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Entries in infertility treatments (2)

Wednesday
Jun272012

Continued Infertility Treatments Drive Pregnancy Successes

iStockphoto/Thinkstock(LANSING, Mich.) -- Women in their 30s and 40s who undergo multiple infertility treatments may be nearly as likely to deliver a baby as women who conceive naturally, according to new research that provides men and women with a more realistic view of their chances of becoming parents.

Until now, the success of in vitro fertilization and other assisted reproductive technology (ART) was based on live births following a single course of treatment, called a cycle. However, researchers for the first time have calculated cumulative success rates for women undergoing several treatment cycles. Among nearly 250,000 U.S. women treated with ART in 2004-2009, 57 percent achieved a live birth, they reported. In addition, 30 percent of all ART cycles were successful, they found.

"This study shows that if you keep at it...your chances of becoming pregnant continue to rise with continuing treatment," said lead researcher Barbara Luke, a professor of obstetrics, gynecology and reproductive biology at Michigan State University's College of Human Medicine in Lansing. "The takeaway message from this is you may need to look at infertility treatment over a course of cycles."

Luke noted that about 25 percent of women drop out after their first cycle for a variety of reasons that may include cost (about $7,000 to $15,000 out-of-pocket per treatment cycle) and stress. Many insurance plans will only cover a couple of cycles; Luke and her co-authors said they hoped their finding might encourage insurance companies to reconsider those limits.

Success depends on many factors, most importantly a woman's age and the quality of her embryos, which are related, Luke said. "As we age, our eggs age, and the quality of the embryo may be less. That's why using a donor egg, from a younger woman, greatly improves the live birth rate among older women."

Donor eggs give women "a 60 to 80 percent chance of live birth, regardless of your age," Luke and her colleagues reported in Wednesday's issue of the New England Journal of Medicine.

Choosing the donor egg route represents "a very personal decision," Luke suggested. Although it may seem cold to advise women in their 40s that their best chances of becoming pregnant lie with the eggs of younger women, she said they might want to think about egg donations "within families," with a younger sister donating to an older sister.

Luke and her co-authors found that for women under age 31 undergoing ART, the live birth rate is 42 percent for the first cycle; 57 to 62 percent for a second cycle; 63 to 75 percent by a third cycle and 66 to 83 percent in the fourth cycle. Among women 43 and over, the chances of a live birth with their own eggs are about four percent for the first cycle; six to eight percent for the second; seven to 11 percent for the third; and seven to 15 percent for a fourth cycle.

For comparison, Luke and her co-authors noted that among the general population, the odds of a couple conceiving spontaneously are 45 percent at one month, 65 percent at six months, and 85 percent at 12 months.

"This study provides patients with important and encouraging information," said Dr. Glenn Schattman, president of the Society for Assisted Reproductive Technology, which compiled the patient data that Luke and her colleagues analyzed. "While tracking outcomes by cycle started or single embryo transfer is a valuable method for assessing quality, having cumulative data linked to individual patients better estimates the prospect for success when they start a treatment cycle."

"Having the data to demonstrate that medically assisted conception can nearly match rates of natural conception is an important milestone," said Dolores J. Lamb, president of the American Society for Reproductive Medicine, which represents more than 8,000 health professionals focused on reproductive biology.

Copyright 2012 ABC News Radio

Saturday
May052012

Fertility Methods May Raise Risk of Birth Defects, Study Says 

Jupiterimages/Thinkstock(NEW YORK) -- Babies conceived with infertility treatment methods are more likely to have certain birth defects than babies who are conceived naturally, according to a study published today in the New England Journal of Medicine.

Australian researchers looked at the medical records of nearly 300,000 babies born in Australia -- more than 4,000 of whom were conceived through an assisted fertility method -- to see if babies born using the various assisting methods were more likely to have birth defects than babies who were conceived naturally.

Eight percent of the babies conceived through assistance were born with birth defects such as heart, genital, kidney, lung and muscle problems, compared to nearly 6 percent of babies who were conceived naturally, the study found. Those conceived through fertility assistance were also more likely to have cerebral palsy.

More than 6 million women of childbearing age in the U.S. have difficulty getting pregnant or staying pregnant, according to the U.S. Centers for Disease Control and Prevention.

Intracytoplasmic sperm injection (ISI), a so-called assisted reproductive technology in which a single sperm is injected into a removed egg and then transferred back to the uterus was the most common type of method associated with birth defects, the study found. The oral hormone pill commonly known as Clomid also increased the risk for defects.

Nearly five percent of infants are conceived using fertility medication, according to the CDC.

Babies conceived through in vitro fertilization (IVF), which is the most common type of assisted reproductive technology, did not have a higher risk for birth defects. Low-dose hormones also did not raise risk.

An estimated 1 percent of all infants born in the U.S. every year are conceived using assisted reproductive technologies such as IVF and ISI, according to the CDC.

The number of women turning to assisted reproductive methods to help them conceive has skyrocketed over the last decade because more women are waiting until they're older to have their first baby.

The increased risk of birth defects may be more likely caused by the identified infertility rather than the assisted methods used to help women get pregnant, according to Dr. James Goldfarb, director of the Fertility Center at University Hospitals Case Medical Center in Cleveland.

"The majority of problems with IVF babies are because the patients undergoing the procedure are more susceptible to the problems rather than because of the IVF," said Goldfarb. "That's encouraging because we can say in the situation that you'll see a 2.5 percent higher chance of birth defects, but that risk could be the same even if done naturally."

Some women who undergo fertility treatments may be older or have reproductive complications that may make pregnancy more difficult.

After five miscarriages, Alicia Cooney, then age 35, and her husband turned to fertility treatments. It started with hormones but the couple soon moved on to ISI and IVF. a

"After three years of fertility treatments, there was a lot of anxiety," said Cooney. "We wanted to be parents. There was frustration and anxiety."

Cooney's first round of IVF led to yet another miscarriage. Cooney said she was never told about any potential risks associated with fertility treatments.

While previous studies suggest a slight increase in the risk of birth defects for babies conceived through assisted reproductive technologies, the risk is still extremely low.

"It would've made me a bit nervous to know that," said Cooney.

But then again, she said, she was determined to keep trying.

"I still would've done it," she said.

Now, with two sons 18 months apart, Cooney, 40, of Cleveland, says she is grateful that methods were able to help her stay pregnant.

"I always think about how hard it was to have them and how happy I am to have them," she said.

The risk of complications to a woman undergoing any type of fertility method is also extremely low, said Goldfarb.

The biggest risk to both the mother and infant is the increased chance of having twins or multiple babies, he said.

Babies born in multiple birth situations can be up to 8 times more likely to have a birth defect, including cerebral palsy, he said.

In this study, however, parents who became pregnant with twins or multiple babies had a smaller risk of birth defects than women who became pregnant with only one baby.

The method in which the embryo is prepared also affected whether the babies conceived were at risk for birth defects. In fresh embryo transfers, there was a higher risk of birth defects than using embryos that had been frozen.

Weaker embryos that go through the freezing process are less likely to survive, allowing only the stronger embryos to be implanted back into mother, according to the researchers.

The findings shouldn't discourage women from using fertility methods to help in getting pregnant, said Goldfarb. The chances of pregnancy are different for each woman, and the risks and benefits of fertility methods also varies, he said.

"The fact that the patient has had a problem getting pregnant only slightly increases the risk to having a healthy pregnancy, but going through IVF isn't going to raise that risk any further," he said.

Copyright 2012 ABC News Radio







ABC News Radio