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#11
General Discussion / The impact of artificial wombs...
Last post by mensfe_admin - 2024-09-11 11:54A look at the potential benefits and challenges
by Philippa Kemp
Birth is a universal experience. Every person has been born from the body of another. The development of artificial wombs will change this.
Artificial wombs are medical devices that mimic the environment of the womb during pregnancy. This technology will allow a human to be gestated in an artificial womb instead of in a human body.
In recent decades there have been significant research breakthroughs in the development of artificial wombs for animals. In 2017, premature lamb fetuses were successfully gestated for up to four weeks in artificial wombs. The lambs not only survived but developed: they gained weight, grew wool coats, and opened their eyes. Artificial wombs have now been tested on hundreds of lambs, pigs, and mice. This animal research has laid the groundwork for the next stage: human trials.
It is expected that the first human trials for artificial wombs will be for premature babies. Babies that are born prematurely have not finished growing and may have health issues associated with their interrupted growth. Babies born as early as 25 weeks have good chances for survival if they receive intensive medical care, but many will develop severe health conditions including problems with breathing and feeding. These health conditions could be prevented or minimised if premature babies can finish growing inside artificial wombs. These devices may also give premature babies a stronger chance of survival, as many babies do not survive after premature birth. Artificial wombs designed specifically for premature babies have been developed and some are on the cusp of human trials (see BioNews 1210).
Countries have distinct legal and ethical requirements that must be satisfied before new medical technology can be tested in humans. In the UK, approval must be obtained from the Medicines and Healthcare products Regulatory Agency (MHRA), according to the Nuffield Council on Bioethics. In the USA, an exemption must be granted by the Food and Drug Agency (FDA). The FDA has already started to consider this new technology, and if an exemption is granted, it is possible that human trials may start in the USA as early as this year, according to MIT Technology Review.
Artificial wombs could also provide an alternative method for having children. A woman could intentionally end her pregnancy – at any stage – by removing the fetus and transferring it to an artificial womb to grow to full term. This would allow someone to have a child even if they are unable to carry a pregnancy to full term or if they develop a condition that prevents them from continuing their pregnancy safely, such as an ectopic pregnancy. It could also be an option for those who simply no longer want to be pregnant but do not want to have a termination via abortion, either because they still want to have the baby, or they would prefer the baby to be adopted.
Artificial womb technology could be further developed to allow a human to be entirely grown within an artificial womb: from embryo to birth. This would provide another method for people to have children without experiencing pregnancy at all, in addition to the current options of adoption and surrogacy, for those who cannot or do not want to become pregnant.
Societal expectations for women may change if they are no longer seen as exclusive child-bearers, potentially leading to increased gender equality. For example, expectations for taking time off work to care for children may no longer primarily fall on women. There is also a finite age range during which a woman is fertile and able to have a child. The use of artificial wombs will provide more flexibility about at what age someone chooses to have a child, which may alter societal expectations about when we choose to have children.
The treatment of premature babies and introduction of new reproductive choices are beneficial changes which may be easily accepted in society. The social use of artificial wombs has been portrayed in films such as The Pod Generation (see BioNews 1235), which follows a couple having a baby via a portable artificial womb called a 'pod' in a technologically advanced society. Science fiction films such as I Am Mother have even touted artificial wombs as a method of creating new humans if humanity becomes extinct. However. the use of artificial wombs also presents several challenges.
It is unclear what legal status should be assigned to humans that reside within artificial wombs. A baby is recognised as a legal person under UK law once it has been born alive. Before birth, an unborn fetus has no legal status. UK law does not provide a clear definition for those residing in artificial wombs, as they do not clearly fit within the born or unborn definitions. Similarly, legal parenthood is assigned based on birth as the birth mother automatically becomes the legal parent. These rules do not currently apply to a baby born from an artificial womb.
The imminence of human trials means that artificial womb technology will become available within the present political and social climate. It could help alleviate politically charged issues about reproduction such as declining birthrates and overseas surrogacy arrangements (see BioNews 1208), as it would allow humans to be created without requiring the reproductive labour of women's bodies. Commercial applications of this technology may also be desirable, such as growing livestock for farmers.
Artificial wombs also raise ethical questions. Concerns have been expressed about the initial safety of artificial wombs because of the difficulties of moving from animal trials to human trials, and there are fears that babies will be negatively affected if they are grown 'without a mother's touch'. Legal systems may also have to consider whether limits should be placed on the number of children that can be born using this technology (or other reproductive methods) after a surrogacy agency in Georgia received requests from parents who wanted up to 1000 babies, Unreported World reported.
