20Aug/17

Breast cancer drug improves IVF success rates, claims Clinic

Breast cancer drug Tamoxifen is being used to improve the success rates in IVF for women over 40.

Doctors at a British Clinic have claimed that they have used the drug to improve IVF results in women over the age of 40, having a lower ovarian reserve or limited number of eggs.

Normally, women in their late 30s and 40s are offered to undergo IVF with donor eggs but if the above claims are proven to have merit, they might be able to use their own eggs for IVF.

 

Tamoxifen trial

Tamoxifen given to patients after their breast cancer surgery as it helps prevent the deadly cells from growing back.

However, a British clinic is using it in fertility treatments for women who are over the age of 40 and have lower egg count and perhaps, a lesser chance of getting pregnant.

Professor Geeta Nargund of Create Fertility has reported that she carried out a trial by giving Tamoxifen to 31 of her patients with an average age of 40 years and a low ovarian reserve. A total of 54 IVF cycle were carried out between the women, using fresh and frozen eggs.

Dr. Nargund told the British Fertility Conference in January that six of these women had successful pregnancies and became mothers.

This means the success rate of IVF in these women was around 20 percent, which is higher than the standard recorded success rate of 12 percent at that age.

Since then Dr. Nargund says she has carried out a hundred IVF cycles and found similar results.

“As the women had more than one embryo transfer, the cumulative birth rate was 19.3 percent per patient using their own eggs.”

“This is an excellent result for women with very low egg reserve because most of them had been told to try donor eggs,” she said. “The results would be a lot higher in women with normal egg reserve.”

Tamoxifen is known to cut the risk of breast cancer by up to 40 percent.

It is believed to improve fertility by lowering oestrogen levels, which causes the ovaries to produce better quality eggs.

Tamoxifen could potentially slash the costs of fertility treatment. In a traditional IVF cycle, a woman would typically inject herself daily for up to four weeks.

“The drug has been shown to provide a realistic opportunity for women who are desperate to have a baby using their own eggs before considering donor egg options,” Dr. Nargund told The Daily Mail.

 

Criticism

Egg quality declines with age increasing age in women and poor quality of eggs is one of the top reasons for IVF failure.

If Tamoxifen can really help improve egg quality, it would be significant in improving success rates and lowering IVF costs, and may even help some women to conceive without IVF.

However, the trial is still too small to draw any conclusions from.

Doctors will certainly question the efficacy of Tamoxifen in improving egg quality and more research is required to back these claims.

Some readers have commented on the same Daily Mail report that their doctors had advised against the ill-effects of the drug.

“I am over 40 and take Tamoxifen and am post menopausal now. It killed off my ovaries. This claim seems to be the opposite info my oncologist told me and I’ve discovered in my own research,” wrote an American reader.

A British woman seemed to agree with her, as she wrote: “Yes, I agree. The leaflet in Tamoxifen also says that it can cause birth defects and my oncologist advises not to get pregnant whilst on it! How weird that it is being used for fertility treatment.”

14Aug/17

Parliamentary panel rejects banning of Commercial Surrogacy

The long wait on India’s surrogacy Bill has finally ended and the Parliamentary committee tasked to review the Bill has voted against it.

Expressing concern over the possibility of illegal business in surrogacy if banned by the government, members of the parliamentary committee have rejected the blanket ban on commercial surrogacy in India, as suggested in the Surrogacy Regulation Bill, 2016.

The proposed Bill called for a complete ban on surrogacy arrangements in which any kind of compensation is offered to the surrogate, and suggested that only the altruistic form of surrogacy be allowed.

However, the parliamentary committee tasked with reviewing these suggestions, has said that banning of commercial surrogacy could lead to the growth of a black market in surrogacy services.

“The whole surrogacy service could go underground and would lead to increased exploitation with no mechanism for protection of any of the parties involved in the surrogacy arrangement,” the committee said in a report.

“There is also the likelihood of surrogacy being driven underground involving illicit inter-country movement of women to be surrogate mothers into foreign nations or safe surrogacy havens globally for monetary returns.

“This may subject the surrogate to worst sufferings. Hence, a prohibition of commercial sector is likely to hurt the very people it seeks to protect,” they said.

 

Surrogacy cannot be altruistic

The 2016 bill requires the complete prohibition of surrogacy arrangements that involve monetary compensation and only allow for altruistic form of surrogacy.

However, the parliamentary committee spoke out against it, saying that expecting a woman to endure the hardships and post-partum period for another couple for only altruistic reasons is “tantamount to a form of exploitation.”

If you only let close relatives be surrogates, it is likely to be out of “compulsion and coercion” and not because of altruism.

“Pure altruistic drive for any substantial and meaningful contribution of someone else’s life is unreasonable to expect in today’s economic and social environment,” said the committee. “Endorsing altruistic surrogacy will enforce emotional and social pressure on close female relatives without any compensation for immense emotional and bodily labour of gestation involved in surrogacy as well as loss of livelihood.”

