Tag Archives: Miscarriage

Second hand smoke affects fertility

If you need another reason to quit smoking, consider that it may diminish your chances of being a parent or grandparent. Scientists at the University of Rochester Medical Center have found that women exposed to second hand smoke, either as adults or children, were significantly more likely to face fertility problems and suffer miscarriages.

 second-hand-smoke1An epidemiologic analysis of more than 4,800 non-smoking women showed those who were exposed to second hand smoke six or more hours per day as children and adults faced a 68 percent greater chance of having difficulty getting pregnant and suffering one or more miscarriages. The study is published online in Tobacco Control and is one of the first publications to demonstrate the lasting effects of second hand smoke exposure on women during childbearing years.

“These statistics are breathtaking and certainly points to yet another danger of second hand smoke exposure,” said Luke J. Peppone, Ph.D., research assistant professor at Rochester’s James P. Wilmot Cancer Center.

 In the study, four out of five women reported exposure to second hand smoke during their lifetime. Half of the women grew up in a home with smoking parents and nearly two-thirds of them were exposed to some second hand smoking at the time of the survey.

More than 40 percent of these women had difficulty getting pregnant (infertility lasting more than a year) or suffered miscarriages, some repeatedly.

 “We all know that cigarettes and second hand smoke are dangerous. Breathing the smoke has lasting effects, especially for women when they’re ready for children,” said Peppone, who analyzed information in the Patient Epidemiology Data System, a well-studied cohort that has yielded information on a variety of cancers.

 Peppone analyzed surveys collected from 4,804 women who visited Roswell Park Cancer Institute for health screenings or cancer care from 1982-1998. The 16-page survey focused on lifestyle, habits, family and personal health history, and occupational and environmental exposures. Each participant in this study reported that they had never smoked, and had been pregnant at least once or tried to become pregnant.

Participants reported whether one or both of their parents smoked and if they lived with or worked with smokers as adults. They also estimated the amount of time they were exposed to second hand smoke.

 Peppone acknowledges that the data is based upon self-reporting and that is not perfect. However, he said “Women, especially mothers, have extremely accurate recall. Mothers can easily recall details like how long they breastfed, what vitamins they took during prenatal care, and childhood activities.”

 Many of the women in the study grew up in the 1940s and 1950s, long before the surgeon general issued the first warning about the dangers of cigarette smoking in 1964. Since then, millions of dollars were spent to study the dangers of cigarette smoking. Tobacco use contributes to more than nearly 90 percent of all deadly lung cancers and 30 percent of all cancer deaths in the U.S., and a host of other health problems.

 Since the mid-1960s, smoking bans and government-funded, anti-smoking campaigns have encouraged smokers to quit and discouraged others from starting using a number of passive and aggressive techniques. Smoking rates have declined, however people continue to use tobacco and suffer the health risks.

The study was funded by a National Cancer Institute grant and was previously presented at the Society for Behavioral Medicine and Society of Research of Nicotine and Tobacco conferences.

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Fat mums 43 per cent more likely to miscarry

Overweight women are at greater risk of miscarrying a genetically normalpicture-131
baby in the early stages of pregnancy than women who maintain a healthy
weight, according to a new study by scientists at the Stanford University
School of Medicine in California, US. The researchers, presenting at the
annual American Society for Reproductive Medicine (ASRM) conference,
suggested that this indicates that a mother’s weight can affect the outcome
of an otherwise healthy pregnancy.
The UK’s National Health Service (NHS) estimates that around a quarter
of all pregnancies in the UK end in miscarriage. The majority of these occur
in the first 12 weeks of pregnancy, but can occur up to 24 weeks. The cause
of miscarriage is not always known, but it is thought that between 50 and 70
per cent occur as a result of chromosomal abnormalities (genetic defects) in
the fetus. The California researchers tested DNA from 204 fetuses miscarried
in the first eight weeks of pregnancy. They compared the rate of chromosomal
abnormalities in the fetuses from women with a normal body mass index (BMI)
with the rate of abnormalities in fetuses from women with a BMI that
classified them as overweight or obese. They found that 53 per cent of
babies lost by overweight women had no chromosomal abnormalities compared to
just 37 per cent of babies lost by women of a more healthy BMI.
Dr Inna Landres, who led the research team, said that these findings
indicate that ‘obesity predisposes women to miscarry normal babies.’ The
reason for this is not yet understood, but Dr Landres suggested that one
explanation could be altered levels of hormones such as oestrogen and
androgens seen in overweight women. She emphasised: ‘It’s important to
identify elevated BMI as a risk factor for miscarriage and counsel those
women who are affected on the importance of lifestyle modification.’
An individual’s BMI is calculated by dividing their weight in kilograms
by their height in metres squared. A BMI of 18 to 25 is considered normal,
whilst over 25 is classed as overweight and over 30 as obese. All the women
in the current study were attending an academic centre for fertility
counselling and had their BMI calculated before conception.
Dr Mark Hamilton, chairman of the British Fertility Society (BFS), said:
‘It is recognised that women who are overweight are at a greater risk of
miscarriage. It has not been defined if that risk is related to genetic
problems for the embryos or the obesity itself is linked to implantation
mechanisms. This study will aid our understanding of the known association
with being overweight and reproductive loss.’

