Month: July 2012

Fertility Clock Headlines, Fertility Headlines

New OB/GYN Guidelines Urge Annual Wellness Visits

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Obstetricians and gynecologists want women to keep coming to them for annual exams, even though women are no longer advised to get yearly Pap tests to screen for cervical cancer.

In new guidelines published Monday, the American College of Obstetricians and Gynecologists makes the case for an annual “well-woman” visit and continues to recommend annual pelvic exams for women older than age 21. But the doctors’ group also says “no evidence supports or refutes,” the value of the internal exam for finding signs of cancer or other problems in women with no symptoms. So the final decision is up to women and their doctors, the group says.

The guidelines come a few months after it, the American Cancer Society, the U.S. Preventive Services Task Force and several other groups said most women need a Pap smear only every three years, starting at age 21, and can get them even less frequently after age 30 if they also get tests for the cancer-causing human papillomavirus. Women with no history of problems can stop Pap tests at 65, the groups say.

But a Pap smear, in which cells are scraped from the cervix, is not a pelvic exam and a pelvic exam is just part of a preventive visit, the gynecologists’ group says.

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Rolling the Dice of a Genetic Legacy

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“Don’t worry. She won’t break.”

This is a classic cliché of new parenthood. “Don’t worry,” nurses say to insecure new parents hesitant to hold their infants. “She won’t break.”

But I know the truth: Babies can break. I broke when I was eight months old, and a year old, and again and again and again. Three dozen broken bones before my twelfth birthday.

And then, at 31, I passed a flawed gene on to my daughter—the gene that caused my osteogenesis imperfecta (OI or “brittle bone disease”) and makes bones fragile instead of resilient.

For my daughter’s second birthday, we bought a child-sized couch to provide a safe place for her—our tiny, fragile girl—to climb without the risk of tumbling from the regular couch to the floor. As she climbed around on the new mini-couch, she fell and broke her leg.

I could not make up a better introduction to the capricious disorder we live with. Last year, my daughter (now 12) fell down a flight of stairs while lining up for a choir concert. She was embarrassed, but fine. A few months ago, she was putting away a laptop computer in her science class when her arm cracked under its weight.

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Happy Birthday IVF

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Carolyn Savage knows more than most about the moral and ethical quandaries of in-vitro fertilization. An IVF clinic mistake left her impregnated with another couple’s child; she carried that child to term and gave him up to his biological parents, knowing that would have to be her last pregnancy for medical reasons. Later, she became the mother of twins through a surrogate. The mom of five reflects on how much has changed, and how much hasn’t, since the first “test tube baby” was born 34 years ago today.

By Carolyn Savage

I remember when the first “test tube baby” was born on July 25, 1978. Even though I was only 9 years old at the time and didn’t know a thing about the “birds and the bees,” I knew enough about where babies came from to understand that the birth of Louise Brown in Oldham, England, was a big deal.

When TODAY Moms asked me to watch the original story of the first child conceived through in-vitro fertilization, I was curious to see how the technology was viewed. I expected the first IVF to be reported with a science fiction aura, but aside from the use of the term “test tube baby,” I was pleasantly surprised to see how accurate and thorough Tom Brokaw’s story was. Surprisingly, it was not the tone of the 34-year-old TODAY report that struck me but, instead, the realization that some of the thornier moral, ethical and religious issues surrounding IVF in 1978 still exist today.

Since the birth of the first IVF child, the field of assisted reproductive technology has made remarkable advances. In-vitro fertilization has been proven to be safe and long-term studies have determined that children conceived through IVF live physically and emotionally healthy lives. Meanwhile, the advancement of embryonic cryopreservation allows pro-life infertile couples to give all of their embryos an eventual chance at life.

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Can’t Get Pregnant? Consider These 5 Tests

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Fertility has become a very hot topic these days with the surge in both assisted reproductive technology (ART) and adoptions.

