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Age Is The Major Factor inAssisted Reproduction
CDC's ninth annual ART report summarizes national trends and provides information on success rates for 399 fertility clinics around the country. Overall, 28 percent of ART procedures resulted in the birth of a baby for women who used their own fresh eggs.
The 2003 report offers more evidence that a woman's age is one of the most important factors in determining whether she will have a live birth by using her own eggs. "Women in their 20s and early 30s had relatively high rates of success for pregnancies, live births, and single live births," said Victoria Wright, a public health analyst in CDC's Division of Reproductive Health. "But success rates declined steadily once a woman reached her mid-30s."
Overall, 37 percent of the fresh non-donor procedures started in 2003 among women younger than 35 resulted in live births. This percentage of live births decreased to 30 percent among women aged 35-37, 20 percent among women aged 38-40, 11 percent among women aged 41-42 and 4 percent among women older than 42.
Women 40 or older are more likely to have a successful ART procedure if they use donor eggs. Egg donors are typically in their 20s or 30s. The average live birth rate for women who used ART with donor eggs is 50 percent, and is independent of age.
About 35 percent of ART deliveries among women who used their own fresh eggs were multiple births (twins or more), compared with 3 percent in the general U.S. population during the same time period. This is because multiple embryos are often transferred to increase the likelihood of a live birth. Multiple births are associated with greater risk for both mothers and babies, such as cesarean section, low birth weight, premature birth, and infant disability or death.........
December 26, 2005
March of Dimes New Year's Resolutions for a Healthy Baby
December 25, 2005, 10:32 AM CT
Merry Christmas To All Our Readers
Oh, jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh
Jingle bells, jingle bells
Jingle all the way
Oh, what fun it is to ride
In a one horse open sleigh........
December 20, 2005
Genetic Testing Still Smart Choice
Citing concerns about the accuracy of preimplantation genetic diagnosis, the method a number of practitioners use to pick the healthiest embryos during IVF, UF scientists set out to study the procedure. Their work, described during a recent meeting of the American Society of Reproductive Medicine, reveals the technique is actually highly reliable. But because there is a slim chance a genetic abnormality can cause doctors to misdiagnose embryos, some concerns still need to be addressed, the scientists said.
Preimplantation genetic diagnosis has been used for more than a decade to screen embryos for hereditary diseases such as Down syndrome and other abnormalities. To do this, one cell from an eight-cell embryo is extracted and examined for chromosomal defects.
However, as a number of as half these embryos spawn cells with different genetic information as they divide, giving doctors an inaccurate idea of how the embryo will continue to develop, said Larissa Kovalinskaia, a UF research associate with the College of Medicine's IVF program. While a number of embryos with this abnormality - called chromosomal mosaicism - stop developing early, some go on to be born. Because these embryos' cells contain different sets of chromosomes, doctors cannot always accurately screen them for genetic diseases, Kovalinskaia said.
"As more data were coming out, saying that as a number of as 50 percent of (IVF) embryos were mosaic, we started worrying about the accuracy of preimplantation genetic diagnosis," she said. "When you take one cell, does it represent the entire embryo? What we've shown is that we can rely on PGD".........
December 20, 2005
Hormone Therapy Goes On Trial
Marcelle Cedars, MDScientists at UCSF Medical Center are about to embark on a study with a controversial theme: Despite its bad reputation at present, can hormone treatment (HT) after menopause protect women from heart disease.
"Heart disease is still the nation's leading killer of women, and we need to understand how the disease develops in women," said lead investigator Marcelle Cedars, MD, director of the Division of Reproductive Endocrinology in the UCSF Department of Obstetrics, Gynecology and Reproductive Sciences.
UCSF is one of eight centers nationwide participating in the Kronos Early Estrogen Prevention Study, known as KEEPS, which is being by coordinated by the Phoenix-based Kronos Longevity Research Institute.
UCSF is recruiting 90 healthy, recently menopausal women who have not had a hysterectomy, are six months to three years from their last menses, and are 42 to 58 years of age.
KEEPS is a randomized, placebo-controlled, double-blind trial of 720 women designed to provide prospective data on the risks and benefits of HT in women who have recently begun menopause. Of particular interest is the role of estrogen during menses as it relates to the progression of atherosclerosis (hardening of the arteries).
Previous to 2002, most studies suggested that HT reduced the risk of heart disease by 30 to 50 percent. But in July of that year, the widely published Women's Health Initiative (WHI) was halted by the National Institutes of Health when results showed no preventive benefit against heart disease in women who were a number of years past menopause. The WHI was a primary prevention trial of estrogen plus progestin hormone treatment in 16,608 postmenopausal women between the ages 50-79. It was the first randomized, placebo-controlled, double-blind trial of HT, and for this reason its results were believed to be nearly definitive, according to Cedars.........
December 20, 2005
Genetics May Guide New Infertility Therapies
One in six couples is experiencing fertility problems worldwide, and people are asking why. This is a question of great medical, social and economic importance - one that cannot be answered until the process of fertilization is more fully understood.
A team led by Andrew Singson, an assistant professor and Pavan Kadandale, a graduate student in the Singson lab at the Waksman Institute of Microbiology at Rutgers, The State University of New Jersey, has taken a new and productive approach in this quest. The scientists found that in the absence of these two genes, the vital process of fertilization came to a halt. "What we learn in studying fertilization is not only important for this event, but also for the functioning of other cells in our bodies and for understanding a number of of those processes," Singson said.
