IVF success 'downhill from age 37' finds Aberdeen study
12/11/2013 06:03:00 AM
The chances of a woman having a baby following IVF go "very rapidly downhill" from the age of 37, according to a study.
The University of Aberdeen study reports a woman's age affects the outcome of every single step of IVF. Researchers studied data from 121,744 women from across the UK.We found that age impacted on every single hurdle that has to be overcome during the emotional rollercoaster that is IVF”Prof Siladitya BhattacharyaUniversity of Aberdeen
They found the chances of having a baby following IVF start to decline by the time the woman reaches her mid-30s, but especially from 37. The team used data from women who underwent their very first cycle of IVF between 2000 and 2007 using their own eggs. The research found that even after a pregnancy has been confirmed, women aged 38-39 were 43% more likely to have a miscarriage than women aged 18-34, while women aged 40-42 were almost twice as likely to lose the baby as the younger age group.
Prof Siladitya Bhattacharya, of the Reproductive Medicine team at the University of Aberdeen who led the research, said: "IVF comprises a number of key steps, each of which has to be successfully achieved before the next stage can be attempted.
"We found that age impacted on every single hurdle that has to be overcome during the emotional rollercoaster that is IVF.
"This influence of age is sustained at each stage of the IVF process.
"There is no point during an IVF treatment - even in women who have done well in a preceding stage - when age ceases to matter.
"Age has the capacity to increase the risk of treatment failure even in women who respond to hormonal treatment, have eggs harvested and embryos replaced."
'Dynamic' prediction
He concluded: "Many couples want to understand how their chances of having a baby evolve over the course of an IVF treatment.
"Previous work has been able to offer a global prediction of success in IVF.
"We hope our study provides a more accurate and dynamic way of predicting a couple's chances of treatment failure as they negotiate each step of IVF."
(Source:http://www.bbc.co.uk/news/uk-scotland-north-east-orkney-shetland-25258483)
The relationship between maternal age and pregnancy rate:
1. In Taiwanese records, 38 years is the crucial cut-off point to achieve a
successful pregnancy. Based on the report of Taiwan Ministry of Health and
Welfare in 2007 to the women those undergoing IVF program, the pregnancy rate
of the women under 35 years was 45.8%, and that of the women over 40 years was
14.8%; the live birth rate of the women under 35 years was 35.9%, and that of
the women over 40 years was 7.4%. – The most important factor
to the quality of ovaries and eggs is maternal age.
2. The solution to overcome the diminished ovarian decline is to "freeze the eggs" beforehand. If we can store our eggs through the recent cryo technique, we can arrange our life schedule flexibly and decrease the expenses to get pregnancy in the future.
How to choose the most appropriate clinical center to store my eggs?
1. Center with higher pregnancy rate in IVF realm
2. Annual cycles of frozen-thawed embryo transfer over 100, and live birth rate over 40%
3. Professional manager team
4. Individual storage space
5. Annual frozen-thawed case report
Docs to Lower IVF Twin Birth Rate
12/03/2013 12:11:00 AM
A growing number of couples are attempting pregnancy with just a single embryo, helped by new ways to pick the ones most likely to succeed. New guidelines urge doctors to stress this approach.
Twins aren’t always twice as nice; they have much higher risks of prematurity and serious health problems. Nearly half of all babies born with advanced fertility help are multiple births, new federal numbers show.
Abigail and Ken Ernst of Oldwick, N.J., used the one-embryo approach to conceive Lucy, a daughter born in September. It “just seemed the most normal, the most natural way” to conceive and avoid a high-risk twin pregnancy, the new mom said. Not all couples feel that way, though. Some can only afford one try with in vitro fertilization, or IVF, so they insist that at least two embryos be used to boost their odds, and view twins as two for the price of one.
Many patients “are telling their physicians ‘I want twins,’ ” said Barbara Collura, president of Resolve, a support and advocacy group. “We as a society think twins are healthy and always come out great. There’s very little reality” about the increased medical risks for babies and moms, she said.
The 2009 case of a California woman who had octuplets using IVF focused attention on the issue of big multiple births, and the numbers have dropped, except for twins. The Centers for Disease Control and Prevention’s most recent numbers show that 46 percent of IVF babies are multiples — mostly twins — and 37 percent are born premature. By comparison, only 3 percent of babies born without fertility help are twins and about 12 percent are preterm.
