ESHRE Endorses Egg Freezing : ASRM Lifts Experimental Label From Egg Freezing

The American Society of Reproductive Medicine (ASRM) and the European Society of Human Reproduction and Embryology (ESHRE) have endorsed oocyte freezing as a standard and safe procedure in  2012. ASRM  issued a new report on 22 October, 2012 stating that in young patients egg freezing techniques have been shown to produce pregnancy rates, leading to the birth of healthy babies, comparable to IVF cycles using fresh eggs. After much work and deliberation by fertility experts, who reviewed the world literature on the effectiveness and safety of egg freezing and, most importantly, on the desired outcome: healthy babies, egg freezing is can now be used in routine practice. More studies are being published regarding this age range, and all is reassuring.

 

APPLICATION:

Egg freezing could provide a viable alternative source for couples needing donor eggs to build their families. In addition, among the medical indications for its use are fertility preservation for patients who may be left infertile following medical treatments for other diseases  (viz., cancer),  some genetic conditions, or IVF treatment interrupted by the unexpected inability to obtain sperm.

 

REASON FOR CAUTION:

The Committee points out that the age of the woman at the time of egg freezing is a very important factor. “Success rates with oocyte cryopreservation appear to decline with maternal age consistent with the clinical experience with fresh oocytes.”  ASRM did not encourage egg freezing for “social reasons,” such as a delay in childbearing as, although the technical procedure of egg freezing is safe, we do not have enough long-term data about babies born to women using eggs frozen when they are older than 35. Citing a lack of data on safety, efficacy, cost-effectiveness, and potential emotional risks, the report states, “Marketing this technology for the purpose of deferring childbearing may give women false hope and encourage women to delay childbearing. Patients who wish to pursue this technology should be carefully counseled.”

 

ROTUNDA EGG FREEZING PROGRAM:

Rotunda is now offering oocyte cryopreservation as part of its ART services  using the latest cutting edge Cryotec vitrification technique. We also have initiated donor egg bank. We have achieved comparable success rates with frozen donor oocytes  to fresh donor oocytes.

The excellent survival rates, embryo development and pregnancy rates have given a tremendous new hope to young cancer women. These young cancer patients can now dream of becoming a mother one day in future when they are cured of their disease.

” If you imagine it, you can achieve it. If you dream it, you can become it.” – William Arthur Ward. One of our patient’s sucess story in his own words

My fatherhood story

From the age of 20 I know I will become a parent, but time past faster than I felt and I was over 40 still a single man with no clue how I am making my biggest dream come true. And it happened a few years ago I came to read in a local newspaper about a gay couple becoming parents to a child getting help by a surrogate via Rotunda.

 It took me more than 2 years before I got the courage to send a mail to Rotunda and on the second mail my angel on earth wrote me. It was Dr Goral who later I understood is going to be the most meaningful person ever for me. She personally was the doctor and embryologist who got my embryos created through egg donation and she personally was the doctor who selected and put back the perfect embryos in my surrogate’s womb.

But this I will tell later. Before I want to tell about how afraid I was to begin the path. I am a single man, living alone in Israel. I don’t have any will changing my status. The only thing ever I wanted was a family! My family! and at the age of 43 I finally said to myself that I can’t wait no more and I sent the first mail to Rotunda. Till that stage it was the most difficult thing I did. No one can understand how much courage I needed and if not the feeling that this is what GOD has wishing for me I would not have become a father. My first try did not succeed. It took me 6 more months and good words from Dr Goral to start 1 more time. Got 1 more flight to Mumbai and again sat in Rotunda while the egg donation and 2 days later getting  embryos back in my surrogate.12 days later Dr Goral sent me the best mail till then telling me there is a pregrancy.

8 months later I became the happiest man living on earth! I am a father of a daughter and a son.

 My twins are 1 year and almost 4 months now. The boy is running for almost 2 month and the girl is making her first steps now. There is no happiness bigger than my happiness! No argument about it. Thank God for allowing me to be a father to my twins and thank Gods angel on earth (Dr Goral).

For anyone reading this blog I wish to explain: You need to stand on your legs and want the impossible! It is possible, just decide you want it. Rotunda knows how to make our biggest dream come true. God is great. Thank you Rotunda and more than anyone thank you Dr Goral & Dr Allahbadia.

