IVF success up by 40% as lab mimics conditions in womb

March 1, 2012 20:08 by PrideAngelAdmin
Doctors have dramatically increased the success of IVF by creating laboratories which mimic conditions found inside the womb. The fertility experts have boosted a woman’s odds of pregnancy by up to 40 per cent simply by keeping lab conditions more similar to those inside a woman’s body.

The success of the technology, developed at Newcastle University, promises to reduce the financial cost of treatment, as well as the emotional heartache of repeatedly failing to become pregnant.

Despite some popular perceptions, IVF is far from fail-safe, with some women undergoing multiple courses costing between £3,000 and £15,000 to try to realise their dream of motherhood.

IVF is a multi-step process that culminates with the embryo being grown in an incubator for several days before being placed into the womb. However many steps, from the actual fertilisation of the egg to checks under the microscope, take place outside the incubator. This can lead to changes in temperature and air quality which can be potentially harmful to the embryo.

To get round this, experts at the Newcastle Fertility Centre created a ‘lab in box’, or a chain of interlinked incubators with in-built microscopes. This allows them to work with and examine the embryo without taking it out of the incubator.

Professor Mary Hebert, who helped draw up the system, said that while the concept is simple, it was difficult to come up with a design that allowed the delicate lab work to be done without taking the embryos out of the incubator.

She added: ‘Our aim was to keep eggs and embryos in conditions similar to those they would experience naturally inside a woman’s body. ‘This led our team to design and develop a system in which it is possible to perform all of the technical procedures while maintaining stable conditions throughout the IVF process.’

As a result, since installing the system in 2007, IVF success rates at the centre have soared. Pregnancy rates at the clinic have gone from between 32 and 35 per cent per session of IVF to 45 per cent – an increase of up to 40 per cent – and hundreds of babies have been born.

The data, published in the journal PLoS ONE applies to women aged 37 and under. A woman aged under 35 has a 32 per cent of giving birth per IVF attempt. The figure falls to 27 per cent in women aged between 35 and 37. Labs in the Netherlands, Canada and Thailand have all installed systems based on the Newcastle design.

Alison Murdoch, professor of reproductive medicine at Newcastle University, said: ‘Growing good embryos is the key to IVF success and everyone, even those with a very small prospect of success, deserves to have the best possible chance.

‘Since installing the technology over 850 babies have been born.’
The Newcastle Fertility Centre mainly does NHS work but some private patients are also treated. Dr Allan Pacey, a fertility expert at Sheffield University, said: ‘Any technical development that can improve the success rate of IVF should be given serious consideration.

‘This is a novel solution to the age-old problem of trying to control the environment in which embryos are grown during IVF. ‘Whilst different units around the world tackle this problem in different ways, we will see whether this development becomes a popular choice now that it has been the subject of scientific evaluation.

Article: 1st March 2012 www.dailymail.co.uk

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Fertility authority has accumulated £3.4million fund - while thousands of women refused IVF treatment on the NHS

February 22, 2012 20:13 by PrideAngelAdmin
The fertility authority, the HFEA has £3.4million of unspent funds – while thousands of women are being refused IVF on the NHS because it is too expensive. Figures reveal the surplus money built up by the Human Fertility and Embryology Authority could pay for 850 women to have treatment.

The funds have been gradually accumulated from the £75 fee paid by the NHS and private clinics to the HFEA every time a woman has treatment. Campaigners have demanded the organisation gives the money back to the dozens of NHS trusts which are refusing women IVF because they are so short of money.

Last year a report by MPs found three quarters of primary care trusts are denying women treatment and not funding the three courses recommended by the health watchdog NICE.

This includes five PCTs which refuse to pay for IVF altogether while many others reject women deemed too fat, thin, old or young. As a result, couples desperate for children are having to go to private clinics and take out loans or re-mortgage their homes to cover the hefty fees.

