Pride Angel

IVF treatment in younger women dramatically increases their chance of developing breast cancer later in life, research suggests.

Women who started taking fertility drugs and went through IVF around their 24th birthday were found to have a 56 per cent greater chance of developing breast cancer than those in the same age group who went through treatments without IVF.

But there was no increased risk for women who started fertility treatments when they were about 40 years old, regardless of whether they had IVF or not, according to the Australian study

The researchers said: 'For younger women there is some cause for concern, because it appears that they may face an increased risk of breast cancer after IVF treatment.'

The findings were based on a study of more than 21,000 women and published in the journal Fertility and Sterility. Study author Louise Stewart from the University of Western Australia said younger women might see an increased risk of breast cancer because they are exposed to higher levels of circulating estrogen during their cycles of IVF treatment.

In the UK 45,264 women had IVF treatment in 2010. A third of women under 35 successfully had a child as a result However, she added: 'I don't think it's a huge increased risk that you should worry or panic (about).'

The researchers collected information on 21,025 women between the ages of 20 and 40 who went through fertility treatment at the hospitals of Western Australia between 1983 and 2002.

They were able to piece together enough data to follow the women for some 16 years to see if they developed breast cancer.

Roughly 1.7 per cent of the 13,644 women who only used fertility drugs without IVF ended up developing breast cancer by the end of the study. That figure was about two percent for women who used fertility drugs and underwent IVF - a difference that researchers said wasn't statistically significant.

This changed when women were divided into different age groups, with women aged 24 about one-and-a-half times more likely to develop breast cancer if they had IVF alongside other fertility treatments.

However, Stewart said they couldn't yet say that IVF was causing the increased cancer risk in younger women, as these women could be different in some significant way from those who only have other types of fertility treatment.

'If for example, younger women who had IVF were more likely to have a specific cause of infertility, and this was related to an increased risk of breast cancer, then it would appear that IVF was related to breast cancer when in fact it was the type of infertility that was more common in women who had IVF,' she said.

Linda Giudice, president-elect of the American Society of Reproductive Medicine, added: 'The development of breast cancer is linked to estrogen exposure and the longer one is exposed, the greater the risk.

'In an IVF cycle there is a short, but significant elevation in circulating estrogen, and whether this is linked to the observations found in the study is not clear at this time.'

The researchers said the study results would reassure women who start IVF treatment in their 30s and 40s. However, they added: 'Women should be aware that delivering their first child late in reproductive life, whether assisted by IVF or not, is associated with an increased risk of breast cancer.'

Statistically, younger women have a greater chance of successfully having a baby following IVF. They suggested a follow-up study of women who undergo a greater range of cycles to see if there's a connection between IVF 'dose' and breast cancer rate.

Article: 25th June 2012 www.dailymail.co.uk

Read more about safe alternatives to IVF such as artificial insemination and the DuoFertility monitor, proven to be as effective as one cycle of IVF after 6 months of use.

A recent report states that there is a higher risk of complications and multiple births in pregnancies that result from IVF techniques.

A report by the Royal College of Obstetricians and Gynaecologists said there were increased risks of premature births, low birth weight and congenital abnormalities. However, it said the vast majority of IVF children were as healthy as other children. IVF accounts for over 1% of UK births. Advances in fertility research have allowed more infertile couples to have children and at an older age.

Risks

The Royal College's Scientific Advisory Committee reviewed the risks of IVF, which it said were directly related to the number of foetuses and that IVF techniques appeared to double the risk of twins.

It said: "About one in four of all IVF pregnancies result in a multiple birth in the UK owing to the common practice of replacing two or three embryos."

It also said there was a 23% increased risk of a premature birth, but the risk remained low. "IVF pregnancies still demonstrate an increased risk of low birth weight," it said. Heart defects, cleft lips and other congenital anomalies are also more common. It said around 5% of all babies were diagnosed with an abnormality, but IVF babies were around a third more likely to have a problem.

Long term

Later in life, the report said there were no differences in brain, language or behavioural development and there "appears to be little impact at age 12".

Prof Jenny Kurinczuk, director of the National Perinatal Epidemiology Unit at the University of Oxford, said: "IVF pregnancies carry an increased risk of poor birth outcomes and complications. Nevertheless the majority of the children born following IVF will have a good outcome just like any other children.