The availability of artificial wombs for humans is imminent, and this technology will fundamentally impact society over the next few decades in many ways – from changing the landscape of reproduction, to altering social attitudes about gender roles.
#12
Research / Study finds psychotherapy as e...
Last post by mensfe_admin - 2024-08-08 09:10Psychotherapy is an effective treatment for adults with post-traumatic stress disorder (PTSD) following exposure to multiple traumatic events, according to new research from the University of East Anglia.
The efficacy of psychotherapeutic interventions, or talking therapies, for treating PTSD in adults has been well-documented in various studies.
However, until now, it had not been established whether the benefit of psychotherapeutic interventions varies depending on whether the disorder is caused by one single event - for example, a traffic accident - or by multiple traumatic events such as during warfare or repeated incidents of sexual or physical violence.
An international team of researchers carried out a meta-analysis, based on data from around 10,600 patients, which has now been published in the journal Lancet Psychiatry.
The work was led by psychologists Dr Thole Hoppen and Prof Nexhmedin Morina from the Department for Clinical Psychology and Psychotherapy at the University of Münster, alongside Prof Richard Meiser-Stedman from the University of East Anglia, Dr Ahlke Kip from the University of Münster, and Prof Marianne Skogbrott Birkeland from the Research Centre for Violence and Traumatic Stress Studies in Norway.
PTSD can be a devastating reaction to trauma.
Talking therapies (e.g. trauma-focused cognitive behavioral therapy) are effective treatments for adults with PTSD.
However, such therapies typically involve detailed discussion of trauma, with some mental health professionals being concerned that this approach may not work when people have suffered multiple traumas, such as combat or sexual abuse.
In our review of over 130 clinical trials we found that adults whose PTSD stemmed from multiple trauma experiences gained the same degree of benefit as adults with single-event-related PTSD.
We hope this evidence will encourage therapists and adults suffering from PTSD, regardless of what type of experiences they have had, to consider trying this powerful treatment."
Richard Meiser-Stedman, Professor of Clinical Psychology, Norwich Medical School
These results had, to date, only been reported for the treatment of children and adolescents with PTSD. Now, this study confirms that it also applies in the treatment of PTSD in adults.
The researchers said this was "very encouraging news" for both patients and therapists.
Around four per cent of the global population suffers from PTSD as a result of traumatic events.
The characteristic symptoms of PTSD include distressing intrusive traumatic memories, avoidance behavior and difficulty with emotional regulation.
The new findings have implications for the clinical practice and training of psychotherapists and mental health professionals more generally.
"Our data helps remove treatment barriers for patients with a history of multiple traumatic events," said Prof Hoppen.
"In addition to patients' fear of talking about their traumatic experiences, some psychotherapists hesitate to directly address traumatic experiences during treatment.
"However, trauma-focused cognitive behavioral therapy - a form of psychotherapy which helps process the traumatic memories - is not only very effective according to the accumulated data but more effective than non-trauma-focused interventions."
As a result, trauma-focused cognitive behavioral therapy is the first line of
Prof Hoppen added that future research requires longer-term data to enable a more solid estimation of the long-term efficacy of the treatment.
'The efficacy of psychological interventions for adult posttraumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials' is published in The Lancet Psychiatry.
Source:
University of East Anglia
Journal reference:
Hoppen, T. H., et al. (2024) The efficacy of psychological interventions for adult post-traumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials. The Lancet
The efficacy of psychotherapeutic interventions, or talking therapies, for treating PTSD in adults has been well-documented in various studies.
However, until now, it had not been established whether the benefit of psychotherapeutic interventions varies depending on whether the disorder is caused by one single event - for example, a traffic accident - or by multiple traumatic events such as during warfare or repeated incidents of sexual or physical violence.
An international team of researchers carried out a meta-analysis, based on data from around 10,600 patients, which has now been published in the journal Lancet Psychiatry.
The work was led by psychologists Dr Thole Hoppen and Prof Nexhmedin Morina from the Department for Clinical Psychology and Psychotherapy at the University of Münster, alongside Prof Richard Meiser-Stedman from the University of East Anglia, Dr Ahlke Kip from the University of Münster, and Prof Marianne Skogbrott Birkeland from the Research Centre for Violence and Traumatic Stress Studies in Norway.
PTSD can be a devastating reaction to trauma.
Talking therapies (e.g. trauma-focused cognitive behavioral therapy) are effective treatments for adults with PTSD.
However, such therapies typically involve detailed discussion of trauma, with some mental health professionals being concerned that this approach may not work when people have suffered multiple traumas, such as combat or sexual abuse.