It’s mostly an American problem — some European countries that pay for fertility treatments require using one embryo at a time.
The American Society for Reproductive Medicine is trying to make it the norm in the U.S., too. Its guidelines, updated earlier this year, say that for women with reasonable medical odds of success, those under 35 should be offered single embryo transfer and no more than two at a time. The number rises with age.
To add heft to the advice, the guidelines say women should be counseled on the risks of multiple births and embryo transfers and that this discussion should be noted in their medical records.
“In 2014, our goal is really to minimize twins,” said Dr. Alan Copperman, medical director of Reproductive Medicine Associates of New York, a Manhattan fertility clinic.
The one-at-a-time idea is catching on. Only 4 percent of women under 35 used single embryos in 2007 but nearly 12 percent did in 2011. It’s less common among older women, who account for fewer IVF pregnancies, but it is gaining among them, too.
“Patients don’t really want multiples. What they want is high delivery rates,” said Dr. Richard T. Scott Jr., scientific director for Reproductive Medicine Associates of New Jersey, which has seven clinics in that state.
Better ways to screen embryos can make success rates for single embryos nearly as good as when two or more are used, he contends. The new techniques include maturing the embryos a few days longer. That improves viability and allows cells to be sampled for chromosome screening. Embryos can be frozen to allow test results to come back and more precisely time the transfer to the womb.
Taking these steps with single embryos results in fewer miscarriages and tubal pregnancies, healthier babies with fewer genetic defects and lower hospital bills from birth complications, many fertility specialists say.
Multiple studies back this up. In May, doctors from the New Jersey clinics did the kind of research considered a gold standard. They randomly assigned 175 women to have either a single embryo transferred after chromosome screening or two embryos with no screening, as is done in most IVF attempts now. Delivery rates were roughly equivalent — 61 percent with single embryos and 65 percent with doubles.
More than half of the double transfers produced twins but none of the single ones did. Babies from double transfers were more likely to be premature; more than one-third spent time in a neonatal intensive care unit versus 8 percent of the others.
Chromosome testing and freezing embryos adds about $4,000 to the roughly $14,000 cost for IVF, “but the pregnancy rates go up dramatically,” and that saves money because fewer IVF attempts are needed, Scott said. Using two or more embryos carries a much higher risk of twins and much higher rates of cerebral palsy and other disorders.
After explaining the risks, “this is the easiest thing in the world to convince patients to do,” Scott said of screening and using single embryos.
But Dr. Fady Sharara of the Virginia Center for Reproductive Medicine in Reston, Va., found otherwise. For a study, he offered 48 couples free medications and embryo freezing if they would agree to transfer one at a time instead of two. Eighteen couples refused, including one-quarter of those whose insurance was covering the treatment. Some who refused said they viewed twins as two for the price of one.
“I tell my patients twins are not twice the fun,” Shahara said. “One is hard enough. Two at a time is a killer for some people. Some marriages don’t survive this.” The New Jersey couple, who had a daughter using a single embryo, has eight more frozen embryos. When it’s time to try again, Abigail Ernst said, “we would do the same thing” and use one at a time.
The progress of IVF techniques:
Development
|
Yesterday
|
Today
|
Program
|
Long protocol
（GnRH agonist）
|
Short protocol
（GnRH antagonist）
|
Trigger shot
|
HCG
|
GnRH agonist
|
Embryo culture
|
Cleavage stage
|
Blastocyst stage
|
Embryo Transfer
|
Fresh embryo
transfer
|
Frozen-thawed
embryo transfer
|
Number of
transferred embryos
|
Double embryo
transfer（DET）
|
Single embryo
transfer
（SET）
|
Risk of OHSS
|
4%
|
0%
|
Risk of multiple
birth
|
20~30%
|
0%
|
http://e-stork.blogspot.tw/2013/11/cost-of-having-baby-21k-for-single.html
Fear and Fertility: Why I Decided to Freeze My Eggs (Cara E. Jones)
11/26/2013 04:34:00 AM
Fear and Fertility: Why I Decided to Freeze My Eggs
Posted: 11/23/2013 9:39 am
(Author: Cara E. Jones http://www.huffingtonpost.com/cara-e-jones/fear-and-fertility-why-i-decided-to-freeze-my-eggs_b_4310104.html)
"Don't be late, don't be late," I repeated to myself as I pulled into the parking garage at San Francisco's Pacific Fertility Center where I had planned to freeze my eggs. My lateness was surely a reflection of an ambivalence I had about the whole process. I was in too much of a rush to notice the "NOT AN ENTRANCE" sign on what appeared to be a front door. I then scurried up five flights and yanked on the 5th floor door. It didn't budge. I raced down the stairs pulling on the doors at the 4th, 3rd, 2nd and 1st floors. I was locked out of all of them.
