You will find these interesting and important information:
1. Froozen Embryo Transfer ...
2. Ten years' pain, 15 IVF attempts, £ 64,000..... one MIRACLE
3. Want to get pregnant? Its better to be fat than thin!
4. Chances of getting pregnant in your 30s and 40s.
5. Reflexology - can't put a foot wrong.
6. Invisable Pain of Infertility.
7. Fat, pregnant or both?
8. Obesity might be the reason for your infertility
Istanbul, 4 July 2012:
There is growing interest in a "freeze-all" embryo policy in IVF. Such an approach, which cryopreserves all embryos generated in a stimulated IVF cycle for later transfer in a non-stimulated natural cycle, would avoid any of the adverse effects which ovarian stimulation might have on endometrial receptivity during the treatment cycle. Ovarian stimulation has been shown to have adverse effects on endometrial receptivity and the risk of ovarian hyperstimulation syndrome (OHSS) is also increased when embryo transfer is performed in the stimulated cycle.
Freezing all embryos for later transfer might therefore improve implantation and pregnancy rates and increase the safety of IVF. Presently, the highest success rates in reproductive medicine are seen in the recipients of donor eggs. These are women who have not had ovarian stimulation - their endometrial tissue has not been exposed to high hormone levels, and they are not at risk of OHSS.
However, while the theory of a freeze-all policy seems attractive - and the technique has been commonly employed as a safety measure when OHSS is a threat - no robust systematic studies have indicated whether the cryopreservation of all viable embryos with later frozen embryo transfer (FET) is associated with better outcomes than fresh embryo transfers.Now, the first meta-analysis on this subject indicates that the chance of a clinical pregnancy is around 30% higher when all embryos are frozen for later transfer than with fresh embryo transfer. The results were presented today at the annual meeting of ESHRE (European Society of Human Reproduction and Embryology) by Professor Miguel Angel Checa from the Hospital Universitari del Mar in Barcelona, Spain.
The study was a systematic review of the entire literature, which provided a pool of 64 relevant studies - with three randomised trials - performed before December 2011. The current review was based on information from 633 IVF/ICSI cycles in which 316 were randomised to fresh embryo transfer and 317 to FET. Results showed - based on a relative risk calculation - that the probability of a clinical pregnancy is significantly higher from freeze-all cycles than in fresh embryo transfers (a relative risk of 1.31, which was statistically significant). The miscarriage rates did not show significantly differences between the two groups.
"The pooled data demonstrates that embryo cryopreservation and subsequent FET may improve the outcome of assisted reproduction treatment," said Professor Checa. The study recorded an ongoing pregnancy rate of 38% in fresh transfer cycles, and 50% in the FET cycles.
Professor Checa also explained why FET in a later non-stimulated cycle might improve IVF results. He noted that the multiple eggs generated by ovarian stimulation will increase release of the hormone estradiol from the ovary, which affects the receptivity of endometrial tissue. In addition, some recent studies have shown that ovarian stimulation causes changes to the endometrial DNA pattern, which are not evident in the normal receptive endometrium.
Professor Checa added that the results of his study were "preliminary", but statistically robust. However, with other groups known to be performing similar studies, he urged patience until their
results were known. "We are quite confident with our results," he said. "But in our view we should wait until the end of the year for results from other studies to confirm our data and recommend a
change in IVF policy."
Feb 3 2008 By James Millbank And Sarah Jellema James.Millbank@People.Co.Uk
EXCLUSIVE MUM HOLDS NEWBORN SHE NEARLY NEVER HAD Couple's joy after marathon battle Delighted Delina Tree has finally become a mum - after FIFTEEN attempts at IVF over TEN heartbreaking years.
Delina and hubby Simon spent a bank-busting £64,000 in their battle to have a baby.
But now all their pain and anguish has been rewarded with the arrival of their beautiful 6lb 11oz daughter Olivia. And overjoyed Delina, 40, said last night: "We are so happy - all that time, effort and money was definitely worth it in the end." Bank clerk Delina and carpenter Simon ran up massive debts and worked hundreds of hours of overtime in their epic struggle to become proud parents.