In our review of over 130 clinical trials we found that adults whose PTSD stemmed from multiple trauma experiences gained the same degree of benefit as adults with single-event-related PTSD.
We hope this evidence will encourage therapists and adults suffering from PTSD, regardless of what type of experiences they have had, to consider trying this powerful treatment."
Richard Meiser-Stedman, Professor of Clinical Psychology, Norwich Medical School
These results had, to date, only been reported for the treatment of children and adolescents with PTSD. Now, this study confirms that it also applies in the treatment of PTSD in adults.
The researchers said this was "very encouraging news" for both patients and therapists.
Around four per cent of the global population suffers from PTSD as a result of traumatic events.
The characteristic symptoms of PTSD include distressing intrusive traumatic memories, avoidance behavior and difficulty with emotional regulation.
The new findings have implications for the clinical practice and training of psychotherapists and mental health professionals more generally.
"Our data helps remove treatment barriers for patients with a history of multiple traumatic events," said Prof Hoppen.
"In addition to patients' fear of talking about their traumatic experiences, some psychotherapists hesitate to directly address traumatic experiences during treatment.
"However, trauma-focused cognitive behavioral therapy - a form of psychotherapy which helps process the traumatic memories - is not only very effective according to the accumulated data but more effective than non-trauma-focused interventions."
As a result, trauma-focused cognitive behavioral therapy is the first line of
Prof Hoppen added that future research requires longer-term data to enable a more solid estimation of the long-term efficacy of the treatment.
'The efficacy of psychological interventions for adult posttraumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials' is published in The Lancet Psychiatry.
Source:
University of East Anglia
Journal reference:
Hoppen, T. H., et al. (2024) The efficacy of psychological interventions for adult post-traumatic stress disorder following exposure to single versus multiple traumatic events: a meta-analysis of randomized controlled trials. The Lancet
#13
News Flash / Natural insemination' sperm do...
Last post by mensfe_admin - 2024-08-06 08:28'
A UK court decision to name a sperm donor a child's legal parent, rather than the mother's wife has been upheld, because the mother secretly had sexual intercourse with the donor.
The case concerned the legal parentage of 'X', a six-year-old girl, born as a result of an 'informal conception arrangement' between the two women 'P' and 'Q' and sperm donor 'F'. They agreed to use artificial insemination (AI) but after two failed attempts P and F had sexual intercourse involving natural insemination –unknown to Q – which coincided with a third AI attempt. This was not revealed until P and Q divorced and disagreed over the care of the child, when P secured a court declaration in April naming F as the child's legal parent.
In the original court ruling, Mrs Justice Gwynneth Knowles declared the case 'a cautionary tale about the consequences for a child and for a same-sex couple of both deceit as to how that child came to be conceived and the unreliability of informal arrangements for AI,' adding that 'the fallout from this couple's separation has been devastating for each of them and for their named sperm donor.'
Justice Knowles concluded that Q had not consented to sexual intercourse between P and F, and because the method of the child's conception was 'unclear', Q could not be considered a parent per the provisions of the Human Fertilisation and Embryology (HFE) Act 2008 which grants parentage to the wives or civil partners of women who give birth following AI.
Q appealed against the decision to replace her with F on the child's birth certificate. However, a three judge panel in the Court of Appeal of England and Wales upheld the original ruling, on the basis that because F was the genetic father and because Q had not proved that the provisions of the HFE Act 2008 on AI applied the court had to declare paternity in F's favour.
'Notwithstanding Q's commitment to X, her understood status as a legal parent arose from informal arrangements, with all their inherent risks', said Lord Justice Peter Jackson in the judgment. 'X exists because P and Q wanted her, and F was at that time no more than a means to an end. It may therefore seem strange that her parentage should be determined by the way in which she was conceived but, in this area, a line must be drawn somewhere'.
The judgment noted that F, P and Q had all obtained parental responsibility after a separate welfare hearing took place.
A UK court decision to name a sperm donor a child's legal parent, rather than the mother's wife has been upheld, because the mother secretly had sexual intercourse with the donor.
The case concerned the legal parentage of 'X', a six-year-old girl, born as a result of an 'informal conception arrangement' between the two women 'P' and 'Q' and sperm donor 'F'. They agreed to use artificial insemination (AI) but after two failed attempts P and F had sexual intercourse involving natural insemination –unknown to Q – which coincided with a third AI attempt. This was not revealed until P and Q divorced and disagreed over the care of the child, when P secured a court declaration in April naming F as the child's legal parent.