"The poor birth outcomes and complications may be a combination of treatment and underlying features of the couple such as older maternal age. However, treatment strategies can be altered to improve outcomes such as the adoption of elective single embryo transfer."

Read more about alternatives to IVF such as home insemination and the Duo-fertility monitor which is as effective as one cycle of IVF after 6 months of use.

Article: 6th June www.bbc.co.uk

Fertility clinics are facing demands to restrict the most popular form of IVF after a shocking new report linked it to an increased risk of birth defects. The study created a major alert after revealing the ICSI treatment, used by 23,000 women in the UK every year, creates a ‘sky high’ chance of having a baby with serious abnormalities.

The procedure, which involves injecting a single sperm into an egg, is used in both the NHS and the private sector, and now represents more than half of all IVF treatments. But it is more expensive than standard IVF, raising fears some clinics may be promoting it to increase profits. Scientists behind the latest survey of 300,000 births found that one child in ten born following ICSI has a defect – twice the level of the general population – but that standard IVF has no extra risks compared with natural births.

Following the report, other experts called for clinics to use ICSI only when there was no medical alternative, and demanded a national database of children born from IVF be set up urgently. Women who undergo the most popular IVF treatment in Britain are twice as likely to have babies with birth defects as the rest of the population, the shocking new survey revealed.

Women who undergo the ICSI process, in which a single sperm is injected into an egg, are more likely to have a baby with problems including cleft palate, heart and lung conditions, cerebral palsy and blood disorders. The extensive research found that ten in every 100 births from ICSI had a defect, compared with five in 100 natural births. But other forms of IVF are no more risky than natural conception. When other factors such as the mother’s age, smoking habits and underlying health problems are taken into account, the ICSI treatment is linked to a 57 per cent increase in birth defects, compared to natural conception.

The treatment was designed to help infertile men become fathers, but has become the dominant IVF process, accounting for 52 per cent of all such treatments carried out in this country. More than 23,000 women were treated using the technique in 2010, when 6,500 babies were born as a result. Previous studies have raised concerns over birth defects from all forms of IVF, but the new research, published yesterday in the prestigious New England Journal of Medicine, concludes that the abnormalities stem specifically from using the ICSI method. The study’s author, Professor Michael Davies from the University of Adelaide, said: ‘We know from the study that standard IVF is safe. But we also now know that with ICSI, the risk is sky high.’

Last night, British doctors said ICSI was too widely used and said it should only be offered if there is no alternative. They also suggested its popularity was caused by clinics promoting the treatment for commercial profit, as it costs an additional £1,000 on top of the £2,500 fee for standard IVF. Scientists also called for a national register of births for all IVF treatments to be established to allow research into long-term effects. Prof Davies said ICSI – intracytoplasmic sperm injection – effectively creates children from single sperm that Nature might have weeded out as unsuitable.

By contrast, in standard IVF, eggs are placed in a dish with a sperm sample and allowed to be fertilise naturally which means it is still the strongest sperm which reaches the egg. Infertility consultant Gedis Grudzinskas said: ‘The use of ICSI has increased in the UK over recent years and in some centres it is used universally. That’s irresponsible and this study should cause those centres to rethink their policy. ‘Some of these ICSI decisions could be commercially driven, although I would hope not.’

Dr Alastair Sutcliffe, an expert on the effects of IVF in children, added: ‘I’m against the widespread increasing unrestricted use of ICSI because it’s hardly a Darwinian way of reproducing. Now this paper’s come out, those who are close to the wind on this issue might think twice.’ Part of the popularity of ICSI is because it has a conception rate of just under 30 per cent, compared to around 25 per cent for standard IVF. Figures from regulators, the Human Fertilisation and Embryology Authority (HFEA), show that fewer than half of couples using ICSI do so because of male infertility.

In one large unit, the London Women’s Clinic, 83 per cent of IVFs were ICSIs. But medical director Peter Bowen-Simpkins denied it was offered to generate profit. He said: ‘That’s an inevitable criticism, but many of our patients are single women and same sex couples using frozen donor sperm which means ICSI will be more successful.’ The new research paper, one of the most comprehensive ever, looked at 300,000 births in South Australia over 16 years, including 6,100 from fertility treatment. It found 8.3 per cent of babies born from any fertility treatment had some defect, compared with 5.8 per cent of those conceived naturally.

