Tag Archives: IVF treatment

” 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

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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

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Preparing for your IVF treatment

Your Emotional Preparedness:

There are many complex emotions that you will be encountering as you are anticipating your IVF cycle. If you are using donor eggs, donor sperm, or a surrogate, the emotions that you have will be even more splintered, as you also must consider the weight of genetics in this equation.

Before you proceed with IVF, you will want to speak with a psychotherapist that is trained in infertility. There are some very natural concerns that you will have and feelings that you will be confronted with. Your therapist can give you gentle guidance as you navigate through these new features, in your pursuit of pregnancy.

Some emotions that you can expect to have are:

• Loss or mourning over lost pregnancies, cycles that failed before and possibly even the loss of your ovaries. If you are having IVF, there is a strong likelihood that you have encountered a great loss to get there. It is natural that you will feel grief, as you are anticipating your cycle.

• Fear of not being a “real” parent is another very normal emotion that you may experience as you are preparing for your IVF cycle. Your child will not be any less than your child, and you will be no less their mother. You’ll still be the one they turn to, when they fall off their first bike. You’re just like any other pregnant woman, only you will have fought harder to get there.

. Being afraid that it won’t work after all of the time, money and emotions that you’ve invested in the procedure is natural. The truth is, it may not work and you need to understand that prior to moving forward. Your counselor will help guide you in this matter.

. You may feel scared that you will let down your donor, if they are a friend or family member. You may feel as though you are personally disappointing someone, who went through an enormous quest to help you, if the cycle fails. It’s important to know that you have no control over the outcome and they have been counseled in the possibilities of a failed cycle, prior to the retrieval.

Don’t be concerned if you start to question the decision to utilize IVF, donor eggs or sperm. When you are faced with a huge decision it’s not unusual to falter now and then. This is a big step and it takes some getting used to.

Finally, after all of these concerns and emotions, you may also feel something you haven’t felt in a long time; you may feel hope. Donor eggs may not be a certainty and IVF may not be 100% successful; but you can permit yourself to enjoy a dash of hope, in your anticipation.

Your Physical Preparedness:

As your cycle approaches, there are a few things that you can do to prepare yourself. It goes without say that you should limit your caffeine intake, eliminate smoking, and drinking alcohol. Light to moderate exercise is beneficial to both your emotional and physical well-being, which ultimately is good for your reproductive health. Consult your doctor before you start a new fitness plan and it’s important to remember that a rigorous routine should be omitted.

Remember that you’re not just preparing for IVF, you’re preparing for a pregnancy. It’s recommended that women who are attempting pregnancy begin taking folic acid, prior to conception and you may want to include prenatal vitamins, in your daily routine. This will create the best environment for your fetus.

A diet that is high in leafy greens, fruits, vegetables, calcium as well as protein, is optimal for your pregnancy. You may want to talk to your doctor or nutritionist about foods that would be most beneficial to you, during your pregnancy, or even to help you build a pre-pregnancy meal plan, to prepare you for conception. Do not begin any restrictive diets, such as low-calorie or low-carbohydrate. Though it’s not ideal to be overweight in pregnancy, this is not the time to start a weight loss plan. You can read more about fertility enhancing food on –  https://therotundaramblings.wordpress.com/2008/09/27/foods-that-make-you-fertile/

The month prior to your transfer your doctor may ask you to participate in a mock cycle, to show that you and your donor respond properly to your respective hormone therapies. The endometrium used to be accessed via biopsy, but this technology did not prove itself reliable. Today you will most likely have an ultrasound about 10-12 days into your estrogen-enhanced cycle to measure your endometrius.

You may need to start birth control pills to regulate your cycle so that you can synchronize with your donor’s. You may also be asked to use a gonadotropin releasing hormone (GnRH) antagonist, which inhibits the luteinizing hormone (LH) surge; so that your own cycle does not get canceled and the uterine lining is ready for the implanted embryo.

You may still feel unprepared when it is time to begin your cycle, but that is completely normal as well. You may never feel completely prepared. The important part is that you have made your decision and are headed toward the next step in your pursuit to have your child.