Oriah (meaning the light of God) – my daughter

Yehonathan (meaning God gave) –  my son &

 Me- Yehoshua / Joshua (meaning God will save)

Email: joshua40@walla.com

Breaking News: Surrogacy not for married couples only – singles and gays will have legal rights to have surrogate babies

Single men, single women, gays and lesbians may soon get the legal sanction to undergo surrogacy in India.

The draft bill legalizing the surrogacy process in India has provided for Single parenthood by allowing “Unmarried Couples” and “Single Persons” from India and abroad to have children in India using ART procedures and surrogate mothers.

By conferring the right to have children on unmarried couples and single persons, the bill attempts to achieve several historic feats – legalizing commercial surrogacy, single parenthood, live-in relationships and entitling gays and lesbians to start families using surrogate mothers – at one go.

The bill proposes to set up a mechanism to regulate and supervise surrogacy in India.

The bill, with potential to rewrite the social landscape, may be tabled in the monsoon session of Parliament if the Union Cabinet clears it.

Read more about this on http://epaper.hindustantimes.com//artMailDisp.aspx?article=21_06_2010_001_020&typ=1&pub=264

Indian IVF bill may stop gay couple surrogacy

In the name of the fathers ... John Allen-Drury, left, and his partner, Darren, nurse their son, Noah, who was born in India using a surrogate mother. Photo: Graham Crouch

If the parents of newborn Noah Allen-Drury are lucky, their son will sleep through the noise as their flight from India lands in Sydney this morning.

Noah’s gay parents, however, are aware of legal turbulence that could prohibit the surrogacy arrangements that fulfilled their wish for a child.

A growing number of male couples from Australia and other Western countries are hiring surrogates in India to bear children, but that might no longer be possible if a draft bill to regulate IVF in India becomes law.

R.S. Sharma, the secretary of the committee writing a bill to govern assisted reproductive technology (ART), told the Herald that unless gay and lesbian relationships are legalised in India, gay couples would be excluded from hiring surrogates.

Delhi’s High Court recently overturned a 150-year-old section of the country’s penal code that outlawed ”carnal intercourse against the order of nature”.

However, gay activists warn this ruling, which in effect decriminalised sodomy, does not legalise gay relationships, leaving the status of such relationships unclear.

“If our government does not permit gay relationships, then it certainly will not be permitted for foreign gay couples to come to this country and have a [surrogacy] agreement,” said Dr Sharma, who is the deputy director-general of the reproductive health and nutrition division at the India Council of Medical Research.

John and Darren Allen-Drury, who live in the Blue Mountains, raced to India earlier this month when their surrogate mother entered labour. She gave birth to Noah on April 8. John Allen-Drury said changes to India’s laws would be a great disappointment, if passed.

”It would prevent a lot of same-sex couples from coming here,” he said.

Although some gay couples sought surrogate mothers in the United States and Thailand, ”India really is the closest country to Australia that offers affordable surrogacy,” he said.

The draft bill could make it difficult for all Australian couples to use Indian surrogates.

One stumbling block would be a requirement that foreign countries guarantee they will accept the surrogate child as a citizen – before a surrogacy could begin.

Dr Sharma said foreign couples would have to obtain a document from their embassy or foreign ministry pledging the surrogate child citizenship of their country. “Only then will they be entitled to sign an agreement with a surrogate or an ART clinic,” he said.

Parents using a surrogate would also be obliged to accept the baby even if it was born with abnormalities.

”Under the Australian Citizenship Act, there are no guarantees,” a spokesman for the Department of Immigration and Citizenship said on Friday. ”What you can infer from this is that while it’s not illegal, we certainly wouldn’t be encouraging it by giving a rubber stamp to anyone who entered into such an agreement.”

Mr Allen-Drury said surrogacy in the US cost $200,000 or more. In India the arrangements could be made for $40,000 to $50,000. Thailand’s laws were changed last year to stop surrogacies for same-sex couples, although it remains legal for single males.

Mr Allen-Drury said a requirement for the Australian government to guarantee citizenship before a surrogacy could begin was impractical. ”That would just close the door,” he said.

Trevor Elwell and his partner, Peter West, have twin girls, Evelyn and Gaia, from a surrogate mother in Mumbai. Mr Elwell predicted parliamentary inertia meant the Indian laws were months or years off. But he was concerned that interim guidelines could be adopted and, in effect, exclude same-sex couples.

Mr Elwell said the citizenship proposal could pose an insurmountable hurdle.