After four increasingly stressful phone calls to the reception desk, a building security guard found me in what I later learned was a back entrance no one used. When I finally arrived where I was meant to be, I couldn't get my name out ahead of an unexpected rush of tears. My internal dialogue stirred up a mix of fearful emotions. "Why am I here? This is not the way I envisioned having a baby!" I provided name and address details to a receptionist who, seeing my fragile state, kindly escorted me to a private room to wait for my doctor. I was late for that appointment as well as a marriage and family that, in my mind, should have happened 10 years ago.
I had been married in my early 20s but divorced after the painful realization that I wasn't ready to be a partner or a mom. After years of traveling, figuring out who I was and intermittent stretches of dating unavailable men, I hit 37 wondering where the time went. As a fellow single friend put it "It's as if I forgot to set the alarm on my biological clock and slept through my 30s." I woke up in a panic. What if I missed my chance to have a family?
I had always thought I may adopt a child one day, but the idea that time was taking away my opportunity to have one of my own seemed unfair. I started experiencing each of my failed relationships like I did the locked doors in the stairwell. Each unsuccessful attempt to make one work left me feeling increasingly stressed.
I sat still fighting tears in my doctor's office when she walked in and welcomed me with a smile of a woman who had seen my strain of anxiety before. As she patiently and thoroughly explained the details of the egg freezing process I tried to wrestle my mind around a swirl of details involved. The idea of freezing the cells of babies-to-be in a $12,000 procedure was not part of my original life plan, but 40 minutes later there was one thing I was clear on: I would do this. I couldn't control when I would meet a potential partner but I could control this. The peace of mind alone seemed worth the big chunk of my savings.
I sat through my injection class in a haze as Power Point images of needles and vials appeared. The class made it all seem so simple. "Fill, measure, inject." It was simple. But on my first try I magically made several hundred dollars worth of liquid Menopur disappear by failing to load it into the correct syringe. I winced at the loss and the idea of injecting myself. I then held my breath, grabbed an inch of skin around my belly, and stuck the needle in.
I knew the hormones were kicking in when, on day three, I cried when someone cut me off in traffic. On day seven, a friend's "I admire what you're doing" sent tears streaming down my face.
But as each doctors visit allowed me to see ultrasound images of my little eggs multiplying, I was reminded of what my body was capable of. The truth is, while I was never confused about whether I wanted children, the thought that I might not get something I wanted so badly was painful. So, over the course of my many years being single, I slowly shut down my relationship with my fertility. And, like any difficult breakup, I wasn't sure we'd ever be getting back together.
The morning of the extraction of my eggs, I walked my bloated belly into the procedure room and made small talk with the anesthesiologist. Before I knew what happened, I woke up to a nurse tapping me on the shoulder to congratulate me. In a drug-induced stupor I cried out "I'm soooo proud of myself!!!"
When a technician later arrived with a snapshot of the microscopic eggs, I studied the contours of each with pride and awe. Those that survived the process will be held for safe keeping until I choose to use or dispose of them. While there is no guarantee of their quality or that any will survive the many steps between being thawed and becoming a baby, I am relived to have them.
This year I went to my 15 year college reunion where, for the first time I can remember, the site of pregnant bellies and waddling toddlers didn't trigger feelings of despair. Doing what I could to preserve my fertility has made me less afraid of losing it.
In the months since, I've been taking better care of my health and feeling less averse to being alone. Perhaps not surprisingly, I'm one of several women I know who started the best romantic relationship of their lives within months of her egg freeze. Maybe its like one of my dad's favorite expressions: "Our ships come in on calm seas."