Fertilization can be a paradigm for gaining insight into how cells interact over the life and development of multicellular organisms because it is one of the most basic of cell-cell interactions. The underlying cell biology is going to be universal with applications even in infectious diseases, such as AIDS, where the virus passes its genetic material to the cells it infects just as fertilization transmits sperm DNA to the egg, Singson explained.
Fertilization has primarily been studied in mammals or select marine invertebrates; but Singson and his group have instead turned to the lowly roundworm Caenorhabditis elegans (C. elegans), the first multicellular organism to have had its genome completely sequenced.........
December 19, 2005
Obesity Before Pregnancy
And there's a good chance that an overweight child will stay overweight for the rest of his or her life.
"Weight persists with time, so a child who is overweight by her second birthday is more likely to be overweight at a later age," said Pamela Salsberry, the study's lead author and an associate professor of nursing at Ohio State University. "Prevention of childhood obesity needs to begin before a woman ever gets pregnant".
Salsberry conducted the study with Patricia Reagan, a professor of economics at Ohio State. Their study appears in the recent issue of the journal Pediatrics.
The scientists analyzed the data for 3,022 children included in the National Longitudinal Survey of Youth's (NLSY) Child-Mother file. The NLSY collected height and weight information at multiple points in time. In this study, children were weighed when they were roughly ages 3, 5 and 7. The survey also gathered information on each child's race and ethnicity, and asked each mother to recall her pre-pregnancy weight, if she had smoked while pregnant and if she had breast-fed her child.
Children were considered overweight if their body mass index (BMI) was greater than or equal to the 95th percentile for their age and gender. BMI is a measurement that relates weight to height. A child in the 95th percentile for his weight is heavier than 95 percent of the children his age.........
December 15, 2005, 11:22 PM CT
Prenatal Test: Detection Of Genetic Disorders
"It's the beginning of a sea change in prenatal diagnosis," said Dr. Arthur Beaudet, chair of molecular and human genetics at BCM. "You are going to be able to detect a range of the most severe conditions, and in the future this can be cheaper than current methods hopefully using a very noninvasive approach." The new test can find more disorders and is as at least as fast as prior techniques.
The technique could even lead to more general use of prenatal screening for these disorders, said Beaudet.
The new test uses a gene chip or microarray to analyze various areas of the human genome for abnormal regions that contain too a number of or too few copies of the genetic material. These gains or losses in DNA can lead to devastating genetic conditions that present serious disabilities for the lives of children born with them.
The microarray or gene chip is like a map that is covered with tiny dots consisting of DNA from known locations on each of the 46 chromosomes. DNA from the patient is labeled one color (for example, red), and DNA from a normal person (control) is labeled another color (in this example, green). The two DNAs are then mixed and added to the microarray. The appropriate part of the genome seeks out the appropriate dot of DNA on the chip and attaches to it. If the DNA in both patient and control is normal, then the two colors of the dye even out and that dot turns yellow. If there is too much DNA (as happens when there are three instead of two copies of a region or an entire chromosome), the dot is more red because there is more of the patient's DNA. If there is too little, the dot is greener because there is more of the control's DNA and less of the patient's.........
December 15, 2005
Prepregnancy Weight Increasing
An analysis of the prepregnancy body mass index of more than 79,000 women in eight counties of Western New York who became pregnant between 1999 and 2003 found that the number of women who were overweight when they became pregnant increased by 11 percent and the number who were obese increased by 8 percent over that time period.
There was a corresponding decrease in the percentage of women who were normal weight or underweight in the prepregnancy period over those five years, results showed. The shift applied regardless of age, ethnicity (black or white), education level, type of insurance, prior live births, urbanization status, median family income and smoking status.
The study appears in the current (Dec. 2005) issue of the American Journal of Obstetrics and Gynecology.
The results are thought to apply to the population-at-large because they are consistent with findings in at least three prior papers and because of the large sample size.
"Cumulatively, 40.5 percent of all patients had prepregnancy BMIs in the overweight and obese categories in 2003 compared with 37.1 percent in 1999," said John Yeh, M.D., lead author who is professor and chair of the Department of Gynecology-Obstetrics, UB School of Medicine and Biomedical Sciences. "This represents a relative 9.2 percent increase over five years of the study.
"This increase in obesity is important to the obstetrician and the patient because obesity can be a high-risk situation in a pregnant woman," said Yeh. "Obese patients who become pregnant are at increased risk of developing gestational diabetes, pregnancy-related hypertension, preeclampsia, neonatal death and labor complications".........
Obesity Before Pregnancy May Cause Childhood Weight Problems (December 11, 2005)
A new study shows that a child's weight may be influenced by the mother even before the child is actually born. The study, conducted by scientists from Ohio State University (OSU) College of Nursing and School of Public Health, appears in the December 5, 2005 issue of the journal Pediatrics and was supported by the National Institute of Nursing Research (NINR), one of the National Institutes of Health (NIH).
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Did you know?
The addition of testosterone to hormone therapy in women after menopause enhances their sexual function. However, it may also reduce HDL cholesterol (the "good" cholesterol) in women, according to a systematic review of current evidence."If the reduction in HDL had been associated with an increase in triglycerides [fatty acids] or LDL cholesterol it would be of great concern," said Dr. Susan Davis, professor of medicine at Monash University, Melbourne, Australia, and study co-author "However, as an isolated finding the significance is difficult to interpret." She added, "Testosterone has not been found to alter other coronary heart disease risk factors.".
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