”If you want to do that process earlier and confirm citizenship, you’re going to have to have a government process upfront,” he said.

The demand for a guarantee of citizenship meant the Australian government would have to grant it on the basis of a contract it did not recognise.

”It is a bit of a tangle, so it might affect heterosexual couples in the long run,” Mr Elwell said.

Since the publicity after they got their twins, Mr Elwell and Mr West say they have helped more than 100 couples – some gay, some straight – arrange a surrogate mother in India.

”The tip of the iceberg may have been us.”

 Source: The Sydney Morning Herald (26 April, 2010)

Vitrification of Cleavage Stage Embryos

Freezing Cleavage-stage Embryos by Vitrification Improves Outcome July 9, 2009 Embryo cryopreservation is known to offer several advantages during ART cycles, including enhancing cumulative pregnancy rates, preventing ovarian hyperstimulation syndrome, reducing multiple pregnancy rates, and lowering treatment costs. After the vitrification technology for cryopreservation was developed, several studies have compared the slow freezing technique and vitrification method in relation to post-thaw survival, implantation, and live-birth rates. Now, a new retrospective study published in the Journal of Assisted Reproduction and Genetics highlights the efficacy of cleavage-stage embryo vitrification in improving the survival rate, post-thaw embryo morphology, and pregnancy outcomes, compared to the slow-freezing technique. Mojtaba Rezazadeh Valojerdi and colleagues, from the Embryology Department, Royan Institute, Iran, compared the effect of vitrification against slow-freezing of cleavage-stage embryos with regard to post-thaw survival rate, embryo morphology, and clinical outcomes. Cleavage-stage embryos of 305 patients were either subjected to vitrification (n=153) or slow-freezing (n=152) procedures. The following results observed during the study demonstrated that vitrification is a better cryopreservation technique compared to the slow-freezing method. Variables Vitrification (%) Slow-freezing (%) Odds Ratio Survival rate 96.9 82.8 6.607 Morphology with intact blastomeres 91.8 56.2 8.769 Clinical pregnancy rate 40.5 21.4 2.427 Implantation rate 16.6 6.8 2.726 Previously, Loutradi et al (Fertility and Sterility, 2008) conducted a systemic review and meta-analysis to compare post-thaw survival rates following vitrification and slow-freezing of human embryos. The investigators analyzed four studies, including three randomized controlled trials, comprising of 7,482 vitrified and 1,342 slow-frozen human blastocysts/cleavage stage embryos. A substantially higher cleavage stage embryo survival rate was observed in the vitrification group as compared to the slow-freezing group (OR=15.57; random effects model). Post-thaw survival rate of blastocysts was also found to be considerably greater in the vitrification group than the slow-freezing group (OR=2.20; fixed effects model). The conventional cryopreservation, by means of the slow-rate freezing protocol is associated with disadvantages such as osmotic shock, cryoprotectant toxicity, and mainly intracellular ice formation that can damage the cell wall and structure. In contrast, vitrification, the ultra-rapid cryopreservation method, eliminates the formation of ice crystals, thereby reducing the chances of cellular damage. The superiority of vitrification over slow-freezing for embryo preservation has been documented by several authors. Balaban et al (Human Reproduction, 2008) demonstrated that vitrification has a lower effect on embryo metabolic rate, compared to slow-freezing; as evident by the higher survival rate and subsequent in vitro development. Apart from the potential advantages of embryo vitrification, the ultra-rapid technique of cryopreservation has also shown its superiority in oocyte and sperm cryopreservation, and is hence becoming a more favorable procedure in comparison to the slow-freezing technique. In a more recent review study, Kolibianakis and colleagues (Current Opinion in Obstetrics and Gynecology, 2009) noted that vitrification was significantly better than slow-freezing with regard to post-thaw survival rates and embryo development of cleavage-stage embryos and blastocysts. However, the clinical pregnancy rates per transfer were comparable between the two groups. Although there seems to be ample evidence from retrospective studies and meta-analyses on the potential benefits of vitrification compared to the conventional freezing techniques, further prospective, randomized controlled trials are mandated for validating these findings and also to assuage the concerns of embryo toxicity due to the cryoprotectants used for vitrification.