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The success rates of gestational surrogacy cycles

In India, especially in Mumbai, gestational surrogacy is helping many couples have children, which may not have been possible in the past.

At Rotunda, we have tripled our gestational surrogacy cycles in 2008, in conjunction with achieving exceptionally high success rates. Our success rates with fresh surrogacy cycles average around 50% per embryo transfer, and are as high as 70% per embryo transfer in cases where eggs from our young healthy donors are used.

Results of last six months’ surrogacy cycles at Rotunda:

Month (2008)

No. of Cycles

No. of Pregnancies

Pregnancy rate per transfer (%)

May

8

5

62.5

June

8

3

38.0

July

15

9

60.0

August

14

5

36.0

September

11

5

45.5

October

11

8

72.7

 

surrogacy-cycles

We understand that when a couple fails to achieve a pregnancy with surrogacy, the situation can be quite overwhelming due to the high expectation of success and the substantial drain on financial resources. Our team is always cognizant of these realities and every attempt is made to work with couples in the event of failure to help them realize their goal of building families.

Since there are potentially significant legal, financial, ethical, and psychological issues with surrogacy, couples should work with centers that have experience in selecting surrogate mothers and provide the infrastructure to deal with these issues. 

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Equal access to IVF for lesbian couples and single women

New laws that grant lesbian couples and single women equal access to IVF have been passed by MPs voting in Victoria’s Parliament. The Assisted Reproductive Treatment bill was approved by 47 votes to 34, in a three day debate that lasted in the early hours. It will now be debated in the Upper House before it can become law. 

MP’s were given a free conscience vote on the bill, which included measures to permit the posthumous use of gametes – such as using a dead partner’s sperm – with many opposing the bill on grounds of the welfare of the child. Labor MP Marlene Kairouz, who voted against the bill, told MPs: ‘Bringing a child into the world without ever having the opportunity to meet both its parents shows disregard for its wellbeing, its needs and dignity.’

The reform comes after a four-year review conducted by the Victorian Law Reform Commission in to the current artificial reproductive technology (ART) laws in Victoria contained in the Infertility Treatment Act, which the new bill will repeal. ‘This is about updating our laws, bringing them into the 21st century but ensuring that the interests of children born of these arrangements are absolutely paramount,’ said the Attorney-General, Rob Hulls, before last week’s debate. It will also mean Victorian laws meet federal discrimination legislation by ensuring all women have equal access to fertility treatment. At present, lesbians and single parents have to travel to other states to receive fertility treatment. The bill also give greater parental rights to gay couples and parents of surrogate children. 

Rainbow Families Council spokeswoman Felicity Marlowe expressed her support for the proposed measures. ‘What we’d be really wanting to see is that people understand that the spirit of this bill is that the rights and best interests of children are upheld and we believe that voting in favour of it in the upper house will ensure that our children are not second class citizens,’ she said. 

The Attorney-General dubbed the bill ‘good reform’. He said, ‘When we’re dealing with social reform and particularly, obviously, conscience votes there are always passionate views that are held on both sides of the house.’

Posted by: Goral Gandhi, MSc

                  Laboratory Director

                  Rotunda – The Center For Human Reproduction

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Widow claims human right to use dead husband’s sperm

 

The UK’s High Court has ruled that it may have been unlawful for a widow to have removed her dead husband’s sperm. Despite UK law requiring valid written consent for the storage and use of sperm, the 42-year-old widow obtained emergency Court permission to have sperm collected from her 31-year-old husband’s body hours after he unexpectedly died from complications with a routine operation to remove his appendix in June 2007. She now seeks authorisation to undergo IVF abroad using his sperm. Giving the judgment, Mr Justice Charles said: ‘I am not satisfied it is possible to lawfully remove sperm from a dead person who has not given effective advanced consent’. 

