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Monday, 19 June 2006 08:50
BNN: British Nursing News Online ·
Fertility expert Dr Laurence Shaw, of the Bridge Centre, London suggests that more should be done to help women in their 30s and 40s become mothers.

Dr Shaw will tell a European fertility conference in Prague increased lifespan mean more childbearing time.

Dr Shaw says: "Homo sapiens have existed for 150,000 years and for all of that time until about 100 to 150 years ago, women had their babies when they were in their late teens and early twenties when their fertility was at its peak.

"Before we criticise 62-year-old women who want to have babies, we should remember that it was not so long ago that women would only have had about 20 or 30 years to care for their offspring and help with the next generation.

"Nowadays 60-year old women in many industrialised countries, have a life expectancy of 80 or 90, so there is no difference in terms of the length of their survival after the birth of a baby than there would have been for most of human existence."

He stopped short of calling for IVF treatment for women in their 60s, but said society should do more to help those women wanting to start families later in life.

"We should use technology to help further with finding better and safer hormone replacement therapies, and with fertility treatments for those seeking pregnancy in their 30s and 40s.

"We need to look at things not just in terms of the 21st century, but in the overall context of evolutionary progress."

Dr Allan Pacey, Senior Lecturer at the University of Sheffield and Honorary Secretary of the British Fertility Society, said: "Long post-menopausal lifespan are almost entirely a human trait and there are many theories to explain why women go through the menopause in contrast to most other animal species.

"One is that they can enhance their own daughters' fertility by becoming helpful grandparents and this is better than having further children themselves."

He added: "In today's modern society the evolutionary pressures that led to this are clearly not the same as they were when we were hunter-gatherers.

"But I am not sure this makes giving IVF to older post-menopausal women any more acceptable."

He said the availability of donor eggs and the right medical management meant post-menopausal women could get pregnant, there were clear risks involved in maintaining that pregnancy.

Dr Pacey added: "Most professionals agree that treatment using donor eggs should generally be confined to women under the age of 50”.

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Friday, 09 June 2006 12:11
BNN: British Nursing News Online ·
A third of people undergoing fertility treatment believe that telling their employers would harm their careers, a study has found.

A survey of nearly 300 patients by Infertility Network UK showed many thought their boss would not be sympathetic.

While the majority of people tell their employers they having treatment, 29 per cent felt they could not discuss the subject. Nearly two-thirds of that group had kept their treatment secret out of fears that it would harm their career if their employer found out they were trying to get pregnant.

The amount of time taken off for treatment varied considerably, but the majority had taken less than 10 working days. More than half had taken time off as sick leave, 47 per cent had used holiday leave, 14 per cent had taken unpaid leave and 20 per cent had been given paid leave to have the treatment.

Infertility Network UK have produced a leaflet explaining what happens when an employee is undergoing fertility treatment, and how a degree of flexibility from their employer can ease the emotional strain, minimise disruption and make the process easier.

Clare Brown, chief executive of the patient support group Infertility Network UK, said worries about work were a recurring theme when people called for advice.

"The emotional and physical impact of infertility and treatment is often underestimated," she said.

"Couples are having to deal with a very distressing illness that they can never get away from, and anything employers can do to help should be encouraged."

Dr Allan Pacey, Honorary Secretary of the British Fertility Society, said: "I'm not surprised by the survey results, dealing with any illness and your employer is very difficult.

"But infertility treatment is something that can last for several years, and it can be very stressful.

"A bit of flexibility from employers, to allow staff to go for things like blood tests, would make all the difference."

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Monday, 08 May 2006 11:37
BNN: British Nursing News Online ·
More than 20 babies a year are being born to women over 50 in Britain with the aid of IVF treatment, official figures show.

Some 96 women aged 50 and over were treated at British fertility clinics in 2002 – a quarter (24) of them successfully.

The Human Fertilisation and Embryology Authority (HFEA) figures show that older women are increasingly seeking IVF treatment. Between 1992 and 2002 the number of births to women aged 45-49 increased from 15 to 106, and the number of births to women over 50 increased 24-fold, in line with attempts at IVF.