Last year 45,000 women underwent IVF treatment, with 60 per cent having to pay for it privately. One cycle of IVF can cost between £4,000 and £8,000 as clinics charge vast fees for ‘extras’, including up to £200 for a consultation and as much as £1,000 for freezing and storing embryos.

The surplus, the equivalent to half of the organisation’s annual budget, could pay for about 850 women to have IVF at a cost of £4,000 a treatment. Clare Lewis-Jones of the charity Infertility UK, said: ‘We believe the funds built up by the HFEA should be re-invested back into the area which they regulate and that infertility patients should in some way benefit from this excess.’

The HFEA has insisted that the money was accumulated through ‘prudent’ budgeting, and said it would be too ‘complex’ to try to give the money back to cash-strapped NHS trusts. The figures were obtained by the Health Service Journal.

A poll in December revealed that a quarter of women having IVF said that they have to take out high-interest loans, reach their credit card limit and even re-mortgage their homes for a chance to realise their dream of motherhood.

A third of the 2,500 British women questioned by Red Magazine for its annual fertility report had spent more than £20,000. Success rates are just 32 per cent for women under 35, falling rapidly with age to just 1.5 per cent for those over 45. This means that many are being forced to fork out for three or more cycles of treatment.

Dr Allan Pacey, of the British Fertility Society, said: ‘This comes at a time when NHS funding for infertility treatment such as IVF has been cut in many parts of the country as a cost cutting measure, and both hospital and household budgets are feeling the squeeze.

‘The £3.4million is a significant sum of money and by a conservative estimate would fund over 850 cycles of IVF treatment. ‘The BFS believes it is inappropriate for the regulator to amass such a sum, which by its own admission is “unusually large”. ‘We will be writing to the HFEA chief executive to ask for an explanation.’

A spokesman from the HFEA said: ‘Previously, we have agreed with the department not to pursue the possibility of returning the money to clinics due to the complex principles and practicalities that would entail.

‘We developed proposals to enhance our capabilities in three ways, to spend the surplus money “wisely”, over three years. ‘The Department of Health have told us that they cannot agree to this for the next financial year, and so we await the department’s alternative suggestions.’

Article: February 2012 www.dailymail.co.uk

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Couples spend thousands on IVF for a baby which might never arrive

June 22, 2011 18:59 by PrideAngelAdmin
Every year, thousands of desperate couples sacrifice their time, emotions and hard-earned cash in pursuit of their dream baby. The average IVF spend is £5,000, with some couples forking out up to £40,000 for a child that might never arrive. Almost 40,000 women had IVF treatment in the UK in 2008.

While around 15,000 children are born every year as a result of the treatment, shockingly just a quarter of IVF cycles end with a baby being born safely. Encouraged by success stories, many childless couples desperately want to believe that impressive records from certain clinics make a baby a real likelihood, rather than just a possibility.

And while most of us don’t have the budget to pay for endless IVF cycles – not to mention the physical strain and emotional turmoil that go with them – there is no doubt some couples will do everything in their power to conceive. It is this level of desperation that some people fear is being exploited by some UK fertility clinics.

Dr Marilyn Glenville, an expert on improving fertility naturally, says: “Some clinics are doing extra tests when they’re not necessary. “But would-be parents are desperate and will try and pay for anything when they don’t know how much is absolutely necessary.”

For Sian Buchanan and her husband Tony, 46, the need for a baby turned into rounds of tests, treatment and IVF cycles that took them to the depths of despair.

Sian, 42, explains: “Being told you can’t have a baby makes you want one even more, and it’s hard to be told you can’t be a mother. “When me and Tony started looking into fertility treatment we had only been trying for six months, but, at 37, I knew I had to get a move on if we were to have a family.

“And although we knew we were entitled to a cycle of IVF on the NHS, we were prepared to pay whatever it took to conceive. “In that situation, you almost become numb to handing over your credit card.”

For Sian, there was no hesitation when an NHS fertility consultant advised them to go to a private clinic rather than wait for their free cycle. At her age, she was convinced she couldn’t afford to wait any longer.