 

NRIs to be allowed commercial surrogacy in India

The committee agreed to not allowing surrogacy for foreign nationals in India but saw “no point” in restricting NRIs to commission for surrogacy services

“Given our sentiments and sensibility, the social status of a woman in our society is judged by her reproductive life and there is a lot of pressure on her for child-bearing.”

Noting the significance of reproductive ability in our society, the members said that any woman is under a lot of pressure to have a child, and surrogacy should be an option for them if they are unable to have one for medical reasons.

The committee members also suggested in favour of keeping surrogacy open for live-in partners because the current time demands that.

To not acknowledge live-in partners’ surrogacy needs would mean that the bill is not in consonance with the “present day modern social milieu that we live in and is too narrow in its understanding,” they said.

 

Need for surrogacy bill

The surrogacy bill, introduced in November 2016 in the Indian Parliament, was aimed at protecting the rights of surrogate mothers.

PadmaShri Dr. Kamini Rao—a pioneer of ART in India, discusses significant points from the medical perspective and insisted that the rights of intending parents should also be protected.

Noting some cases where the surrogate was exploiting the commissioning parents, Dr. Rao called for a greater regulation in the surrogacy sector of India and opines that the surrogacy Bill has to be a part of the ART Bill, which has been worked upon for almost 20 years.

14Jul/17

Have low-carb diet for IVF success : Research

Cutting down the amount of carbohydrates in your diet could raise your chances of conceiving, British fertility experts said at the European Society of Human Reproduction and Embryology in Geneva.

Dr Gillian Lockwood of the Midland Fertility Clinic in Tamworth, Staffordshire, says she encourages the couples who are trying to conceive to eat more lean protein and leafy vegetables.

The Telegraph reports that doctors are now advising lower amount of refined carbohydrates— such as those in bread and pasta—to women who are planning to conceive. They also encourage patients to select muesli, porridge, eggs and yogurts over processed breakfast cereals.

“I tell my patients that if they are going to have toast for breakfast, then that is their carbs for the day,” Dr. Lockwood said.

She added, “They cannot then have a sandwich for lunch and pasta for dinner. If they want a pasta supper that has to be their carb, or if they want a jacket potato for lunch, then that is it.”

If you trying to conceive have only one carbohydrate-rich meal per day: Experts

 

Diet for IVF success

Dr Lockwood highlighted research that found women who consumed lesser amounts of carbs had four times the success rates in IVF as compared to those who were on standard diets.

A study by the Delaware Institute for Reproductive Medicine (DIRM) in Newark observed 120 women undergoing IVF and divided them into two groups – high carb diet and low carb diet.

58 percent of those in the “low-carb” group conceived successfully with IVF and had a baby. While in the other group (women with high-carb diet), only 11 percent had a baby.

Researchers concluded if you are trying to conceive, you should try to have less than 40 per cent carbohydrates and up to 35 per cent protein in your every day diet.

 

How do carbs affect fertility?

Female egg quality and capability of conception are both affected by carbs and evidence suggests that you can almost double your chances of conceiving if you follow the low-carb diet that doctors are now encouraging.

Excess of stodgy food may hinder or even stop your ovulation, according to the recent report.

Refined carbohydrates are simple molecules that quickly break down, causing a quick rise in blood sugar.

Over time the sugar processing mechanism of our bodies slows down, which possibly damages the body cells including reproductive gametes (sperm and eggs).

In a different study, back in 2013, a team led by the Delaware Institute for Reproductive Medicine reported similar findings.

They studied 120 women that were undergoing fertility treatment.

The ones who had 40 per cent carbs in their diet were found to have a pregnancy rate of 63.2 per cent – almost double the 33.8 per cent rate of the group with higher carb intake.

The lining of the womb also becomes less receptive to an embryo in women who consume higher doses of carbohydrates.

“We know that diet has a major impact on the chance of conception and on egg quality and increasingly it seems that carbohydrates play a particular role,” says Professor Adam Balen, chairman of the British Fertility Society.

“When trying to conceive, men and women should have individual checks on their diet, and on levels of vitamins, minerals and nutrients.”

 

Do you have any thoughts on the best diet for conception? Do you think it really works?
23May/17

Commercial surrogacy in Canada to become legal soon

Fertility specialists are urging the government to overturn a 13-year-old ban that makes commercial surrogacy in Canada illegal. It is also illegal in Canada to pay for donor eggs and sperms, which the doctors say, largely limits the options for infertile couples.

The Canadian Fertility and Andrology Society (CFAS) suggests that with the people becoming more familiar with infertility problems and more accepting of assisted reproduction technologies, it is only appropriate the government allows for commercialisation of key human elements under careful regulation.

It is important to note here that surrogacy in Canada was allowed but the surrogate could not accept any fee from the commissioning parents.

The 2004 law allows surrogates and donors of egg and sperm to be reimbursed for some expenses but makes it a crime to pay them fees. 

Canadians have been travelling for surrogacy in Punjab, India for the obvious cost benefit ans easy process but they might want to stay back in their home country, if the Government allows it.