The figures emerged after consultant child psychiatrist Patricia Rashbrook, 63, announced she was seven months pregnant after conceiving using a donor egg from Russia and sperm from her 61-year-old husband, John. The treatment was conducted outside the UK by Italian professor Severino Antonori.

In Britain, the NHS refuses to treat women over 39, although there is no legal age limit for the 85 private clinics.

"The law says clinics must take into account the welfare of the child - including the mother's age, health and ability to provide for the needs of the child - as well as the risk of serious medical, physical or psychological harm," said James Healey, an HFEA spokesman.

Unofficial guidance form the British Fertility Society advises that women over 50 should not be treated, citing concerns about increased risk of heart attack, stroke, haemorrhaging, pre-eclampsia, diabetes and high blood pressure.

Geeta Nargund, consultant in reproductive medicine at St George's Hospital, London, said: "I certainly believe there should be an upper age limit, because it's important to safeguard the health of the woman and the child. I wouldn't want it to be any more than 50. Since we regulate anyway, why not regulate this?"

Alan Pacey, secretary of the British Fertility Society, said he was surprised by the number of over-50s becoming mothers, but he did not see any need for new regulation as "most people have a certain amount of common sense".

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Thursday, 04 May 2006 11:39
BNN: British Nursing News Online ·
A 63-year-old woman is to become Britain’s oldest mother after undergoing IVF treatment at a controversial Italian clinic.

Patricia Rashbrook, a child psychologist from East Sussex, flew to Rome last October for treatment by Sergio Antinori, the Sun newspaper has reported.

She is now seven months pregnant with her third child.

"A great deal of thought has been given to planning and providing for the child's present and future well-being, medically, socially and materially," she said in a joint statement with her husband.

"We are very happy to have given life to an already much-loved baby, and our wish now is to give him the peace and security he needs."

The couple said they were pleased with the pregnancy "notwithstanding its unusual and potentially controversial aspects".

Dr Antinori specialises in treating older women. He mad headlines in 1994 after helping a post-menopausal 63-year-old woman become pregnant with donor eggs and hormones.

While there is no age limit for fertility treatment in UK law, most British doctors hold back from treating women over 45 because of concerns over the ability of older parents to provide for the needs of the child or children.

But secretary to the British Fertility Society and senior lecturer at Sheffield University, Dr Allan Pacey, said there were not necessarily any health risks associated with older women getting IVF.

He said: "It's pretty clear that she would have needed donor eggs because of her age.

"My understanding is that an older women with a younger woman's donor eggs will have the same success rate applicable to the younger woman.

"She would have needed hormonal treatment to get her body to respond in the right way. As long as there's nothing wrong with the womb it should be OK."

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Monday, 24 April 2006 10:32
BNN: British Nursing News Online ·
Thousands of infertile couples seeking donor insemination are facing long waits and charges of £1,000 per treatment because sperm supplies have been severely reduced by a new law removing the donors’ right to anonymity.

Government figures show that, following the introduction of the new law, 18 men donated sperm last April, 12 in May and 10 in June. The traditional source of sperm – students seeking to earn extra cash – has all but disappeared.

Some clinics have warned that recruitment will get harder still following a recent change in the law which also removes the anonymity of overseas donors and requires the destruction of all sperm donated before April 2005. Furthermore, under the changes, donors’ can be paid only expenses.

Alan Pacey, secretary of the British Fertility Society, said the initial findings of a survey of clinics revealed rapidly depleting stocks. "The cost is going up, the supply is going down and waiting lists are growing. Patients are getting a raw deal," he said.

The Bath assisted conception unit has written to 20 patients to tell them it is suspending services, and St James's hospital in Leeds is not taking patients.

Adam Balen, professor of reproductive medicine at Leeds, said: "The change in the law has decimated our donor service. Many couples are now being denied the treatment they so much desire ... I know that many couples are travelling overseas for egg and sperm donation."

William Ledger, of the centre for reproductive medicine and fertility at the Royal Hallamshire hospital, Sheffield, said: "In the past we've done matching of eye and hair colour. Not any more. Sperm prices have gone up fivefold in the last year. It's a seller's market and we have to pass the cost on to patients."

He said a year ago the centre charged £200 a cycle; now it charged £700. Private clinics have charged up to £1,000. "Ordinary folk are being denied access as a result of the change in these guidelines," he said.