In the original court ruling, Mrs Justice Gwynneth Knowles declared the case 'a cautionary tale about the consequences for a child and for a same-sex couple of both deceit as to how that child came to be conceived and the unreliability of informal arrangements for AI,' adding that 'the fallout from this couple's separation has been devastating for each of them and for their named sperm donor.'
Justice Knowles concluded that Q had not consented to sexual intercourse between P and F, and because the method of the child's conception was 'unclear', Q could not be considered a parent per the provisions of the Human Fertilisation and Embryology (HFE) Act 2008 which grants parentage to the wives or civil partners of women who give birth following AI.
Q appealed against the decision to replace her with F on the child's birth certificate. However, a three judge panel in the Court of Appeal of England and Wales upheld the original ruling, on the basis that because F was the genetic father and because Q had not proved that the provisions of the HFE Act 2008 on AI applied the court had to declare paternity in F's favour.
'Notwithstanding Q's commitment to X, her understood status as a legal parent arose from informal arrangements, with all their inherent risks', said Lord Justice Peter Jackson in the judgment. 'X exists because P and Q wanted her, and F was at that time no more than a means to an end. It may therefore seem strange that her parentage should be determined by the way in which she was conceived but, in this area, a line must be drawn somewhere'.
The judgment noted that F, P and Q had all obtained parental responsibility after a separate welfare hearing took place.
#14
Research / Diagnosis of male infertility
Last post by mensfe_admin - 2024-08-02 11:25According to a World Health Organization (WHO) study (2017), about half of all infertility is due to men. Semen analysis is considered essential for diagnosis of male infertility, but is not readily available at medical institutions other than those specializing in infertility treatment, and there is a high threshold for receiving it.
In this study, a group led by Associate Professor Hideyuki Kobayashi of the Department of Urology, Toho University School of Medicine, Tokyo, Japan developed an AI model that can predict the risk of male infertility without the need for semen analysis by only measuring hormone levels in a blood test. AI creation software that requires no programming was used for the model, and the study was reported in the British scientific journal Scientific Reports. The AI prediction model was based on data from 3,662 patients and had an accuracy rate of approximately 74%. In particular, it was 100% correct in predicting non-obstructive azoospermia, the most severe form of male infertility.
The current study collected clinical data from 3,662 men who underwent semen and hormone testing for male infertility between 2011 and 2020. Semen volume, sperm concentration, and sperm motility were measured in the semen tests, and LH, FSH, PRL, testosterone, and E2 were measured in the hormone tests. T/E2 was also added. Total motile sperm count (semen volume X sperm concentration X sperm motility rate) was calculated from the semen test results. Based on the reference values for semen testing in the WHO laboratory manual for the examination and processing of human semen, 6th edition (2021), a total motile sperm count of 9.408 X 106 (1.4 mL X 16 X 106/mL X 42%) was defined as the lower limit of normal, assigning a value of "0" if the total motility sperm count for an individual patient was above 9.408 X 106 and a value of "1" when it was below. The accuracy of the AI model was approximately 74%.
Next, the AI model was validated using data from 2021 and 2022 for which both semen and hormone tests were available. Using the data of 188 patients in 2021, the accuracy was about 58%, while accuracy using the data for 166 patients in 2022 was about 68%. However, non-obstructive azoospermia could be predicted with a 100% accuracy rate in both 2021 and 2022.
According to Associate Professor Kobayashi, "This AI prediction model is intended only as a primary screening step prior to semen testing, and while it is not a replacement for semen testing, it can be easily performed at facilities other than those specializing in infertility treatment."
The AI prediction model used in this study was particularly accurate in predicting non-obstructive azoospermia, which is a severe form of azoospermia. When the prediction model detects abnormal values, since patients may possibly have non-obstructive azoospermia, this should be a trigger for them to undergo detailed testing at a specialist infertility clinic and receive appropriate treatment."
Hideyuki Kobayashi, Associate Professor, Department of Urology, Toho University School of Medicine, Tokyo, Japan
CreaTact, Inc. (Mito City, Ibaraki Prefecture, Japan; President: Iori Nakaniwa) is conducting software development and data analysis to develop a commercial original AI prediction model for the above purpose. "In the future, we hope that clinical laboratories and health checkup centers will use our AI prediction model to screen for male infertility, thereby making testing for male infertility, more accessible by overcoming hurdles to it," said Associate Professor Kobayashi.
The study was published in Scientific Reports on 31 July, 2024.
Source:
Toho University
Journal reference:
Kobayashi, H., et al. (2024). A new model for determining risk of male infertility from serum hormone levels, without semen analysis. Scientific Reports. doi.org/10.1038/s41598-024-67910-0.