 

Why are people still travelling for surrogacy in Canada?

Intending parents still travel to avail surrogacy in Canada because ambiguous regulations allow people to find loopholes and Canadians continue to deliver surrogate babies for foreigners.

Besides, the pregnancy and delivery costs of the surrogate are covered by Canada’s universal health care system, as it is for any other pregnant lady in the country.

Surrogacy agencies even market this price advantage in Canada, noting that in comparison foreign intending parents pay for health insurance for the surrogate mother in the US. 

What are the murky laws of Canada surrogacy?

Lawyers refer to Canada as the “wild west” for surrogacy because the laws are so unclear that people can bend them to their advantage.

According to Arthur Leader, a partner at the Ottawa Fertility Centre, who also often advises governments on assisted human reproduction policies, “anything goes.”

He calls on federal officials to finally draft out some firm rules for Canadian surrogacy because the current system “doesn’t protect anybody and doesn’t act in the best interest of the child or the commissioning couple or the surrogate,” he says in a report published by the CBC.

In a 2010 ruling the Supreme Court of Canada struck down parts of the Assisted Human Reproduction Act, rendering a lot of issues unclear. Compensation for egg donors, sperm donors, and surrogates, was legally banned but the court allows them to be reimbursed for certain expenses—without clearly defining what those expenses are. 

So the compensation is open to interpretation and it is easy to breach the rule, which fertility brokers and others often do.

 “There is an altruistic element to it, but I’ve honestly in my career never met someone who is willing to do that for free for a stranger,” said Dr. Jeff Roberts, president of the CFAS. “But there may be a sizeable number willing to do it if at least they’re compensated for wages and some of their time.”

Despite foreign families taking advantage of Canada’s murky laws, most Canadians, who wouldn’t take a risk on the law, have to resort to fertility tourism and import the gametes from the US.

 

Govt. agrees to regulate Surrogacy in Canada

Finally, the government plans to develop regulations for testing and screening egg donors and rules for tracing donations.

Noting that the AHR act was intended “to protect and promote the health, safety, dignity and rights of individuals who use, or are born of assisted human reproduction,” the department announced its decision to consider the proposed changes.

These changes respond to evolving technology, said Health Minister Jane Philpott, adding that many Canadians have benefited from the scientific developments in ART.

“Our laws need to adapt so that they can continue to protect the health and safety of Canadians,” she said. “By adopting new regulations, we will continue to ensure that the risks posed are minimized and families are supported.”

Comments on the proposed changes will be heard until Nov. 29 and the people concerned can also offer suggestions when the regulations are previewed in the Canada Gazette, later.

11Mar/17

Male infertility can be resolved with this protein : Study

Researchers at Qatar University have identified a key protein in human sperm as a vital component of the fertilization process. Problems with a protein known as phospholipase C zeta (PLC-zeta) is thought to be the causative factor for male infertility, and fixing this could be a real solution for men facing infertility.

During lab experiments, the investigators were able to bring about fertilization of eggs by injecting them with larger amounts of PLC-zeta protein from men who were otherwise infertile.

Infertile men were found to have either reduced amounts or some mutation of the said protein, rendering it ineffective and consequently failing the process of fertilization, even in cases where rigorous ivf technique was followed.

“Recent clinical studies have highlighted the crucial importance of PLC-zeta in human fertilization, reporting that sperm from infertile patients, who exhibited failed fertilization even after the most powerful in vitro fertilization techniques, contained either reduced amounts or mutated forms of this protein,” said Dr. Michail Nomikos of Qatar University in Doha, who was the lead author of the Biochemical Journal paper, as reported in the Science Daily.

In the process of natural or in-vitro fertilization—just before an embryo begins to form, the human egg is known to undergo a significant increase in calcium levels known as “calcium oscillations,” which are actually activated by a nudge from the sperm.

This elevation in calcium levels is considered vital not only for fertilization but also for early development of the embryo.

The sperm-specific PLC-zeta protein was discovered back in 2002 by Professor Tony Lai of Cardiff University, UK and his colleagues. Professor Lai is also a senior author in this new study and the research performed by him over this past decade has revealed that PLC-zeta is actually the key activator of calcium oscillations in the egg during fertilization.

Dr. Nomikos and his colleagues, in the current study, found on injecting mouse eggs with lower levels of the abnormal PLC-zeta protein (as found in infertile men), failed to bring about any calcium oscillations and consequently no fertilization resulted. However, on increasing amount of the injected protein, it was observed that calcium oscillations started and subsequently the fertilization process began.

According to the researchers, these finding could prove very helpful in treatment of this type of infertility in the coming future.

“The identification and characterization of another male infertility-linked PLC-zeta mutation necessitates that we begin to consider use of recombinant PLC-zeta protein in a clinical setting, with the aim being to rescue such cases of egg activation failure,” said Professor Lai.

“We believe that our research can eventually give hope to many infertile couples in the near future; our goal is to help them have a family,” he added.

This research was originally published by the Biochemical Society.