Speaking at their home in Sevenoaks, Kent, Delina said: "We have had to remortgage the house twice, taken out loans and asked our parents to help us financially. "I stayed in a job I hated as a cashier manager at the Abbey and Simon worked evenings and weekends just so we had enough money for the IVF. "Whenever a treatment failed we felt it was like pouring money down the drain." Each IVF cycle cost an average of more than £4,000 - but doctors were left baffled by Delina's failure to get pregnant. Delina first tried it after she had to have a fallopian tube removed when a natural pregnancy went wrong.
But she had problems from the very start. She said: "Each time I had the IVF treatment I couldn't relax. "On one occasion I fell pregnant but miscarried very early on. It was heartbreaking."
Dozens of IVF consultants across Britain studied her case. But they could not explain why eggs removed from her womb to be fertilised had not developed once they had been put back.
Three years ago, desperate Delina and Simon, 40, decided to adopt a child instead. But they backed out because they found the interviews too harrowing. Delina said: "It was worse than going through IVF. "I know they have to make sure you are a good family for the children but the grilling was not a nice process to go through." The couple decided to give IVF another go and went to an expert at Oxford's John Radcliffe Hospital two years ago. But Delina recalled: "He said because I've had so many treatments I would have only a five per cent chance of conceiving." However, her family doctor in Kent had other ideas. Delina said: "My GP told me if I was producing eggs there was still a chance I could have a baby. His words really encouraged me." Last March she started her 15th IVF cycle. And to Delina's astonishment, the treatment worked.
She said: "For the first four months I was terrified and when friends congratulated me it didn't sink in. I would even go for extra private scans to make sure that the baby was OK." Then on January 15 this year Delina was rushed to hospital with labour pains - and hours later Olivia was delivered by Caesarean. Jubilant Simon said: "It's taken a lot of time, a lot of patience and a lot of money but having our baby has made it all worthwhile.
"We hope other couples going through this are encouraged by our story."
Their IVF marathon is thought to be the longest ever in Britain. And last night top medics paid tribute to Delina for refusing to quit.
Fertility consultant Dr Geeta Nargund, of Create Health in London, said: "You have to admire her for going on so long.
"To put yourself through that so many times is amazing."
And Prof Stuart Campbell, former head of gynaecology at St George's Hospital, London, said: "She has been very plucky. Many fertility experts would want to call it a day before it reached double figures." Read more
"I'm not fat, I'm pregnant!" Actually, some women may be both but there are currently no UK guidelines to help midwives and women define how much is too much when it comes to weight gain during pregnancy.
In this week's Scrubbing Up, Bridget Benelam from the British Nutrition Foundation says there needs to be clear advice on weight control for pregnant women.
Nearly half of women of childbearing age are overweight or obese in the UK and this means there are increasing numbers of obese pregnant women. But spotting those mothers whose bumps are due to fat as well as baby is difficult, not least because there are no UK guidelines on how much weight women should gain during pregnancy.
Pregnancy weight gain varies and depends on many things - including the weight of the baby, the amount of amniotic fluid and the mother's increased blood volume - as well as body fat. Some additional fat is stored during pregnancy to provide a reserve for breast feeding when the baby is born.
But excessive weight gain during pregnancy carries health risks for the mother and child. It also makes the delivery of the baby more difficult, with caesarean sections and forceps deliveries more common. All this puts a strain on an already stretched maternity service.
Despite the common idea that women need to "eat for two" when pregnant, there is actually only a small number of extra calories needed in pregnancy.
No extra calories are needed during the first 28 weeks of pregnancy and only an extra 200kcal per day are required during the last 12 weeks, the equivalent of two small slices of bread.
In a survey of over 6,000 women carried out by the Royal College of Midwives and NetMums last year, 61% said their midwife did not have enough time to discuss their concerns about weight management and nutrition, meaning many women may embark on pregnancy without having discussed how to manage their weight at this important time.
And whilst there is a clear need for readily available advice, guidance is lacking.
Current recommendations in England from NICE (National Institute for health and Clinical Excellence ) do not address the issue of how much weight gain is healthy in pregnancy. Indeed, they flag up the need for UK-specific guidance.
These guidelines, issued in 2010, do say that women who are overweight or obese should be encouraged to lose weight before trying for a baby.