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Saturday, 15 April 2006 09:37
BNN: British Nursing News Online ·
Research by a clinic in Cleveland, Ohio, claim that men are not taking the necessary steps to ensure their vasectomies have been successful.

The American study that is published in the UK-based BJU International found that a quarter of men who had undergone sterilisation did not return for any follow up test to check whether the procedure had worked.

Dr Nivedita Dhar, chief resident urologist at the Glickman Urological Institute where the study was conducted, said: "Our results show that only three quarters of the men in the study turned up for their eight-week sperm test.

"This means a quarter of them had no idea whether the procedure had worked and whether their partner could still fall pregnant”.

He added: "It is impossible to assess the true vasectomy failure rate in the full study sample as many failed to turn up for follow-up tests, despite careful counselling."

Vice-chairman of the institute Dr J Stephen Jones who directed the study said the other research suggested the non-compliance with follow-up checks among vasectomy patients was between 25 and 40%.

"It may, however, be possible to improve full compliance among those who return for at least one test by simplifying the follow-up tests in line with current medical evidence and making sure that this is backed up by adequate counselling”.

Secretary of the British Fertility Society and Senior Lecturer at the University of Sheffield Dr Allan Pacey said it was obviously very important for men to return for semen analysis to check whether or not their vasectomy surgery has worked.

"It is also vital that the laboratory undertaking the analysis of the sample does it properly.

"Diagnosing whether there is sperm in the ejaculate is quite tricky to do and in the UK we have strict guidelines that all laboratories should adhere to.

"But it does not matter how strict they are if the man does not turn up for testing in the first place!"

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Saturday, 11 February 2006 11:05
BNN: British Nursing News Online ·
Researchers from the Harvard Medical School have identified a key component of the mechanism sperm use to speed up their progress to the egg.

The chemical change converts the sperm's tail motion from a steady swimming undulation to a whip-cracking snap.

The researchers believe their work could potentially aid the study of male infertility, and the design of new contraceptives.

The Harvard team had already identified a protein called CatSper1 - which is only found in the sperm tail - as key to the process.

In the latest study they were able to show just why the protein plays such a key role.

The researchers used a sophisticated technique called patch clamp recording, to monitor electrical activity with the sperm cell.

The technique is widely used to examine other cells, but until now it had not been applied to sperm cells, which are constantly wriggling around, and are protected by tough outer membranes.

The results showed that CatSper1 plays a central role in controlling the flow of calcium ions into the sperm cell. It is thought that it is this flow of ions that triggers hyperactivation.

Lead researcher Dr David Clapham said: "No one had ever seen inside sperm cells to measure all the currents that control their activity.

"We are already measuring many of these currents and beginning to answer questions about what they are and what they do".

Dr Clapham said CatSper1 was a good target for new forms of contraception.

"We know that defects in CatSper1 block fertilization in mice.

"And since the channels in human sperm are very similar, there is no reason to believe you couldn't develop a male or female birth control pill that would block the protein before it functions to hyper activates sperm, preventing fertilisation".

Dr Allan Pacey, senior lecturer at the University of Sheffield, said: "The sperm tail is an incredibly complex and elegant machine that we really struggle to understand at the molecular level.

"This kind of approach is a real step forward.

"We know that hyperactivation is crucial to successful fertilisation, and we suspect that in some men this might be why they have difficulty in conceiving with their partners, if we could better understand the molecules involved in that process we might be able to diagnose the problem earlier and therefore save the couple both time and heartache.

"This research could also help us understand how sperm actually find and reach the egg in the first place as we suspect that hyperactivated motility is also involved in that process too.

"If we could understand that mystery too, that would be fantastic”.

The research is published in the journal Nature.

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Wednesday, 25 January 2006 11:04
BNN: British Nursing News Online ·
A new test that allows women to predict the rate at which their fertility is declining is being offered by private health providers.

The Plan Ahead test, which costs £179 and is not available on the NHS, works by measuring the number of eggs in a woman’s ovaries and indicating what that level will be in two years time.

It is hoped the test will allow women to judge how long they can delay trying for a baby.