But when they took into account other factors, standard IVF was no more risky than naturally conception. In contrast, ICSI babies did have a high risk of defects, even after these factors were taken into account. Out of 939 single babies born from ICSI, 91 were found later to have a birth defect – a rate of 9.9 per cent. The researchers said in general ICSI babies were therefore 57 per cent more likely to have an abnormality than those born after standard IVF or conceived naturally. But that figure could be as much as 90 per cent in a worst-case scenario. The risk of cerebral palsy also doubled following ICSI treatment, although it was still rare (0.4 per cent compared to 0.2 per cent conceived naturally).

Prof Davies, who did not call for the technique to be abandoned, said it was unclear whether the increased birth defects following ICSI was down to a problem inherent in the technique, or because of the quality of sperm used, which could carry damaged DNA. He said: ‘There are some seriously defective sperm that can be selected and there are many occasions when that sperm could never naturally fertilise an egg. But we can’t jump to that conclusion straight away. ‘This is a technology that’s operating at the absolutely limits of available knowledge, which does open up a debate about how fast should some of these things be implemented.’

Advice on the HFEA website has not been updated since March 2009. It says: ‘Although some research suggests that fertility treatment may be associated with an increased incidence of birth defects, this risk remains low. ‘Research to date does not show with absolute certainty that any increased risk is due to fertility treatment. Other causes cannot be discounted, including underlying sub-fertility in the parents, their age and unexplored factors.’

Last night the regulator said it has ‘no plans’ to update its guidance as a result of the latest research. A spokeswoman said: ‘Research into the area is ongoing and, to make sure patients understand the risks of fertility treatment, we keep research of this kind under review.’ The question all couples must now ask: Do you REALLY need this procedure? Researchers said children born via ICSI were 57 per cent more likely to have an abnormality than those born by standard IVF.

Unless you’ve had personal experience of infertility, it isn’t easy to understand how devastating it can be to find that you’re not able to become pregnant naturally or the lengths to which you would go in order to have a much-longed-for baby. Couples who are trying unsuccessfully to conceive are faced with an ever-expanding fertility industry offering everything from the latest high-tech treatments to the wackiest complementary therapies.

ICSI, the focus of the new research, was developed in the early Nineties and has been a huge step forward in the treatment of male infertility. It has allowed men who once would never have been able to have their own genetic children to become fathers. ICSI has been so successful that some clinics now use it widely, and may offer it even when there isn’t a male fertility problem. Cynics might suggest that this is because ICSI is a more expensive treatment and makes the specialists more money, but it’s also true that some clinics believe they get better success rates when they use ICSI.

So what should couples do if they’re about to embark on fertility treatment in the light of this new research? The message for anyone having standard IVF is extremely positive and reassuring, but there may be more concerns for those who have been recommended ICSI. Talking it through with your fertility specialist is a good idea, and if you’re considering ICSI as an optional add-on to your treatment, you may want to think about whether you really need it. For couples where there is a male factor fertility problem and ICSI is the only possibility, the real risks are still small, and ICSI has produced many thousands of healthy babies.

What’s more, one interesting result from the research was that when embryos created using ICSI were frozen, the risks were reduced. It has been suggested that only the most robust embryos will survive the freezing and thawing process. The researchers themselves haven’t concluded that couples who need ICSI for male fertility problems should not go ahead with the treatment, but have shown that considering freezing embryos before having them transferred is something couples may want to think about. This particular research paper is actually a good news story for fertility patients, as it has found that babies born after standard IVF treatment have no greater risk of problems than those conceived naturally.

Infertility is tough, and one of the best ways to help yourself get through it is to ensure that you are well-informed. If you’ve got concerns about any aspect of infertility or treatment, it’s always advisable to raise them with a doctor or fertility specialist who will be able to offer the best advice for your individual situation.

Article: 5th May 2012 www.dailymail.co.uk

Read more about IVF, ICSI and alternatives to fertility treatment at www.prideangel.com

Women who have one embryo transferred during IVF treatment are five times more likely to give birth to a healthy baby than those who receive two embryos, research shows today.

Those who have two embryos are more likely to get pregnant but are at greater risk of delivering a premature or low-weight child, researchers found.