References:
1. Rezazadeh Valojerdi M, Eftekhari-Yazdi P, Karimian L, Hassani F, Movaghar B. Vitrification versus slow freezing gives excellent survival, post warming embryo morphology and pregnancy outcomes for human cleaved embryos. J Assist Reprod Genet. 2009 Jun 10. [Epub ahead of print]
2. Loutradi KE, Kolibianakis EM, Venetis CA, et al. Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis. Fertil Steril. 2008 Jul;90(1):186-93.
3. Balaban B, Urman B, Ata B, et al. A randomized controlled study of human Day 3 embryo cryopreservation by slow freezing or vitrification: vitrification is associated with higher survival, metabolism and blastocyst formation. Hum Reprod. 2008 Sep;23(9):1976-82.
4. Kolibianakis EM, Venetis CA, Tarlatzis BC. Cryopreservation of human embryos by vitrification or slow freezing: which one is better? Curr Opin Obstet Gynecol. 2009 Jun;21(3):270-4.

Surrogate Pregnancy after transfer of Cryoshipped, Vitrified Human Blastocysts

Rotunda achieved its first pregnancy with Cryoshipped Vitrified embryos from USA and transferring them into a surrogate mother.

Till now, we have received frozen embryos from many countries and successfully transferred them into surrogate mothers at Rotunda. Most of these embryos were frozen by the slow freezing process. As vitrification is becoming popular as a method of choice for freezing gametes, we have started receiving vitrified embryos from world over. Our first case of cryoshipped, vitrified blastocyst transfer has resulted in a pregnancy.

A short history lesson:

In 1972 preimplantation mammalian embryos were first successfully cryopreserved. The method was very time consuming. Slow cooling was used (1 degree/min or less) to about -80 degrees Centigrade. Then the embryos were placed in liquid nitrogen.

The embryos also needed to be thawed slowly and a cryoprotectant added and removed in many gradual steps. This was a lot of work.

The first reported pregnancy in humans from frozen embryos was in 1983.

Most of the research has been done on mouse embryos. Development of frozen thawed mouse embryos, in vitro and in vivo, is not statistically reduced as compared to their nonfrozen counterparts.

Research continues in this area and human embryo freezing and thawing protocols have improved tremendously over the past 25 years. Hopefully, the newer vitrification technique will prove to have equivalent success rates with human blastocyst embryos transferred fresh or after freezing and thawing.

What is the difference between slow freezing and vitrification?

Patients who undergo IVF may have several eggs collected. The eggs are then fertilized with a sperm and checked for fertilization. Fertilized eggs are called embryos. A patient may have multiple high quality embryos eligible for embryo transfer back to the uterus. A certain number of embryos are chosen for embryo transfer, and the surplus of high quality embryos can be cryopreserved for future use.

Previously, embryos were cryopreserved using a slow freeze method. Embryos were run through different solutions of media todehydrate the cells of water and replace it with cryoprotectant. Then the cryoprotected embryos were individually labeled and stored in cryopreservation straws, which were put in special freezers. These freezers slowly (-0.3 degrees Celsius per minute), cooled the embryos to -35 degrees Celsius using liquid nitrogen. They were then stored in liquid nitrogen (-196 degrees Celsius). At that extremely cold temperature, cellular activity is essentially brought to a halt, allowing the embryos to remain viable indefinitely.

When patients decide to use their cryopreserved embryos to try for a pregnancy, the embryos are removed from the liquid nitrogen, warmed and run through solutions of media to remove the cryoprotectant and rehydrate the cells with water. During cryopreservation, the formation of intracellular ice crystals can damage the cells of the embryo, decreasing future viability. Therefore, new methods were developed to improve cryopreservation techniques.

Recent technical advancement in the field of cryobiology has opened up various options for freezing gametes and embryos at different developmental stages. The tendency of the IVF world to switch over to natural cycle IVF and to elective single-embryo transfer has put cryotechnology in the forefront of IVF. Vitrification method is gaining popularity as the method of choice for gamete/embryo cryopreservation.

Vitrification is a new process for cryopreserving embryos. Through vitrification, the water molecules in an embryo are removed and replaced with a higher concentration of cryoprotectant than in the slow freeze method. The embryos are then plunged directly into liquid nitrogen. This drastic (-12,000 degrees Celsius per minute) freezing creates a glass transition temperature, commonly called a “glass” state, and the embryos are vitrified. This quick freezing reduces the chance for intercellular ice crystals to be formed, thus decreasing the degeneration of cells upon thawing for embryo transfer.