The mother-of-one pleaded that the couple had wanted another child, discussed their desire with family and friends and had sought information regarding IVF together. She explained that they had not thought to have him provide written permission because they had not feared that the minor surgery would be fatal. While the attempt to construct retrospective consent with evidence of his intentions holds little legal weight in light of the clear statutory provisions, her lawyer also argued that disposal of his sperm would contravene her human right to establish a family (protected under article 8 of the European Convention on Human Rights, enshrined in UK law by the Human Rights Act 1998). Because fresh sperm will lose viability over time, the Court authorised the emergency sample collection pending later legal resolution. Upon closer examination at the hearing, Mr Justice Charles questioned the decision. 

The final decision now resides with the Human Fertilisation and Embryology Authority (HFEA), which regulates gamete storage and its use. If permission is denied, then the HFEA decision will likely be legally challenged as was done by Diane Blood in a similar case in 1997. HFEA chair, Lisa Jardine, commented that the organisation sympathises with these ‘difficult’ situations but ‘must operate within the legislation’. 

This case, like the landmark Blood case, may turn on the statutory loophole that provides the HFEA discretionary powers to dispense with the consent requirements for the sperm to be exported – in accordance with an EU citizen’s right to receive health treatment in another member state. 

Diane Blood ultimately won a protracted legal battle through the English Courts in 1997 and was able to conceive two sons using her late husband’s sperm. The Bloods attempted to start a family but Stephen Blood contracted meningitis and lapsed into a coma – his sperm was collected shortly before he died in 1995. The HFEA refused Mrs Blood authorisation to use the sperm as she did not have written consent from her husband. The High Court upheld the authority’s decision because the HFE Act does not provide discretionary powers to waive domestic consent requirements. The Court of Appeal agreed but also decided that the authority could have used a statutory discretion to allow the transport of Blood’s sperm to Belgium for treatment.

In Blood’s case, Lord Hoffman noted that the sperm’s storage was unlawful without the requisite written consent. However, given the unprecedented circumstances, he realised it was necessary for the clinic to store the sperm first and decide the legality later. He commented that he did not foresee the Courts would consider the legality of exporting unlawfully stored sperm again. A decade later, posthumous sperm has unlawfully been stored pending resolution of new legal arguments and Mr Justice Charles has likewise declared the case a ‘novelty’ in the law. 

Following the Blood case, the Government held a review of the law. The 1998 report concluded that the ‘written consent’ requirement should remain. Coincidentally, on the same day last week, MPs in the lower house of Victoria, Australia passed a package of reproductive law reforms which included a controversial clause to allow women to conceive using their partner’s posthumous gametes provided she has prior written consent.

Posted by: Goral Gandhi, MSc

                  Laboratory Director

                  Rotunda – The Center For Human Reproduction

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Ovarian stimulation before IVF ‘does not influence birthweight’

German investigators claim they have produced “robust” evidence that ovarian stimulation for IVF does not influence the birthweight of resulting babies.

Singleton children conceived through IVF have lower birthweights, on average, than their naturally conceived counterparts, and it has been hypothesized that ovarian stimulation could be a cause.

To find out, Georg Griesinger (University Clinic of Schleswig-Holstein) and colleagues analyzed data from a national IVF registry with 65-70 percent coverage. They retrieved information for all IVF cycles in women aged 25-35 years who underwent ovarian stimulation and had a live, singleton birth (n = 32,416).

On multivariate regression, the baby’s birthweight was significantly and independently predicted by each of maternal height, maternal weight, duration of infertility, and the number of embryos transferred.

However, none of the parameters of ovarian stimulation studied-including duration of stimulation, use of gonadotrophins, and the number of oocytes retrieved-significantly predicted birthweight.

“The present study provides robust evidence from a large sample of IVF singletons that ovarian stimulation and birthweight have no apparent quantitative (eg, dose-response) association,” say the researchers.

However, they caution: “Although this is reassuring to the clinician, it does not invalidate the need for studying the effect of ovarian stimulation on outcomes other than birthweight, such as epigenetic alterations, and associated health disorders.”

Source: Human Reproduction 2008; Advance online publication

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