The findings, in the British Medical Journal, will increase the pressure for double embryo transfer (DET), which is already discouraged, to be ended because it risks pregnancies involving twins or triplets. UK fertility clinics should halt the practice as multiple pregnancies put mother and child at risk, the researchers say.

Twin and triplet pregnancies are associated with a higher risk of miscarriage, as well as prematurity and low birthweight. But some fertility experts say the widespread lack of IVF treatment on the NHS, which is meant to offer three free cycles to all, means some women seek two embryos.

An international research team, led by Aberdeen University scientists, studied data on 1,367 women who had taken part in eight previous trials who had either had elective single embryo transfer (eSET) or DET.

A full-term birth, at least 37 weeks, after eSET was nearly five times more likely than with DET, they found. Women were 87% more likely to avoid a premature birth after eSET, while their chance of having a low-weight baby was only a third of those who had DET.

The researchers say "elective single embryo transfer should be the default position" for all the 35,000 women who undergo IVF in the UK every year.

The Human Fertilisation and Embryology Authority welcomed the study. Its policy of minimising DET use has helped see multiple pregnancy rates after IVF drop from 24% in 2008 to 20% last year. The regulator hopes to reduce that still further, to 15%, by the end of March 2012.

Article: 23rd December 2010 www.guardian.co.uk

Read more about IVF and home insemination

IVF could double the risk of cerebral palsy, according to a study of more than 90,000 children.

Several studies have shown that rates of the neurological condition, which can result in speech problems, muscular stiffness and curvature of the spine, are higher in couples who have undergone in vitro fertilisation (IVF).

But this is the first to suggest that the process of IVF itself could increase the risk, rather than it being a consequence of the parents' impaired fertility

Researchers at the University of Aarhus in Denmark found that babies born by IVF were more than twice as likely to have cerebral palsy as those conceived naturally.

The result held up even after adjusting for factors like the age of the mother, if she smoked, and whether the baby was premature or a twin.

Dr Jin Lieang Zhu, an epidemiologist, and his team concluded that IVF was probably the underlying cause by looking at how rates of cerebral palsy changed depending on how long it took the mother to conceive naturally. This is considered a good measure of underlying fertility.

They found no statistically significant difference in rates between those whose mothers took less than two months to conceive, and those who took more than a year.

However, there was a much bigger difference between those who took over a year to conceive and those who only got pregnant thanks to IVF.

Even though this difference was not statistically significant, probably due to the small number of cases of cerebral palsy, the researchers concluded that IVF "confers a risk of cerebral palsy".

Dr Zhu stressed that the overall risk of having a child with cerebral palsy was still low.

About one in 176 children born via IVF in the study had the condition, compared to the British average of about one in 400.

He also said modern IVF techniques, such as only transferring one embryo to the womb, could eliminate the heightened risk altogether.

The study is published today in the journal Human Reproduction

Article 3rd November 2010 www.telegraph.co.uk

Read more about IVF and alternatives to IVF

Researchers today suggested a life-threatening complication of fertility treatment could be prevented by a cup of coffee, after a study identified a possible cause.

In vitro fertilisation has resulted in the birth of many babies since the first 'test tube' baby in 1978. But around 5 per cent to 10 per cent of women undergoing IVF experience a condition known as ovarian hyperstimulation syndrome (OHSS).

Although the majority of cases are mild, with symptoms including abdominal bloating, nausea and weight gain, in its most serious form it can cause blood clotting disorders, kidney damage and chest pain.

Scientists from Middlesex University and Barts and The London School of Medicine and Dentistry who analysed fluid around the human egg reported finding surprisingly high levels of the chemical adenosine.

They believe OHSS is caused when IVF drug stimulation creates high levels of adenosine, causing the blood vessels to dilate and blood fluid to leak into tissue.

The authors of the study, published in Metabolism Journal, wrote: 'Although adenosine has been detected in follicular fluid before, we were surprised at the extremely high levels detected in this study.'

They described the chemical as a 'significant contender as the molecular cause of OHSS'. To detect adenosine in blood samples, the scientists used a technique called metabolomics, which involves the study of chemical evidence of cellular processes.