I'm sure if I had been in a little less of a hurry the day of my first appointment I would have seen the "NOT AN ENTRANCE" sign, walked in the "correct" door and not been late. Still I can't regret that 20-minute detour, nor the 10-year one that took me off track from the life I had planned. But I do believe that sometimes when we stop being in such a fear-driven hurry, life is far more likely to get us where we want to be. Right on time.
Don't be late!
What is the real age of my ovaries?
AMH
|
> 6
|
4
|
3
|
2
|
1
|
Age of the ovaries (y/o)
|
< 25
|
35
|
38
|
40
|
43 >
|
How
about the efficiency of IVF program based on my age?
AMH
|
> 2
|
< 2
|
< 0.8
|
Reserved amount of the oocytes
|
Enough
|
Obviously decrease
|
Severely decrease
|
Stimulated amount of the oocytes in IVF
program
|
4<
|
≦4
|
1~2
|
Doctor' s suggestions
|
Start considering to freeze the oocytes
based on my age
|
Start freezing my oocytes as soon as possible
|
Start freezing my oocytes as soon as possible
|
More information to freeze my eggs in Taiwan
Register：Oversea Form
E-mail：en_service@icryobank.com
WhatsApp：+886-905-737-501
LINE ID：storkcryo
Register：Oversea Form E-mail：en_service@icryobank.com WhatsApp：+886-905-737-501 LINE ID：storkcryo12 Foods to boost fertility in men and why they work
11/19/2013 11:38:00 PM
12 Foods to boost fertility in men and why they work
When it comes to pregnancy, starting a family and fertility issues, the focus tends to be on the mother-to-be, but the truth is that men have their own fair share of fertility issues.
When it comes to pregnancy, starting a family and fertility issues, the focus tends to be on the mother-to-be, but the truth is that men have their own fair share of fertility issues.
While many of the conditions which influence a couple’s fertility need to be addressed in a clinical setting, there are some things men can do to boost fertility while they wait for a doctor visit or just to prevent any future issues, and one of those areas to focus on is diet.
There are a handful of things to keep in mind when it comes to foods to boost fertility in men, according to Baby Center, and those key guidelines include:
Eating plenty of foods rich in vitamin C and antioxidants to prevent sperm defects and improve sperm mobility. Getting enough zinc to prevent sperm from clumping together.
Eating enough folic acid to encourage the production of healthy sperm. Avoid or limit alcohol which can reduce testosterone levels and increase the number of unhealthy sperm. Get enough vitamin A to increase sperm mobility.
But what foods should men eat to boost fertility?
It’s well and good to know what nutritional components a man should have in his diet to boost fertility, but what specific foods are ideal for this purpose?
- Oysters: High in zinc.
- Oranges: High in vitamin C and vitamin A.
- Grapefruit: High in vitamin C and vitamin A.
- Broccoli: High in vitamin C and vitamin A.
- Beans: High in zinc and folic acid.
- Sweet potato: High in zinc, vitamin C, vitamin A, and folic acid.
- Tomatoes: High in vitamin C and vitamin A.
- Green, leafy vegetables: High in folic acid, vitamin C and vitamin A.
- Dairy: High in zinc.
- Eggs: High in zinc.
- Nuts: High in zinc.
While the nutritional contents of different fruits and vegetables will vary, a diet high in these items will give men the best chances of boosting fertility naturally. And, when it comes to food, there may even be one unexpected super fertility food out there, according to recent research.
Of all the foods men consume to boost fertility, researchers from Harvard University indicatecarrots should be top on the list.
In a study following the diets of more than 200 men, carrots were found to have the greatest impact on sperm’s ability to swim towards an egg. This important fertility booster in carrots was attributed to their high content of betacarotene, which improved sperm swimming ability by as much as 8 percent. Other foods which caused a similar effect were lettuce and spinach.
Lycopene, which is what give tomatoes their red color, was also found to be important in the male fertility trial.
“In a population of healthy young men, carotenoid intake was associated with higher sperm motility and, in the case of lycopene, better sperm morphology,” the study stated. “Our data suggest that dietary carotenoids may have a positive impact on semen quality.”
Overall, researchers suggest men looking to boost fertility stick to a diet full of orange, red and yellow fruits and vegetables to capitalize on the nutrients necessary for optimal fertility.