ART typically consists of medications, intrauterine insemination (IUI) or in vitro fertilization (IVF) with the sole purpose of becoming pregnant.

In general, experts tell women under 35 years old to try regularly to get pregnant at ovulation for 12 months before considering additional work-up. Women between 35 and 40 years old should try for six months.

Whether you are in your first month or your first year without success, here are five tests to talk about with your doctor….

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Frozen Sperm Offer a Lifeline for Coral

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COCONUT ISLAND, Hawaii — Just before sunset, on the campus of the Hawaii Institute of Marine Biology, Mary Hagedorn waited for her mushroom corals to spawn.

As corals go, Fungia is fairly reliable, usually releasing its sperm and eggs two days after the full moon. Today was Day 3. “Sometimes we get skunked,” she fretted.

The recalcitrant corals sat outdoors in water-filled glass dishes, arranged in rows on a steel lab table. Each was about the size and shape of a portobello mushroom cap, with a sunburst of brown ribs radiating from a pink, tightly sealed mouth.
As Dr. Hagedorn and her assistant watched, one coral tightened its mouth and seemed to exhale, propelling a cloud of sperm into its bath with surprising vigor. The water bubbled like hot oatmeal.

A reproductive physiologist with the Smithsonian Institution, Dr. Hagedorn, 57, is building what is essentially a sperm bank for the world’s corals. She hopes her collection — gathered in recent years from corals in Hawaii, the Caribbean and Australia — will someday be used to restore and even rebuild damaged reefs.

She estimates that she has frozen one trillion coral sperm, enough to fertilize 500 million to one billion eggs. In addition, there are three billion frozen embryonic cells; some have characteristics of stem cells, meaning they may have the potential to grow into adult corals.

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Fertility Clock Blog, My Future Baby Blog

What Are Fertility Drugs?

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There are a variety of drugs used for fertility treatment. Some are used to produce more ovarian egg follicles. Some are also used to suppress the pituitary gland and prevent ovulation. Others are used to support the uterine lining and early pregnancy.

Medications That Affect Follicles:

Eggs are housed in a protective sac called a follicle. To promote the growth of ovarian egg follicles, the pituitary gland naturally secretes the hormone Follicle Stimulating Hormone (FSH) into the blood stream. Typically only enough FSH is secreted each month to promote the growth of one egg follicle despite there being many follicles available in each ovary.  A tablet form of fertility medication called clomiphene citrate (Clomid) can be taken to increase the amount of FSH being secreted by the ovary. In this manner clomiphene citrate induces the growth of multiple egg follicles, typically 2-4 in number.

Alternatively, injections of FSH (called gonadotropins, Follistim, Gonal-F, Menopur, and Bravelle) can be used to induce the growth of even more follicles. These injections are given subcutaneously (under the skin) for 8-12 days. Once the follicles are ready, an injection of the hormone hCG (Ovidrel, Pregnyl) is used to ovulate the follicles. At this point eggs are either combined with artificial insemination or harvested and fertilized in the lab (in-vitro-fertilization) to create embryos which can then be transferred directly to the uterus.

Medications That Affect Ovulation:

During in-vitro fertilization treatment, drugs are used to turn off the natural pituitary hormones in order to synchronize egg follicles and prevent premature ovulation. The most common drug used for this purpose are oral contraceptive pills. During in-vitro treatment, injections of gonadotropin help eggs to develop better. However, during this stage eggs become vulnerable to premature ovulation. A second medication called leuprolide acetate (Lupron) can be used, in conjunction with oral contraceptive pills or alone, in order to prevent premature ovulation. Interestingly, leuprolide acetate actually belongs to a class of drugs called GnRH agonists- which, when injected, initially cause the pituitary gland to produce more FSH. However, with continued use, the drug eventually overwhelms the pituitary gland resulting in the opposite effect – pituitary suppression. For women who make a low number of eggs, leuprolide acetate in sometimes administered in micro-dose amounts to promote higher pituitary FSH production in order to yield more eggs. Instead of administering leuprolide acetate for a prolonged period of time to achieve pituitary suppression, a similar medication called a “GnRH antagonist” (Ganirelix, Cetrorelix), can be injected when egg follicles begin to grow. The use of this additional drug prevents the pituitary gland from causing premature ovulation. The “antagonist” provides instant pituitary suppression unlike that of leuprolide acetate which requires prolonged use to achieve suppression.