In this study, a group led by Associate Professor Hideyuki Kobayashi of the Department of Urology, Toho University School of Medicine, Tokyo, Japan developed an AI model that can predict the risk of male infertility without the need for semen analysis by only measuring hormone levels in a blood test. AI creation software that requires no programming was used for the model, and the study was reported in the British scientific journal Scientific Reports. The AI prediction model was based on data from 3,662 patients and had an accuracy rate of approximately 74%. In particular, it was 100% correct in predicting non-obstructive azoospermia, the most severe form of male infertility.
The current study collected clinical data from 3,662 men who underwent semen and hormone testing for male infertility between 2011 and 2020. Semen volume, sperm concentration, and sperm motility were measured in the semen tests, and LH, FSH, PRL, testosterone, and E2 were measured in the hormone tests. T/E2 was also added. Total motile sperm count (semen volume X sperm concentration X sperm motility rate) was calculated from the semen test results. Based on the reference values for semen testing in the WHO laboratory manual for the examination and processing of human semen, 6th edition (2021), a total motile sperm count of 9.408 X 106 (1.4 mL X 16 X 106/mL X 42%) was defined as the lower limit of normal, assigning a value of "0" if the total motility sperm count for an individual patient was above 9.408 X 106 and a value of "1" when it was below. The accuracy of the AI model was approximately 74%.
Next, the AI model was validated using data from 2021 and 2022 for which both semen and hormone tests were available. Using the data of 188 patients in 2021, the accuracy was about 58%, while accuracy using the data for 166 patients in 2022 was about 68%. However, non-obstructive azoospermia could be predicted with a 100% accuracy rate in both 2021 and 2022.
According to Associate Professor Kobayashi, "This AI prediction model is intended only as a primary screening step prior to semen testing, and while it is not a replacement for semen testing, it can be easily performed at facilities other than those specializing in infertility treatment."
The AI prediction model used in this study was particularly accurate in predicting non-obstructive azoospermia, which is a severe form of azoospermia. When the prediction model detects abnormal values, since patients may possibly have non-obstructive azoospermia, this should be a trigger for them to undergo detailed testing at a specialist infertility clinic and receive appropriate treatment."
Hideyuki Kobayashi, Associate Professor, Department of Urology, Toho University School of Medicine, Tokyo, Japan
CreaTact, Inc. (Mito City, Ibaraki Prefecture, Japan; President: Iori Nakaniwa) is conducting software development and data analysis to develop a commercial original AI prediction model for the above purpose. "In the future, we hope that clinical laboratories and health checkup centers will use our AI prediction model to screen for male infertility, thereby making testing for male infertility, more accessible by overcoming hurdles to it," said Associate Professor Kobayashi.
The study was published in Scientific Reports on 31 July, 2024.
Source:
Toho University
Journal reference:
Kobayashi, H., et al. (2024). A new model for determining risk of male infertility from serum hormone levels, without semen analysis. Scientific Reports. doi.org/10.1038/s41598-024-67910-0.
#15
Research / Unique immune responses reveal...
Last post by mensfe_admin - 2024-08-01 09:05Unique immune responses of those who avoid developing COVID-19 have been uncovered in a new study.
The study wanted to understand how some people had never developed COVID-19 despite encountering others infected with the SARS-CoV-2 virus, which causes COVID-19. The research, published in Nature, examined the immune responses in clinical trial volunteers before and immediately after infection with the SARS-CoV-2 virus. Previous studies have investigated the immune response from the first appearance of symptoms of COVID-19 rather than from the moment of infection.
'This was an incredibly unique opportunity to see what immune responses look like when encountering a new pathogen – in adults with no prior history of COVID-19, in a setting where factors such as time of infection and comorbidities could be controlled,' said Dr Rik Lindeboom, study co-author and researcher at the Netherlands Cancer Institute.
This work was a collaboration between Imperial College London, the Wellcome Sanger Trust, University College London (UCL), and the Netherlands Cancer Institute. The research was part of the Human Cell Atlas, which seeks to identify each cell type within the human body (see BioNews 946).
Researchers from Imperial College London injected 36 volunteers with a SARS-Cov-2 viral load into their nasal cavities. All volunteers had never sustained a COVID-19 infection or been vaccinated with a COVID-19 vaccine. The immune activity of 16 of the volunteers was examined before infection.
Biological samples of the volunteers' nasal cavities lining and their blood were taken and sequenced by researchers at the Wellcome Sanger Institute and UCL, producing a dataset of over 600,000 single cells. The results revealed the different responses of the mucosal cells within the nasal lining compared to the white blood cells.