More information about examinations of male fertility:
http://taiwanivfsfc.blogspot.tw/2013/10/basic-examinations-for-husbands.html
Cost of having baby: $21K for single birth, $105k for twins
11/14/2013 05:32:00 AM
(Source: http://www.scientificamerican.com/article.cfm?id=identical-twins-genes-are-not-identical)
Having a baby can lead to a lifetime of expenses, ranging from diapers to down payments on that first car. But before that even begins, families have to pay the medical bill from the baby's birth. A new study finds having one child will cost about $21,000. That price tag skyrockets to $105,000 when having twins -- and more than $400,000 for triplets or more.
"On average, combined all-cause healthcare expenses for mothers with twins or higher-order multiple births were about five and 20 times more expensive, respectively, than singleton delivery," Dr. Dongmu Zhang, a researcher at Global Health Outcomes at Merck & Co., said in a statement. Researchers wanted to determine the medical expenses associated with multiple deliveries when compared to a single birth, noting that multiple pregnancies were on the rise in the United States and worldwide. Those rates parallel a rise inassisted reproductive technologies, such as in vitro fertilization (IVF), which are linked to a higher likelihood for having multiple births. About three percent of all U.S. births in 2010 were multiple deliveries, according to federal estimates. For the study, researchers looked at a health care database that included nearly 438,000 deliveries that took place between Jan. 2005 and Sept. 2010. Ninety-seven percent were single births, which mirrored U.S. rates.
Medical expenses included treatment costs for mom during the 27 weeks before the due date and one month after birth, along with medical expenses for the infant until he or she turned 1. The authors said expenses were likely due to increased use of a C-section and longer hospital stay for women who deliver multiple births, along with increased admission rates and longer stays in the neonatal intensive care unit (NICU) for multiple births. They noted that with single births, 60 percent of medical expenses are tied to mom's care whereas with twins or multiple births, 70 percent to 85 percent of costs are for infant care respectively.
Multiple births were also linked with a higher risk for death in mom and the babies, but Zhang noted those overall rates were small.
· Grandmother gives birth to her own twin grandchildren
· More women using donor eggs to get pregnant, study finds
· C-sections may be unnecessary for twin births
The researchers recommend more strategies aimed at minimizing the amount of embryos transferred for IVF procedures, since the risk for multiple pregnancy is due almost entirely to the transfer phase.
· Grandmother gives birth to her own twin grandchildren
· More women using donor eggs to get pregnant, study finds
· C-sections may be unnecessary for twin births
The researchers recommend more strategies aimed at minimizing the amount of embryos transferred for IVF procedures, since the risk for multiple pregnancy is due almost entirely to the transfer phase.
The American Society for Reproductive Medicine recommends that women seeking IVF who have a favorable prognosis receive one to two embryo transfers if they are under 35. They suggest two transfers if they are 35 to 37, three if they are between the ages of 38 to 40, and five transfers if they are 41 to 42. The new study was published Nov. 11 in the American Journal of Obstetrics & Gynecology.
(Source: http://www.cbsnews.com/8301-204_162-57611831/cost-of-having-baby-$21k-for-single-birth-$105k-for-twins/ )
Since the Stork Fertility Center has reached world-wide standards, we are exerting our very best efforts to ensure multiple births will be limited to twins at the most to decrease chances of any pregnancy-related complications. Also, we are promoting single-blastocyst-transfer (SBT) and cryopreservation in order to decrease the rate of multiple births.
Since the Stork Fertility Center has reached world-wide standards, we are exerting our very best efforts to ensure multiple births will be limited to twins at the most to decrease chances of any pregnancy-related complications. Also, we are promoting single-blastocyst-transfer (SBT) and cryopreservation in order to decrease the rate of multiple births.
IVF Babies Have No Greater Risk of Cancer
11/12/2013 06:28:00 AM
IVF Babies Have No Greater Risk of Cancer
by Steve Williams November 11, 2013 4:00 am
by Steve Williams November 11, 2013 4:00 am
Children conceived through
fertility treatment are on the whole at no greater risk of developing childhood
cancers, a new and largest of its kind study has found.
The study, conducted by the
impartial Cancer Research UK, saw researchers examine the medical records of
some 106,013 children up to the age of 15 who were born in the UK between 1992
and 2008. All those children were conceived through in-vitro fertilization
(IVF). Their records were then checked against medical reports from the
National Registry of Childhood Tumours to give comparable data for those age
ranges.