Medications That Support The Uterine Lining:

During a normal menstrual cycle, one egg follicle is recruited under the influence of pituitary FSH and subsequently ovulates as a result of the pituitary LH surge. The egg follicle makes a potent hormone called estradiol during the first two weeks of the egg’s development (pre-ovulation). After the egg is ovulated the remaining part of the egg follicle then begins to produce progesterone in addition to estradiol. These hormones together cause the uterine lining (the endometrium) to thicken and begin to secrete molecules which help the embryo develop into a pregnancy. In some forms of fertility treatment such as frozen embryo transfer, egg donation and surrogacy, tablets or patches of estradiol and suppositories or injections of progesterone are given to artificially prepare the endometrium to be able to support the early pregnancy.

By Dr. John Jain

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Pfizer Loses Prempro Ruling Must Pay 10 Million

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Pfizer (PFE) (PFE) Inc. must pay $10.4 million in damages to a woman who blamed the company’s Prempro menopause drug for her breast cancer, an appeals court said.

Jurors properly awarded Audrey Singleton, who sued Pfizer’s Wyeth unit over Prempro, compensatory and punitive damages for the company’s marketing of the drug, the Pennsylvania Superior Court ruled yesterday. Singleton’s lawyers alleged that Wyeth hid the drug’s health risks and a jury awarded her damages on those claims in 2010.

“Wyeth’s concerted effort to misdirect physicians from the dangers of Prempro illustrates the consciousness that its conduct was not at all reasonable,” the three-judge panel said in upholding the jury’s findings.

The ruling comes as Pfizer officials are working to settle lawsuits over the menopause drugs. The drugmaker has settled about 60 percent of cases over the medicines and paid out $896 million, executives said in a May filing with the U.S. Securities and Exchange Commission. The company has set aside an additional $330 million to resolve the remaining cases.

More than 6 million women took Prempro and related menopause drugs to treat symptoms including hot flashes and mood swings before a 2002 study highlighted their links to cancer. At one point, Pfizer and its units faced more than 10,000 lawsuits over the medications.

Many Patients
Until 1995, many patients combined Premarin, Wyeth’s estrogen-based drug, with progestin-laden Provera, made by Pfizer’s Pharmacia & Upjohn unit. Wyeth combined the two hormones in Prempro. The drugs are still on the market.

Chris Loder, a spokesman for the company, said “the evidence in this case does not support the plaintiff’s claims,” and that the company is “evaluating its next steps.”

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Fertility Clock Headlines, Fertility Headlines

Fake Tans Can Cause Infertility Problems

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Does a woman risk fertility problems by using fake tan? ‘Cocktail’ of chemicals in products can affect development of babies

Women who use fake tan could put themselves at an increased risk of fertility problems and having babies with birth defects, according to experts.

Although seen as a safe alternative to sunbeds, the products can contain a ‘cocktail’ of chemicals which may pose a risk to health – and can even cause cancer.

Among the dangerous ingredients found in fake tan are hormone-disrupting compounds, which can affect the healthy development of babies.

The products often also contain carcinogens, including formaldehyde and nitrosamines, as well as skin irritants and chemicals linked to allergies, diabetes, obesity and fertility problems.

The potentially dangerous effects of fake tan are thought to be more worrying than for other cosmetics as it is applied over the whole body regularly.

Jacqueline McGlade, executive director of the European Environment Agency, said the chemicals it contains ‘may be a contributing factor behind the significant increases in cancers, diabetes, obesity and falling fertility’.

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