A heightened immune response was observed in the mucosal cells of the volunteers who recorded no symptoms of infection or a positive PCR test. This activity prevented an infection from developing in the nose and was associated with the upregulation of the gene HLA-DQA2. In addition, a decrease in the number of white blood cells responsible for identifying and engulfing pathogens was measured.
In contrast, six volunteers developed a sustained infection, displaying disease symptoms and testing positive on a PCR test. Results from these individuals showed a faster immune response in the blood compared to the nasal lining, suggesting that the infection could develop more in the nose, leading to a more sustained infection.
'These findings shed new light on the crucial early events that either allow the virus to take hold or rapidly clear it before symptoms develop. We now have a much greater understanding of the full range of immune responses, which could provide a basis for developing potential treatments and vaccines that mimic these natural protective responses,' said Dr Marko Nikolić, study senior author and researcher at UCL.
It is hoped that a greater understanding of the different immune responses to COVID-19 infection, particularly the activity of T cells (a type of white blood cell), could aid in more potent treatments for COVID-19.
#16
General Discussion / Research: No difference in pre...
Last post by mensfe_admin - 2024-07-30 08:56The largest study of its kind has found no difference in pregnancy rates between intrauterine insemination (IUI) cycles using fresh or frozen sperm.
The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.
'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'
The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.
'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.
One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.
'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'
Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology
The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.
'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'
The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.
'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.
One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.
'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'
Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology
#17
Research / Research: No difference in pre...
Last post by mensfe_admin - 2024-07-30 08:54The largest study of its kind has found no difference in pregnancy rates between intrauterine insemination (IUI) cycles using fresh or frozen sperm.
The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.
'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'
The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.
'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.
One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.
'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'
Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology
The research was presented at the annual meeting of the European Society of Human Reproduction and Embryology by Dr Panagiotis Cherouveim from Massachusetts General Hospital and Harvard Medical School.
'The fact that our data did not reveal any significant difference in success between the utilisation of fresh ejaculated and frozen sperm, except in a subgroup of patients given oral ovulation-inducing agents, is very reassuring to all involved,' said Dr Cherouveim. 'No detrimental effect of sperm cryopreservation on IUI outcomes was noted.'
The study looked at outcomes from 5335 IUI treatments that took place from 2004-2021. Overall there was no significant difference in pregnancy rates, but some differences were observed in patients who had ovarian stimulation prior to insemination, versus those who did not.
'Although, specific subgroups might benefit from fresh sperm utilisation and time-to-pregnancy might be shorter with fresh than frozen sperm, patients should be counselled about the non-inferiority of frozen sperm,' said Dr Cherouveim.
One limitation of the study is that most of the frozen sperm came from anonymous donors, who tend on average to be younger, and healthier than the partners providing fresh sperm, and usually have good quality sperm.
'On the face of it, it's reassuring to find that there is no material difference in the success of fresh or frozen sperm during an IUI procedure,' andrologist Professor Allan Pacey from the University of Sheffield told BioNews. 'However, in this study, the frozen sperm was from donors who are highly selected men precisely because their sperm can survive the freezing process. Therefore, is there really any surprise that the authors found no difference?'
Sources and References
4 July 2022
38th annual meeting of the European Society of Human Reproduction and Embryology
#18
General Discussion / Re: Surrogates more likely to ...
Last post by mensfe_admin - 2024-07-30 08:48Welcome to this week's BioNews – news, plus comment and reviews curated by our editors.
(To see 'Sources and References' for an article below, click on the article title and then scroll to the bottom of the website version of the article.)
Comment
Surrogacy health risks – Do UK surrogates need to be worried?
by Sarah Jones
As an experienced altruistic surrogate in the UK, I found Marina Ivanova's research paper as presented at the ESHRE 40th Annual Meeting in Amsterdam interesting (see BioNews 1246). The study suggested that gestational carriers (known as surrogates in the UK), face higher risks of maternal morbidity and pregnancy complications in comparison to those who experience pregnancy and childbirth after natural conception or IVF.
Any study that includes nearly 1000 surrogate pregnancies should be looked at closely by the UK surrogacy community and any conclusions considered when looking at the risks to surrogates in the UK. Dr Raj Mathur, a consultant gynaecologist and former chair of the British Fertility Society told BioNews that surrogacy organisations should take on board the need for careful screening and counselling of surrogates 'and ensure that they have criteria to ensure that women at increased risk of complications, such as high blood pressure, are not encouraged to act as surrogates'.