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Fertility a matter of mind as well as body

Infertile women’s brains – and not just their bodies – may be blocking them from conceiving a baby, a new book says.

 Some women may be sabotaging their chances of having a baby by failing to address their emotional needs, according to Melbourne author Michaela Ryan. Her new book, Trying to Conceive, tells 15 stories of women who miraculously fell pregnant after they solved a range of personal issues.

 The stories include Deb and Keith, who endured 23 cycles of IVF and several miscarriages before Deb fell pregnant after she quit her job and reconnected with her long lost dad.

 And there is Naomi, who spent eight years trying to conceive, but was successful only when she started relaxing more and believing in herself.

 Ryan was moved to collect the stories after her own experience.

 “I tried to conceive for 12 stress-filled months, then as soon as I stopped obsessing about having a baby, I fell pregnant,” she said.

 “So I became very interested in looking at the possible effects of emotional issues and the impact this might be having for couples wanting to fall pregnant.”

 Ryan, 32, a freelance writer from Elwood and her husband Ted, 34, are now the proud parents of Declan, 3.

 “For a lot of the people I spoke to there were hidden fears that hadn’t really been addressed like fear of repeating the mistakes of the past, fear of subsequent miscarriage or fears of not being a good mother,” Ryan said.

 “It’s a really individual thing, but the common feeling is at some point there’s an emotional shift — a letting go — and many women fall pregnant soon after that.”

 Ryan said medical science “has really caught up, and there are improved pregnancy rates for those on stress reduction programs, for instance”.

 “A lot of women are only given very physical approaches and this offers another angle. “

 Dr Lynn Burmeister, clinical director of Monash IVF, said there was an underlying association between emotions and the body when it came to fertility.

 “There are no studies in humans to confirm this, but what we do know is that stress can reduce fertility in a number of ways,” she said.

 “We do our best to make sure we look after our patients’ minds as well as their bodies.”

 “Some do acupuncture and others attend our lifestyle modification clinics or see counsellors.”

 Dr Burmeister said she had seen patients with similar stories to those in the book.

 “I have had patients who have made an appointment with us and just doing that has taken a weight off their shoulders, and they ring back saying that they are not going to need us,” she said.

Posted by : Goral Gandhi, MSc,

                   Laboratory Director,

                   Rotunda – Center for Human Reproduction (Pvt) Ltd

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ADVANCED MICROSCOPY TO SELECT BEST SPERM FOR IVF

Two independent studies presented at a European fertility meeting this week highlight new techniques for selecting those sperm most likely to result in successful pregnancies following IVF using intra-cytoplasmic sperm injection (ICSI). The first, by Italian scientists, uses high-powered microscopy to choose the healthiest-looking sperm for fertilisation, while the second, by US scientists, uses fluorescence microscopy to distinguish which ‘healthy-looking’ sperm are in fact harbouring DNA damage, which can decrease the chances of achieving pregnancy.
The Italian group, lead by Dr Monica Antinori, of RAPRUI clinic in Rome, used a microscope five times more powerful than standard microscopes to select sperm with the best genetic quality on the basis of their size and shape. When these sperm were each injected directly into an egg, they found that the overall pregnancy rate rose from 26.5 per cent in patients treated using standard methods, to 39.2 per cent in those treated with the new approach, known as intra-cytoplasmic morphologically-selected sperm injection (IMSI).
‘By treating this kind of patient with this technique, we offer them an opportunity to solve their fertility problems. As you can see from the results, the group that has had two or more IVF failures can get more than twice the opportunity to have a pregnancy with this new technique’, Dr Antinori  told the Times newspaper. But, being about twice as expensive as ICSI, which costs between £3,000 and £5,000 in the UK, the treatment does come at a price, warned Dr Antinori.
Meanwhile, the US group, led by Mr Conrado Avendano, of the Jones Institute for Reproductive Medicine in Virginia, found that 20-66 per cent of the sperm selected using conventional methods – which analyse size and shape using much lower power microscopy than the IMSI method – turned out to be harbouring DNA damage, suggesting that appearances can be deceptive and should therefore not be solely relied on.
‘DNA-damaged sperm has a highly deleterious effect on the ability to achieve a pregnancy. Even if damaged sperm are used and the woman becomes pregnant, the chances of miscarrying are significantly higher’, said Mr Avendano, speaking at the annual meeting of the European Society for Human Reproduction and Embryology (ESHRE).
While these studies have the potential to bring dramatic benefits to infertile males, they also highlight the need for further research to evaluate the various methods available for identifying the sperm most likely to result in pregnancy.

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