In 1998, it was shown that vitrification using an EG-based vitrification solution (EFS40) (Kasai et al., 1990) with conventional cryo-straws was effective for human embryos at the 4- to 8-cell stage (Mukaida et al., 1998). The effectiveness of vitrification was confirmed for human embryos at the 8- to 16-cell stage (Saito et al., 2000) and the morula stage (Yokota et al., 2001b), also using EG-based solutions.

Many studies show survival rates of vitrified embryos to be far higher than survival rates of slow freeze embryos. Thus far at Rotunda, vitrification results are very encouraging, and we are excited to offer this cutting edge technology to our patients.

For more information about vitrification, ask to speak to the embryologist at your center.

Vitrification, a cutting edge technology for cryopreservation of embryos, is now available at Rotunda – Center for Human Reproduction.

Egg Donation

For many couples, being infertile no longer means having to go through life without children. Modern science and continued research in this direction has helped millions of couples all over the world become parents to a healthy child. Even issues that were once thought to make it impossible to conceive a child can now be overcome. One such female fertility problem is having a lack of eggs available for fertilisation.

What is Egg Donation

So what is a woman to do if her eggs have been found to be of poor quality or low quantity? Using an egg donor can significantly increase your chances of pregnancy. Compared to a your own eggs, using donor eggs are typically a better option when you do not have a very good ovarian reserve.

Ovarian reserve is the quantity and quality of eggs present in a woman’s body and this number differs for from every woman. In some cases, in spite of a high number of follicles, a woman may not have her eggs mature due to issues like premature ovarian failure. Other women may have eggs that are incapable of being fertilised or implanting on the uterine wall due to structural defects.

On the whole, donor eggs may be a better option when:

– Premature ovarian failure due to genetic or auto-immune disorders has been diagnosed or has occurred due to radiation therapy or artificial removal of the ovaries

– A woman is over 40 and is going through or has already gone through menopause

– There has been no response to fertility drugs

– There is a high level of FSH in the blood (FSH is a hormone that stimulates follicles to mature into eggs. If its level is too high in the blood, it signifies fewer eggs present in the body.)

– A woman cannot conceive in spite of repeated IVF cycles

– There is a risk of transferring genetic disease, like haemophilia, to the child from the mother

Physical Considerations

Doctors recommend that if a couple is opting for donor eggs, the mother should undergo a detailed medical analysis to check whether her body is suitable for pregnancy or if she is at a health risk. This particularly becomes important for women aged 40 years or more.

The uterus is also checked for deformations such as fibroids and scarred tissues that may not allow the egg to implant.

Psychological Considerations

The decision of using an egg that is not yours is a difficult one. The choice of the donor, her being known or anonymous, the ethical or religious aspects, the choice of telling the child, the involvement of relatives and friends and most importantly the parents’ firm will to use donor eggs are some aspects of the issue that have to be dealt with.

Psychological counseling can be very helpful for couples in this regard to make a concrete decision.

Selection of Donor

Choosing a donor is a crucial aspect. She might be a family friend, relative or a person known to you. There are also many organisations and online sites that provide a list of donors who are willing to donate eggs. If you are already attending a fertility clinic, they too may have a pool of egg donors from which you can choose. Some couples have also successfully advertised for donors, though this may not be a safe approach, as the person’s background cannot be sufficiently verified.

Depending on how you locate your donor, the donor may remain anonymous. For instance, if your infertility clinic offers an egg donor program, you will likely be able to read about a donor’s health history, physical traits, education level, possibly profession and other general information. However, you will not learn the donors name, address or any other information that will allow you to identify them.

In general, women between the ages of 18 and 35 who are physically healthy, non-smokers, with no hereditary or sexually transmitted diseases and who are psychologically fit are most suited to become donors.

Donor’s Check-Up

In order to ensure that a donor is physically, genetically and psychologically healthy for the donation, she has to undergo a number of tests. These may include:

– Blood tests to know the blood group, blood count and check for any infectious diseases might be passed on to the child

– HIV tests

– Hepatitis B and C tests

– Test for syphilis

– Medical history of the donor and her family to ensure that no hereditary problems are present

– The level of hormones present to know how fertile she is and whether her eggs are healthy enough

Psychological counseling is also advised to know her better as well as prepare her for the process.

The Procedure

Once you have decided to use donor eggs, the first step involves consultation with a physician or an organisation providing the donors. This helps in identifying your needs better and also answers any queries you might have regarding the procedure. The consultant also tries to find out your physical characteristics, likes, and dislikes to best match you with a donor.