However, they say once a woman is pregnant, she should not be encouraged to diet to lose weight as this may harm the health of the growing baby and so women should follow a healthy diet and be physically active.
But what does this mean in practice?
In the US, guidelines go further.
The Institute of Medicine sets out what is a healthy weight gain - 25 to 35 pounds (11.5 to 16kg) during pregnancy for women at a normal weight for their height.
And it says overweight and obese women should gain less weight during pregnancy than lean women. For example, no more than 20 pounds (9kg) for the most obese.
Pregnancy is a window of opportunity where women are particularly interested in looking after their health and that of their growing baby.
Getting the right help and advice about weight control to pregnant women (and those planning a pregnancy) could help to reduce the risks to both mums and their babies, and also help mitigate the strain that obesity in pregnancy puts on the health service.
But midwives need support in delivering this advice on weight control, something they may never have been trained to provide. Arming them with clear guidance would be a good place to start.
How are obesity and infertility related?
Recent findings show very clearly that fertility can be negatively affected by obesity. In women, early onset of obesity favors the development of menses irregularities, chronic low rate of ovulation and infertility in the adult age. Obesity in women can also increase risk of miscarriages and affect negatively the outcomes of assisted reproductive technologies such as IVF and other modalities as well as pregnancy, when the body mass index exceeds 30 kg/m2. The main factors implicated in the association may be insulin excess and insulin resistance. These adverse effects of obesity are specifically evident in women with PCOS (polycystic ovary syndrome). In men, obesity is associated with low testosterone levels. In massively obese individuals, reduced spermatogenesis associated with severe hypotestosteronemia (low testosterone levels in the blood) which may cause severe infertility difficulties in the male. Moreover, the frequency of erectile dysfunction increases with increasing body mass index and the incidence of obesity. In summary, much more attention should be paid to the impact of obesity on fertility in both women and men. This appears to be particularly important for women before assisted reproductive technologies are attempted. Treatment of obesity may improve androgen imbalance and erectile dysfunction, the major causes of infertility in obese men, especially for those men in Middle East countries.
Do you feel that people in Oman and the Middle East in general are sufficiently educated on this link?
Obesity in the Middle East is a notable health issue. In 2005, the World Health Organization reported that 1.6 billion people were overweight Worldwide and 400 million were obese. It estimates that by the year 2015, 2.3 billion people will be overweight and 700 million will be obese. The Middle East, including the Arabian Peninsula, is no exception to the worldwide increase in obesity. Subsequently, some call this trend the New World Syndrome. The lifestyle changes associated with the discovery of oil and the subsequent increase in wealth is one contributing factor. Urbanization has occurred rapidly and has been accompanied by new technologies that promote sedentary lifestyles. Due to accessibility of private cars, television, and household appliances, the population as a whole is engaging in less physical activity. The rise in caloric and fat intake in a region where exercise is not a defining part of the culture has added to the overall increased percentages of overweight and obese populations. In addition, women are more likely to be overweight or obese due to cultural norms and perceptions of appropriate female behavior and occupations inside and outside of the home. Unfortunately people in Oman and the Middle East in general are not sufficiently educated on this link and an effort should be made of the consequences of obesity has on the overall reproductive health for both male and female.
Are there any other problems cause by obesity in the fertility process, ie passing on diseases and other illnesses onto newborns?
The most recent statistics on the general health of people are not encouraging. For example, current assessments indicate that over 60% of Americans meet criteria for being either overweight or obese. Those statistics are beginning to appear in locations around the globe including the Middle East and possibly Oman. Excess weight initiates a cascade of health problems through related conditions such as diabetes, heart disease, stroke, joint degeneration, sleep apnea and most recently, obesity has been linked to cancer.
In the USA, the
results of a recent research study found that overweight and obese people have medical bills up to $1500 greater a year than those not carrying excess weight. There is a domino effect
associated with dramatic weight gain: People become more sedentary and less able to tolerate exercise. The heart has to work harder to supply oxygen-rich blood to the extra tissue. (extra work due to
an increased body surface area). In some cases, the body becomes resistant to its own insulin, blood sugar levels begin to increase and Type II diabetes develops. In most cases, excess weight lends
itself to increased blood cholesterol levels and high blood pressure. This process presents us with the beginning of cardiovascular disease.