Professor Bill Ledger, of Sheffield University, who developed the test kit, said he was confident it was an accurate predictor of fertility.

"If having family is the most important thing, you're best trying to have babies when you're in your twenties - there's no question that the longer you delay, the bigger your chance of heartbreak," he said.

"But I think the reality of modern life is that women in the Western world, for all sorts of good reasons, are putting off starting a family until they are in their thirties.

"There is more research going on but this is good enough to do what it says it does - give people a two-year warning that their ovarian reserve is declining."

The test measures the levels of three fertility hormones in the blood and compares the results with the average fertility for the woman’s age.

On the third day of her period, a woman gives a small blood sample, which is sent to a laboratory for testing to measure the level of the hormones. The first two, Inhibin B and AMH, decline as the menopause approaches, while the third, FSH, tends to increase.

A combination of the three indicates the woman’s reserve fertility for the next two years, scientists say.

Female fertility drops sharply from the age of 35, on average, but some women are affected even earlier. One per cent of women experience menopause before the age of 40, but fertility begins to decline a number of years beforehand.

Clare Brown, chief executive of Infertility Network UK, said the test would allow women to make a more informed decision about when to start a family.

But she added: "It is important to realise that whilst Plan Ahead is a valuable test, there are other factors that may cause difficulties in conceiving so it is vital that men and women make sure they are fully informed when making decisions on when to have a family."

Dr Susan Bewley, pregnancy specialist at Guy's and St Thomas' Hospital, recently warned in a British Medical Journal article that women risked heartbreak if they delayed attempting to conceive.

She said: "The only reliable test of fertility is actually trying to get pregnant. Test kits are likely to lead to people putting off that process and can give false reassurance.

"Couples would be better off spending their money on a candlelit dinner."

Dr Allan Pacey, secretary of the British Fertility Society, said: "This will be a useful test for those women who want to be able to better plan when they want to have their children.

"However, they should remember that female fertility declines with age and that there are dangers of leaving things too late in life.

"IVF doesn't work for everyone and there are dangers in thinking it can."

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Tuesday, 24 January 2006 12:00
BNN: British Nursing News Online ·
US researchers have found that stress may cause a woman’s body to kill off weaker male foetuses.

It is known that fewer boys tend to be born during times of hardship, such as a natural disaster. Male foetuses and embryos are weaker than females and are less likely to survive to birth, although experts are unsure why this is the case

Researchers from the University of California examined data on Swedish births from 1751 to 1912 and offered two explanations for the dip in male births during times of stress.

They said it is possible that a mother’s stress can harm her unborn babies, with already weaker males affected more than female foetuses.

However, the scientists added it was more likely that stress reduces the tolerance of the mother’s body to unhealthy embryos and foetuses, and causes women to spontaneously abort offspring that would have normally been carried to birth.

Dr Ralph Catalano, who led the research, said that if stress simply damaged male foetuses then it could be expected that even those boys that made it to full term would be damaged and have a shorter life expectancy.

However, the researchers found that the males that survived to full-term actually had a longer than average life expectancy, suggesting that only weaker male foetuses are selectively targeted by the mother’s body and giving the stronger males every chance of survival.

Writing in Proceedings of the National Academy of Sciences, the researchers said that actively culling weak male foetuses might increase the overall chance that a woman’s genetic line will survive into the future, as weak individuals are less likely to produce offspring.

They added that the findings may have implications for public health by providing clues as to what proportion of the population are likely to suffer from stress related illnesses.

Dr Catalano said: "These findings demonstrate yet again that we need not go to museums of natural history to find evidence of natural selection.

"Indeed things as common and immediate as the gender and health of our children show its effects."

Dr Allan Pacey, an expert in andrology at the University of Sheffield, told the BBC News website: "Many scientists suspect that there must also be other mechanisms at play to manipulate the sex ratio in other situations.

"After the last world war there was a dramatic increase in the number of boys born and this theory cannot explain how that was achieved. Its a very complex area of biology.

"It is important that women don't take the wrong message from this work and think that if they have a miscarriage that it is because they are under stress or they are dong the wrong thing.

"These mechanisms are only likely to kick-in in periods of severe famine or after natural events like earthquakes. Neither of these happen in Britain very often."

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