After the selection of the donor comes the evaluation cycle phase.

Egg Donation Cycle

When the process of pregnancy takes place naturally, the uterus of the mother prepares itself by thickening the lining of the inner wall, while the body automatically produces an increase of hormones, like estrogen and progesterone, for the conception. But in the case of pregnancy with donor eggs, a mother’s body is not prepared for pregnancy and therefore the hormones have to be artificially induced.

A prospective mother will undergo an evaluation to determine the correct amount of estrogen and other hormonal supplements to be administered prior to transferring a fertilised donor egg. This is done by measuring your blood estrogen level and through ultrasound check ups to observe the uterine lining. The doctor may also give oral or estrogen injections to raise your hormone levels, which you may continue to take for a period of 10 to 14 days.

Then, the donor and the mother’s cycle are synchronized with the help of birth control pills. Once this has been done, the donor is given fertility drugs to promote a greater number of eggs being matured during her cycle. Meanwhile, you are given the appropriate dose of estrogen to prepare your uterus for the embryo.

A day before your donor under goes egg retrieval, you are given progestrone vaginally or with an injection. When the donors egg are retrieved, your partner will provide a semen sample that day so that his sperm can be combined that day with the freshly retrieved eggs. After 3 to 5 days, once the embryos have formed, two to three embryos will be transferred to your uterus as it normally would during an IVF procedure.

You will continue to receive estrogen and progestrone doses to help encourage a pregnancy. 10 to 11 days after the embryo transfer, a pregnancy test is carried out to check the success of the procedure.

Benefits

There are a number of benefits to using donor eggs:

– A donor egg from a younger woman increases the chances of conception to 50% as compared to 15% to 18% with your own eggs. This is because donor eggs are of better quality and there are more numbers of eggs available for fertilisation.

– As the donor egg provides a better chance of fertilisation, you may not have to undergo as many IVF cycles thereby saving yourself from the physical, mental, and financial anxieties associated with each cycle.

– Donor eggs provide an opportunity to conceive a child whose genetic make up resembles one of the parents.

– You are able to experience the process of giving birth when the fertilised egg is placed inside your uterus, which is not possible with an adopted child.

Risk Factors

A common fear of parents is that their child will be born with a genetic defect. Donors, however, are usually extensively checked for any signs of physical and genetic abnormalities. As a result, the chances of your child being affected by genetic problems caused by a donor are significantly reduced. However, they cannot be completely eliminated.

Unlike donor sperm, which is frozen and quarantined for at least six months, donor eggs are not frozen. This is because the freezing technique for eggs has yet to be perfected; in fact, freezing eggs typically damages the egg making it unusable. Therefore, fresh eggs must be used when you opt for donor eggs. Some infections, like HIV, may not produce a positive result until months after the infection, which means, although a donor may be tested, there is still a chance that she, and her eggs, could have a serious infection.

Other risks associated with this procedure include those associated with the IVF process itself as well as the chance of miscarriage if your body does not respond to the embryo. Furthermore, because two to three embryos are transferred, your risk of a multiple pregnancy occurring is increased.

Success Rate

Research has shown that there is about a 48% to 50% chance of conceiving using donor eggs. For women above the age of 40, who in general have a lower quality and quantity of eggs, the chances of conceiving with a donor egg is 5 times more than with their own eggs.

A Cancer Patient Fathers a Child After 22 Years

A man who had his sperm frozen whilst undergoing treatment for leukaemia as a teenager, has, at 38, become the father of a healthy baby girl. Christopher Biblis from Charlotte, North Carolina, was 16 when he underwent radiotherapy treatment which would have left him sterile had his doctors not recommended he have his sperm frozen cryogenically for future use. In early March, his daughter Stella was born having been conceived using the technique intracytoplasmic sperm injection (ICSI), a technique developed long after Biblis’ sperm had been frozen in 1986. 

’From my life being saved to being able to create a life…It’s truly a miracle’ Mr Biblis told ABC News. Stella was conceived after doctors selected the healthiest of Mr Biblis’ sperm cells after defrosting, and injected them directly into ten eggs cells which had been harvested from Melodie Biblis, Mr Biblis’s wife. Seven of the ten eggs fertilised successfully and two were implanted, leaving the other five for future treatment should the couple wish to have more children. Only one embryo survived and Stella is now a healthy one month old baby.