The researchers said a solution could lie in caffeine, which acts as a block to adenosine. Ray Iles, professor of biomedical science at Middlesex University, said: 'It may be that a cup of strong coffee with every IVF cycle could reduce the chances of OHSS.

'Caffeine competes with adenosine for the same receptors, effectively blocking adenosine's action, and it could therefore potentially treat the cause of this condition.'

Further research is under way at Barts and The London Centre for Reproductive Medicine with IVF patients who have suffered OHSS to find out if caffeine could help avoid the complication.

Article: 2nd October 2010 www.dailymail.co.uk

Read more about IVF and home insemination.

Researchers believe the increased threat may come from the body rejecting donated eggs or underlying health problems that may come to the fore during artificial conception.

They want increased vigilance so that the exact nature of the risk can be calculated.

"Women should be counselled and made aware of the risks they are taking and deaths should be properly reported," Professor Didi Braat at Radboud University in the Netherlands told the Sunday Times.

Prof Braat looked at the deaths between 1984 and 2008 in the Netherlands but believes they will apply to any developed country.

She found 17 women who died in pregnancy who had had IVF treatment – a death rate of 42.5 for every 100,000 pregnancies.

The death rate is 12.1 in every 100,000 for women who conceived naturally.

The rising age of mothers may be increasing the number of complications. Last year nearly 27,000 women over 40 gave birth, a rise of 50 per cent in a decade.

There are about 13,000 IVF births a year in Britain.

The research was published in the Journal Human Reproduction.

Pride Angel added that artificial insemination (intra-cervical insemination) such as that performed with home insemination kits, does not carry any more risks of death in pregnancy than natural conception.

Read more about home insemination

The first "test tube baby" was born in 1978. With advances in reproductive science, an estimated one percent of all American babies are now born each year through in vitro fertilization (IVF). But IVF and other assisted fertility treatments may be solving one problem by creating another, suggests new evidence from Tel Aviv University.

In a recent study, Dr. Ditza Zachor of Tel Aviv University's Sackler School of Medicine reported a strong link between IVF and mild to moderate cases of autism. Her findings were presented last month at the International Meeting for Autism Research in Philadelphia.

According to her research at the Autism Center at the Assaf Harofeh Medical Center in Israel, which Dr. Zachor directs, 10.5% of 461 children diagnosed with a disorder on the autism spectrum were conceived using IVF, a significantly higher number than the 3.5% autism rate in the general Israeli population.

Other factors in play

While the study doesn't draw any definitive conclusions, it presents some urgent questions, says Dr. Zachor. "It's too early to make a serious deduction based on that evidence alone," she says, citing other birth-related factors in her study, such as low birth rate and prematurity. Dr. Zachor's ongoing research will attempt to separate out these risk factors to come up with more precise numbers for autism and other prenatal conditions in IVF.

The key may be "imprinting," a biochemical procedure during cell division which determines which genes will be selected or "expressed" in the embryo. Research into epigenetics -- changes in gene expression that occur without a change in the DNA sequence -- suggest that the malformations may be caused by imprinting abnormalities introduced into the embryo while it's in a test tube environment, says Dr. Zachor. One such disorder linked with IVF appears to be Angelman syndrome.

However, Dr. Zachor does not want to discourage infertile couples from undergoing IVF implantation, which most often results in a healthy child.

Age-appropriate fertility treatments

Dr. Zachor notes that mothers in her study who had IVF tended to be older -- with a median age of 32.6 years. Also significantly, nearly 4% of the children with autism were born prematurely, and about 5% of those had a low birth weight. In the general population, only about 1% of all newborns are delivered with a low birth weight.

Aware of these risks, however, health practitioners may be able to intervene and find ways to avoid the problems, the researcher says. For example, they might recommend that IVF treatments be delayed for a longer period, despite any psychological stress this might cause to would-be parents. Some researchers believe that unassisted fertilization is a better way to avoid negative health effects.

"Many infertile couples choose this procedure, and they need to know whether there is a risk of autism," concludes Dr. Zachor. She stresses, however, that most women who undergo fertility treatments should not be scared away from IVF procedures: the majority of children born using IVF do not have autism, and most children who have autism were not conceived using IVF.

American Friends of Tel Aviv University (2010, June 14). IVF linked to autism, Israeli study suggests. ScienceDaily.

Read more about In-Vitro Fertilisation (IVF)