She recalls: “We chose a London clinic that had an incredibly impressive success rate for IVF. “We had tests, scans and blood tests, but when we came to the point of starting IVF, having built us up, they suddenly told me my hormone levels were too high.

“Even though we’d paid £1,000 by this point, we walked away as we didn’t feel they were giving us enough clear information, and suspected they were more concerned about their success rates than me getting pregnant. “We felt we were handing over money without knowing what was really happening.

“It was so disheartening. We then started private IVF treatment through a hospital, at a cost of £6,000, but this not only didn’t work but it also left me with an infection that landed me in hospital. “It was a very lonely and desperate time for us.

“After spending that much money, the feeling of disappointment and isolation was huge.” Apart from the cost and the trauma, it seems the biggest problem is a lack of information and support for couples, resulting in misinformed decisions. Some would-be parents are even missing free treatment.

Couples contemplating IVF should do research in advance, says Camille Strachan, whose charity To Hatch provides details on NHS fertility policies, criteria for each area, plus clinics’ success rates.

She explains: “When you first visit your GP to discuss options, it pays to do your homework first or you could end up losing out on free NHS treatment. “There’s a referral period, which in some areas is six months, but for others can be up to two years.

“Your age can affect whether or not you’ll be referred – if a woman’s not on a waiting list by 38, there’s a good chance she’s not going to be seen in time. “And in some boroughs you must have lived there at least a year.”

NHS guidelines recommend offering eligible couples up to three cycles of IVF, but budget constraints have been so severe that several health trusts have been forced to restrict access to fertility treatment, with some suspending artificial insemination altogether. It’s no surprise that up to 80% of IVF work is done privately, with cycles costing £3,500 on average – and extras, including hormone treatments, cost thousands more.

Camille, who herself had one failed cycle of IVF before conceiving naturally with the help of acupuncture and Chinese herbs, believes clinics are overcharging and taking advantage of couples’ desperation to conceive. She says: “Prices vary enormously between clinics. One might charge £1,900 for IVF and another £2,500. And there’s no difference between the treatment offered. “I believe that there should ­simply be ­a blanket set price agreed ­between them.” Of course, a price list doesn’t tell the whole story.

Medical circumstances might mean couples need more tests or surgery, or require a higher dosage of drugs. It might cost one couple £2,000 or £3,000 more than another, and that cannot always be avoided. Camille explains: “This just increases the belief that some clinics will overcharge. “There needs to be transparency over the potential costs of IVF.”

So how do clinics massage their figures? Dr Glenville explains: “Some keep their success rates high by being very selective – they won’t take on any unsuccessful candidates for a full-term pregnancy as it would affect their statistics. “Couples in that situation end up getting private IVF through hospitals that don’t have that criteria.

“Or some clinics will take a couple through the start of IVF and then tell them it’s going to be turned into a IUI (artificial insemination). “By doing that, it doesn’t class as an abandoned cycle of IVF, thus not affecting the clinic’s statistics.” If you have to go private, there are key things to check when choosing a clinic.

“Look at the take-home baby rate, not just the pregnancy rate, as many IVF pregnancies end in miscarriage,” explains Dr Glenville. “And look for success rates in your age group, not just the average across the board.”

The good news is the Human Fertilisation and Embryology Authority has committed to making clinics take more responsibility for patient information, ensuring their websites give vulnerable couples realistic guidance. This news comes after fertility treatment pioneer, Lord Robert Winston, criticised clinics for making exaggerated claims and overcharging for treatment and drugs.

For many hopeful couples, the changes can’t come soon enough. But in the meantime, there are alternatives to IVF. Acupuncture and Chinese herbs are believed to help boost fertility, and lifestyle changes can make a massive difference.

At the Marilyn Glenville Clinic couples are helped to conceive naturally through making lifestyle changes, which can ­­also improve the chances of IVF being successful. Dr Glenville says: “We can’t change the quantity of a woman’s eggs, but we can improve quality.” This normally involves two visits, costing between £155 and £175 for the first appointment and from £97 to £115 for the second.