The fertility specialist treating the Biblis’s was Dr Richard L. Wing, founder of the Reproductive Endocrinology Associates of Charlotte (REACH). He said ‘I had no concern about working with old sperm – bovine and equine sperm has been frozen for long periods and has resulted in successful gestations’. The ICSI method brings an increased chance of conception beyond that expected in conventional IVF procedures where sperm and eggs are mixed to fertilise spontaneously. ‘They achieved pregnancy on their first cycle of ICSI…We had every reason to expect a perfect baby but are thrilled nonetheless’ said Dr Wing.

Last February, it was reported that a Canadian couple successfully conceived a baby boy after using sperm that had been stored 22 years, two months and two weeks. The longest-known storage period for sperm resulting in a live birth worldwide is 28 years, according to a 2005 data report in the American journal Fertility and Sterility.

Childhood cancer treatment has improved dramatically in the last decade resulting in a greater number of survivors. At the same time, improvements in the field of assisted conception are providing a great chance for male cancer survivors to father children of their own after potentially fertility-damaging treatment.

There is a relatively small window of opportunity before young male cancer patients begin treatment, so it is essential that health care providers are prepared and diligent about providing all options available in regard to improving future fertility.

There should be improved awareness of sperm banking and future fertility treatments that may impact the cancer patients quality of life.

Rotunda Sperm Bank offers sperm banking facilities to cancer patients and we have many cancer patients who have preserved their semen samples at Rotunda.

A man who had his sperm frozen whilst undergoing treatment for leukaemia as a teenager, has, at 38, become the father of a healthy baby girl. Christopher Biblis from Charlotte, North Carolina, was 16 when he underwent radiotherapy treatment which would have left him sterile had his doctors not recommended he have his sperm frozen cryogenically for future use. In early March, his daughter Stella was born having been conceived using the technique intracytoplasmic sperm injection (ICSI), a technique developed long after Biblis’ sperm had been frozen in 1986. 

’From my life being saved to being able to create a life…It’s truly a miracle’ Mr Biblis told ABC News. Stella was conceived after doctors selected the healthiest of Mr Biblis’ sperm cells after defrosting, and injected them directly into ten eggs cells which had been harvested from Melodie Biblis, Mr Biblis’s wife. Seven of the ten eggs fertilised successfully and two were implanted, leaving the other five for future treatment should the couple wish to have more children. Only one embryo survived and Stella is now a healthy one month old baby.

The fertility specialist treating the Biblis’s was Dr Richard L. Wing, founder of the Reproductive Endocrinology Associates of Charlotte (REACH). He said ‘I had no concern about working with old sperm – bovine and equine sperm has been frozen for long periods and has resulted in successful gestations’. The ICSI method brings an increased chance of conception beyond that expected in conventional IVF procedures where sperm and eggs are mixed to fertilise spontaneously. ‘They achieved pregnancy on their first cycle of ICSI…We had every reason to expect a perfect baby but are thrilled nonetheless’ said Dr Wing.

Last February, it was reported that a Canadian couple successfully conceived a baby boy after using sperm that had been stored 22 years, two months and two weeks. The longest-known storage period for sperm resulting in a live birth worldwide is 28 years, according to a 2005 data report in the American journal Fertility and Sterility.

Childhood cancer treatment has improved dramatically in the last decade resulting in a greater number of survivors. At the same time, improvements in the field of assisted conception are providing a great chance for male cancer survivors to father children of their own after potentially fertility-damaging treatment.

There is a relatively small window of opportunity before young male cancer patients begin treatment, so it is essential that health care providers are prepared and diligent about providing all options available in regard to improving future fertility.

There should be improved awareness of sperm banking and future fertility treatments that may impact the cancer patients quality of life.

Rotunda Sperm Bank offers sperm banking facilities to cancer patients and  many young cancer patients have preserved their semen samples at Rotunda.

