SpainFertility

Mild IVF treatment has proven to be more effective and affordable than intensive fertility injections, according to specialists attending an international fertility conference in London this week. The “mild IVF” technique involves fewer fertility-boosting jabs and is safer, the doctors said.

They showed that about 23 percent of women given the mild treatment had a baby –which is less than the 29.6 percent obtained with regular treatment, but that used routinely, mild IVF would cut costs by around a quarter, making it more affordable and increasing the number of women that can get the treatment

With the traditional IVF, women get more than 40 egg-boosting injections in a month. These injections are now being associated with several health issues, including mood swings and boating, and the potential –and fatal- ovarian hyperstimulation syndrome, in which ovaries fail to cope with the extra eggs produced.

In the mild IVF study, Dr Shokichi Teramoto gave women in the Kato Ladies Clinic in Tokyo a course on Clomid, a fertility pill, followed by a couple of days of hormonal jabs.

This treatment focuses on the idea, which is getting stronger by the day, of doing single-embryo transfers in fertility treatments, needing fewer eggs to be successful. This would lead to a safer and more affordable treatment, allowing more women to be mothers in the long run.

The UK has, according to an article in the British newspaper The Telegraph, one of the worst safety records for fertility treatment in Europe. New figures show that the risk of developing serious complications is four times higher than in other countries. These figures stem out from a report by the European Society for Human Reproduction and Embryology.

This report warns that women’s lives are put in danger due to the need to increase the number of successful births. Therefore, the clinics in the UK have the highest levels of ovarian hyperstimulation syndrome (OHSS) – one of the most serious downsides of IVF treatment, that can even be fatal, in which ovaries produce more eggs than expected.

This causes the ovaries to get bigger and the woman experiences nausea and pain in the abdomen. In the worst cases it can lead to shortness of breath and a decrease in the amount of urine produced.

The article states that at least two women with this illness have died in the past three years, but experts state that many more cases go unrecorded. Many patients are directed straight to casualty or intensive care, so their illness is not reported to the Human Fertilisation and Embryology Authority (HFEA), the fertility watchdog in the UK.

The figures show that Germany performed almost three times as many IVF cycles - implantations of fertilised embryos - as the UK in 2003, but the UK had nearly three times more cases of OHSS.

Dr Karl Nygren, the chairman of the International Committee on the Monitoring of Assisted Reproductive Technology, which monitors IVF treatments, said: “In the UK, you are good on efficacy - your success rates are in the top 10 countries - but your safety record is low” He added that “procedures are not being handled as optimally as they should be.”

The British Government has paid out nearly £1billion to compensate for mistakes made on maternity wards, and £828million has been spent on settling clinical negligence claims in childbirth cases since 1995.

Along with humans, in few other species females go through menopause. Clear insight into the reason for this is currently elusive. However, a new research by scientists at the Universities of Cambridge and Exeter indicate that menopause may be an adaptation to reduce reproductive competition between generations of females in the same family unit.

The current theory regarding menopause was proposed 50 years ago and is known as the `grandmother hypothesis´, which states that natural selection can favour post-reproductive survival if older non-breeding women assist their children in surviving and reproducing.   

The new study, published this week in the journal PNAS, the researchers suggest that the timing of reproductive cessation in humans can be interpreted as an adaptation to diminish reproductive competition between different generations of women.

In humans there is almost no overlap between reproductive generations. In average, women have their first baby at 19 years and their last at 38. That is, women stop breeding when the upcoming generation starts to.

The researchers developed a simple mathematical model of this competition which predicts that older women should cease breeding when younger women in the same social unit start to breed. This hypothesis and model can thus explain the observed timing of reproductive cessation in humans, and so contributes to a much better understanding of how menopause evolved.

Women in all societies experience menopause. This can mean that the human fertility schedule is hard-wired into our genetic makeup as a consequence of our evolutionary history, prior to more recent cultural and technological advances.

Dr Michael Cant at the University of Exeter explains, “Women everywhere experience a rapid decline in fertility after the age of forty, culminating in menopause around ten years later. Our study helps to explain why this phase of rapid ’senescence’ of the reproductive system starts when it does, and why women, on average, stop having children a full ten years before the onset of menopause.”

It also helps to explain why in some societies (particularly in Africa and Asia), women are required by social law to stop having children when their first grandchild is born. A better understanding of the selective forces that have shaped the genetically programmed human fertility schedule may in future provide medical insights into the genetic causes of premature ovarian failure and other diseases of low fertility.

Dr Rufus Johnstone at the University of Cambridge adds, “It should open up new avenues for research on menopause and fertility in humans, and provide new insights into the evolution of menopause in the two other species in which it occurs under natural conditions - killer whales and pilot whales.”

Last year, 1320 egg donations were registered in the main fertility centres of the city of Valencia, Spain. From those, 1200 were made in the Instituto Valenciano de la Infertilidad (IVI) and the rest in the centre for assisted reproduction Crea. The average age of the donors is 23.5 years and € 800 was paid to each woman for their donation.

Of all donations, around 400 (30 %) were actually made by women from other countries according to IVI (the previous year they had been 25 %). “Usually, these are women that need money in a quick way, and want other women to have the opportunity of being mothers”, say at the IVI.

Most of the egg donors are college students. “The physical appearance most looked for is that of the East Europeans, they are the major egg donors in Valencia”, affirm at both clinics.

This is because of the fact that women from abroad come into Spain to get fertility treatments. Hence, the IVI assisted in 2007 in more than 17 % of the cases foreign women, while Crea helped women from other countries in more than 40 % of the cases.

The vast majority of these women come from Italy, Germany and UK because they have some difficulties getting a fertility treatment in their countries and come to Spain for an effective and fast alternative.