In fact, surrogacy organisations in the UK are already quite diligent about this. The organisation that I undertook my own surrogacy journeys with, SurrogacyUK, who I now work for, carefully consider the health of the surrogates they accept. Historically we have rejected over two-thirds of all applications to be a surrogate that we receive.
SurrogacyUK has implemented a robust admissions policy for several years. The comprehensive risk assessments undertaken during the admissions process evaluates various factors including obstetric health, BMI, age, physical health, emotional health, previous and current medical conditions, and any medications taken.
Social factors such as family composition and support systems are also thoroughly considered. Further checks include background checks on all adults in the household, social services checks, and an assessment of the applicant's understanding and potential vulnerability. This includes identifying any risks of coercion, including financial coercion.
It is important to acknowledge that every pregnancy, whether naturally-conceived, through IVF, or via surrogacy, carries some risks. Some risks may be unpredictable and remain unknown despite comprehensive research and consultation, such as such as low-lying placenta, placenta previa, baby lying in a breach or transverse position, hyperemesis gravidarum or symphysis pubis dysfunction - these can happen in a pregnancy, without ever having been experienced in previous pregnancies. However, many can be mitigated through careful monitoring and adherence to medical advice for example. For example gestational diabetes, can be controlled using diet and medication, or c-sections can be planned if a surrogate has had one previously. However, potential risks can never be entirely eliminated.
As an experienced surrogate, I weighed these risks carefully as part of my decision-making process, just as I did when deciding to have my own children. Surrogacy organisations have an ethical duty to establish criteria that help reduce risks and ensure potential surrogates are given sufficient information to provide informed consent. However, it is equally important that surrogates are not infantilised or stripped of their autonomy. At present SurrogacyUK, Brilliant Beginnings and My Surrogacy Journey all have admissions policies and surrogate eligibility criteria, but they are not required to do so as they are not regulated.
My most recent surrogacy journey resulted in the birth of a wonderful little boy, now aged three, who was born into his genetic family, joining his genetic mum, dad, and siblings. During this pregnancy, two risk factors were identified: I was classified as being of advanced maternal age (over 35) and having a high parity (over five births).
These risks were known to me, and my decision to embark on a surrogacy journey was made after carefully assessing them. Before offering to help my friends complete their family, I discussed the potential risks with my IVF clinic, my GP, and my obstetric consultant. With the support and guidance of medical professionals who evaluated my individual circumstances, I felt confident making an informed choice.
In my case, I was well aware of my risk factors, a blanket ban would have removed my ability to make an informed choice, disregarding my individual history, level of understanding, and the personal medical advice I received. It is essential that policies consider each woman's unique situation and allow for personalised decision-making based on medical advice.
Interestingly, when I decided to have my own children, I did not face the same level of scrutiny. No one evaluated my understanding or ensured I was making an informed choice before expanding my family. My medical history was not reviewed by a medical professional, the stability of my family unit was not considered, nor was my support network or the potential risks to myself. No one questioned my decision to have my own children. In contrast, my decision to be a surrogate was a much safer one to make, as it involved thorough assessments and consultations with medical professionals, ensuring I was fully informed and supported.
The study author Marina Ivanova summarised a number of possible causes for their findings: baseline health, IVF treatment, differing prenatal care and monitoring, as well as the physiological and psychological impact of carrying a pregnancy for someone else. The author floated surrogates' lower socioeconomic status, as a possible reason, but showed that adjusting findings for socioeconomic status did not explain the discrepancies they had found.
Considering the possible causes, and considering if they are relevant to UK surrogates results in more questions: Are Canadian surrogates offered the option of mild or natural IVF like UK surrogates? At SurrogacyUK we advise our surrogates that it may be possible to have a non-medicated cycle, purely because it reduces the risks and side effects. Would this impact the results?
Are the risks only higher for surrogates because they are more likely to have had more children before embarking on a surrogacy journey? Those undertaking IVF for themselves are far less likely to have a parity over five. How would the results compare to a similar survey of non-surrogate pregnancies where the mothers had a parity of five or more?
These questions could be addressed by a similar large-scale study in the UK which would ideally include parity and IVF-type comparison groups. We know that maternal morbidity is relatively low within the surrogate community, as most surrogates obtain medical approval for subsequent surrogacy journeys and are deemed fit to receive treatment by UK clinics. Comparing data from both countries could provide much needed information to elucidate mechanisms underpinning increased risks of pregnancy complications, that could lead to real improvements for UK surrogates.