Adult stem cells may lead to new infertility treatment

A special class of adult stem cells, known as human induced pluripotent stem (iPS) cells, has for the first time been reprogrammed into cells that develop into human eggs and sperm. The research, carried out by members of the University of California, Los Angeles (UCLA)’s Broad Stem Cell Research Center, was published in the January 27 online edition of the journal Stem Cells. Derived from adult body cells that have been engineered to return to an embryonic state, iPS cells have the ability to become every cell type in the human body – a characteristic they share with embryonic stem (ES) cells. In this study the iPS cells were coaxed into forming the germ line precursor cells that are capable of giving rise to sperm and eggs. ‘This finding could be important for people who are rendered infertile through disease or injury’. said Amander Clark, the senior author of the study. ‘We may, one day, be able to replace the germ cells that are lost, and these germ cells would be specific and genetically related to that patient’. Many infertile couples would see this process as preferable to using eggs or sperm from a donor who would then become one of the child’s genetic parents. However, Clark cautioned that scientists are still many years from offering treatments involving iPS cells to infertile patients. There are many uncertainties and dangers that need to be resolved. For example, the process of reprogramming involves using viruses to deliver genes to the cells, potentially increasing the likelihood of genetic abnormalities and cancers. Crucially, Clark’s team found that the germ line cells derived from iPS cells did not perform certain key regulatory processes as well as those generated from ES cells. The associated increased risk of chromosomal errors, or abnormal growth, could have serious health consequences for any child conceived using egg or sperm obtained in this way. Therefore Clark believes that it is vital that research using human ES cells continues. These cells can be derived from left over embryos used during in vitro fertilisation, and would otherwise be destroyed, yet their use is controversial and the topic remains fiercely debated.

Sources : Los Angeles Times, IVF News

Debate Over Genetic Screening of Embryos as New Tests Emerge

As more families opt for pre-implantation genetic diagnosis to screen embryos for inherited diseases, determining the regulatory and ethical guidelines to govern such screenings is “proving difficult,” the Chicago Tribune reports. Although the field of embryonic testing initially focused on identifying genetic defects that are certain to cause suffering or death early in life, it has broadened to include tests for genes linked to breast and ovarian cancer, which are not always fatal, occur later in life and affect 50% to 85% of those who carry the gene, according to the Tribune. The leading U.S. genetic diagnosis clinic, which is the largest in the world, conducted more than 1,800 screenings in 2008 “aimed at weeding out embryos that carried worrisome family conditions, from sickle cell anemia to cystic fibrosis,” the Tribune reports. Different countries vary in their regulation of PGD. In the U.S., doctors are allowed to select embryos for a particular sex, a practice that is not allowed in Great Britain, where each instance of PGD must be registered with the British Human Fertilization and Embryology Authority. BFEA has approved the use of PGD for about 70 genetic defects “after intensive public consultation about what is a serious enough problem to justify trying to eliminate it,” the Tribune reports. It is “significantly easier” to conduct PGD in the U.S. because the government only licenses clinics, not individual procedures, the Tribune reports. Mark Hughes, director of the Detroit-based Genesis Genetics Institute, said his company has tested for 171 genetic defects. In the U.S., “there is no approval mechanism,” Hughes said, adding, “No one is saying you can do this to save a sibling but you can’t do this for BRCA1,” a gene linked to breast cancer. According to a John Hopkins University study, nearly 40% of individuals surveyed believed that embryo screening should be regulated more closely for ethical reasons. An additional 19% said the screening should be banned altogether, for reasons ranging from the belief that discarding an embryo is immoral to concerns that selecting against certain diseases will devalue the lives of people already living with those conditions. Clare Williams, a bioethics specialist at Kings College London, said that during public hearings in Britain, “quite a lot of people felt there could well be treatment (for some conditions) by the time these children grow up, and then (their condition) won’t be an issue.” Some experts say it would be beneficial to place limits on the type of genetic defects doctors are allowed to screen for in the U.S., the Tribune reports. The Hopkins study found that, as of 2006, 65% of about 200 U.S. clinics offering embryo screenings allowed clients to choose the gender of the implanted embryo, regardless of the gender of existing children or whether the child was their first. The Tribune reports that such data and a California-based genetics lab’s recent announcement that it would be able to select eye and hair color have raised public concerns about genetic selection of embryos. The lab’s claims have been “disproved,” and many experts believe that expanded embryo screening “probably is not a slippery slope toward designer babies” because PGD is “costly and difficult,” there are a limited number of embryos to choose from and “finding one that includes a number of desired traits would be very difficult,” the Tribune reports. Hughes said the “things you might want to select for in a child — intelligence, athletic prowess, body stature — involve not single genes but many, many genes.” According to the Tribune, PGD, used in conjunction with in vitro fertilization, costs about $3,500 in the U.S. and twice that in Britain (Goering, Chicago Tribune, 3/25).