Helen Heap, senior nutritionist at the clinic, says: “Follow a wholesome diet with minimal additives, eat meals cooked from scratch and lots of fruit and veg. “Cut down on tea, coffee, sugar, alcohol and red meat and stick to organic meat and milk, or there can be negative hormonal influences.” Sian has had a happy ending, but not without a struggle.

“We finally had our free cycle of IVF on the NHS and also a treatment called ICSI where the sperm is injected into the egg, but we were struggling to get viable embryos. “As I was about to turn 40 we decided to do another cycle privately after my birthday, as three embryos get transferred (before 40 only two are transferred) increasing your chances of conceiving.

“So, for the first time in a long time, we kicked back and relaxed with our family for a while. “And that’s when, to our utter disbelief, I got pregnant naturally. “When the test showed positive I crumpled on the floor, sobbing. “I’d learned to live with ‘no’ and this was so unexpected – and so incredibly welcome.” Now their daughter Francesca is a happy, 20-month-old child.

And anyone would think Sian wouldn’t dream of enduring the trauma, cost and discomfort of IVF again – right? She says: “Tony doesn’t want to, but I would – we’d find the money somehow. I’d give it one more go and then stop trying.”

● IUI or Artificial Insemination – lower cost, lower success rate but less invasive and traumatic. Sperm are washed and the best are inseminated into the cervix with the help of an ultrasound scan to monitor ovulation.

It is a good idea to try this before IVF.

● Egg sharing – during the course of an IVF cycle, you donate six of your 12 eggs, and these can be sold to another woman – in theory, paying for your IVF. But you must be happy with the thought that the other woman may conceive with your eggs, and there’s a chance you may not. Anonymity has now been taken away for donors, so any children can track you down from the age of 18.

● Embryo freezing – if your IVF treatment produces 12 eggs and six are good embryos, only two can be implanted so the rest can be frozen. If that cycle doesn’t work, those frozen embryos can be implanted for the next cycle, and this reduces cost.

Article: 22nd June 2011 www.mirror.co.uk

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IVF treatment being suspended or axed as NHS cut costs

December 5, 2010 19:19 by PrideAngelAdmin
Couples are being told their IVF treatment is being suspended or axed completely as NHS trusts battle to cut costs, it emerged today. Primary care trusts are also making patients wait months longer for common operations in an attempt to slash their budgets.

A shortage of funding has hit thousands of patients waiting for operations such as hip and knee operations. NHS trusts are planing to save £20billion by 2014 to cope with an aging population, and overall health funding is receiving limited increases.

Groups have attacked the plans, calling the cuts 'desperate' and 'appalling' but figures show that many PCTs are facing a cash crisis.

At least nine PCTs have culled IVF treatment, despite guidance that infertile women should be given three cycles of treatment.

Susan Seenan of the Infertility Network said she was angry about the cutting of IVF treatment.

'Infertility is an illness, people who cannot have children have no cloice over the matter...They deserve medical treatment the same way anyone suffering from any other illness does,' she says. Katherine Murphy, head of the Patient's Association told the Sunday Telegraph: 'These decisions will absolutely ruin the quality of life for people.

'For years the NHS has wasted money paying managers over-inflated salaries. Now times are getting tight, and it's not the bureaucrats who suffer, but the most vulnerable groups of patients.'

She says the Patient's Association has been contacted by several elderly people worried about the cancellation of their operations, with many reporting long delays in seeing specialists at pain management clinics. Other areas which could be affected include non-urgent diabetes, rheumatology and oral treatment. Reviews of other non-urgent specialist procedures are also taking place.

The Health Service Journal reports that many trusts have changed the rules to reduce the number of patients who are allowed surgery.

A spokesman for the Department of Health said: 'We have been very clear that NHS organisations should not interpret efficiency savings as budget and service cuts.