As a surrogate, and CEO at SurrogacyUK, I passionately believe that having access to comprehensive information, including up-to-date research is crucial to being able to make fully informed choices. Every surrogate, like any woman planning a pregnancy, should have absolute clarity on the risks they face before making their decision. At SurrogacyUK, the health and wellbeing of surrogates is, and must remain, the highest priority. Marina Ivanova's study is an important and interesting addition to the research already undertaken on surrogacy. For me, though, it raises as many questions as it answers and highlights the need for UK-specific clinical and academic research.
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General Discussion / Surrogates more likely to have...
Last post by mensfe_admin - 2024-07-23 08:15Surrogates more likely to have hypertension and postpartum haemorrhage
by Hannah Flynn
Surrogates experience higher levels of complications during and after pregnancy compared to other IVF patients, a non-peer reviewed cohort study in Canada has shown.
The study of 937,938 singleton births, including 956 women acting as surrogates for intended parents, found that these women were more likely to be older, have had children, reside in low-income areas and have chronic hypertension when compared to other women in the cohort. Authors from Canada presented the results at the 40th annual meeting of the European Society of Human Reproduction and Embryology.
Dr Raj Mathur a consultant gynaecologist and former chair of the British Fertility Society who was not involved in the research told BioNews: 'This study shows that gestational surrogates are at increased risk of serious complications in pregnancy. This highlights the importance of careful screening and counselling of surrogates. Surrogacy organisations should take on board this need and ensure that they have criteria to ensure that women at increased risk of complications such as high blood pressure are not encouraged to act as surrogates.'
Surrogates were found to have a 14.9 percent risk of hypertension and postpartum haemorrhage, compared to an 11 percent or 12 percent risk, respectively, for women who have a baby following IVF. Women who conceived naturally experienced a six percent risk of postpartum haemorrhage, and seven percent risk of hypertension. The cohort was followed between 20 weeks' gestation and 42 days after the delivery.
One in 14 surrogates experienced severe health conditions linked to their pregnancy and birth compared to one in 22 women giving birth following IVF, and one in 42 women who conceived naturally. There was no difference in the rate of poor outcomes for babies up to 28 days old, born to women following IVF or natural conception and those born to surrogates.
Authors said that the results could reflect that surrogates are likely to have poorer overall health before pregnancy, despite there being clear calls for only women with 'favourable characteristics for a healthy pregnancy' to be selected for surrogacy.
'Gestational carriers were also less likely to be in the highest income bracket, and we know that lower socioeconomic status is associated with higher serious maternal morbidity rates. However, sociodemographic characteristics were accounted for in the analysis, and the results were similar, which suggest potential different mechanisms,' said Dr Maria Velez, study supervisor and senior author.
Considering that surrogates were more likely to have had previous pregnancies and be older it was important to 'ensure that any woman intending to be a surrogate is both medically assessed as fit for pregnancy and given the opportunity to have implications counselling where all risks, including health risks, are made known to her prior to trying to conceive. If she knows and understands these risks and continues the surrogacy journey, her decision should be respected,' Kirsty Horsey, professor in law at Kent University, who was not involved in the study, told BioNews.
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General Discussion / Prolific Dutch sperm donor res...
Last post by mensfe_admin - 2024-07-16 08:02A Dutch sperm donor is threatening to sue Netflix over allegations made about him in a recent documentary series.
Jonathan Meijer is the subject of the recent Netflix documentary 'The Man with 1000 Kids', which includes interviews with families who have children conceived using his sperm. Some accused him of lying about the number of families he had already helped create.
'Technically I did not lie. I followed the guidelines of every large commercial international sperm bank that does not inform the recipients about the amount of offspring one donor will produce,' Meijer told NBC News. 'I gave the parents an estimated number, this was better and more info than they would ever get at any clinic.'
The number of donations made by Meijer had already been the subject of potential legal action, after a district court in The Hague banned him from making further donations earlier this year (see BioNews 1188) in response to a lawsuit brought by an organisation representing donor-conceived people in the Netherlands (see BioNews 1185). As many as 11 sperm banks holding his samples have also been asked to destroy them.
Dutch guidelines limit sperm donors to a maximum of 25 genetic offspring, and allow donation at only one sperm bank. Warnings about the number of donations made by Meijer go back to 2017 when he had already contributed to the creation of over 100 children (see BioNews 915). Meijer told the Independent that he stopped donating to new families in 2019, and estimates that he has around 550 donor children, not 1000 as the Netflix title suggests.
The documentary also contains allegations that Meijer mixed his sperm with that of another prolific donor before giving it to a recipient, in a competition to see whose sperm would 'win'. Meijer denied this ever happened and said in a YouTube video he will sue Netflix for defamation if the claim is not removed.