For a sample of this size, the
researchers expected that around 110 children would develop a childhood cancer,
the most common types being leukaemia, neuroblastoma, or retinoblastoma,
among others. In fact, only 108 children in the IVF sample developed a cancer,
slightly lower than the prediction but of course not of any real statistical
significance.
Previous studies had
shown a possible link between IVF and an increased risk of childhood
cancers, though those studies involved much smaller sample sizes and, even in
those cases, the risks were not attributed to the IVF techniques themselves but
other factors like underlying genetic problems that could be traced back to the
parents. As such, this latest study helps clarify that IVF techniques appear
safe.
Sperm Recipient Program Procedure
11/08/2013 06:24:00 AM
Sperm Recipient Program
Procedure
1. Documents preparation:
a.
Registration (please e-mail to our coordinators. see contact us)
b. Fill out
Kinship form and get recipient consent notarized
c. Fill out
IVF consent
b. Matching
2. Infertility workup
a. Stork
Fertility Center will give notification if there’s suitable donor matched.
b. Please
wire TWD 45,000 for the matching fee.
c. Please
finish the following check up:
3. For IVF
a. Start
stimulation process during MC day1 to day3.
b. Medication
is around TWD 10,000-40,000, depending on your individualized ovarian stimulation protocol.
c. Follicle
follow up by ultrasound during the course of the stimulation cycle.
d. Upon
oocyte retrieval day, the fee for thaw sperm fertilization and embryo culture
is around TWD 135,000.
e. Embryo
culture to day7.
f. Embryo
transfer is around TWD 50,000--60,000 per cycle.
4. For IUI
a. Start
stimulation process during MC day1 to day3.
b. Medication
is around TWD 40,000.
c. Follicle
follow up by ultrasound during the course of the stimulation cycle.
d. Thaw sperm
and IUI conducted, around TWD 15,000.
Form of payment
Cash – Please pay at the
counter of Stork Fertility Center
Telegraphic Transfer
(TT)/ Bank deposit – Please note account details as ff:
Account name: STORK LADIES CLINIC LAI HSING-HUA
Bank Name: First Commercial Bank, Hsin Chu Branch
Bank Code: 007
Account No.: 301-10-057266
Fax Number: (886) 3-573-9011
(Note: Upon payment,
please send copy of telegraphic transfer or deposit slip via fax to the
Administrative Office - Accounting Department )
Oocyte Donation Program Procedure (oocyte donation in Taiwan)
11/08/2013 06:04:00 AMOocyte Donation Program Procedure
1.
Documents preparation:
b.
Fill out Kinship form and get recipient consent notarized
c.
Fill out IVF consent
b.
Matching
2.
Infertility workup
a.
Stork Fertility Center will give notification if there’s suitable donor
matched.
b. For frozen egg set (the oocytes can be used immediately), which the cryopreserved eggs can be used immediately, please wire TWD 430,000. For fresh egg set (the donor must undergo OPU cycle), please wire TWD 370,000.
c.
Please finish the following check up:
‧ Sperm cryopreservation
3.
Embryo transfer cycle
a.
Donor start the stimulation procedure.
b.
Stork Fertility Center will give notification if the date for donor’s egg
retrieval is determined. ( two days before the
egg retrieval)
c.
On the date of egg retrieval, husband collects sperm sample in Stork Fertility
Center. Or using the frozen sperm for fertilization.
d.
Fertilization takes place, embryo culture to day5. And freeze all
the resulting embryos.
e.
Frozen embryo transfer will be arranged according to recipient’s next cycle,
around TWD 50,000-60,000 per cycle.
- Cash – Please pay at the counter of Stork Fertility Center
- Telegraphic Transfer (TT)/ Bank deposit – Please note account details as ff:
Account
name: STORK LADIES CLINIC LAI HSING-HUA
Bank
Name: First Commercial Bank, Hsin Chu Branch
Bank
Code: 007
Account
No.: 301-10-057266
Fax
Number: (886) 3-573-9011
(Note:
Upon payment, please send copy of telegraphic transfer or deposit slip via fax
to the Administrative Office - Accounting Department )