancy and just turned three months old
Ruehs and Smeets named their son Emmett and their twin girls Harper and Collins. All three babies are pictured next to the family’s dog
Smeets and Ruehs, who met online, went through five IVF transfers, one miscarriage and worked with three surrogates before their successful triplet pregnancy.
For this last pregnancy, they had two embryos transferred to the surrogate’s uterus after being told that the odds of a successful implantation were 50 per cent.
‘The technician told us that we had three heartbeats and embryo A had split into twins!’ Ruehs told Gay Times.
‘Out loud I said, “What do you mean there are three? We only put in two?” After the initial surprise wore off we were elated and thankful that we were pregnant.’
A South African couple, Theo and Christo Menelaou, had a similar experience this summer.
They too had three babies, including identical twins, after both providing sperm to fertilize the eggs, the New York Daily News reported.
Ruehs and Smeets have both managed to take leave from work to take care of their triplets, who were born 35 weeks into the pregnancy.
They will return to work soon.
‘We represent that gay couples have families, and families are not defined as just one thing or another,’ Smeets said. ‘It comes in many different shapes and sizes, too.’
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Order A Daddy: Tinder-Style App Allows Women To Pick Sperm Donor
It is now easier for British women to select a sperm donor to father their child as the London Sperm Bank has just launched a Tinder-style smartphone app that would allow them to choose a sperm donor based on certain qualifications.
The “order a daddy” app allows women to browse for sperm donors, one of whom could potentially become the father of their child, by choosing those with particular physical characteristics such as those that relate to the height, weight as well as hair and eye color.
Women can likewise filter applicants based on the potential donor’s nationality, educational level and occupation. They can also read details about the applicant’s personality to see if this suits the characteristics that they want.
The applicants come from a range of professions which include finance, medicine, law, performing arts and engineering.
After picking a donor, women pay £950, or about 1,200 U.S. dollars, through the mobile app for a sample of the sperm, which will then be delivered to the clinic where they are treated.
If the ideal donor is not immediately available, users can opt to set up a wish list that will send an alert once someone with the desired attributes makes a sperm donation.
London Sperm Bank scientific director Kamal Ahuja said that the app provides privacy to women looking for a sperm donor. Ahuja said that the app, which legally meets the requirements of IVF regulator Human Fertilisation and Embryology Authority (HFEA), also gives women the ability to choose and make decision in their own time.
“You make all the transactions online, like you do anything else these days,” Ahuja said. “We think this is the first-of-its-kind in the world.”
About half of the IVF clinics in Britain, which include private and NHS institutions, already registered to use the service.
Despite the privacy and conveniences offered by the app, it still does not free women from other challenges associated with having a child through in vitro fertilization. IVF treatments do not always result in live births so women may have to make several attempts.
A 2015 study found that the rate of live births during the first cycle of IVF treatment was only a little over 29 percent. The study, which involved 156,947 from UK showed that persistence is key to producing a child via in vitro fertilization. Researchers found that 65.3 percent of women successfully give birth after six IVF cycles.
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Study: IVF doesn’t increase breast cancer risk
A significant new study confirms what previous studies also found to be true: in vitro fertilization is not linked to an increased risk of breast cancer.
“Women have long been concerned that IVF may raise their risk of breast cancer. While there’s never been any study that linked IVF and breast cancer, this study is significant because of its huge size and the length of follow up,” said Dr. Richard J. Paulson, chief, Division of Reproductive Endocrinology and Infertility, Keck School of Medicine, University of Southern California.
The study looked at the results from over 25,000 women who underwent IVF between 1983 and 1995 and concluded that they were no more likely to develop breast cancer than women in the general population or women who were treated for fertility but did not undergo IVF.
Not only was there no significant increase of breast cancer risk in the study population, it was also found that women who received more than six IVF treatments had a lower breast cancer risk than women who received one or two treatments.
For decades, breast cancer has been the most common malignancy among women worldwide. Estrogen and progesterone, both used in IVF, have been implicated in cancer risk. Estrogen levels increase during IVF to facilitate pregnancy.
“I like to use an analogy,” said Paulson, president-elect, American Society for Reproductive Medicine. During a normal menstrual cycle, estrogen levels reach 300. During IVF estrogen levels reach 3,000 – 10 times as high. During pregnancy, estrogen levels hit 30,000, 10 times higher than IVF and 100 times more than a normal menstrual cycle, he said.
“We know pregnancy doesn’t increase risk for breast cancer. In fact it can lower risk. The brief increase of hormone levels during IVF is not thought to have an effect” on increasing risk of breast cancer, Paulson said.
“It’s not Earth-shattering news,” Paulson said. “Previous studies indicated the same thing, but it confirms what we have thought: Ovary stimulation (during IVF) does not increase the risk of breast cancer.”
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