'We would expect the NHS to make decisions locally, based on the clinical needs of their patients and with regard to the need to make the most efficient use of funding.'

Article: 5th December 2010 www.dailymail.co.uk

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NHS cuts back costs by suspending IVF treatment in Yorkshire

November 1, 2010 19:42 by PrideAngelAdmin
NHS North Yorkshire and York is to suspend IVF procedures in the final quarter of this financial year as part of measures to reduce costs. The trust said it would honour its current IVF waiting list but, from 1 November 2010, no new patients would be added other than in exceptional clinical circumstances. NHS North Yorkshire and York budgets £1 million for up to 250 IVF patients per year and offers one cycle to patients below its sub-fertility criteria.

Dr David Geddes, Medical Director of NHS North Yorkshire and York, said: 'We fully appreciate that infertility is a highly emotive issue but, due to considerable financial pressure, NHS North Yorkshire and York has taken the difficult decision to not routinely commission assisted conception services for the final quarter of the financial year'.

He added: 'This decision affects IVF and other assisted conception procedures. However, it does not affect couples experiencing fertility problems having access to non-surgical treatments, such as drug treatments that may result in successful conception'.

The funding cut has prompted concern from Susan Seenan from the Infertility Network UK. She told BBC Radio York: 'I don't think we can actually express how angry and let down we feel about this decision to suspend funding for IVF treatments'. She added: 'On behalf of patients in Yorkshire, it's appalling that the trust has taken this decision'.

Chief Executive of NHS North Yorkshire and York, Jayne Brown, said: 'We have a statutory obligation to achieve financial balance and our priority is to achieve significant short-term savings whilst maintaining essential services for patients in North Yorkshire and York'. She added: 'We fully appreciate that the decisions we have taken will be unpalatable'.

The trust's current overspend is £17.9 million, which represents around 1.4 percent of its annual budget of £1.3 billion. Without action to reduce costs, this could rise to an estimated £29.4 million and a cash flow shortfall of £33.8 million for the 2010-2011 financial year.

NHS North Yorkshire and York will also lose 60 management posts, cease minor surgery at GP clinics such as vasectomies and colonoscopies, and reduce the amount of money paid to voluntary sector organisations as part of significant money-saving measures.

Article: 1st November 2010 Bionews 582

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IVF postcode lottery as NHS cuts costs

September 5, 2010 16:55 by PrideAngelAdmin
IVF Childless couples are facing a widening postcode lottery after NHS officials ordered GPs to slash the amount of fertility treatment on offer to cut costs, stark new figures show.

Women in some areas are being denied access to the treatment altogether while others are facing new restrictions which appear to flout national guidelines.

One in five local Primary Care Trusts (PCTs) said they had cut the number of IVF procedures they had funded over the past three years, the study by the health magazine, Pulse, found.

Some trusts have frozen funding for IVF completely while reduced the number of cycles on offer.

Funding chiefs blamed the economic downturn and the looming spending cuts for the decision but campaigners said many infertile couples were now being denied a “fundamental right”.

Under guidance from the National Institute for Health and Clinical excellence (Nice) GPs are advised to offer women under 40 up three cycles of IVF on the NHS.

But several trusts have recently ordered family doctors to cut the number of cycles on offer to two or one.

Nine PCTs – in Luton, Greater Glasgow & Clyde, Waltham Forest, Lambeth, Southwark, Lewisham, Portsmouth, Bolton and West Kent – admitted they had not funded any IVF treatment for two years, acccording to the Pulse study.

NHS Warrington, which recently stopped all funding for IVF until at least 2011 insisted its priority had to be maintaining “high quality local healthcare”.

NHS Brighton and Hove, which now funds only two cycles, said the limit was in line with a region-wide policy across the south east of England.

Some GPs warned that the dilemma was “typical” of the problems they would have to grapple with under government plans to hand them control of their own budgets.

A total of 124 PCTs responded to questions put by the magazine under the Freedom of Information Act.

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