Weight gain for most people, is the result of increased energy intake and decreased energy output. Translation: We eat too much and do not exercise enough. This is where knowing and doing collide. Exercising and being attentive to diet requires effort and long-term commitment. Our society demands” immediate gratification” with most things (Ex: Standing in front of a microwave and saying “hurry-up”). Seemingly, if it takes too long, requires too much effort, or is uncomfortable, we will opt not to do it. We also factor in, that if anything goes wrong with our health, there is an intervention or pill that will “fix us”.
“If you are standing on the tracks and you see the train coming, common sense dictates that you get out of the way”.
This same principle applies to a multitude
of topics and very appropriately to the cascade of health problems that will accompany excess body weight and obesity. We know that excess weight leads to a domino effect of health issues.
Interventions and medications do not fix things 100%. The only true fix is to prevent it from happening.
In general, loss of general health has negative implications on sexual performance and diminished reproductive capacity. As to passing on diseases and other illnesses onto newborns, this has never been observed directly but indirectly by attempting to reproduce and raise a family using unhealthy modalities.
Is this a growing problem in Oman and out of infertility cases you deal with, how many of these are related to obesity?
As I mentioned previously, the Middle
East, including the Arabian Peninsula and Oman, are no exception to the worldwide increase in obesity. The lifestyle changes associated with the discovery of oil and the subsequent increase in wealth is one
contributing factor for the people of the Middle East and particularly those in Oman and the surrounding area. These adverse effects of obesity are specifically evident in women with PCOS (polycystic
ovary syndrome). In men, obesity is associated with low testosterone levels. In massively obese individuals, reduced spermatogenesis associated with severe hypotestosteronemia (low testosterone
levels in the blood) which may cause severe infertility difficulties in the male. Moreover, the frequency of erectile dysfunction increases with increasing body mass index and the incidence of
I have devoted more than 35 years studying and treating infertility in humans and I must admit that challenges are enormous for treatment of serious symptoms of infertility in countries around the Arabian Peninsula. In men for example, obesity, erectile dysfunction, spermatogenic deficiencies and similar type of problems seem to have reached epidemic proportions and they seem to be getting worse over time. One of my plans for the future is to establish a prominent center similar to the Andrology Institute of Andrology for the Middle East to treat severe male infertility difficulties. I challenge my friends in the Middle East to assist me with such plan.
Which age group or sex is most susceptible to obesity-related infertility illnesses?
Obesity tends to have an impact on fertility in both women and men. Obesity in women can also increase risk of miscarriages and affect negatively the outcomes of assisted reproductive technologies such as IVF and other modalities as well as pregnancy, when the body mass index exceeds 30 kg/m. As I mentioned before, the main factors implicated in the association may be insulin excess and insulin resistance. These adverse effects of obesity are specifically evident in women with PCOS (polycystic ovary syndrome). In men, obesity is associated with low testosterone levels. In massively obese individuals, reduced spermatogenesis associated with severe low testosterone levels in the blood can cause severe infertility difficulties in the male. Moreover, the frequency of erectile dysfunction increases with increasing body mass index and the incidence of obesity. In summary, much more attention should be paid to the impact of obesity on fertility in both women and men. This appears to be particularly important for women before assisted reproductive technologies are attempted. Treatment of obesity may improve androgen imbalance and erectile dysfunction, the major causes of infertility in obese men, especially in Middle East countries.
What can be done to tackle this problem and how does New Life work to tackle the issue?
The goal of any obesity treatment, like New Life and others is to achieve and maintain a healthier weight to reduce the patient’s risk of serious health problems and enhance their quality of life. An obese individual, male or female may need to work with a team of health professionals, including a nutritionist, dietitian, therapist or an obesity specialist, to help them understand and make changes in their eating and activity habits. All together, they can determine a healthy goal weight and how to achieve it for anyone suffering from obesity. Any one’s initial goal may be to lose 5 to 10 percent of their body weight within six months. General health brings about better reproductive performance, healthier sex life and better life styles.
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Al Azaiba, Near Rawasco
Way 4429, Villa 2029
Muscat, Sultanate of Oman
00968 24490737 or 93276693
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NewLife is celebrating their 50th healthy, life-born baby! Congratulation to the happy parents.